Augmented reality

增强现实
  • 文章类型: Journal Article
    增强现实(AR)通过允许外科医生可视化患者体内的关键结构,具有彻底改变外科手术程序的潜力。这是通过将术前器官模型叠加到实际解剖结构上来实现的。挑战来自手术过程中器官的动态变形,使术前模型不足以忠实地表示术中解剖结构。为了在增强手术中实现可靠的导航,术中变形建模以获得术前器官模型与术中解剖结构的精确对准是必不可少的。尽管存在各种方法来模拟术中器官变形,仍然很少有文献综述对这些方法进行系统的分类和总结。这篇综述旨在通过提供针对手术增强现实中术中器官变形的建模方法的全面和面向技术的概述来填补这一空白。通过系统的搜索和筛选过程,112篇密切相关的论文被纳入这篇综述。通过介绍器官变形建模方法及其临床应用的现状,这篇综述旨在加强对AR引导手术中器官变形建模的理解,并讨论未来发展的潜在主题。
    Augmented Reality (AR) holds the potential to revolutionize surgical procedures by allowing surgeons to visualize critical structures within the patient\'s body. This is achieved through superimposing preoperative organ models onto the actual anatomy. Challenges arise from dynamic deformations of organs during surgery, making preoperative models inadequate for faithfully representing intraoperative anatomy. To enable reliable navigation in augmented surgery, modeling of intraoperative deformation to obtain an accurate alignment of the preoperative organ model with the intraoperative anatomy is indispensable. Despite the existence of various methods proposed to model intraoperative organ deformation, there are still few literature reviews that systematically categorize and summarize these approaches. This review aims to fill this gap by providing a comprehensive and technical-oriented overview of modeling methods for intraoperative organ deformation in augmented reality in surgery. Through a systematic search and screening process, 112 closely relevant papers were included in this review. By presenting the current status of organ deformation modeling methods and their clinical applications, this review seeks to enhance the understanding of organ deformation modeling in AR-guided surgery, and discuss the potential topics for future advancements.
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  • 文章类型: Journal Article
    目的:泌尿外科二维(2D)成像的三维(3D)虚拟重建的日益普及导致了重大的技术进步,从而创建高度精确的3D虚拟模型(3DVM),忠实地复制各个解剖细节。这项技术增强了手术的现实,为外科医生提供对瞬时主观手术解剖结构的超精确见解,并改善术前手术计划。在肿瘤领域,3D虚拟重建的实用性已在保留肾单位的手术中得到证明,影响前列腺癌(PCa)的手术策略和术后结局。这项研究的目的是对3D重建和增强现实(AR)在根治性前列腺切除术(RP)中的现状和应用进行全面的叙述性回顾。
    方法:使用Medline进行非系统文献综述,PubMed,Cochrane数据库,和Embase收集临床试验信息,随机对照试验,评论文章,以及与RP中3DVM和AR相关的前瞻性和回顾性研究。搜索策略遵循PICOS(患者,干预,比较,结果,研究设计)标准,并于2024年1月进行。
    3D可视化的采用已变得广泛,应用范围从术前计划到术中咨询。泌尿外科社区对术中手术导航使用认知,虚拟,混合,RP期间的AR在大量文献中很明显,包括16项值得注意的调查。这些研究强调了将3D重建和AR整合到RP中的各种经验和好处,展示术前计划的改进,术中导航,和实时决策。
    结论:3DVM和AR技术在泌尿外科肿瘤中的整合,特别是在RP的背景下,已经显示出有希望的进步。这些技术为术前计划提供了至关重要的支持,术中导航,和实时决策,显着改善复杂解剖结构的可视化,有助于神经保留(NS)方法调制并降低阳性手术切缘(PSM)率。尽管取得了积极成果,挑战,如小型患者队列,缺乏标准化的方法,对成本和技术采用的担忧持续存在。
    OBJECTIVE: The increasing popularity of three-dimensional (3D) virtual reconstructions of two-dimensional (2D) imaging in urology has led to significant technological advancements, resulting in the creation of highly accurate 3D virtual models (3DVMs) that faithfully replicate individual anatomical details. This technology enhances surgical reality, providing surgeons with hyper-accurate insights into instantaneous subjective surgical anatomy and improving preoperative surgical planning. In the uro-oncologic field, the utility of 3D virtual reconstruction has been demonstrated in nephron-sparing surgery, impacting surgical strategy and postoperative outcomes in prostate cancer (PCa). The aim of this study is to offer a thorough narrative review of the current state and application of 3D reconstructions and augmented reality (AR) in radical prostatectomy (RP).
