Using mixed reality immersive simulation to enhance learners’ confidence in competency

Louise Harmer, Vicky Almey, Maddie Harper, Lisa Mason · British Journal of Midwifery · 2025

Background/Aims Medical students are required to understand labour and birth, but observing a birth in the clinical area can be challenging. Literature supports simulation use but there is little evidence to support mixed reality. This study's aim was to investigate whether mixed reality could enhance learners’ confidence in their clinical competency and knowledge. Methods Mixed reality education was offered to a cohort of 47 students at a UK trust over 1 year. This mixed methods study collected data on participants’ pre- and post-training confidence as well as feedback on the technique. Results There was no significant difference in knowledge, but confidence increased after use of mixed reality education (P<0.0001). Qualitative themes included the usefulness of technology and the learning tool, and increased confidence and satisfaction. Conclusions Mixed reality can improve learners’ confidence significantly, but it is not a replacement for clinical exposure and may not improve knowledge. Further work may improve pedagogical design. Implications for practice Mixed reality simulation is useful for supplementing clinical opportunities and supporting curriculum delivery, but is resource and faculty intensive. Developing cost-effective hardware and software with shareable scenarios that work for different manikins would assist educators to use this technology further.

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