Journal of Korean Society of Dental Hygiene (J Korean Soc Dent Hyg)
4
Weeks in Review
2
Weeks to Publication
Journal of Korean Society of Dental Hygiene
Open access, Peer Reviewed
pISSN 2287-1705, eISSN 2288-2294
Weeks in Review
Weeks to Publication
Journal of Korean Society of Dental Hygiene Open access, Peer Reviewed
pISSN 2287-1705, eISSN 2288-2294
Ji-Eun Im1
, Ju-Hee Lee1, Soon-Ryun Lim2, Won-Jae Lee1
1Department of Dental Hygiene, Graduate School of Namseoul University
2Department of Dental Hygiene, Namseoul University
Correspondence to Won-Jae Lee, Department of Dental Hygiene, Namseoul University, Cheonan-si, 31020, Korea, Tel: +82-10-7259-6638, E-mail: wonjae3235@gmail.com
Volume 24, Number 3, Pages 197-208, June 2024.
J Korean Soc Dent Hyg 2024;24(3):197-208. https://doi.org/10.13065/jksdh.20240301
Received on March 25, 2024 , Revised on April 09, 2024, Accepted on April 21, 2024, Published on June 30, 2024.
Copyright © 2024 Journal of Korean Society of Dental Hygiene.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License(http://creativecommons.org/licenses/by-nc/4.0)
Objectives: Extended reality technology offers an innovative opportunity to enhance self-directed learning through interactive processes in healthcare education. This study aims to analyze research trends in the application of extended reality technologybased educational content in the field of healthcare. Methods: Through literature search, selection, and exclusion processes based on predefined criteria, we conducted an analysis of domestic healthcare studies employing extended reality technology, ultimately selecting and examining 39 relevant publications. Results: The analysis reveals diverse applications of extended reality across various fields such as medicine, dentistry, and nursing. Positive effects, including increased academic satisfaction, immersion, and interest, are observed, alongside challenges like media usage difficulties and cybersickness. Conclusions: Future research should focus on the development and application of extended reality-based educational content in diverse healthcare curricula, emphasizing both educational approaches and continuous technological advancements.
Augmented reality, Convergence, Healthcare, Research trends, Virtual reality
Extended reality (ER) is a technology that fuses the real and virtual worlds to provide new experiences and includes virtual reality, augmented reality, mixed reality, and metaverse. A key feature of ER is that it merges or expands the boundaries between the physical world and digital information, allowing users to have a variety of experiences [1]. Virtual reality consists of visual and auditory elements that immerse the user in a complete virtual environment, creating a life-like experience [2]. This immersion can be used in education and training as a tool for hands-on training and simulation, maximizing learning through interactive experiences within a virtual environment. Augmented reality, on the other hand, superimposes digital information about threedimensional objects on the real world, increasing interactivity and accessibility of information [3]. Users interact with virtual objects based on their real-world environment and, in the process, experience enhanced information accessibility and expanded perception. Augmented reality contributes to enriching real-world interactions in a variety of fields, including education, entertainment, and industrial design. Metaverses provide virtual spaces where users can interact through avatars and engage in economic and social activities [4]. Metaverses enable new forms of engagement and experience in an environment that blends the virtual world and reality, creating new opportunities in education, business, entertainment, and more. These ER technologies offer new pedagogical approaches in education with the potential to improve intrinsic motivation and academic performance.
According to Edgar Dale’s ‘active learning’, hands-on experience or simulation typically results in a ninefold difference in retention compared to reading alone [5]. Compared to traditional textbook-based lectures ER technology can help improve the quality of education by facilitating active participation in learning, boosting comprehension, and providing interactivity, such as real-time feedback. Traditional textbook-centered education is primarily based on methodologies such as lecture, discussion, or flipped classroom [6]. Textbook-based learning poses limitations in the process of understanding three-dimensional objects, structures, and environments, and there may be limitations with hands-on practice due to time and environmental constraints [7,8]. To overcome the limitations of space and time, educational contents developed based on ER technology are increasingly being utilized. Hsieh et al. [9] reported that the application of augmented and virtual reality in medical education can improve the inconvenience of traditional medical practice and education and increase the effectiveness and efficiency of medical services. In contrast, Danciu et al. [10] pointed out that the application of augmented and virtual reality has limitations, such as the need for users to set their own environment and adjust mobile and wearable systems. Nevertheless, the adoption of ER technology provides real-world, experiential learning opportunities and offers the opportunity to acquire specialized knowledge.
