Mixed Reality Simulation Research Articles

Exploring L2 Teacher Identities in an Intercultural Telecollaborative Mixed-Reality Teaching Environment

This study investigates the identities produced by three L2 teachers of different backgrounds and experiences in an intercultural telecollaborative project that integrated the use of mixed-reality technology. Content-analysis (Hoffman et al., 2011) and multimodal (inter)action analysis (Norris, 2011) were employed to identify the identity elements produced during their multimodal interactions. Using Darvin and Norton’s (2015) model of investment (MOI) as an interpretative lens, this study uncovers the different identities held by the participants, and the ways in which they aspired to become good teachers. Findings also show that mixed-reality simulated teaching provided a safe environment for exercising professional agency, thereby facilitating identity development and promoting the sense of getting there. Interactive reflection provided a site of struggle where the value of capital and imagined identities shifted. Dialoguing among the participants allowed them to reassess the value of pre-acquired capital and move to (re)imagining new teacher identities and restructuring ideological structures. Mixed-reality teaching and intercultural professional learning sensitizes the less experienced teachers to the socially and culturally complex roles required for L2 teachers. The mixed-reality simulation technology still has its limitations, mainly where classroom interaction is concerned, because the number of avatar students is small and they cannot move around physically.

Telehealth training: Interprofessional mixed reality simulation in a retrieval service setting.

The use of Telehealth is well established in Australian retrieval service settings to aid assessment and management of patients requiring aeromedical transportation and to provide support to clinicians at remote facilities. Telehealth ensures prompt advice and treatment for critically ill and injured patients and can facilitate a resuscitation until the retrieval team arrives. There is scant information regarding the knowledge, skills and abilities required of Telehealth professionals, despite the universal recognition of it requiring a complex skill set, comprehensive understanding of technology and mastery of retrieval medicine. We share the experiences of the South Australia Ambulance Service MedSTAR Emergency Medical Retrieval Service preparing an education programme focussed on the psychometric skills in Telehealth. Our programme realistically simulates Telehealth and coordination systems in use across South Australia, provides in-depth hands-on practice for medical and nursing staff that incorporates teamwork, communication, technical and critical thinking skills and culminates with a mixed-reality simulation scenario and formal debrief.

Preservice special education teachers’ perceptions of mixed-reality simulation experiences

Special educators are expected to implement High-Leverage Practices to support diverse learners. This article describes the findings from a mixed-reality simulation project structured around the framework of connected learning. The project sought to evaluate how 30 preservice teacher candidates in special education feel about mixed-reality simulation compared to traditional classroom practice (i.e., role playing) in learning the High-Leverage Practice of system of least prompts. Results of this study indicate that those who participated in the mixed-reality simulator had significantly different social validity survey responses from the live practice group on items related to perceived performance, perceived tool value, and treatment experience; these findings can help inform teacher educators on how to incorporate mixed-reality simulation. Limitations and future research are discussed.

Design and analysis of depth cues on depth perception in interactive mixed reality simulation systems

AbstractImplementing an interactive mixed reality simulation system is an economical and risk‐free method for skill training. However, research to enhance the accuracy of mixed reality simulation has always been a challenge. One of the key indicators of a simulation's accuracy is the user's depth perception. Adding depth cues to the simulation scene can effectively increase the accuracy of depth perception. Therefore, in this study, we designed five depth cues to find the one most beneficial for depth perception: (1) depth bar, (2) location ball, (3) fixed window, (4) 3D wireframe, and (5) movable silhouettes. These depth cues were tested using an experimental system with two sets of experimental settings. The first experiment compared the five depth cues at five different viewing distances and showed that the movable silhouettes benefited depth perception accuracy the most. The second experiment compared depth perception accuracies among three different horizontal tilt settings, showing that depth perception accuracy is dependent on the horizontal tilt. Furthermore, different depth perception accuracies were obtained with and without depth cues, proving that the effects from the horizontal tilts were independent of depth cues. The results of these studies provide references for designing interactive mixed reality simulation systems.

