The Benefits of an Augmented Reality Magic Mirror System for Integrated Radiology Teaching in Gross Anatomy

Early exposure to radiological cross-section images during introductory anatomy and dissection courses increases students’ understanding of both anatomy and radiology. Novel technologies such as augmented reality (AR) offer unique advantages for an interactive and hands-on integration with the student at the center of the learning experience. In this article, the benefits of a previously proposed AR Magic Mirror system are compared to the Anatomage, a virtual dissection table as a system for combined anatomy and radiology teaching during a two-semester gross anatomy course with 749 first-year medical students, as well as a follow-up elective course with 72 students. During the former, students worked with both systems in dedicated tutorial sessions which accompanied the anatomy lectures and provided survey-based feedback. In the elective course, participants were assigned to three groups and underwent a self-directed learning session using either Anatomage, Magic Mirror, or traditional radiology atlases. A pre- and posttest design with multiple choice questions revealed significant improvements in test scores between the two tests for both the Magic Mirror and the group using radiology atlases, while no significant differences in test scores were recorded for the Anatomage group. Furthermore, especially students with low mental rotation test (MRT) scores benefited from the Magic Mirror and Anatomage and achieved significantly higher posttest scores compared to students with a low MRT score in the theory group. Overall, the results provide supporting evidence that the Magic Mirror system achieves comparable results in terms of learning outcome to established anatomy learning tools such as Anatomage and radiology atlases.     

The Effectiveness of an Augmented Reality Head-Mounted Display in Learning Skull Anatomy at a Community College

Despite an increase in the use of technology in undergraduate anatomy education, and the rising popularity of online anatomy courses at community colleges in the United States, there have been no reports on the efficacy of augmented reality on anatomy education in this population. The purpose of this study was to test the hypothesis that augmented reality is an effective and engaging tool for learning anatomy in community college students. Participants recruited from Cuyahoga Community College (Cleveland, OH) studied skull anatomy using either traditional tools (i.e., textbook and plastic skull model) or an augmented reality head-mounted display with an interactive virtual skull application. Comparison of knowledge before and following the study period revealed that augmented reality was an effective tool for learning skull anatomy: pre-quiz = 32.7% (± 25.2); mean (± SD), post-quiz = 61.8% (± 19.5); n = 15; t₍₂₈₎ = 3.53; P = 0.001. The traditional tools were equally effective: pre-quiz = 44.9 % (± 18.6), post-quiz = 67.9 % (± 17.3); n = 17; t₍₃₂₎ = 3.73; P = 0.0007. Students rated the augmented reality device as 9.6 (± 1.0); mean (± SD) when asked if it fit the statement “fun to use” on a semantic differential scale from 1 (poor) to 10 (excellent). In conclusion, this study found that augmented reality is an effective and engaging tool for the instruction of skull anatomy at a community college.     

Virtual Reality in Anatomy: A Pilot Study Evaluating Different Delivery Modalities

Technologies such as virtual reality are used in higher education to develop virtual learning resources (VLRs). These VLRs can be delivered in multiple modalities, from truly immersive involving wearable devices to less immersive modalities such as desktop. However, research investigating perceptions of VLRs in anatomy has mainly focused on a single delivery modality and a limited-demographic participant cohort, warranting a comparison of different modalities and a consideration of different cohorts. This pilot study aimed to compare perceptions of highly immersive and less immersive VLR deliveries among anatomy students and tutors and evaluate the impact of prior university experience on students' perceptions of VLRs. A skull anatomy VLR was developed using the Unity^® gaming platform and participants were voluntarily recruited to assess highly immersive stereoscopic and less immersive desktop deliveries of the VLR. A validated survey tool was used to gather perceptions of both deliveries. Most participants agreed that both VLR deliveries were interesting and engaging and provided an immersive experience. Anatomy students perceived the stereoscopic delivery to be significantly more useful for understanding (P = 0.013), while anatomy tutors perceived the desktop delivery as more useful. A degree of physical discomfort and disorientation was reported by some participants for both deliveries, although to a greater extent for the stereoscopic delivery. The stereoscopic delivery was also found to be more mentally taxing than desktop delivery. These results suggest that desktop VLR delivery may minimize the risk of discomfort and disorientation associated with more immersive modalities while still providing a valuable learning experience.     

