Abstract: A extended reality communication system, methods, apparatus, and computer program product are disclosed. The communication system provides for remote real-time communication between a proctor and an operator, where the operator is performing tasks on a local work object, such as a patient. The system incorporates a combination of haptic, virtual keyboard, VR, XR, and audio inputs to provide communication of instructions between the proctor and the operator that are projected as a holographic image in a field of view on the patient. The system includes a proctor station and an operator station communicatively coupled with one or more servers.