{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T12:08:29Z","timestamp":1775477309467,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T00:00:00Z","timestamp":1517356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Information"],"abstract":"<jats:p>New accessible learning methods delivered through mobile mixed reality are becoming possible in education, shifting pedagogy from the use of two dimensional images and videos to facilitating learning via interactive mobile environments. This is especially important in medical and health education, where the required knowledge acquisition is typically much more experiential, self-directed, and hands-on than in many other disciplines. Presented are insights obtained from the implementation and testing of two mobile mixed reality interventions across two Australian higher education classrooms in medicine and health sciences, concentrating on student perceptions of mobile mixed reality for learning physiology and anatomy in a face-to-face medical and health science classroom and skills acquisition in airways management focusing on direct laryngoscopy with foreign body removal in a distance paramedic science classroom. This is unique because most studies focus on a single discipline, focusing on either skills or the learner experience and a single delivery modality rather than linking cross-discipline knowledge acquisition and the development of a student\u2019s tangible skills across multimodal classrooms. Outcomes are presented from post-intervention student interviews and discipline academic observation, which highlight improvements in learner motivation and skills, but also demonstrated pedagogical challenges to overcome with mobile mixed reality learning.<\/jats:p>","DOI":"10.3390\/info9020031","type":"journal-article","created":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T12:41:24Z","timestamp":1517402484000},"page":"31","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":130,"title":["Mobile Mixed Reality for Experiential Learning and Simulation in Medical and Health Sciences Education"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0422-4867","authenticated-orcid":false,"given":"James","family":"Birt","sequence":"first","affiliation":[{"name":"Faculty of Society and Design, Bond University, Robina QLD 4226, Australia"}]},{"given":"Zane","family":"Stromberga","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine, Bond University, Robina QLD 4226, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1444-1563","authenticated-orcid":false,"given":"Michael","family":"Cowling","sequence":"additional","affiliation":[{"name":"School of Engineering &amp; Technology, Central Queensland University, Brisbane QLD 4000, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2190-8301","authenticated-orcid":false,"given":"Christian","family":"Moro","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine, Bond University, Robina QLD 4226, Australia"}]}],"member":"1968","published-online":{"date-parts":[[2018,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s40670-017-0384-6","article-title":"Supporting students\u2019 transition to university and problem-based learning","volume":"27","author":"Moro","year":"2017","journal-title":"Med. Sci. Educ."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/ase.1373","article-title":"An enriched multimedia ebook application to facilitate learning of anatomy","volume":"7","author":"Stirling","year":"2014","journal-title":"Anat. Sci. Educ."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1111\/j.1365-2923.2010.03750.x","article-title":"The effectiveness of self-directed learning in health professions education: A systematic review","volume":"44","author":"Murad","year":"2010","journal-title":"Med. Educ."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Clark, R.C., and Mayer, R.E. (2016). E-Learning and the Science of Instruction: Proven Guidelines for Consumers and Designers of Multimedia Learning, John Wiley & Sons.","DOI":"10.1002\/9781119239086"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/SIH.0b013e3182614f95","article-title":"Comparative effectiveness of technology-enhanced simulation versus other instructional methods: A systematic review and meta-analysis","volume":"7","author":"Cook","year":"2012","journal-title":"Simul. Healthc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e867","DOI":"10.3109\/0142159X.2012.714886","article-title":"Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis","volume":"35","author":"Cook","year":"2013","journal-title":"Med. Teach."