Collocated mixed reality for basic life support training in medical students: a randomised pilot feasibility trial

Background Simulation-based basic life support (BLS) training often lacks patient-level and contextual realism. Mixed reality (MR) may enrich manikin-based simulation with virtual patient cues while preserving tactile interaction. This study evaluated the feasibility of integrating collocated MR-supported BLS training into undergraduate instruction. Methods We conducted a single-centre, 1:1 randomised pilot feasibility trial embedded within an 8-hour BLS course. First-year medical students were randomised to MR-supported or conventional training. Feasibility domains included course integration, same-day safety and technical delivery, learner-reported workload, and exploratory MR-specific usability and acceptability feedback. Secondary learner-reported outcomes included self-efficacy, situational motivation, student satisfaction and self-confidence in learning. Results Sixty-one students participated (MR n = 31; control n = 30), of whom 53 completed the post-training questionnaire (MR n = 24; control n = 29). MR-supported training was delivered within the scheduled course. No technical failures prevented delivery, and no falls, severe discomfort, or headset-related events requiring discontinuation were recorded. Learner-reported workload did not differ significantly between groups (NASA Task Load Index mean difference, MR minus control: 0.63; 95% CI -1.20 to 2.47; p = 0.49). Secondary learner-reported outcomes did not differ significantly between groups. Exploratory open-ended feedback from 10 of 31 participants in the MR arm identified areas for refinement, including headset stability, avatar responsiveness, and integration into teaching; views of added value were mixed. Conclusions Collocated MR-supported BLS training could be integrated into undergraduate instruction, with no evidence of higher learner-reported workload. Further refinements should precede larger evaluations of objective BLS performance, retention, and transfer.