There is growing interest in using immersive technology, which includes augmented, virtual, and mixed reality, in medical education. We conducted a narrative literature review to identify elements to consider when using immersive technologies in medical education. Our search revealed clusters of key articles for different applications that point to four categories of elements to consider. We recommend matching learning objectives with choices aligned with these elements for the purchase, implementation, and use of immersive technologies with individuals and groups of medical students.
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References
1.
AndreattaP. B.et al. (2010). “Virtual reality triage training provides a viable solution for disaster-preparedness.” Acad Emerg Med17(8): 870-876.
2.
BartlettR. D.et al. (2017). “A pilot study to assess the utility of a freely downloadable mobile application simulator for undergraduate clinical skills training: a single-blinded, randomised controlled trial.” BMC Med Educ17(1): 247.
3.
BermanN. B.ArtinoA. R.Jr. (2018). “Development and initial validation of an online engagement metric using virtual patients.” BMC Med Educ18(1): 213.
4.
BowyerM. W.et al. (2010). “Teaching breaking bad news using mixed reality simulation.” J Surg Res159(1): 462-467.
5.
ChengA.,
et al. (2014). “Technology-enhanced simulation and pediatric education: a meta-analysis.” Pediatrics133(5): e1313-1323.
6.
CourteilleO.et al. (2018). “Learning through a virtual patient vs. recorded lecture: a comparison of knowledge retention in a trauma case.” Int J Med Educ9: 86-92.
7.
De LeoG.et al. (2014). “Measuring sense of presence and user characteristics to predict effective training in an online simulated virtual environment.” Simul Healthc9(1): 1-6.
8.
DengX.et al. (2018). “Effectiveness evaluation of digital virtual simulation application in teaching of gross anatomy.” Ann Anat218: 276-282.
9.
EkstrandC.et al. (2018). “Immersive and interactive virtual reality to improve learning and retention of neuroanatomy in medical students: a randomized controlled study.” CMAJ Open6(1): E103-E109.
10.
EllingtonD. R.et al. (2018). “Female Pelvic Floor Immersive Simulation: A Randomized Trial to Test the Effectiveness of a Virtual Reality Anatomic Model on Resident Knowledge of Female Pelvic Anatomy.” J Minim Invasive Gynecol.
11.
FooJ. L.et al. (2013). “Evaluating mental workload of two-dimensional and three-dimensional visualization for anatomical structure localization.” J Laparoendosc Adv Surg Tech A23(1): 65-70.
12.
GurusamyK.AggarwalR.PalaniveluL.DavidsonB. R. (2008). Systematic review of randomized controlled trials on the effectiveness of virtual reality training for laparoscopic surgery. British Journal of Surgery, 95(9), 1088-1097.
13.
Gutierrez-MaldonadoJ.,
et al. (2014). “Virtual humans and formative assessment to train diagnostic skills in bulimia nervosa.” Stud Health Technol Inform199: 30-34.
14.
HamstraSJBrydgesRHatalaRZendejasBCookDA.Reconsidering fidelity in simulation-based training. Acad Med. 2014Mar;89(3):387-92. doi: 10.1097/ACM.0000000000000130
15.
HuangC. Y.et al. (2018). “The use of augmented reality glasses in central line simulation: “see one, simulate many, do one competently, and teach everyone”.” Adv Med Educ Pract9: 357-363.
16.
HuangZ.,
et al. (2018). “Three-dimensional printing model improves morphological understanding in acetabular fracture learning: A multicenter, randomized, controlled study.” PLoS One13(1): e0191328.
17.
IzardS. G.et al. (2018). “Virtual Reality as an Educational and Training Tool for Medicine.” J Med Syst42(3): 50.
18.
JungE. Y.et al. (2012). “Evaluation of practical exercises using an intravenous simulator incorporating virtual reality and haptics device technologies.” Nurse Educ Today32(4): 458-463.
19.
KavanaghS.Luxton-ReillyA.WuenscheB.PlimmerB. (2017). A systematic review of Virtual Reality in education. Themes in Science and Technology Education, 10(2), 85-119.
20.
KayDKibbleJ.Learning theories 101: application to everyday teaching and scholarship. Adv Physiol Educ. 2016Mar;40(1):17-25. doi: 10.1152/advan.00132.2015
21.
KockroR. A.et al. (2015). “Stereoscopic neuroanatomy lectures using a three-dimensional virtual reality environment.” Ann Anat201: 91-98.
22.
KronF. W.et al. (2017). “Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.” Patient Educ Couns100(4): 748-759.
23.
