The Role of Augmented Reality in Advancing Medical Training Techniques: A Pilot RCT Study on Cricothyroidotomy

Cricothyroidotomy is a critical procedure for managing difficult airways, yet it is infrequently performed, leading to limited familiarity among medical professionals. This study explores the effectiveness of augmented reality (AR)-based training using HoloLens compared to traditional non-head mounted device (HMD) training in teaching cricothyroidotomy. This study aims to confirm the effect of technical practice using AR on participants' performance ability, performance confidence, learning self-efficacy, and practical satisfaction, and to present basic data for using AR in medical education.

All participants received initial guidance via PowerPoint (PPT) on laptops. The AR group performed the procedure with three-dimensional models via HoloLens, while the non-HMD group used the initial PPT guidance. Effectiveness was assessed through a pre- and post-test design, including cricothyroidotomy estimated time, skill confidence, NASA-Task Load Index, System Usability Scale, and participant satisfaction.

The average pre-test procedure time for the AR group was 188 seconds, and 150 seconds for the non-HMD group. In the post-test, the AR group recorded 146 seconds and the non-HMD group 136 seconds, showing no statistically significant difference in procedure time (p>0.05). The HMD group showed a significant improvement in confidence levels (median increase from 1.0 to 5.0), and both groups demonstrated similar proficiency in cricothyroidotomy performance over time. Satisfaction rates were similar, but the AR group reported lower mental demand.

Despite initial technical challenges, AR showed potential for enhancing learning and confidence without compromising performance, indicating the need for further research to optimize AR in medical training.