Enhancing the Pedagogical Healthcare Environment with Innovation: A Comparison of Traditional versus Mixed Reality Learning for CPR Training
by Lisa Marie Gonzalez
Thesis supervisor: Dr. Hande Sungur
Cardiac arrest is known to be one of the leading causes of death per year (Elmer & Callaway, 2017). Cardiopulmonary resuscitation (CPR) is the most successful method in victim revival but, many do not know how to perform it well. A longitudinal study on bystander CPR conducted by Yan et al. (2020) discovered an increase in survival rates when innovative training methods were implemented. This was due to faster response in skill use (i.e., AED and chest compressions; Yan et al. 2020). Thus, assessing the effectiveness of innovative training methods is detrimental in uncovering solutions to proper CPR performance and contributes to the fields of emergency response and extended reality (XR).
In this study we examined the usefulness of mixed reality (MR) CPR training (see Figure 1) compared to a traditional method. The final sample (N = 60) consisted of 41 women and 19 men. Of the 60 participants, five had previously performed CPR, and 16 had previously followed CPR training. The majority of the participants were undergraduate students and reported zero prior experience with MR. Participants were placed in two equal groups, traditional (n = 30) or MR (n = 30).
The traditional CPR training session consisted of a training from a certified CPR trainer, a defibrillator and a manikin. The manikin was connected to the trainers cell phone via an app that displayed the metrics of the participants chest compressions (CC; i.g., rate and depth). The session began with theory of CPR and then a hands-on learning experience. During the hands-on experience, the trainer provided verbal feedback about mistakes and allowed participants to view the CC live feedback via the application.
The MR CPR training session began with a hands-on introduction to MR using the TIPS application inside the HoloLens2 (see Figure 2). The TIPS application engages users to interact with holograms such as tapping gems and enlarging objects. Next, participants watched a theoretical explanation of CPR via a hologram video from a MR CPR application within the HoloLens2. Shortly afterward, participants engaged in a hands-on CPR experience with a manikin. In this scenario, CC depth and rate were given to participants via live feedback within the HoloLens2. Furthermore, if a participant performed an incorrect step, they were corrected by the MR CPR application.
Concluding theoretical and hands-on training, both groups were given one-on-one exams with a trainer without using hardware. They were evaluated according to CPR guidelines provided by The Orange Cross. This consists of steps for CPR performance, consisting of breathing check, calling local authorities, CC, and AED use. The correct order and proper execution of the steps was evaluated. Finally, all participants submitted a self-completion questionnaire about their experience.
This study revealed that MR CPR training was just as efficient as traditional training. A theoretical circumstance that was uncovered was the lower levels of performance scores in relation to higher levels of presence while using MR. In conclusion, MR can be a useful tool in CPR trainings especially since it was found to be more enjoyable than traditional training. However, creators should be mindful of overstimulating users with learning how to use new hardware and with consuming training material at the same time.