Assessing the Impact of Immersion on Learning in Medical Students: A Pilot Study Comparing Two-Dimensional and Three-Dimensional Virtual Simulation

Introduction Virtual simulation within health professions education can be categorized as two-dimensional or three-dimensional, dependent upon how users interact with the scenario. A core difference between these two categories is the degree of immersion experienced by the user. The importance of immersion for knowledge-based learning is unclear. Hence, this pilot study compares two virtual simulators to determine the impact of immersion on knowledge acquisition and retention and user experience. Methods This randomized crossover trial consisted of 25 fifth-year medical students attending two consecutive teaching sessions using two-dimensional and three-dimensional virtual simulation, respectively. Multiple-choice questions, completed immediately before and after, and one-month after the sessions, were employed to determine knowledge acquisition and retention. Questionnaires, consisting of Likert-scale and open-ended questions, evaluated user experience. Quantitative data was analyzed using a Student’s t-test and qualitative data was analyzed using thematic analysis. Results Both interventions demonstrated statistically significant levels of knowledge acquisition and retention, though there was no significant difference in the extent of learning between the simulators. The two interventions offered valuable and acceptable approaches to virtual simulation, though Likert-scale responses indicated that participants significantly preferred three-dimensional virtual simulation. Free-form responses revealed themes of education and technology, with subthemes of desirability, learning, curriculum integration, fidelity, hardware and software. Conclusions The findings indicate that higher levels of immersion do not appear to offer greater educational benefit, with two-dimensional simulation possibly offering an equally valuable learning experience to three-dimensional simulation. Participants appeared to significantly prefer three-dimensional virtual simulation, though potential uses for both simulators were identified.