Using Mixed Reality to Teach Medical Students Lumbar Punctures.

Background: Gaining familiarity with bedside procedures during medical school is essential for preparing medical students for intern year. However, this is often not a core component of undergraduate medical education, and students often feel unprepared to perform bedside procedures upon graduation from medical school. Extended reality technologies have rapidly developed in the past few years, become more accessible, and show great promise in education, most recently in healthcare. We aim to show the feasibility and usability of a mixed-reality lumbar puncture simulated experience.

Methods: We created the mixed-reality simulation by filming a procedure conducted by an expert on a lumbar puncture simulator from the first-person view. We performed a study to assess the feasibility and usability of mixed-reality lumbar puncture training compared with traditional faculty-led high-fidelity mannikin-based simulation training. Fourth-year medical students were randomly selected to participate in the mixed-reality lumbar puncture training. Students watched the virtual first-person teaching via a virtual reality headset while mimicking hand movements on a lumbar puncture mannikin. Faculty taught students in the traditional high-fidelity group in small groups before practicing on the high-fidelity manikin. Students in both groups then performed the procedure entirely with performance assessed via a standardized checklist. Number of attempts to achieve a predetermined minimum passing score were recorded, and students were also surveyed regarding their experience with both simulations.

Results: Fifty-nine percent of students felt comfortable using mixed reality as a training modality with less than 6% having any prior extended reality experience. More than 55% felt the mixed-reality experience was as effective as the traditional high-fidelity simulation training. Many students (72%) desired more mixed-reality opportunities. In terms of performance, 58.8% of students in the mixed-reality group vs 65.5% in the traditional group completed the checklist in 1 attempt (P = .79).

Conclusions: We demonstrate that mixed reality is an acceptable and effective modality to train health care professionals in lumbar punctures with opportunities to further enhance the immersive learning experience.