A Multi-Level HXRI-Based Approach for XR-Based Surgical Training.

In the past decade, Extended Reality (XR), through rapid technological advancement, has managed to make modest changes in surgical training approaches. Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR)-based simulators have been adopted for training in various surgical domains such as brain, eye, laparoscopic, and orthopedic surgery among others. However, there is a lack of effort in exploring Human Extended Reality Interaction (HXRI)-based concepts to design effective training environments that corroborate the actual training procedure. In this paper, an HXRI-based multi-level approach has been proposed for the creation of XR-based training environments. The multi-level approach takes advantage of both Virtual and Mixed Reality to create a holistic training environment while eliminating the disadvantage arising from using stand-alone VR and MR-based training environments. The approach was based on the results of an exhaustive study in which medical personnel interacted with VR and MR environments to train in an orthopedic surgical procedure. The approach, design, and development of the XR environments, the study, and the results from the study which underscore the importance of such a multi-level approach are presented in the paper.