Leveraging extended reality technologies to enhance the architectural design of healthcare environments: A Systematic Review.

Extended-Reality Technologies: An Overview of Emerging Applications in Medical Education and Clinical Care.

The purpose of this study is to determine perception of postgraduate Computer Education and Instructional Technologies (CEIT) students regarding the concepts of Augmented Reality (AR), Virtual Reality (VR), Mixed Reality (MR), Augmented Virtuality (AV) and Mirror Reality; and to offer a table that includes differences and similarities between these concepts. This study also aims to determine the likelihood of CEIT postgraduate students for using the said concepts in education. In this context, the frequently used reality concepts in the CEIT field have been examined from the perspective of the participants and in terms of the following traits: frequency of potential use, perceived usefulness, and perceived effectiveness. The phenomenological method was used in this qualitative study. 10 CEIT graduate students have been the participants of this research; with 4 of these pursuing a PhD and 6 pursuing a Master's Degree. 14 open-ended questions related to AR, VR, MR, AV and Mirror Reality concepts were used throughout semi-structured and face-to-face interviews in order to collect data. Findings show that AR and VR are the most familiar concepts. Participants have several misconceptions about the reality concepts but the least amount of misconception was associated with AR and VR. Most of the participants had no idea about MR and none of them had any idea about Mirror Reality. Findings refer that VR is the most frequently used kind of reality owing to the fact that it can be developed and implemented more easily and there are several AR studies because of its current popularity.

The study examines the problem of using augmented and virtual reality in the process of blended learning in general secondary education. Analysis of recent research and publications has shown that the use of augmented and virtual reality in the educational process has been considered by scientists. However, the target group in these studies is students of higher education institutions. Most of the works of scientists are devoted to the problem of introducing augmented reality into the traditional educational process. At the same time, the use of augmented and virtual reality technologies in the process of blended learning remains virtually unexplored. The study analyzes the meaning of the concept of "blended learning". The conceptual principles of blended learning are considered. It has been found that scholars differ in their understanding of the concept of "blended learning". Sometimes researchers distinguish between the components of blended learning: full-time and online learning. The study presents the special advantages of blended learning and the taxonomy of blended learning. It was found that there are some difficulties in implementing blended learning. The article outlines the practical use of virtual and augmented reality. The definition of augmented and virtual reality is given. The mixed reality is considered as a separate kind of notion. Separate applications of virtual and augmented reality that can be used in the process of blended learning are considered (MEL Chemistry VR; Anatomyou VR; Google Expeditions; EON-XR). As a result of the study, the authors propose possible ways to use augmented reality in the educational process. The model of using augmented and virtual reality in blended learning in general secondary education institutions was designed. It consists of the following blocks: goal; teacher’s activity; forms of education; teaching methods; teaching aids; organizational forms of education; pupil activity and results. Based on the model, the methodology of using augmented and virtual reality in blended learning in general secondary education was developed. The methodology contains the following components: target component, content component, technological component and resultant component. The methodology is quite universal and can be used for any subject in general secondary education. The types of lessons in which it is expedient to use augmented (AR) and virtual reality(VR) are determined. Recommendations are given at which stage of the lesson it is better to use AR and VR tools (depending on the type of lesson).

