Background: The shortage of nursing and healthcare clinical placements has prompted the investigation of ways to supplement authentic learning. Mobile mixed reality has become increasingly available as the ubiquity of the technology improves, however, the affordances and design principles for the facilitation of critical thinking is yet to be explored.

Objective: To examine the state of the art of how mobile mixed reality facilitates critical thinking in nursing and healthcare higher education.

Design: Systematic review. Review Methods: A search in seven databases (MEDLINE, PsychINFO, AMED, ERIC, Scopus, Cochrane, and Web of Science) was conducted with 3488 titles and abstracts screened according to pre-determined inclusion and exclusion criteria. The quality of included studies was evaluated using the Mixed Methods Assessment Tool (MMAT).

Results: A total of 12 studies with 1,108 participants were included. The breadth of healthcare disciplines was limited to dentistry, medicine, nursing, midwifery, and paramedicine who mainly utilised bespoke scenarios on head mounted displays. Most scenarios were emergency or critical response by nature, with limited time provided for pre-brief, debrief, or overall user time. Only two studies directly measured critical thinking, with others indirectly referring to development of ‘decision making’ by conducting diagnoses, interpretation, analysis, or evaluation of healthcare scenarios in a mixed reality environment. Affordances and design principles for future development of mobile mixed reality for critical thinking in nursing and healthcare higher education are identified.

Conclusions: While some pedagogical affordances of mobile mixed reality can be identified in a narrow number of healthcare disciplines; there remains to be limited valid measure of critical thinking used to quantify effectiveness. Future studies would benefit to consider scenarios beyond emergency and critical responses, include longitudinal studies that reflect development of critical thinking over time, and exploration of co-designed scenarios with and by nursing and allied healthcare students.