Healthcare content related to ER has been developed and studied in various subjects [11–13], but the diversity of tools across fields hinders direct comparisons. Further, research trends on this topic are lacking. Systematic reviews of virtual reality programs in nursing and of augmented reality programs in fields, such asl liberal arts and special education, have been conducted [14,15]. However, there is a lack of literature reviews on educational trends and applications of ER applied to the healthcare field. Therefore, this study aims to shed light on the direction of research on ER in healthcare by analyzing the association between healthcare educational contents based on ER from 2013 to 2023 and general characteristics, the effectiveness of such contents reported in interventional studies, and relevant research trends.
This study extracted literature that met the selection criteria and analyzed research trends among studies on the use of ER-based healthcare contents in Korea. The research trend analysis was conducted through the process of identification of the study question, literature search, literature evaluation, and literature analysis. The literature search was conducted from September 5, 2023, to September 18, 2023, and included literature published in Korean journals <Fig. 1>. The Korean literature was obtained from the National Assembly Library (NAL), Korean studies Information Academic (KISS), Research Information Sharing Service (RISS), and DataBase periodical information academic (DBpia).
Fig. 1. Flow diagram for data collection. DBpia: DataBase periodical information academic, KISS: Korean studies Information Service System, NAL: National Assembly Library, RISS: Research Information Sharing Service
The search was conducted using combinations of the following keywords: 1) ‘healthcare,’ ‘medicine,’ ‘dentistry,’ ‘Korean medicine,’ ‘nursing,’ ‘physical therapy,’ ‘occupational therapy,’ ‘radiology,’ ‘clinical pathology,’ ‘dental hygiene,’ and ‘dental technician’; 2) ‘virtual reality,’ ‘augmented reality,’ ‘mixed reality,’ and ‘metaverse’; and 3) ‘education.’ A total of two hundred one articles (nineteen articles from NAL, sixty five articles from KISS, forty two articles from RISS, and ninety five articles from DBpia) were generated in the search. After excluding duplicate results, one hundred six articles were reviewed. The titles and abstracts were first reviewed, and seventy four articles, including systematic reviews and theses, were excluded. After the initial screening, the titles, abstracts, and contents of sixty two articles were reviewed. The inclusion and exclusion criteria are shown in <Table 1>. Twenty-three articles were excluded, including qualitative studies, media development studies, media needs surveys, media analysis studies, studies for recommending study designs, studies that do not involve students, and studies published conducted before 2013. As a result, thirty nine articles were selected.
The final thirty nine articles were organized according to the objectives of this study to extract general characteristics (year of publication, research method, field, media, sample size, grade, and group), intervention methods, intervention duration, and measurement variables. Additionally the key interview findings from six mixed-methods studies were analyzed.
Table 1. Paper selection criteria
| Type | Inclusion | Exclusion |
|---|---|---|
| Paper publication year | 2013-2023 | Before 2013 |
| Types of literature | Domestic academic journals | Master’s thesis, Doctoral dissertation |
| Study object | Undergraduate student | Children |
| Graduate student | ||
| Healthcare professional | ||
| Study design | Cross-sectional study | Meta-analysis |
| Experimental studies (Experimental design, Non-experimental design) | Systematic analysis |
The thirty nine articles included thirty three quantitative studies and six mixed methods studies published between 2013 and 2023 <Fig. 2>. Quantitative studies were published most often in 2021 and 2022, with twelve articles each, while mixed methods studies were published in 2020 (two articles), 2022 (two articles), 2019 (one article), and 2021 (one article). The content and topics of the analyzed literature are shown in <Table 2>. The disciplines comprised medicine (five articles), dentistry (five articles), nursing (twenty nine articles), radiology (one article), and dental hygiene (two articles). The media used were augmented reality (nine articles), virtual reality (twenty five articles), and metaverse (five articles). The sample size was 50 or less in nineteen articles, 51–100 in fifteen articles, and 101 or more in five articles. Participants were current students, either from the same grade level or from two or more grade levels. There were 20 single-group studies and 19 controlled experimental studies. The extended reality intervention used in the studies included viewing virtual reality video (one article), virtual reality experiences using HMDs (nineteen articles), augmented reality applications (nine articles), and metaverse platforms (five articles) <Table 3>.
