JMIR Publications

ABSTRACT

Background:

Simulation-based medical education provides key medical training for high-risk events. Augmented reality enhanced simulation (AR) projects digital images of realistic exam findings into a participant’s field of view. It is unknown how AR-enhanced simulation compares to traditional mannequin-based simulation (TM) with regards to influencing participant behavior and attention.

Objective:

Ethnographically compare and categorize Traditional Mannequin-Based Simulation Based Medical Education (SBME) to Augmented Reality-Enhanced SBME and provide suggestions for educators looking to delineate these two modalities.

Methods:

Twenty recorded interprofessional simulations (10 TM, 10 AR) featuring a decompensating child were evaluated through video-based focused ethnography. A generative question was posed, “How do the experiences and behaviors of participants vary based on the simulation modality?” Iterative data collection, analysis, and pattern explanation were performed by a review team spanning critical care, simulation, and qualitative expertise.

Results:

Findings clustered into three core themes: 1) focus and attention, 2) suspension of disbelief, and 3) communication. AR facilitated a more comprehensive clinical assessment; however kinesthetic interventions were impeded. Participant focus during AR was on patient exam changes, whereas in TM focus was on the cardiorespiratory monitor. Finally, communication differed with calmer and clearer communication during TM while AR communication was more chaotic.

Conclusions:

Primary differences clustered to focus and attention, suspension of disbelief, and communication. TM may be superior for hands-on skill acquisition while AR may be superior for assessment-focused simulations. Next steps include applying these themes to virtual reality-based simulation and true patient encounters to inform best practices for use of the growing portfolio of simulation modalities to best align with targeted learning objectives.