Extended reality as a modality to train non-technical skills in healthcare: A scoping review

The need to train non-technical skills (NTS) has seen a growing emphasis in recent literature, as they have been associated with improved patient outcomes. NTS training often utilizes live simulations where healthcare workers can practice these skills, but simulations like this can be expensive and resource intensive to run. Training technical skills using extended reality tools (e.g., virtual, augmented, or mixed reality) has seen a growth in popularity across healthcare domains, however, the use of XR to train specific interpersonal and cognitive skills comprises a smaller part of the literature. As such, this study aims to scope the literature to identify how NTS have been trained through XR-based systems. The specific aims were to identify: 1) which NTS are being trained in healthcare, 2) which modality of XR these skills are being trained in, 3) what specialties are using XR to train NTS in healthcare, and 4) potential areas for future work. Based on consistent search terms for each database, 18,984 articles were initially retrieved, and articles were removed per the screening criteria. Results from the 15 included articles show that the most common NTS construct evaluated was communication (80%), the most common XR modality was virtual reality (80%), and the most common healthcare domain was surgery (46.7%). These articles found that training NTS in XR can lead to comparable, or better, learning outcomes compared to traditional methods. However, future work may look to consider additional NTS in training, improve interaction with XR environments, and measure NTS with XR technology.