Sun Wan-Na, Hsieh Min-Chai, Wang Wei-Fang
Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
J Med Internet Res. 2024 Dec 5;26:e57327. doi: 10.2196/57327.
Advanced cardiac life support (ACLS) skills are essential for nurses. During the COVID-19 pandemic, augmented reality (AR) technologies were incorporated into medical education to increase learning motivation and accessibility.
This study aims to determine whether AR for educational applications can significantly improve crash cart learning, learning motivation, cognitive load, and system usability. It focused on a subgroup of nurses with less than 2 years of experience.
This randomized controlled trial study was conducted in a medical center in southern Taiwan. An ACLS cart training course was developed using AR technologies in the first stage. Additionally, the efficacy of the developed ACLS training course was evaluated. The AR group used a crash cart learning system developed with AR technology, while the control group received traditional lecture-based instruction. Both groups were evaluated immediately after the course. Performance was assessed through learning outcomes related to overall ACLS and crash cart use. The Instructional Materials Motivation Survey, System Usability Scale, and Cognitive Load Theory Questionnaire were also used to assess secondary outcomes in the AR group. Subgroup analyses were performed for nurses with less than 2 years of experience.
All 102 nurses completed the course, with 43 nurses in the AR group and 59 nurses in the control group. The AR group outperformed the control group regarding overall ACLS outcomes and crash cart learning outcomes (P=.002; P=.01). The improvement rate was the largest for new staff regardless of the overall learning effect and the crash cart effect. Subgroup analysis revealed that nurses with less than 2 years of experience in the AR group showed more significant improvements in both overall learning (P<.001) and crash cart outcomes (P<.001) compared to their counterparts in the control group. For nurses with more than 2 years of experience, no significant differences were found between the AR and control groups in posttraining learning outcomes for the crash cart (P=.32). The AR group demonstrated high scores for motivation (Instructional Materials Motivation Survey mean score 141.65, SD 19.25) and system usability (System Usability Scale mean score 90.47, SD 11.91), as well as a low score for cognitive load (Cognitive Load Theory Questionnaire mean score 15.42, SD 5.76).
AR-based learning significantly improves ACLS knowledge and skills, especially for nurses with less experience, compared to traditional methods. The high usability and motivational benefits of AR suggest its potential for broader applications in nursing education.
ClinicalTrials.gov NCT06057285; https://clinicaltrials.gov/ct2/show/NCT06057285.
高级心脏生命支持（ACLS）技能对护士至关重要。在新冠疫情期间，增强现实（AR）技术被引入医学教育，以提高学习动机和可及性。
本研究旨在确定用于教育应用的AR是否能显著改善急救推车学习、学习动机、认知负荷和系统可用性。研究聚焦于经验不足2年的护士亚组。
本随机对照试验在台湾南部的一家医疗中心进行。第一阶段使用AR技术开发了一个ACLS急救推车培训课程。此外，对所开发的ACLS培训课程的效果进行了评估。AR组使用基于AR技术开发的急救推车学习系统，而对照组接受传统的讲座式教学。两组在课程结束后立即进行评估。通过与整体ACLS和急救推车使用相关的学习成果来评估表现。还使用教学材料动机调查问卷、系统可用性量表和认知负荷理论问卷来评估AR组的次要结果。对经验不足2年的护士进行亚组分析。
所有102名护士均完成了课程，AR组有43名护士，对照组有59名护士。在整体ACLS结果和急救推车学习成果方面，AR组的表现优于对照组（P = 0.002；P = 0.01）。无论整体学习效果还是急救推车效果，新员工的改善率都是最大的。亚组分析显示，与对照组的同行相比，AR组中经验不足2年的护士在整体学习（P < 0.001）和急救推车成果（P < 0.001）方面都有更显著的改善。对于经验超过2年的护士，AR组和对照组在急救推车培训后学习成果方面没有显著差异（P = 0.32）。AR组在动机方面得分较高（教学材料动机调查问卷平均得分141.65，标准差19.25），系统可用性方面得分较高（系统可用性量表平均得分90.47，标准差11.91），认知负荷方面得分较低（认知负荷理论问卷平均得分15.42，标准差5.76）。
与传统方法相比，基于AR的学习显著提高了ACLS知识和技能，尤其是对于经验较少的护士。AR的高可用性和激励效益表明其在护理教育中具有更广泛应用的潜力。
ClinicalTrials.gov NCT06057285；https://clinicaltrials.gov/ct2/show/NCT06057285
