Using immersive virtual reality to enhance anatomical understanding

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1. Using immersive virtual reality to enhance anatomical understanding A way forward for the teaching and learning of anatomy? Dr Rob Appleyard, Dr Heidi Probst 2. Spatial anatomical cognition Essential in medical/health care education Developed via combination of didactic teaching, anatomical textbooks and: 3. Study aims 1. Evaluate the educational potential of an immersive virtual environment (IVE) to enhance health care students spatial anatomical cognition of the brain. 2. Establish a coherent explanatory framework for how students develop this spatial anatomical cognition using an IVE. 4. Study design convergent parallel mixed methods design Quantitative strand: Pre and post-test RCT to assess extent to which a VR model of the brain enhances spatial cognition of anatomy compared with a comparable plastic model Qualitative strand: Constructivist Grounded Theory using semi- structured interviews to determine models for how participants interpret and use VR and plastic models to construct spatial anatomical cognition Comparison: Use of a triangulation protocol to identify where data converges and diverges Interpretation: Generation of a coherent, explanatory framework for the use of a VR environment to enhance spatial anatomical cognition n=106 n=24 5. Assessing spatial anatomical cognition 26 items 8 rods 10 BEV 8 slice All unusual orientations Cronbachs Alpha: 0.7 6. IVE and plastic model 7. Enhancement in spatial anatomical knowledge 0 2 4 6 8 10 12 14 16 -60-55-50-45-40-35-30-25-20-15-10 -5 0 5 10 15 20 25 30 35 40 45 50 55 60 Frequency % score Intervention Control Mean improvement: 18.8% vs 10.8% Diff. 8% 5.2% (95%CIdiff), p = 0.003 d = 0.59 BESD1 = 0.29 CLES2 = 0.66 1. Binomial effect size display 2. Common language effect size 8. Impact of spatial ability? 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% 0 10 20 30 40 Pre-interventionMCQscore Spatial ability score Intervention Control Linear (Intervention) Linear (Control) 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% 0 10 20 30 40Post-interventionMCQscore Spatial ability score Intervention Control Linear (Intervention) Linear (Control) rint. = 0.571, rcont. = 0.385 rint. = 0.432, rcont. = 0.437 9. But no impact on enhancement -40.0% -30.0% -20.0% -10.0% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 0 5 10 15 20 25 30 35 40 Enhancementinspatialanatomicalcognition Spatial ability score Intervention Control Linear (Intervention) Linear (Control) rint. = -0.08, rcont. = 0.119 10. Participant experiences significantly better in virtual reality group for: Enjoyment Ease of use Perceived enhancement of anatomical cognition Promoting 3D visualisation of anatomy Promoting importance of spatial anatomical knowledge 11. Regression analysis Only the extent to which the model was perceived to enhance visualisation of anatomy and pre-intervention MCQ score were significant predictors of variation in spatial knowledge enhancement (Adjusted R2 = 0.284). The intervention was not a significant predictor when added to the model So ... Although spatial knowledge in the intervention group was significantly higher this was not necessarily attributable to VR alone. Differences in how learners interpret and use VR models to develop spatial understanding are important. 12. A few key points about HOW students develop spatial anatomical cognition? MOST students do not visualise anatomy in 3D. Adopt a predominantly vocationally orientated strategy Imaging based Reconstruct/mentally rotate to recognisable key views Adopt a learning strategy to recall the info in a structured way: Bottom to top, front to back etc. Predominantly employ a surface approach to learning A more positive learning experience and the additional interaction afforded by the IVE are the most likely explanation for the difference in effect. 13. A theory for the development of spatial anatomical cognition 14. Conclusions Engagement with a virtual model of the brain in an IVE resulted in significantly enhanced spatial knowledge of brain anatomy and better reported experiences compared to engagement with plastic anatomical models Pre-existing spatial anatomical knowledge is a significant indicator of knowledge enhancement Much of the variation in differences in knowledge enhancement can be ascribed to differences in learners' experience and the user- defined interaction afforded by the virtual model User-control of orientation and viewpoint/transparency Most learners do not visualise anatomy in 3D but mentally construct it in a vocationally orientated way Learners exploit individual traits, prior experiences and features of the model in order to apply personal learning strategies within a constructivist framework to enhance spatial cognition


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