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.surg.2012.06.025","article-title":"Cost: The missing outcome in simulation-based medical education research: A systematic review","volume":"153","author":"Zendejas","year":"2013","journal-title":"Surgery"},{"key":"ref_8","first-page":"1","article-title":"Toward future \u2018mixed reality\u2019 learning spaces for steam education","volume":"25","author":"Birt","year":"2017","journal-title":"Int. J. Innov. Sci. Math. Educ."},{"key":"ref_9","unstructured":"Cowling, M., Moore, E., and Birt, J. (2015, January 27\u201329). Augmenting distance education skills development in paramedic science through mixed media visualisation. Proceedings of the EUROMEDIA\u20192015, Lisbon, Portugal."},{"key":"ref_10","first-page":"1321","article-title":"A taxonomy of mixed reality visual displays","volume":"77","author":"Milgram","year":"1994","journal-title":"IEICE Trans. Inf. Syst."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.compedu.2013.11.012","article-title":"Learning strategies and multimedia techniques for scaffolding size and scale cognition","volume":"72","author":"Magana","year":"2014","journal-title":"Comput. Educ."},{"key":"ref_12","unstructured":"Johnson, L., Adams Becker, S., Cummins, M., Estrada, V., Freeman, A., and Hall, C. (2016). Nmc Horizon Report: 2016 Higher Education Edition, The New Media Consortium."},{"key":"ref_13","unstructured":"Johnson, L., Adams Becker, S., Cummins, M., Estrada, V., Freeman, A., and Ludgate, H. (2013). Nmc Horizon Report: 2013 Higher Education Edition, The New Media Consortium."},{"key":"ref_14","unstructured":"Johnson, L., Adams Becker, S., Estrada, V., and Freeman, A. (2014). Nmc Horizon Report: 2014 Higher Education Edition, The New Media Consortium."},{"key":"ref_15","unstructured":"Johnson, L., Adams Becker, S., Estrada, V., and Freeman, A. (2015). Nmc Horizon Report: 2015 Higher Education Edition, The New Media Consortium."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1145\/3019008","article-title":"Augmenting reality for augmented reality","volume":"24","author":"Cowling","year":"2016","journal-title":"Interactions"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14742\/ajet.3840","article-title":"Virtualisation devices for student learning: Comparison between desktop-based (Oculus Rift) and mobile-based (Gear VR) virtual reality in medical and health science education","volume":"33","author":"Moro","year":"2017","journal-title":"Australas. J. Educ. Technol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.14742\/ajet.3596","article-title":"Improving paramedic distance education through mobile mixed reality simulation","volume":"33","author":"Birt","year":"2017","journal-title":"Australas. J. Educ. Technol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Birt, J., Moore, E., and Cowling, M.A. (2017, January 2\u20134). Piloting mobile mixed reality simulation in paramedic distance education. Proceedings of the 2017 IEEE 5th International Conference on Serious Games and Applications for Health (SeGAH), Perth, Australia.","DOI":"10.1109\/SeGAH.2017.7939270"},{"key":"ref_20","unstructured":"Birt, J., Hovorka, D., and Nelson, J. (arXiv, 2016). Interdisciplinary translation of comparative visualization, arXiv."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1002\/ase.1696","article-title":"The effectiveness of virtual and augmented reality in health sciences and medical anatomy","volume":"10","author":"Moro","year":"2017","journal-title":"Anat. Sci. Educ."},{"key":"ref_22","first-page":"48","article-title":"Challenges and opportunities facing medical education","volume":"122","author":"Densen","year":"2011","journal-title":"Trans. Am. Clin. Climatol. Assoc."},{"key":"ref_23","first-page":"429","article-title":"How much effort is needed to keep up with the literature relevant for primary care?","volume":"92","author":"Alper","year":"2004","journal-title":"J. Med. Libr. Assoc."},{"key":"ref_24","first-page":"499","article-title":"Growth and decentralization of the medical literature: Implications for evidence-based medicine","volume":"93","author":"Druss","year":"2005","journal-title":"J. Med. Libr. Assoc."},{"key":"ref_25","unstructured":"Huang, R., and Spector, J.M. (2013). Digital natives: Exploring the diversity of young people\u2019s experience with technology. Reshaping Learning: Frontiers of Learning Technology in a Global Context, Springer."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Mayer, R.E. (2014). The multiple representation principle in multimedia learning. The Cambridge Handbook of Multimedia Learning, Cambridge University Press. [2nd ed.].","DOI":"10.1017\/CBO9781139547369"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/j.1467-8535.2009.01038.x","article-title":"What are the learning affordances of 3-D virtual environments?","volume":"41","author":"Dalgarno","year":"2010","journal-title":"Br. J. Educ. Technol."