Transforming Anatomy Education with Mixed Reality: A Curriculum-Based Study Using a Holographic Anatomy Software Suite

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

This study aims to explore the transformative impact of Mixed Reality (MR) technologies in the U.S. retail sector. It focuses on analyzing how MR reshapes shopping experiences, enhances customer engagement, and influences the economic landscape of retail. The methodology encompasses a comprehensive literature review, utilizing academic journals, conference proceedings, and industry reports. The search strategy involved keyword searches and manual screening, with inclusion and exclusion criteria set to filter relevant literature. The selection criteria prioritized recent studies to capture the latest trends in MR technology. The key findings reveal that MR technologies have evolved significantly, offering immersive and interactive shopping experiences that revolutionize customer engagement and satisfaction. The economic implications of MR in retail are profound, indicating substantial market growth and financial opportunities for retailers. However, the adoption of MR also presents challenges, including the need for integration into existing retail models and the development of user-friendly interfaces. The study also highlights the importance of regulatory frameworks and standardization in the successful implementation of MR technologies in retail. In conclusion, MR technologies hold great potential for the retail sector, offering innovative ways to engage customers and enhance their shopping experiences. However, realizing these opportunities requires overcoming various challenges, including adapting financial strategies and addressing infrastructure needs. As MR continues to evolve, it is poised to play a pivotal role in shaping the future of the retail sector. The study underscores the need for ongoing research to fully understand and leverage the potential of MR in retail.

A key part of gynecologic education is the gynecologic examination, especially the bimanual pelvic examination (BPE). Many medical students feel unsure and unprepared when they do pelvic examinations. The present study focused on whether immersive mixed reality (MR) technology can help to improve training efficiency in teaching BPE. The teaching efficiency was assessed by students' performance, satisfaction, and motivation. This was a prospective cohort study. We enrolled 120 students from the class of 2021 at Xiangya Hospital and divided them into two groups. One group trained with the MR gynecologic examination training system (MR + traditional group) and the other group used traditional teaching methods (tTraditional group). We accessed the efficiency of MR technology in teaching BPE through quizzes, surveys about user experience, and the Revised Instructional Materials Motivation Survey (RIMMS). The RIMMS results showed that the MR + traditional group demonstrated significant improvements in operational skills and student motivation compared to the traditional group, with substantial increment in attention (13.1 ± 0.92 vs. 9.87 ± 1.29, p < 0.001), relevance (12.8 ± 0.84 vs. 12.2 ± 1.24, p = 0.003), confidence (13.0 ± 0.97 vs. 11.4 ± 0.95, p < 0.001), and satisfaction (12.8 ± 0.94 vs. 10.8 ± 1.08, p < 0.001). Results of the subjective learner survey shows MR significantly increment in useful for learning (4.15 ± 0.63 vs. 3.55 ± 0.57, p < 0.001), enjoyable (4.20 ± 0.61 vs. 3.60 ± 0.62, p < 0.001), engaging (4.13 ± 0.70 vs. 3.38 ± 0.64, p < 0.001) and recommendation (4.15 ± 0.61 vs. 3.27 ± 0.55, p < 0.001), while easy-to-use scores were comparable between both groups (3.48 ± 0.50 vs. 3.45 ± 0.50, p = 0.717). This study shows that MR technology is effective for training medical students in BPE. It helps to increase engagement and motivation. MR technology adds to traditional training methods by providing a more interactive learning environment. Adding MR technology to medical training can significantly improve the quality of education for future medical professionals in BPE.

