JMIR Publications

ABSTRACT

Background:

Augmented (AR), mixed (MR) and virtual reality (VR), realized as head-mounted devices (HMDs), may open up new ways of teaching medical content including in low-resource settings.

Objective:

This review examines the effectiveness of AR and VR HMDs for medical education, with a particular focus on low- and middle-income countries.

Methods:

A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Cochrane guidelines. Seven medical databases were searched for peer-reviewed publications from 1st January 2014 to 31st May 2019. An extensive search was carried out to examine relevant literature using three broad terms ‘extended reality (XR)’ which comprises the concepts of AR, MR, and VR, ‘medicine' and ‘education'.

Results:

A total of 27 studies were included. The participants included all types of healthcare professionals, especially medical students. AR and VR implemented with HMDs was most often used for training in the fields of surgery and anatomy. A various range of study designs was employed whereby quantitative methods were clearly dominant. Training with AR- and VR-based HMDs was perceived as salient and motivating, it engaged the user in the learning process. In the majority of studies (63%) HMD-based interventions were deemed effective, thus indicating potential benefits of HMDs for LMICs. A small number of included studies (15%) indicated that HMDs were effective for certain aspects of medical skills and knowledge learning and training, while other studies suggested that HMDs were only viable as an additional teaching tool (15%). Only two studies (7%) found that there was no prove of effectiveness for using HMDs.

Conclusions:

The majority of included studies suggest that XR-based HMDs have beneficial effects for medical education. Studies showed non-inferior results if compared to conventional teaching and training, but users showed more enthusiasm and enjoyment. HMDs enable repeated practice without adverse effects on the patient in various medical disciplines. However, many HMD-based interventions were small-scale and conducted as short-termed pilots. Therefore, it is key to rigorously evaluate XR-based HMDs with AR and VR implementations in LMICs to better understand the strengths and shortcomings of HMDs for medical education in LMICs contexts.