},{"key":"ref_28","first-page":"709","article-title":"Virtual learning environments to enhance spatial orientation","volume":"14","author":"Saorin","year":"2017","journal-title":"Eurasia J. Math. Sci. Technol. Educ."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1365-2044.2011.06939.x","article-title":"Education in airway management","volume":"66","author":"Baker","year":"2011","journal-title":"Anaesthesia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/CCM.0b013e31829a721f","article-title":"Advanced airway management simulation training in medical education: A systematic review and meta-analysis","volume":"42","author":"Kennedy","year":"2014","journal-title":"Crit. Care Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1553-2712.2011.01115.x","article-title":"Paramedic laryngoscopy in the simulated difficult airway: Comparison of the venner A.P. Advance and glidescope ranger video laryngoscopes","volume":"18","author":"Butchart","year":"2011","journal-title":"Acad. Emerg. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s11606-007-0283-4","article-title":"Simulation technology for skills training and competency assessment in medical education","volume":"23","author":"Scalese","year":"2008","journal-title":"J. Gen. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1097\/ALN.0b013e31816bbd54","article-title":"Part task and variable priority training in first-year anesthesia resident educationa combined didactic and simulation-based approach to improve management of adverse airway and respiratory events","volume":"108","author":"Johnson","year":"2008","journal-title":"Anesthesiology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3109\/0142159X.2014.889290","article-title":"Cognitive load theory: Implications for medical education: Amee guide no. 86","volume":"36","author":"Young","year":"2014","journal-title":"Med. Teach."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1177\/0018720812451994","article-title":"Effectiveness of part-task training and increasing-difficulty training strategies: A meta-analysis approach","volume":"55","author":"Wickens","year":"2013","journal-title":"Hum. Factors"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/acp.3142","article-title":"State-of-the-art research into multimedia learning: A commentary on Mayer\u2019s handbook of multimedia learning","volume":"29","author":"Ayres","year":"2015","journal-title":"Appl. Cogn. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1111\/medu.12649","article-title":"Self-regulated learning in simulation-based training: A systematic review and meta-analysis","volume":"49","author":"Brydges","year":"2015","journal-title":"Med. Educ."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/ACM.0000000000000130","article-title":"Reconsidering fidelity in simulation-based training","volume":"89","author":"Hamstra","year":"2014","journal-title":"Acad. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1111\/j.1365-2923.2012.04243.x","article-title":"The minimal relationship between simulation fidelity and transfer of learning","volume":"46","author":"Norman","year":"2012","journal-title":"Med. Educ."},{"key":"ref_40","unstructured":"Queensland Ambulance Service, C.U. (2018, January 29). Clinical Practice Procedures: Airway Management, Available online: https:\/\/www.ambulance.qld.gov.au\/CPPtable.html."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3102\/0013189X11428813","article-title":"Design-based research: A decade of progress in education research?","volume":"41","author":"Anderson","year":"2012","journal-title":"Educ. Res."},{"key":"ref_42","first-page":"52","article-title":"Design research from a technology perspective","volume":"1","author":"Reeves","year":"2006","journal-title":"Educ. Des. Res."}],"container-title":["Information"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2078-2489\/9\/2\/31\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:53:15Z","timestamp":1760194395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2078-2489\/9\/2\/31"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,31]]},"references-count":42,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,2]]}},"alternative-id":["info9020031"],"URL":"https:\/\/doi.org\/10.3390\/info9020031","relation":{"has-review":[{"id-type":"doi","id":"10.14293\/S2199-1006.1.SOR-UNCAT.ANU602.v1.RRSOIG","asserted-by":"object"}]},"ISSN":["2078-2489"],"issn-type":[{"value":"2078-2489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,31]]}}}