JMIR Publications

ABSTRACT

Background:

Surgical teaching programmes have maintained core fundamentals of precise anatomical understanding, cadaveric specimens and expert guidance, but in recent years, these methods have been supplemented by digital technologies including VR, MR and AR. AR has stood out in measures such as patient safety and skill acquisition and has been subject to less scrutiny compared to similarly trialled VR.

Objective:

To evaluate whether the use of Augmented Reality (AR), in addition to or as a replacement for traditional surgical teaching methods, improves the performance levels of surgical trainees. This is accomplished by analyzing both objective measures (e.g., completion rate, error rate, and accuracy) and subjective trainee experiences from selected studies, using systematic review methodologies like PICO and PRISMA. The ultimate aim is to assess AR's potential impact and identify areas for further scrutiny through larger and more standardized studies.

Methods:

To establish a research question, PICO was initially used to arrive at: “Does the use of Augmented Reality in addition to or in place of traditional teaching methods improve surgical trainee performance levels?” PRISMA guidelines were used to organise the review with inclusion and exclusion criteria narrowing down 312 studies from Google Scholar, PubMed and Ovid browsers to 14 studies suitable for analysis.

Results:

Of 14 studies elected, 8 were subject to review of their objective measures, while 6 were reviewed for both objective and subjective data. To tackle heterogeneity across studies assessed, the ISS was used to generate a composite score that acknowledged different weightings according to participant numbers throughout studies. Objective measures included completion rate, error rate, and accuracy. Reliability of analysis was limited by small sample sizes and short study times. Qualitative analysis looked at subjective trainee experiences and revealed a positive trend favouring use of AR in surgical teaching but preferring a combination of both AR and expert guidance.

Conclusions:

AR technologies in replacement or in addition to traditional teaching methods show moderately improved surgical trainee performance levels. However, the promise AR has showed so far must be scrutinised further with larger sample-size studies and longer study periods with assessments using standardised objective frameworks.