JMIR Publications

ABSTRACT

Background:

Mixed reality (MR) has the potential to transform the delivery of medical education. With tools like HoloLens 2, educators can create immersive, interactive simulations that allow medical students to practice and engage with real-world scenarios in a controlled environment. EyelearnMR is an MR simulation application designed to teach and assess ocular examination via a wearable headset.

Objective:

We postulate that a hybrid ophthalmology curriculum that incorporates EyelearnMR with traditional teaching is non-inferior to traditional teaching. We compare learning outcomes and obtain user feedback.

Methods:

This is a single-blind cluster randomised prospective study. Medical students in their fourth year were organized into batches and then randomly assigned to two groups: the EyelearnMR and the control arm. The study group had an additional 2 hours of practice session with the EyelearnMR devices. During the second week of their posting, a video assessment was conducted for both groups - mid-posting for the study group and at the end of the posting for the control group. Students in the control group were allowed to experience the Eyelearn MR modules for 2 hours at the end of the posting. Both groups were asked to complete the User Experience Questionnaire (UEQ).

Results:

This study was funded from February 2023 and recruitment started in July 2023 to January 2024. Recruitment has been completed as of submission of manuscript. Fifty-four medical students were recruited– 24 in control arm and 30 in EyelearnMR arm. EyelearnMR group performed significantly better than control group (median score was 16 and 15 respectively, P=0.032, Mann-Whitney U test). Students in the EyelearnMR group performed significantly better than the control overall and had 100% of the students scoring full marks (3/3) for the technique portion, compared to 80.8% of the students in the control group (P=0.002). There was no statistically significant difference between the groups for the examination and pathology portions. This was despite the EyelearnMR group having reduced overall clinical exposure time of 7 days compared to 10 days in the control group. UEQ showed positive evaluation for attractiveness, efficiency, dependability, stimulation and novelty.

Conclusions:

Students exposed to EyelearnMR during their clinical rotation had significantly higher scores on video assessment despite having reduced clinical exposure time compared to the control group. There was positive evaluation for attractiveness, efficiency, dependability, stimulation, and novelty based on the validated UEQ. Eyelearn MR facilitates deliberate practice and experiential learning for students. Every student is given the opportunity to examine a defined and comprehensive set of conditions to fully experience and learn from “patients” displaying consistent and reproducible clinical signs. In the real-world setting, one has to rely on chance encounters with patients in the clinical setting, likely with varying physical findings. Eyelearn MR is an effective supplementary teaching tool in ophthalmic education and may confer additional learning benefits to a traditional clinical posting.