Mobile Augmented Reality as a Feature for Self-Oriented, Blended Learning in Medicine: Randomized Controlled Trial

Abstract

BackgroundAdvantages of mobile Augmented Reality (mAR) application-based learning versus textbook-based learning were already shown in a previous study. However, it was unclear whether the augmented reality (AR) component was responsible for the success of the self-developed app or whether this was attributable to the novelty of using mobile technology for learning.ObjectiveThe study’s aim was to test the hypothesis whether there is no difference in learning success between learners who employed the mobile AR component and those who learned without it to determine possible effects of mAR. Also, we were interested in potential emotional effects of using this technology.MethodsForty-four medical students (male: 25, female: 19, mean age: 22.25 years, standard deviation [SD]: 3.33 years) participated in this study. Baseline emotional status was evaluated using the Profile of Mood States (POMS) questionnaire. Dermatological knowledge was ascertained using a single choice (SC) test (10 questions). The students were randomly assigned to learn 45 min with either a mobile learning method with mAR (group A) or without AR (group B). Afterwards, both groups were again asked to complete the previous questionnaires. AttrakDiff 2 questionnaires were used to evaluate the perceived usability as well as pragmatic and hedonic qualities. For capturing longer term effects, after 14 days, all participants were again asked to complete the SC questionnaire. All evaluations were anonymous, and descriptive statistics were calculated. For hypothesis testing, an unpaired signed-rank test was applied.ResultsFor the SC tests, there were only minor differences, with both groups gaining knowledge (average improvement group A: 3.59 [SD 1.48]; group B: 3.86 [SD 1.51]). Differences between both groups were statistically insignificant (exact Mann Whitney U, U=173.5; P=.10; r=.247). However, in the follow-up SC test after 14 days, group A had retained more knowledge (average decrease of the number of correct answers group A: 0.33 [SD 1.62]; group B: 1.14 [SD 1.30]). For both groups, descriptively, there were only small variations regarding emotional involvement, and learning experiences also differed little, with both groups rating the app similar for its stimulating effect.ConclusionsWe were unable to show significant effects for mAR on the immediate learning success of the mobile learning setting. However, the similar level of stimulation being noted for both groups is inconsistent with the previous assumption of the success of mAR-based approach being solely attributable to the excitement of using mobile technology, independent of mAR; the mAR group showed some indications for a better long-term retention of knowledge. Further studies are needed to examine this aspect.Trial RegistrationGerman Clinical Trials Register (DRKS): 00012980; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012980 (Archived by WebCite at http://www.webcitation.org/ 6tCWoM2Jb).

Exploring mobile mixed reality in healthcare higher education: A systematic review

“…Not all studies identified the participant age and/or gender. Two studies included undergraduate nursing students (Aebersold et al 2018;Garrett, Jackson, and Wilson 2015); 12 included medical students (Albrecht et al 2013;Amer et al 2017;Bartlett et al 2017;De Oliveira et al 2013;John et al 2015;Kowalewski et al 2017;Küçük, Kapakin, and Göktaş 2016;Moro et al 2017;Morone et al 2017;Noll et al 2014Noll et al , 2017Sugand, Mawkin, and Gupte 2015); 3 included paramedicine students (Birt et al 2017a(Birt et al , 2017bCowling and Birt 2018) and 1 included dentistry students (Khelemsky, Hill, and Buchbinder 2017).…”

“…Common skills included mMR was utilised for procedural clinical skills, assessment skills and anatomy knowledge. Twelve studies focused on clinical skills, with the majority focused on catheter or scope insertion (Aebersold et al2018;Bartlett et al 2017;Birt et al 2017aBirt et al , 2017bCowling and Birt 2018;De Oliveira et al 2013); surgical procedures (Amer et al 2017;John et al 2015;Khelemsky, Hill, and Buchbinder 2017;Kowalewski et al 2017;Morone et al 2017); familiarisation with general clinical skills and equipment (Garrett, Jackson, and Wilson 2015); wound and dermatology management (Albrecht et al 2013;Noll et al 2014Noll et al , 2017; and aiding clinical anatomy knowledge (Küçük, Kapakin, and Göktaş 2016;Moro et al 2017). One study used mMR for augmenting a respiratory failure case scenario (Garrett, Jackson, and Wilson 2015).…”

“…The majority of studies included iPhone and/or Android mobile phones (Albrecht et al 2013;Amer et al 2017;Bartlett et al 2017;Birt et al 2017aBirt et al , 2017bCowling and Birt 2018;De Oliveira et al 2013;Garrett, Jackson, and Wilson 2015;John et al 2015;Khelemsky, Hill, and Buchbinder 2017;Küçük, Kapakin, and Göktaş 2016;Morone et al 2017;Noll et al 2014Noll et al , 2017, with some also including tablets alongside the phones or as the sole means of mMR. The iPad was mentioned in the majority of tablet-led studies (Aebersold et al 2018;De Oliveira et al 2013;Garrett, Jackson, and Wilson 2015;John et al 2015;Khelemsky, Hill, and Buchbinder 2017;Kowalewski et al 2017;Küçük, Kapakin, and Göktaş 2016;Noll et al 2014Noll et al , 2017, while others used the iPad alongside other tablets or did not specify the brand or type (Garrett, Jackson, and Wilson 2015;Khelemsky, Hill, and Buchbinder 2017;Küçük, Kapakin, and Göktaş 2016;Moro et al 2017). Google Cardboard or ColorCross were also used with mobile phones in three studies (Birt et al 2017a(Birt et al , 2017bCowling and Birt 2018).…”

An app to enhance resident education in otolaryngology

“…Also, a Hawthorne effect may have existed in which residents, knowing they are being studied, perhaps modified their behaviors via higher engagement with the app and increased studying. However, the use of a mobile app in and of itself has been demonstrated in multiple studies to enhance engagement among millennials . One of the greatest challenges with the implementation of the app was the limited involvement of faculty attendings.…”

“…However, the use of a mobile app in and of itself has been demonstrated in multiple studies to enhance engagement among millennials. [17][18][19][20][21] One of the greatest challenges with the implementation of the app was the limited involvement of faculty attendings. Reportedly, many faculty had difficulty incorporating the app into their daily workflow.…”