Enhancement of Anatomical Education Using Augmented Reality: An Empirical Study of Body Painting

Students in undergraduate premedical anatomy courses may experience suboptimal and superficial learning experiences due to large class sizes, passive lecture styles, and difficult-to-master concepts. This study introduces an innovative, hands-on activity for human musculoskeletal system education with the aim of improving students’ level of engagement and knowledge retention. In this study, a collaborative learning intervention using the REFLECT (augmented reality for learning clinical anatomy) system is presented. The system uses the augmented reality magic mirror paradigm to superimpose anatomical visualizations over the user’s body in a large display, creating the impression that she sees the relevant anatomic illustrations inside her own body. The efficacy of this proposed system was evaluated in a large-scale controlled study, using a team-based muscle painting activity among undergraduate premedical students (n = 288) at the Johns Hopkins University. The baseline knowledge and post-intervention knowledge of the students were measured before and after the painting activity according to their assigned groups in the study. The results from knowledge tests and additional collected data demonstrate that the proposed interactive system enhanced learning of the musculoskeletal system with improved knowledge retention (F_(10,133) = 3.14, P < 0.001), increased time on task (F_(1,275) = 5.70, P < 0.01), and a high level of engagement (F_(9,273) = 8.28, P < 0.0001). The proposed REFLECT system will be of benefit as a complementary anatomy learning tool for students.     

Neuroanatomy Learning: Augmented Reality vs. Cross-Sections

Neuroanatomy education is a challenging field which could benefit from modern innovations, such as augmented reality (AR) applications. This study investigates the differences on test scores, cognitive load, and motivation after neuroanatomy learning using AR applications or using cross-sections of the brain. Prior to two practical assignments, a pretest (extended matching questions, double-choice questions and a test on cross-sectional anatomy) and a mental rotation test (MRT) were completed. Sex and MRT scores were used to stratify students over the two groups. The two practical assignments were designed to study (1) general brain anatomy and (2) subcortical structures. Subsequently, participants completed a posttest similar to the pretest and a motivational questionnaire. Finally, a focus group interview was conducted to appraise participants’ perceptions. Medical and biomedical students (n = 31); 19 males (61.3%) and 12 females (38.7%), mean age 19.2 ± 1.7 years participated in this experiment. Students who worked with cross-sections (n = 16) showed significantly more improvement on test scores than students who worked with GreyMapp-AR (P = 0.035) (n = 15). Further analysis showed that this difference was primarily caused by significant improvement on the cross-sectional questions. Students in the cross-section group, moreover, experienced a significantly higher germane (P = 0.009) and extraneous cognitive load (P = 0.016) than students in the GreyMapp-AR group. No significant differences were found in motivational scores. To conclude, this study suggests that AR applications can play a role in future anatomy education as an add-on educational tool, especially in learning three-dimensional relations of anatomical structures.     

The Effect of Stereoscopic Augmented Reality Visualization on Learning Anatomy and the Modifying Effect of Visual-Spatial Abilities: A Double-Center Randomized Controlled Trial

Monoscopically projected three-dimensional (3D) visualization technology may have significant disadvantages for students with lower visual-spatial abilities despite its overall effectiveness in teaching anatomy. Previous research suggests that stereopsis may facilitate a better comprehension of anatomical knowledge. This study evaluated the educational effectiveness of stereoscopic augmented reality (AR) visualization and the modifying effect of visual-spatial abilities on learning. In a double-center randomized controlled trial, first- and second-year (bio)medical undergraduates studied lower limb anatomy with stereoscopic 3D AR model (n = 20), monoscopic 3D desktop model (n = 20), or two-dimensional (2D) anatomical atlas (n = 18). Visual-spatial abilities were tested with Mental Rotation Test (MRT), Paper Folding Test (PFT), and Mechanical Reasoning (MR) Test. Anatomical knowledge was assessed by the validated 30-item paper posttest. The overall posttest scores in the stereoscopic 3D AR group (47.8%) were similar to those in the monoscopic 3D desktop group (38.5%; P = 0.240) and the 2D anatomical atlas group (50.9%; P = 1.00). When stratified by visual-spatial abilities test scores, students with lower MRT scores achieved higher posttest scores in the stereoscopic 3D AR group (49.2%) as compared to the monoscopic 3D desktop group (33.4%; P = 0.015) and similar to the scores in the 2D group (46.4%; P = 0.99). Participants with higher MRT scores performed equally well in all conditions. It is instrumental to consider an aptitude–treatment interaction caused by visual-spatial abilities when designing research into 3D learning. Further research is needed to identify contributing features and the most effective way of introducing this technology into current educational programs.     