In the field of surgery, major changes that have occurred include the advent of minimally invasive surgery and the realization of the importance of the ‘systems’ in the surgical care of the patient (Pierorazio & Allaf, 2009). Challenges in surgical training are two-fold: (i) to train the surgical residents to manage a patient clinically (ii) to train them in operative skills (Singh & Darzi,2013). In Pakistan, another issue with surgical training is
 that we have the shortest duration of surgical training in general surgery of four years only, compared to six to eight years in Europe and America (Zafar & Rana, 2013). Along with it, the smaller number of patients to surgical residents’ ratio is also an issue in surgical training. This warrants formal training outside the operation room. It has been reported by many authors that changes are required in the current surgical training system due to the significant deficiencies in the graduating surgeon (Carlsen et al., 2014; Jarman et al., 2009; Parsons, Blencowe, Hollowood, & Grant, 2011). Considering surgical training, it is imperative that a surgeon is competent in clinical management and operative skills at the end of the surgical training. To achieve this outcome in this challenging scenario, a resident surgeon should be provided with the opportunities of training outside the operation theatre, before s/he can perform procedures on a real patient. The need for this training was felt more when the Institute of Medicine in the USA published a report, ‘To Err is Human’ (Stelfox, Palmisani, Scurlock, Orav, & Bates, 2006), with an aim to reduce medical errors. This is required for better training and objective assessment of the surgical residents. The options for this training include but are not limited to the use of mannequins, virtual patients, virtual simulators, virtual reality, augmented reality, and mixed reality. Simulation is a technique to substitute or add to real experiences with guided ones, often immersive in nature, that reproduce substantial aspects of the real world in a fully interactive way. Mannequins, virtual simulators are in use for a long time now. They are available in low fidelity to high fidelity mannequins and virtual simulators and help residents understand the surgical anatomy, operative site and practice their skills. Virtual patients can be discussed with students in a simple format of the text, pictures, and videos as case files available online, or in the form of customized software applications based on algorithms. In a study done by Courtielle et al, they reported that knowledge retention is increased in residents when it is delivered through virtual patients as compared to lecturing (Courteille et al., 2018).But learning the skills component requires hands-on practice. This gap can be bridged with virtual, augmented, or mixed reality. There are three types of virtual reality (VR) technologies: (i) non-immersive, (ii) semi-immersive, and (iii) fully immersive. Non-immersive (VR) involves the use of software and computers. In semi-immersive and immersive VR, the virtual image is presented through the head-mounted display(HMD), the difference being that in the fully immersive type, the virtual image is completely obscured from the actual world. Using handheld devices with haptic feedback the trainee can perform a procedure in the virtual environment (Douglas, Wilke, Gibson, Petricoin, & Liotta, 2017). Augmented reality (AR) can be divided into complete AR or mixed reality (MR). Through AR and MR, a trainee can see a
 virtual and a real-world image at the same time, making it easy for the supervisor to explain the steps of the surgery. Similar to VR, in AR and MR the user wears an HMD that shows both images. In AR, the virtual image is transparent whereas, in MR, it appears solid (Douglas et al., 2017). Virtual augmented and mixed reality has more potential to train surgeons as they provide fidelity very close to the real situation and require fewer physical resources and space compared to the simulators. But they are costlier, and affordability is an issue. To overcome this, low-cost solutions to virtual reality have been developed. It is high time that we also start thinking on the same lines and develop this means of training our surgeons at an affordable cost.

The perceptual behavior of consumers on a product displayed in the market has a vital role in analyzing the importance given to that product. Therefore, various strategies have been developed to understand this consumer behavior in the selection of products. Immersive technologies like virtual, augmented, and mixed reality are among them. With the foremost feature of immersion in the virtual world and interaction of users with virtual objects, virtual reality, and augmented reality have unlocked their potential in research and a user-friendly tool for analyzing consumer behavior. In addition to these technologies, mixed reality also has a significant role in investigating consumer behavior. Studies on immersive technologies in food applications are vast, hence this review focuses on the applications of virtual, augmented, and mixed reality in the food selection behavior of consumers. The behavioral studies are elicited to develop new products based on consumer needs, to understand the shopping behavior in supermarkets for real-time usage, and to know the influence of emotions in a selection of products. The findings suggest that virtual, augmented, and mixed reality induce immersion of the users in food selection behavioral studies. Information on the technological advancements in the tools used for bringing immersion and interaction are discussed for its futuristic applications in food. Though immersive technology gives users a realistic virtual environment experience, its application in food systems is in the budding stage. More research on human response studies would contribute to its innovative and inevitable application in the future.

Mixed reality (MR) provides new opportunities for creative and innovative learning. MR supports the merging of real and virtual worlds to produce new environments and visualisations where physical and digital objects co-exist and interact in real-time (MacCallum & Jamieson, 2017). The MR continuum links both virtual and augmented reality, whereby virtual reality (VR) enables learners to be immersed within a completely virtual world, while augmented reality (AR) blend the real and the virtual world. MR embraces the spectrum between the real and the virtual; the mix of the virtual and real worlds may vary depending on the application. The integration of MR into education provides specific affordances which make it specifically unique in supporting learning (Parson & MacCallum, 2020; Bacca, Baldiris, Fabregat, Graf & Kinshuk, 2014). These affordance enable students to support unique opportunities to support learning and develop 21st-century learning capabilities (Schrier, 2006; Bower, Howe, McCredie, Robinson, & Grover, 2014).
 
 In general, most integration of MR in the classroom tend to be focused on students being the consumers of these experiences. However by enabling student to create their own experiences enables a wider range of learning outcomes to be incorporated into the learning experience. By enabling student to be creators and designers of their own MR experiences provides a unique opportunity to integrate learning across the curriculum and supports the develop of computational thinking and stronger digital skills. The integration of student-created artefacts has particularly been shown to provide greater engagement and outcomes for all students (Ananiadou & Claro, 2009).
 
