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García-Robles P, Cortés-Pérez I, Nieto-Escámez FA, García-López H, Obrero-Gaitán E, Osuna-Pérez MC. Immersive virtual reality and augmented reality in anatomy education: A systematic review and meta-analysis. ANATOMICAL SCIENCES EDUCATION 2024; 17:514-528. [PMID: 38344900 DOI: 10.1002/ase.2397] [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: 08/28/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 04/04/2024]
Abstract
The purpose of this review was to (1) analyze the effectiveness of immersive virtual reality (iVR) and augmented reality (AR) as teaching/learning resources (collectively called XR-technologies) for gaining anatomy knowledge compared to traditional approaches and (2) gauge students' perceptions of the usefulness of these technologies as learning tools. This meta-analysis, previously registered in PROSPERO (CRD42023423017), followed PRISMA guidelines. A systematic bibliographical search, without time parameters, was conducted through four databases until June 2023. A meta-analytic approach investigated knowledge gains and XR's usefulness for learning. Pooled effect sizes were estimated using Cohen's standardized mean difference (SMD) and 95% confidence intervals (95% CI). A single-group proportional meta-analysis was conducted to quantify the percentage of students who considered XR devices useful for their learning. Twenty-seven experimental studies, reporting data from 2199 health sciences students, were included for analysis. XR-technologies yielded higher knowledge gains than traditional approaches (SMD = 0.40; 95% CI = 0.22 to 0.60), especially when used as supplemental/complementary learning resources (SMD = 0.52; 95% CI = 0.40 to 0.63). Specifically, knowledge performance using XR devices outperformed textbooks and atlases (SMD = 0.32; 95% CI = 0.10 to 0.54) and didactic lectures (SMD = 1.00; 95% CI = 0.57 to 1.42), especially among undergraduate students (SMD = 0.41; 95% CI = 0.20 to 0.62). XR devices were perceived to be more useful for learning than traditional approaches (SMD = 0.54; 95% CI = 0.04 to 1), and 80% of all students who used XR devices reported these devices as useful for learning anatomy. Learners using XR technologies demonstrated increased anatomy knowledge gains and considered these technologies useful for learning anatomy.
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Affiliation(s)
- Paloma García-Robles
- FRATERNIDAD Muprespa, Linares, Spain
- Department of Health Sciences, University of Jaén, Jaén, Spain
| | | | - Francisco Antonio Nieto-Escámez
- Department of Psychology, University of Almeria, Almeria, Spain
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), Almeria, Spain
| | - Héctor García-López
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
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Grainger R, Liu Q, Gladman T. Learning technology in health professions education: Realising an (un)imagined future. MEDICAL EDUCATION 2024; 58:36-46. [PMID: 37555302 DOI: 10.1111/medu.15185] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023]
Abstract
CONTEXT Technology is being introduced, used and studied in almost all areas of health professions education (HPE), often with a claim of making HPE better in one way or another. However, it remains unclear if technology has driven real change in HPE. In this article, we seek to develop an understanding of the transformative capacity of learning technology in HPE. METHODS AND OUTCOMES We first consider the wider scholarship highlighting the intersection between technology and pedagogy, articulating what is meant by transformation and the role of learning technology in driving educational transformation. We then undertake a synthesis of the current high visibility HPE-focused research. We sampled the literature in two ways-for the five highest impact factor health professional education journals over the past decade and for all PubMed indexed journals for the last 3 years-and categorised the extant research against the Substitution, Augmentation, Modification, Redefinition model. We found that the majority of research we sampled focussed on substituting or augmenting learning through technology, with relatively few studies using technology to modify or redefine what HPE is through the use of technology. Of more concern was the lack of theoretical justification for pedagogical improvement, including transformation, underpinning the majority of studies. CONCLUSIONS While all kinds of technology use in learning have their place, the next step for HPE is the robust use of technology aiming to lead transformation. This should be guided by transformational educational theory and aligned with pedagogical context. We challenge HPE practitioners and scholars to work thoughtfully and with intent to enable transformation in education for future health professionals.