Inferences on enacted understanding: using immersive technologies to assess intuitive physical science knowledge

Purpose This study aims to advance the proposal to use immersive virtual learning environments to stimulate and reveal deep-seated knowledge about science, giving instructors and researchers unique possibilities for assessing and identifying intuitive physical science knowledge. Aside from the ability to present rich and dynamic stimuli, these environments afford bodily enactment of people’s understanding, which draws less from declarative knowledge stores and more from everyday experiences with the physical world. Design/methodology/approach The authors ground their proposal in a critical review of the impact of stimulus and task characteristics of traditional physics inventories. Using a grounded theory approach, the authors present classifications and interpretations of observed bodily enactments of physics understandings in a study where participants enacted their understanding of force and motion of space in an immersive, interactive mixed reality (MR) environment. Findings The authors find that instances of these action categories can be interpreted as relating to underlying knowledge, often identified by other studies. The authors thus replicate a number of prior findings, which provide evidence to establish validation for using MR simulation as a tool for identifying people’s physical intuitions. Research limitations/implications This study targeted only a few specific physical science scenarios. Further, while a number of key insights about student knowledge came from the analysis, many of the observations are mere leads in need of further investigation and interpretation rather than core findings. Originality/value Immersive digital learning environments are primarily used for instruction. The authors propose to use and design them for assessment as well. This paper should prompt more research and development in this direction.

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

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

Virtual Reality in Healthcare Skills Training: The Effects of Presence on Acceptance and Increase of Knowledge

Abstract With an ever-increasing need of skilled healthcare workers, efficient learning methods like Virtual Reality (VR) are becoming increasingly important. We developed and tested a VR simulation for endotracheal suctioning. The aim of this pilot study was to examine the VR simulation’s acceptance and increase of knowledge among participants. Furthermore, the effects of presence on acceptance and increase of knowledge were investigated. A total of 51 students participated in the pilot study, using a quasi-experimental pre-post-test design. A modified Unified Theory of Acceptance and Use of Technology (UTAUT) and the Igroup Presence Questionnaire (IPQ) were used. Correlation and regression analyses were performed. Pre- and post-tests showed a significant increase of knowledge (p < 0.001). The correlation between presence and behavioural intention was highly positive (r = 0.52, p < 0.001). Performance and effort expectancy are dominant effects on behavioural intention of using the VR simulation as an educational tool. The results indicate that a simulation which conveys a higher sense of presence is more likely to be accepted by learners. Regarding outcomes of presence on increase of knowledge, we found no significant correlation. Based on our study, we propose a design for a future mixed reality simulation with haptic elements and a plan on how to assess skills improvement.

Mixed-Reality Simulation With Preservice Teacher Candidates: A Conceptual Replication

Given the critical importance of discrete instructional practices in special education, teacher candidates must be prepared to implement them upon entering the classroom. In preservice teacher education programs, field placements and clinical experiences rarely provide enough opportunities for preservice teachers to gain the proficiency needed to provide effective instruction. In this study, a randomized control research design was used to investigate the effects of a mixed-reality simulation experience compared with traditional classroom practice in the implementation of a system of least prompts. Results suggest that mixed-reality simulation with additional coaching supports significantly improved preservice teachers’ implementation of the prompting sequence. Social validity data collected offer insights into the use of mixed-reality simulation in practice with preservice teachers. Limitations and suggestions for future work are discussed.

SpaceX: The Unreal Reality

The project aims in designing a simulation which will be operated on Android and IOS mobile comprising of gyroscope. The interactive simulation of ‘SpaceX: The unreal reality’, is demonstrated in our smartphone using coordinative combination of computer game and augmented reality. Here within the project the VR Box 2 is employed to look at the simulation of computer game with Gaze Interaction and Virtual Buttons are to interact in Augmented Reality. Android and iOS is that the software stack for mobile devices that has an OS , middleware and key applications. Gyroscope present within the device is employed to detect the orientation that's to augment the objects in world and consider through virtually designed world. Additionally , Unity plays a key role in developing the appliance providing vast plugins to embed AR and VR technologies and also provide cross platform applicability. Augmented reality is that the mixture of video game with world , using computer generation layers to enable us an enhanced interaction with reality. This is generally done through applications, (for example, Pokemon GO), however can likewise be utilized for games, driving, and significantly more. Computer game , on the other hand, could also be a totally artificial, computer-generated simulation of a real-life experience. This typically required the use of a video game headset, like Oculus Rift or HTC Vive, so on to completely immerse the user. This project contains various user interaction by means of virtual buttons, gaze interaction and speech recognition The project eventually provides the Mixed Reality Simulation combining both AR and VR technologies and depicts the vision of Elon Musk’s Mission of SpaceX to colonize Mars.

