Mixed Reality: A Tool for Investigating the Complex Design and Mechanisms of a Mechanically Actuated Digital Pump

In this paper, we report findings from a systematic mapping study, conducted to review the existing literature on collaborative educational environments incorporating mixed reality technologies. There is increasing interest in mixed reality technologies in education, especially with the introduction of new over head mounted displays (OHMDs), such as HoloLens, Oculus Rift, and HTC Vive. with the consideration of areas, such as education, dynamic technology, and complex environments, a research area is identified. We carried out an extensive review of the literature from 2007 to 2017 and conducted an analysis of the works on mixed reality technologies and its subcategories applied to collaborative education environments. Results highlighted the lack of research across the mixed reality spectrum, especially in the augmented virtuality subcategory, as well as technical limitations such as response time in the development of mixed reality technologies for collaborative environments. Furthermore, the difficulty of teaching professionals to replicate mixed reality experiments in real environments, due to the technical skills required, was identified. The main contribution of this paper is the discussion of the current works with visualization of the present state of the area, which is aimed to encourage educators to develop mixed reality artefacts and conduct further research to support collaborative educational environments.

MP41-16 EVALUATION OF MIXED REALITY (MR) TECHNOLOGIES FOR REMOTE GUIDANCE DURING TRANSRECTAL ULTRASOUND BIOPSY (TRUS-BX) SIMULATION: A PROSPECTIVE, RANDOMIZED COMPARATIVE TRIAL

BackgroundThis was a prospective comparative study of mixed reality (MR) technology assisted lumbar pedicle screws placement and traditional lumbar pedicle screws placement.Material/MethodsFifty cases of lumbar pedicle screws placement were randomly divided into 2 groups: 25 cases with MR technology in group A, and 25 cases without MR technology in group B. All patients had their scores on the Oswestry disability index (ODI) of low back pain and the visual analog scale (VAS) of the affected lower limb recorded at pre-operation. Blood loss, operative duration, success rate of first penetration by tap, and number of times C-arm fluoroscopy was performed were recorded at intraoperation. The postoperative drainage was recorded. The ODI of low back pain and VAS of the affected lower limb were recorded at 1, 3, and 6 months after operation.ResultsGroup A had less bleeding, shorter operation time, higher success rate of first penetration by tap, and fewer times using C-arm fluoroscopy at intraoperation (P<0.05). There was significant difference in ODI scores and VAS scores at 1 mouth after operation (P<0.05). The postoperative drainage of group A was less than group B (P<0.05). The implantation accuracy of group A was higher than group B (P<0.05). The postoperative recovery rate of low back pain of group A was faster than group B (P<0.05).ConclusionsThe safety of spinal surgery and implantation accuracy of pedicle screw fixation system could be increased by MR technology.

Virtual and mixed reality technology has advanced tremendously over the past several years. This nascent medium has the potential to transform how people communicate over distance, train for unfamiliar tasks, operate in challenging environments, and how they visualize, interact, and make decisions based on complex data. At the same time, the marketplace has experienced a proliferation of network-connected devices and generalized sensors that are becoming increasingly accessible and ubiquitous. As the Internet of Things expands to encompass a predicted 50 billion connected devices by 2020, the volume and complexity of information generated in pervasive and virtualized environments will continue to grow exponentially. The convergence of these trends demands a theoretically grounded research agenda that can address emerging challenges for human-information interaction (HII). Virtual and mixed reality environments can provide controlled settings where HII phenomena can be observed and measured, new theories developed, and novel algorithms and interaction techniques evaluated. In this paper, we describe the intersection of pervasive computing with virtual and mixed reality, identify current research gaps and opportunities to advance the fundamental understanding of HII, and discuss implications for the design and development of cyber-human systems for both military and civilian use.

The steady increase in the aging population worldwide is expected to cause a shortage of doctors and therapists for older people. This demographic shift requires more efficient and automated systems for rehabilitation and physical ability evaluations. Rehabilitation using mixed reality (MR) technology has attracted much attention in recent years. MR displays virtual objects on a head-mounted see-through display that overlies the user's field of vision and allows users to manipulate them as if they exist in reality. However, tasks in previous studies applying MR to rehabilitation have been limited to tasks in which the virtual objects are static and do not interact dynamically with the surrounding environment. Therefore, in this study, we developed an application to evaluate cognitive and motor functions with the aim of realizing a rehabilitation system that is dynamic and has interaction with the surrounding environment using MR technology. The developed application enabled effective evaluation of the user's spatial cognitive ability, task skillfulness, motor function, and decision-making ability. The results indicate the usefulness and feasibility of MR technology to quantify motor function and spatial cognition both for static and dynamic tasks in rehabilitation.

