Augmented reality and mixed reality for healthcare education beyond surgery: an integrative review

Abstract

Objective: This study aimed to review and synthesize the current research and state of augmented reality (AR), mixed reality (MR) and the applications developed for healthcare education beyond surgery. Methods: An integrative review was conducted on all relevant material, drawing on different data sources, including the databases of PubMed, PsycINFO, and ERIC from January 2013 till September 2018. Inductive content analysis and qualitative synthesis were performed. Additionally, the quality of the studies was assessed with different structured tools. Results: Twenty-six studies were included. Studies based on both AR and MR involved established applications in 27% of all cases (n=6), the rest being prototypes. The most frequently studied subjects were related to anatomy and anesthesia (n=13). All studies showed several healthcare educational benefits of AR and MR, significantly outperforming traditional learning approaches in 11 studies examining various outcomes. Studies had a low-to-medium quality overall with a MERSQI mean of 12.26 (SD=2.63), while the single qualitative study had high quality. Conclusion: This review suggests the progress of learning approaches based on AR and MR for various medical subjects while moving the research base away from feasibility studies on prototypes. Yet, lacking validity of study conclusions, heterogeneity of research designs and widely varied reporting challenges transferability of the findings in the studies included in the review. Future studies should examine suitable research designs and instructional objectives achievable by AR and MR-based applications to strengthen the evidence base, making it relevant for medical educators and institutions to apply the technologies.

Current Perspectives on Augmented Reality in Medical Education: Applications, Affordances and Limitations

“… 12 A further review of research into AR in orthopedic surgery also included some examples of education and training. 13 There have also been some more general analyses of the literature pertaining to AR in medical education, for example a review of articles relating to AR for healthcare education in areas other than surgery, 14 while Barsom et al and Tang et al have produced systematic reviews of augmented reality across all aspects of medical education. 15 , 16 Both these studies focused specifically on the different types of AR applications (ARAs) adopted in medical education.…”

Augmenting Surgery: Medical Students’ Assessment and Ergonomics of 3D Holograms vs. CT Scans for Pre-Operative Planning

“…decades, especially in the field of surgery, is Mixed Reality (MR) [6][7][8]. While Virtual Reality refers to devices that fully immerse the users within virtual simulations (also employed in surgery education) [8], MR could be defined as the merging of real and digital stimuli, aimed at enriching user's perception and interaction; in the literature it could be referred to also as "augmented reality" (AR) or "augmented virtuality" (AV), depending on whether the emphasis is put on the real or the digital stimuli.…”

Effectiveness of the Use of Augmented Reality in Teaching the Management of Anaphylactic Shock at the Primary Care Level: Protocol for a Randomized Controlled Trial

“…The other 3 levels will be assessed through the RCT: (1) construct validity (ie, inherent differences in outcome between experts and novices on outcome parameters relevant to the educational construct), (2) concurrent validity (ie, concordance of the subject's outcome parameters using AR compared to the outcome parameters of an established instrument or method that is assumed to measure the same educational construct), and (3) predictive validity (ie, the degree of agreement between the outcome parameters of AR and the respondent's performance goals, which are supposed to be similar in reality). With the qualitative part of the study, we also want to address the possible downsides of the use of AR in medical education that have already been reported in previous studies [ 15 ].…”

“…Despite the growing body of evidence that AR is effective in medical education, some studies failed to confirm this, reporting no significant impact of the use of AR on learning and no differences according to device used (mobile or other) [ 15 ].…”