    METHODS: A non-systematic literature review was conducted using Medline, PubMed, the Cochrane Database, and Embase to gather information on clinical trials, randomized controlled trials, review articles, and prospective and retrospective studies related to 3DVMs and AR in RP. The search strategy followed the PICOS (Patients, Intervention, Comparison, Outcome, Study design) criteria and was performed in January 2024.
    UNASSIGNED: The adoption of 3D visualization has become widespread, with applications ranging from preoperative planning to intraoperative consultations. The urological community\'s interest in intraoperative surgical navigation using cognitive, virtual, mixed, and AR during RP is evident in a substantial body of literature, including 16 noteworthy investigations. These studies highlight the varied experiences and benefits of incorporating 3D reconstructions and AR into RP, showcasing improvements in preoperative planning, intraoperative navigation, and real-time decision-making.
    CONCLUSIONS: The integration of 3DVMs and AR technologies in urological oncology, particularly in the context of RP, has shown promising advancements. These technologies provide crucial support in preoperative planning, intraoperative navigation, and real-time decision-making, significantly improving the visualization of complex anatomical structures helping in the nerve sparing (NS) approach modulation and reducing positive surgical margin (PSM) rate. Despite positive outcomes, challenges such as small patient cohorts, lack of standardized methodologies, and concerns about costs and technology adoption persist.
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  • 文章类型: Journal Article
    增强现实(AR)和虚拟现实(VR)是即将到来的技术,具有巨大的潜力,彻底改变医疗保健教育,提高患者安全,并提高医疗保健质量,特别是在印度的背景下。进行这项审查是为了查看考虑COVID-19影响的印度环境的当前情景。当前的系统评价研究是根据PRISMA2020指南使用关键术语“增强现实,\"\"虚拟现实,\“\”医疗保健,\"和\"印度。\"只有PubMed数据库是根据其声誉和真实性选择的,这是这项研究的唯一限制和力量。定性和定量方法都用于合成结果。在印度的背景下,发现12篇(1.7%)和36篇(2.2%)与AR和VR相关的文章,分别。六个摘要无法检索,在筛选摘要后,发现三个不适合VR,八个发现重复。本综述共考虑了30篇文章。18(50%)是原创的,12人(33.3%)进行了审查,6篇(16.7%)为其他文章。03(8.3%),21(58.3%),12篇(33.3%)文章与AR有关,VR,AR和VR,分别。考虑到单个数据库搜索和六个不可检索的摘要,AR,VR,混合现实(MR),柔软的电子皮肤,和扩展现实(XR)技术有可能彻底改变医疗保健教育和培训,减少现实生活中的错误和提高患者的安全。尽管印度医疗保健行业仅对PubMed与AR和VR相关的出版物贡献了1.7-2.2%。.审查未注册。
    Augmented reality (AR) and virtual reality (VR), are upcoming technologies with considerable potential to revolutionizing healthcare education, enhancing patient safety, and improving healthcare quality particularly in the Indian context. This review is conducted to view the current scenario of Indian context considering the impact of COVID-19. The current systematic review study was done following PRISMA 2020 guidelines using the key terms \"Augmented Reality,\" \"Virtual Reality,\" \"Healthcare,\" and \"India.\" Only the PubMed database was selected based on its reputation and authenticity, which is the only limitation of this study and strength. Both qualitative and quantitative methods are used for synthesis of results. In Indian context, 12 (1.7%) and 36 (2.2%) articles related to AR and VR were found, respectively. Six abstracts could not be retrieved, and after screening abstracts, three were found not suitable in VR and eight were found duplicate. A total of 30 articles were considered for this review. 18 (50%) were original, 12 (33.3%) were review, and 6 (16.7%) were other articles. 03 (8.3%), 21 (58.3%), and 12 (33.3%) articles were related to AR, VR, and both AR and VR, respectively. Considering the single database search and six unretrievable abstract, AR, VR, mixed reality (MR), soft e-skin, and extended reality (XR) technologies have the potential to revolutionize healthcare education and training, reducing real-life errors and improving patient safety. Although the Indian healthcare sector only contributes 1.7-2.2% to PubMed publications related to AR and VR.. The review was not registered.
