The use of immersive simulation in paramedicine education: a scoping review

The emergence of augmented reality (AR) and mixed reality (MR) modalities has increased the potential of simulation in paramedicine education. The integration of AR/MR into education programmes should be underpinned by sound learning design; however, little is known about their effective use. The purpose of this scoping review was to identify the application and integration of AR/MR within paramedicine education. The review searched MEDLINE, EMBASE, PsychInfo, CINAHL and ERIC up to February 2020 to identify peer-reviewed articles describing the application or integration of any AR/virtual reality (VR) in the context of paramedicine education. The search yielded 11 records for qualitative synthesis from 170 unique records. The quality assessment showed diversity, from good to very poor quality papers. Categories of AR/MR were identified: computer-based avatar worlds, headset-based VR and screen-projection immersive spaces. An application was diverse, with triage and management of mass casualty featuring prominently. One paper described cost-effectiveness, and none discussed issues associated with volume or frequency of exposure required to achieve sustained outcomes. This review identified a small and heterogeneous evidence base describing AR/MR in paramedicine education. Limited, weak evidence demonstrates outcomes of equal to or better than traditional simulation when using AR/VR in paramedicine education.