Thinking outside the screen

Co-designing mobile immersive reality for critical thinking in health professional education

Abstract

Background: Developing critical thinking in health professional education is essential to ensure safe, effective and timely client management (Carbogim et al., 2018). High-fidelity immersive reality has been used to supplement critical thinking development. However, it can be expensive, dependent on developers to create scenarios, and limited when offered to large cohorts (Abadia et al., 2024). Mobile immersive reality (mXR) offers affordances of being accessible, cost-effective, easy to use, engaging and providing scalable, authentic learning (Stretton et al., 2024). This study aimed to investigate how mXR facilitates critical thinking in a safe, authentic learning experience.

Method: A learning activity was co-developed by the subject coordinator and researchers for a cohort of second-year Doctor of Physiotherapy students (n=123, between 22- 26 years old). Strength and Conditioning for Life subject students self-assigned to a target exercise population and were provided with a set of 360-degree clinic-based images captured and uploaded to a web-based platform (www.seekbeak.com). Over six weeks, small groups co-designed a client audio biography and “clinical clue” hotspots within the virtual environment that would require critical consideration of viewers (student peers) to determine an optimal exercise for the client. Students also developed a templated exercise video for the optimal exercise and were encouraged to include “alternative exercises” that viewers would need to eliminate based on clues in the virtual environment. Development of critical thinking during the six weeks was measured pre- and post-learning activity using the Health Science Reasoning Test (HSRT-N). Demographic, usability (System Usability Scale) and peer feedback data were also collected.

Findings demonstrated an improvement in critical thinking with a small effect size for all HSRT-N domains, with statistical significance in improving the ability to analyse, interpret, and make inferences and deductions with unfamiliar information. Students reported that mXR was quick to learn and easy to use, that they were confident in the use of the virtual environment and would like to use it more frequently. They enjoyed being able to navigate new spaces virtually first, having a creative license to develop their scenario, and co-designing with peers. However, a few students identified some inconsistencies that made the mXR environment cumbersome to use and observed some symptoms of cybersickness. Peer feedback findings indicated that students found the virtual environments easy to navigate and provided more authentic learning compared to conventional modes of learning experiences.

This study has demonstrated that critical thinking can be facilitated using mXR- enhanced with pedagogical considerations that draw on collaborative, situated and self-determined learning.

The associated presentation will elaborate on some of the study findings, as well as provide a theoretical framework and design principles utilised to develop critical thinking, including the facilitation by mobile immersive reality. It will draw on the considerations of situated, scaffolded, and sense-ational learning while recognising the needs of generational learners in health professional education.

References

Abadia, R., Fritsch, J., Abdelaal, S., & Jayawickrama, T. (2024). Opportunities overcome challenges in adopting immersive virtual reality in online learning. Computers and Education Open, 7, 100208. https://doi.org/10.1016/j.caeo.2024.100208  

Carbogim, F. D., Barbosa, A. C., de Oliviera, L. B., de Sá Diaz, F. B., Toledo, L. V., Alves, K. R., Friedrich, D. B., Luiz, F. S., & Püschel, V. A. (2018). Educational intervention to improve critical thinking for undergraduate nursing students: A randomized clinical trial. Nurse Education in Practice, 33, 121-126. https://doi.org/10.1016/j.nepr.2018.10.001  

Stretton, T., Cochrane, T., Sevigny, C., & Rathner, J. (2024). Exploring mobile mixed reality for critical thinking skills in nursing and healthcare education: a systematic review. Nurse Education Today 133(9), 106072. https://doi.org/10.1016/j.nedt.2023.106072