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  • 文章类型: Journal Article
    这篇文献综述全面系统地介绍了对具有扩展现实(XR)的儿童经历的研究,包括VR,AR,以及其他类型的沉浸式技术,可以增强和增强儿童的活动。在Scopus和WebofScience上的搜索产生了531个输出。具有评分者间可靠性(Krippendorff'sα)和Leximancer的内容分析,一个文本挖掘软件,用于分析材料。确定了四个研究方向:(1)干预措施,治疗,(2)XR增强的教学和学习;(3)儿童的采用和用户体验;(4)儿童XR硬件和软件的设计和原型设计。结果显示了以下发现:(a)使用HMD支持的沉浸式虚拟现实进行儿童临床干预和治疗的研究是最实质性的研究;(b)该领域的研究,在教学和学习研究中,自2017年以来已大幅增长,而其他领域多年来一直停滞不前;(c)AR研究仍然有限,主要应用于教育环境中的设计和原型制作;(d)很少有研究考虑儿童对XR安全问题的看法;(e)关于使用XR增强社交和情感技能发展的研究不足。未来的研究应该集中在XR技术在干预措施中的潜力,以更广泛地提高儿童的心理健康和健康。还讨论了这一跨学科研究领域快速发展的进一步含义和研究局限性。
    This literature review presents a comprehensive and systematic account of research on the experiences of children with extended reality (XR), including VR, AR, and other types of immersive technologies that enhance and augment children\'s activities. The search on Scopus and Web of Science produced 531 outputs. Content analysis with inter-rater reliability (Krippendorff\'s α) and Leximancer, a software for text mining, were used for analyzing the material. Four research strands were identified: (1) interventions, treatments, and medical procedures in clinical contexts; (2) teaching and learning enhanced by XR; (3) children\'s adoption and user experiences; (4) design and prototyping of XR hardware and software for children. The results showed the following findings: (a) studies on children\'s clinical interventions and treatments using HMD-supported immersive virtual reality comprise the most substantial strand of studies; (b) research in this area, and in teaching and learning studies, has grown dramatically since 2017, while the other areas have been stagnant over the years; (c) AR research is still limited and is mainly applied in educational contexts for design and prototyping; (d) few studies have considered children\'s perspectives on XR safety issues; (e) research on the use of XR for enhancing social and emotional skills development is underrepresented. Future research should focus on the potential of XR technologies for interventions to enhance children\'s psychosocial wellbeing and health more broadly. The further implications and study limitations for the fast-developing nature of this transdisciplinary research field are also discussed.
