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The Use of Augmented Reality Checklists by Nursing Students to Support Healthcare Decision-Making: Results of a Randomized-Controlled Trial

SessionExtended Reality Applications for Simulating Human Factors Interventions (SE2)

DescriptionMedical errors contribute significantly to diminished patient wellbeing and financial burden. It is imperative for nurses to identify and respond to deteriorating patients in a timely manner to maintain patient safety. Checklists have been shown to guide decision-making and prevent medical errors. Our study aimed to use an Augmented Reality (HoloLens) checklist prompt to support nursing student decision making and evaluate its impact on the behavior and performance of student-nurses during a simulated stroke scenario. Physiological sensing data obtained with an eye tracking device, subjective questionnaires, performance time measurements and expert evaluations were employed to assess the effectiveness of the Hololens-delivered checklists. There were significant differences in the average visit durations on critical Areas of Interests such as patient notes and patient monitor, with the durations being more than double in the HoloLens group when compared to the control group. Performance times in the two groups indicated that there was no deterioration of performance while using the HoloLens device. Additionally, subjective questionnaire tools such as the System Usability Scale and Clinical Learning Environment Comparison Survey 2.0 indicated good scores for the users’ perceived usability and learning outcome of the HoloLens-delivered checklist system. Expert evaluations using the Lasater Clinical Judgment Rubric scores demonstrated higher scores in ‘Noticing’ and ‘Responding’ survey items for the HoloLens group compared to controls. The results have promising implications for the effective use of AR-mediated decision-support tools in time-critical healthcare settings. This is demonstrated by the HoloLens-supported group exhibiting more directed attention on Areas of Interests most pertinent to clinical decision-making.

Authors