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Use of a head-mounted patient display in a task driven anaesthesia simulator: a randomised trial
Jacob Henry Cole1,2, S Hughey2,3
1Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA cole.jacob.h@gmail.com.
Introduction:
Head-mounted displays (HMDs) are becoming increasingly investigated in the realm of healthcare. These devices are worn on the user's head and display information directly to the eye. This allows for near-constant delivery of information, regardless of user position. Increasing advances in technology have allowed for miniaturisation, increasing sophistication, wireless capability and prolonged battery life, all of which allow for more opportunities for these devices to be used in a clinical setting.
Methods:
A prospective, randomised, controlled, parallel-group study was conducted. Subjects were randomised to either an HMD group or a non-HMD group. All subjects then underwent a standardised intraoperative care simulation experience consisting of multiple procedures that required completion within a set time limit. During this period, subjects concurrently monitored the physiological state of a simulated patient. Multiple standardised physiological derangements were displayed to the subjects via either the worn HMD or standard monitors. The primary outcome was the time to recognition of these physiological derangements.
Results:
A total of 39 anaesthesia providers were enrolled in this study. There was a significant decrease in the total time it took them to recognise the simulated physiological derangements in the HMD group (difference of 38.2% (95% CI 20.3% to 56.1%); p=0.011) No significant differences in the time that it took to perform the required simulated procedures were observed. Significantly fewer physiological derangements were overlooked by the HMD group than the control group overall (relative risk reduction 0.78 (95% CI 0.31 to 0.94); p=0.003).
Conclusions:
Recent advances in HMD technology may be able to produce a functional adjunctive monitoring device that improves the speed with which anaesthesia providers respond to intraoperative events. This benefit comes without increasing distraction from the task. Further studies in true operative environments are needed to validate this technology.
