Augmented Reality-Enhanced Simulation in Surgical Education: A Scoping Review of Implementation, Skill Retention, and Equity in Low-Resource Settings.

Many developments have been made to enhance surgical training, including the usage of augmented reality (AR) simulation. However, its implementation within surgical training programs, impact on skill retention, and applicability in low-resource settings remain unclear. A scoping review was used to explore the role of AR technology and its implementation in surgical education, maintenance of skill retention, and equity and access in low-resource settings. A systematic search was conducted across four databases, which yielded 185 records, of which 30 met the inclusion criteria. Most studies were published after 2019 and evaluated AR interventions in simulated environments involving medical students or residents. AR intervention was primarily used for visual guidance, telestration and image overlay. Evidence for skill retention remains limited, with only four studies assessing retention outcomes. Short-term improvements in task performance and procedural planning were reported, while skills transfer to clinical environments and long-term retention remain underexplored. Several studies created low-resource, reusable AR systems, reporting increased learner confidence and procedural knowledge; however, these studies were limited by small sample sizes and a reliance on subjective outcome measures. In conclusion, current evidence suggests that AR has the potential to become a useful tool for surgical education. However, the literature remains preliminary, with more longitudinal, objective and equity-focused studies required.