Experimental Development of XR Enteral Feeding Function for an Endotracheal Suctioning Training Environment Simulator

Existing XR simulators for enteral feeding rely mainly on self-reported learning outcomes and procedural checklists. As a result, they offer limited opportunities to capture objective behavioral data or to present dynamic patient reactions. This two-stage pilot study evaluated an XR-based gastrostomy tube-feeding simulator (ESTE-TF) that integrates sensor-derived performance metrics and two biological-reaction presentation modalities (projection mapping and tablet display).

In Experiment 1, nursing students completed pre- and post-experience questionnaires assessing perceived learning across seven domains, alongside sensor-based measurements of feeding-start timing, dosing-rate characteristics, and total procedure time. Experiment 2 employed a tablet-based version with four learning items assessed for students and post-experience evaluations collected from registered nurses. Participants also compared the two XR presentation methods.

Students demonstrated perceived learning gains of small-to-large magnitude across both experiments (Experiment 1: d = 0.455-0.974; Experiment 2: d = 0.014-0.886), with wide 95% confidence intervals reflecting the exploratory nature of this pilot work. Sensor-derived data showed greater dosing-rate variability and longer procedure times among students than nurses. Participants reported that projection mapping offered a more embodied experience, whereas tablet displays provided clearer visibility.

These findings indicate the feasibility and preliminary educational potential of integrating sensing technologies with XR-based biological-reaction presentation for gastrostomy-feeding training. Given the small samples and non-validated measures, results should be interpreted as exploratory. Future research will refine sensor accuracy, establish standardized performance metrics, and evaluate learning outcomes using validated instruments and controlled study designs.