 In the past, the development of student-created MR experiences has been difficult, especially due to the steep learning curve of technology adoption and the overall expense of acquiring the necessary tools to develop these experiences. The recent development of low-cost mobile and online MR tools and technologies have, however, provided new opportunities to provide a scaffolded approach to the development of student-driven artefacts that do not require significant technical ability (MacCallum & Jamieson, 2017). Due to these advances, students can now create their own MR digital experiences which can drive learning across the curriculum.
 
 This presentation explores how teachers at two high schools in NZ have started to explore and integrate MR into their STEAM classes. This presentation draws on the results of a Teaching and Learning Research Initiative (TLRI) project, investigating the experiences and reflections of a group of secondary teachers exploring the use and adoption of mixed reality (augmented and virtual reality) for cross-curricular teaching. The presentation will explore how these teachers have started to engage with MR to support the principles of student-created digital experiences integrated into STEAM domains.

Recent advancements in artificial intelligence (AI) have shown significant potential in the medical field, although many applications are still in the research phase. This paper provides a comprehensive review of advancements in augmented reality (AR), mixed reality (MR), and virtual reality (VR)for surgical applications from 2019 to 2024 to accelerate the transition of AI from the research to the clinical phase. This paper also provides an overview of proposed databases for further use in extended reality (XR), which includes AR, MR, and VR, as well as a summary of typical research applications involving XR in surgical practices. Additionally, this paper concludes by discussing challenges and proposed solutions for the application of XR in the medical field. Although the areas of focus and specific implementations vary among AR, MR, and VR, current trends in XR focus mainly on reducing workload and minimizing surgical errors through navigation, training, and machine learning-based visualization. Through analyzing these trends, AR and MR have greater advantages for intraoperative surgical functions, whereas VR is limited to preoperative training and surgical preparation. VR faces additional limitations, and its use has been reduced in research since the first applications of XR, which likely suggests the same will happen with further development. Nonetheless, with increased access to technology and the ability to overcome the black box problem, XR's applications in medical fields and surgery will increase to guarantee further accuracy and precision while reducing risk and workload.

A switchable virtual reality (VR), augmented reality (AR), and mixed reality (MR) system is proposed using digital optical cloaking. Optical cloaking allows completely opaque VR devices to be cloaked, switching to AR or MR while providing correct three-dimensional (3D) parallax and perspective of the real world, without the need for transparent optics. On the other hand, 3D capture and display devices with non-zero thicknesses, require optical cloaking to properly display captured reality. A simplified stereoscopic system with two cameras and existing VR systems can be an approximation for limited VR, AR, or MR. To provide true 3D visual effects, multiple input cameras, a 3D display, and a simple linear calculation amounting to cloaking can be used. Since the display size requirements for VR, AR, and MR are usually small, with increasing computing power and pixel densities, the framework presented here can provide a widely deployable VR, AR, MR design.

Changing the physical environment of healthcare facilities can positively impact patient outcomes. Virtual reality (VR) offers the potential to understand how healthcare environment design impacts users’ perception, particularly among those with brain injuries like stroke, an area with limited research. In this study, our objective was to forge a new pathway in healthcare environment research by developing a comprehensive, six-module ‘user-centered’ design decision support approach, utilizing VR technology. This innovative method integrated patient engagement, architectural design principles, BIM prototyping, and a sophisticated VR user interface to produce realistic and immersive healthcare scenarios. Forty-four stroke survivors participated, experiencing 32 VR scenarios of in-patient bedrooms, followed by interactive in-VR questions and semi-structured interviews. The results of the approach proved to be comparatively efficient and feasible, provided a high level of immersion and presence for the participants, and effectively elicited extremely rich quantifiable response data, which revealed distinct environmental preferences. Our novel approach to understanding end-user responses to stroke rehabilitation architecture demonstrates potential to inform user-centered evidence-based design decisions in healthcare, to improve user experiences and health outcomes in other healthcare populations and environments.

ABSTRACTThis article provides the first review of the existing literature consolidating research into the use of virtual, augmented and mixed reality technologies within K–12 educational environments. The review explores the peer-reviewed scholarly studies conducted between 2006 and May 2017, which involved the use of virtual reality (VR), augmented reality (AR) or mixed reality (MR) technologies in the instruction of students in elementary, middle or high school. The literature revealed common themes including collaboration, communication, critical thinking, attitude, engagement, learning, motivation, performance or achievement, and technology (used or proposed). This literature review will contribute to the field by providing clarity on definitions for VR, AR and MR technologies in consideration of educational use, present an overview of the existing research on VR, AR and MR specific to K–12 educational environments and identify future research needs and directions.

