High acuity trauma necessitates experienced and rapid intervention to
prevent patient harm. However, upskilling junior trainees through handson management of real trauma cases is rarely feasible without
compromising patient safety. This Quality Education Report (QER)
sought to investigate whether a simulation course operated via Mixed
Reality (MR) headset devices (Microsoft HoloLens) could enhance the
clinical knowledge recall and preparedness to practice of junior trainees
with no prior experience managing trauma.
The Plan Do Study Act (PDSA) quality improvement method was used to
refine six emergency trauma vignettes compatible with a MR teaching
platform. Each vignette was curated by a multidisciplinary team of
orthopaedic surgeons, clinical fellows and experts in simulation-based
medical education. As a baseline assessment, a two-hour emergency
trauma course was delivered using traditional didactic methods to a
cohort of pre-registration medical students with no clinical exposure to
high-acuity trauma (n=16). Next, we delivered the MR simulation to an
equivalent cohort (n=32). Clinical knowledge scores (CKS) derived from
written test papers were recorded for each group during and two weeks
after each course. Each attendee’s end-of-rotation clinical supervisor
appraisal grade was recorded, as determined by a consultant surgeon
who supervised participants during a two-week placement on a major
trauma ward. Balancing measures included participant feedback and
validated cognitive load questionnaires (NASA-TLX).
Overall, attendees of the MR simulation course achieved and sustained
higher clinical knowledge scores and were more likely to receive a
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BMJ Open Quality
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positive consultant supervisor appraisal. This project serves as a proof of
concept that MR wearable technologies can be used to improve clinical
knowledge recall and enhance the preparedness to practice of novice
learners with otherwise limited clinical exposure to high-acuity trauma