The Impact of Virtual Reality on Exam Performance in a Neuromusculoskeletal Anatomy Course Among Doctor of Physical Therapy Students
Authors: Farkas Gary J. , Yu Stacey J. , Klein Barbie , Harmon Derek 
Published: April 2020

INTRODUCTIONFor doctor of physical therapy students (DPT), neuromusculoskeletal anatomy is a critical component of clinical practice; however, students often struggle due to the complex spatial processing required. Virtual reality (VR) applications allow students to deconstruct and reconstruct anatomy in 3D, aiding in knowledge acquisition.AIMThe aim of this study was to investigate the impact of VR on exam performance among DPT students enrolled in a neuromusculoskeletal anatomy course, and evaluate the students’ overall satisfaction in using VR to learn anatomy. We hypothesize students who complete the VR session will perform significantly better on the exam than those who do not use the technology.METHODSStudy details were provided to all first‐year DPT students (n=51) during the eighth week of a 10‐week class in this IRB‐approved study. Students independently determined if they wanted to complete the VR session, not complete the VR session and remain in the control group (CG), or opt out of the study prior to the third exam, which included a lab practical and written component worth 35 points each. Anatomy VR software (3D Organon, Queensland) was available on the VR system (HTC Vive, Taiwan) over a single day for groups of 4 students using 2 VR headsets for 1 hour, for a total of 6 hours. During the VR session, students completed a self‐directed learning activity on the anatomy of the upper limb. Following the session, the students completed a Likert‐based questionnaire about their experience. Participants’ responses were analyzed for common themes and ordered into categories. Differences between the groups were evaluated with the Mann‐Whitney U test. Alpha<0.05.RESULTSTwenty students completed the VR session, 28 remained in the CG, and 3 opted out. On the practical exam (VR: 28.1±3.9 vs. CG: 27.8±4.3), written exam (VR: 32.1±3.8 vs. CG: 30.9 ± 4.6), and the sum of the exams (VR: 60.7±7.2 vs. CG: 58.3±8.2), the VR group scored higher than the CG; however, these differences were not significant (p≥0.33). Questionnaire data showed 70% of students thought the VR session helped them understand spatial relationships, 93% enjoyed participating in the session, and 93% were likely to recommend VR for learning neuromusculoskeletal anatomy. Analysis of the responses showed that students found the VR session beneficial for manipulating anatomical structures, visualizing spatial relationships, observing structures not easily seen in cadavers, and identifying muscle attachment sites. Students suggested that future sessions have greater direction and objectives and changes to the software (i.e., a search bar for specific structures, the ability to visualize muscle actions, and include surrounding structures to identify anatomical relationships). Lastly, students recommended additional anatomical regions or systems for VR, including plexuses and the neck.DISCUSSION/CONCLUSIONResults from the present study demonstrate there is no significant improvement in exam scores with the use of VR, and that students valued VR in learning neuromusculoskeletal anatomy despite some system limitations. VR is a valuable tool to supplement learning in anatomy, and future research should increase the sample size and incorporate a greater number of VR sessions.