Exploring the use of the HoloLens as an innovative means to facilitate early clinical exposure in medical school

BACKGROUND  Studies have shown that acute medicine is poorly taught in medical school 1 . Subsequently students feel unprepared for clinical practice when entering Foundation Training 2 . The GMC recommends early clinical exposure to maximise students’ learning 3 . The HoloLens 2 (HL2), mixed reality headset allows the projection of an unwell patient into the classroom using the HoloPatient and Remote Assist applications. These features can provide clinical exposure in a safe setting, without disrupting the clinical environment, thus optimising student learning. This study explored student perceptions of the use of applications on the HL2 to facilitate clinical learning within a classroom setting. SUMMARY OF WORK Whilst on their elective, two groups of American third year medical students (n=7) attended four tutorials (2 = traditional, 1 = Remote Assist, 1 = HoloPatient). In this mixed method study pre and post-tutorial questionnaires that measured changes in confidence levels were statistically analysed using a Wilcoxon Signed-Rank test. Student perceptions of the HL2 and its applications were explored using focus groups which were thematically analysed. SUMMARY OF RESULTS Data suggested that the HoloPatient tutorials had a greater effect on both groups’ confidence levels when compared to the Remote Assist tutorials, although this was not statistically significant (Group 1: p=0.072, Group 2:  p=0.127). Three themes were revealed from the qualitative analysis, promoting the HL2; ‘ creating a safe learning environment’, ‘painting the clinical picture’ and ‘immersive experience’.  A subtheme of ‘improved engagement’ was exclusively seen with the HoloPatient. Although limitations in the technology were evident, more effective uses of the Remote Assist feature were identified by students and will be incorporated into future tutorials. DISCUSSION AND CONCLUSION This study suggests that both of the HL2’s applications provide an immersive learning experience that is desired by students. The HoloPatient although engaging, stimulates a single modality, where as the Remote Assist feature allows two-way communication between patient and classroom. Therefore if used effectively can transform clinical learning with minimal disruption to patient care. Future studies should explore the HoloLens’ as a means of creating a safe and diverse learning environment.