Integrating VR, AR, and Haptics in Basic Surgical Skills Training: A Review and Perspective

The Accreditation Council for Graduate Medical Education (ACGME) and American Board of Orthopaedic Surgery (ABOS) recently mandated major changes to curricular requirements for the PGY-1 (intern) year for categorical orthopaedic surgery residents. Since July 1, 2013, PGY-1 residents are required to have 6 months of orthopaedic surgery rotations, 6 months of nonorthopaedic surgery rotations, and complete a mandatory surgical skills curriculum [1, 2]. The ACGME and ABOS executed these changes in an effort to improve the quality and breadth of education for interns, preparing them for more advanced orthopaedic education. These changes were prompted by shifts in general surgery procedures (from open to laparoscopic), which have reduced the operating room experience of suturing and knot tying for interns, as well as by duty hour requirements that further reduce the operating room experience for interns. Together, these shifts in first-year resident experience have resulted in less surgical training for the orthopaedic surgery intern. The new ABOS requirements, which commence on July 1, 2014, seek to offset those losses [1, 2]. This column describes the changes mandated by the ABOS and ACGME for the orthopaedic intern year, discusses some limitations associated with these changes, and offers program strategies for effective implementation.

Changes to Training Practices during a Pandemic - The Experience of the Irish National Trauma & Orthopaedic Training Scheme

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

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.

The integration of immersive technology into educational settings has garnered substantial interest as a potential means to improve teaching and learning (TnL)experiences. The dynamic landscape of education demands innovative approaches to engage, motivate, and empower both educators and learners. Immersive technology, including Virtual Reality (VR), Augmented Reality (AR), as well as Mixed Reality (MR), provides uncommon probabilities to transcend traditional classroom boundaries and provide interactive and immersive learning experiences. However, to harness the full potential of immersive technology, a clear understanding of the conceptual frameworks guiding its implementation is essential. This study utilizes the PRISMA approach. Furthermore, the systematic search of academic databases using the Web of Science (WoS) as well as the Scopus database resulted in an extensive selection of studies, reviews and articles related to immersive learning. Following the implementation of an advanced search approach utilizing keywords (1. Immersive learning, 2. AR, as well as 3. Technology Impact on TnL), the systematic review process yielded a diverse array of articles. These articles were identified and included in the review due to their exploration of the conceptual frameworks that underlie the integration of immersive technology in the field of education. Additionally, the review reveals common themes and emerging trends within the field, shedding light on the diverse approaches to leveraging immersive technology for TnL. The final finding data is (n: 29), which reviews identified key themes. Expect validation to be divided into three themes, which are (1) Immersive learning, (2) AR, and (3) Technology Impact on TnL. Meanwhile, the findings emphasize the importance of well-defined theoretical foundations and best practices when implementing immersive technology for educational purposes. The review underscores the importance of ongoing research as well as innovation in the domain of immersive technology to fully exploit its potential for enhancing TnL experiences. In essence, this systematic review adds to the continued conversation about the efficient utilization of immersive technology in education and paves the way for further exploration and advancement in this field.

AimsAccording to literature,newly qualified doctors are at risk of being unable to perform practical procedures safely. This has been exacerbated by the disruptions to training and education which the covid-19 pandemic has caused. This intensive course has been developed to improve basic surgical skills and improve confidence in simple wound closure, to mitigate these disruptions.MethodsCandidates attended a three-part course in small groups, where they learned hand ties, basic laparoscopic skills and wound closure on animal models. Self assessment data were collected pre and post workshop on a Likert scale. All data was assessed using basic descriptive analysis.ResultsData was collected from 13 participants (M:F, 5:8) at the level of foundation year 1(61.5%,n=8) and foundation year 2(38.5%,n=5). Only 38.5% (n = 5) had previous basic surgical skills training. Our delegates reported an improvement in the following surgical skills: suturing (n = 11, 84.6%), hand tying (n = 10, 76.9%), laparoscopic skills (n = 10, 76.9%). Overall 61.5% (n = 8) of our delegates reported an improvement in all three domains.ConclusionsParticipants reported limited exposure prior to this course despite successfully completing an undergraduate curriculum. Overall, participants' self-scores improved in all three taught surgical skills. We believe ourcourse is a practical and reproducible solution to help bridge training gaps, which can be safely conducted with social distancing measures.

