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

What once seemed sci-fi is now common practice in many areas of healthcare: extended reality – virtual reality, augmented reality and mixed reality – is finding favor in clinical settings and proving its worth for both patients and providers.

One major area where these technologies are enabling big innovation, of course, is in education and training for clinical staff.

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

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

We checked in with Jonathan Letourneau, innovation analyst at Mass General Brigham and Chenzhen Cao, manager of MGB’s Digital Innovation Hub, who offered a sneak-peek of their session, Training the Next Generation of Nursing Leaders Using Augmented Reality.

Q. How promising are XR and AR for training nurses, generally speaking, and what are some use cases with most potential?

A. The immersive aspect of XR technologies is very promising 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 provider. Use cases we are currently exploring involve scenario development of interactions that a nurse may encounter with a patient. That being said, currently, we face technical and financial barriers to 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 is already integrated into nurse education at Brigham and Women’s Hospital

Q. What makes these technologies useful for training?

A. XR enables two key benefits for nurse education. First, the creation of immersive educational experiences is tremendously valuable. Transitioning educational components from lectures and presentations into immersive virtual experiences helps improve knowledge retention through the use of interactive modules. Secondly, virtual experiences help reduce the material costs of nurse education. For many education sessions, nurse educators must 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 colleagues in nursing are very excited to reduce these costs.

Q. Could you offer a bit of background about your use of AR at Brigham and Women’s – specifically the feasibility study around code cart training? 

A. Our team spent over a year and a half exploring a variety of XR applications within healthcare. We followed the medical axiom of see one, do one, teach one. We began with an internal and external landscape of current solutions, while building an internal community of staff interested in XR. We activated our community through monthly events, and it is through these events that spurred many of the projects we work on today. Our work has also spread to other hospitals and areas within the larger Mass General Brigham system. So it’s been very impactful and fulfilling for us to see this work gain further traction beyond Brigham.

Q. What were some of the opportunities you uncovered in the study? What were some of the challenges or drawbacks you identified? Any surprises?

A. The opportunities we saw while conducting this study was the value in a distributed digital solution. Nursing education in its current form is hindered by the quantity of resources required to train nurses effectively. A scalable digital platform helps remove these monetary and waste costs. The drawback is some of the more tactile components of training (like inserting a needle) are more difficult to replicate in a digital setting. Haptic feedback is not accurate enough to simulate some key interactions, although we hope this barrier will be solved 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 nursing colleagues. In fact, news of our solution has reached other sites within our organization, and we are currently building three additional code carts 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 are able to follow along on their own devices. Furthermore, we built out QR code badges for each nurse to have. New nurses love the ability to review the code cart anywhere and on their own time.

Q. How do you see AR continuing to improve healthcare training and processes in the near future, particularly as the technology evolves and improves – whether in training or in other clinical areas?

A. We see the key improvement for healthcare training is in the development of interactive, responsive scenarios. Real-world training is certainly the gold standard. But training in XR allows nurses to have that near-real-world scenarios without any risk to patients. This approach of risk-free immersive training has a scope larger than nursing – this can help a wide breadth of staff train and improve their interactions, surgery, and much more.  

Q. Any closing thoughts, or hopes for what attendees will take away from this session?

A. We hope the other health systems, as well as institutions that work with healthcare players will gain an appreciation and adopt XR as part of their toolkit. There is definitely tremendous value, both from the workforce perspective, as well as infrastructure and financial. While still early, the technology and resources in XR are at a mature stage for healthcare to experiment and adopt widely.

Cao and Letourneau will explain more in their HIMSS24 session, “Training the Next Generation of Nursing Leaders Using Augmented Reality.” It’s scheduled for Tuesday, March 12, 10:15-10:45 a.m. in Room W307A. Learn more and register.