Fig. 2. Bar chart of number of publications by year and research
Table 2. Content and themes of selected articles
| Author (yr) | Research method | Field | Subjects | Use of extended reality | Content and themes |
|---|---|---|---|---|---|
| Lee (2019) | Quantitative | Medical | Functional anatomy | Virtual reality | Evaluation of academic satisfaction in virtual reality classes |
| Jeong et al. (2023) | Quantitative | Medical | Structure and function of the human body I | Virtual reality | Comparison of virtual reality anatomy learning and traditional learning experiences |
| Lee (2022) | Quantitative | Medical | Basic medicine Physiology | Metaverse | Evaluation of presence and immersion in classes using metaverse |
| Lee et al. (2022) | Mixed | Medical | Medical humanities | Metaverse | Evaluation of class experience using metaverse for medical students |
| Lee (2022) | Quantitative | Medical | Basic medicine Physiology | Metaverse | Evaluation of presence and immersion in physiology classes using the metaverse |
| Kim et al. (2020) | Mixed | Dental | Clinical practice | Augmented reality | Comparative analysis of user evaluations on virtual pediatric patient simulation |
| Kim et al. (2020) | Quantitative | Dental | Unspecified | Augmented reality | Development and application of a virtual reality program that allows pediatric patients to experience dental caries diagnosis |
| Lee et al. (2023) | Quantitative | Nursing | Anatomy | Virtual reality | Usability evaluation of a virtual reality-based anatomy education program |
| Lim (2021) | Quantitative | Nursing | Adult nursing | Virtual reality | Analysis of differences in learning ability, job performance ability, and self-efficacy before and after virtual reality simulation training |
| Kim et al. (2022) | Quantitative | Nursing | Unspecified | Virtual reality | Analysis of learning ability, job performance ability, and academic satisfaction before and after virtual reality simulation training |
| Chae (2021) | Quantitative | Nursing | Unspecified | Virtual reality | Comparative analysis of virtual reality simulation and traditional education methods |
| Kim (2021) | Quantitative | Nursing | Unspecified | Virtual reality | Development and evaluation of virtual reality content |
| Ha et al. (2022) | Quantitative | Nursing | Unspecified | Virtual reality | Analysis of job performance ability, self-efficacy, and academic satisfaction in nursing practice using virtual reality |
| Lee et al. (2021) | Quantitative | Nursing | Adult nursing | Virtual reality | Development and evaluation a nursing education program using virtual reality |
| Son et al. (2022) | Quantitative | Nursing | Mental health nursing | Virtual reality | Evaluation of learning ability and academic satisfaction when using virtual reality simulation |
| Kim et al. (2021) | Quantitative | Nursing | Basic nursing arts | Virtual reality | Evaluation of self-efficacy, immersion, and academic satisfaction when using virtual reality |
| Han et al. (2021) | Quantitative | Nursing | Mental health nursing | Virtual reality | Analysis of differences in motivation and self-efficacy before and after virtual reality classes |
| Lim et al. (2020) | Quantitative | Nursing | Unspecified | Virtual reality | Self-efficacy and learning ability evaluation before and after virtual reality simulation training |
| Seo et al. (2016) | Quantitative | Nursing | Unspecified | Virtual reality | Evaluation of immersion and academic satisfaction before and after virtual reality-based practice |
| Lee et al. (2022) | Quantitative | Nursing | Unspecified | Virtual reality | Development virtual reality program and evaluation of media satisfaction |
| Lee et al. (2021) | Quantitative | Nursing | Unspecified | Virtual reality | Virtual reality program development and evaluation of usability |
