The affective impact of mixed reality on medical students' learning outcomes in clinical skills: A preliminary study.

OBJECTIVES: This study aimed to investigate the relationship between affective responses to mixed reality (MR)-assisted learning and clinical skill performance among medical students in a preclinical training setting. MATERIALS AND METHODS: A preliminary study was conducted among 33 fourth-year medical students who participated in an MR-assisted clinical skills curriculum. After initial traditional lectures, students engaged in MR-assisted sessions using Microsoft HoloLens 2® for themes of oropharyngeal management. Learning outcomes were evaluated via written tests, Objective Structured Clinical Examinations (OSCEs), and a validated Mixed-Reality Learning Environment (MRLE) questionnaire assessing satisfaction and affective attitudes. RESULTS: A total of 33 students were analyzed. Checklist scores for Group A and Group B differed significantly (88.61 ± 4.79 vs. 75.45 ± 11.11, P < 0.001), while written test scores were comparable (P = 0.094). Regression showed a positive correlation between written and OSCE scores (P = 0.003). Female students reported higher affective responses (P = 0.022), while males achieved slightly higher, although nonsignificant, OSCE scores. MRLE satisfaction was not significantly associated with academic performance. CONCLUSION: MR-assisted learning potentially supported clinical skill acquisition and learner engagement, although affective attitudes and satisfaction might not directly predict performance. These findings highlighted MR's value in bridging theoretical instruction and hands-on practice, with implications for curriculum design that account for individual learning differences.