Using Augmented Reality to Train Kidney Care Professionals to Operate and Maintain Devices
For years Kelly was working as a nursing assistant for a home health care provider. She was working towards her RN in hopes of transitioning into a role in the kidney care field. Growing up, two of Kelly’s uncles had been on dialysis, so she had always wanted to help patients like them and others in her community with kidney disease. Before graduation, a few friends from her nursing program — all of whom went on to work with dialysis patients — had been asking Kelly to make the career transition and join them as a home therapies RN.
So when the opportunity presented itself for the position she had been waiting for, Kelly took it. She enrolled in the company's in-house training program where she spent six months learning to care for and maintain three home dialysis machines for two home therapies. She was surprised to learn that although the machines accomplished similar tasks for patients, the operational differences were far more complex and detailed than she had expected. Even further, she had not expected the training materials to be as difficult to translate into practice, nor did she think patients could have so many questions about their dialysis treatments and considerations. Luckily, throughout the training process and beyond, Kelly was surrounded by a great network of supportive RNs to help her get up to speed and established in the field.
The Current Training Program
The company’s training program consisted of online learning (at home) followed by extensive hands-on instruction at the company’s regional training facility.
Kelly had no trouble with the online training portion. In fact, she has always been good at book learning and memorization. She completed the online component in one week and was excited to start the hands-on training, in much the same way she had experienced during her clinical rotations as a nursing student. She was confident that she would excel once she had the chance to apply her new knowledge base — everything was going according to plan.
Then something unexpected happened.
When Kelly showed up to her first hands-on training session she felt completely out of place. It was as if she had learned completely different material in the online course. She figured part of the problem was that some of the online material was outdated, but quickly realized some of the material she had learned online did not translate to the hands-on clinical applications. Kelly felt like the information in her brain was useless when it came to using her hands to operate and maintain these new machines. It was like starting from square one after weeks of studying.
After much effort, twice the training time than was scheduled (and extensive help from an incredible instructor), Kelly obtained enough hands-on experience with the two dialysis machines that she was deemed qualified to serve as a home dialysis RN for her company.
Unfortunately, Kelly did not feel confident.
She felt proficient with both machines, but not confident that she understood the operation and maintenance of each machine to the level she needed. Kelly always had to stop and double check herself to make sure that she was performing the steps in the correct order, and was constantly worried that she would apply the wrong steps for the wrong machine. At the end of the day, Kelly cared deeply about her patients’ well being and did not want to make any mistakes in caring for them.
Because she lacked confidence, Kelly was dissatisfied and chronically stressed at work. Over time, and after many close calls and lessons learned, she developed the confidence that she wanted and became one of the best home dialysis nurses on the team.
Kelly’s experience is common during home dialysis training. Students often find the online information to be completely distinct from (and ineffective for developing) hands-on expertise. Although the details are beyond the scope of this report (learn more here), suffice it to say that the problem is that online learning is all cognitive in nature, whereas expertise with the dialysis machine is cognitive, behavioral and experiential. Online training provides information by engaging cognitive learning centers in the brain. Unfortunately, expertise with the operation and maintenance of a dialysis machine, and a deep understanding of the similarities and differences across machines requires that experiential and behavioral learning centers in the brain are engaged under a broad range of conditions, many that involve emotional engagement (e.g., stress, anxiety) — and a lot of it.
Hands-on training is an ideal approach to dialysis machine training because it engages cognitive, behavioral and experiential learning in the brain. The problem is that the hands-on training is only as good as the quality of the trainer, and great trainers are few and far between. Even if an organization has a fantastic trainer or two, they cannot be cloned, nor are they available 24/7.
Thus, although hands-on training is ideal, it is not consistent, scalable or available 24/7.
The ideal solution is to provide hands-on experience that is of consistent high-quality, is scalable and available 24/7.
Augmented reality (AR) devices address this need.
Imagine having Kelly don one of the many augmented reality devices such as the Microsoft Hololens or the AR glasses from RealWear while looking at a dialysis machine. Kelly can see the dialysis machine but computer-generated graphics can also be displayed on the screen that provide guidance on what steps to follow to operate and maintain the device. These come in the form of text, and colored arrows and boxes, as well as voice over from that amazing trainer.
The step-by-step training curriculum can be developed in collaboration with that amazing trainer thus allowing the organization to, in a sense, clone that trainer. The visual graphics and voice commands guide Kelly through the steps of operation and maintenance and can make a special point to highlight those critical areas of difference between the dialysis devices that can cause problems. Kelly and the thousands of other dialysis RNs in training can be trained by that expert trainer 24/7 at any location.
As Kelly gains expertise, she can be tested under time pressure to ensure that she is competent at any speed. She can be put in situations in AR where a critical tool or piece of equipment is missing and can be shown an effective work around. In short, Kelly can get limitless practice, under a broad-range of conditions.
Dialysis device education and training that relies on AR, as opposed to traditional approaches that rely on online and hands-on clinical training, lead to faster learning and stronger retention of relevant information.
Broad-based behavioral repertoires and situational awareness develop quickly and naturally in nurses. AR provides the RN-in-training with what they need, where they need it and when they need it, directly in the flow of learning. Nurses are on-the-job ready quickly and with confidence and satisfaction – one experience at a time.