| Hyun et al. (2020) | Mixed | Nursing | Transfusion nursing | Virtual reality | Correlation analysis of job performance ability, self-efficacy, presence, and immersion in virtual reality education |
| Jung et al. (2022) | Mixed | Nursing | Unspecified | Virtual reality | Analysis of differences in learning immersion, self-efficacy, job performance ability, and usability between the experimental and control groups of a virtual reality simulation program |
| You et al. (2021) | Quantitative | Nursing | Unspecified | Virtual reality | Analysis of learning ability and self-efficacy when applying virtual reality simulation scenarios |
| Oh et al. (2021) | Quantitative | Nursing | Unspecified | Virtual reality | Evaluation of virtual simulation learning experience on self-efficacy and academic satisfaction |
| Ko et al. (2021) | Quantitative | Nursing | Unspecified | Augmented reality | Augmented reality-based application development and academiic satisfaction evaluation |
| Kim et al. (2022) | Quantitative | Nursing | Basic Nursing Arts | Augmented reality | Evaluation of job ability, self-efficacy, and academic satisfaction during augmented reality-based practical training |
| Kim et al. (2022) | Quantitative | Nursing | Unspecified | Augmented reality | Evaluation of the effects on academic satisfaction and learning ability during augmented reality-based learning |
| Kim (2022) | Quantitative | Nursing | Unspecified | Augmented reality | Evaluation of the effects on academic satisfaction and learning ability in augmented reality-based education |
| Suh et al. (2021) | Quantitative | Nursing | Unspecified | Augmented reality | Evaluation of media satisfaction during augmented reality application classes |
| Kim (2021) | Quantitative | Nursing | Unspecified | Augmented reality | Evaluation and analysis of learning ability after augmented reality classes |
| Kim et al. (2022) | Quantitative | Nursing | Unspecified | Augmented reality | Analysis of the effect on learning ability during augmented reality-based learning |
| An (2019) | Mixed | Nursing | Unspecified | Augmented reality | Usability analysis of learning using augmented reality |
| Lee et al. (2021) | Mixed | Nursing | Unspecified | Virtual reality | Comparison and analysis of virtual simulation and high fidelity simulation practical training experience |
| Ahn (2022) | Quantitative | Nursing | Unspecified | Metaverse | Development of metaverse -based content and verify effectiveness |
| Ahn (2023) | Quantitative | Nursing | Unspecified | Metaverse | Analysis of the effects of metaverse -based content education on self-efficacy and job performance ability |
| Shim et al. (2020) | Quantitative | Radiology | Radiation therapeuties | Virtual reality | Development of virtual reality content on radiation therapy and evaluation of learning ability, self-efficacy, and academic satisfaction |
| Choi et al. (2022) | Quantitative | Dental hygiene | Dental radiology practice | Virtual reality | Evaluation of interest, immersion, and motivation using virtual reality media |
| Lee et al. (2023) | Quantitative | Dental hygiene | Dental morphology | Augmented reality | Analysis of differences in learning ability in practice using augmented reality-based applications |
Table 3. General characteristics of included articles
| Categories | Division | Total | 2016 | 2019 | 2020 | 2021 | 2022 | 2023 |
|---|---|---|---|---|---|---|---|---|
| N(%) | N(%) | N(%) | N(%) | N(%) | N(%) | N(%) | ||
| Field | Medicine | 5(12.8) | 0(0.0) | 1(20.0) | 0(0.0) | 0(0.0) | 3(60.0) | 1(20.0) |
| Dentistry | 2(5.1) | 0(0.0) | 0(0.0) | 2(100.0) | 0(0.0) | 0(0.0) | 0(0.0) | |
| Nursing | 29(74.4) | 1(3.4) | 1(3.4) | 2(6.9) | 13(44.9) | 10(34.5) | 2(6.9) | |
