Assessment of the Psychological and Physiological Effects of Augmented Reality (APPEAR)

Augmented reality (AR) is the use of a computer-based simulation engine to add non-real sensory information to the real sensory world. Essentially, AR directs participants’ attention to either existing information that they would have not been consciously aware of or to new information that changes their perceptual information. Although this co-registered information can be visually projected directly onto real objects, AR information is often presented directly to the recipient by a device attached to the recipient.

APPEAR maps to Defense Health Agency’s (DHA’s) Joint Evacuation and Transport Simulation (JETS) and Point of Injury and Trauma Simulation (POINTS) programs, under the U.S. Army Medical Research and Materiel Command (USAMRMC) Joint Program Committee-1 (JPC-1) Medical Simulation and Information Sciences Research Program (MSISRP) Medical Simulation (MedSim) portfolio. It addresses the capability gaps in the Virtual Patient System (VPS) of JETS and POINTS. The VPS provides intelligent, scalable, modular medical training products, tools, and devices across globally distributed, integrated, and interconnected Live, Virtual, Constructive, and Gaming training environments. Technology using Augmented Reality (AR) is a significant piece of the VPS, at point of injury (POINTS) and point of demand across the complete chain of evacuation (JETS). This research is critical for assessing the limitations of AR that could impact learning effectiveness to ensure optimal development and utilization of AR technology to address the identified capability gaps in military medical simulation training.

 The ultimate goal of this program is to identify psychological and physiological limitations of AR prototypes currently under development or used for medical simulation training in the diverse high pressure and stressful context anticipated in Roles of Care 1-4. This research will assess and inform prototype development and/or refinement of existing AR prototypes for medical simulation, reducing overall developmental risk, 1) enabling efficiency in the design of future AR scenarios, 2) identifying potential safety issues, and 3) identifying risk factors for adverse reactions to AR medical simulations. Assessing the physiological and psychological effects of AR prototypes for military medical simulations is imperative to the technological development and refinement needed to fully address the existing capability gaps identified in the JETS and POINTS programs and deliver effective solutions to the Warfighter. The outcomes of this work will be used to ensure that AR technology is safely and optimally utilized to enhance learning capabilities in medical simulation.

This MTEC program is expected to conduct human studies to address either:

  • Psychological effects of AR on the end user in training behavior (secondary assessments of cognitive load during learning using AR and/or assessment of neuropsychiatric conditions contraindicated for training with AR could be included), or
  • Physiological effects of AR on the end user in training behavior (secondary assessments of cognitive load during learning using AR and/or assessment of physical conditions contraindicated for training with AR could be included).

It is anticipated that the outcome of these awards will achieve at least one of the following (not in rank order):

  • Deliver a human subjects study that assesses the physiological or psychological effects of AR that will be analyzed and recorded in technical reports and, eventually, in the final report.
  • Enable efficiency in the design of future AR scenarios/prototypes in medical simulations.
  • Identify potential safety issues that should be accounted for in AR prototypes used in medical simulation training.
  • Provide recommendations and/or proposed mitigation strategies regarding any safety issues identified to improve or refine development of or existing AR prototypes.
  • It is anticipated that AR scenarios assessed will be relevant across the military and U.S. Department of Veterans Affairs and potential academic, clinics, rural healthcare settings, private and public hospitals, and international healthcare situations.
  • If applicable, support safety data in investigational device exemption or 510K applications or provide post-mark surveillance data for Food and Drug Administration (FDA)-cleared AR technology.

The research project award recipients were selected from the Offerors who responded to MTEC’s Request for Project Proposals (MTEC-18-09-APPEAR).