Feasibility, Adoption, and Utility of Augmented Reality in Lumbar Puncture Simulation by Medical Students: A Pilot Study.

Abstract

Background: The acquisition of procedural skills by medical trainees remains challenging, time-consuming, and risky. The use of augmented reality in the clinical setting is increasing because of its growing accessibility and potential to aid medical education and clinical care delivery.

Objective: This study investigated the feasibility, adoption, and efficacy of augmented reality (AR)-supported lumbar puncture (LP) simulation for medical student training.

Methods: A randomized and controlled approach was used to assess the effect of AR-supported simulation training versus standard simulation training on the number of sticks for successful LP, distance of first puncture from the target, and the time to successful LP. Pre- and post-surveys were used to assess medical student satisfaction with AR-supported LP simulation.

Results: Thirty-four third-and fourth-year medical students were equally randomized into a AR-supported or control LP simulation groups. The median number of punctures required for a successful LP was 2 (interquartile range [IQR] 2) in the control group and 1 (IQR 2) in the AR group (p = 0.58). The median distance of the first puncture from the target was 5 mm (IQR 25) in the control group and 10 mm (IQR 18) in the AR group (p = 0.51). The median time to successful puncture was 137.9 s (IQR 283.1) in the control group and 93.8 s (IQR 117.7) in the AR group (p = 0.27). Confidence in performing LP on real patients on a 1-5 Likert scale improved from a median of 1 (IQR = 1) to 3 (IQR = 1, p < 0.01).

Conclusions: There was no statistically significant difference in the number of sticks, distance from the target, and the time to successful puncture between the AR and control groups. Significant improvements in confidence levels were reported after simulation training via a survey. Although most of this cohort had no previous exposure to AR, the majority expressed willingness and preference to use AR in the procedural simulation. Future studies would benefit from a multisite design for a larger sample, as well as the use of newer AR technologies.