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Background: The addition of biofeedback and artificial intelligence (AI) in simulation training and serious games has shown promising results in improving the effectiveness of training and can lead to increased engagement, motivation, and retention of information. This systematic literature review explores the integration of biofeedback and artificial intelligence into eXtended reality (XR) training scenarios and is the first review to provide a consolidated overview of applied biofeedback and AI technologies in this area. Method: This review was conducted using keywords related to biofeedback, AI, XR, and training and included papers that: contained the use of biofeedback and AI in XR training scenarios; reported on at least one outcome related to training effectiveness; were published in English; were peer-reviewed; date from 1 January 2016 – 7 February 2022. Results: The results indicate that many studies collect two or more biosignals using a single biosensing device. This is particularly relevant in applied settings, where ease of use and minimal interference in training/education activities is desired. Also, that light, portable devices such as wrist bands, wireless straps, or headbands are preferred. Additionally, eye tracking, electrodermal activity (EDA), and photoplethysmograms (PPG) present as particularly useful biomarkers of stress and/or cognitive load in XR training contexts. A wide variety of machine learning (ML) approaches were used to support biofeedback systems in XR environments. However, a limited number of studies employed real-time analysis of biosignals (just 1% of studies) which indicates current challenges in implementing such systems. Conclusion: The majority of papers meeting the selection criteria were from the fields of education and healthcare. Further research in other domains, such as defense and general industry, is needed to gain a comprehensive understanding of the potential for biofeedback and AI integration in XR training scenarios used in these domains. [ABSTRACT FROM AUTHOR]

Background. During the last decades, the use of simulations for training purposes has sparked wide interest. However, it is unclear how training format characteristics may affect learning, resulting in a lack of evidence-based guidelines for training developers and organizations. Aim. We explore to what extent variation in the situations presented during a simulation training may improve learning outcomes. We test this research question in the context of a simulation-based training for improving innovation knowledge. Methods. A sample of 131 business students was invited to participate in a study with a pretest and two posttests (within 48 hours after and 4 weeks later) and three conditions : a control group without training, an experimental training group with low situational variation, and an experimental training group with high situational variation. Results and Conclusion. Compared to the control group, high but not low situational variation improved innovation knowledge. Participants' prior innovation knowledge did not moderate the results. Hence, our findings indicate that ideally a simulation training includes multiple situations that offer learners various opportunities to practice innovation challenges. [ABSTRACT FROM AUTHOR]

Background. Although instructor participation is generally thought to improve the effectiveness of simulation-based training, trainees may have time and opportunity to practice skills in simulation when an instructor is not available.Aim. The question of whether complex psychomotor skills, such as air combat maneuvering, can be acquired and improved entirely without instructor assistance through self-study and simulation-based practice is investigated.Method. The results of an extended sequence of simulated air combat missions flown by a single experimental subject are reported and analyzed. Over a period of eight calendar years the subject flew 2,950 simulated air combat missions organized into 138 campaigns using seven different aircraft types. Throughout the period the subject studied air combat maneuvering in a self-guided, self-study mode and consciously used maneuvers and tactics learned during that study with the intent of improving his performance. However, determining whether the subject’s skills were actually improving over time was confounded by the fact that between some campaigns the subject changed the aircraft type he was flying as well as the aircraft types flown by the opposition, making direct campaign-to-campaign performance comparisons problematic. Consequently, a type-independent measure of performance was developed to normalize for the different aircraft types and allow direct comparison of performance across different aircraft types flown and opposed.Results. Two different nonparametric statistical tests were applied to the normalized performance measure across all campaigns. A third nonparametric statistical method was applied to victories within each aircraft type. All three showed statistically significant improvement in the subject’s skills over time despite the complete absence of instructor assistance.Conclusions. Although this case study must be considered anecdotal because it involves only a single experimental subject, it does provide an existence proof that self-guided self-study and simulation-based practice without an instructor can produce improvement in complex psychomotor skills in some learners. In addition, the analytical methods used to normalize for different aircraft types and test for improvement may be useful in similar situations where performance must be compared across time-varying circumstances. [ABSTRACT FROM AUTHOR]

Background. Simulation-based instruction can be applied successfully to communication skills training. However, communication skills training (CST) for salespeople is a somewhat underdeveloped area, and only limited knowledge of different theoretical approaches and their application to sales education is available.Aim. We introduce (a) situated learning theory (SLT), and connect it to the theoretical framework of communication in the disciplines (CID), and (b) principles of drama education. We apply these theories to simulation-based training in communication skills.Method. We use a Sales Theatre Workshop (STW) as an example to show how SLT and CID can guide instructional design. We explain how the principles of drama education guided the design of role-play with simulated clients and of a structured debriefing process.Results. Using SLT, the CID theoretical framework and the principles of drama education allowed successful communication learning in the STW. Following these theoretical ideas, we chose a specific communication context, created authentic client cases, emphasized reflective participation and a psychologically safe learning environment, and made the experience applicable to real sales situations.Conclusions. We conclude by stating how SLT and the principles of drama education can be applied to simulation-based training. We propose more investigation of the debriefing process as a subject for future research. [ABSTRACT FROM AUTHOR]

Background. Fidelity - an intrinsic property of simulation is crucial to simulation design and to educational effectiveness. Yet the term fidelity is inconsistently used, which makes it difficult to draw inferences from current literature and translate research into practice.Aim. In this article, we attempt to bring some clarity to the term simulation fidelity in healthcare education.Method. We are opposed to the notion that high-fidelity simulation requires complete and faithful replication of reality, and instead argue for an accurate representation of real-world cues and stimuli. We address a number of issues surrounding the term fidelity and how it is currently used in the literature.Result. In recognising the limitations of current methods of describing fidelity in the literature, we propose an alternative 3-dimensional framework for fidelity along the axes of the patient, clinical scenario, and healthcare facilities as a means for more precise and practical positioning of current healthcare simulation activities.Conclusion. All aspects of fidelity significantly hinge on the learners’ perceived realism of the context of the learning episode as opposed to any one particular element such as the technology used. [ABSTRACT FROM AUTHOR]

The article examines the cognitive processes of health care professionals across trauma simulations. The team reported their transactive memory perceptions before and after participating in the simulation. An increase in transactive memory was reported by the participants and the transactive memory was noted to relate with observer-rated performance. The design and evaluation of simulation-based training programs were deemed valuable to facilitate the development of the cognitive processes.

The development of appropriate scenarios is critical in high-fidelity simulation training. They need to be developed to address specific learning objectives, while not preventing other learning points from emerging. Buying a patient simulator, finding a volunteer to act as the patient, or even obtaining ready-made scenarios from another simulation center are rarely insurmountable challenges. The issue often lies in how to use or adapt these for your own purpose: with your team, facilities, and resources but primarily for your learners. Published information is limited in the area of scenario preparation for health care education and continuing medical education or continuing professional development. This article is a guide for clinical tutors, standardized patient trainers, and patient simulator operators on how to script scenarios and proposes a new detailed and reusable template for writing scenarios. It contains practical sections such as how to decide on the learning objectives to be addressed, how to script and organize your scenarios, and how to pitch the suitable level of details to make the scenarios appropriately realistic. [ABSTRACT FROM AUTHOR]