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Affiliation(s)
- Rebecca Grainger
- Education Unit Te Pou Whirinaki, University of Otago Wellington, Wellington, New Zealand
- Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Qian Liu
- Higher Education Development Centre, University of Otago, Dunedin, New Zealand
| | - Tehmina Gladman
- Education Unit Te Pou Whirinaki, University of Otago Wellington, Wellington, New Zealand
- Otago Medical School, University of Otago, Dunedin, New Zealand
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Rainford L, Tcacenco A, Potocnik J, Brophy C, Lunney A, Kearney D, O'Connor M. Student perceptions of the use of three-dimensional (3-D) virtual reality (VR) simulation in the delivery of radiation protection training for radiography and medical students. Radiography (Lond) 2023; 29:777-785. [PMID: 37244141 DOI: 10.1016/j.radi.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND VR simulation-based learning is increasingly used in healthcare education to prepare students for clinical practice. This study investigates healthcare students' experience of learning radiation safety in a simulated interventional radiology (IR) suite. METHOD Radiography students (n = 35) and medical students (n = 100) were introduced to 3D VR radiation dosimetry software designed to improve the learners' understanding of radiation safety in IR. Radiography students underwent formal VR training and assessment, which was complemented with clinical placement. Medical students practiced similar 3D VR activities informally without assessment. An online questionnaire containing Likert questions and open-ended questions was used to gather student feedback on the perceived value of VR-based radiation safety education. Descriptive statistics and Mann-Whitney U tests were used to analyse Likert-questions. Open-ended question responses were thematically analysed. RESULTS A survey response rate of 49% (n = 49) and 77% (n = 27) was obtained from radiography and medical students respectively. Most respondents (80%) enjoyed their 3D VR learning experience, favouring the in-person VR experience to online VR. 73% felt that VR learning enhanced their confidence across all relevant learning outcomes. Whilst confidence was enhanced across both cohorts, VR learning had a greater impact on confidence levels amongst medical students with respect to their understanding of radiation safety matters (U = 375.5, p < 0.01). 3D VR was deemed a valuable assessment tool. CONCLUSION Radiation dosimetry simulation-based learning in the 3D VR IR suite is perceived to be a valuable pedagogical tool by radiography and medical students and enhances curricula content.
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Affiliation(s)
- L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - A Tcacenco
- School of Medicine, University College Dublin, Ireland.
| | - J Potocnik
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - C Brophy
- Radiology Department, Blackrock Clinic, Dublin, Ireland.
| | - A Lunney
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - D Kearney
- Radiology Department, Mater Misericordiae University Hospital, Dublin, Ireland.
| | - M O'Connor
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland. michelle.o'
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Tsirulnikov D, Suart C, Abdullah R, Vulcu F, Mullarkey CE. Game on: immersive virtual laboratory simulation improves student learning outcomes & motivation. FEBS Open Bio 2023; 13:396-407. [PMID: 36723273 PMCID: PMC9989934 DOI: 10.1002/2211-5463.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/15/2022] [Accepted: 01/31/2023] [Indexed: 02/02/2023] Open
Abstract
The use of gamified learning interventions is expanding in postsecondary education as a means to improve students' motivation and learning outcomes. Virtual laboratory simulations have been used in science education to supplement students' learning, as well as to increase engagement with course material. Due to COVID-19, many instructors sought to replace or supplement hands-on 'wet-lab' work in an online environment. In this paper, we explored how the use of head-mounted display technology in two laboratory simulations impacts learner motivation and learning outcomes. We used a mixed-methods approach to analyze the experience of 39 undergraduate participants, examining test scores pre- and postsimulation, qualitative feedback, and quantitative experience ratings. The head-mounted display technology was described as easy to use, with eye strain identified as a common occurrence. Participants had increased test scores following the laboratory simulations, with no significant difference between simulation groups. Very positive self-reported measures of motivation and learner engagement were documented. Ninety-one percent of participants agreed that virtual reality laboratory simulation would be a good supplement to regular teaching modalities. Overall, our results suggest that immersive virtual reality laboratory simulations experienced through head-mounted display technology can be used to enhance learning outcomes and increase learner motivation.
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Affiliation(s)
- Danielle Tsirulnikov
- Bachelor of Health Sciences Program, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
| | - Celeste Suart
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Ream Abdullah
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Felicia Vulcu
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Caitlin E Mullarkey
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
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Wan KL, Sen A, Selvaratnam L, Naing MIM, Khoo JJ, Rajadurai P. Visual-spatial dimension integration in digital pathology education enhances anatomical pathology learning. BMC MEDICAL EDUCATION 2022; 22:587. [PMID: 35907832 PMCID: PMC9339176 DOI: 10.1186/s12909-022-03545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
Literature review demonstrated a surprising lack of publications on digital e-learning pathology resources for senior medical undergraduates and interns. An interactive Digital Pathology Repository (iDPR) integrating two- and three-dimensional (2D, 3D) high-resolution anatomical pathology images with correlated digital histopathology was developed. The novel iDPR was rigorously evaluated using mixed methods to assess pathology knowledge gains (pre- and post-tests), quality impact analysis (questionnaire), user feedback (focus group discussions) and user visual behaviour (eye gaze tracking analysis of 2D/ 3D images).Exposure to iDPR appeared to improve user pathology knowledge, as observed by significantly increased test scores on topic-related quizzes (n = 69, p < 0.001). In addition, most users were highly satisfied with the key design elements of the iDPR tool. Focus group discussion revealed the iDPR was regarded as a relevant online learning resource, although some minor technical issues were also noted. Interestingly, visual behaviour trends indicated that specific diagnostic pathological lesions could be correctly identified faster in 3D images, when compared to 2D images.The iDPR offers promise and potential in pathology education for senior clinical students and interns, gauging from both qualitative and quantitative positive user feedback. With incorporation of image annotations and interactive functionality, and with further technology development, this would prove a useful tool for diagnostic pathology and telepathology. As images with added visual-spatial dimension can provide enhanced detail and aid more rapid diagnosis, future applications of the iDPR could include virtual reality or holographic images of anatomical pathology specimens.
