Date of this Version

2025

Document Type

DNP Project

Rights

default

Abstract

Background: Central line placement (CLP) is a critical skill for nurse anesthesiology residents, yet proficiency gaps can lead to serious complications, including arterial puncture, hematoma, and pneumothorax. Although ultrasound guidance is the current standard for teaching this procedure, it lacks tactile feedback, which limits learners’ spatial awareness and control—both essential for accurate needle tip tracking (NTT). This shortcoming in traditional simulation-based education (SBE) contributes to inconsistent skill acquisition and potential patient harm. Augmented reality (AR) with haptic feedback has emerged as a promising tool to address the issue by enhancing realism and engagement in procedural training. This project aimed to determine whether, among nurse anesthesiology residents, the use of AR haptic feedback versus ultrasound-guided methods in SBE would improve success in needle tip tracking.

Methods: This quality improvement project employed a virtual educational module to address CRNAs’ knowledge gaps in AR haptic feedback and ultrasound-guided CLP. The intervention, delivered via Qualtrics, included a 10-question pre-test, a 10-minute voice-narrated PowerPoint, and a 10-question post-test. Participants were CRNAs from a major South Florida healthcare facility. Project impact was evaluated by comparing pre- and post-test responses to measure knowledge gains and attitude shifts, with demographic data also collected. Rogers’ Diffusion of Innovations theory guided the project to frame adoption of new educational tools.

Results: Of 12 individuals who viewed the consent form, 11 (91.7%) consented, and 10 (83.3%) completed both surveys. Baseline knowledge was limited, with only 64% identifying AR’s key feature, 36% the benefit of haptic feedback, and 27% simulation limitations. After the module, recognition of AR and haptic benefits rose to 70%, understanding of simulation limitations to 60%, and acknowledgment of key benefits, such as spatial awareness and accuracy, to 90%. Likelihood of adoption increased from 36% to 70%, with none reporting they were unlikely to adopt. Recognition of error reduction improved from 36% to 80%.

Discussion: This project showed that a brief, self-paced virtual module significantly improved CRNAs’ knowledge and perceptions regarding AR and haptic feedback in SBE. Findings are consistent with prior evidence that immersive technologies can enhance learning by reducing cognitive load and improving efficiency. Limitations included a small sample size, asynchronous delivery potentially impacting engagement, single-site recruitment limiting generalizability, and no hands-on component, meaning outcomes reflect perception rather than skill transfer. Additionally, lack of survey answer validation could introduce response error. Despite these limitations, this module represents a feasible, scalable step toward broader simulation technology integration. Future work should assess long-term impacts on clinical performance and patient outcomes. DNPs can champion this innovation to improve care.

Keywords: Augmented reality, haptic feedback, ultrasound-guided, central line placement, needle tip tracking, simulation, education

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