Abstract
Background:
Over the past decade, and especially since 2020, augmented reality (AR) has become one of
the most important digital technologies changing modern healthcare systems. Defined as the
overlay of digital information on a user’s view of the physical environment, AR stands out in the
extended-reality spectrum. Unlike virtual reality (VR), which engages users in computer-
generated settings, AR retains a connection to the real world while enhancing situational
awareness through explicit digital overlays. This framework provides a unique advantage for AR
in contexts where real-time cognitive support, spatial cognition, complex decision-making, and
kinaesthetic skills are central to clinical practice. While many studies yield favourable results,
the evidence is still fragmented, and critical questions regarding workflow implications, safety
profile, and clinical efficacy have yet to be systematically synthesised in the post-2020 context.
Objective:
To systematically review peer-reviewed journals published from January 2020 to
October 2025 that evaluate the workflow impacts, safety and efficacy of AR technology
in healthcare settings.
Methods:
A thorough search followed the guidelines outlined in PRISMA 2020 for databases
including PubMed, Scopus, Web of Science, IEEE Xplore, and the Cochrane Library.
Studies eligible for this meta-analysis included randomised trials, quasi-experimental
studies, cohort studies, and validated simulation studies that investigated AR
interventions for clinical care, health education, or rehabilitation of patients. For each
study, data extraction was performed, including the domains of efficacy (including
accuracy, clinical outcomes, and learning performance), safety (including adverse
events, cognitive load, hygiene, and contamination), and workflow outcomes (including
task efficiency, communication, and decision support). Methodological quality was
assessed using the Cochrane RoB 2 and JBI checklists. Due to heterogeneity across
outcomes and study designs, the ensuing analysis was synthesized narratively.
Results
Conclusion
Keywords: augmented reality; AR; patient care; workflow optimisation; safety;
systematic review
Introduction
Augmented Reality (AR) has increasingly become a transformative technology that has
reshaped how people perceive and interact with the world. By superimposing virtual
objects onto real-world environments, AR improves sensory experiences, offering
additional layers of data that improve the understanding of the real world. AR is
represented as being somewhere on the reality-virtuality continuum as illustrated by
Milgram and Kishino [1]; it is a variation of Virtual Environments (VE), since it is a part of
the general area referred to as mixed reality. While virtual reality (VR) immerses users
into computer-generated virtual worlds, as its purpose, AR follows the opposite
approach, utilising computer-generated objects as supplements of realities, rather than
replacing them [2]. By its properties, the AR system combines real with virtual objects in
real environments and registers real with virtual objects while running interactively in 3D
and in real time [3]. According to Danciu et al. [2], Ar inherits the philosophy that
intelligence amplification (IA) of a user has more potential than artificial intelligence (AI),
since human intuition and experience can be coupled with the computational power of
computers.
Reality-virtuality continuum [1]
In healthcare, AR has emerged as a critical and promising technology with a wide range
of applications. From helping healthcare professionals in planning medical procedures
and improving patient care to supporting medical trainees in visualising complex
anatomical features, AR has become increasingly important in healthcare settings [4].
Today, AR in healthcare has evolved from an experimental novelty to a transformative
technological paradigm that is reshaping how clinical professionals (as well as patients)
perceive, interpret, and interact with complex biomedical information.