Augmented Reality Medical Simulation: A Multi-Site Study of Factors That Influence Acceptance

Background: The infrequent occurrence of resuscitating critically ill pediatric patients poses educational challenges for pediatric anesthesiology residents developing competence. Traditional medical simulations, despite their utility, incur significant costs due to the need for monitors, mannequins, and personnel. Augmented reality (AR) medical simulation shows promise as an alternative clinical teaching tool. The Technology Acceptance Model (TAM) assesses usefulness, ease of use, and attitudes toward new technologies, offering insights into their adoption. Following successful application with other healthcare innovations, the TAM can also assess innovations in pediatric anesthesiology resident education, including AR medical simulation. Aims: The primary aim identified factors that influenced acceptance of AR for medical simulation in pediatric anesthesiology using a TAM. The secondary aims assessed the model's reliability, usability, and ergonomics. Methods: This prospective, multi-site study was carried out across nine academic children's hospitals around the United States and Hong Kong. We recruited anesthesiology residents with a minimum of two weeks of pediatric anesthesia experience, excluding those with severe motion sickness, seizures, or who wore corrective glasses. Using Magic Leap 1 headsets, participants underwent a simulated AR pediatric resuscitation scenario. Data were collected via electronic surveys, evaluating TAM factors, usability (System Usability Scale), and ergonomics (ISO 9241-400 standard). Results: A total of 101 participants completed the study. The AR TAM model indicated that perceived ease of use and computer self-efficacy predicted perceived usefulness. Behavioral intention to use the AR system was influenced by perceived usefulness and perceived ease of use. System usability scores showed 83% agreement on ease of use. Ergonomic assessments indicated minimal physical discomfort. Conclusion: AR simulations are highly acceptable and usable for pediatric resuscitation training, with perceived ease of use and computer self-efficacy influencing AR adoption. These findings align with previous TAM studies, supporting AR's potential to supplement traditional simulations and enhance accessibility.