An Augmented Reality–Based Guide for Mechanical Ventilator Setup: Prospective Randomized Pilot Trial

Abstract

Background Recently, the demand for mechanical ventilation (MV) has increased with the COVID-19 pandemic; however, the conventional approaches to MV training are resource intensive and require on-site training. Consequently, the need for independent learning platforms with remote assistance in institutions without resources has surged. Objective This study aimed to determine the feasibility and effectiveness of an augmented reality (AR)–based self-learning platform for novices to set up a ventilator without on-site assistance. Methods This prospective randomized controlled pilot study was conducted at Samsung Medical Center, Korea, from January to February 2022. Nurses with no prior experience of MV or AR were enrolled. We randomized the participants into 2 groups: manual and AR groups. Participants in the manual group used a printed manual and made a phone call for assistance, whereas participants in the AR group were guided by AR-based instructions and requested assistance with the head-mounted display. We compared the overall score of the procedure, required level of assistance, and user experience between the groups. Results In total, 30 participants completed the entire procedure with or without remote assistance. Fewer participants requested assistance in the AR group compared to the manual group (7/15, 47.7% vs 14/15, 93.3%; P=.02). The number of steps that required assistance was also lower in the AR group compared to the manual group (n=13 vs n=33; P=.004). The AR group had a higher rating in predeveloped questions for confidence (median 3, IQR 2.50-4.00 vs median 2, IQR 2.00-3.00; P=.01), suitability of method (median 4, IQR 4.00-5.00 vs median 3, IQR 3.00-3.50; P=.01), and whether they intended to recommend AR systems to others (median 4, IQR 3.00-5.00 vs median 3, IQR 2.00-3.00; P=.002). Conclusions AR-based instructions to set up a mechanical ventilator were feasible for novices who had no prior experience with MV or AR. Additionally, participants in the AR group required less assistance compared with those in the manual group, resulting in higher confidence after training. Trial Registration ClinicalTrials.gov NCT05446896; https://beta.clinicaltrials.gov/study/NCT05446896

Educational effects of and satisfaction with mixed-reality-based major trauma care simulator: A preliminary evaluation

“…[34] A recent study demonstrated high satisfaction due to easy use and high immersion. [14,24,30,35] The overall satisfaction level of the MR-based TNXRtc system was similar to that of the previous MR system. [24] The MR-based TNXRtc system received relatively high scores in terms of immersion and interest.…”

“…In addition, trainees do not have sufficient time to repeat the procedures, and when they practice alone, it is difficult to assist them properly. [ 24 ]…”

“…In addition, trainees do not have sufficient time to repeat the procedures, and when they practice alone, it is difficult to assist them properly. [24] Therefore, various educational programs using XR have been developed for the acute treatment of trauma patients. Initially, relatively simple education, such as patient classification in a mass disaster, was applied to VR.…”

Virtual and augmented reality in critical care medicine: the patient’s, clinician’s, and researcher’s perspective

“…In the AR-group, the nurses were guided by AR-based instructions and could request assistance using the head-mounted display. AR resulted in a lower need for assistance compared to the manual group and a higher level of confidence after training [ 52 ].…”

The Application of Mixed Reality in Bronchoscopy Simulation Training: A Feasibility Study

“…3 Heo et al demonstrated that the use of Dynamics 365 Guides application for mechanical ventilator setup was feasible for both novices with no prior experience, and for those who required less assistance. 4 Possible advantages of the MR guide include the ability of self-training at one’s own pace and hands-free training while using actual medical equipment.…”