Abstract
Simulation-based medical training is considered an effective tool to acquire/refine technical skills, mitigating the ethical issues of Halsted’s model. This review aims at evaluating the literature on medical simulation techniques based on augmented reality (AR), mixed reality (MR), and hybrid approaches. The research identified 23 articles that meet the inclusion criteria: 43% combine two approaches (MR and hybrid), 22% combine all three, 26% employ only the hybrid approach, and 9% apply only the MR approach. Among the studies reviewed, 22% use commercial simulators, whereas 78% describe custom-made simulators. Each simulator is classified according to its target clinical application: training of surgical tasks (e.g., specific tasks for training in neurosurgery, abdominal surgery, orthopedic surgery, dental surgery, otorhinolaryngological surgery, or also generic tasks such as palpation) and education in medicine (e.g., anatomy learning). Additionally, the review assesses the complexity, reusability, and realism of the physical replicas, as well as the portability of the simulators. Finally, we describe whether and how the simulators have been validated. The review highlights that most of the studies do not have a significant sample size and that they include only a feasibility assessment and preliminary validation; thus, further research is needed to validate existing simulators and to verify whether improvements in performance on a simulated scenario translate into improved performance on real patients.
Highlights
Until the 20th century, the apprenticeship model, focused on the educational philosophy of “see one, do one, teach one”, was the standard teaching methodology in medical education
We present a systematic review of simulation techniques based on augmented reality (AR), mixed reality (MR), and hybrid approaches in the context of healthcare, to investigate the challenges and trends in this discipline
In the following paragraphs we report technical details on the implementation of the virtual component of the simulator, including the tracking approach adopted for deriving the spatiotemporal relationship between the real and virtual worlds (FQ3), the display technologies to provide the user with computer-generated information (FQ4), and the implementation of artificial intelligence (AI) techniques (FQ5)
Summary
Until the 20th century, the apprenticeship model, focused on the educational philosophy of “see one, do one, teach one”, was the standard teaching methodology in medical education. The trainee directly observes a procedure performed by the expert supervisor several times, (once the apprentice is considered ready) he/she executes the same procedure by imitating the supervisor’s skills; possible mistakes are prevented or fixed immediately by the supervisor to protect the patient This model undoubtedly has strengths thanks to the trainee’s early immersion in the clinical environment which allows him/her to acquire practical and applied knowledge. The rapid introduction of new techniques and surgical approaches, such as the minimally invasive and robotic procedures, combined with the new legislative restrictions on surgeons’ working hours have worsened the issues of the apprenticeship model [5,6,7] Based on these considerations, the surgical community was forced to reconsider training strategies [8]
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