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

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          Abstract

          Objectives

          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.

          Conclusions

          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.

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          Most cited references41

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          Recent advances in augmented reality

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            Appraising the quality of medical education research methods: the Medical Education Research Study Quality Instrument and the Newcastle-Ottawa Scale-Education.

            The Medical Education Research Study Quality Instrument (MERSQI) and the Newcastle-Ottawa Scale-Education (NOS-E) were developed to appraise methodological quality in medical education research. The study objective was to evaluate the interrater reliability, normative scores, and between-instrument correlation for these two instruments.
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              Association between funding and quality of published medical education research.

              Methodological shortcomings in medical education research are often attributed to insufficient funding, yet an association between funding and study quality has not been established. To develop and evaluate an instrument for measuring the quality of education research studies and to assess the relationship between funding and study quality. Internal consistency, interrater and intrarater reliability, and criterion validity were determined for a 10-item medical education research study quality instrument (MERSQI). This was applied to 210 medical education research studies published in 13 peer-reviewed journals between September 1, 2002, and December 31, 2003. The amount of funding obtained per study and the publication record of the first author were determined by survey. Study quality as measured by the MERSQI (potential maximum total score, 18; maximum domain score, 3), amount of funding per study, and previous publications by the first author. The mean MERSQI score was 9.95 (SD, 2.34; range, 5-16). Mean domain scores were highest for data analysis (2.58) and lowest for validity (0.69). Intraclass correlation coefficient ranges for interrater and intrarater reliability were 0.72 to 0.98 and 0.78 to 0.998, respectively. Total MERSQI scores were associated with expert quality ratings (Spearman rho, 0.73; 95% confidence interval [CI], 0.56-0.84; P < .001), 3-year citation rate (0.8 increase in score per 10 citations; 95% CI, 0.03-1.30; P = .003), and journal impact factor (1.0 increase in score per 6-unit increase in impact factor; 95% CI, 0.34-1.56; P = .003). In multivariate analysis, MERSQI scores were independently associated with study funding of $20 000 or more (0.95 increase in score; 95% CI, 0.22-1.86; P = .045) and previous medical education publications by the first author (1.07 increase in score per 20 publications; 95% CI, 0.15-2.23; P = .047). The quality of published medical education research is associated with study funding.
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                Author and article information

                Journal
                Int J Med Educ
                Int J Med Educ
                IJME
                International Journal of Medical Education
                IJME
                2042-6372
                18 January 2020
                2020
                : 11
                : 1-18
                Affiliations
                [1 ]School of Medical Sciences, University of Copenhagen, Denmark
                [2 ]Department of Pediatrics, Herlev and Gentofte Hospital, Denmark
                [3 ]Copenhagen Academy of Medical Education and Simulation (CAMES), Center for Human Resources, Herlev and Gentofte Hospital, Denmark
                Author notes
                Correspondence: Jaris Gerup, School of Medical Sciences, University of Copenhagen, Denmark. Email: jaris.gerup@ 123456gmail.com
                Article
                11-118
                10.5116/ijme.5e01.eb1a
                7246121
                31955150
                dd2ce09f-c027-4cff-853b-0551d36dd3b5
                Copyright: © 2020 Jaris Gerup et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0/

                History
                : 24 December 2019
                : 27 April 2019
                Categories
                Review Literature
                Augmented Reality

                augmented reality,mixed reality,healthcare education,medicine,integrative review

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