Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/164783
Title: Outcomes, measurement instruments, and their validity evidence in randomized controlled trials on virtual, augmented, and mixed reality in undergraduate medical education: systematic mapping review
Authors: Car, Lorainne Tudor
Kyaw, Bhone Myint
Teo, Andrew
Fox, Tatiana Erlikh
Vimalesvaran, Sunitha
Apfelbacher, Christian
Kemp, Sandra
Chavannes, Niels
Keywords: Science::Medicine
Issue Date: 2022
Source: Car, L. T., Kyaw, B. M., Teo, A., Fox, T. E., Vimalesvaran, S., Apfelbacher, C., Kemp, S. & Chavannes, N. (2022). Outcomes, measurement instruments, and their validity evidence in randomized controlled trials on virtual, augmented, and mixed reality in undergraduate medical education: systematic mapping review. JMIR Serious Games, 10(2), e29594-. https://dx.doi.org/10.2196/29594
Journal: JMIR Serious Games 
Abstract: Background: Extended reality, which encompasses virtual reality (VR), augmented reality (AR), and mixed reality (MR), is increasingly used in medical education. Studies assessing the effectiveness of these new educational modalities should measure relevant outcomes using outcome measurement tools with validity evidence. Objective: Our aim is to determine the choice of outcomes, measurement instruments, and the use of measurement instruments with validity evidence in randomized controlled trials (RCTs) on the effectiveness of VR, AR, and MR in medical student education. Methods: We conducted a systematic mapping review. We searched 7 major bibliographic databases from January 1990 to April 2020, and 2 reviewers screened the citations and extracted data independently from the included studies. We report our findings in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Of the 126 retrieved RCTs, 115 (91.3%) were on VR and 11 (8.7%) were on AR. No RCT on MR in medical student education was found. Of the 115 studies on VR, 64 (55.6%) were on VR simulators, 30 (26.1%) on screen-based VR, 9 (7.8%) on VR patient simulations, and 12 (10.4%) on VR serious games. Most studies reported only a single outcome and immediate postintervention assessment data. Skills outcome was the most common outcome reported in studies on VR simulators (97%), VR patient simulations (100%), and AR (73%). Knowledge was the most common outcome reported in studies on screen-based VR (80%) and VR serious games (58%). Less common outcomes included participants' attitudes, satisfaction, cognitive or mental load, learning efficacy, engagement or self-efficacy beliefs, emotional state, competency developed, and patient outcomes. At least one form of validity evidence was found in approximately half of the studies on VR simulators (55%), VR patient simulations (56%), VR serious games (58%), and AR (55%) and in a quarter of the studies on screen-based VR (27%). Most studies used assessment methods that were implemented in a nondigital format, such as paper-based written exercises or in-person assessments where examiners observed performance (72%). Conclusions: RCTs on VR and AR in medical education report a restricted range of outcomes, mostly skills and knowledge. The studies largely report immediate postintervention outcome data and use assessment methods that are in a nondigital format. Future RCTs should include a broader set of outcomes, report on the validity evidence of the measurement instruments used, and explore the use of assessments that are implemented digitally.
URI: https://hdl.handle.net/10356/164783
ISSN: 2291-9279
DOI: 10.2196/29594
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Research Centres: Centre for Population Health Sciences 
Rights: © Lorainne Tudor Car, Bhone Myint Kyaw, Andrew Teo, Tatiana Erlikh Fox, Sunitha Vimalesvaran, Christian Apfelbacher, Sandra Kemp, Niels Chavannes. Originally published in JMIR Serious Games (https://games.jmir.org), 13.04.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on https://games.jmir.org, as well as this copyright and license information must be included.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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