Horos-based cardiac virtual anatomy as an adjunct to nurse training: a single-center randomized study

To determine whether adding Horos-based, patient-specific three-dimensional cardiac visualization to routine case-based ward-round training produced greater longitudinal improvements in nurses’ theoretical knowledge, critical-thinking disposition, and core competence. In this single-center study, 56 cardiology nurses were randomized 1:1 to routine training alone or routine training plus 12 monthly 90-minute Horos sessions. Outcomes were assessed at baseline and quarterly. Linear mixed-effects models adjusted for age, work experience, and education were the primary analysis; time-specific comparisons were exploratory. All 56 nurses completed follow-up. Scores changed significantly over time for theoretical knowledge (F = 106.96, P < 0.001), CTDI-CV (F = 14.12, P < 0.001), and CIRN (F = 4.38, P = 0.002). However, neither the group main effect nor the time-by-group interaction was significant for any outcome (all P > 0.05). Exploratory fourth-quarter mean differences favored the Horos group for theoretical knowledge (3.21 points, 95% CI 0.40 to 6.02), CTDI-CV (22.35, 95% CI 5.71 to 38.99), and CIRN (15.25, 95% CI 2.70 to 27.80); only the CTDI-CV contrast remained significant after multiplicity adjustment. Both groups improved, but the primary longitudinal analyses did not show a clear additional overall Horos effect. The fourth-quarter contrasts require confirmation in larger trials with matched teaching exposure and validated outcomes.