The effect of autostereoscopic holograms on anatomical knowledge: a randomised trial.

Abstract

Three-dimensional (3-D) visualisation in anatomical education has been shown to be broadly beneficial for students. However, there is limited research on the relative efficacy of 3-D modalities. This study compares knowledge performance, mental effort and instructional efficiency between autostereoscopic 3-D visualisation (holograms), monoscopic 3-D visualisation (3-DPDFs) and a control (2-D printed images). A cardiac anatomy model was used to generate holograms, 3-DPDFs and 2-D printed images. Nursing student participants (n=179) were randomised into three groups: holograms (n=60), 3-DPDFs (n=60) and printed images (n=59). Participants completed a pre-test followed by a self-study period using the anatomical visualisation. Afterwards, participants completed the NASA-Task Load Index (NASA-TLX) cognitive load instrument and a knowledge post-test. Post-test results showed participants studying with holograms (median=80.0, interquartile range [IQR]=66.7-86.7) performed significantly better regarding cardiac anatomy knowledge than participants using 3-DPDF (median=66.7, IQR=53.3-80.0, p=0.008) or printed images (median=66.7, IQR=53.3-80.0, p=0.007). Mental effort scores, on a scale from 1 to 20, showed hologram (mean=4.9, standard deviation [SD]=3.56) and 3-DPDF participants (mean=4.9, SD=3.79) reported significantly lower cognitive load than printed images (mean=7.5, SD=4.9, p<0.005). Instructional efficiency (E) of holograms (E=0.35) was significantly higher than printed images (E=-0.36, p<0.001), although not significantly higher than 3-DPDF (E=0.03, p=0.097). Participants using holograms demonstrated significant knowledge improvement over printed images and monoscopic 3-DPDF models, suggesting additional depth cues from holographic visualisation provide benefit in understanding spatial anatomy. Mental effort scores and instructional efficiency of holograms indicate holograms are a cognitively efficient instructional medium. These findings highlight the need for further study of novel 3-D technologies and learning performance.