Cochrane, TAiello, SCook, SAguayo, CWilkinson, N2020-07-122020-07-1220202020Research in Learning Technology, 28. https://doi.org/10.25304/rlt.v28.23572156-70692156-7077https://hdl.handle.net/10292/13516This article evaluates the results of two prototype iterations of a design-based research project that explores the application of mobile mixed reality (MMR) to enhance critical care clinical health education simulation in Paramedicine. The project utilises MMR to introduce critical elements of patient and practitioner risk and stress into clinical simulation learning scenarios to create more authentic learning environments. Subjective participant feedback is triangulated against participant biometric data to validate the level of participant stress introduced to clinical simulation through the addition of MMR. Results show a positive impact on the learning experience for both novice and professional paramedic practitioners. The article highlights the development of implementation and data triangulation methodologies that can be utilised to enhance wider clinical simulation contexts than the original context of Paramedicine education. We argue that our collaborative transdisciplinary design team model provides a transferable framework for designing MMR-enhanced clinical simulation environments.This work is licensed under a Creative Commons Attribution 4.0 International License. Authors contributing to Research in Learning Technology retain the copyright of their article and at the same time agree to publish their articles under the terms of the Creative Commons CC-BY 4.0 License (http://creativecommons.org/licenses/by/4.0/) allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.Immersive reality; Biometrics; Design-based research; Critical care health educationJournal ArticleOpenAccess10.25304/rlt.v28.2357