Use of Mixed-Reality Device
EMERGENCY
A, Patient detail and clinical history are provided bedside, representing true head-up display functionality with the ability to place 2D and 3D objects within a user’s visual field. B, Emergency thoracotomy instrument selection is facilitated through inclusion of mixed-reality assets and via live, bidirectional communication with senior support via video and voice. C, Demonstration of the digital data repository and clinical guidance use. D, Insertion of chest drain with guidance and senior support through remote assistance and mixed-reality device support, representing safety areas for chest drain insertion.The study was performed at a specialist high-fidelity simulation suite located within a UK Academic Health Sciences Centre. Sessions were facilitated and led by experienced simulation practitioners (M.G. and A.N.). A high-fidelity adult patient simulator (Laerdal Medical Ltd) was used to simulate an adult who was unwell and required resuscitation, including procedural intervention in the form of a chest drain insertion. Clinical scenarios are provided in the eTable in The primary outcome measure was error rate as assessed by the Imperial College Error Capture (ICECAP) tool, a validated, multidimensional assessment of error.Further exploratory analyses were undertaken, including of time to complete the clinical scenario and global assessments of team performance via 2 specific assessment tools. First, the Observational Teamwork Assessment for Surgery (OTAS) tool