Background Emerging technologies, such as virtual reality (VR), augmented reality (AR), mixed reality (MR), and 3D printing (3DP), have transformative potential in education and health care. However, complete integration has not yet been achieved, and routine use is limited. There may exist gaps in the perspectives of these technologies between users and developers, and improvement may be necessary in developing such technologies. Objective The purpose of this study was to investigate the gaps in perspectives between medical students and developers in medical education regarding satisfaction and anticipated future use of VR, AR, MR, and 3DP technologies, as well as developers’ perspectives on their advantages and current challenges. Methods This retrospective survey study was conducted during a 4-hour elective course over a period of 4 weeks. In this course, computed tomography scans of congenital heart disease patients, medical image processing software, head-mounted displays, and a virtual table were used. Student pre- and postsurveys and the developer survey included demographic and other characteristics, satisfaction, and anticipated future use of VR, AR, MR, and 3DP technologies. The advantages and current challenges of these technologies were only assessed in the developer survey. Results The study enrolled 41 participants, including 15 first-year medical students and 26 software and content developers. Students were more satisfied than developers across AR, VR, and 3DP in terms of overall satisfaction (VR and AR: P&lt;.001; 3DP: P=.002), esthetics (VR: all P&lt;.001; AR: vividness, P=.006 and design, P&lt;.001; 3DP: vividness, P=.001 and design, P=.002), and continuous use intention (VR: repetition, P=.04 and continuous use, P=.02). Particularly in VR, satisfaction with reality was higher among students than among developers (real world, P=.006). Developers anticipated future use of MR for educating medical students and residents, individual and collaborative surgical planning, and performing surgery on patients. In contrast, students anticipated future use of VR primarily for student education, 3DP for resident education and individual surgical planning, and AR for collaborative surgical planning and performing surgery on patients. Developers perceived the inherent capabilities of VR, AR, and MR technologies as strengths, with hardware performance identified as a drawback. For 3DP, the possibility of customized product manufacturing was seen as an advantage, while cost was seen as a disadvantage. Conclusions This study elucidated the different perspectives between medical students and developers regarding 3D technologies, highlighting the discrepancy in potential applications and challenges within the medical field. These findings will guide the integration of 3D technologies in education and health care to fulfill the needs and goals of both medical students and developers.

This article was migrated. The article was not marked as recommended. Introduction: Motivation plays an important role in the learning process and strongly influences learning outcomes. However, it remains unclear how the use of technologies like mixed reality (MR) affect student motivation for learning. Our study aims to assess differences in student motivation for learning using MR technology in comparison to large group, didactic learning. Methods: First-year medical students (n = 18) were given a survey to measure three components of motivation: attention, relevance, and confidence. The survey was given after classroom learning on cardiovascular anatomy and physiology was completed, and again after completing a learning activity on the same topic using MR technology. Results: The analysis showed overall student motivation to learn in the classroom and from the MR activity were similar (p &gt; 0.05). However, the specific motivating factors differed between the two instructional methods. Students were motivated to learn using the MR activity because it better held their attention (p &lt; 0.05). In contrast, classroom instruction motivated students to learn primarily because students viewed it as more worthwhile and useful (p &lt; 0.05). There was no difference in student confidence as a motivating factor to learn. Conclusions: These findings suggest MR instructional activities may be designed to motivate student learning by holding their attention because of the variety of interactive learning options it is capable of presenting. However, instructional activities using MR technology may not be perceived by students as being as worthwhile and useful as formal classroom instruction.

Teratomas are rare neoplasms that arise from pluripotent germ cells. Sacrococcygeal teratomas are often diagnosed in infants but are rare in adults; a mature teratoma can contain hair, teeth, bony tissue, and other mature tissue types. Herein, we report for the first time a patient with a teratoma containing intact bones that formed a pseudoarthrosis. A 49-year-old woman was admitted to hospital after a massive life-long sciatic tumor had begun to grow larger over the past year. A 16 cm × 25 cm solid mass with a clear boundary was palpable in the sacrococcygeal region. Radiography, computed tomography, and magnetic resonance imaging indicated a sacrococcygeal teratoma, although blood alpha-fetoprotein levels were normal. The teratoma was completely excised using 3-dimensional reconstruction mixed reality (MR) technology with no notable complications. Postoperative pathological examination of the excised lesion confirmed a mature teratoma. Interestingly, two intact irregular bones that formed a pseudoarthrosis were isolated; one was 11 cm and the other 6 cm. The patient is currently healthy and has experienced no recurrences. Sacrococcygeal teratomas are rare, especially in adults, and often comprised lots of components, such as fat, bony tissue. However, it's first reported that formation of pseudoarthrosis in this case so far. It is difficult for surgeons to achieve complete excision without complications owing to the complex anatomic structure of the sacrum. The 3-dimensional reconstruction and mixed reality (MR) technology based on computed tomography can provide spatial visualization, which allows surgeons to examine the teratoma at different angles preoperatively. Combining 3-dimensional reconstruction and mixed reality (MR) technology in this case facilitated complete resection and prevented recurrence.