SpaceX: The Unreal Reality

The project aims in designing a simulation which will be operated on Android and IOS mobile comprising of gyroscope. The interactive simulation of ‘SpaceX: The unreal reality’, is demonstrated in our smartphone using coordinative combination of computer game and augmented reality. Here within the project the VR Box 2 is employed to look at the simulation of computer game with Gaze Interaction and Virtual Buttons are to interact in Augmented Reality. Android and iOS is that the software stack for mobile devices that has an OS , middleware and key applications. Gyroscope present within the device is employed to detect the orientation that's to augment the objects in world and consider through virtually designed world. Additionally , Unity plays a key role in developing the appliance providing vast plugins to embed AR and VR technologies and also provide cross platform  applicability. Augmented reality is that the mixture of video game with world , using computer generation layers to enable us an enhanced interaction with reality. This is generally done through applications, (for example, Pokemon GO), however can likewise be utilized for games, driving, and significantly more. Computer game , on the other hand, could also be a totally artificial, computer-generated simulation of a real-life experience. This typically required the use of a video game headset, like Oculus  Rift or HTC Vive, so on to completely immerse the user. This project contains various user interaction by means of virtual buttons, gaze interaction and speech recognition The project eventually provides the Mixed Reality Simulation combining both AR and VR technologies and depicts the vision of Elon Musk’s Mission of SpaceX to colonize Mars.

Developing Interpersonal and Counseling Skills Through Mixed-Reality Simulation in Communication Sciences and Disorders

Purpose Simulation is increasingly becoming a valuable tool for training and educating students in communication sciences and disorders (CSD). The purpose of this study is to examine the impact of a mixed-reality simulation on CSD students' perceptions of their ability to apply clinical and counseling skills. Additionally, this study sought to investigate the overall efficacy and acceptance of this type of clinical simulation experience for undergraduate CSD students. Method A total of 29 undergraduate students participated in a clinical simulation experience that used actor-controlled avatars in a mixed-reality simulation environment to practice collecting case history information and delivering diagnostic news to parents of a child client. All students completed pre- and postsimulation questionnaires that rated the impact of the clinical simulation experience on their confidence in demonstrating targeted clinical skills and their general attitudes about their participation. Additionally, five lead participants participated in follow-up interviews to gather data to best describe students' perceptions. Quantitative and qualitative data were recorded and analyzed. Results The majority of the students exhibited positive attitudes toward the mixed-reality clinical simulation experience and reported an increase in their perceived ability to apply several counseling skills (e.g., listening and selective feedback) following the session. Analysis showed that the perceived confidence levels on seven out of the 17 targeted skill items increased on the postevent questionnaire to a level of statistical significance and that the simulation experience was described as meaningful and supportive for increasing confidence. Conclusions Mixed-reality clinical simulation may be a useful tool for teaching interpersonal communication and counseling skills for students, including undergraduates, in CSD. Additionally, the use of mixed-reality technology in this study produced similar results seen with other clinical simulation methods such as standardized patients or computer-based simulations.

Mixed reality simulations for social-emotional learning

Although social-emotional learning is associated with long-term success in school and careers, it is often a missing link in U.S. public education. The COVID-19 pandemic has intensified the need for social-emotional supports for children. In this time of crisis, educators have also sought new ways to make connections and reimagined how students might actively learn with each other. Kristin Murphy, Amy Cook, & Lindsay Fallon discuss what they have learned about using mixed reality simulations to facilitate social-emotional learning with children and what makes this technology a promising active learning tool.

Integration of teaming therapy and mixed-reality simulation as remote learning modality for couple and family therapy graduate training programs.

In response to COVID-19, a couple and family therapy (CFT) graduate training program integrated a teaming therapy model with virtual technology using mixed-reality simulation software. By utilizing teaming therapy--a model with strong roots in systemic theory and practice-- combined with cutting-edge simulation technology, this distance learning modality provides distinctly relational therapy supervision and training for students at a time when their internships sites are struggling to offer remote clinical services due to the pandemic. This integrative framework offers a high degree of both realism and safety, allowing experiential learning to be appropriately scaffolded for optimum creativity and engagement in an online setting. This paper describes the conceptual, systemic basis for the learning modality, steps for implementation, benefits of the model, and the authors plan for further evaluation.

