Exploring different communication modes for intravenous infusion training using mixed reality: A healthcare e-learning case study with student directed learning

Rohith Jayaraman Krishnamurthy, Vanessa Lo, Jay Jang, Iman Jalilvand, Abhijit Date, Debra Ambrosetti, Hamid Khayyam, Khalad Hasan, Abbas Sadeghzadeh Milani · Computers in Human Behavior Reports · 2025

The COVID-19 pandemic presented challenges for healthcare students, necessitating the acquisition of clinical skills through online learning due to time constraints and limited access to medical supplies. In response to such major interruptions in the healthcare-related and other educational sectors, extended reality (XR) technologies have been swiftly emerging as a promising solution. Our case study here focuses on developing an augmented reality training platform in Unity, and compatible with Microsoft HoloLens. This platform often projects the virtual training components into the user’s surrounding real-world environment, reducing dependence on physical lab sessions and promoting Student Directed Learning (SDL). To illustrate the platform's effectiveness, we focused on teaching the assembly of an intravenous infusion (IV) pump. Four communication/mentoring modes (computer agent-text, agent-audio, human-text, and human-audio) have been enabled within the present XR-based SDL tool. A user study with 8 senior nursing students revealed that the agent-text mode (out of all four modes) was the most effective, considering trust, reliability, usefulness, satisfaction, and ease of use measures. • Developed an Extended Reality with different communication modes for IV infusion training. • Emphasized Student Directed Learning, fostering motivation and deeper engagement. • User study included trust, reliability, usefulness, satisfaction, and ease of use. • Computer agent instructor-text mode delivery was top-ranked communication option.

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