Abstract:

Technology tools in aiding 3D Visualisation is critical for authentic medical education. Three-dimensional visualisation tools (3DVT) are utilised in anatomy learning, specifically using augmented reality (AR) application. We have developed innovative Monash Augmented Reality Anatomy Learning Objects (MARALO). MARALO are easy-accessible, convenient and cost-efficient without losing the realistic view of physical models in the laboratory. More importantly, MARALO provides visualisation of the structures comprehensively from different orientations and positions which is the shortcoming of 2D images on the textbook.

According to cognitive load theory (CLT), any information that is perceived or processed will contribute to the cognitive load which optimally functions below working memory capacity. Visualisation while learning anatomical structures occupies extensive capacity in the memory. Previous studies assessed the impact of visualisation with cognitive load measuring through complex rating scale , secondary task performance, and physiological measures - but did not give a direct result of improvement of the visualisation impact was improved,

Objective:
To use simple subjective and objective evaluation methods in directly assess visualisation impact of different 3D anatomical structures in MARALO amongst medical students.

Methodology:
Pre-test and post-test evaluations with simple subjective and objective tests to evaluate the visualisation impact of the AR anatomical models. In experiment 1 (MARALO skull) and experiment 2 (MARALO lung) AR anatomical models were used in the testing of students’ visualisation. In the pre-test, students were tested their understanding and visualisation of the anatomical structure through sketching/drawing the structure (objective) with their pre-existing knowledge. Participants then viewed the MARALO model through scanning printed QR code via an application on iPad. They were allowed to navigate, zoom and spin the MARALO models interactively with an additional page of labelling and clinical applications as a reference and a revision. For objective evaluation, after the post-test drawing evaluation, researchers created a coding scheme for drawing to evaluate their visualisation of the AR models. For subjective visualisation impact, a focus group discussion with open ended questions was carried out to collect students’ feedback on their MARALO visualisation experience.

Results and Discussion:
The objective findings (pre and post test drawings) showed significant visualisation improvement while the subjective responses showed a positive feedback on visualisation impact of MARALO. This correlates with the literature that informs that although spatial ability affects effectiveness in learning with visualisation to some extent, well-designed dynamic 3D models can offer substantial learning assistance particularly to students with low spatial ability.

Conclusion:
These simple subjective and objective tests could well directly assess the visualisation impact of well-designed high resolution AR models such as MARALO. Overall, 3D visualisation via AR can reduce the cognitive load and enhance the learning process. The application of our AR anatomy objects is promising for anatomy learning where students can now access the realistic models on personal devices for authentic learning. Educational visualisation tools can be even generalised to broader educational purposes to multiply its benefits in education.

Keywords:

3D visualisation, evaluation, augmented reality, anatomy learning, drawing.