Use of augmented reality in learning lumbar spinal anatomy for training in labor epidural insertion: A pilot study

Background: Augmented reality (AR) has gained importance, complementing teaching and learning in medicine. However, there is limited use of AR in anesthesia. We aimed to explore the usefulness of AR in learning spinal anatomy relevant to neuraxial needle insertion training in labor epidural analgesia with feedback from trainers and learners. Materials and Methods: A pilot study was conducted from January to March 2022 at a local specialist maternity hospital. Computer tomography images were obtained from an epidural mannequin trainer, reconstructed, and uploaded to an AR program loaded onto an AR device. Anesthetists with varying experiences utilized the AR program to evaluate the AR experience, with pre- and postuser surveys conducted. Results: Thirty-one participants were recruited with a mean (standard deviation) of 7.9 (6.2) years of anesthesia experience. Twenty-five (80.6%) were aware of AR applications, but most (80.6%) had no prior experience with AR-based learning. Using the Likert scale (1 being strongly disagree and 5 being strongly agree), the postuser survey showed median scores of ≥4 in all questions on AR-based learning. The majority (92%) agreed that the AR software should include functions for obtaining clear visualization of anatomy, rotating 3D structures, changing magnification, and selecting specific parts to focus on. Feedback also highlighted the need for familiarization and flexibility with manipulating holographic images and haptic device links for task training. Conclusions: Our study showed potential for AR in facilitating anatomy learning related to training in labor epidural insertion. Improvements through program flexibility and haptic device link could enhance task training.