Use of smart glasses technology for indirect supervision of trainee learning events in University Hospitals Sussex NHS Trust critical care units

Introduction: Telementoring offers the potential for indirect evaluation of a trainee’s independent performance. Wearable devices enhance remote clinical skills monitoring due to portability and hands-free use. Studies in surgery demonstrate educational uses in anatomical teaching and surgical telementoring. Evidence regarding ICU telementoring is limited. One study conducted telementored ward rounds on a neurocritical care during the SARS CoV-2 pandemic, reporting high user satisfaction.
Objectives: Does the use of smart glasses for indirect supervision of trainees during supervised learning events (SLEs) enhance the educational experience of the trainee and trainer?
Methods: The project was approved by the research and development department. Ethical approval was not required because the protocol did not affect usual clinical practise. Vuzix M300 smart glasses allow continuous audio-visual teleconferencing to an iPad for remote trainee supervision (RTS). The trainee wore smart glasses throughout a clinical encounter, conducting their usual clinical practice. The consultant assessor was in a private non-clinical area, observing the trainee’s clinical interaction indirectly by continuous audio-visual streaming to an iPad. The iPad used a single account on a dedicated device over hospital Wi-Fi. No material was recorded. Both participants completed a QR code linked online satisfaction survey. User experience and technical feasibility were assessed using Likehart scales and free text
answers.
Results: Ten RTS episodes were undertaken, completed questionnaires were received from 9 trainees and 10 consultants. The SLEs were 50% case based discussions and 50% mini clinical evaluation exercises. 80% of trainees were at core training level. Thematic analysis of the free text showed prominent
negative themes of inadequate Wi-Fi, causing disruption of video conferencing, and feeling self-conscious. A prominent positive theme was the innovative use of
technology to capture real time events whilst still allowing the trainee to practice independently.
Conclusions: Telementoring has potential to enhance the value of feedback from SLEs, especially for trainees transitioning from directly to indirectly supervised practise. Reliable WiFi and a more intuitive smart glasses interface would allow RTS to be adopted more readily.