| Radiology | 1(2.6) | 0(0.0) | 0(0.0) | 1(100.0) | 0(0.0) | 0(0.0) | 0(0.0) | |
| Dental hygiene | 2(5.1) | 0(0.0) | 0(0.0) | 0(0.0) | 0(0.0) | 1(50.0) | 1(50.0) | |
| Media | Augmented reality | 9(23.1) | 0(0.0) | 1(11.1) | 0(0.0) | 3(33.3) | 4(44.5) | 1(11.1) |
| Virtual reality | 25(64.1) | 1(4.0) | 1(4.0) | 3(12.0) | 12(48.0) | 6(24.0) | 2(8.0) | |
| Metaverse | 5(12.8) | 0(0.0) | 0(0.0) | 0(0.0) | 0(0.0) | 4(80.0) | 1(20.0) | |
| Sample size | Less than 50 | 19(48.7) | 1(5.3) | 2(10.5) | 3(15.7) | 6(31.6) | 6(31.6) | 1(5.3) |
| Between 51 and 100 | 15(38.5) | 0(0.0) | 0(0.0) | 1(6.7) | 6(40.0) | 6(40.0) | 2(13.3) | |
| More than 101 | 5(12.8) | 0(0.0) | 0(0.0) | 1(20.0) | 1(20.0) | 2(40.0) | 1(20.0) | |
| Year | 1st | 5(11.1) | 0(0.0) | 2(40.0) | 0(0.0) | 0(0.0) | 1(20.0) | 2(40.0) |
| 2nd | 12(26.7) | 0(0.0) | 1(8.3) | 0(0.0) | 5(41.7) | 5(41.7) | 1(8.3) | |
| 3rd | 12(26.7) | 0(0.0) | 0(0.0) | 4(33.3) | 3(25.0) | 5(41.7) | 0(0.0) | |
| 4th | 12(26.7) | 1(8.3) | 0(0.0) | 2(16.7) | 6(50.0) | 3(25.0) | 0(0.0) | |
| Unspecified | 4(8.8) | 0(0.0) | 0(0.0) | 1(25.0) | 0(0.0) | 2(50.0) | 1(25.0) | |
| Group | Single | 20(51.3) | 1(5.0) | 1(5.0) | 3(15.0) | 7(35.0) | 5(25.0) | 3(15.0) |
| Two | 19(48.7) | 0(0.0) | 0(0.0) | 2(10.5) | 6(31.6) | 9(47.4) | 2(10.5) |
The interventions comprised virtual reality video viewing (one article), virtual reality experiences using HMDs (nineteen articles), augmented reality applications (nine articles), and metaverse platforms (five articles). The duration of the intervention was 1 week or less (eleven articles), 1–4 weeks (four articles), 1–3 months (eleven articles), and 3 months or more (four articles). Factors measured in the included articles were academic satisfaction, media satisfaction, interest, motivation, immersion, presence, self-efficacy, usability, learning ability, and job performance <Table 4>.
Table 4. Intervention methods, duration, and measurement variables included in the articles
| Categories | Division | Total | 2016 | 2019 | 2020 | 2021 | 2022 | 2023 |
|---|---|---|---|---|---|---|---|---|
| N(%) | N(%) | N(%) | N(%) | N(%) | N(%) | N(%) | ||
| Inter- vention method | Watch virtual reality video | 1 | 0(0.0) | 0(0.0) | 0(0.0) | 1(100.0) | 0(0.0) | 0(0.0) |
| Virtual reality using head -mounted reality | 19 | 0(0.0) | 1(5.3) | 5(26.2) | 8(42.1) | 4(21.0) | 1(5.3) | |
| Augmented reality application | 9 | 0(0.0) | 1(11.1) | 0(0.0) | 3(33.3) | 4(44.5) | 1(11.1) | |
| Metaverse platform | 5 | 0(0.0) | 0(0.0) | 0(0.0) | 0(0.0) | 4(80.0) | 1(20.0) | |
| Unspecified | 5 | 1(20.0) | 0(0.0) | 0(0.0) | 1(20.0) | 2(40.0) | 1(20.0) | |
| Inter- vention duration | Within 1 week | 11 | 0(0.0) | 1(9.1) | 2(18.2) | 2(18.2) | 4(36.3) | 2(18.2) |
| More than 1 week – within 1 month | 4 | 1(25.0) | 0(0.0) | 1(25.0) | 0(0.0) | 2(50.0) | 0(0.0) | |
| More than 1 month – within 3 months | 11 | 0(0.0) | 1(9.1) | 0(0.0) | 5(45.4) | 4(36.4) | 1(9.1) | |
| More than 3 months | 4 | 0(0.0) | 0(0.0) | 0(0.0) | 2(50.0) | 1(25.0) | 1(25.0) | |
| Unspecified | 9 | 0(0.0) | 0(0.0) | 2(22.2) | 4(44.5) | 3(33.3) | 0(0.0) | |
| Variable | Academic satisfaction | 16 | 1(6.25) | 0(0.0) | 1(6.25) | 8(50.0) | 6(37.5) | 0(0.0) |
| Media satisfaction | 3 | 0(0.0) | 0(0.0) | 1(33.3) | 0(0.0) | 2(66.7) | 0(0.0) | |
| Interest | 5 | 0(0.0) | 2(40.0) | 0(0.0) | 1(20.0) | 1(20.0) | 1(20.0) | |
| Motivation | 3 | 0(0.0) | 0(0.0) | 0(0.0) | 1(33.3) | 2(66.7) | 0(0.0) | |
| Immersion | 11 | 2(18.2) | 1(9.1) | 1(9.1) | 4(36.3) | 3(27.3) | 0(0.0) | |
| Presence | 12 | 0(0.0) | 0(0.0) | 2(16.7) | 0(0.0) | 10(83.3) | 0(0.0) | |
| Self-efficacy | 16 | 0(0.0) | 0(0.0) | 3(18.75) | 7(43.75) | 5(31.25) | 1(6.25) | |
| Usability | 14 | 0(0.0) | 3(21.4) | 1(7.2) | 3(21.4) | 5(35.7) | 2(14.3) | |
