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Upadhyay B, Brady C, Chalil Madathil K, Bertrand J, McNeese NJ, Gramopadhye A. Collaborative augmented reality in higher education: A systematic review of effectiveness, outcomes, and challenges. APPLIED ERGONOMICS 2024; 121:104360. [PMID: 39127028 DOI: 10.1016/j.apergo.2024.104360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 07/11/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024]
Abstract
This article reports a systematic literature review that examined past research exploring the effectiveness of collaborative Augmented Reality (AR) enabled instruction, in higher education contexts. To be included, an article should consist of an experimental study investigating the use of collaborative AR for learning in higher education settings. An initial search was conducted on five databases that resulted in a total of 2537 articles, of which 20 were finalized for this review. The main findings suggest that AR-enabled collaborative learning benefits students' overall learning outcomes and provides a positive collaboration experience in higher education settings. Further research is needed to determine the interaction elements, collaboration mechanisms, and information representation through AR that would potentially enhance student learning outcomes. This article concludes by discussing the implications of these findings, identifying challenges and strategies for developing effective collaborative AR-enabled learning content.
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Affiliation(s)
- Bhargav Upadhyay
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA.
| | - Camden Brady
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA.
| | - Kapil Chalil Madathil
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA.
| | - Jeffrey Bertrand
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA.
| | - Nathan J McNeese
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA.
| | - Anand Gramopadhye
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA.
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Neri I, Cercenelli L, Marcuccio M, Lodi S, Koufi FD, Fazio A, Marvi MV, Marcelli E, Billi AM, Ruggeri A, Tarsitano A, Manzoli L, Badiali G, Ratti S. Dissecting human anatomy learning process through anatomical education with augmented reality: AEducAR 2.0, an updated interdisciplinary study. ANATOMICAL SCIENCES EDUCATION 2024; 17:693-711. [PMID: 38520153 DOI: 10.1002/ase.2389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 03/25/2024]
Abstract
Anatomical education is pivotal for medical students, and innovative technologies like augmented reality (AR) are transforming the field. This study aimed to enhance the interactive features of the AEducAR prototype, an AR tool developed by the University of Bologna, and explore its impact on human anatomy learning process in 130 second-year medical students at the International School of Medicine and Surgery of the University of Bologna. An interdisciplinary team of anatomists, maxillofacial surgeons, biomedical engineers, and educational scientists collaborated to ensure a comprehensive understanding of the study's objectives. Students used the updated version of AEducAR, named AEducAR 2.0, to study three anatomical topics, specifically the orbit zone, facial bones, and mimic muscles. AEducAR 2.0 offered two learning activities: one explorative and one interactive. Following each activity, students took a test to assess learning outcomes. Students also completed an anonymous questionnaire to provide background information and offer their perceptions of the activity. Additionally, 10 students participated in interviews for further insights. The results demonstrated that AEducAR 2.0 effectively facilitated learning and students' engagement. Students totalized high scores in both quizzes and declared to have appreciated the interactive features that were implemented. Moreover, interviews shed light on the interesting topic of blended learning. In particular, the present study suggests that incorporating AR into medical education alongside traditional methods might prove advantageous for students' academic and future professional endeavors. In this light, this study contributes to the growing research emphasizing the potential role of AR in shaping the future of medical education.
