Abstract

Background: Central line placement (CLP) is a critical skill for nurse anesthesiology residents, yet proficiency gaps can lead to serious complications, including arterial puncture, hematoma, and pneumothorax. Although ultrasound guidance is the current standard for teaching this procedure, it lacks tactile feedback, which limits learners’ spatial awareness and control—both essential for accurate needle tip tracking (NTT). This shortcoming in traditional simulation-based education (SBE) contributes to inconsistent skill acquisition and potential patient harm. . This project aimed to determine whether, among nurse anesthesiology residents, the use of AR haptic feedback versus ultrasound-guided methods in SBE would improve success in needle tip tracking. While simulation-based education is widely recognized as an effective training method, there are limited studies comparing advanced simulation modalities, such as AR with haptic feedback to traditional US-guided methods. There is an absence of innovative techniques that incorporate tactile feedback into simulation-based instruction in current practice.

Methods: A systematic review of PubMed, Cumulated Index in Nursing and Allied Health Literature, and Embase was performed. The search utilized the Boolean string: ("augmented reality" OR "haptic feedback" OR "virtual reality" OR "ultrasound-guided" OR "ultrasound") AND ("central line placement" OR "needle tip tracking" OR "venous catheterization") AND ("simulation" OR "education" OR "mannequin"). Upon applying inclusion and exclusion criteria, 10 articles were selected for the review, consisting primarily of RCTs.

Discussion: The studies explored the use of AR haptic feedback versus US-guided methods for improving needle tip tracking success in simulation-based education for nurse anesthesiology residents. A total of 315 participants were involved, with 143 in the augmented reality group and 172 in the ultrasound-guided group. Key outcomes across the studies included needle tip tracking accuracy, training efficiency, and resident self-efficacy. All of the studies considered procedural success rates as a primary outcome, while simulation performance, time to completion, and post-training confidence were secondary outcomes.

Notes

References:

1. Pepley DF, Gordon AB, Yovanoff MA, et al. Training surgical residents with a haptic robotic central venous catheterization simulator. J Surg Educ. 2017;74(6):1066-1073. doi:10.1016/j.jsurg.2017.06.003

2. Liao SC, Shao SC, Gao SY, Lai EC. Augmented reality visualization for ultrasound-guided interventions: A pilot randomized crossover trial to assess trainee performance and cognitive load. BMC Med Educ. 2024;24(1):1058. doi:10.1186/s12909-024-05998-8

3. Andersen NL, Jensen RO, Posth S, Laursen CB, Jørgensen R, Graumann O. Teaching ultrasound-guided peripheral venous catheter placement through immersive virtual reality. Medicine. 2021;100(27). doi:10.1097/md.0000000000026394

4. Zhao Y, Zheng S, Cai N, et al. Utility of artificial intelligence for real-time anatomical landmark identification in ultrasound-guided thoracic paravertebral block. J Digit Imaging. 2023;36(5):2051-2059. doi:10.1007/s10278-023-00851-8

5. Vinayagamurugan A, Badhe AS, Jha AK. Comparison of external jugular vein-based surface landmark approach and ultrasound-guided approach for internal jugular venous cannulation: A randomised crossover clinical trial. Int J Clin Pract. 2021;75(3):e13783. doi:10.1111/ijcp.13783

Description

The literature emphasizes that feedback mechanisms enhance procedural accuracy, efficiency, and safety. These technologies offer adaptable and individualized learning experiences. This research demonstrates that systems designed to provide real-time performance data not only help trainees recognize errors but also foster a deeper understanding of the skills required for CLP. This evidence reinforces the importance of integrating feedback-rich technologies into educational curricula.

Author Details

Arielle Kayla Vargas, DNP, CRNA, APRN; Yasmine N. Campbell DNP, CRNA, APRN, CNE, CHSE, FAANA (Member of Sigma's Pi Alpha chapter); Valerie J. Diaz, DNP, CRNA, PMHNP-BC, APRN, CNE, CHSE, FAANA, CAPT (ret), NC, USN (Submitting author and presenter. Member of Sigma's Pi Alpha chapter)

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Emerging Technologies, Simulation, Virtual Learning, Haptic Devices, Augmented Reality, Virtual Reality, Simulation Methods & Models

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-09-06

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The Utilization of Augmented Reality Haptic Feedback for Simulation-Based Education: A Quality Improvement Project

Toronto, Ontario, Canada

Background: Central line placement (CLP) is a critical skill for nurse anesthesiology residents, yet proficiency gaps can lead to serious complications, including arterial puncture, hematoma, and pneumothorax. Although ultrasound guidance is the current standard for teaching this procedure, it lacks tactile feedback, which limits learners’ spatial awareness and control—both essential for accurate needle tip tracking (NTT). This shortcoming in traditional simulation-based education (SBE) contributes to inconsistent skill acquisition and potential patient harm. . This project aimed to determine whether, among nurse anesthesiology residents, the use of AR haptic feedback versus ultrasound-guided methods in SBE would improve success in needle tip tracking. While simulation-based education is widely recognized as an effective training method, there are limited studies comparing advanced simulation modalities, such as AR with haptic feedback to traditional US-guided methods. There is an absence of innovative techniques that incorporate tactile feedback into simulation-based instruction in current practice.

Methods: A systematic review of PubMed, Cumulated Index in Nursing and Allied Health Literature, and Embase was performed. The search utilized the Boolean string: ("augmented reality" OR "haptic feedback" OR "virtual reality" OR "ultrasound-guided" OR "ultrasound") AND ("central line placement" OR "needle tip tracking" OR "venous catheterization") AND ("simulation" OR "education" OR "mannequin"). Upon applying inclusion and exclusion criteria, 10 articles were selected for the review, consisting primarily of RCTs.

Discussion: The studies explored the use of AR haptic feedback versus US-guided methods for improving needle tip tracking success in simulation-based education for nurse anesthesiology residents. A total of 315 participants were involved, with 143 in the augmented reality group and 172 in the ultrasound-guided group. Key outcomes across the studies included needle tip tracking accuracy, training efficiency, and resident self-efficacy. All of the studies considered procedural success rates as a primary outcome, while simulation performance, time to completion, and post-training confidence were secondary outcomes.