Developing culturally responsive practice using mixed reality (XR) simulation in Paramedicine Education

The department of Paramedicine at Auckland University of Technology is committed to establishing informed evidence and strategies representative of all ethnicities. The MESH360 team propose that immersive mixed reality (XR) can be employed within the learning environment to introduce critical elements of patient care through authentic environmental and socio-cultural influences without putting either students, educators, practitioners or patients at risk.
 Clinical simulation is a technique that replicates real-world scenarios in a controlled and non-threatening environment. However, despite the legal and moral obligations that paramedics have to provide culturally competent care, a lack of evidence and guidelines exist regarding how to adequately integrate simulation methods for cultural competence training into paramedicine education. In our curriculum, clinical simulation has been used mainly to teach the biomedical aspects of care with less focus on the psychological, cultural, and environmental contexts. A potential, therefore, exists for high-fidelity clinical simulation and XR as an effective teaching strategy for cultural competence training by providing learners with the opportunity to engage and provide care for patients from different cultural backgrounds, ethnic heritages, gender roles, and religious beliefs (Roberts et al., 2014). This is crucial preparation for the realities of professional practice where they are required to care for patients that represent the entirety of their community.
 This presentation explores the MESH360 project and the development of a theoretical framework to inform the design of critical thinking in enhanced culturally diverse simulation clinical scenarios (ResearchGate, n.d.). The project aims to develop a transferable methodology to triangulate participant subjective feedback upon learning in high stress environments within a wide range of cultural-responsive environments. The implications for practice and/or policy are the redefinition of the role of simulation in clinical health care education to support deeper critical learning and paramedic competency within cross-cultural environments within XR.
 The aim of the research is to develop simulation based real-world scenarios to teach cultural competence in the New Zealand paramedicine curriculum. Using a Design-Based Research framework in healthcare education the project explores the impact of culturally-responsive XR enhanced simulation for paramedicine students through the triangulation of participant subjective feedback, observation, and participant biometric data (heart rate) (Cochrane et al., 2017). Data analysis will be structured around the identification and description of the overarching elements constituting the cultural activity system in the study, in the context of XR in paramedicine education (Engeström, 1987).
 Our research objective focuses upon using XR to enable new pedagogies that redefine the role of the teacher, the learner, and of the learning context to:
 
 Develop clinically appropriate and contextually relevant simulation-based XR scenarios that teach students how to respect differences and beliefs in diverse populations whose world view may be different from ones’ own.
 
 
 Inform culturally-responsive teaching and learning in paramedicine education research and practice.
 
 
 Implementation of pedagogical strategies in paramedicine critical care simulation to enhance culturally-responsive understandings and practice.

ESOL pre-service teachers’ culturally and linguistically responsive teaching in mixed-reality simulations

PurposeSimulation technology has been used as a viable alternative to provide a real life setting in teacher education. Applying mixed-reality classroom simulations to English for Speakers of Other Languages (ESOL) teacher preparation, this qualitative case study aims to examine how pre-service teachers (PSTs) practice culturally and linguistically responsive teaching to work with an English learner (EL) avatar and other avatar students.Design/methodology/approachUsing an embedded single case study, three PSTs’ teaching simulations and interviews were collected and analyzed.FindingsThis study found PST participants made meaningful connections between theory and practices of culturally and linguistically responsive teaching, particularly by connecting academic concepts to students’ life experiences, promoting cultural diversity, using instructional scaffolding and creating a safe environment. Nevertheless, they needed further improvement in incorporating cultural diversity into content lessons, creating a challenging and supportive classroom and developing interactional scaffolding for ELs’ language development. The findings also show that while PST participants perceived simulation technology as very beneficial, expanding the range of technological affordances could provide PSTs an opportunity to undertake a full range of critical teaching strategies for ELs.Originality/valueThis research contributes to broadening the realm of mixed-reality technology by applying it to ESOL teacher education and has implications for both ESOL teacher educators and simulation technology researchers.

