Augmented Reality

In recent years, there has been an increase in the development of innovative digital technology, including Augmented Reality (AR). AR is the overlaying of virtual content on a user’s view of the real world. Cases supporting the use of AR smart glasses exist if an application is needed to be timely, mobile, and hands-free and continuous attention on the task is necessary. For example, in maintenance a worker could use a smart glass with a live-streaming feature to get advice of technicians, including watching demonstrations, while doing the work. Because of the novelty of AR applications, we find ourselves at an interesting waypoint in the process of finding further use cases for AR.

Why think about Augmented Reality in nursing?

Nursing is an interesting field in which to apply AR, as nurses often have to work quickly, stay mobile, and have both their hands available for their work. Furthermore, new challenges in the nursing field, such as demographical change and rising multimorbidity, invite the use of new technologies. Technical solutions and social innovation may improve healthcare; however, it is important to take the special circumstances of care workers into consideration.

Overviews regarding use cases of AR have been published for various fields. As there was no systematic review about AR in nursing, it was the logical step to conduct this work ourselves. With the review we aimed to gain insights to the following research question:

To date, what research has been performed regarding the use of AR in nursing?

Methodical challenges

As we had a broad research question without concrete output categories, in the beginning we were not able to conduct a systematic review. Thus, we started looking for a type of review which allowed identifying relevant result categories during the process.

New use cases for AR in nursing … will need to be evaluated with a focus on added value first and impact afterwards.

Furthermore, addressing the study quality was a challenging task. To date only a few studies on AR in nursing exist. Therefore, we decided to include studies of varying quality. Finally, we decided to conduct a scoping review. This review type allows the kinds of freedom we needed to identify relevant topics.

As we followed the guidelines for scoping reviews, we still faced the task of identifying relevant topics inductively. To get an overview about topics mentioned in the studies we used a mindmap.

What did we find?

We found 23 studies identifying use cases for AR in nursing. Use cases for AR in nursing focus on specific fields of use, and use case identification and requirements elicitation were often not described in detail. In addition, we identified that the results of studies evaluating AR in nursing were predominantly positive; however, several technical challenges were described for most of these devices. Moreover, most applications could be identified as prototypes in an early stage of implementation.

The settings in which the studies operated are noteworthy. While twelve studies could be grouped into a broad clinical setting with variation in use cases, eleven studies were set in the field of nursing education. We found that many studies focused on obtaining knowledge on the applications developed instead of the effects of technology inclusion on nursing. No studies questioned the clinical relevance of their results.

Considering context while evaluating applications would be an important goal for future research. This could be achieved through performing field trials.

For future development trends, we infer that further technological advances will lead to new use cases for AR in nursing. These may be developed rapidly and will need to be evaluated with a focus on added value first and impact afterwards.

How did we use the findings?

As part of a consortium project, we had the aim to develop applications of AR in nursing. Thus, we needed an overview regarding existing developments. We have already used the results of our review, along with additional workshops, to design and evaluate prototypes for applications in the fields of wound care management, hand hygiene, and education.