- Although there are plenty of resuscitation trainings available, clinicians often still find a gap between training and real-life events.
- Applying innovative technologies like augmented reality to resuscitation training can help bridge that gap.
- Potential benefits of augmented reality include: realistic training scenarios, in-the-moment feedback, improved CPR quality, and increased engagement.
Adequately training and preparing Code Blue clinicians is crucial for a well-executed response — but that doesn’t mean it is easy. Thanks to the innate stress of a high-stakes emergency event, lapse of skills between codes, or other reasons, hospitals and responders often find a gap between training and real-life events.
That’s why it makes sense to consider innovative technologies that can improve training and better prepare clinicians with the skills they need to respond effectively. One such emerging technology? Augmented reality (AR).
But what is AR, how can it be applied to resuscitation training, and what might it bring to the table? Keep reading to find out.
Augmented reality: The basics
What is AR?
As its name suggests, augmented reality enhances the real-world environment with virtual elements, often by using glasses or a smartphone app. It’s often confused with virtual reality, but the two concepts aren’t the same. In virtual reality, the user is fully immersed in a digital, completely computer-created environment. By contrast, AR overlays digital content onto the existing environment. The difference lies in supplementing your existing environment (augmented reality) versus creating an entirely new one (virtual reality).
How can AR be applied to resuscitation training?
AR is an emerging technology for resuscitation, and its use will likely continue to evolve and change over time. So far, one way it has been applied is by combining AR technology with a cardiopulmonary resuscitation (CPR) manikin to visualize internal blood flow. Since the blood flow improves or worsens based on the quality of CPR performed on the manikin, trainees receive real-time feedback about the quality of their CPR effort and its effect on a patient.1
Why consider augmented reality for resuscitation training?
Today, we have no shortage of options when it comes to resuscitation training:
- Live Advanced Cardiac Life Support/Basic Life Support certification training, or virtual/online certification courses
- Mock codes
- Live and simulated team trainings
- Different styles of manikins with various feedback responses (pulse, breath, light indicator for depth confirmation, etc.)
The goal of all these options: to enhance resuscitation training, team response, and muscle memory. Ideally, clinicians will walk away from these trainings with the skills needed to perform high-quality CPR, establish early defibrillation for patients with ventricular fibrillation or pulseless ventricular tachycardia, and initiate post-arrest care.1
So why consider adding AR to this list?
Even with multiple courses and certifications available, it is difficult for clinicians to obtain enough of the practical, hands-on training that translates directly in a high-stakes emergency medical situation. Plus, skill decay continues to be a persistent problem in resuscitation training. Healthcare providers are expected to digest a large volume of information, knowledge, and skills during training courses. Since they may not use these skills daily, it’s hard to keep that knowledge fresh. For example, studies show that CPR skills start to deteriorate after 3 months, and — if not used or reinforced — are completely lost by 6 months.2
Resuscitation isn’t the only area where obtaining (and retaining) hands-on skills is a challenge — and where augmented reality might be part of the solution. AR technology has also been used to help medical students better learn about and visualize human anatomy — and to practice surgeries in a realistic but risk-free environment. Outside of healthcare, the technology is being used for training in everything from the military (AR combat training) to the retail industry (simulating challenging customer interactions for retail trainees).3
The bottom line: The traditional resuscitation trainings available may not be enough. Knowledge starts to go stale quickly if not applied in a practical, hands-on way. Plus, responding to cardiac or respiratory arrest is challenging and complex. Any clinician knows that it requires much more than simple recall of knowledge; it calls for optimized, hands-on skills and the ability to support a patient throughout a rapidly changing situation.4
Potential benefits of augmented reality for resuscitation training
So what might AR technology bring to the table when it comes to resuscitation training?
AR can allow for a more immersive, realistic experience that better depicts the patient’s situation leading to an arrest — and their response to various interventions.5
It can also help clinicians by showing them the impact to the patient in real time, allowing them to react and adjust immediately. This is exactly why it’s so helpful for trainees to visualize the internal blood flow of the CPR manikin: they can see what is and isn’t working and make adjustments to their CPR efforts as they go.
Improved CPR quality
Because of these advantages, AR can help support high-quality CPR skills that are often lost during resuscitation events, even by the most skilled responders: rate of 100-120 compressions per minute, depth of 2 inches, and no excessive ventilation.6
Gamified learning — recognized by the American Heart Association (AHA) as an important area for innovation in resuscitation education — has been shown to increase engagement, which improves knowledge retention.1
The bottom line
AR technology is still in its infancy when it comes to resuscitation training, and its specific applications will continue to evolve as we learn more. For instance, one way it might be used is to enhance traditional trainings already offered by the AHA, such as the Resuscitation Quality Improvement (RQI)® skills training, which is completed by a provider alone. AR could potentially help to make the skills used more realistic and to better support muscle memory.
But regardless of what it looks like in the future, AR is a concept that is worth continuing to explore now. When it comes to high-stakes emergency events, muscle memory is critical, and there is no such thing as too much practice or reinforcement. Continuing to explore innovative technologies like AR is a crucial step to bridging the gap between training and real-life events.
Ready to learn more?
What other innovative technologies have the potential to transform resuscitation response? Read our article on mechanical CPR next, where we explore its pros and cons, how the COVID-19 pandemic changed its use, and what it might mean for the future of Code Blue response.
Balian S, McGovern SK, Abella, BS, et al. (2019). Feasibility of an augmented reality cardiopulmonary resuscitation training system for health care providers. Heliyon, 5(8), e02205. https://doi.org/10.1016/j.heliyon.2019.e02205
Kovács E, Jenei Z, Csordás K, et al. (2019). The timing of testing influences skill retention after basic life support training: A prospective quasi-experimental study. BMC Medical Education, 19(1). https://doi.org/10.1186/s12909-019-1881-7
Fade L. (2021). The benefits of augmented reality for employee training. Available at: The Benefits Of Augmented Reality For Employee Training (forbes.com)
Halamek, LP & Weiner GM. (2022). State-of-the art training in neonatal resuscitation. Seminars in Perinatology, 46(6), 151628. https://doi.org/10.1016/j.semperi.2022.151628
Kuyt K, Park S-H, Chang TP, et al. (2021). The use of virtual reality and augmented reality to enhance cardio-pulmonary resuscitation: A scoping review. Advances in Simulation, 6(1). https://doi.org/10.1186/s41077-021-00158-0
Higashi E, Fukagawa K, Kasimura R, et al. (2017). Development and evaluation of a corrective feedback system using augmented reality for the high-quality cardiopulmonary resuscitation training. 2017 IEEE International Conference on Systems, Man, and Cybernetics (SMC), 2017, pp. 716-721, doi: 10.1109/SMC.2017.8122692.