Use of Augmented and Virtual Reality in Remote Higher Education: A Systematic Umbrella Review

A comprehensive study on unraveling the advances of immersive technologies (VR/AR/MR/XR) in the healthcare sector during the COVID-19: Challenges and solutions

The current COVID-19 pandemic has affected almost every aspect of life but its impact on the healthcare landscape is conspicuously adverse. However, digital technologies played a significant contribution in coping with the challenges spawned by this pandemic. In this list of applied digital technologies, the role of immersive technologies in battling COVID-19 is notice-worthy. Immersive technologies consisting of virtual reality (VR), augmented reality (AR), mixed reality (MR), extended reality (XR), metaverse, gamification, etc. have shown enormous market growth within the healthcare system, particularly with the emergence of pandemics. These technologies supplemented interactivity, immersive experience, 3D modeling, touching sensory elements, simulation, and feedback mechanisms to tackle the COVID-19 disease in healthcare systems. Keeping in view the applicability and significance of immersive technological advancement, the major aim of this study is to identify and highlight the role of immersive technologies concerning handling COVID-19 in the healthcare setup. The contribution of immersive technologies in the healthcare domain for the different purposes such as medical education, medical training, proctoring, online surgeries, stress management, social distancing, physical fitness, drug manufacturing and designing, and cognitive rehabilitation is highlighted. A comprehensive and in-depth analysis of the collected studies has been performed to understand the current research work and future research directions. A state-of-the-artwork is presented to identify and discuss the various issues involving the adoption of immersive technologies in the healthcare area. Furthermore, the solutions to these emerging challenges and issues have been provided based on an extensive literature study. The results of this study show that immersive technologies have the considerable potential to provide massive support to stakeholders in the healthcare system during current COVID-19 situation and future pandemics.

The use of immersive technologies in distance education: A systematic review

This study aims to conduct a systematic review that includes studies on the use of immersive technologies in distance education. For this purpose, 132 studies detected by searching Web of Science, Eric, Taylor & Francis and Education Full Text (EBSCO) databases were examined. The studies were analysed using the content analysis method. As a result of the analyses, it was observed that the first study investigating the subject was conducted in 2002, and the number of related studies increased over the years. In addition, these studies were primarily conducted quantitatively, were mainly journal articles, and originated mostly from China and the USA. Moreover, the sample groups of these studies consisted mostly of university students. Therefore, they mainly used academic performance and motivation variables. Furthermore, these studies were conducted primarily in the science and medical education disciplines. When the studies were evaluated in terms of publication journals, it was determined that they were published mostly in "Education Science" and "Computers & Education" journals. They were also included in the proceedings published within the scope of various conferences. When the application platforms in the studies were examined, it was determined that the UNITY and ARTUTOR platforms were mostly used. The findings of the studies revealed that the increase in academic performance and motivation was one of the most reported advantages of such technologies. On the other hand, the problems caused while using these technologies and the internet were the most reported difficulties in the studies. Finally, the review presented suggestions for future studies.

The Use of Metaverse in Nursing Education: An Umbrella Review

BACKGROUND

Given the wide range of metaverse technologies, there is a need to synthesize evidence of metaverse pedagogy used effectively for nursing education.

PURPOSE

This umbrella review synthesized systematic reviews on the use of metaverse in nursing education.

METHODS

A search was performed in MEDLINE, EMBASE, CINAHL, Web of Science, and Education Full Text. This umbrella review was conducted with reference to the Joanna Briggs Institute (JBI) Reviewer's Manual and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The JBI Critical Appraisal Checklist for Systematic Review was used to assess the quality of studies.

RESULTS

The final review comprised 15 articles published between 2013 and 2021, most of which indicate that metaverse interventions support increased knowledge, self-confidence, engagement, satisfaction, and performance in nursing students. Several articles in this review presented mixed findings related to certain learning outcomes.

CONCLUSION

This umbrella review supports the viability and effectiveness of metaverse in nursing education.

