Randomized controlled trial evaluating mixed reality technology for training scrub nurses in anterior cervical spine surgery.

BACKGROUND

Mastery of instrument sequencing and spatial anatomy is crucial for scrub nurses in anterior cervical spine surgery (ACSS), yet conventional training often fails to provide immersive, three-dimensional practice.

AIM: This randomized controlled trial evaluated a novel Mixed Reality (MR) training module against standard training for ACSS scrub nurse education.

METHODS

Sixty nurses were randomly assigned to an MR training group (n = 30) or a traditional training group (n = 30). The intervention group completed a structured MR curriculum using Microsoft HoloLens 2, featuring interactive 3D anatomy, virtual instrument handling, and emergency scenario simulation. The control group received standard lectures and video-based instruction. Primary outcomes were scores on theoretical knowledge, practical performance, and emergency response assessments. Secondary outcomes included cognitive load (NASA-TLX) and training satisfaction.

RESULTS

The MR group achieved significantly higher post-training scores in theoretical knowledge (92.47 vs. 86.33, p < 0.001), practical performance (94.50 vs. 88.97, p < 0.001), and emergency response (91.73 vs. 85.40, p < 0.001). Participants in the MR group also reported a significantly lower overall cognitive load (NASA-TLX total: 28.60 vs. 36.43, p < 0.001) and markedly higher satisfaction across all measured domains (p < 0.001).

CONCLUSION

Immersive MR training is more effective than traditional methods in developing essential knowledge, skills, and situational preparedness for ACSS. It facilitates learning by reducing cognitive burden and increasing engagement, presenting a valuable tool for advancing surgical nursing education.