Virtual Reality Bell-Ringer: The Development and Testing of a Stereoscopic Application for Human Gross Anatomy

Danielle Brewer-Deluce; Alex B Bak; Abigail J Simms; Sakshi Sinha; Josh P Mitchell; David Shin; Anthony N Saraco; Bruce C Wainman

doi:10.1002/ase.2074

Virtual Reality Bell-Ringer: The Development and Testing of a Stereoscopic Application for Human Gross Anatomy

Anat Sci Educ. 2021 May;14(3):330-341. doi: 10.1002/ase.2074.

Authors

Danielle Brewer-Deluce^{1

2}, Alex B Bak^{1

3}, Abigail J Simms¹, Sakshi Sinha¹, Josh P Mitchell¹, David Shin¹, Anthony N Saraco¹, Bruce C Wainman^{1

4}

Affiliations

¹ Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
² School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada.
³ Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁴ Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

PMID: 33735524
DOI: 10.1002/ase.2074

Abstract

As post-secondary education migrates online, developing and evaluating new avenues for assessment in anatomy is paramount. Three-dimensional (3D) visualization technology is one area with the potential to augment or even replace resource-intensive cadaver use in anatomical education. This manuscript details the development of a smartphone application, entitled "Virtual Reality Bell-Ringer (VRBR)," capable of displaying monoscopic two-dimensional (2D) or stereoscopic 3D images with the use of an inexpensive cardboard headset for use in spot examinations. Cadaveric image use, creation, and pinning processes are explained, and the source code is provided. To validate this tool, this paper compares traditional laboratory-based spot examination assessment stations against those administered using the VRBR application to test anatomical knowledge. Participants (undergraduate, n = 38; graduate, n = 13) completed three spot examinations specific to their level of study, one in each of the modalities (2D, 3D, laboratory) as well as a mental rotation test (MRT), Stereo Fly stereotest, and cybersickness survey. Repeated measures ANCOVA suggested participants performed significantly better on laboratory and 3D stations compared to 2D stations. Moderate to severe cybersickness symptoms were reported by 63% of participants in at least one category while using the VRBR application. Highest reported symptoms included: eye strain, general discomfort, difficulty focusing, and difficulty concentrating. Overall, the VRBR application is a promising tool for its portability, affordability, and accessibility. Due to reported cybersickness and other technical limitations, the use of VRBR as an alternative to cadaveric specimens presents several challenges when testing anatomy knowledge that must be addressed before widespread adoption.

Keywords: assessment; gross anatomy education; objective structured practical examinations; spot examination; stereoscopy; technology-enhanced education; virtual practical examination; virtual reality.

MeSH terms

Anatomy* / education
Cadaver
Humans
Imaging, Three-Dimensional
Software
Virtual Reality*