Perceptions of Self-Efficacy in Mixed Reality Simulations

ABSTRACT The purpose of this multiple case study was to gain insight into the self-efficacy beliefs of pre-service teachers participating in a teacher education curriculum that used mixed reality simulation experiences. Qualitative data were collected from a purposeful sampling of 49 student participants (n = 49), as well as 5 professional participants (n = 5). Semi structured interviews were conducted in addition to observations of the mixed reality simulation experiences. Data were explored using inductive coding and directed content analysis via codes informed by the literature. Student participants engaged in simulations and feedback sessions that enhanced self-efficacy through enactive learning, vicarious learning, as well as opportunities to give and receive feedback, and by learning to manage one’s emotions. Implications and recommendations are provided.

Coaching in the time of coronavirus 2019: how simulations spark reflection

PurposeThis study investigates how debrief conversations unfold during virtual coaching sessions that provide embedded opportunities to practice teaching within a mixed reality simulation (MRS). We examine how teacher and coach topical episodes function (agreeing, explaining, clarifying, probing, recapping, reflecting and suggesting) to activate reflection as part of virtual coaching.Design/methodology/approachGrounded in Vygotsky's sociocultural theory and the belief that learning is collaborative and impacts how pre- and in-service teachers construct knowledge, this exploratory case study draws on insights from 15 graduate students (5 pre-service teachers (PSTs) and 10 in-service teachers (ISTs)) who participated in virtual coaching with embedded practice opportunities. Data sources were video recordings and transcripts of 15 virtual coaching sessions, and one-on-one postcoaching interviews. Coding categories were determined through the constant comparative analysis method.FindingsFindings indicate that an MRS provides an immediate context for reflection, which guided the debrief conversations. Additionally, functions occurred with varying frequency among PSTs and ISTs, and across both groups, probing questions often led directly to reflecting and recapping the shared simulation context.Research limitations/implicationsThis study had a small sample (n = 15) and the use of an MRS, while widely used, is not necessarily a scalable practice.Originality/valueIn times of remote teaching, like during corona virus 2019 (COVID-19), opportunities to simulate clinical experiences become vital. With a limited research base, learning how teachers engage with and learn from simulated experiences is a key to creating rich learning opportunities for teachers.

Effects of Using Mixed Reality With Coaching on the Interprofessional Communication Skills of Speech-Language Pathology Graduate Students

Purpose Communication between allied health professionals, teachers, and family members is a critical skill when addressing and providing for the individual needs of patients. Graduate students in speech-language pathology programs often have limited opportunities to practice these skills prior to or during externship placements. The purpose of this study was to research a mixed reality simulator as a viable option for speech-language pathology graduate students to practice interprofessional communication (IPC) skills delivering diagnostic information to different stakeholders compared to traditional role-play scenarios. Method Eighty graduate students ( N = 80) completing their third semester in one speech-language pathology program were randomly assigned to one of four conditions: mixed-reality simulation with and without coaching or role play with and without coaching. Data were collected on students' self-efficacy, IPC skills pre- and postintervention, and perceptions of the intervention. Results The students in the two coaching groups scored significantly higher than the students in the noncoaching groups on observed IPC skills. There were no significant differences in students' self-efficacy. Students' responses on social validity measures showed both interventions, including coaching, were acceptable and feasible. Conclusions Findings indicated that coaching paired with either mixed-reality simulation or role play are viable methods to target improvement of IPC skills for graduate students in speech-language pathology. These findings are particularly relevant given the recent approval for students to obtain clinical hours in simulated environments.

Interaction principles for digital puppeteering to promote teacher learning

This literature review analyzed 18 studies published between 2013 and 2020 to understand the role of virtual humans in mixed reality digital puppeteering simulations aimed at promoting teacher learning. Research questions explored: simulation design models, interactor training, and the attention researchers gave to language and race in the virtual classroom. The descriptive and logistical findings from this review resulted in three learning design models and five design principles that may guide the future use of digital puppeteering in mixed-reality virtual classrooms to promote teacher learning. Across studies, findings suggested promising results of teacher learning through mixed reality simulations and illuminated possible areas for future research. These included the documentation of interactor preparation and detailed evaluation of the interactions between teachers and avatars in virtual classrooms.

A Nonverbal Immediacy Treatment with Pre-Service Teachers Using Mixed Reality Simulations

The purpose of this mixed method embedded design study was to examine the effect of a treatment package consisting of video and reflection, video feedback, and coaching on pre-service teachers’ use...