背景：混合现实技术可能比传统的教学方法提供许多优势。尽管有潜力,该技术尚未用于临床能力的正式评估。这项研究旨在收集有效性证据并评估使用HoloLens2混合现实耳机进行和增强客观结构化临床检查（OSCE）的可行性。
方法：进行了一项前瞻性队列研究，以比较通过HoloLens2实时（HLL）和记录（HLR）进行OSCE的本科生评估，和金标准当面(IP)方法。还评估了增强混合现实场景。
结果：13名本科生参与者共完成了65个OSCE站。总体模态间相关性为0.81(p=0.01)，0.98（p=0.01）和0.82（p=0.01）的IP与HLL,HLLvs.HLR和IPvs.分别为HLR。基于技能的IP与IP的相关性对HLR进行了病史评估(0.82，p=0.01)，临床检查（0.81，p=0.01），手术（0.88，p=0.01）和临床技能（0.92，p=0.01），和虚拟混合现实患者的评估（0.74，p=0.01）。HoloLens设备被认为是可用和实用的（标准可用性量表（SUS）评分=51.5），这项技术被认为提供了更大的灵活性和便利性，并有潜力扩大和增加评估机会。
结论：HoloLens2与传统的医学本科生现场和记录评估的面对面考试相当。因此是客观评估绩效的有效和稳健的方法。这项技术还处于起步阶段，用户需要对其作为评估工具的可用性和可靠性建立信心。然而,集成附加功能的潜力，包括全息内容，自动跟踪和数据分析，并促进远程评估可能允许技术增强，在一系列教育环境中扩展和标准化考试。
BACKGROUND: Mixed Reality technology may provide many advantages over traditional teaching methods. Despite its potential, the technology has yet to be used for the formal assessment of clinical competency. This
study sought to collect validity evidence and assess the feasibility of using the HoloLens 2 mixed reality headset for the conduct and augmentation of Objective Structured Clinical Examinations (OSCEs).
METHODS: A prospective cohort
study was conducted to compare the assessment of undergraduate medical students undertaking OSCEs via HoloLens 2 live (HLL) and recorded (HLR), and gold-standard in-person (IP) methods. An augmented mixed reality scenario was also assessed.
RESULTS: Thirteen undergraduate participants completed a total of 65 OSCE stations. Overall inter-modality correlation was 0.81 (p = 0.01), 0.98 (p = 0.01) and 0.82 (p = 0.01) for IP vs. HLL, HLL vs. HLR and IP vs. HLR respectively. Skill based correlations for IP vs. HLR were assessed for history taking (0.82, p = 0.01), clinical examination (0.81, p = 0.01), procedural (0.88, p = 0.01) and clinical skills (0.92, p = 0.01), and assessment of a virtual mixed reality patient (0.74, p = 0.01). The HoloLens device was deemed to be usable and practical (Standard Usability Scale (SUS) score = 51.5), and the technology was thought to deliver greater flexibility and convenience, and have the potential to expand and enhance assessment opportunities.
CONCLUSIONS: HoloLens 2 is comparable to traditional in-person examination of undergraduate medical students for both live and recorded assessments, and therefore is a valid and robust method for objectively assessing performance. The technology is in its infancy, and users need to develop confidence in its usability and reliability as an assessment tool. However, the potential to integrate additional functionality including holographic content, automated tracking and data analysis, and to facilitate remote assessment may allow the technology to enhance, expand and standardise examinations across a range of educational contexts.