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Affiliation(s)
- Irene Neri
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Laura Cercenelli
- eDIMES Lab-Laboratory of Bioengineering, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Massimo Marcuccio
- Department of Educational Science "Giovanni Maria Bertin", University of Bologna, Bologna, Italy
| | - Simone Lodi
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Foteini-Dionysia Koufi
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Antonietta Fazio
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Maria Vittoria Marvi
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Emanuela Marcelli
- eDIMES Lab-Laboratory of Bioengineering, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Anna Maria Billi
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Alessandra Ruggeri
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Achille Tarsitano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- Department of Maxillo-Facial Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lucia Manzoli
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Giovanni Badiali
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- Department of Maxillo-Facial Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Ratti
- Cellular Signalling Laboratory, Anatomy Center, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Wang J, Li W, Dun A, Zhong N, Ye Z. 3D visualization technology for Learning human anatomy among medical students and residents: a meta- and regression analysis. BMC MEDICAL EDUCATION 2024; 24:461. [PMID: 38671399 PMCID: PMC11055294 DOI: 10.1186/s12909-024-05403-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND 3D visualization technology applies computers and other devices to create a realistic virtual world for individuals with various sensory experiences such as 3D vision, touch, and smell to gain a more effective understanding of the relationships between real spatial structures and organizations. The purpose of this study was to comprehensively evaluate the effectiveness of 3D visualization technology in human anatomy teaching/training and explore the potential factors that affect the training effects to better guide the teaching of classroom/laboratory anatomy. METHODS We conducted a meta-analysis of randomized controlled studies on teaching human anatomy using 3D visualization technology. We extensively searched three authoritative databases, PubMed, Web of Science, and Embase; the main outcomes were the participants' test scores and satisfaction, while the secondary outcomes were time consumption and enjoyment. Heterogeneity by I² was statistically determined because I²> 50%; therefore, a random-effects model was employed, using data processing software such as RevMan, Stata, and VOSviewer to process data, apply standardized mean difference and 95% confidence interval, and subgroup analysis to evaluate test results, and then conduct research through sensitivity analysis and meta-regression analysis. RESULTS Thirty-nine randomized controlled trials (2,959 participants) were screened and included in this study. The system analysis of the main results showed that compared with other methods, including data from all regions 3D visualization technology moderately improved test scores as well as satisfaction and enjoyment; however, the time that students took to complete the test was not significantly reduced. Meta-regression analysis also showed that regional factorsaffected test scores, whereas other factors had no significant impact. When the literature from China was excluded, the satisfaction and happiness of the 3D virtual-reality group were statistically significant compared to those of the traditional group; however, the test results and time consumption were not statistically significant. CONCLUSION 3D visualization technology is an effective way to improve learners' satisfaction with and enjoyment of human anatomical learning, but it cannot reduce the time required for testers to complete the test. 3D visualization technology may struggle to improve the testers' scores. The literature test results from China are more prone to positive results and affected by regional bias.
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Affiliation(s)
- Junming Wang
- Department of Health Management, The First Affiliated Hospital, Shandong Provincial Qianfoshan Hospital, Shandong First Medical University, 250013, Jinan, Shandong, China
- School of clinical and basic medicine, Shandong First Medical University, Jinan, China
| | - Wenjun Li
- Department of Health Management, The First Affiliated Hospital, Shandong Provincial Qianfoshan Hospital, Shandong First Medical University, 250013, Jinan, Shandong, China
- School of clinical and basic medicine, Shandong First Medical University, Jinan, China
| | - Aishe Dun
- School of Stomatology, Shandong First Medical University, Jinan, China
| | - Ning Zhong
- Department of Health Management, The First Affiliated Hospital, Shandong Provincial Qianfoshan Hospital, Shandong First Medical University, 250013, Jinan, Shandong, China.
| | - Zhen Ye
- Department of Health Management, The First Affiliated Hospital, Shandong Provincial Qianfoshan Hospital, Shandong First Medical University, 250013, Jinan, Shandong, China.
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Jiang N, Jiang Z, Huang Y, Sun M, Sun X, Huan Y, Li F. Application of augmented reality models of canine skull in veterinary anatomical education. ANATOMICAL SCIENCES EDUCATION 2024; 17:546-557. [PMID: 38238283 DOI: 10.1002/ase.2372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 04/04/2024]
Abstract
Veterinary anatomy plays a crucial role in the curriculum for veterinary medicine and surgery. The integration of modern information technology in veterinary education can greatly benefit from innovative tools such as augmented reality (AR) applications. The aim of this study was to develop an accurate and interactive three-dimensional (3D) digital model of an animal skull using AR technology, aiming to enhance the learning of skull anatomy in veterinary anatomy education. In this study, a canine skull specimen was isolated, and the skull bones were scanned using a structured light scanner to create a 3D digital model of the canine skull, which was found to be indistinguishable from the original specimen by measurement of skull proportions. Furthermore, the interactive AR model of the canine skull, displayed using Unity3D, was subjected to testing and evaluation by 60 first-year veterinary medical students attending the gross anatomy of the animal. The students were divided into two groups: the traditional group and AR group. Both groups completed an objective test and a questionnaire. The evaluation of learning effectiveness in the test revealed no significant difference between the traditional group (which learned using textbooks and a canine skull specimen) and AR group (which learned using AR tools). However, in the questionnaire, students displayed high enthusiasm and interest in using the AR tool. Therefore, the application of AR tools can improve students' motivation for learning and enhance the comprehension of anatomical structures in three dimensions. Furthermore, this study exemplifies the use of AR as an auxiliary tool for teaching and learning in veterinary anatomy education.
