TrainAR: A Scalable Interaction Concept and Didactic Framework for Procedural Trainings Using Handheld Augmented Reality

The potential of Augmented Reality (AR) for educational and training purposes is well known. While large-scale deployments of head-mounted AR headsets remain challenging due to technical limitations and cost factors, advances in mobile devices and tracking solutions introduce handheld AR devices as a powerful, broadly available alternative, yet with some restrictions. One of the current limitations of AR training applications on handheld AR devices is that most offer rather static experiences, only providing descriptive knowledge with little interactivity. Holistic concepts for the coverage of procedural knowledge are largely missing. The contribution of this paper is twofold. We propose a scalabe interaction concept for handheld AR devices with an accompanied didactic framework for procedural training tasks called TrainAR. Then, we implement TrainAR for a training scenario in academics for the context of midwifery and explain the educational theories behind our framework and how to apply it for procedural training tasks. We evaluate and subsequently improve the concept based on three formative usability studies (n = 24), where explicitness, redundant feedback mechanisms and onboarding were identified as major success factors. Finally, we conclude by discussing derived implications for improvements and ongoing and future work.

Cardiovascular Medical Education During the Coronavirus Disease 2019 Pandemic: Challenges, Adaptations, and Considerations for the Future

The coronavirus disease 2019 (COVID-19) pandemic has greatly impacted graduate medical education for cardiovascular fellows in training. During the initial case surge in the US in early 2020, most training programs reformatted didactic curricula, redeployed fellows in training to non-cardiac services or furloughed fellows in training on non-essential services, reimagined procedural training in light of decreased case volumes, and balanced issues regarding trainee wellbeing and safety with occupational COVID-19 exposure risk. In this article, the authors review the educational challenges posed by the COVID-19 pandemic, and discuss opportunities to incorporate technological and curricular innovations spurred by the pandemic into cardiovascular fellowship training in the future.

Procedural Competency Among Hospitalists: A Literature Review and Future Considerations

BACKGROUND: As general internists practicing in the inpatient setting, hospitalists at many institutions are expected to perform invasive bedside procedures, as defined by professional standards. In reality, hospitalists are doing fewer procedures and increasingly are referring to specialists, which threatens their ability to maintain procedural skills. The discrepancy between expectations and reality, especially when hospitalists may be fully credentialed to perform procedures, poses significant risks to patients because of morbidity and mortality associated with complications, some of which derive from practitioner inexperience. METHODS: We performed a structured search of the peer-reviewed literature to identify articles focused on hospitalists performing procedures. RESULTS: Our synthesis of the literature characterizes contributors to hospitalists’ procedural competency and discusses: (1) temporal trends for procedures performed by hospitalists and their associated referral patterns, (2) data comparing use and clinical outcomes of procedures performed by hospitalists compared with specialists, (3) the lack of nationwide standardization of hospitalist procedural training and credentialing, and (4) the role of medical procedure services, although limited in supportive evidence, in concentrating procedural skill and mitigating risk in the hands of a few well-trained hospitalists. CONCLUSION: We conclude with recommendations for hospital medicine groups to ensure the safety of hospitalized patients undergoing bedside procedures.