Virtual and Augmented Reality Enhancements to Medical and Science Student Physiology and Anatomy Test Performance: A Systematic Review and Meta-Analysis

Virtual and augmented reality have seen increasing employment for teaching within medical and health sciences programs. For disciplines such as physiology and anatomy, these technologies may disrupt the traditional modes of teaching and content delivery. The objective of this systematic review and meta-analysis is to evaluate the impact of virtual reality or augmented reality on knowledge acquisition for students studying preclinical physiology and anatomy. The protocol was submitted to Prospero and literature search undertaken in PubMed, Embase, ERIC, and other databases. Citations were reviewed and articles published in full assessing learning or knowledge acquisition in preclinical physiology and anatomy from virtual or augmented reality were included. Of the 919 records found, 58 eligible articles were reviewed in full-text, with 8 studies meeting full eligibility requirements. There was no significant difference in knowledge scores from combining the eight studies (626 participants), with the pooled difference being a non-significant increase of 2.9 percentage points (95% CI [−2.9; 8.6]). For the four studies comparing virtual reality to traditional teaching, the pooled treatment effect difference was 5.8 percentage points (95% CI [−4.1; 15.7]). For the five studies comparing augmented reality to traditional teaching, the pooled treatment effect difference was 0.07 (95% CI [−7.0; 7.2]). Upon review of the literature, it is apparent that educators could benefit from adopting assessment processes that evaluate three-dimensional spatial understanding as a priority in physiology and anatomy. The overall evidence suggests that although test performance is not significantly enhanced with either mode, both virtual and augmented reality are viable alternatives to traditional methods of education in health sciences and medical courses.     

An Alternative Method for Anatomy Training: Immersive Virtual Reality

The aim of this study was to investigate the effect of immersive three-dimensional (3D) interactive virtual reality (VR) on anatomy training in undergraduate physical therapy students. A total of 72 students were included in the study. The students were randomized into control (n = 36) and VR (n = 36) group according to the Kolb Learning Style Inventory, sex, and Purdue Spatial Visualization Test Rotations (PSVT-R). Each student completed a pre-intervention and post-intervention test, consisting of 15 multiple-choice questions. There was no significant difference between the two groups in terms of age, sex, Kolb Learning Style Inventory distribution, and the PSVT-R (P > 0.05). The post-test scores were significantly higher compared to pre-test scores in both the VR group (P < 0.001) and the control group (P < 0.001). The difference between the pre-test and post-test results was found to be significantly higher in favor of the VR group (P < 0.001). In this study, anatomy training with a 3D immersive VR system was found to be beneficial. These results suggest that VR systems can be used as an alternative method to the conventional anatomy training approach for health students.     

The Use of Augmented Reality Technology in Medical Specimen Museum Tours

Human anatomical specimen museums are commonly used by medical, nursing, and paramedical students. Through dissection and prosection, the specimens housed in these museums allow students to appreciate the complex relationships of organs and structures in more detail than textbooks could provide. However, it may be difficult for students, particularly novices, to identify the various parts of these anatomical structures without additional explanations from a docent or supplemental illustrations. Recently, augmented reality (AR) has been used in many museum exhibits to display virtual objects in videos captured from the real world. This technology can significantly enhance the learning experience. In this study, three AR-based support systems for tours in medical specimen museums were developed, and their usability and effectiveness for learning were examined. The first system was constructed using an AR marker. This system could display virtual label information for specimens by capturing AR markers using a tablet camera. Individual AR markers were required for all specimens, but their presence in and on the prosected specimens could also be obtrusive. The second system was developed to set the specimen image itself as an image marker, as most specimens were displayed in cross section. Visitors could then obtain the label information presented by AR without any markers intruding on the display or anatomical specimens. The third system was comprised of a head-mounted display combined with a natural click interface. The system could provide visitors with an environment for the natural manipulation of virtual objects with future scalability.     

