Background: Digital rectal examination is a difficult examination to learn and teach because of limited opportunities for practice; however, the main challenge is that students and tutors cannot see the finger when it is palpating the anal canal and prostate gland inside the patients. Objective: This paper presents an augmented reality system to be used with benchtop models commonly available in medical schools with the aim of addressing the problem of lack of visualization. The system enables visualization of the examining finger, as well as of the internal organs when performing digital rectal examinations. Magnetic tracking sensors are used to track the movement of the finger, and a pressure sensor is used to monitor the applied pressure. By overlaying a virtual finger on the real finger and a virtual model on the benchtop model, students can see through the examination and finger maneuvers. Methods: The system was implemented in the Unity game engine (Unity Technologies) and uses a first-generation HoloLens (Microsoft Inc) as an augmented reality device. To evaluate the system, 19 participants (9 clinicians who routinely performed digital rectal examinations and 10 medical students) were asked to use the system and answer 12 questions regarding the usefulness of the system. Results: The system showed the movement of an examining finger in real time with a frame rate of 60 fps on the HoloLens and accurately aligned the virtual and real models with a mean error of 3.9 mm. Users found the movement of the finger was realistic (mean 3.9, SD 1.2); moreover, they found the visualization of the finger and internal organs were useful for teaching, learning, and assessment of digital rectal examinations (finger: mean 4.1, SD 1.1; organs: mean 4.6, SD 0.8), mainly targeting a novice group. Conclusions: The proposed augmented reality system was designed to improve teaching and learning of digital rectal examination skills by providing visualization of the finger and internal organs. The initial user study proved its applicability and usefulness.

Background: Artificial intelligence (AI) has introduced novel opportunities for assessment and evaluation in surgical training, offering potential improvements that could surpass traditional educational methods. Objective: This scoping review examines the integration of AI in surgical training, assessment, and evaluation, aiming to determine how AI technologies can enhance trainees’ learning paths and performance by incorporating data-driven insights and predictive analytics. In addition, this review examines the current state and applications of AI algorithms in this field, identifying potential areas for future research. Methods: Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, the PubMed, Scopus, and Web of Science were searched for studies published between January 2020 and March 18, 2024. Eligibility criteria included English-language full-text articles that investigated the application of AI in surgical training, assessment, or evaluation; non-English texts, reviews, preprints, and studies not addressing AI in surgical education were excluded. After duplicate removal and screening, 56 studies were included in the analysis. Data were structured by categorizing studies according to surgical procedure, AI technique, and training setup. Results were synthesized narratively and summarized in frequency tables. Results: From 1400 initial records, 56 studies met the inclusion criteria. Most were journal articles (84%, 47/56), with the remainder being conference papers (16%, 9/56). AI was most frequently applied in minimally invasive surgery (27%, 15/56), neurosurgery (20%, 11/56), and laparoscopy (16%, 9/56). Common techniques included machine learning (20%, 11/56), clustering (14%, 8/56), deep learning (11%, 6/56), convolutional neural networks (11%, 6/56), and support vector machines (11%, 6/56). Training setups were dominated by simulation platforms (33%, 19/56) and box trainers (24%, 13/56), followed by surgical video analysis (16%, 9/56), and robotic systems such as the da Vinci platform (13%, 7/56). Across studies, AI-enhanced training environments provided automated skill assessment, personalized feedback, and adaptive learning trajectories, with several reporting improvements in trainees’ learning curves and technical proficiency. However, heterogeneity in study design and outcome measures limited comparability, and algorithmic transparency was often lacking. Conclusions: The application of AI in surgical training demonstrates the potential to enhance skill acquisition and support more efficient, personalized, and adaptive learning pathways. Despite encouraging findings, several limitations exist, including small sample sizes, the lack of standardized evaluation metrics, and insufficient external validation of AI models. Future studies should aim to clarify AI methodologies, improve reproducibility, and develop scalable, simulation-based solutions aligned with global education goals.

Although visualization remains a primary mode of interaction in simulations, touch is the most common way people use to interact with the physical objects. A greater sense of immersion in a learning environment can be reached when the user is able to feel and manipulate objects as compared to only seeing or listening. Despite the affordances of haptic technologies, which could serve as scaffolds for deep conceptual learning, their true potential in education has not been fully harnessed and little research has been done to investigate its effectiveness for learning difficult concepts. This study explores the potential of haptic technologies in supporting conceptual understanding of difficult concepts in science, specifically concepts related to electricity and magnetism. A pretest-posttest study identified if students improved their conceptual understanding of electricity and magnetism concepts. Specifically, this study identified (a) how students, with different physics background, conceptually interpreted the tactile learning experience in the context of the visualization, and (b) students’ perceptions on the use of haptic technologies for their learning, as well as their perceived usefulness and ease of use. Our results suggest that overall students significantly improved their conceptual understanding about electric fields for distributed charges after being exposed to a visuohaptic simulation guided activity. Regarding students’ prior coursework, students with high school-only physics background outperformed students who have been previously exposed to college-level physics courses 8% higher in the posttest average score. Similarly, students overall agreed that they enjoyed using the haptic device for learning and found the technology as easy to interact with. Implications for teaching and learning are provided as well as venues for future work.

In this paper, a map of the state of the art of recent medical simulators that provide evaluation and guidance for surgical procedures is performed. The systems are reviewed and compared from the viewpoint of the used technology, force feedback, learning evaluation, didactic and visual aid, guidance, data collection and storage, and type of solution (commercial or non-commercial). The works’ assessment was made to identify if—(1) current applications can provide assistance and track performance in training, and (2) virtual environments are more suitable for practicing than physical applications. Automatic analysis of the papers was performed to minimize subjective bias. It was found that some works limit themselves to recording the session data to evaluate them internally, while others assess it and provide immediate user feedback. However, it was found that few works are currently implementing guidance, aid during sessions, and assessment. Current trends suggest that the evaluation process’s automation could reduce the workload of experts and let them focus on improving the curriculum covered in medical education. Lastly, this paper also draws several conclusions, observations per area, and suggestions for future work.