Augmented Reality in Ward Round-Based Simulation: Exploring Student Experiences and Impact on Confidence

Introduction: Doctors in training make substantial contributions to ward rounds. Despite this, formal education in this area is lacking, leading to diminished confidence and competence among undergraduate students and trainees. Ward round-based simulation (WRBS) has shown promise in improving clinical and decision-making skills. This quasi-experimental mixed-methods study aims to explore student experiences of augmented reality (AR) in simulated medical ward rounds. Specifically, it seeks to compare AR to existing traditional simulation modalities (TSM), manikin, and actor, to evaluate its viability as an alternative and to explore the impact of a mixed-modality simulated ward round on student confidence levels in performing ward round tasks.

Materials and methods: Fourteen participants engaged in a simulated ward round involving three cases: an actor as a patient, a manikin, and an AR case. Guided by pre- and post-simulation questionnaires, confidence levels around WRBS were explored using Wilcoxon's signed-rank test. Additionally, thematic analysis of semi-structured focus groups explored the use of AR in simulation compared to TSM.

Results: Significant improvements in confidence shown through the pre- and post-simulation questionnaires (p < 0.019) were found using Wilcoxon's signed-rank test across all 11 questions, with effect sizes (r) ranging from 0.65 to 0.9. The highest effect size observed (r = 0.9) asked about the change in confidence when starting or stopping medications during a ward round (p = 0.002). Qualitative analysis of focus group discussions identified key themes such as the visual accuracy of AR, the need for interactivity, and the cognitive load of mixed-method simulations.

Conclusion: The findings suggest that AR can significantly enhance medical training by providing realistic and immersive learning experiences, although further refinements are necessary to improve interactivity and reduce cognitive demands. This study highlights the potential for integrating innovative technologies to better prepare students for clinical practise and provides further insight into the practicalities of using AR in medical education.