Evaluating knowledge acquisition, confidence, and cognitive workload in immersive virtual reality anatomy education: a prospective study of medical students.

Abstract

Background: Immersive virtual reality (VR) allows learners to interact with anatomical structures in three dimensions, potentially improving spatial understanding compared to traditional instructional methods. While VR is increasingly incorporated into medical curricula, prospective studies evaluating both learning outcomes and experiential measures remain limited. This study aimed to evaluate the impact of a single immersive VR anatomy session on knowledge acquisition, learner confidence, cognitive workload, and perceived immersion among first-year medical students.

Methods: In this prospective educational intervention, first-year medical students at Kansas City University completed a standardized immersive VR anatomy module. Anatomy knowledge was assessed using a 20-item multiple-choice examination administered pre-session, immediately post-session, and at a 20-day follow-up. Learner confidence was measured using a 5-point Likert scale. Cognitive workload was assessed using the NASA Task Load Index (NASA-TLX), and immersion was measured using validated presence and usability items.

Results: Anatomy knowledge improved significantly from pre- to post-intervention (mean increase 7.2% points, 95% CI [3.9, 10.6], p < 0.001). However, scores declined at delayed follow-up (mean change - 15.3% points from post, 95% CI [-19.8, -10.7], p < 0.001), falling below baseline mean levels. Confidence demonstrated a significant upward shift in distribution (p = 0.018), although change in confidence was not associated with knowledge gain (p = 0.863). Cognitive workload was not significantly associated with learning outcomes, while small negative correlations were observed between knowledge gain and both presence (r = -0.31, p = 0.022) and usability (r = -0.28, p = 0.034).

Conclusion: Immersive VR produces significant short-term improvements in anatomy knowledge and learner confidence but does not sustain retention following a single exposure. While effective for enhancing short-term anatomy knowledge and learner engagement, these findings suggest that immersive VR may be most effective when integrated as a complementary component within a multimodal anatomy curriculum rather than used as a standalone instructional modality.