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Use of an augmented reality application for paediatric code cart training
  1. Keith Hanson1,
  2. Nadia Shaikh1,
  3. Abigail Wooldridge2,
  4. Harleena Kendhari1,
  5. Sara M Krzyzaniak3,
  6. Teresa Riech4,
  7. Elsa Vazquez-Melendez1,
  8. Matthew Mischler5,
  9. Rebecca Ebert-Allen6,
  10. Ginger Barton7,
  11. Kyle Formella6,
  12. Zachary Abbott6,
  13. David Wolfe8,
  14. Trina Croland1
  1. 1 Department of Pediatrics, University of Illinois College of Medicine, Peoria, Illinois, USA
  2. 2 Department of Industrial & Enterprise Systems Engineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
  3. 3 Department of Emergency Medicine, Stanford University, Stanford, California, USA
  4. 4 Department of Emergency Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA
  5. 5 Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA
  6. 6 Jump Simulation, OSF HealthCare System, Peoria, Illinois, USA
  7. 7 Children's Service Line, OSF HealthCare System, Peoria, Illinois, USA
  8. 8 Healthcare Analytics, OSF Healthcare System, Peoria, Illinois, USA
  1. Correspondence to Dr Trina Croland, Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL 61637, USA; Trina.D.Croland{at}

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Summary box

What are the new findings?

  • The literature suggests that augmented reality (AR) is a feasible and engaging platform for foundational learning events, particularly where the visualisation and recognition of devices, medications and tools are the objectives.

  • This study found that mobile-based AR training can provide familiarity with low-frequency and high-risk equipment and its location, to optimise speed and efficiency.

How might it impact on healthcare in the future?

  • Educators may wish to leverage mobility-based AR for foundational learning which may ‘layer’ experience and create efficiencies for learners.

  • Use of ‘bring your own device’ asynchronous training has the advantages of time, place and learner readiness often preferred by adult learners.


Paediatric resuscitation is recognised as a low-volume, high-stress environment for even the most experienced practitioners. Stress can be amplified if rescue equipment is not readily available. Time is critical and delays in the delivery of medications have been shown to decrease the odds of survival in children and adults.1 While most providers working in healthcare areas are certified to provide life support, knowledge of the resuscitation cart contents and timely access to the right equipment are challenging. These factors may lead to delays in providing optimal patient care and compromise patient safety.2

Simulation is one way to identify factors that potentially affect patient safety,3 and our experience with simulation at our institution has demonstrated that many providers do not feel comfortable accessing the code cart and locating items within it. The Joint Commission has emphasised the development of standardised staff education of cart contents and drawer organisation for patient safety.4 There is evidence that weight-based dosing carts are superior in paediatrics.5 6 The use of weight-based dosing carts is endorsed by the American Heart Association.7 8 However, there is neither a standard for training on cart contents nor is there standardisation on how the paediatric code cart is stocked, …

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  • Contributors TC, KH, NS, HK, MM, TR, SMK, EV-M and GB served as clinical content experts for application development, designed the study and ran the study activity. AW served as human factors expert and participated in study design. RE-A contributed to the design and execution of the study. KF and ZA participated in application design and technical development. DW participated in data analysis. All authors contributed to and reviewed the final manuscript.

  • Funding Funding for this project was obtained from local institutional grants: a Dean's Award for Innovative Medical Education (University of Illinois College of Medicine at Peoria) and a Jump Applied Research through Community Health through Engineering and Simulation grant. There are no applicable grant award numbers.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.