| Learning ability | 17 | 0(0.0) | 1(5.9) | 3(17.7) | 4(23.5) | 9(52.9) | 0(0.0) | |
| Job performance ability | 11 | 0(0.0) | 1(9.1) | 2(18.2) | 4(36.3) | 3(27.3) | 1(9.1) | |
| Others | 11 | 0(0.0) | 0(0.0) | 2(18.2) | 3(27.3) | 5(45.4) | 1(9.1) |
This study conducted a literature review of the educational applicability of ER technology to comprehensively understand the research trends in the field. The 39 included articles analyzed the practical applicability and effectiveness of healthcare education using ER technology, and the research objectives and main conclusions of each article are summarized and categorized in <Table 5>. The research objectives were broadly categorized into three main categories. The first category was ‘Evaluating the application and applicability of ER’. These studies focused on evaluating how ER technology can be integrated into the current education system and its effectiveness, as well as confirmed the contribution of ER to learners’ engagement and understanding of learning content. The second category was ‘Analyzing the ER-based classroom experience and validating the effectiveness’. These studies analyzed how ER is currently utilized in education based on empirical data on the differences between teaching using ER and traditional textbook-centered teaching methods. The third category was ‘Discussing the potential of this technology as a new teaching method’. These studies analyzed the possibilities of using ER to overcome the limitations of traditional education methods and present a new education paradigm. Based on the detailed research objectives of each study, we derived four main conclusions: 1) higher student satisfaction, immersion, and interest; 2) more interactive training opportunities for students; 3) the use of ERbased content is independent of previous media experience or gender; and 4) ability to utilize the technology in both online and offline environments.
Table 5. Meaning of virtual and augmented reality learning experiences
| Classification | Details |
|---|---|
| Research objectives | Evaluation of the applicability and potential applications of extended reality |
| Analysis and validation of classroom experiences using extended reality | |
| Discussion on the alternative potential of extended reality as a new educational method | |
| Major conclusion | Elicits high academic satisfaction, interest and immersion |
| Provides increased opportunities for student interaction and training | |
| The use of extended reality content is unrelated to previous media usage experiences or gender | |
| Extended reality content can be utilized in both online and offline environments |
Based on interview results from six studies, we categorized students’ experiences of using ER media into four advantages and three disadvantages <Table 6>. The four advantages of using ER media were as follows: 1) ‘acquire knowledge and enhance memory’ through the use of three-dimensional images to improve learning and memory of practical procedures; 2) ‘interactivity of the learning process’ through immediate feedback on action and changes in communication methods; 3) ‘increased learning satisfaction and self-directed learning’ through motivation through immersion in the situation and increased interest in learning; and 4) ‘freedom of learning’ through the flexibility of new teaching methods and repeated use of the media. In contrast, the disadvantages mentioned after using ER media were: 1) ‘difficulty in using the medium’ due to inexperience in operating the device and shaking of the video screen; 2) ‘cyber sickness’ (dizziness or nausea) during use; and 3) ‘limitations in complex situations’ due to lack of detailed expressions, systematic lesson design, diverse content, and realism.
