Evidence supporting the clinical efficacy of clinical breast examination (CBE) emerged from recent studies recognized the need for CBE training to increase the physician's clinical skills in detecting subsurface tumors. A virtual reality system utilizing the new developed five-fingers haptic interface HIRO-II was created to address this need. The simulation considers multiple fingers contact and the interaction between the forces exerted by each finger. A physical-based model using Finite Element Method (FEM) with elementary displacement method was used to calculate the real reaction forces. This paper also presented a simple method on how to simulate the non-linearity aspect of the breast tissue. An evaluation of the system based on subjective factors is proposed. The results show how the virtual breast could generate nonlinear forces that are very close to that generated by the real training model.

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It is important to reproduce the realistic palpation for the injection training system based on VR (Virtual Reality). The haptic texture on the surface of a virtual human body is one of the approaches for realistic reproduction. The conventional haptic texture, however, has the problem that the directionality of the reaction force is unconsidered. In this paper, the DHT (Directional Haptic Texture) is introduced to solve the problem of the conventional method. It is difficult to store the huge amount of pre-computed DHT data into the memory. Then we use a graphics processor to achieve the real-time calculation. The effectiveness of the proposed method has been compared with the conventional method. By using DHT, we have developed the VR injection training system with realistic haptic sense.

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The system overlaying the stereoscopic images onto the haptic interface is proposed. In order to develop the tnaining systems based on virtual reality for medical doctors to experience medical treatments, it is important to improve the reality that visual and haptic information are synchronized. Our training system proposed in a previous paper for central venous injection uses the stereoscopic glasses and the haptic interface. This system has a palpation phase and an injection phase. During the injection phase, it is important that the user can see 3D injector images and the stylus of the haptic interface corresponding. In the proposed system, the user can look down the images projected from the display and reflected on the half mirror, and the haptic interface through the mirror. Using infrared LEDs wirelessly attached to the stereoscopic glasses and the infrared camera set under the display, the proposed system can show the 3D images considering with the face position in real-time. This system can achieve higher reality and more effectiveness than our conventional system. This system is evaluated by the experienced medical doctor as effective one.

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Flying phobia is one of the well known phobias. In-vivo and virtual reality exposure is one of the effective therapies for flying phobia. But these exposure therapies have some problems such as a loss of confidentiality, a lack of controllability, needs of long time, and high expense. To resolve these problems, we developed a new light type of virtual reality system exposing patients into inside of flying airplane. Our purpose of this study is to confirm that there are no medical side effect by use of this new system and to evaluate usability and difficulty of the system before using on clinical case. Ten participants who was not flying phobia experienced the system. We evaluated the system by checking blood pressure and pulse rate of the participants, and by questionnaires written by the participants. It was confirmed that there were no medical side effects by use of the system, and we evaluated that the system would be useful enough.

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