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  • 文章类型: Journal Article
    外科教育需要在有限的时间内获得广泛的知识和技能。通常受到培训机会减少和高压环境的限制。这篇综述评估了扩展的基于现实的头戴式显示器(ExR-HMD)技术在外科教育中的有效性,研究其对教育成果的影响,探索其优势和局限性。数据来自PubMed,科克伦图书馆,WebofScience,ScienceDirect,Scopus,ACM数字图书馆,IEEEXplore,WorldCat,和谷歌学者(年份:2014-2024)进行了合成。筛选后,确定了32项比较ExR-HMD和传统的医学生或住院医师手术培训方法的研究。使用医学教育研究质量工具评估质量和偏见,纽卡斯尔-渥太华规模教育,和Cochrane偏差工具的风险。结果表明,ExR-HMD提供的好处,如增加浸泡,空间意识,和互动,并支持运动技能习得理论和建构主义教育理论。然而,挑战,如系统保真度,操作不便,并注意到身体不适。近一半的研究报告结果与传统方法相当或优于传统方法。强调社会互动的重要性。限制包括研究异质性和纯英文出版物。ExR-HMD显示出希望,但需要教育理论整合和社交互动。未来的研究应解决全球无障碍的技术和经济障碍。
    Surgical education demands extensive knowledge and skill acquisition within limited time frames, often limited by reduced training opportunities and high-pressure environments. This review evaluates the effectiveness of extended reality-based head-mounted display (ExR-HMD) technology in surgical education, examining its impact on educational outcomes and exploring its strengths and limitations. Data from PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ACM Digital Library, IEEE Xplore, WorldCat, and Google Scholar (Year: 2014-2024) were synthesized. After screening, 32 studies comparing ExR-HMD and traditional surgical training methods for medical students or residents were identified. Quality and bias were assessed using the Medical Education Research Study Quality Instrument, Newcastle-Ottawa Scale-Education, and Cochrane Risk of Bias Tools. Results indicate that ExR-HMD offers benefits such as increased immersion, spatial awareness, and interaction and supports motor skill acquisition theory and constructivist educational theories. However, challenges such as system fidelity, operational inconvenience, and physical discomfort were noted. Nearly half the studies reported outcomes comparable or superior to traditional methods, emphasizing the importance of social interaction. Limitations include study heterogeneity and English-only publications. ExR-HMD shows promise but needs educational theory integration and social interaction. Future research should address technical and economic barriers to global accessibility.
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  • 文章类型: Journal Article
    目的:评估沉浸式技术在口腔健康促进和教育中的应用效果。
    方法:使用系统评价和荟萃分析(PRISMA)方法的首选报告项目进行了广泛的文献综述。这项研究是在六个著名的电子数据库(PubMed,谷歌学者,WebofScience,科克伦,Scopus,和EBSCO)。使用Cochrane工具使用RoB2.0和ROBINS-I评估偏倚风险。
    结果:为纳入研究制定了PICOS标准。书目搜索确定了10,074篇文章,随后被过滤。最后,纳入了最相关的9篇文章,并对其进行了数据综合和分析。这包括5项随机对照试验和4项非随机对照试验,分别在不同国家开展,重点关注儿童(33.3%)。青少年(11.1%),成人(55.6%)。干预措施使用虚拟现实(VR)和增强现实(AR)来促进对口腔护理的知识和态度,提高刷牙性能,戒烟,在口腔健康教育中降低焦虑水平。
    结论:本系统综述表明,沉浸式技术,包括VR和AR,显著提高口腔健康知识,态度,和自我效能感,改善健康结果。
    结论:VR和AR等沉浸式技术有可能为加强口腔健康促进和教育提供创新和有效的方法,在促进积极健康行为的同时,这对于改善整体口腔健康结果至关重要。
    OBJECTIVE: To evaluate the effectiveness of immersive technologies in oral health promotion and education.
    METHODS: An extensive literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. This study was systematically performed in six electronic databases (PubMed, Google Scholar, Web of Science, Cochrane, Scopus, and EBSCO). The risk of bias was assessed with the Cochrane tools using RoB 2.0 and ROBINS-I.
