# Augmented Reality: Mapping Methods and Tools for Enhancing the Human Role in Healthcare HMI
## 3 Results
### Training  
The training of new surgeons is a slow but essential process so that they gain the necessary experience to manage surgical procedures without jeopardizing patient safety. In this context, it is critical to develop surgical simulation platforms to improve outcomes and reduce the likelihood of potentially serious risks. AR features have the capability to train new surgeons by providing guidance and optimizing the visualization of hidden hard tissues and soft tissues while performing surgery. In their study on AR-based applications for STEM subject learning, [PERSON] et al. [87] identified five instructional models, which were distinguished based on the instructional approach applied to subjects' learning: experiential, activity-based, presentation, cooperative/collaborative, and discovery instructional strategies. According to this distinction, five of the studies reviewed [27; 68; 77; 84; 85] applied the experiential instructional design strategy, in which the subject takes advantage of his or her prior experience and applies it in a simulated environment, while only one study [42] followed the activity-based instructional design strategy, in which subjects were guided by an expert in carrying out the training activity. [PERSON] et al. [85] developed a proof-of-concept digital fluoroscopic imaging simulator for guidewire insertion in dynamic hip screw (DHS) surgery. With AR they simulated fluoroscopy in order to allow the trainee to interact with real instrumentation and perform the procedure on workshop bone models. The developed device uses a visual tracking \begin{table}
\begin{tabular}{c c c} \hline \hline
**Purpose** & **Features** & **Outcomes** \\ \hline \multirow{4}{*}{Training} & Hybrid environment simulators that recreate surgical conditions using AR display and phantoms, 3D models, and surgical instruments & Trainees are provided guidance and advanced visualization; surgical simulation can be repeated multiple times in a safe and controlled environment; live feedback is obtained \\ \cline{2-3}  & AR-based platforms that involve controlled, user-specific environmental and perceptual stimuli to achieve functional recovery, improve range of motion, reach patient autonomy & Patient activity is constantly monitored; real-time feedback is obtained; tasks are engaging and motivating \\ \hline \multirow{4}{*}{Intraoperative} & AR-based applications or surgical navigation systems that project virtual additional information and images directly on the site of intervention, giving the surgeon improved sensory perception & Optimized visualization and better understanding of spatial relationship between surgical instrument and anatomical structures is achieved; surgery time and radiation exposure are decreased \\ \cline{1-1} \cline{2-3}  & & \\ \cline{1-1} \cline{2-3}  & & \\ \cline{1-1} \cline{2-3}  & & \\ \cline{1-1} \cline{2-3}  & & \\ \cline{1-1} \cline{2-3}  & & \\ \cline{1-1} \cline{2-3}  & & \\ \hline \hline \end{tabular}
\end{table} 
Table 2: Overview of the main features and expected outcomes of AR-based applications. system consisting of two video cameras and image processing algorithms to superimpose the position of the guidewire on the corresponding fluoroscopic images, by tracking colored markers attached to the guidewire. To assess the accuracy of the guidewire tracking system, the tip-apex distance (TAD) was calculated, and compared with that physically measured, obtaining 4.2 mm as the average root mean square error. The work of [PERSON] et al. [68] involved the use of an HMD and an innovative AR platform. Using a MicronTracker camera (ClaroNav, Toronto, ON, Canada), the system can track the implant position and orientation in relation to bony anatomy. During simulated THA a clinically relevant level of accuracy was obtained. Through the platform, the use of real instruments was allowed, and live feedback was provided.