“Visualization matters” – Stereoscopic visualization of 3D graphic neuroanatomic models through AnaVu enhances basic recall and radiologic anatomy learning when compared with monoscopy

Abstract

Background The authors had previouslydeveloped AnaVu, a low-resource 3D visualization tool for stereoscopic projection of 3D models generated from annotated MRI neuroimaging data. However, its utility in neuroanatomical education needs to be quantified,and the students’ perspectives known. Methods A three-limb randomized controlled trial with crossover was designed. A sample (n=152) from the 2022 cohort of MBBS students at Government Medical College, Thiruvananthapuram (GMCT), was randomly selected from those who gave informed consent. After a one-hour introductory lecture on brainstem anatomy and a dissection session, students were randomized to three groups (S – stereo; M – Mono and C – Control). S was given a 20-minute demonstration on the brainstem lesson module in AnaVu in stereoscopic mode. M was given the same demonstration, but in monoscopic mode.The C group was taught using white-board drawn diagrams. Pre-intervention and post-intervention tests for four domains (basicrecall, analytical, radiological anatomy and diagram-based questions) were conducted before and after the intervention. Cognitive loads were measured using a pre-validated tool. The crossover part consisted of swapping groups -S, M and C,and they were asked to compare the modes. Results For basic recall examinations, there was a statistically significant increase in the pre/post-intervention score difference of the S group when compared to the M group [p=0.03; post hoc analysis, Bonferroni corrections applied] and the C group [p = 0.001; post hoc analysis, Bonferroni corrections applied]. For radiological anatomy examinations, the difference was significantly higher for S compared to C [p < 0.001; post hoc analysis, Bonferroni corrections applied]. Cognitive load scores showed increased mean germane load for S (33.28 ± 5.35) compared with C (28.18 ± 8.17). The qualitative comments indicated general appreciation about stereoscopy and critical points such as inconvenience of wearing goggles, eye strain, and sleepiness. In spite of these comments, out of the S and M swap cohorts, 79/102 preferred S, 13/102 preferred M, and 6/102 preferred both. Conclusions Since stereoscopic projection is technically challenging and cost considerations arehigher compared to monoscopic projection, the specific advantages and disadvantages of each are relevant in the Indian medical education scenario.