增强现实技术在室内设计教学中的研究与应用

研究提出"体验式辅助设计"理念.通过增强现实技术,设计了"增强现实技术设计环境"系统,让初学者能直接体验现实感较强的室内设计技巧.经教学验证,该系统对于初学者快速掌握计算机辅助室内设计设计技巧有极强的促进作用,填补了计算机辅助设计教学的空白.     

基于“视联网”增强现实技术的教学应用研究

增强现实(Augmented Reality,AR)是在虚拟现实技术的基础上,将计算机生成的虚拟对象叠加到用户所看到的真实场景中,以构造出虚实结合的虚拟空间技术。将虚拟对象无缝的叠加于真实场景中帮助用户加强对环境的理解与情景的感知。文章介绍了当前增强现实技术的有关概念,结合其特点探索了其在教学中的应用。     

增强现实外语教学环境及其多模态话语研究

外语教学活动的多模态化对现代信息技术的应用提出了更高的要求。文章分析了外语教学在多模态化进程中遇到的制约因素,提出应用增强现实构建虚实融合的多模态外语教学情境,探讨了增强现实在外语基本概念学习及外语情境交际能力训练中的应用,进一步分析了增强现实多模态外语教学环境中的虚拟视觉及听觉模态符号。研究表明,增强现实在外语教学的多模态化中能够发挥重要作用,是提升外语教学效果的有力手段。     

Evaluation of an Augmented Reality Application for Learning Neuroanatomy in Psychology

Neuroanatomy is difficult for psychology students because of spatial visualization and the relationship among brain structures. Some technologies have been implemented to facilitate the learning of anatomy using three-dimensional (3D) visualization of anatomy contents. Augmented reality (AR) is a promising technology in this field. A mobile AR application to provide the visualization of morphological and functional information of the brain was developed. A sample of 67 students of neuropsychology completed tests for visuospatial ability, anatomical knowledge, learning goals, and experience with technologies. Subsequently, they performed a learning activity using one of the visualization methods considered: a 3D method using the AR application and a two-dimensional (2D) method using a textbook to color, followed by questions concerning their satisfaction and knowledge. After using the alternative method, the students expressed their preference. The two methods improved knowledge equally, but the 3D method obtained higher satisfaction scores and was more preferred by students. The 3D method was also more preferred by the students who used this method during the activity. After controlling for the method used in the activity, associations were found between the preference of the 3D method because of its usability and experience with technologies. These results found that the AR application was highly valued by students to learn and was as effective as the textbook for this purpose.     

Improving Academic Performance of Sport and Exercise Science Undergraduate Students in Gross Anatomy Using a Near-Peer Teaching Program

Peer and near-peer teaching programs are common in medical undergraduate courses. However, there are no studies that have investigated the effectiveness of a near-peer teaching program on the academic performance of undergraduate students pursuing sport and exercise science coursework. This study was conducted to analyze the effectiveness of such a program for students who participated in a course on the functional anatomy of the locomotor apparatus. A total of 39 student participants were divided into two groups: students in one group voluntarily attended at least one session of a near-peer teaching program, and students in the other group attended no sessions. The final grade (range 0–100%) was recorded and used as an indicator of academic performance. The final grade of students who attended the near-peer teaching program (69.5 ± 16.0%) was 38.7% higher (P = 0.002, d = 1.06) than those who did not (50.1 ± 20.4%). When the academic performance of the same students was evaluated in another course (exercise physiology) that did not offer a near-peer teaching program, there were no significant differences between the groups (students who attended or did not attend the near-peer teaching program). A significant positive association was found between near-peer teaching program frequency and the number of students approved and not approved in the course (P = 0.041). A significant difference (P = 0.001) was found in the attendance at regular classes between the group who participated in the near-peer teaching program (median: 62 hours; IQR [interquartile ranges]: 4.0 hours) and those who did not (median: 58 hours; IQR: 4.0 hours). Gender was not a moderating factor on academic performance or near-peer teaching program attendance. These results highlight the effectiveness of a near-peer teaching program on the academic performance of students from a sport and exercise science degree program while enrolled in an anatomy course. Anat Sci Educ. © 2018 American Association of Anatomists.     