Purpose: This study investigates the transformative role of augmented reality (AR) and virtual reality (VR) technologies in e-commerce and digital marketing. It aims to understand how these immersive technologies enhance consumer experiences by addressing challenges such as product visualization, consumer trust, and engagement while fostering higher purchase intent and customer satisfaction. Design/Method/Approach: A systematic literature review synthesizes findings from empirical and theoretical studies published between 2011 and 2024. The methodologies analyzed include experimental designs, market analyses, and conceptual frameworks assessing the integration of AR and VR technologies in online retail. Findings: The findings indicate that AR enhances online shopping through features such as virtual try-ons and spatial placement visualization, reducing return rates and increasing purchase confidence. VR, on the other hand, provides immersive environments that simulate physical shopping experiences, strengthening consumer-brand connections. While AR demonstrates broader applicability in fostering interactive and personalized experiences, VR remains limited by accessibility and cost constraints. Both technologies exhibit immediate costs but offer long-term benefits, positively influencing conversion rates and customer loyalty. Theoretical Implications: This study contributes to consumer behavior research by applying value perception models, immersive technology frameworks, and engagement metrics to the e-commerce landscape. It refines existing theoretical perspectives on technological adoption by highlighting the interplay between sensory engagement, emotional connection, and consumer decision-making. Practical Implications: The research underscores the strategic importance of integrating AR and VR into digital marketing and e-commerce platforms. It suggests leveraging AR for product categories requiring spatial interaction and using VR for high-detail product exploration. The study provides actionable insights for businesses looking to enhance online shopping experiences through immersive technologies. Originality/Value: This study offers a comprehensive synthesis of AR and VR applications in e-commerce, highlighting their potential to reshape online shopping. By bridging the gap between physical and digital retail experiences, it provides a fresh perspective on how immersive technologies can drive engagement, accessibility, and personalized consumer interactions. Research Limitations/Future Research: While this study synthesizes existing literature, empirical validation through longitudinal studies and cross-industry applications is necessary. Future research should explore the long-term effects of AR and VR adoption on consumer trust, loyalty, and behavioral changes. Additionally, further exploration is encouraged into gamification, artificial intelligence (AI) integration, and demographic-specific implementations to drive sustainable engagement.

To report the development of minimally invasive training courses and workshops in the Caribbean and specifically the establishment of the Basic Surgical Skills Course of the Royal College of Surgeons of England (RCSEng) in Trinidad with respect to their value toward Surgical laparoscopic or minimally invasive training in the Caribbean. & Methods: The literature written on laparoscopy in the region was reviewed and in particular that related to the minimally invasive training courses provided over the period 2004 to 2019 and the development of laparoscopic surgical training described from a historic perspective. The factors that contribute to sustainability of courses were identified. Laparoscopic surgical training courses were sporadically introduced into the Caribbean over the period 2004 to 2019 in countries including Barbados, Curacao, Guyana, St. Lucia, Jamaica and Trinidad & Tobago. These were timed and closely related to the establishment of the Caribbean College of Surgeons (CCOS) with the help of the Royal College of Surgeons of England. However, the only certified course introduced was the Basic Surgical Skills (BSS) course of the RCSEng into Trinidad in 2012. This has now been established as a recognised overseas centre by the RCSEng and provides the Intercollegiate BSS course annually forming a solid basis for trainees to learn safe surgical and laparoscopic skills prior to commencing formal surgical training. This has resulted in the sustainable development of minimally invasive training in Trinidad in particular. Laparoscopic skills courses and workshops have been established in the Caribbean for 15 years beginning circa. 2004 to 2019 and have grown in number and locations throughout the Caribbean. The RCSEng and the CCOS have been instrumental in the development process. Of note, the only recognised overseas training centre for Basic Surgical Skills Course was established in Trinidad & Tobago with the support of the RCSEng and seems to be the main contributor to the successful, regular maintenance of these and other minimally invasive courses in General Surgery, ENT, Gynaecology and other fields on an annual, sustainable basis.

