Extended Reality-A Narrative Review of Current State and Best Use in Health Care Simulation.

Extended reality (XR) is rapidly gaining ground in the field of health care simulation. Much remains to be explored in terms of how best to make use of this simulation modality while at the same time maintaining adherence to health care simulation standards of best practice. The effect of XR on learner cognitive load is controversial. On the contrary, XR is considered facilitative towards reducing cognitive load by enhancing audio-visual learning. However, technical adaptation requires adequate exposure to the device, in addition to which cybersickness can be a challenging side effect for users. Therefore, it is essential that prior to using XR simulations in health care education, both faculty implementers and learners should be provided with thorough training on how to use the technology effectively. Learning should be scaffolded by gradually increasing the complexity of XR simulations as learners become more proficient. Adapting simulation design principles for technology-enriched learning environments may help reduce cognitive load as well as positively affect performance. Novice learners benefit when they learn supporting information separately from complex procedural content. Extraneous cognitive load can also be minimized by avoiding redundant expressions of content. Future research should focus on improving XR-related hardware and software and assessing the effectiveness of XR as a simulation modality.