20 June 2019

Nijboer uses virtual reality to apply her research in practice

Betto Deelman award for neuropsychologist Tanja Nijboer

Neuropsychologist Tanja Nijboer, who is affiliated with Utrecht University and the Utrecht Rehabilitative Medicine Knowledge Centre (Kenniscentrum Revalidatiegeneeskunde Utrecht), created a virtual supermarket with her team. In this virtual supermarket, people with brain damage look for products that are on a shopping list: an innovative way of detecting disorders in their thinking functions. The Utrecht researcher is also known as someone who bridges the gap between theory and practice. In recognition of her exceptional merits as a neuropsychologist, Nijboer received the Betto Deelman Award on 21 June.

Tanja Nijboer

Until ten years ago, Nijboer's neuropsychological attention was focused on the lab. Consequently, her research was fairly theoretical. One of her research areas was people suffering from neglect, a condition in which the patient unconsciously 'ignores' part of his or her environment. 'Naturally, we did and do a lot of fine research there. We continue to advance the theoretical field,' the Utrecht neuropsychologist explained. 'After publishing the research findings in a scientific journal, we proceed to conduct further research. I was always surprised that all that research led to so few changes in clinical practice.'

Different language

Ten years ago, Nijboer started as a researcher at De Hoogstraat, a rehabilitation clinic in Utrecht. 'It was there that I came in contact with clinical practice. I was dealing with patients who had suffered a stroke and were subsequently dealing with the effects of a brain injury, effects that had an impact on their daily lives and on their social interactions. I also came into contact with the doctors in charge of their cases. Professionals in the field often turned out to have very different questions than those we tried to find answers to in our lab. It took me quite a while to appreciate the size of the difference in language, customs and wishes between theorists and clinicians.'

Brushing teeth

Connecting with the practical side proved to be an eye-opener for the Utrecht researcher: 'We also tested interventions for certain cognitive impairments in the lab, of course. But when I approached clinicians with the results of those experiments, I was often asked how it helped the patients. "Will this make brushing their teeth easier for my patients?" clinicians would ask me. Or: "Will my patient be able to go grocery shopping on their own now?" We had never studied anything along those lines.'

Virtual supermarket

With that in mind, Nijboer took the latter practical question to heart. Together with a large team, she created a virtual supermarket. In this virtual supermarket, people with brain damage look for products that are on a shopping list. As the patients navigate the virtual supermarket by means of a VR headset, the researchers observe them on a computer screen. 'A disorder such as neglect can be investigated in a more complex environment with much more interaction this way. We store all data gathered during the performance of the task – where someone has been, where someone was standing still and for how long, where someone was looking – and gain many more detailed insights as a result.'

Different approach

Nijboer's approach is very different than the traditional pen and paper test, in which large and small stars are shown on a piece of paper, for example. The patient is asked to use a pen to circle the smaller stars. There are limitations to this slightly dated method of diagnosis. Nijboer: 'Using our virtual supermarket, we can reveal more subtle issues. This is also something that we can show the patient and their loved ones afterwards, which allows us to increase their insight into the condition and clarify and explain the consequences. When problems become visible in a situation that resembles real life much more closely, they resonate more.' Recently, Nijboer and her team built a virtual environment for children with brain damage: the virtual toy shop.