Evaluating the Impact of a Mixed-reality Simulator for Point-of-care Echocardiography Training for Novice Trainees: A Parallel Group Feasibility Study

BACKGROUND AND AIMS: While learning point-of-care ultrasound (POCUS), novice critical care trainees often face challenges in spatial understanding and image acquisition. This study evaluated the feasibility and user experience of an ultraportable mixed-reality (MR) echocardiography simulator as an adjunct to conventional patient-based teaching. PATIENTS AND METHODS: In a parallel group feasibility study in two tertiary intensive care units (ICUs) in India, 14 novice intensive care trainees received a 45-minute didactic session and were randomized into two groups: Group I performed an initial echocardiogram on a patient and group II on the simulator. Following this, both groups performed a second scan on a different ICU patient in alternating sequence. Primary outcomes included trainee feedback on simulator design, comfort, usability, and image realism. Secondary outcomes included setup time, trainee handover and onboarding times, barriers to use, and the time required to acquire echocardiographic views. RESULTS: Simulator setup took 92 seconds; median handover and onboarding times were 45 (41.5–48) and 66 (54.5–69.5) seconds, respectively. All trainees reported satisfaction with simulator design and image realism; 10 felt it improved spatial understanding. Reported challenges included headset fit for spectacle wearers, battery life, and anatomical alignment. Group II acquired acceptable images faster than group I (8.1 vs 9.7 minutes; p = 0.002). CONCLUSION: In this pilot feasibility study, the simulator demonstrated operational feasibility and was well-received in a workshop setting. Its potential role as a training adjunct for POCUS education to enhance image acquisition skills in novice critical care trainees needs to be validated in larger studies with an adequate sample size and robust clinical and educational outcomes.