KucukS.,
et al. (2016). “Learning anatomy via mobile augmented reality: Effects on achievement and cognitive load.” Anat Sci Educ9(5): 411-421.
24.
KugelmannD.,
et al. (2018). “An Augmented Reality magic mirror as additive teaching device for gross anatomy.” Ann Anat215: 71-77.
25.
KyawB. M.et al. (2019). “Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.” J Med Internet Res21(1): e12959.
26.
Luigi IngrassiaP.et al. (2015). “Virtual reality and live simulation: a comparison between two simulation tools for assessing mass casualty triage skills.” Eur J Emerg Med22(2): 121-127.
27.
MareskyH. S.et al. (2019). “Virtual reality and cardiac anatomy: Exploring immersive three-dimensional cardiac imaging, a pilot study in undergraduate medical anatomy education.” Clin Anat32(2): 238-243.
28.
McGrathJ. L.et al. (2018). “Using Virtual Reality Simulation Environments to Assess Competence for Emergency Medicine Learners.” Acad Emerg Med25(2): 186-195.
29.
McGrathJ.et al. (2015). “Virtual alternative to the oral examination for emergency medicine residents.” West J Emerg Med16(2): 336-343.
30.
MichaelM.et al. (2014). “Performance of technology-driven simulators for medical students–a systematic review.” J Surg Res192(2): 531-543.
31.
MilgramP.ColquhounH. (1999). A taxonomy of real and virtual world display integration. Mixed reality: Merging real and virtual worlds, 1, 1-26.
32.
MilgramP.KishinoF. (1994). A taxonomy of mixed reality visual displays. IEICE TRANSACTIONS on Information and Systems, 77(12), 1321-1329.
33.
MilitelloL.SusherebaC.BarrieM.PattersonE. (2019, March) Augmented Reality Adaptive Training Principles, Paper presented at the Human Factors and Ergonomics Society Healthcare Symposium, Chicago, IL.
34.
MoroC.et al. (2017). “The effectiveness of virtual and augmented reality in health sciences and medical anatomy.” Anat Sci Educ10(6): 549-559.
35.
NicholsonD. T.et al. (2006). “Can virtual reality improve anatomy education? A randomised controlled study of a computer-generated three-dimensional anatomical ear model.” Med Educ40(11): 1081-1087.
36.
OlszewskiA. E.et al. (2018). “Teaching Pediatric Peritoneal Dialysis Globally through Virtual Simulation.” Clin J Am Soc Nephrol13(6): 900-906.
37.
PasquierP.et al. (2015). “New insights into virtual medical education and assess- ment, Serious Games, and Digital Platforms.” Bull Acad Natl Med199(7): 1153-1164.
38.
PattersonE. S.HoffmanR. R. (2012). Visualization framework of macrocognition functions. Cognition, Technology & Work, 14(3), 221-227.
39.
PierceJ.et al. (2008). “Comparative usability studies of full vs. partial immersive virtual reality simulation for medical education and training.” Stud Health Technol Inform132: 372-377.
40.
PosnerG.et al. (2012). “Assessing residents’ disclosure of adverse events: traditional objective structured clinical examinations versus mixed reality.” J Obstet Gynaecol Can34(4): 367-373.
41.
RealF. J.et al. (2017). “A Virtual Reality Curriculum for Pediatric Residents Decreases Rates of Influenza Vaccine Refusal.” Acad Pediatr17(4): 431-435.
42.
RealF. J.et al. (2017). “Resident perspectives on communication training that utilizes immersive virtual reality.” Educ Health (Abingdon)30(3): 228-231.
43.
SakakushevB. E.et al. (2017). “Striving for Better Medical Education: the Simulation Approach.” Folia Med (Plovdiv)59(2): 123-131.
44.
SchwaabJ.et al. (2011). “Using second life virtual simulation environment for mock oral emergency medicine examination.” Acad Emerg Med18(5): 559-562.
45.
SemeraroF.et al. (2013). “Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality training: a randomised crossover mannequin pilot study.” Resuscitation84(4): 501-507.
46.
StepanK.,
et al. (2017). “Immersive virtual reality as a teaching tool for neuroanatomy.” Int Forum Allergy Rhinol7(10): 1006-1013.
47.
WilsonK. L.et al. (2013). “Using augmented reality as a clinical support tool to assist combat medics in the treatment of tension pneumothoraces.” Mil Med178(9): 981-985.
48.
ZhuE.HadadgarA.MasielloI.ZaryN. (2014). Augmented reality in healthcare education: an integrative review. PeerJ, 2, e469.