增强现实技术在移动学习中的应用初探

增强现实技术是在虚拟现实技术基础上发展起来的一种新技术,智能手机的迅速发展又推动了增强现实技术的实际应用。文章在阐述增强现实概念的基础上介绍了增强现实技术在智能手机上的应用以及支持智能手机增强现实系统的核心技术,并论证了增强现实技术在移动学习中应用的前景。     

Not Just a Specimen: A Qualitative Study of Emotion,Morality, and Professionalism in One Medical School Gross Anatomy Laboratory

Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview-based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. All students oscillated involuntarily between seeing the cadaver as a specimen for learning and seeing the cadaver as a person, with some students intentionally cultivating one of these ways of seeing over the other. These views shaped students’ emotional and moral responses to the experiences of dissection. The “specimen” view facilitated a technical, detached approach to dissection, while the “person” view made students engage emotionally. Further, students who intentionally cultivated a “specimen” view generally felt less moral distress about dissection than students who intentionally cultivated a “person” view. The concept of respect gave students permission to perform dissections, but “person-minded” students developed more complex rules around what constituted respectful behavior. Both groups of students connected the gross anatomy experience to their professional development, but in different ways. “Specimen-minded” students intentionally objectified the body to learn the emotional control physicians need, while “person-minded” students humanized the body donor to promote the emotional engagement required of physicians. These findings support efforts to integrate professionalism teaching into gross anatomy courses, particularly content, addressing the balance between professional detachment and concern.     

Survey of Gross Anatomy Education in China: The Past and the Present

Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990–1999, 2000–2009, and 2010–2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000–2009 to 36.10 ± 47.26 in 2010–2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990–1999 to 14.22 ± 5.0 in 2010–2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000–2009 to 1:33.2 in 2010–2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.     

增强现实技术在医疗领域的应用

增强现实技术将计算机生成的虚拟图形等信息融合叠加到现实世界场景中,使用户看到虚实结合的三维世界,提高用户对现实世界的感知与理解。从手术培训、手术规划与手术导航3个方面介绍增强现实技术在医疗领域的应用,指出在应用中存在手术导航三维注册等挑战,并展望了未来发展方向。     

Integration of Scientific Competence into Gross Anatomy Teaching Using Poster Presentations: Feasibility and Perception among Medical Students

Scientific competencies, as defined in the German competency framework, describe the ability to think independently and act scientifically which is a central component of medical education. This report describes integration of scientific competencies into anatomical teaching. Based on findings seen in two consecutive years of dissection courses, students worked on either a case report (n = 70) or an original research study (n = 6) in the format of a scientific poster while learning to use primary literature. Posters were evaluated by juror teams using standardized evaluation criteria. Student perception of the project was assessed by quantitative and qualitative data obtained from the faculty's course evaluation and an online-survey. Overall, students worked collaboratively and invested extra-time (median 3.0 hours) in poster creation. Primary literature was integrated in 90.8% of the posters. Overall poster quality was satisfactory (46.3 ± 8.5 [mean ± standard deviation] out of 72 points), but several insufficiencies were identified. Students integrated information gained from the donor's death certificate, post-mortem full-body computed tomography (CT) scan (22.4%), and histopathological workup (31.6%) in their case reports. Students responded positively about learning new scientific skills (median 4.0 on a six-point Likert scale), but free-text answers revealed that some students experienced the project as an extra burden in a demanding gross anatomy course. In summary, it was feasible to introduce students to scientific skills during the dissection course and to increase interest in science in approximately a third of the survey respondents. Further adjustments to ensure the posters' scientific quality might be necessary for the future.