Computational thinking (CT) skills are increasingly important in education to prepare students for the challenges of the digital age. Augmented Reality (AR) and Virtual Reality (VR) have been introduced as immersive technologies that have the potential to enhance CT skills through more interactive learning experiences. However, there is still a gap in understanding the effectiveness of these technologies in supporting the development of CT, particularly in different levels of education and disciplines. Although several studies have highlighted the benefits of AR and VR in education, no systematic review integrates these findings to identify advantages, challenges, and opportunities for further implementation. Therefore, this study conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by analyzing 25 empirical studies (AR=17, VR=8) obtained from the Scopus database (2008-2024). The analysis addresses four key research questions: (1) the current state of AR/VR in CT development, (2) their advantages, (3) implementation challenges, and (4) future research directions. The results show that AR is more widespread than VR at various levels of education, with dominance in higher education followed by secondary and primary schools. Computer science is the main field of application of AR and VR, while AR is also widely applied in mathematics to increase interest and problem-solving. A total of 11 studies reported significant impacts of these technologies on CT, with AR being superior in increasing student motivation and engagement, as well as aiding in problem-solving and debugging. In contrast, VR provides a more immersive learning experience by strengthening concept understanding, especially in programming and recursion. However, several obstacles in the application of AR and VR, such as hardware limitations, costs, and user skills, affect the effectiveness of these technologies in the learning environment. This study also identified potential future research, including the exploration of VR in primary and kindergarten education, the application of VR in non-computer science fields, and the efficient use of these technologies in supporting the CT process. This study provides more precise insights into the optimal ways of utilizing AR and VR in developing CT skills. It is a reference for educators, policymakers, and researchers in supporting CT learning.

Aim Attention to surgical skills development of UK foundation trainees within the UK foundation training programme appears to be neglected. This study aimed to ascertain junior doctors’ perceptions of surgical skills within the foundation training programme, irrespective of their future career intentions. Method An online survey generated using SurveyMonkey was distributed to all 18 UK foundation training schools. This survey assessed foundation trainees’ surgical skills experience in medical school, current career intentions, confidence at basic surgical skills and perceptions of the level of surgical skills training within the foundation programme. Results A total of 245 responses were collected. Career intentions amongst foundation trainee respondents was evenly distributed with 39.6% aiming for a career in surgery, 41.6% opting for a non-surgical career and 18.8% of participants were undecided on their future career path. Trainees felt that they did not have adequate exposure to surgical skills (4.5, Likert scale 1–10) and did not have adequate exposure to specialty specific skills within the foundation training programme (3.3, Likert scale 1–10). On average, 75% of participants believed further exposure to surgical skills training would be beneficial to their professional development. Furthermore, 67% believed that surgical skills should be incorporated in the core competencies for the foundation training programme. Conclusions Our study shows that foundation trainees feel that there is a lack of adequate exposure to surgical skills within the foundation programme. Foundation trainees feel change is required to help improve competency in basic surgical skills and as an extension increase interest in a surgical career.

This study provides an in-depth analysis of the impact, effectiveness, and future prospects of Augmented Reality (AR) and Virtual Reality (VR) in educational settings. The primary objective was to explore how these immersive technologies are reshaping learning and teaching landscapes. Employing a systematic literature review and content analysis methodology, the research analyzed recent scholarly articles and reports from 2014 to 2024, focusing on AR/VR applications in education. The findings reveal that AR and VR significantly enhance learning experiences by offering immersive, interactive, and engaging environments. These technologies have been shown to improve student engagement, knowledge retention, and skill development. AR enriches traditional educational materials by overlaying digital information onto the real world, while VR facilitates experiential learning in virtual environments. However, challenges such as high costs, technical infrastructure requirements, and content development complexities were identified as barriers to widespread adoption. The study predicts a future where AR and VR technologies will continue to evolve, focusing on enhancing user experience, improving accessibility, and integrating seamlessly into educational curricula. Recommendations for stakeholders, including educators, administrators, and policymakers, emphasize the need for investment in infrastructure, educator training, content development, and collaboration with technology companies. Lastly, AR and VR technologies hold great promise for transforming educational practices. Addressing current challenges and leveraging opportunities will be key to realizing their full potential in enhancing teaching and learning experiences. Continued research and innovation in this field are essential for the effective integration of AR and VR in education. Keywords: Augmented Reality (AR), Virtual Reality (VR), Educational Technology, Immersive Learning.

Technologies such as (AR) Augmented Reality &(VR) Virtual Reality, which provide immersive digital experiences, interactive environments, simulation, and engagement, have completely changed how we approach learning. However, in order to meet the huge demand in education, these technologies which are still in the emerging stage need to be heavily customized and heavily invested in. This thorough analysis seeks to contextualize the last few years of development of Virtual and Augmented Reality in the Education. For additional study, a total one thousand five hundred and thirty-six articles are chosen using text mining and theme analysis techniques. Based on earlier research on AR and VR in education, hypotheses were developed and are currently being processed and analysed to reveal the current development in literature via Augmented Reality and Virtual Reality, applications, benefits, and future directions. The findings show that wearable technology has contributed significantly to the exponential expansion in the use of Virtual and Augmented Reality in education in recent years. Results also highlight the need for faster adoption and customization of these technologies in educational institutions, based on secondary data. An increasing number of educational applications for the learning process are emerging as Virtual and Augmented Realityexp and quickly. It is advised that researchers stay up to date on the gaps in AR and VR’s Changeover to education &develop practical adaptation strategies to maximize the benefits of these technological development with significant developments in high-speed transmission and processing, AR &VR are developing as Display Platforms for Next Generation for more intimate human-digital interactions. Nonetheless, matching the extraordinary Human Vision Performance while keeping Near the Eye Display module tiny and lightweight presents unprecedented hurdles for optical engineering. Fortunately, new advances in Holographic Optical Elements HOEs and Lithography Enable Devices present novel approaches to overcoming these challenges in Virtual and Augmented Reality which would otherwise be problematic with traditional optics