Current Current Challenges and Future Research Directions in Augmented Reality for Education

The progression and adoption of innovative learning methodologies signify that a respective part of society is open to new technologies and ideas and thus is advancing. The latest innovation in teaching is the use of Augmented Reality (AR). Applications using this technology have been deployed successfully in STEM (Science, Technology, Engineering, and Mathematics) education for delivering the practical and creative parts of teaching. Since AR technology already has a large volume of published studies about education that reports advantages, limitations, effectiveness, and challenges, classifying these projects will allow for a review of the success in the different educational settings and discover current challenges and future research areas. Due to COVID-19, the landscape of technology-enhanced learning has shifted more toward blended learning, personalized learning spaces and user-centered approach with safety measures. The main findings of this paper include a review of the current literature, investigating the challenges, identifying future research areas, and finally, reporting on the development of two case studies that can highlight the first steps needed to address these research areas. The result of this research ultimately details the research gap required to facilitate real-time touchless hand interaction, kinesthetic learning, and machine learning agents with a remote learning pedagogy.

The effects of maternal-child nursing clinical practicum using virtual reality on nursing students' competencies: a systematic review

PURPOSE

This study aimed to investigate the effects of virtual reality used in maternal-child nursing clinical practicums on nursing students' competencies through a systematic review.

METHODS

The inclusion criteria were peer-reviewed papers in English or Korean presenting analytic studies of maternal-child nursing practicums using virtual reality. An electronic literature search of the Cochrane Library, CINAHL, EMBASE, ERIC, PubMed, and Research Information Sharing System databases was performed using combinations of the keywords "nursing student," "virtual reality," "augmented reality," "mixed reality," and "virtual simulation" from February 4 to 15, 2022. Quality appraisal was performed using the RoB 2 and ROBINS-I tools for randomized controlled trials (RCTs) and non-RCTs, respectively.

RESULTS

Of the seven articles identified, the RCT study (n=1) was deemed to have a high risk of bias, with some items indeterminable due to a lack of reported details. Most of the non-RCT studies (n=6) had a moderate or serious risk of bias related to selection and measurement issues. Clinical education using virtual reality had positive effects on knowledge, skills, satisfaction, self-efficacy, and needs improvement; however, it did not affect critical thinking or self-directed learning.

CONCLUSION

This study demonstrated that using virtual reality for maternal-child nursing clinical practicums had educational effects on a variety of students' competencies. Considering the challenges of providing direct care in clinical practicums, virtual reality can be a viable tool that supplements maternal-child nursing experience. Greater rigor and fuller reporting of study details are required for future research.

Virtual Reality as an Immersive Teaching Aid to Enhance the Connection between Education and Practice

Maximizing knowledge transfer is one of the main factors of modern education. It is important to raise the probability that students can successfully apply acquired knowledge into practice. This article deals with virtual reality (VR) as an alternative method to provide students with a more immersive approach to semester assignments and their completion. In addition to information on paper, they are provided with an immersive virtual environment that interactively visualizes problems. To test this approach, a case study took place at the Department of Industrial Engineering, Faculty of Mechanical Engineering at the University of Žilina. Students were given a standard assignment for workplace analysis and optimization. However, in addition to papers containing all the necessary information about the workplace and its processes (a drilling workplace), the students could also put on a VR headset and walk through a virtual copy of the assigned workplace. Instead of relying on a 2D layout and a few photos, the students observed every detail of the workplace from any angle. Moreover, the immersive virtual workplace was interactive, and the students could interact with machine tools and replicate the real manufacturing process. With this new addition, the students completed the assignment and then filled out a short questionnaire questioning their satisfaction with the chosen approach. With positive feedback, the implementation of VR into the teaching process could further motivate students and make the transfer of knowledge into their future jobs easier.

Digital Experiential Learning for Sustainable Horticulture and Landscape Management Education

During the COVID-19 pandemic, horticulture and landscape management programmes in higher education experienced a huge drawback because of the impossibility of organising field studies and conducting site research. To pursue a more sustainable method of teaching, immersive technology such as augmented reality (AR) and virtual reality (VR) has been increasingly adopted as an effective approach for multimodal experiential learning. This study examines student perceptions on the use of digital technology in team-based hybrid learning to achieve sustainability in tree management using data collected from students of horticulture and landscape management in a higher education institute in Hong Kong. Key theoretical principles on Kolb’s experiential learning cycle as an interactive process are discussed, followed by an empirical analysis of student survey results. This research deepens the understanding of how immersive technology enhances both environmental sustainability and learning innovation. The results demonstrate that innovative ideas in instructional methods such as ARVR simulation can enhance the environmental sustainability of how tree management can be conducted, promoting a more environmentally conscious, experiential, collaborative and digital learning experience in higher education.

