{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:12:41Z","timestamp":1778649161257,"version":"3.51.4"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mastery of instrument sequencing and spatial anatomy is crucial for scrub nurses in anterior cervical spine surgery (ACSS), yet conventional training often fails to provide immersive, three-dimensional practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This randomized controlled trial evaluated a novel Mixed Reality (MR) training module against standard training for ACSS scrub nurse education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sixty nurses were randomly assigned to an MR training group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f30) or a traditional training group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f30). The intervention group completed a structured MR curriculum using Microsoft HoloLens 2, featuring interactive 3D anatomy, virtual instrument handling, and emergency scenario simulation. The control group received standard lectures and video-based instruction. Primary outcomes were scores on theoretical knowledge, practical performance, and emergency response assessments. Secondary outcomes included cognitive load (NASA-TLX) and training satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The MR group achieved significantly higher post-training scores in theoretical knowledge (92.47 vs. 86.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), practical performance (94.50 vs. 88.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and emergency response (91.73 vs. 85.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Participants in the MR group also reported a significantly lower overall cognitive load (NASA-TLX total: 28.60 vs. 36.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and markedly higher satisfaction across all measured domains (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Immersive MR training is more effective than traditional methods in developing essential knowledge, skills, and situational preparedness for ACSS. It facilitates learning by reducing cognitive burden and increasing engagement, presenting a valuable tool for advancing surgical nursing education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1818354","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:38:54Z","timestamp":1778647134000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Randomized controlled trial evaluating mixed reality technology for training scrub nurses in anterior cervical spine surgery"],"prefix":"10.3389","volume":"13","author":[{"given":"Wenqing","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Operating Room, The Affiliated Suqian Hospital of Xuzhou Medical University","place":["Suqian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Operating Room, The Affiliated Suqian Hospital of Xuzhou Medical University","place":["Suqian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1097\/BSD.0000000000001544","article-title":"Risk factors for reintubation after anterior cervical spine surgery: comparative study of patients with cervical spine trauma and patients with cervical degenerative disease","volume":"37","author":"Tanaka","year":"2024","journal-title":"Clin Spine Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.surge.2022.04.009","article-title":"Technology-enhanced learning in orthopaedics: virtual reality and multi-modality educational workshops may be effective in the training of surgeons and operating department 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