Fire in the operating room: Use of mixed reality simulation with nurse anesthesia students

Linda Wunder, Nicole A.Gonzaga Gomez, Juan E. Gonzalez, Greta Mitzova-Vladinov, Max Cacchione, Jampierre Mato, Cynthia L. Foronda, Jeffrey A. Groom

Research output: Contribution to journalArticlepeer-review


Background: The occurrence of a fire when implementing anesthesia is a high-risk, low-frequency event. The operating room is a high-stakes environment that has no room for error. Mixed reality simulation may be a solution to better prepare healthcare professionals. The purpose of this quantitative, descriptive study was to evaluate the technical and non-technical skills of student registered nurse anesthetists (SRNAs) who participated in a mixed reality simulation of an operating room fire. Methods: Magic Leap OneTM augmented reality headsets were used by 32 student registered nurse anesthetists to simulate an emergent fire during a simulated tracheostomy procedure. Both technical and non-technical skills were evaluated by faculty members utilizing a checklist. Results: The SRNAs' overall mean technical skill performance was 18.161.44 out of a maximum score of 20, and the mean non-technical skill performance was 91.25% out of 100%. Conclusions: This study demonstrated the utility and limitations in applying novel technology in simulation. Participants demonstrated a strong performance of technical and non-technical skills in the management of a simulated operating room fire. Recommendations for future applications include the use of multiple sensory inputs into the scenario design and including all core team members in the immersive mixed reality environment.

Original languageEnglish (US)
Article number7040040
Issue number4
StatePublished - Sep 2020


  • Anesthesia
  • Augmented reality
  • Education
  • Fire
  • Mixed reality
  • Non-technical skills
  • Nursing
  • Simulation
  • Technical skills
  • Virtual reality

ASJC Scopus subject areas

  • Communication
  • Human-Computer Interaction
  • Computer Networks and Communications


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