Currently submitted to: JMIR Medical Education
Date Submitted: Apr 13, 2026
Open Peer Review Period: Apr 13, 2026 - Jun 8, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Augmented Reality-Based Rapid Blood Transfusion Device Training for Emergency Nurses: Randomized Controlled Trial
ABSTRACT
Background:
In critical situations such as hypovolemic shock, nurses must master the Level-1® rapid infusion system. However, training opportunities for this device are limited compared to more commonly used medical devices due to resource constraints. Previous research has shown that augmented reality (AR)-based training programs can provide immersive experiences closely resembling clinical scenarios, offering an effective method to address this gap.
Objective:
This study investigated the impact of AR-based Level-1® education on nurses' clinical performance, self-efficacy, and educational satisfaction compared with traditional guideline-based self-directed learning.
Methods:
A randomized controlled post-experimental design was used. Forty-two practical nurses without prior Level-1® experience were recruited from Samsung Medical Center in Seoul, Korea, between July 17 and July 20, 2023. The experimental group (n=21) received AR-based training using Microsoft HoloLens 2®, while the control group (n=21) followed traditional guideline-based self-learning. Structured measurements assessed clinical performance (time, accuracy, and assistance requests), self-efficacy (6-item modified scale, Cronbach α=.80), and educational satisfaction (4-item scale, Cronbach α=.87). Independent sample t-tests were used to compare outcomes between groups.
Results:
AR-based training extended learning time (18.45 vs 10.78 minutes; P<.001) but resulted in significantly faster device setup (3.70 vs 9.81 minutes; P<.001). The experimental group demonstrated superior clinical competency scores (91.67 vs 63.81; P<.001) with fewer assistance requests (0.33 vs 2.86; P<.001). Self-efficacy scores were significantly higher in the experimental group (20.90 vs 16.52; P<.001), particularly for confidence-related items such as advising others (P<.001) and troubleshooting device issues (P<.001). Educational satisfaction was also significantly higher in the experimental group (17.19 vs 11.71; P<.001).
Conclusions:
AR-based Level-1® education enhances nurses' clinical competency, self-efficacy, and satisfaction compared to traditional methods. This approach enables quicker and more accurate device setup, enhances confidence in handling equipment, and improves overall educational experience. These findings highlight AR technology's potential to transform nursing education for critically important but infrequently used medical devices. Clinical Trial: ClinicalTrials.gov NCT06506851
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.