Mixed reality versus manikins in basic life support simulation-based training for medical students in France: the mixed reality non-inferiority randomized controlled trial

To compare the effectiveness of mixed reality with traditional manikin-based simulation in basic life support (BLS) training, testing the hypothesis that mixed reality is non-infe rior to manikin-based simulation. A non-inferiority randomized controlled trial was conducted. Third-year medical students were randomized into 2 groups. The mixed reality group received 32 minutes of individual training using a virtual reality headset and a torso for chest compressions (CC). The manikin group participated in 2 hours of group training consisting of theoretical and practical sessions using a low-fidelity manikin. The primary outcome was the overall BLS performance score, assessed at 1 month through a standardized BLS scenario using a 10-item assessment scale. The quality of CC, student satisfaction, and confidence levels were secondary outcomes and assessed through superiority analyses.