SomaVR: A low-cost virtual reality platform and implementation framework for medical education in resource-limited settings

Quality medical training is vital for effective healthcare worldwide. In low- and middle-income countries (LMICs), traditional training methods often face significant challenges, including limited resources, logistical barriers, and difficulties in safely replicating high-risk scenarios for infectious diseases like COVID-19 and Ebola. Additionally, medical training demands high costs, significant time, and specialized supervision, limiting its accessibility. Although virtual reality (VR) offers promising solutions to these problems, most evidence comes from high-income settings, leaving limited guidance on implementation in resource-constrained settings. We developed SomaVR, a low-cost VR platform and implementation framework for medical training in LMICs. Built with Unity3D, 'SomaVR' (soma - Swahili/Luganda for "to learn") integrates 360-degree and interactive virtual environments to create customizable training experiences aligned with specific curricula needs. Beyond the software, the framework provides a structured approach covering hardware selection, software architecture, content development workflows, and strategies for local capacity building. The platform prioritizes cross-platform compatibility, offline functionality, and cost-effective deployment. SomaVR's modular components support both high-end VR systems and low-cost solutions such as smartphone-based. The platform and framework were validated through two independent case studies: 1. COVID-19 infection prevention; and 2. Surgical training. In the surgical training, trainers from a high-income country guided Ugandan learners remotely, illustrating SomaVR's potential for long-distance knowledge exchange. In both cases, cohorts trained using SomaVR consistently outperformed those receiving conventional training, with significant improvements in procedural understanding and user engagement. Our findings also highlight that as VR technology costs decline, frugal approaches such as delivering 360-degree video via smartphone can maintain educational effectiveness in low-resource environments. This paper provides a practical blueprint for developing and implementing sustainable VR medical training platforms in resource-limited settings. By detailing the technical framework, development processes, and implementation strategies of SomaVR, we offer a replicable model for institutions seeking to leverage VR technology for medical education in LMICs.