    RESULTS: PICOS criteria were formulated for study inclusion. The bibliographical search identified 10,074 articles, which were filtered subsequently. Finally, the most pertinent nine articles were included and scrutinized for data synthesis and analysis. This includes five randomized controlled trials and four non-randomized controlled trials in different countries that focused on children (33.3%), adolescents (11.1%), and adults (55.6%). The interventions used virtual reality (VR) and augmented reality (AR) to promote knowledge and attitudes towards oral care, improve toothbrushing performance, and smoking cessation, and reduce anxiety levels in oral health education.
    CONCLUSIONS: This systematic review demonstrates that immersive technologies, including VR and AR, significantly enhance oral health knowledge, attitudes, and self-efficacy, leading to improved health outcomes.
    CONCLUSIONS: Immersive technologies such as VR and AR have the potential to provide innovative and effective methods for enhancing oral health promotion and education, while promoting positive health behaviours, which are crucial for improving overall oral health outcomes.
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  • 文章类型: Systematic Review
    混合现实是一种技术,由于其访问和可视化信息的独特功能而受到关注。当与语音控制机制集成时,手势甚至虹膜运动,它成为医学的宝贵工具。这些功能对手术室和外科学习特别有吸引力,在这里,获取信息和手部操作自由是至关重要的。本研究考察了过去五年来关于手术室混合现实的最重要的研究,为了识别趋势,用例,它的应用和局限性。根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行了系统评价,以回答使用PICO(人口,干预,比较器和结果)框架。尽管在手术室中实施混合现实应用程序存在一些挑战,如果使用得当,它可以产生显著的结果。它可以使学习更容易,扁平化几个程序的学习曲线,并促进外科手术的各个方面。文章的结论强调了这些创新在外科实践中的潜在好处,同时承认必须解决的挑战。技术复杂性,设备成本,陡峭的学习曲线对广泛采用混合现实和计算机辅助评估提出了重大障碍。程序的特殊性和有限的样本量强调了对更灵活的方法和全面研究的需求。成像模式和创新功能的集成为临床应用带来了希望。然而,重要的是要考虑与可用性有关的问题,偏见,和统计分析。混合现实提供了显著的好处,但是仍然存在一些开放的挑战,例如人体工程学问题,视野有限,和电池自主性,必须解决以确保广泛接受。
    Mixed Reality is a technology that has gained attention due to its unique capabilities for accessing and visualizing information. When integrated with voice control mechanisms, gestures and even iris movement, it becomes a valuable tool for medicine. These features are particularly appealing for the operating room and surgical learning, where access to information and freedom of hand operation are fundamental. This study examines the most significant research on mixed reality in the operating room over the past five years, to identify the trends, use cases, its applications and limitations. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to answer the research questions established using the PICO (Population, Intervention, Comparator and Outcome) framework. Although implementation of Mixed Reality applications in the operations room presents some challenges, when used appropriately, it can yield remarkable results. It can make learning easier, flatten the learning curve for several procedures, and facilitate various aspects of the surgical processes. The articles\' conclusions highlight the potential benefits of these innovations in surgical practice while acknowledging the challenges that must be addressed. Technical complexity, equipment costs, and steep learning curves present significant obstacles to the widespread adoption of Mixed Reality and computer-assisted evaluation. The need for more flexible approaches and comprehensive studies is underscored by the specificity of procedures and limited samples sizes. The integration of imaging modalities and innovative functionalities holds promise for clinical applications. However, it is important to consider issues related to usability, bias, and statistical analyses. Mixed Reality offers significant benefits, but there are still open challenges such as ergonomic issues, limited field of view, and battery autonomy that must be addressed to ensure widespread acceptance.
