Augmented reality (AR) continues to show its impact in education. While systematic review and meta-analysis studies have synthesized the evidence of this impact, most of them did not differentiate how AR may foster various learning outcomes to different degrees. In this study, 134 (quasi-)experimental studies on augmented reality (AR) in education from 2012 to 2021 were reviewed to discern the impact of AR on three levels of learning outcomes, namely response, knowledge and skill, and performance. The 134 studies are the data of this study for meta-analysis, which were obtained following the procedure of the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Moreover, meta-regression was employed to investigate important factors relating to the variation of the impact, including educational level, subject area, treatment duration, and AR affordance. Findings from the meta-analysis suggest that AR technology has benefited all three learning outcomes, with a larger mean effect size on the outcome of performance. Furthermore, the meta-regression results indicate treatment duration as a significant factor likely relating to the variation in the impact of AR in education. Moreover, AR used to support the learning of languages or social studies is likely associated with higher positive learner responses such as learning motivation or attitude than AR used for science learning. The meta-regression result indicated that use of 3-D visualization in AR needs to be carefully designed and evaluated. The implications of using AR to support learning, the design of AR learning environments, and the future direction of research are discussed. • AR has a larger mean effect size on students' performance. • AR treatment duration is likely related to the variation of the AR impact. • AR for language or social study learning is likely associated with higher positive learner responses. • Use of 3-D visualization in AR needs to be carefully designed. 

Ten years of augmented reality in education: A meta-analysis of (quasi-) experimental studies to investigate the impact

The HoloLens in medicine: A systematic review and taxonomy

Immersive technology is a growing field in healthcare education—attracting educationalists to evaluate its utility. There has been a trend of increasing research in this field; however, a lack of quality assurance surrounding the literature prompted the narrative review. Web Of Science database searches were undertaken from 2002 to the beginning of 2022. The studies were divided into three mixed reality groups: virtual reality (VR), augmented reality (AR), 360 videos, and learning theory subgroups. Appraising 246 studies with the Medical Education Research Study Quality Instrument (MERSQI) indicated a gap in the validation of measures used to evaluate the technology. Although, those conducted in VR or those detailing learning theories scored higher according to MERSQI. There is an educational benefit to immersive technology in the healthcare setting. However, there needs to be caution in how the findings are interpreted for application beyond the initial study and a greater emphasis on research methods.

A Narrative Review of Immersive Technology Enhanced Learning in Healthcare Education

BACKGROUND: Augmented reality (AR) technology is a new and promising option to advance and expand neurosurgical training because of recent advances in computer vision technology, improved AR software and hardware, and growing acceptance of this technology in clinical practice. OBJECTIVE: To analyze the current status of AR use cases with the goal of envisioning future uses of AR in neurosurgical education. METHODS: Articles applying to AR technology use in neurosurgical education were identified using PubMed, Google Scholar, and Web of Science databases following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines. Articles were included for review based on applicable content related to neurosurgical or neuroanatomy training. Assessment of literature quality was completed using standardized MERSQI scoring. RESULTS: The systematic search identified 2648 unique articles. Of these, 12 studies met inclusion criteria after extensive review. The average MERSQI score was 10.2 (SD: 1.7). The most common AR platform identified in this study was the Microsoft Hololens. The primary goals of the studies were to improve technical skills and approaches to surgical planning or improve understanding of neuroanatomy. CONCLUSION: Augmented reality has emerged as a promising training tool in neurosurgery. This is demonstrated in the wide range of cases in technical training and anatomic education. It remains unclear how AR-based training compares directly with traditional training methods; however, AR shows great promise in the ability to further enhance and innovate neurosurgical education and training.

Expanding Educational Frontiers in Neurosurgery: Current and Future Uses of Augmented Reality

Background Mixed reality (MR) and its potential applications have gained increasing interest within the medical community over the recent years. The ability to integrate virtual objects into a real-world environment within a single video-see-through display is a topic that sparks imagination. Given these characteristics, MR could facilitate preoperative and preinterventional planning, provide intraoperative and intrainterventional guidance, and aid in education and training, thereby improving the skills and merits of surgeons and residents alike. Objective In this narrative review, we provide a broad overview of the different applications of MR within the entire spectrum of surgical and interventional practice and elucidate on potential future directions. Methods A targeted literature search within the PubMed, Embase, and Cochrane databases was performed regarding the application of MR within surgical and interventional practice. Studies were included if they met the criteria for technological readiness level 5, and as such, had to be validated in a relevant environment. Results A total of 57 studies were included and divided into studies regarding preoperative and interventional planning, intraoperative and interventional guidance, as well as training and education. Conclusions The overall experience with MR is positive. The main benefits of MR seem to be related to improved efficiency. Limitations primarily seem to be related to constraints associated with head-mounted display. Future directions should be aimed at improving head-mounted display technology as well as incorporation of MR within surgical microscopes, robots, and design of trials to prove superiority.

pdf/mixed-reality-in-modern-surgical-and-interventional-practice-3v9vf4pe.pdf

Mixed Reality in Modern Surgical and Interventional Practice: Narrative Review of the Literature

OBJECTIVE The traditional freehand technique for external ventricular drain (EVD) placement is most frequently used, but remains the primary risk factor for inaccurate drain placement. As this procedure could benefit from image guidance, the authors set forth to demonstrate the impact of augmented-reality (AR) assistance on the accuracy and learning curve of EVD placement compared with the freehand technique. METHODS Sixteen medical students performed a total of 128 EVD placements on a custom-made phantom head, both before and after receiving a standardized training session. They were guided by either the freehand technique or by AR, which provided an anatomical overlay and tailored guidance for EVD placement through inside-out infrared tracking. The outcome was quantified by the metric accuracy of EVD placement as well as by its clinical quality. RESULTS The mean target error was significantly impacted by either AR (p = 0.003) or training (p = 0.02) in a direct comparison with the untrained freehand performance. Both untrained (11.9 ± 4.5 mm) and trained (12.2 ± 4.7 mm) AR performances were significantly better than the untrained freehand performance (19.9 ± 4.2 mm), which improved after training (13.5 ± 4.7 mm). The quality of EVD placement as assessed by the modified Kakarla scale (mKS) was significantly impacted by AR guidance (p = 0.005) but not by training (p = 0.07). Both untrained and trained AR performances (59.4% mKS grade 1 for both) were significantly better than the untrained freehand performance (25.0% mKS grade 1). Spatial aptitude testing revealed a correlation between perceptual ability and untrained AR-guided performance (r = 0.63). CONCLUSIONS Compared with the freehand technique, AR guidance for EVD placement yielded a higher outcome accuracy and quality for procedure novices. With AR, untrained individuals performed as well as trained individuals, which indicates that AR guidance not only improved performance but also positively impacted the learning curve. Future efforts will focus on the translation and evaluation of AR for EVD placement in the clinical setting.

/pdf/the-effect-of-augmented-reality-on-the-accuracy-and-learning-2mdpwtbtp6.pdf

The effect of augmented reality on the accuracy and learning curve of external ventricular drain placement.

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The effect of augmented reality on the accuracy and learning curve of external ventricular drain placement.