Mixed reality simulation training in the assessment and management of acutely unwell patients in undergraduate medical education: a pilot study

Abstract

Background: Development of the undergraduate simulation experience is needed to continue developing aspiring clinicians’ ability to assess and manage unwell patients. However, its heavy resource demand and ‘Generation Z’s’ desire for technologically enhanced learning means novel simulation modalities must now be considered. Mixed reality (MR) provides a platform to deliver such simulation; however, it is yet to be studied in this context. We conducted an observational cohort study with the aim to assess ift MR simulation improves students’ perceived ability to assess and manage unwell patients. Methods: We recruited 32 undergraduate medical students and asked them to rate their ability to assess and manage acutely unwell patients, out of 10. An MR simulation was then delivered using the Microsoft HoloLens and HoloScenario software produced by GigXR. Students then rated their assessment and management ability again, alongside their experience of the system and its usability. Data analysis used paired t-tests to assess for significant differences. Results: By attending the simulation, students showed a significant improvement in perceived ability to assess (p < 0.001) and manage (p < 0.001) acutely unwell patients. Mean assessment scores improved by 1.09/10 (95% confidence interval [CI 0.67, 1.52]) with 89% of students feeling more confident. Mean management scores improved by 1.63/10 (95% CI [1.15, 2.10]) with 84% of students reporting increased confidence levels. When considering usability, 69% of students did not find the MR system easy to use, with 75% of students having technical issues and 38% experiencing side effects. Overall, 88% of students believed the experience was beneficial to their learning. Conclusions: MR shows promise in its ability to deliver simulation training and improve students’ perceived ability to assess and manage unwell patients. Advances in software availability and content are required for integration into undergraduate medical curricula. Further research is required to assess if these results are replicated objectively.