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  • 文章类型: Journal Article
    本文报告了一个系统的文献综述,审查了过去的研究,探索协作增强现实(AR)启用指令的有效性,在高等教育环境中。要包括在内,一篇文章应该包括一项实验研究,调查在高等教育环境中使用协作AR进行学习。对5个数据库进行初步检索,共检索2537篇,其中20项已为本次审查定稿。主要研究结果表明,基于AR的协作学习有利于学生的整体学习成果,并在高等教育环境中提供积极的协作体验。需要进一步的研究来确定相互作用元素,合作机制,和通过AR的信息表示,这可能会提高学生的学习成果。本文最后讨论了这些发现的含义,确定开发有效的协作AR支持学习内容的挑战和策略。
    This article reports a systematic literature review that examined past research exploring the effectiveness of collaborative Augmented Reality (AR) enabled instruction, in higher education contexts. To be included, an article should consist of an experimental study investigating the use of collaborative AR for learning in higher education settings. An initial search was conducted on five databases that resulted in a total of 2537 articles, of which 20 were finalized for this review. The main findings suggest that AR-enabled collaborative learning benefits students\' overall learning outcomes and provides a positive collaboration experience in higher education settings. Further research is needed to determine the interaction elements, collaboration mechanisms, and information representation through AR that would potentially enhance student learning outcomes. This article concludes by discussing the implications of these findings, identifying challenges and strategies for developing effective collaborative AR-enabled learning content.
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  • 文章类型: Journal Article
    当前消化外科实践中新技术的引入正在逐步重塑手术室,定义第四次外科革命。黑匣子和控制塔的实施旨在通过早期识别和分析来简化工作流程并减少手术错误,而增强现实和人工智能通过将三维模型叠加到实时手术图像来增强外科医生的感知和技术技能。此外,手术室架构正在向集成的数字环境过渡,以提高效率和,最终,患者的结果。这篇叙述性综述描述了有关这些技术在改变当前消化外科实践中的作用的最新证据。强调它们在效率和患者预后方面的潜在利弊,为了预见到明天的消化外科实践。
    The introduction of new technologies in current digestive surgical practice is progressively reshaping the operating room, defining the fourth surgical revolution. The implementation of black boxes and control towers aims at streamlining workflow and reducing surgical error by early identification and analysis, while augmented reality and artificial intelligence augment surgeons\' perceptual and technical skills by superimposing three-dimensional models to real-time surgical images. Moreover, the operating room architecture is transitioning toward an integrated digital environment to improve efficiency and, ultimately, patients\' outcomes. This narrative review describes the most recent evidence regarding the role of these technologies in transforming the current digestive surgical practice, underlining their potential benefits and drawbacks in terms of efficiency and patients\' outcomes, as an attempt to foresee the digestive surgical practice of tomorrow.
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  • 文章类型: Journal Article
    背景:基于模拟的护理教育中沉浸式技术的采用显着增长,提供资源限制的解决方案,并实现对临床环境的安全访问。尽管有其优势,关于沉浸式技术的有效性,仍然有各种各样的报道。验证沉浸式技术在护理教育中的有效性对于未来的教育计划至关重要。
    目的:本系统综述旨在确定针对本科护生的沉浸式技术教育的内容,并评估与传统教学方法相比,沉浸式技术的有效性。
    方法:使用四个数据库进行文献检索:PubMed,护理和相关健康文献累积指数(CINAHL),Embase,和WebofScience,最新搜索于2023年1月19日完成。纳入标准如下:参与者是本科护理学生;研究以韩语或英语发表;设计包括随机对照试验(RCT)或非随机研究;干预涉及虚拟现实(VR),增强现实(AR)混合现实(MR),或扩展现实(XR)。使用Cochrane偏倚风险工具(RoB2)的第2版和非随机研究偏倚风险评估工具(RoBANS)进行质量评估。纳入研究的主要结果根据新世界柯克帕特里克模型(NWKM)进行分类,范围从1级(反应)到4级(结果)。采用RevMan5.4软件进行Meta分析。由于meta分析结果的异质性,进行了亚组分析.建议的分级,评估,发展,采用了评估(GRADE)方法来评估确定性并综合相关文献的结果。
    结果:共纳入23项研究,参与者人数从33到289不等。19项研究采用VR模拟各种护理场景,包括灾难训练,复苏,健康评估,和家庭保健。四项研究利用了AR技术。15项研究涉及虚拟患者的场景。基于NWKM,主要结果变量被归类为1级(可用性和满意度),二级(知识,动机,信心,性能,态度,和自我效能感),和3级(临床推理)。在选定的研究中没有发现4级结果。荟萃分析的亚组分析结果表明,基于沉浸式技术的护理教育比传统教育更有效(标准均差(SMD)=0.59,95%置信区间(CI)=0.28-0.90,P<.001,I2=49%)。此外,实验组和对照组之间的置信度存在显着差异(SMD=0.70,95%CI=0.05-1.35,P=0.03,I2=82%),和自我效能感(SMD=0.86,95%CI=0.42-1.30;P<.001,I2=63%)。
