Rama Asheen, Rojas-Pino Marcos S, Wang Ellen Y, Rodriguez Samuel T, Suen Man Yee, Titzler Janet S, Zuniga-Hernandez Michelle, Jackson Christian, Rosales Oswaldo, Collins Faith, Caruso Thomas J
The following authors are in the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA: Asheen Rama is Clinical Assistant Professor; Ellen Y. Wang, Samuel T. Rodriguez, and Thomas J. Caruso are Clinical Professors; and Christian Jackson is a Statistician. Marcos S. Rojas-Pino and Oswaldo Rosales are Doctoral Candidates, Stanford University Graduate School of Education, Stanford, CA. The following authors are in the Stanford Chariot Program, Lucile Packard Children's Hospital Stanford, Palo Alto, CA: Man Yee Suen is a Clinical Research Coordinator, Janet Titzler and Michelle Zuniga-Hernandez are Clinical Research Assistants, and Faith Collins is a Laboratory Manager and Teacher.
J Educ Perioper Med. 2025 Apr 8;27(1):E740. doi: 10.46374/VolXXVII_Issue1_Rama. eCollection 2025 Jan-Mar.
Traditional medical simulations leverage stressful scenarios to potentiate memory. Augmented reality (AR) simulations provide cost-effective experiences using holograms instead of mannequins. This study investigated the physiologic response to AR simulations.
This was a noninferiority, controlled trial at an academic, pediatric hospital in Northern California among health care workers randomized to AR or traditional, in situ medical simulations. The primary outcome investigated parasympathetic tone. Biometric sensors assessed parasympathetic tone as respiratory sinus arrhythmia (RSA). A difference in RSA of less than 10% between groups was considered noninferior. Secondary outcomes explored usability, ergonomics, satisfaction, and recall with the System Usability Scale (SUS), ISO 9241-400, Simulation Design Scale (SDS), and an electronic questionnaire 5 months after the intervention, respectively.
A total of 111 participants were enrolled and 106 analyzed. Both groups experienced a decrease in mean RSA from baseline to during the simulation ( < .001 for both groups). Subsequently, there was an increase in RSA from the simulation period to the recovery period ( < .001 for the AR group and = .035 for the traditional group). Regarding secondary outcomes, the mean SUS score of 70.5 suggested good usability, 65.38% of AR participants reported feeling comfortable using the headset, and satisfaction in both groups was similar except for differences in use of real-life factors. The recall assessment was completed by 12 AR and 15 traditional participants, with similar scores between the 2 groups ( = .4).
AR simulations produced a noninferior change in parasympathetic tone compared with traditional simulations. Future investigations may explore the effectiveness of AR simulations for developing nontechnical skills during remote training. (Registration: Clinical Trials Registry NCT05674188.).
传统医学模拟利用压力情景来增强记忆。增强现实（AR）模拟使用全息图而非人体模型提供具有成本效益的体验。本研究调查了对AR模拟的生理反应。
这是一项在北加利福尼亚一家学术性儿科医院进行的非劣效性对照试验，将医护人员随机分为AR组或传统的现场医学模拟组。主要结局指标为副交感神经张力。生物传感器将副交感神经张力评估为呼吸性窦性心律不齐（RSA）。两组之间RSA差异小于10%被认为是非劣效的。次要结局指标分别在干预后5个月使用系统可用性量表（SUS）、ISO 9241-400、模拟设计量表（SDS）和电子问卷探讨可用性、人体工程学、满意度和记忆情况。
共纳入111名参与者，106名进行分析。两组从基线到模拟期间平均RSA均下降（两组均P<0.001）。随后，从模拟期到恢复期RSA增加（AR组P<0.001，传统组P = 0.035）。关于次要结局指标，SUS平均得分为70.5表明可用性良好，65.38%的AR参与者报告使用头戴式设备感觉舒适，除了在使用现实生活因素方面存在差异外，两组的满意度相似。12名AR参与者和15名传统参与者完成了记忆评估，两组得分相似（P = 0.4）。
与传统模拟相比，AR模拟在副交感神经张力方面产生了非劣效变化。未来的研究可能会探索AR模拟在远程培训中培养非技术技能的有效性。（注册：临床试验注册中心NCT05674188。）