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Affiliation(s)
- Nan Jiang
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People's Republic of China
| | - Zhongling Jiang
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People's Republic of China
| | - Yufeng Huang
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People's Republic of China
| | - Mingju Sun
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People's Republic of China
| | - Xuejing Sun
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People's Republic of China
| | - Yanjun Huan
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People's Republic of China
| | - Fangzheng Li
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People's Republic of China
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Rodríguez-Abad C, Martínez-Santos AE, Fernández-de-la-Iglesia JDC, Rodríguez-González R. Online (versus face-to-face) augmented reality experience on nursing students' leg ulcer competency: Two quasi-experimental studies. Nurse Educ Pract 2023; 71:103715. [PMID: 37437514 DOI: 10.1016/j.nepr.2023.103715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/21/2023] [Accepted: 07/01/2023] [Indexed: 07/14/2023]
Abstract
AIM The aim of this study was two-fold. Firstly, to describe the influence of an augmented reality (AR)-based online educational experience on the academic performance and learning determinants of nursing students related to the study of leg ulcer care. We also set out to compare these online results with those obtained in the same experience developed a year before but in a face-to-face design. BACKGROUND Undergraduate education in nursing aims to train students towards an acceptable level of competence for professional practice. Sometimes, some essential clinical areas of knowledge are particularly challenging for both students and nurse educators. One of these is the care of chronic wounds, particularly in leg ulcers where nurses play a key role. Currently face-to-face teaching methods are evolving to more active contexts and alternative means such as online learning and AR are becoming widely used, garnering encouraging results. DESIGN A quasi-experimental design was used. Two experiments were carried out to meet the aims of the study, the first one was a pre-test post-test design in one group and the second one a post-test two experimental groups design. METHODS Participants were undergraduate nursing students from the School of Nursing of the University of Santiago de Compostela (Spain). The two experimental groups received the same training but in different environments: online during 2019/2020 (n = 111) and onsite during 2018/2019 (n = 72). The instruments selected were a knowledge and skills test and two validated questionnaires. RESULTS Regarding academic performance, the study demonstrated significant differences towards learning after the AR-based online experience (Z = -9.074; p ≤ 0.001). The participants also showed good results in relation to the learning determinants studied. Compared with students receiving AR-based face-to-face teaching, the students with the online learning approach scored better in the dimensions Autonomous Learning (U=3104.5; p = 0.020) and 3D Comprehension (U=3167.0; p = 0.035). However, the participants in the onsite experience scored higher in the Attention dimension (U=3163.0; p = 0.035). CONCLUSIONS AR positively influences academic performance and diverse educational variables when this experience is carried out online. Since both the online and face-to-face experience show statistically significant benefits in different dimensions of the learning determinants, the need to improve the AR learning experience through blended-learning environments should be promoted.
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Affiliation(s)
- Carlos Rodríguez-Abad
- University of Santiago de Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain
| | - Alba-Elena Martínez-Santos
- University of Santiago de Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur). SERGAS-UVIGO, Spain; Dermatology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | | | - Raquel Rodríguez-González
- University of Santiago de Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain.
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Niedermair JF, Antipova V, Manhal S, Siwetz M, Wimmer-Röll M, Hammer N, Fellner FA. On the added benefit of virtual anatomy for dissection-based skills. ANATOMICAL SCIENCES EDUCATION 2023; 16:439-451. [PMID: 36453060 DOI: 10.1002/ase.2234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 05/11/2023]
Abstract
Technological approaches deploying three-dimensional visualization to integrate virtual anatomy are increasingly used to provide medical students with state-of-the-art teaching. It is unclear to date to which extent virtual anatomy may help replace the dissection course. Medical students of Johannes Kepler University attend both a dissection and a virtual anatomy course. This virtual anatomy course is based on Cinematic Rendering and radiological imaging and teaches anatomy and pathology. This study aims to substantiate student benefits achieved from this merged teaching approach. Following their dissection course, 120 second-year students took part in objective structured practical examinations (OSPE) conducted on human specimens prior to and following a course on Cinematic Rendering virtual anatomy. Likert-based and open-ended surveys were conducted to evaluate student perceptions of both courses and their utility. Virtual anatomy teaching was found to be unrelated to improvements in student's ability to identify anatomical structures in anatomical prosections, yielding only a 1.5% increase in the OSPE score. While the students rated the dissection course as being more important and impactful, the virtual anatomy course helped them display the learning content in a more comprehensible and clinically applicable way. It is likely that Cinematic Rendering-based virtual anatomy affects knowledge gain in domains other than the recognition of anatomical structures in anatomical prosections. These findings underline students' preference for the pedagogic strategy of the dissection course and for blending this classical approach with novel developments like Cinematic Rendering, thus preparing future doctors for their clinical work.