Medical simulations bridge theory and practice in immersive settings. During this unique form of education, learners experience challenging medical scenarios without risking patient harm. The effectiveness of simulations stem from their ability to induce autonomic stress responses, which potentiate memory formation. Educators have adopted virtual reality (VR) and augmented reality (AR) to supplement traditional, mannequin-based simulations. In this Pro-Con commentary article, we discuss the competitive advantages and limitations of VR and AR simulation for medical training. VR uses computer-generated images (CGI) within head-mounted displays (HMDs) to enhance learning. Gamification of medical procedures in VR improves acquisition of complex skills, positioning VR simulation as a pivotal training tool. Participant embodiment while in VR develops non-technical skills such as improved communication and enhanced empathy. The placement of participants within CGI worlds that would otherwise be difficult or impossible to recreate situate VR as the ideal next step in simulation evolution. VR is superior to AR given its lower hardware costs, expansive software libraries, and complete immersion in CGI compared to limited holographic fields of view within AR. By displaying holograms within the participant's natural world, AR is primed to replace screen and VR technologies as the premier learning adjunct. The integration of real-world instruments with AR holograms provides innumerable methods for teaching procedural skills. In addition, AR enhances pre- and intra-operative planning by overlaying holographic, radiographic patient images over their own bodies. Because AR has the unique feature of maintaining direct eye contact between participants, scenarios that improve communication skills are easily created with holograms in the real world, eliminating the need for an entirely CGI VR environment. Immersive simulation efforts should skip the costs of creating VR scenarios and redirect efforts to developing AR simulation software. Although both VR and AR have limitations related to cost and ergonomics, immersive technologies are relatively more affordable and versatile than traditional mannequins and physical simulation centers. As adjuncts to enhance traditional simulation curricula, we advocate for continued research to demonstrate the validity and utility of these immersive technologies.

Telementoring in surgical training enables expert surgeons to provide real-time remote guidance to trainees. This technique is increasingly adopted to address surgical training gaps in low- and middle-income countries (LMICs), i.e., nations with a gross national income per capita of $13,845 or less. However, existing systems are constrained by conventional communication systems, which experience high latency, limited bandwidth, and poor video resolution. These challenges hinder the integration of immersive and interactive technologies such as virtual reality (VR), augmented reality (AR), and haptic feedback, which would enhance learning outcomes, especially in resource-constrained environments. AR overlays digital images onto the real-world environment, whereas VR immerses users in a fully computer-generated environment, enabling trainees to interact with surgical components as if they are in the real world. In addition, the advent of the fifth generation of mobile networks (5G), which delivers ultra-low latency, high bandwidth, and support for network slicing, offers a promising foundation for scaling high-fidelity telementoring systems. Moreover, the integration of artificial intelligence (AI), i.e., equipping computer systems with the ability to perform tasks that would typically require human intelligence, can enable real-time performance analytics and skill assessment of the trainees. In regions lacking reliable network backbone infrastructure, such as fiber, hybrid approaches that combine low-cost 5G deployments with satellite communication can be leveraged to achieve reliable end-to-end connectivity. Therefore, this systematic literature review evaluates current surgical telementoring systems, their enabling technologies, and associated challenges, with emphasis on LMIC contexts, where such systems will have the greatest benefits. Through a structured Population, Intervention, Comparison, and Outcome (PICO)-based synthesis, we address five key research questions that span key aspects such as current telementoring systems and technologies, functional and technical requirements, educational outcome effectiveness, and the gaps addressed by modern technology and connection solutions, i.e., 5G, AI, VR, and AR. In addition, we identify recurrent challenges and propose a design framework that can be adopted in low-resource settings. Finally, we outline future development directions, including AI-driven evaluation models, scalable system architectures, and policy frameworks to guide the development of secure, cost-effective, and equitable telementoring platforms to advance global surgical education.

Electroencephalography correlates of transcranial direct-current stimulation enhanced surgical skill learning: A replication and extension study