ObjectiveTo provide an overview of the current state of mixed reality (MR) technology’s application in medical education and to review a research scope of the area.MethodsAccording to the Joanna Briggs Institute’s scope-based review procedures, searches were conducted in the following databases: PubMed, Embase, Web of Science Core Collection, Cochrane Library, CNKI, WanFang Database, and VIP Database. The included literatures were compiled and examined, and the search period was limited to the period from the database’s creation to April 20, 2025.ResultsIn all, 4118 records were found. After eligibility assessment, 28 studies in English or Chinese that examine the use of MR in education for medical students were included. Data extraction focused on theoretical/skills test scores, students’ satisfaction, testing and evaluation of the system operation as well as students’ learning interest of MR. The majority of studies indicated MR technology effectively enhances students’ theoretical knowledge and skill proficiency. Eighteen studies consistently reported a high students’ satisfaction level with MR-assisted instruction; MR systems demonstrated favorable usability due to its high consistency. Ten studies showed students in the MR-assisted learning groups exhibit heightened learning interest.ConclusionMR Technology has demonstrated excellent performance in enhancing students’ mastery of theories/skills, improving students’ satisfaction, and increasing students’ interest. However, it has not yet been widely adopted due to the high costs associated with teacher training and the purchase and maintenance of equipment. The future should prioritize continuously developing the immersive experience and engagement of MR technology, integrating ecological instantaneous evaluation methodologies and artificial intelligence technology, and combining economic benefit analysis and feasibility testing to perform higher-quality original research.

This study aimed to analyze the impact of design classes based on mixed reality (MR) on the learning experiences and outcomes of elementary school students and to explore the characteristics of human-technology interactions in the MR environment. The research was conducted with 24 sixth-grade students at S Elementary School in Seoul, allowing learners to experience creative learning in an immersive environment where virtual and real worlds are combined through MR technology. The results show that MR-based design education significantly enhanced students' spatial understanding and problem-solving abilities, and positively influenced collaborative learning and creative interaction. Additionally, human-technology interaction in the MR environment provided students with the experience of handling both virtual and physical objects simultaneously, contributing to the improvement of digital literacy and collaborative problem-solving skills. These findings suggest the potential of MR technology as an innovative educational method suitable for the digital age, highlighting its applicability in future educational settings.

Mixed reality (MR) technology has the potential to enhance medical education by overlaying digital anatomical models onto physical trainers, potentially addressing some limitations of traditional teaching tools. This study evaluated the feasibility and value of MR in a physician assistant (PA) clinical skills course to improve understanding of anatomy and confidence in procedural skills. The study involved 96 first-year PA students at a health professions university in the southwestern United States that were randomly assigned to an experimental group using MR headsets or a control group using physical trainers alone for a glenohumeral joint injection procedure. Presurveys and postsurveys measured confidence and preparedness in anatomy and in performing procedural skills. The experimental group also completed a system usability scale (SUS) and provided qualitative feedback. The experimental group demonstrated a significant increase in confidence in regional anatomy knowledge (pre: 3.4 ± 1.0; post: 4.8 ± 0.4, P < .001) compared with the control group (pre: 3.5 ± 0.7; post: 4.5 ± 0.5, P < .001). Preparedness and procedural confidence improved similarly in both groups, though MR showed greater engagement and perceived learning benefits. The SUS score of 82.44 indicated excellent usability, placing it between the 90th and 95th percentiles based on normative data. Qualitative feedback highlighted enhanced and detailed anatomy visualization and appreciation of the use of innovative technology in procedural skills. Mixed reality technology has a potential to complement traditional teaching, improving anatomy comprehension and procedural confidence in PA education. Its alignment with adult learning principles in providing immediate feedback and realistic simulations and high usability supports its integration into PA curriculum.