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Affiliation(s)
| | - Veronica Antipova
- Department of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Simone Manhal
- Office of the Vice Rector for Studies and Teaching, Medical University of Graz, Graz, Austria
| | | | - Monika Wimmer-Röll
- Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Niels Hammer
- Department of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Medical Branch, Fraunhofer Institute for Machine Tools and Forming Technology (IWU), Chemnitz, Germany
| | - Franz A Fellner
- Central Radiology Institute, Johannes Kepler University Hospital, Linz, Austria
- Division of Virtual Morphology, Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
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George O, Foster J, Xia Z, Jacobs C. Augmented Reality in Medical Education: A Mixed Methods Feasibility Study. Cureus 2023; 15:e36927. [PMID: 37128541 PMCID: PMC10148745 DOI: 10.7759/cureus.36927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Augmented reality (AR) is a novel technology with many applications in medical education. Perhaps one of the most beneficial potential applications is to enable better clinical access for students; however, there is limited research into this use. The purpose of this mixed-methods feasibility study was to evaluate the applicability and acceptability of AR in undergraduate and early postgraduate medical education. METHODS Single-group quasi-experimental study design was developed for critical care-themed simulation teaching delivered using Microsoft HoloLens (Microsoft Corporation, Redmond, Washington, United States). Post-test questionnaires were completed including a validated adapted immersive experience questionnaire (AIEQ) and an abridged intrinsic motivation inventory (AIMI). The AIMI focused on the domains of 'interest and enjoyment', and 'value and usefulness'. Following the teaching, focus group interviews with thematic analysis were conducted to evaluate participants' experiences with AR. RESULTS All 15 participants (100%) completed the AIEQ and AIMI. Co-located airway teaching (i.e., the demonstrator and participants were placed in the same AR environment) was reported as having a moderate level of user immersion (median 72) and a high level of user enjoyment and value (median 52). Thematic analysis revealed four key themes: visual conceptualization for learning, accessibility, varied immersion, and future application. Conclusions: Remote simulation for the management of airways in critical care was found to be acceptable and afforded a high level of enjoyment and value. Similarly, this was reflected in the thematic analysis. However, immersion was rated variably in both AIEQ and thematic analysis. The challenges identified with the application of AR included technical infrastructure and patient consent. AR-enabled education benefits are relevant to a number of clinical teaching areas.
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Styn A, Scheiter K, Fischer MR, Shiozawa T, Behrmann F, Steffan A, Kugelmann D, Berndt M. Effects of tablet-based drawing and paper-based methods on medical students' learning of gross anatomy. ANATOMICAL SCIENCES EDUCATION 2023; 16:266-279. [PMID: 36453083 DOI: 10.1002/ase.2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 10/20/2022] [Accepted: 11/09/2022] [Indexed: 06/17/2023]
Abstract
The way medical students learn anatomy is constantly evolving. Nowadays, technologies such as tablets support established learning methods like drawing. In this study, the effect of drawing on a tablet on medical students' anatomy learning was investigated compared to drawing or summarizing on paper. The quality of drawings or summaries was assessed as a measure of the quality of strategy implementation. Learning outcome was measured with an anatomy test, both immediately afterward and after 4-6 weeks to assess its sustainability. There were no significant group differences in learning outcome at both measurement points. For all groups, there was a significant medium strength correlation between the quality of the drawings or summaries and the learning outcome (p < 0.05). Further analysis revealed that the quality of strategy implementation moderated outcomes in the delayed test: When poorly implemented, drawing on a tablet (M = 48.81) was associated with lower learning outcome than drawing on paper (M = 58.95); The latter (M = 58.89) was related to higher learning outcome than writing summaries (M = 45.59). In case of high-quality strategy implementation, drawing on a tablet (M = 60.98) outperformed drawing on paper (M = 52.67), which in turn was outperformed by writing summaries (M = 62.62). To conclude, drawing on a tablet serves as a viable alternative to paper-based methods for learning anatomy if students can make adequate use of this strategy. Future research needs to identify how to support student drawing, for instance, by offering scaffolds with adaptive feedback to enhance learning.
