Beyond the Surface: Mixed Reality in Procedural Skill Development in Physician Assistant Education

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INTRODUCTION: Mixed reality (MR) technology has the potential to enhance medical education by overlaying digital anatomical models onto physical trainers, potentially addressing some limitations of traditional teaching tools. This study evaluated the feasibility and value of MR in a physician assistant (PA) clinical skills course to improve understanding of anatomy and confidence in procedural skills. METHODS: The study involved 96 first-year PA students at a health professions university in the southwestern United States that were randomly assigned to an experimental group using MR headsets or a control group using physical trainers alone for a glenohumeral joint injection procedure. Presurveys and postsurveys measured confidence and preparedness in anatomy and in performing procedural skills. The experimental group also completed a system usability scale (SUS) and provided qualitative feedback. RESULTS: The experimental group demonstrated a significant increase in confidence in regional anatomy knowledge (pre: 3.4 ± 1.0; post: 4.8 ± 0.4, P < .001) compared with the control group (pre: 3.5 ± 0.7; post: 4.5 ± 0.5, P < .001). Preparedness and procedural confidence improved similarly in both groups, though MR showed greater engagement and perceived learning benefits. The SUS score of 82.44 indicated excellent usability, placing it between the 90th and 95th percentiles based on normative data. Qualitative feedback highlighted enhanced and detailed anatomy visualization and appreciation of the use of innovative technology in procedural skills. DISCUSSION: Mixed reality technology has a potential to complement traditional teaching, improving anatomy comprehension and procedural confidence in PA education. Its alignment with adult learning principles in providing immediate feedback and realistic simulations and high usability supports its integration into PA curriculum.

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