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Extended reality (XR) has emerged as an innovative simulation-based learning modality. An integrative review was undertaken to explore the nature of evidence, usage, and effectiveness of XR modalities in medical education. One hundred and thirty-three ( N  = 133) studies and articles were reviewed. XR technologies are commonly reported in surgical and anatomical education, and the evidence suggests XR may be as effective as traditional medical education teaching methods and, potentially, a more cost-effective means of curriculum delivery. Further research to compare different variations of XR technologies and best applications in medical education and training are required to advance the field., Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01698-4., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) under exclusive licence to International Association of Medical Science Educators 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Mixed reality (MR), the computer-supported augmentation of a real environment with virtual elements, becomes ever more relevant in the medical domain, especially in urology, ranging from education and training over surgeries. We aimed to review existing MR technologies and their applications in urology., Methods: A non-systematic review of current literature was performed using the PubMed-Medline database using the medical subject headings (MeSH) term "mixed reality", combined with one of the following terms: "virtual reality", "augmented reality", ''urology'' and "augmented virtuality". The relevant studies were utilized., Results: MR applications such as MR guided systems, immersive VR headsets, AR models, MR-simulated ureteroscopy and smart glasses have enormous potential in education, training and surgical interventions of urology. Medical students, urology residents and inexperienced urologists can gain experience thanks to MR technologies. MR applications are also used in patient education before interventions., Conclusions: For surgical support, the achievable accuracy is often not sufficient. The main challenges are the non-rigid nature of the genitourinary organs, intraoperative data acquisition, online and multimodal registration and calibration of devices. However, the progress made in recent years is tremendous in all respects and the gap is constantly shrinking., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors.)

It is well known that the appearance of food, particularly its color, can influence flavor perception and identification. However, food studies involving the manipulation of product color face inevitable limitations, from extrinsic flavors introduced by food coloring to the cost in development time and resources in order to produce different product variants. One solution lies in modern virtual reality (VR) technology, which has become increasingly accessible, sophisticated, and widespread over the past years. In the present study, we investigated whether making a coffee look milkier in a VR environment can alter its perceived flavor and liking. Thirty-two United Kingdom (UK) consumers were given four samples of black cold brew coffee at 4 and 8% sucrose concentration. They wore VR headsets throughout the study and viewed the same coffee in a virtual setting. The color of the beverage was manipulated in VR, such that participants saw either a dark brown or light brown liquid as they sipped the coffee. A full factorial design was used so that each participant tasted each sweetness x color combination, Participants reported sweetness, creaminess, and liking for each sample. Results revealed that beverage color as viewed in VR significantly influenced perceived creaminess, with the light brown coffee rated to be creamier than dark brown coffee. However, beverage color did not influence perceived sweetness or liking. The present study supports the role of VR as a means of conducting food perception studies, either to gain a better understanding of multisensory integration, or, from an industry perspective, to enable rapid product testing when it may be time-intensive or costly to produce the same range of products in the real-world. Furthermore, it opens potential future opportunities for VR to promote healthy eating behavior by manipulating the visual appearance of foods., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Wang, Meyer, Waters and Zendle.)

Purpose: Real-time ultrasound has become a crucial aspect of several image-guided interventions. One of the main constraints of such an approach is the difficulty in interpretability of the limited field of view of the image, a problem that has recently been addressed using mixed reality, such as augmented reality and augmented virtuality. The growing popularity and maturity of mixed reality has led to a series of informal guidelines to direct development of new systems and to facilitate regulatory approval. However, the goals of mixed reality image guidance systems and the guidelines for their development have not been thoroughly discussed. The purpose of this paper is to identify and critically examine development guidelines in the context of a mixed reality ultrasound guidance system through a case study., Methods: A mixed reality ultrasound guidance system tailored to central line insertions was developed in close collaboration with an expert user. This system outperformed ultrasound-only guidance in a novice user study and has obtained clearance for clinical use in humans. A phantom study with 25 experienced physicians was carried out to compare the performance of the mixed reality ultrasound system against conventional ultrasound-only guidance. Despite the previous promising results, there was no statistically significant difference between the two systems., Results: Guidelines for developing mixed reality image guidance systems cannot be applied indiscriminately. Each design decision, no matter how well justified, should be the subject of scientific and technical investigation. Iterative and small-scale evaluation can readily unearth issues and previously unknown or implicit system requirements., Conclusions: We recommend a wary eye in development of mixed reality ultrasound image guidance systems emphasizing small-scale iterative evaluation alongside system development. Ultimately, we recommend that the image-guided intervention community furthers and deepens this discussion into best practices in developing image-guided interventions.