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Affiliation(s)
- Amelie Styn
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Scheiter
- Leibniz-Institut für Wissensmedien Tübingen, Tübingen, Germany
- Department of Educational Science, University of Potsdam, Potsdam, Germany
| | - Martin R Fischer
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Shiozawa
- Department of Anatomy, Institute of Clinical Anatomy and Cell Analysis, Faculty of Medicine, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Felix Behrmann
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | | | - Daniela Kugelmann
- Chair for Vegetative Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Markus Berndt
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
- Richard W. Riley College of Education and Human Sciences, Walden University, Minnesota, Minneapolis, USA
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Curran VR, Xu X, Aydin MY, Meruvia-Pastor O. Use of Extended Reality in Medical Education: An Integrative Review. MEDICAL SCIENCE EDUCATOR 2023; 33:275-286. [PMID: 36569366 PMCID: PMC9761044 DOI: 10.1007/s40670-022-01698-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Extended reality (XR) has emerged as an innovative simulation-based learning modality. An integrative review was undertaken to explore the nature of evidence, usage, and effectiveness of XR modalities in medical education. One hundred and thirty-three (N = 133) studies and articles were reviewed. XR technologies are commonly reported in surgical and anatomical education, and the evidence suggests XR may be as effective as traditional medical education teaching methods and, potentially, a more cost-effective means of curriculum delivery. Further research to compare different variations of XR technologies and best applications in medical education and training are required to advance the field. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-022-01698-4.
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Affiliation(s)
- Vernon R. Curran
- Office of Professional and Educational Development, Faculty of Medicine, Health Sciences Centre, Memorial University of Newfoundland, Room H2982, St. John’s, NL A1B 3V6 Canada
| | - Xiaolin Xu
- Faculty of Health Sciences, Queen’s University, Kingston, ON Canada
| | - Mustafa Yalin Aydin
- Department of Computer Sciences, Memorial University of Newfoundland, St. John’s, NL Canada
| | - Oscar Meruvia-Pastor
- Department of Computer Sciences, Memorial University of Newfoundland, St. John’s, NL Canada
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Richards S. Student Engagement Using HoloLens Mixed-Reality Technology in Human Anatomy Laboratories for Osteopathic Medical Students: an Instructional Model. MEDICAL SCIENCE EDUCATOR 2023; 33:223-231. [PMID: 36691419 PMCID: PMC9850333 DOI: 10.1007/s40670-023-01728-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Mixed-reality technology is a powerful tool used in healthcare and medical education to engage students in life-like scenarios. This blend of virtual and augmented reality images incorporates virtual projections with the real environment to allow real-time observation and interaction [1]. While this immersive technology offers advantages over cadaver dissections, it creates new challenges to keeping students engaged [2, 3]. Student engagement improves students' commitment to learning, critical thinking, and motivation and results in successful course outcomes [4, 5]. This paper provides an activity model using the HoloLens mixed-reality technology to deliver human gross anatomy laboratory sessions to first-year osteopathic medical students. The activity was designed using Gagne's model for instructional design and team-based learning to create an active learning model, which targets the behavioral, emotional, and cognitive dimensions of student engagement [6, 7]: behavioral engagement through autonomy and time on task, emotional engagement through providing the guiding exploration and narrative flow to accompany students' visual experience, and cognitive engagement by incorporating team-based learning (TBL) and case-based learning (CBL). The instructional model also answers the call for a new type of virtual reality instructor and pedagogical strategy that addresses the unique challenges and increases student engagement with this new technology. The effectiveness of this classroom activity was assessed by observing students for indicators or behaviors of student engagement, which are discussed. Further studies are required to measure the extent to which these indicators were exhibited and compare student engagement with this mixed-reality to didactic cadaver-based laboratory sessions.
