The Effect of Varied Learning Environments and Modalities on Anatomical Knowledge Acquisition, Perceived Workload, Cybersickness, and Learner Engagement

Abstract

Institutions are looking to find the best learning technologies to deliver anatomy curricula to diverse student populations, often working with financial and time-based constraints. Visualization techniques, particularly the widespread use of virtual reality headsets, have made once-impossible learning experiences possible. This thesis explores the effect of different learning modalities (virtual reality headset, computer screen, and 3D-printed models) and environments (clinical context or context-free) on knowledge acquisition and learning experiences for a pelvic floor anatomy module. We investigated how these factors, along with mental rotation ability and stereoacuity, impact various aspects of learning, including performance on anatomy tests, perceived workload (measured using the NASA Task Load Index), cybersickness (measured using the Simulator Sickness Questionnaire), and engagement during learning (measured using the User Engagement Scale). Significant interactions were found between modality and environment for test scores and workload, a significant main effect of modality and environment for cybersickness, and a significant main effect of modality for engagement. Importantly, though significant differences were found between modalities and environments, participants reported concerningly high levels of workload and cybersickness across all conditions. High levels of engagement were also reported across all learning conditions. The lack of meaningful differences between intervention groups emphasizes the importance of curricular design over the implementation of new technologies and the need to be critical of the impression that a one-size-fits-all solution exists. Theories of cognitive load, constructivism, syncretion, visuospatial ability, cybersickness, and embodied learning in the context of technology-enhanced anatomy education are discussed as the foundation upon which design decisions should be made. A multi-faceted approach focused on aligning learning objectives with learning activities is outlined as a means of driving more impactful research and improving anatomy education.