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Affiliation(s)
- Ken Lee Wan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
| | - Arkendu Sen
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Lakshmi Selvaratnam
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Mohd Imran Mohd Naing
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Joon Joon Khoo
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Pathmanathan Rajadurai
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
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Darici D, Schneider AYD, Missler M, Pfleiderer B. Are stereotypes in decline? The portrayal of female anatomy in e-learning. ANATOMICAL SCIENCES EDUCATION 2022. [PMID: 35844161 DOI: 10.1002/ase.2211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/06/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Sex and gender bias in anatomy learning materials are considered a "hidden obstacle" to gender equity in medical curricula. The purpose of this study was to investigate whether quantitative sex and gender biases do exist in popular anatomy e-learning platforms and compare the results with those found in contemporary textbooks and atlases. A systematic content-analysis was performed on N = 3767 images published from 2008 to 2021 in which sex/gender could be identified by considering technical aspects of illustration and various intersectional categories. E-learning platforms took into account an appropriate representation of the female body and presented even more females (n = 932/1412; 66%), more frequently from a ventral/anterior (χ2 = 26, P < 0.001) and whole-body perspective (χ2 = 27, P < 0.001). This was in contrast to German anatomy books, where the results pointed to a significant sex and gender bias. For example, all books assessed underrepresented females (n = 707/2355; 30%) and placed them in stereotypical sex-specific context (χ2 = 348, P < 0.001), showing them more often from a caudal/inferior (χ2 = 99, P < 0.001) and internal (χ2 = 132, P < 0.001) perspective. Altogether, the visual representation of sex and gender in anatomical curricula is still biased and the stereotypical perceptions of human anatomy seem to be a global issue. However, the increasing use of electronic learning platforms, which gradually replace traditional books is changing the way the male and female body is depicted, which might offer new opportunities for reducing stereotypes in anatomy education.
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Affiliation(s)
- Dogus Darici
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | | | - Markus Missler
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Bettina Pfleiderer
- Radiology Clinic, Medical Faculty, Westfälische Wilhelms-University, Münster, Germany
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Gloy K, Weyhe P, Nerenz E, Kaluschke M, Uslar V, Zachmann G, Weyhe D. Immersive Anatomy Atlas: Learning Factual Medical Knowledge in a Virtual Reality Environment. ANATOMICAL SCIENCES EDUCATION 2022; 15:360-368. [PMID: 33896115 DOI: 10.1002/ase.2095] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
In order to improve learning efficiency and memory retention in medical teaching, furthering active learning seems to be an effective alternative to classical teaching. One option to make active exploration of the subject matter possible is the use of virtual reality (VR) technology. The authors developed an immersive anatomy atlas which allows users to explore human anatomical structures interactively through virtual dissection. Thirty-two senior-class students from two German high schools with no prior formal medical training were separated into two groups and tasked with answering an anatomical questionnaire. One group used traditional anatomical textbooks and the other used the immersive virtual reality atlas. The time needed to answer the questions was measured. Several weeks later, the participants answered a similar questionnaire with different anatomical questions in order to test memory retention. The VR group took significantly less time to answer the questionnaire, and participants from the VR group had significantly better results over both tests. Based on the results of this study, VR learning seems to be more efficient and to have better long-term effects for the study of anatomy. The reason for that could lie in the VR environment's high immersion, and the possibility to freely and interactively explore a realistic representation of human anatomy. Immersive VR technology offers many possibilities for medical teaching and training, especially as a support for cadaver dissection courses.
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Affiliation(s)
- Kilian Gloy
- Department for Visceral Surgery, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Paul Weyhe
- Department for Visceral Surgery, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Eric Nerenz
- Department for Visceral Surgery, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Maximilian Kaluschke
- Institute for Computer Graphics and Virtual Reality, University of Bremen, Bremen, Germany
| | - Verena Uslar
- Department for Visceral Surgery, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Gabriel Zachmann
- Institute for Computer Graphics and Virtual Reality, University of Bremen, Bremen, Germany
| | - Dirk Weyhe
- Department for Visceral Surgery, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
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Chytas D, Salmas M, Skandalakis GP, Troupis TG. Can Immersive Virtual Reality Function as a Suitable Alternative to Conventional Anatomy Education Methods? ANATOMICAL SCIENCES EDUCATION 2021; 14:693-694. [PMID: 33811476 DOI: 10.1002/ase.2081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Dimitrios Chytas
- Department of Anatomy, School of Physiotherapy, University of Peloponnese, Sparta, Greece
| | - Marios Salmas
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Theodore G Troupis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
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Evans DJR. Assessing the Wider Outcomes of Anatomy Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:275-276. [PMID: 33768720 DOI: 10.1002/ase.2076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Darrell J R Evans
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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