| 摘要： | Background: Advanced cardiac life support (ACLS) skills are essential for nurses. During the COVID-19 pandemic, augmented
reality (AR) technologies were incorporated into medical education to increase learning motivation and accessibility.
Objective: This study aims to determine whether AR for educational applications can significantly improve crash cart learning,
learning motivation, cognitive load, and system usability. It focused on a subgroup of nurses with less than 2 years of experience.
Methods: This randomized controlled trial study was conducted in a medical center in southern Taiwan. An ACLS cart training
course was developed using AR technologies in the first stage. Additionally, the efficacy of the developed ACLS training course
was evaluated. The AR group used a crash cart learning system developed with AR technology, while the control group received
traditional lecture-based instruction. Both groups were evaluated immediately after the course. Performance was assessed through
learning outcomes related to overall ACLS and crash cart use. The Instructional Materials Motivation Survey, System Usability
Scale, and Cognitive Load Theory Questionnaire were also used to assess secondary outcomes in the AR group. Subgroup analyses
were performed for nurses with less than 2 years of experience.
Results: All 102 nurses completed the course, with 43 nurses in the AR group and 59 nurses in the control group. The AR group
outperformed the control group regarding overall ACLS outcomes and crash cart learning outcomes (P=.002; P=.01). The
improvement rate was the largest for new staff regardless of the overall learning effect and the crash cart effect. Subgroup analysis
revealed that nurses with less than 2 years of experience in the AR group showed more significant improvements in both overall
learning (P<.001) and crash cart outcomes (P<.001) compared to their counterparts in the control group. For nurses with more
than 2 years of experience, no significant differences were found between the AR and control groups in posttraining learning
outcomes for the crash cart (P=.32). The AR group demonstrated high scores for motivation (Instructional Materials Motivation
Survey mean score 141.65, SD 19.25) and system usability (System Usability Scale mean score 90.47, SD 11.91), as well as a
low score for cognitive load (Cognitive Load Theory Questionnaire mean score 15.42, SD 5.76).
Conclusions: AR-based learning significantly improves ACLS knowledge and skills, especially for nurses with less experience,
compared to traditional methods. The high usability and motivational benefits of AR suggest its potential for broader applications
in nursing education.
Trial Registration: ClinicalTrials.gov NCT06057285; https://clinicaltrials.gov/ct2/show/NCT06057285 |
