Comparing the effectiveness of augmented reality-based and conventional instructions during single ECMO cannulation training

Abstract

Purpose Effective training of extracorporeal membrane oxygenation (ECMO) cannulation is key to fighting the persistently high mortality rate of ECMO interventions. Though augmented reality (AR) is a promising technology for improving information display, only a small percentage of AR projects have addressed training procedures. The present study investigates the potential benefits of AR-based, contextual instructions for ECMO cannulation training as compared to instructions used during conventional training at a university hospital. Methodology An AR step-by-step guide was developed for the Microsoft HoloLens 2 that combines text, images, and videos from the conventional training program with simple 3D models. A study was conducted with 21 medical students performing two surgical procedures on a simulator. Participants were divided into two groups, with one group using the conventional instructions for the first procedure and AR instructions for the second and the other group using instructions in reverse order. Training times, a detailed error protocol, and a standardized user experience questionnaire (UEQ) were evaluated. Results AR-based execution was associated with slightly higher training times and with significantly fewer errors for the more complex second procedure ($$p<0.05$$ p < 0.05 , Mann–Whitney U). These differences in errors were most present for knowledge-related errors, resulting in a 66% reduction in the number of errors. AR instructions also led to significantly better ratings on 5 out of the 6 scales used in the UEQ, pointing to higher perceived clarify of information, information acquisition speed, and stimulation. Conclusion The results extend previous research on AR instructions to ECMO cannulation training, indicating its high potential to improve training outcomes as a result of better information acquisition by participants during task execution. Future work should investigate how better performance in a single training session relates to better performance in the long run.

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

“…As this was a preliminary study, we were unable to determine the sample size. However, we referenced to past research on the step-by-step procedures with AR [ 19 , 24 ]. We set a target of 30 participants for recruitment.…”

“…The AR system enables virtual objects to be overlaid onto a real-world environment by visualizing the physiological anatomy or enhancing the operator’s view [ 17 , 18 ]. A few AR-guided medical procedure training regimes have been reported in the emergency department and intensive care environments [ 13 , 15 , 19 - 21 ]. They suggested that AR systems are effective in step-by-step procedures; however, the studies were limited to procedures lasting less than 10 minutes or to simple steps that did not reflect the usual complexity of procedures performed in the ICU or emergency department [ 22 , 23 ].…”

“…They suggested that AR systems are effective in step-by-step procedures; however, the studies were limited to procedures lasting less than 10 minutes or to simple steps that did not reflect the usual complexity of procedures performed in the ICU or emergency department [ 22 , 23 ]. Additionally, limited research has been conducted on the independence or accuracy of the step-by-step procedures in AR systems [ 19 ].…”

Augmented reality in medical education: students’ experiences and learning outcomes

“…Wolf et al describe the recent development of an AR program using Microsoft HoloLens 2, for training the surgical procedure of extracorporeal membrane oxygenation cannulation. Compared to conventional training, medical students that received the AR version exhibited a higher level of learning and made fewer procedural errors [35]. Another platform has been developed by Nagayo and colleagues for open surgery training.…”

Microsoft HoloLens 2 in Medical and Healthcare Context: State of the Art and Future Prospects

“…Nine contributions [ 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 ] described the use of AR technology and the feasibility of using the HoloLens 2 headset to deliver remote bedside teaching or to enable 3D display for the facilitation of the learning process or in tele-mentoring and tele-consulting contexts.…”