# The Use of Mixed Reality in Training Trainers--A Single-Centre Study
## 5 Discussion  
Recent times have seen a gradual shift away from didactic teaching across medical schools worldwide due to the availability, cost and time restraints of traditional methods [23]. This effect has been further potentiated following the COVID-19 pandemic, which led to a transition of medical education away from an in-person format towards an online model [9]. Therefore, concurrent technological advances have prompted the use of VR and MR software to supplement more traditional methods of [24]. There is well-established evidence to support that both MR and VR teaching provide high rates of satisfaction and acceptability as a supplementary education aid [25]. Our group has previously demonstrated that mixed reality can supplement highly focused teaching in neuroanatomy [8]. However, the question of whether this can be extrapolated to training the trainers to assist them in using MR in their endeavours remains unanswered. MR technology provides an immersive experience, providing a platform to utilise different imaging modalities to view in a 3-dimensional space. The new headsets are easy to wear, light weight, and has been tried in myriads of non-educational uses [26]. This cross-sectional study provides insights into new user experience when viewing and manoeuvring more complex anatomical structures. Only 29% of the responders had previously used an MR device. In a 2-h session of implementing an MR-based device, the results of the UEQ were encouraging. The attractiveness, stimulation, and novelty were rated as excellent. To make MR a regular component in teaching, the trainers should not find the device obstructive or unpleasant to use. The high perspicuity score again reflected that the instructions to use the MR platform were clear and easy to learn. The authors acknowledge that there was heterogeneity in the participant background (doctors, nurses, and allied health professionals) with varying clinical experience preventing us to generalise the results of this study. At the same time, the heterogenous cohort used this MR platform to visualise and interact with a set of images that was irrelevant to their clinical background. Extrapolating both subjective and objective feedback, the results highlight the ability to implement MR platform in routine teaching environments. Using our previous experience [8], a modified questionnaire was used in understanding the utility of MR in anatomy teaching. Figure 5A,B provide insights into this. The interactive nature of the device and ability of the MR platform to provide 360 degrees of freedom, the participants rated the MR platform very highly where visualisation of the anatomical structures were concerned. As the authors did not focus on specific anatomical understanding in this study, we were unable to provide any results if it improved the understanding of the participants. In Figure 5B, one of the lowest scores was in the learning curve. This is not unexpected given lack of previous experience. Only 2 h were allocated for this study, which is likely insufficient to make a user proficient. Furthermore, different MR devices and software platforms may require different training times. Our study only presents the results using one platform. Training times may differ and institutions planning to implement this across different disciplines should take note that additional time is required to train the trainers in addition to developing content for MR platforms. Whilst the authors predominantly looked at responses for \"anatomical teaching\", there are multiple other uses of MR. Trainers who may deal with procedures such as insertion of central venous catheters, arterial lines, and even intubation can put these devices to use to supplement teaching. By demonstrating the ease of learning in a diverse group of trainers, the authors highlight the ease with which MR can be introduced into a learning environment.