The role of contemporary digital tools and technologies in COVID-19 crisis: An exploratory analysis

Following the COVID-19 pandemic, there has been an increase in interest in using digital resources to contain pandemics. To avoid, detect, monitor, regulate, track, and manage diseases, predict outbreaks and conduct data analysis and decision-making processes, a variety of digital technologies are used, ranging from artificial intelligence (AI)-powered machine learning (ML) or deep learning (DL) focused applications to blockchain technology and big data analytics enabled by cloud computing and the internet of things (IoT). In this paper, we look at how emerging technologies such as the IoT and sensors, AI, ML, DL, blockchain, augmented reality, virtual reality, cloud computing, big data, robots and drones, intelligent mobile apps, and 5G are advancing health care and paving the way to combat the COVID-19 pandemic. The aim of this research is to look at possible technologies, processes, and tools for addressing COVID-19 issues such as pre-screening, early detection, monitoring infected/quarantined individuals, forecasting future infection rates, and more. We also look at the research possibilities that have arisen as a result of the use of emerging technology to handle the COVID-19 crisis.

What is Significant in Modern Augmented Reality: A Systematic Analysis of Existing Reviews

Augmented reality (AR) is a field of technology that has evolved drastically during the last decades, due to its vast range of applications in everyday life. The aim of this paper is to provide researchers with an overview of what has been surveyed since 2010 in terms of AR application areas as well as in terms of its technical aspects, and to discuss the extent to which both application areas and technical aspects have been covered, as well as to examine whether one can extract useful evidence of what aspects have not been covered adequately and whether it is possible to define common taxonomy criteria for performing AR reviews in the future. To this end, a search with inclusion and exclusion criteria has been performed in the Scopus database, producing a representative set of 47 reviews, covering the years from 2010 onwards. A proper taxonomy of the results is introduced, and the findings reveal, among others, the lack of AR application reviews covering all suggested criteria.

Perspectives of 360-Degree Cinematic Virtual Reality: Interview Study Among Health Care Professionals

BACKGROUND

The global market for medical education is projected to increase exponentially over the next 5 years. A mode of delivery expected to drive the growth of this market is virtual reality (VR). VR simulates real-world objects, events, locations, and interactions in 3D multimedia sensory environments. It has been used successfully in medical education for surgical training, learning anatomy, and advancing drug discovery. New VR research has been used to simulate role-playing and clinical encounters; however, most of this research has been conducted with health professions students and not current health care professionals. Thus, more research is needed to explore how health care professionals experience VR with role-playing and clinical encounters.

OBJECTIVE

The aim of this study was to explore health care professionals' experiences with a cinematic VR (cine-VR) training program focused on role-playing and clinical encounters addressing social determinants of health, Appalachian culture, and diabetes. Cine-VR leverages 360-degree video with the narrative storytelling of cinema to create an engaging educational experience.

METHODS

We conducted in-depth telephone interviews with health care professionals who participated in the cine-VR training. The interviews were audio recorded and transcribed verbatim. A multidisciplinary team coded and analyzed the data using content and thematic analyses with NVivo software.

RESULTS

We conducted 24 in-depth interviews with health care professionals (age=45.3, SD 11.3, years; n=16, 67%, women; n=22, 92%, White; and n=4, 17%, physicians) to explore their experiences with the cine-VR training. Qualitative analysis revealed five themes: immersed in the virtual world: seeing a 360-degree sphere allowed participants to immerse themselves in the virtual world; facilitated knowledge acquisition: all the participants accurately recalled the culture of Appalachia and listed the social determinants of health presented in the training; empathized with multiple perspectives: the cine-VR provided a glimpse into the real life of the main character, and participants described thinking about, feeling, and empathizing with the character's frustrations and disappointments; perceived ease of use of cine-VR: 96% (23/24) of the participants described the cine-VR as easy to use, and they liked the 360-degree movement, image resolution, and sound quality but noted limitations with the buttons on the headsets and risk for motion sickness; and perceived utility of cine-VR as a teaching tool: participants described cine-VR as an effective teaching tool because it activated visual and affective learning for them.

