Using Mixed Reality Headsets to Deliver Remote Bedside Teaching During the COVID-19 Pandemic: Feasibility Trial of HoloLens 2

Abstract

Background COVID-19 has had a catastrophic impact in terms of human lives lost. Medical education has also been impacted as appropriately stringent infection control policies precluded medical trainees from attending clinical teaching. Lecture-based education has been easily transferred to a digital platform, but bedside teaching has not. Objective This study aims to assess the feasibility of using a mixed reality (MR) headset to deliver remote bedside teaching. Methods Two MR sessions were led by senior doctors wearing the HoloLens headset. The trainers selected patients requiring their specialist input. The headset allowed bidirectional audiovisual communication between the trainer and trainee doctors. Trainee doctor conceptions of bedside teaching, impact of the COVID-19 pandemic on bedside teaching, and the MR sessions were evaluated using pre- and postround questionnaires, using Likert scales. Data related to clinician exposure to at-risk patients and use of personal protective equipment (PPE) were collected. Results Prequestionnaire respondents (n=24) strongly agreed that bedside teaching is key to educating clinicians (median 7, IQR 6-7). Postsession questionnaires showed that, overall, users subjectively agreed the MR session was helpful to their learning (median 6, IQR 5.25-7) and that it was worthwhile (median 6, IQR 5.25-7). Mixed reality versus in-person teaching led to a 79.5% reduction in cumulative clinician exposure time and 83.3% reduction in PPE use. Conclusions This study is proof of principle that HoloLens can be used effectively to deliver clinical bedside teaching. This novel format confers significant advantages in terms of minimizing exposure of trainees to COVID-19, reducing PPE use, enabling larger attendance, and delivering convenient and accessible real-time clinical training.

Learning technology in health professions education: Realising an (un)imagined future

“…For example, three studies used live streaming plus HoloLens glasses or mixed reality headsets to allow students a clinicians-eye view of surgery and bedside patient interactions. [102][103][104] These examples make clinical exposures possible by distance and with added value from additional resources and real-time Q and A with the clinician during the session. One used fully immersive virtual reality storytelling, 105 and the final study created an intelligent virtual case learning system using big data architecture to create authentic cases based on real case files from a large hospital database.…”

“…[109][110][111] We were however encouraged by a more recent work redefining education through technology. [104][105][106]…”

“…In all five articles (one in 2020, two in 2021 and two in 2022), technology was used to give students learning experiences that would be challenging or even impossible to offer in a traditional paradigm. For example, three studies used live streaming plus HoloLens glasses or mixed reality headsets to allow students a clinicians‐eye view of surgery and bedside patient interactions 102–104 . These examples make clinical exposures possible by distance and with added value from additional resources and real‐time Q and A with the clinician during the session.…”

“…Other foci included augmentation of current teaching methods, primarily through the use of additional learning and feedback opportunities, and the use of technology to allow students to visualise more than they would with traditional teaching methods 109–111 . We were however encouraged by a more recent work redefining education through technology 104–106 …”

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

“…For those introducing AR into health care, the research necessary to support its adoption extends beyond potential clinical and educational benefits. Evidence of patient satisfaction and financial gains is also perceived to be essential, with an example of the latter being the use of AR-enabled devices for telecommunication to conserve personal protective equipment [ 20 , 65 , 66 ]. Future, large studies can focus on which factors are most valued and whether factors change depending on the type of provider using AR.…”