&lt;span&gt;This study investigates users' perception and acceptance of mixed reality (MR) technology. Acceptance of new information technologies has been important research area since 1990s. It is important to understand the reasons why people accept information technologies, as this can help to improve design, evaluation and prediction how users will respond to a new technology. MR is one of the potential technologies that has gained attention in recent time, offering a unique environment as it combines real and virtual objects, interactive in real time and registered in three dimensions. This paper discusses a study into users' acceptance of a mixed reality prototype, named &lt;/span&gt;&lt;em&gt;Mixed Reality Regenerative Concept&lt;/em&gt;&lt;span&gt; (MRRC). MRRC was developed using mixed reality technology to provide Biomedical Science students with exposure to regenerative concepts and tissue engineering processes. MRRC integrates situated learning as the model of instruction, emphasising authentic context and activities. Volunteer sampling was used in this study to obtain 63 participants comprising 2nd, 3rd and 4th year Biomedical Science students in two public universities in Malaysia, who had not previously experienced mixed reality technology. In this study, the constructs used to determine acceptance of mixed reality technology were personal innovativeness (PI), perceived enjoyment (PE), perceived ease of use (PEOU), perceived usefulness (PU), and intention to use (ITU). Results from simple correlation analyses showed positive linear correlations between the constructs. However, findings from regression analysis suggested that perceived usefulness was the most important factor determining users' intention to use this technology in the future. Findings from this study also suggested that tertiary level science students showed a high willingness to use mixed reality technology in the future.&lt;/span&gt;

Abstract: While the application of virtual reality (VR) and mixed reality (MR) technologies to enhance learning motivation in science education remains a hot topic that garners significant interest from scholars, there is a paucity of studies addressing whether and how VR or MR may be more effective in motivating students’ learning intention. Accordingly, the current study investigates the distinctive effects of VR and MR on students’ learning intention through the theoretical lenses of plausibility illusion and enjoyment. Employing a within-subject design experiment ( N = 71), the current research explores whether and how the learning experience of the solar system, either via VR or MR headsets, may impact students’ intention to learn using VR or MR. We posited that the sense of plausibility illusion and enjoyment will serially mediate the impact of XR modality (VR vs. MR) on students’ learning intention. Results from a two-condition within-subjects mediation analysis confirmed the significant mediating effects of plausibility illusion and enjoyment on the relationship between XR modality and learning intention. By exploring the differences in the structural affordances of VR and MR technologies, this study provides insights into understanding the distinctive roles of VR and MR technologies on students’ learning intentions.

Introduction As a medical student's first encounter with human anatomy, cadaveric dissection facilitates a comprehensive, three-dimensional (3D) understanding of the human body. We believe that this interaction is vital for future clinicians' ability to interpret medical imaging, specifically when the anatomy may be viewed in different planes, such as in Magnetic Resonance Imaging (MRI). In this study, we evaluated how learning anatomy through cadaveric vs. virtual dissection software programs affected medical students' ability to interpret medical imaging, as well as the impact it had on student satisfaction with their anatomical education. Methods Twenty first year medical students and 8 senior-level pre-medical students were recruited for this study, each of them having no prior experience with cadaveric dissection. The first year medical students learned anatomy via virtual dissection software, while the pre-medical students performed in-person dissections. After both groups completed the musculoskeletal system in their respective program, each student was given a 16-question agree/neutral/disagree survey with questions regarding their confidence and satisfaction with their anatomical education, as well as questions about respecting human dignity and empathizing with future patients. Following the survey, each student was asked to complete a 30-question open-answer assessment which asked them to identify various musculoskeletal structures on MRI scans. Both cohorts received identical assessments and were given the same time restrictions. Two months later, each student was asked to complete a second, identical 30-question assessment in order to evaluate anatomical knowledge retention. Results The pre-medical students who were enrolled in a human anatomy dissection course scored higher than the first year medical students learning anatomy virtually on both assessments in this study. The pre-medical students had average scores of 43.3% (SD 9.4) and 41.7% (SD 10.8) for the initial and 2-month assessments, respectively. The first-year medical students had average scores of 37.5% (SD 12.6) and 32.2% (SD 13.4) for the initial and 2-month assessments, respectively. Additionally, the survey results demonstrated that the majority of first-year medical students (90%) felt that the virtual software was inadequate compared to in-person dissection. The survey also revealed that those who participated in cadaveric dissection developed more respect for the dignity of human beings and empathy for future patients (87.5% and 100%, respectively) compared to those who did not (25% and 5%, respectively). Conclusion This study demonstrates that cadaveric dissection provides several benefits to future physicians. In-person dissection facilitates a deeper understanding of the anatomy, and provides a 3D awareness of the human body that enables future physicians to comprehend anatomy on multiple planes. Additionally, this study demonstrates that cadaveric dissection not only improves student satisfaction, but it develops intangible characteristics in future physicians such as respect and empathy for human beings.