The active development of adaptive-interactive systems, in particular virtual, augmented and mixed reality, in the field of education makes it appropriate to study the possibilities of using these systems directly to train personnel. The reduction of costs and increase of the availability of adaptive-interactive systems, including those that can be used in the training process, encourages their use in a growing number of companies around the world. The aim of the article is to study the usage of modern adaptive-interactive systems in the field of personnel training, such as virtual, augmented and mixed reality, to determine their advantages and disadvantages, as well as prospects for mass implementation of these systems in the practice of personnel training. Different types of virtual reality systems are distinguished, the delimitation of which lies in the plane of ways and modes of their interaction with the user. The research methodology is based on the semantic analysis of the interpretation of different types of adaptive-interactive systems of personnel training and analysis of their usage cases on existing enterprises. The expediency of using virtual and augmented reality technologies as methods of active learning in order to study various subjects is described and examples of personnel training systems using mixed reality are presented. The advantages and disadvantages of using these technologies in staff training are analyzed. Examples of application of adaptive-interactive systems at Ukrainian and foreign enterprises are given. The limited supply of adaptive-interactive systems of personnel training by the developers of such software and hardware indicates a lack of relevant specialists and the unwillingness of domestic enterprises to invest in these systems. At the same time, modern digital technologies such as virtual reality, augmented reality and mixed reality using artificial intelligence provide in practice high efficiency of the educational process in the enterprise by increasing concentration and attention of learners, easiness of information retrieval, providing practical skills, independence and simultaneous safety of employee training. In response, the directions of further researches in implementation of modern technologies of training of the personnel of the enterprises in Ukraine are offered.

User Experience and Engagement in the Reality–Virtuality Continuum: A Special Issue Guest Editorial

When working with emergent and appealing technologies as Virtual Reality, Mixed Reality and Augmented Reality, the issue of definitions appear very often. Indeed, our experience with various publics allows us to notice that technology definitions pose ambiguity and representation problems for informed as well as novice users. In this paper we present Immercity, a content curation system designed in the context of a collaboration between the University of Montpellier and CapGemi-ni, to deliver a technology watch. It is also used as a testbed for our experiences with Virtual, Mixed and Augmented reality to explore new interaction techniques and devices, artificial intelligence integration, visual affordances, performance , etc. But another, very interesting goal appeared: use Immercity to communicate about Virtual, Mixed and Augmented Reality by using them as a support.

The recent advancements in digital technologies have led to exponential progress in dentistry. This narrative review aims to summarize the applications of Augmented Reality, Virtual Reality and Mixed Reality in dentistry and describes future challenges in digitalization, such as Artificial Intelligence and Robotics. Augmented Reality, Virtual Reality and Mixed Reality represent effective tools in the educational technology, as they can enhance students’ learning and clinical training. Augmented Reality and Virtual Reality and can also be useful aids during clinical practice. Augmented Reality can be used to add digital data to real life clinical data. Clinicians can apply Virtual Reality for a digital wax-up that provides a pre-visualization of the final post treatment result. In addition, both these technologies may also be employed to eradicate dental phobia in patients and further enhance patient’s education. Similarly, they can be used to enhance communication between the dentist, patient, and technician. Artificial Intelligence and Robotics can also improve clinical practice. Artificial Intelligence is currently developed to improve dental diagnosis and provide more precise prognoses of dental diseases, whereas Robotics may be used to assist in daily practice.

Background and Aims: Understanding how immersive technologies like AR, VR, and MR can transform education by enabling interactive and experiential learning. By addressing adoption challenges and highlighting successful case studies, it aims to help educators and policymakers effectively integrate these technologies while promoting equitable access and informed decision-making. Thus, this paper aims to explore the role of AR, VR, and MR in enhancing learning experiences. Methodology: The methodology ensures a thorough review by taking a systematic approach to data collection and analysis from various sources, with a focus on recent advances in immersive technologies. By combining qualitative and quantitative analyses, the paper aims to provide a comprehensive overview of how AR, VR, and MR affect educational practices and outcomes. Results: Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR) improve education by making difficult concepts more accessible and engaging. AR makes abstract concepts tangible, VR provides immersive experiences for deeper understanding, and MR connects the digital and physical worlds. These technologies work together to create interactive learning environments that meet a variety of learning needs, promote critical thinking, and encourage creativity. Conclusion: Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR) all improve education by making complex concepts more understandable and engaging through interactive experiences. These technologies create a dynamic learning environment by combining AR's tangibility, VR's immersion, and MR's integration of the digital and physical worlds.