JMIR Publications

ABSTRACT

Background:

Pharmaceutical counselling is a core competence in contemporary pharmacy practice; however, pharmacy education often provides limited opportunities for repeated, structured counselling training with objective assessment. Augmented reality (AR) has demonstrated educational potential across health professions education, but its application in pharmacy education—particularly for communication-intensive counselling competencies—remains underexplored.

Objective:

This study examined whether AR, used strictly as a structural scaffold rather than a content-delivery system, enhances pharmaceutical counselling competence in pharmacy students.

Methods:

A within-subjects counterbalanced experimental study was conducted with 32 seventh-semester pharmacy students. Each participant completed two standardised counselling consultations with a simulated patient, once with AR support and once without. The AR application provided only the structural phases of the consultation and no pharmacological or clinical content. Performance was assessed using an analytical Objective Structured Clinical Examination (OSCE) checklist applied to consultation transcripts, capturing coverage and correctness of counselling elements. Inter-rater reliability was assessed in 26 consultations from 13 randomly selected participants — both AR and non-AR consultations of each — yielding 13 AR / 13 non-AR consultation ratings (780 rating pairs = 26 × 30 scoring decisions), followed by consensus resolution of disagreements. Within-subject differences were analysed using paired t-tests, repeated-measures ANOVA, and mixed-effects regression models. Order effects were examined with between-group t-tests and the condition × sequence group interaction term. Post-task survey data were analysed descriptively.

Results:

Consultations conducted with AR support achieved significantly higher OSCE scores than those conducted without AR support (mean difference = 4.03 points; t(31) = 4.35; p < 0.001; Cohen’s d_z = 0.77). The paired comparison was consistent with equivalent repeated-measures ANOVA (F(1,31) = 18.90; p < 0.001; η²_p = .38) and additive mixed-effects regression analyses (b = 4.03; p < .001). An exploratory analysis showed a +3.46-point order-group difference in the AR benefit, favouring AR when completed after the non-AR consultation (p = 0.062). Participants rated the AR scaffold as moderately helpful despite the measured objective improvement; whether this reflects a metacognitive mismatch cannot be established with these data.

Conclusions:

AR, when implemented as a process-oriented scaffold, is associated with improved structured verbal counselling performance in simulated pharmacy consultations, as assessed by transcript-based OSCE ratings. By supporting the organisation and execution of counselling tasks without providing clinical content, AR may complement existing instructional approaches in pharmacy education. However, the findings are limited to short-term effects in a controlled setting and to the verbal domain of performance; further research is required to examine transfer to real-world practice and long-term learning outcomes.