Right hemicolectomy (RHC) is an important treatment for colorectal cancer. The superior mesenteric artery and superior mesenteric vein are known for their significant vascular variations. This study evaluated the short-term outcomes of integrating Mixed Reality (MR) technology into RHC for the treatment of colorectal cancer. Patients who underwent RHC for clinical stage II or III colon cancer between January 2015 and August 2024 were included. Patients were divided into two groups: the MR (+) group (n = 47), in which MR was used, and the MR (−) group (n = 145), in which MR was not used. MR using SYNAPSE VINCENT, Holoeyes MD, and HoloLens2 was utilized for detailed 3D visualization of the vascular anatomy preoperatively and intraoperatively. Forty-four patients per group were matched via propensity score matching and surgical outcomes were compared. In both groups, approximately 70% of the surgeries were performed by the training surgeon. Compared with the MR (−) group, intraoperative blood loss and hospital stay were decreased, and the number of lymph nodes harvested around the middle colic artery/vein were increased without prolonging the operative time in the MR (+) group. MR in RHC offers surgical precision, safety, enhanced patient recovery, and educational value.

Digital hydraulics is a discrete technology that integrates advanced dynamic system controls, digital electronics, and machine learning to enhance fluid power systems’ performance, overall efficiency, and controllability. A mechanically actuated inline three-piston variable displacement digital pump was previously proposed and designed. The inline three-piston pump incorporates complex mechanical and hydraulic subsystems and highly coupled mechanisms. The complexity of the utilized subsystems poses challenges when assessing the viability of the conceptual design. Therefore, this work focuses on designing, developing, and implementing a collaborative virtual platform involving a digitized module showcasing the internal mechanical structure of the digital pump utilizing mixed reality (MR) technology. MR technology is acknowledged as the forthcoming evolution of the human–machine interface in the real–virtual environment utilizing computers and wearables. This technology permits running simulations that examine the complexity of highly coupled systems, like the digital pump, where understanding the physical phenomenon is far too intricate. The developed MR platform permits multiple users to collaborate in a synchronized immersive MR environment to study and analyze the applicability of the pump’s design and the adequacy of the operated mechanisms. The collaborative MR platform was designed and developed on the Unity game engine, employing Microsoft Azure and Photon Unity Networking to set up the synchronized MR environment. The platform involves a fully interactive virtual module on the digital pump design, developed in multiple stages using Microsoft’s Mixed Reality Tool Kit (MRTK) for Unity and deployed in the synchronized MR environment through a HoloLens 2 MR headset. A research study involving 71 participants was carried out at Purdue University. The study’s objective was to explore the impact of the collaborative MR environment on understanding the complexity and operation of the digital pump. It also sought to assess the effectiveness of MR in facilitating collaboration among fluid power stakeholders in a synchronized digital reality setting to study, diagnose, and control their complex systems. Surveys were designed and completed by all 71 participants after experiencing the MR platform. The results indicate that approximately 75% of the participants expressed positive attitudes toward their overall MR platform experience, with particular appreciation for its immersive nature and the synchronized collaborative environment it provided. More than 70% of the participants agreed that the pump’s collaborative MR platform was essential for studying and understanding the complexity and intricacy of the digital pump’s mechanical structure. Overall, the results demonstrate that the MR platform effectively facilitates the visualization of the complex pump’s internal structure, inspection of the assembly of each of the involved subsystems, and testing the applicability of the complicated mechanisms.

It is clinically challenging to accurately drill femoral and tibial tunnels to reconstruct the anterior cruciate ligament (ACL). Mixed reality (MR) technology, a further development of virtual reality technology, presents virtual scene information in real time and establishes an interactive feedback information loop among the real world, the virtual world, and the user. The purpose of this study was to investigate the structural and early clinical outcomes of ACL reconstruction assisted by MR technology. It was hypothesized that MR technology would improve the accuracy of tunnel localization. Cohort study; Level of evidence, 3. Included were 44 patients at a single institution who underwent arthroscopic single-bundle ACL reconstruction between June 2020 and March 2022. Reconstruction with the aid of MR technology was performed in 21 patients (MR group), and conventional arthroscopic reconstruction was performed in 23 patients. Postoperatively, the parameters related to the bone tunnel positioning were compared by computed tomography imaging with 3-dimensional (3D) reconstruction, and 12-month postoperative clinical outcomes were assessed with the Lysholm and International Knee Documentation Committee scores. There was no statistically significant difference in projection angles in the coronal, axial, or sagittal plane between the preoperative virtually created tunnel guide pin and the actual tunnel (P > .05 for all). In the MR group, the center of the femoral tunnel exit was closer to the apex of the lateral femoral condyle along the proximal-distal axis (14.07 ± 4.12 vs 17.49 ± 6.24 mm for the conventional group; P < .05) and the graft bending angle was lower (117.71° ± 8.08° vs 127.81° ± 11.91° for the conventional group; P < .05). The scatterplot of the femoral tunnel location distribution showed that the entrance and exit points in the MR group were more concentrated and closer to the ideal location of the preoperative design than in the conventional group. Patients in both groups had significant preoperative-to-postoperative improvement based on outcome scores (P < .001 for all), with no significant difference between groups. ACL reconstruction with the aid of MR technology allowed for more accurate positioning and orientation of the femoral tunnel during surgery when compared with conventional reconstruction.

