Communication Skills Training Using Remote Augmented Reality Medical Simulation: a Feasibility and Acceptability Qualitative Study

Abstract

Introduction Augmented reality (AR) has promise as a clinical teaching tool, particularly for remote learning. The Chariot Augmented Reality Medical (CHARM) simulator integrates real-time communication into a portable medical simulator with a holographic patient and monitor. The primary aim was to analyze feedback from medical and physician assistant students regarding acceptability and feasibility of the simulator. Methods Using the CHARM simulator, we created an advanced cardiovascular life support (ACLS) simulation scenario. After IRB approval, preclinical medical and physician assistant students volunteered to participate from August to September 2020. We delivered augmented reality headsets (Magic Leap One) to students before the study. Prior to the simulation, via video conference, we introduced students to effective communication skills during a cardiac arrest. Participants then, individually and remotely from their homes, synchronously completed an instructor-led ACLS AR simulation in groups of three. After the simulation, students participated in a structured focus group using a qualitative interview guide. Our study team coded their responses and interpreted them using team-based thematic analysis. Results Eighteen medical and physician assistant students participated. We identified four domains that reflected trainee experiences: experiential satisfaction, learning engagement, technology learning curve, and opportunities for improvement. Students reported that the simulator was acceptable and enjoyable for teaching trainees communication skills; however, there were some technical difficulties associated with initial use. Conclusion This study suggests that multiplayer AR is a promising and feasible approach for remote medical education of communication skills during medical crises. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-022-01598-7.

Augmented Reality in Real-time Telemedicine and Telementoring: Scoping Review

“…The articles discussed in this section ( Multimedia Appendix 3 [ 32 , 36 , 40 - 42 , 47 - 51 , 58 , 62 , 69 ]) are divided based on nonsurgical contexts, which include clinical skills, autopsy, and sonography, and surgical contexts, which include procedure observation, tool-specific training, simulations, and intraoperative learning. Of note, one-third (6/19, 32%) of the articles that involved education have been described in the previous section and will be briefly mentioned in this section.…”

“…Hess et al [ 42 ] described a remote advanced cardiovascular life support simulation using Magic Leap One headsets distributed to second-year medical and physician assistant students. The HMDs used AR to display the holographic simulation apparatus (eg, patients, beds, and monitors) modulated by instructors, thereby allowing students to attend the simulation from their homes.…”

“…The HMDs used AR to display the holographic simulation apparatus (eg, patients, beds, and monitors) modulated by instructors, thereby allowing students to attend the simulation from their homes. Postsession interviews yielded positive feedback regarding experiential satisfaction and value in practicing communication skills [ 42 ].…”

Perceptions About Augmented Reality in Remote Medical Care: Interview Study of Emergency Telemedicine Providers

“…Although the same quantitative measures are not consistently measured across these studies, favorable results in qualitative measurements such as ease of use and perceived efficacy have suggested that users are interested in using AR for remote learning. The role of AR in the education of trainees has also been previously investigated for anatomy [ 56 , 57 ], simulation [ 58 , 59 ], and social skills such as communication [ 32 , 60 ], with such applications increasingly appearing in the remote setting owing to interest in distance learning options [ 61 , 62 ]. Although our interviews reiterate the benefits of AR for medical trainees, they also suggest the use of AR in remotely teaching those without professions in health care.…”

“…A 2019 review of AR technology in emergency medicine found 8 papers related to telemedicine including remote surgical treatments, triage, and telementoring [ 27 ], whereas more recent papers have similarly described the use of AR in remote communication for emergency responders and procedures [ 28 , 29 ]. In addition to support for disaster medicine [ 30 ], AR has also been used in other remote contexts such as teleultrasound [ 31 ] and the teaching of teamwork during high-risk scenarios [ 32 ]. Although these studies suggest that emergency medicine as a specialty is poised to further explore the intersection of AR and telemedicine, there is paucity of literature on the perspectives of emergency telemedicine providers regarding the subject.…”