How Mass General Brigham is using augmented reality to train its nurses

What once seemed sci-fi is now a common practice in many areas of healthcare: virtual reality – or more accurately augmented reality and extended reality – is finding popularity in clinical settings, proving their value to patients and healthcare providers alike.

Of course, a key area where these technologies are enabling major innovation is in the education and training of clinical staff.

Next month at HIMSS24 in Orlando, Mass General Brigham innovation leaders will share results from a recent feasibility study at Brigham and Women’s Hospital that demonstrates the tremendous potential of AR and XR in code cart training for new nurses.

They will explain how they worked with clinical and IT colleagues to develop an AR application that has delivered ‘profound’ and ‘immensely positive’ benefits to nurse onboarding and training – with staff reporting higher satisfaction scores, shorter training periods and fewer email questions about processes they don’t understand. Educators at MGB, meanwhile, see AR training as a ‘paradigm shift’ in workforce training and are already looking at broader applications for it across the enterprise.

We reached out to Jonathan Letourneau, innovation analyst at Mass General Brigham and Chenzhen Cao, manager of MGB’s Digital Innovation Hub, who previewed their session: Training the next generation of nursing leaders using Augmented Reality.

Q. How promising are AR and XR for educating nurses in general, and what are some use cases with the most potential?

A. The immersive aspect of XR technologies holds great promise for medical education and training. The technology solutions enable experiential, detailed and personalized training exercises that more accurately simulate the nursing workflow and role as a healthcare provider. Use cases that we are currently investigating involve scenario development of interactions that a nurse may encounter with a patient. That said, we currently face technical and financial barriers in adopting and scaling the use cases. The second use case solves the technical and financial challenges our teams have faced and leverages web XR to create discrete apps, digitizing key nursing equipment. Most notably, we have developed a virtual code cart that has already been integrated into nursing training at Brigham and Women’s Hospital

Q. What makes these technologies useful for training?

A. XR offers two important benefits to nurse education. First, creating immersive educational experiences is extremely valuable. Transitioning educational components from lectures and presentations to immersive virtual experiences improves knowledge retention through the use of interactive modules. Second, virtual experiences help reduce the material costs of nursing education. Many teaching sessions require nurse educators to purchase brand new medical equipment for the nurses to train on. This is not only a significant cost for training, but also a major source of medical waste. Our nursing colleagues are very enthusiastic about reducing these costs.

Q. Can you provide some background on your use of AR at Brigham and Women’s – specifically the feasibility study around code cart training?

A. Our team has been researching various XR applications within healthcare for over a year and a half. We followed the medical axiom: see one, do one, learn one. We started with an internal and external landscape of current solutions, while building an internal community of collaborators interested in XR. We activated our community through monthly events, and it is these events that sparked many of the projects we are working on today. Our work has also spread to other hospitals and areas within the larger Mass General Brigham system. So it’s been very impressive and gratifying for us to see this work gaining traction beyond Brigham.

Q. What were some of the opportunities you discovered during the research? What were some of the challenges or drawbacks you identified? Are there any surprises?

A. The opportunity we saw while conducting this research was the value of a distributed digital solution. Nursing education in its current form is hampered by the amount of resources required to effectively train nurses. A scalable digital platform helps eliminate these monetary and waste costs. The downside is that some of the more tangible components of training (such as inserting a needle) are more difficult to replicate in a digital environment. Haptic feedback is not accurate enough to simulate some important interactions, although we hope this barrier will be resolved soon.

Q. What was the response from nurses and clinical staff? How did they like it?

A. We have received very positive responses from our fellow nurses. News of our solution has even reached other sites within our organization and we are currently building three additional code cars for other use cases. Nurse educators appreciate the distributed approach to learning this provides. Previously, a classroom of nurses had to share one code cart during training, and now students can track the code on their own device. In addition, we have developed QR code badges that every nurse can use. New nurses love that they can view the code cart from anywhere and on their own time.

Q: How do you see AR continuing to improve healthcare training and processes in the near future, especially as technology evolves and improves – both in training and other clinical areas?

A. We see that the most important improvement for healthcare training lies in the development of interactive, responsive scenarios. Real-world training is certainly the gold standard. But thanks to training in XR, nurses can create almost realistic scenarios without any risk to patients. This approach to risk-free immersive training has a broader scope than nursing – it can help a wide range of employees train and improve their interactions, operations and much more.

Q. Do you have any closing thoughts or expectations for what participants will take away from this session?

A. We hope that the other healthcare systems, as well as institutions working with healthcare players, will appreciate and adopt XR as part of their toolkit. There is definitely tremendous value, both from a workforce perspective, but also from an infrastructure and finance perspective. Although still in its infancy, the technology and resources in XR are at a mature stage where healthcare can experiment and adopt them at scale.

Cao and Letourneau will explain more in their HIMSS24 session, “Training the Next Generation of Nursing Leaders Using Augmented Reality.” It is scheduled for Tuesday, March 12, 10:15-10:45 AM in room W307A. More information and registration.