    结论:这些发现支持沉浸式技术教育对护理本科生的有效性,尽管方法和干预措施存在异质性。我们建议应进行长期队列研究,以评估基于沉浸式技术的护理教育对NWKM4级的影响。
    背景:
    BACKGROUND: The adoption of immersive technology in simulation-based nursing education has grown significantly, offering a solution to resource limitations and enabling safe access to clinical environments. Despite its advantages, there are still diverse reports regarding the effectiveness of immersive technology. It is crucial to verify the effectiveness of immersive technology in nursing education to inform future educational programs.
    OBJECTIVE: This systematic review aimed to identify the contents of immersive technology-based education for undergraduate nursing students and evaluate the effectiveness of immersive technology compared to traditional teaching methods.
    METHODS: A literature search was performed using 4 databases: PubMed, CINAHL, Embase, and Web of Science; the latest search was completed on January 19, 2023. The inclusion criteria were as follows: participants were undergraduate nursing students; studies were published in Korean or English; designs included randomized controlled trials (RCTs) or nonrandomized studies; and interventions involved virtual reality (VR), augmented reality (AR), mixed reality, or extended reality. Quality assessment was conducted using Cochrane Risk-of-Bias Tool version 2 for RCTs and the Risk-of-Bias Assessment Tool for Nonrandomized Studies. The main outcomes of the included studies were classified according to the New World Kirkpatrick Model (NWKM), ranging from level 1 (reaction) to level 4 (results). Meta-analysis was conducted using RevMan 5.4 software, and subgroup analysis was conducted due to heterogeneity of the results of the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation approach was adopted for assessing certainty and synthesizing results of the relevant literature.
    RESULTS: A total of 23 studies were included, with participant numbers ranging from 33 to 289. Of these, 19 (82.6%) studies adopted VR to simulate various nursing scenarios, including disaster training, resuscitation, health assessments, and home health care; 4 (17.4%) studies used AR technologies; and 15 (65.2%) studies involved virtual patients in their scenarios. Based on the NWKM, the main outcome variables were classified as level 1 (usability and satisfaction), level 2 (knowledge, motivation, confidence, performance, attitude, and self-efficacy), and level 3 (clinical reasoning); level 4 outcomes were not found in the selected studies. Results of the subgroup analysis showed that immersive technology-based nursing education is more effective than traditional education in knowledge attainment (standard mean difference [SMD]=0.59, 95% CI 0.28-0.90, P<.001, I2=49%). Additionally, there were significant difference differences between the experimental and control group in confidence (SMD=0.70, 95% CI 0.05-1.35, P=.03, I2=82%) and self-efficacy (SMD=0.86, 95% CI 0.42-1.30, P<.001, I2=63%).
    CONCLUSIONS: These findings support the effectiveness of immersive technology-based education for undergraduate nursing students, despite heterogeneity in methods and interventions. We suggest that long-term cohort studies be conducted to evaluate the effects of immersive technology-based nursing education on NWKM level 4.
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