Mixed-reality (MR) technology has the potential to enhance care delivery, but there remains a paucity of evidence for its efficacy and feasibility. To assess the efficacy and feasibility of MR technology to enhance emergency care delivery in a simulated environment. This pilot randomized crossover trial was conducted from September to November 2021 at a single center in a high-fidelity simulated environment with participants block randomized to standard care (SC) or MR-supported care (MR-SC) groups. Participants were 22 resident-grade physicians working in acute medical and surgical specialties prospectively recruited from a single UK Academic Health Sciences Centre. Data were analyzed from September to December 2022. Participants resuscitated a simulated patient who was acutely unwell, including undertaking invasive procedures. Participants completed 2 scenarios and were randomly assigned to SC or MR-SC for the first scenario prior to crossover. The HoloLens 2 MR device provided interactive holographic content and bidirectional audiovisual communication with senior physicians in the MR-SC group. The primary outcome was error rate assessed via the Imperial College Error Capture (ICECAP) multidimensional error-capture tool. Secondary outcomes included teamwork (Observational Teamwork Assessment for Surgery [OTAS]; range, 0-6 and Teamwork Skills Assessment for Ward Care [T-SAW-C]; range, 1-5), scenario completion, stress and cognitive load (NASA Task Load Index [NASA-TLX; range 0-100]), and MR device user acceptability. A total of 22 physicians (15 males [68.2%]; median [range] age, 28 [25-34] years) were recruited. MR technology significantly reduced the mean (SD) number of errors per scenario compared with SC (5.16 [3.34] vs 8.30 [3.09] errors; P = .003), with substantial reductions in procedural (0.79 [0.75] vs 1.52 [1.20] errors; P = .02), technical (1.95 [1.40] vs 3.65 [2.03] errors; P = .01), and safety (0.37 [0.96] vs 0.96 [0.85] errors; P = .04) domains. MR resulted in significantly greater scenario completion rates vs SC (22 scenarios [100%] vs 14 scenarios [63.6%]; P = .003). It also led to significant improvements in the overall quality of teamwork and interactions vs SC as measured by mean (SD) OTAS (25.41 [6.30] vs 16.33 [5.49]; P < .001) and T-SAW-C (27.35 [6.89] vs 18.37 [6.09]; P < .001) scores. As reported via mean (range) NASA-TLX score, there were significant reductions for MR-SC vs SC in participant temporal demands (38 [20-50] vs 46 [30-70]; P = .03) and significant improvements in self-reported task performance (50 [30-60] vs 39 [10-70]; P = .01). Overall, 19 participants (86.4%) reported that they were more confident in making clinical decisions and undertaking clinical procedures with MR support. This study found that the use of MR technology reduced error, improved teamwork, and enhanced practitioner confidence when used to support the delivery of simulated emergency medical care. ClinicalTrials.gov Identifier: NCT05870137.

The integration of mixed reality (MR) technology into physical systems represents a significant advancement in bridging the gap between educational environments and industrial applications. This study explores the development of a robotic arm prototype controlled through MR technology, aimed at enhancing educational experiences in the field of robotics. By utilizing augmented reality (AR), virtual reality (VR), and real-time physical interactions, students gain a comprehensive understanding of robotic systems. The project combines open-source platforms with MR to provide a hands-on, immersive learning environment. The primary objective is to foster high-impact learning and practical training, thus reducing the gap between educational settings and real-world industrial applications.

Mobile robots start to appear in everyday life, e.g., in shopping malls or nursing homes. Often, they are operated by staff with no prior experience in robotics. False expectations regarding the capabilities of robots, however, may lead to disappointments and reservations when it comes to accepting robots in ones personal space. We make use of state-of-the-art Mixed Reality (MR) technology by integrating a Microsoft HoloLens into the robot»s operating space to facilitate acceptance and interaction. The MR device is used to increase situation awareness by (a) externalizing the robot»s behavior-state and sensor data and (b) projecting planned behavior. In addition to that, MR technology is (c) used as satellite sensing and display device for human-robot-communication.

PD30-08 EVALUATION OF MIXED REALITY (MR) TECHNOLOGIES FOR REMOTE GUIDANCE DURING ULTRASOUND (US)-GUIDED PERCUTANEOUS RENAL ACCESS SIMULATION: A PROSPECTIVE, RANDOMIZED COMPARATIVE TRIAL

BackgroundApplications of robotics in daily life are becoming essential by creating new possibilities in different fields, especially in the collaborative environment. The potentials of collaborative robots are tremendous as they can work in the same workspace as humans. A framework employing a top-notch technology for collaborative robots will surely be worthwhile for further research.ObjectiveThis study aims to present the development of a novel framework for the collaborative robot using mixed reality.MethodsThe framework uses Unity and Unity Hub as a cross-platform gaming engine and project management tool to design the mixed reality interface and digital twin. It also uses the Windows Mixed Reality platform to show digital materials on holographic display and the Azure mixed reality services to capture and expose digital information. Eventually, it uses a holographic device (HoloLens 2) to execute the mixed reality–based collaborative system.ResultsA thorough experiment was conducted to validate the novel framework for mixed reality–based control of a collaborative robot. This framework was successfully applied to implement a collaborative system using a 5–degree of freedom robot (xArm-5) in a mixed reality environment. The framework was stable and worked smoothly throughout the collaborative session. Due to the distributed nature of cloud applications, there is a negligible latency between giving a command and the execution of the physical collaborative robot.ConclusionsOpportunities for collaborative robots in telerehabilitation and teleoperation are vital as in any other field. The proposed framework was successfully applied in a collaborative session, and it can also be applied in other similar potential applications for robust and more promising performance.

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

A mixed reality environment for collaborative product design and development