CONCLUSIONS

Participants emphasized the realism of the cine-VR training program. They attributed the utility of the cine-VR to visual learning in conjunction with the emotional connection to the VR characters. Furthermore, participants reported that the cine-VR increased their empathy for people. More research is needed to confirm an association between the level of immersion and empathy in cine-VR training for health care professionals.

Satisfaction Levels of Sport Sciences University Students in Online Workshops for Substituting Practice-Oriented Activities during the COVID-19 Lockdown

Laboratory teaching in sport and exercise sciences universities is of fundamental importance as it provides students with the necessary hands-on skills that are indispensable to future kinesiologists. However, due to the COVID-19 pandemic, students in lockdown missed the opportunity to acquire laboratory skills. Here we report the solutions adopted by a blended exercise science Master’s degree program of an online Italian university to ensure didactic continuity in the practice-oriented activities during the period of the COVID-19 lockdown. In order to mitigate this issue, laboratory sessions were replaced with online workshops and students’ satisfaction levels in this regard were investigated in the present study using an online survey conducted on 101 students during lockdown. The survey consisted of 7-point Likert scale items focusing on computer usage (CU), learning satisfaction (LS), social interaction (SI), and perceived value (PV). The analysis of the results revealed a good level of learning satisfaction of the students. Conversely, students perceived a moderate level of social interaction and had a moderate perception that online workshops can enhance their learning abilities. In conclusion, the results of the present study seem to indicate that online workshops can be considered a good and acceptable compromise during an emergency, although face-to-face activities remain the preferable learning delivery modality when dealing with the acquisition of hands-on skills.

Regulation of Digital Behavior Models for Knowledge Transfer: Organizational Concerns of Remote Learning

Research on behavior regulation was carried out after several months of social isolation, provoked by the pandemic, between the months of February and March 2020. In spring 2020, many higher education institutions began to introduce digital tools of education, remote learning, and distance teaching. The reaction during the first weeks and months was negative, but the experience of this remote regime of work and learning continued into the autumn semester due to COVID-19. This experience included the perceptions of new organizational approaches that were needed to regulate digital behavior as a specific type of strategy and choices made in the virtual space. This need was expressed in an understanding of the improvements to be implemented in the organization of educational processes at traditional institutions to efficiently apply the remote learning regime. Between December 2020 and March 2021, six focus groups were conducted to investigate if the regulation of behavior for remote work and learning (work for university administrative staff and academic teachers; studying for students) differed, with informal interviews also conducted to check the validity of the opinions formulated. The hypotheses of the lack of responsibility, and of iterative accomplishment of shorter and simpler tasks, were supported with the data obtained. The hypothesis on an imbalanced vision of mutual interests, and of the assessments of gains and costs of the remote activity, was confirmed. The hypothesis of the externalization of motivation was neither confirmed nor rejected, contradictory opinions were obtained, and, thus, further quantitative study is required. The conclusions based on the obtained results included support for improving the regulation mechanisms required to organize knowledge transfer when digital tools are applied at traditional educational institutions. To enhance the remote regime of learning, redesign and reorganization is necessary when considering the assistance needed by teachers and learners. Specific organizational efforts need to be implemented to restructure the teaching to shorter sequences, to stimulate the creativity of both teachers and learners (due to the readiness to experiment and the lack of critics, and constant access to online bases), and to identify the borders of the “sandbox” to clearly define and articulate the common rules of behavior.

Most significant barriers and proposed solutions for medical schools to facilitate simulation-based undergraduate curriculum in OBGYN

Despite having a good understanding of medicine, doctors lack clinical skills, problem-solving abilities, and the ability to apply knowledge to patient care, particularly in unanticipated circumstances. To overcome this, medical education has evolved into a system-oriented core curriculum with cognitive, psychomotor, and affective learning goals. With an emphasis on problem-based learning, the educator's aim is to establish a long-term, predetermined improvement in the learner's behavior, acquired skills, and attitudes (Datta R, Upadhyay KK, Jaideep CN. Simulation and its role in medical education. Med J Armed Forces India. 2012;68(2):167-172. https://doi.org/10.1016/S0377-1237(12)60040-9 ). However, teaching these disciplines to real patients is almost impossible; this is where simulation comes in. This opinion paper will discuss the relevance and necessity of a simulation-based undergraduate curriculum in obstetrics and gynecology. What are the biggest obstacles that medical schools face in making the most of simulation-based learning, and how can they be overcome?