Current technologies, especially digital media have developed very fast in the last ten years, bringing changes to our lives and presents new challenges, opportunities and new requirements which are different from conventional delivery modes in education. Mixed reality (MR) technologies, with the features of immersive and tangible interaction, have been explored in education, which provide a more 'engaging' experience to learners. In this article, we will introduce a MR classroom developed for a local primary school in Singapore that includes two modules – solar system and plant system, and a MR exhibition about evolution, which was a public exhibition in the Singapore Science Centre. This novel, interesting learning experience is provided by combining tangible interactions and MR technologies. To identify and address usability and usefulness issues, a study on our MR classroom was conducted. Participants were surveyed on their perceptions towards the MR classroom systems. Preliminary results seemed to indicate participants' intention to use MR for learning, and it was influenced directly by perceived usefulness, and indirectly through perceived ease of use and social influence.

Fluid power systems can be expensive and difficult to access, making it challenging to provide hands-on training. This work discusses the incorporation of Mixed Reality (MR) technology in Fluid Power applications for providing a virtual training environment that simulates the behavior of fluid power systems, allowing users to receive immediate feedback on the system’s performance. Mixed reality is a digitized-based technology that integrates a virtual environment with our real world by utilizing real-world sensor data and computer models. This technology allows running simulations that examine the complexity of highly-coupled systems, producing new digital environments where physical and digital elements can interact in real-time. With all these features, MR technology can be a practical training tool for running virtual simulations that mimic real-life industry settings. It can extend the user with a virtual training environment, thus preparing the next generation of fluid power engineers and specialists. Throughout this work, we present the development and capabilities of a digitized virtual copy of a hydraulic excavator’s arm in an MR environment as a proof of concept. The MR arm module is developed and deployed using Microsoft’s Mixed Reality Tool Kit (MRTK) for Unity through HoloLens 2 MR headset. The MR development involves generating virtual copies of the mechanical and hydraulic subsystems, conducting the virtual assembly, and creating a user interface in the MR environment to visualize and interact with the model. The developed MR module enables visualizing the excavator’s internal structure, conducting the virtual assembly, and running virtual simulations, all of which assist in training future fluid power operators. It is an effective training tool that helps train junior engineers/technicians, cutting down on cost and time.

IntroductionOrthognathic surgery (OGS) is a highly sophisticated surgical technique that aims to repair a variety of skeletal and dental abnormalities, including misaligned jaws and teeth. It requires precise preoperative preparation and advanced surgical skills, which are typically learned through years of practical experience in operating rooms or laboratory-based surgical training facilities utilizing cadavers or models. The traditional physical hands-on method of surgical training is still used at OGS. However, this method requires a longer time of preparation. Currently, mixed reality (MR)—a combination of virtual reality and augmented reality technology—is an innovation of OGS. The present study aimed to present a comprehensive review of studies that assessed the advantages of utilizing mixed reality technology in OGS.MethodsA modified Population, Intervention, Comparison, Outcome strategy was performed using a combination of electronic (PubMed, Cochrane, Embase) and manual searches between 2013 and 2023 exploring mixed reality (MR) technology in OGS in the last 10 years. The inclusion criteria were limited to the patient and study model focusing on the clinical application of MR and the associated field of OGS.ResultThe initial search indicated 1731 studies, of which 17 studies were included for analysis. The main results indicated that the use of MR technology in OGS led to high accuracy and time reduction as primary outcomes and cost-effectiveness and skill improvement as secondary outcomes. The review firmly concluded that MR technology exhibited a positive impact on students, trainees, and oromaxillofacial surgeons. However, due to the heterogeneity of the included studies, meta-analyses could not be performed. Collectively, these findings provide strong evidence for the advantages of MR technology in orthognathic surgery.ConclusionMR technology significantly improves OGS planning efficiency by providing pre-surgical information and serving as an intraoperative navigation tool, reducing surgical time without compromising outcomes. Virtual training using MR technology exerts a positive impact on knowledge and skill improvement for OGS. This innovative technology will revolutionize the healthcare system and enhance patient care.