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Affiliation(s)
- Sherese Richards
- California Health Sciences University, Department of Biomedical Education- Anatomy, Clovis, CA 93611 USA
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Geerlings-Batt J, Tillett C, Gupta A, Sun Z. Enhanced Visualisation of Normal Anatomy with Potential Use of Augmented Reality Superimposed on Three-Dimensional Printed Models. MICROMACHINES 2022; 13:1701. [PMID: 36296054 PMCID: PMC9608320 DOI: 10.3390/mi13101701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
Anatomical knowledge underpins the practice of many healthcare professions. While cadaveric specimens are generally used to demonstrate realistic anatomy, high cost, ethical considerations and limited accessibility can often impede their suitability for use as teaching tools. This study aimed to develop an alternative to traditional teaching methods; a novel teaching tool using augmented reality (AR) and three-dimensional (3D) printed models to accurately demonstrate normal ankle and foot anatomy. An open-source software (3D Slicer) was used to segment a high-resolution magnetic resonance imaging (MRI) dataset of a healthy volunteer ankle and produce virtual bone and musculature objects. Bone and musculature were segmented using seed-planting and interpolation functions, respectively. Virtual models were imported into Unity 3D, which was used to develop user interface and achieve interactability prior to export to the Microsoft HoloLens 2. Three life-size models of bony anatomy were printed in yellow polylactic acid and thermoplastic polyurethane, with another model printed in white Visijet SL Flex with a supporting base attached to its plantar aspect. Interactive user interface with functional toggle switches was developed. Object recognition did not function as intended, with adequate tracking and AR superimposition not achieved. The models accurately demonstrate bony foot and ankle anatomy in relation to the associated musculature. Although segmentation outcomes were sufficient, the process was highly time consuming, with effective object recognition tools relatively inaccessible. This may limit the reproducibility of augmented reality learning tools on a larger scale. Research is required to determine the extent to which this tool accurately demonstrates anatomy and ascertain whether use of this tool improves learning outcomes and is effective for teaching anatomy.
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Affiliation(s)
- Jade Geerlings-Batt
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia
| | - Carley Tillett
- Curtin HIVE (Hub for Immersive Visualisation and eResearch), Curtin University, Perth, WA 6845, Australia
| | - Ashu Gupta
- Department of Medical Imaging, Fiona Stanley Hospital, Perth, WA 6150, Australia
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6845, Australia
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12
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Taylor L, Dyer T, Al-Azzawi M, Smith C, Nzeako O, Shah Z. Extended reality anatomy undergraduate teaching: a literature review on an alternative method of learning. Ann Anat 2021; 239:151817. [PMID: 34391910 DOI: 10.1016/j.aanat.2021.151817] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/11/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The majority of undergraduate anatomy learning has shifted online, or to a mixture of virtual and face-to-face teaching, due to the COVID-19 pandemic. Cadaveric shortages have also influenced the need for alternative methods of anatomical education. This study examines the current literature on the use of extended reality technologies (XR) such as Virtual reality (VR), Augmented reality (AR), and Mixed reality (MR) for anatomy teaching and explores its potential for implementation in medical education. METHODS A literature review was performed of PubMed, ProQuest, Science Direct, and Springer databases. Included studies were assessed for user satisfaction, perceived effectiveness, cost, acceptability and side effects. RESULTS The database search identified 1687 papers, of which 45 papers were included in this review. Both AR and VR had high rates of satisfaction and acceptability as a supplementary teaching aid amongst undergraduate participants. AR was found to have higher effectiveness than VR. VR is more expensive than AR. Results and comparisons were limited due to short length of study. CONCLUSIONS VR is a popular choice with undergraduates as an aid to supplement teaching, in spite of the associated cost and side effects such as nausea. AR has shown the most potential for independent study. Larger and long-term studies are required to determine true effectiveness, and consideration of the clinical relevance of these technologies.
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Affiliation(s)
- Lucy Taylor
- GKT School of Medical Education, Kings College London, Great Maze Pond, London SE1 1UL, United Kingdom.
| | - Tamsin Dyer
- GKT School of Medical Education, Kings College London, Great Maze Pond, London SE1 1UL, United Kingdom
| | - Mohammed Al-Azzawi
- Department of Orthopaedics, Guy's and St Thomas' NHS Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom.
| | - Christian Smith
- Department of Orthopaedics, Guy's and St Thomas' NHS Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom
| | - Obi Nzeako
- Department of Orthopaedics, Guy's and St Thomas' NHS Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom
| | - Zameer Shah
- Department of Orthopaedics, Guy's and St Thomas' NHS Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom
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Darici D, Reissner C, Brockhaus J, Missler M. Implementation of a fully digital histology course in the anatomical teaching curriculum during COVID-19 pandemic. Ann Anat 2021; 236:151718. [PMID: 33675948 PMCID: PMC8739541 DOI: 10.1016/j.aanat.2021.151718] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 02/07/2023]
Affiliation(s)
- D Darici
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany.
| | - C Reissner
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany
| | - J Brockhaus
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany
| | - M Missler
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany.
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