Table 6. Pros and cons of learning experiences utilizing ER media
| Meanings | Themes | |
|---|---|---|
| Pros | Acquisition of knowledge and enhancenment of momory | Improved retention of performance procedures |
| Learning througn three-dimensional images | ||
| Interaction with the learning process | Immediate feedback on motor performance | |
| Shift in communication style | ||
| Enhancement of learning satisfaction and promotion of self-directed learning | Immersive experience in the situation | |
| Motivation through heightedned interest in learning | ||
| Freedom of learning | Flexibility in adopting new teaching methods | |
| Availability of repetitive media | ||
| Cons | Challenges in media utilization | Inexperience with operation equiment |
| Orrurrence of video screen shaking phonomenon | ||
| Cybersickness | Reports of symptoms such as dizziness and nausea | |
| Limited detailed expression | ||
| Limiatations in handiling complex situations | Difficulty in learning within complex situations | |
| Absence of systematic course design and varied contents | ||
| Necessity to enhance realism comparable to the real world | ||
This study aimed to investigate the trends of research on the use of ER contents in healthcare to provide foundational data for utilizing ER technology in healthcare, including dental hygiene, and to shed light on the potential of ER contents and future research directions. A total of 39 studies were selected from Korean databases. The number of published studies on the use of ER in healthcare has steadily increased from one in 2016 to five in 2020 and 14 in 2022. This is believed to be a result of mounting interests in offline and online ER contents owing to advances in technology and environmental factors. However, the majority of these studies were conducted in nursing. In the field of healthcare, diverse curricula and repetitive learning through clinical practicum are essential. Therefore, continued research is needed to explore the application of ER in various healthcare disciplines and courses. The most common duration of ER-based interventions was ‘1 week or shorter’ and ‘1–3 months’. In order to evaluate the educational outcomes of students in studies that implemented ER, there are various complex conditions that need to be controlled, such as the environment, instructor, and the time and number of times the media is used. However, the included studies were heterogeneous in these aspects, so it is difficult to objectively determine the educational effects of ER technology. Therefore, future studies should expand the use of and analyze the quantitative effects of ER media by maintaining consistency in the duration of the intervention, time, and number of times the media is used.
User evaluations after using ER media showed that ER impacts academic satisfaction, interest and motivation, engagement, learning, and job performance. In dental education, the group that used virtual reality content had higher performance and satisfaction with clinical practicum [16]. This is thought to be due to students’ perceived usefulness of three-dimensional visual elements and self-directed learning experiences in acquiring new knowledge compared to textbook-centered teaching methods. In particular, 25 of the 39 studies developed and implemented virtual reality programs. virtual-reality-based practicum can provide students with a structured and varied learning experience through interactivity. There are more cases using virtual reality, as it can be easily applied in games and videos in various fields. However, side effects, such as cyber sickness symptoms, fatigue, and glare, are some drawbacks of the technology. Therefore, when applying virtual reality in learning, learners should be adequately guided on how to use the display and be informed of the possible side effects.
From the six mixed-methods studies analyzed, we identified four advantages and three disadvantages of ER. The three-dimensional elements of ER were beneficial in acquiring knowledge, retaining memory, and facilitating interactions. This suggests that teaching methods based on ER technology can improve students’ cognitive and educational outcomes [17]. In contrast, there are concerns about the difficulty of operating the device and side effects from shaking of images on screen. Therefore, ER technologies should be made more user-friendly and accessible in order to expand its use in learning contents [18]. Cybersickness, which often occurs when using ER technologies, can cause physical discomfort to users and impair learning [19]. Therefore, it is necessary to limit the time of use when developing and applying ER content in the future. The studies on ER-based education in healthcare analyzed in this review emphasize the need for continuous development of ER technologies to reproduce complex practicum processes and skills. Findings confirm that ER-based education offers benefits in terms of technical, cognitive, and educational aspects during theoretical learning and practicum. However, given that most studies were conducted in the context of nursing, and that ER has high potential as a new educational approach, future studies should develop educational contents to be used both online and offline in more diverse healthcare disciplines.
In this study, we investigated the research trends regarding the use of ER technologies in healthcare education and provided foundational data that promote the use of these technologies in other fields, such as dental hygiene. We drew the following conclusions:
1. The application of ER technology in healthcare in Korea increased in 2020 and 2021.
2. Of 39 included studies, 29 were conducted in the context of nursing.
3. Of 39 included studies, 25 used virtual reality technology.
This study analyzed cases of education and research utilizing ER in healthcare in Korea. However, most studies were focused in the field of nursing, and many of them utilized virtual reality programs. Therefore, studies should continue to develop and research systematic class designs and learner-centered interaction experiences using diverse forms of ER media in various other disciplines. This calls for in-depth research and technological advancement of ER in healthcare, and the findings can contribute to promoting the use of a new educational approach.
Conceptualization: JE Im; Data collection: JE Im, JH Lee, WJ Lee; Formal analysis: JE Im, JH Lee, WJ Lee; Writing-original draft: JE Im, JH Lee, WJ Lee, SR Lim; Writing-review&editing: JE Im, JH Lee, WJ Lee, SR Lim
The authors declared no conflicts of interest.
None.
None.
None.
None.
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