The implementation of cognitive load theory in developing an augmented reality (AR) mobile-based application for learning neural pathways
Creators: name: Thanasorn Asawesna
name: Poyade, Matthieu
name: Rea, Paul M
name: Clancy, Jenny
Publisher: name: F1000 Research Limited
Year: 2023

description: <b>Introduction</b><br> Anatomy is one of the many biomedical fields which has seen a surge in the popularity of technological advances in learning and teaching, especially during the Covid-19 pandemic. Augmented reality (AR), one of the most promising innovative technologies, has been applied to a variety of research areas, but little has been done in the field of neuroanatomy, one of the most challenging for students to study. However, there are still inconsistencies and disagreement between studies involving AR, highlighting current difficulties for the implementation of effective learning experiences. Integrating cognitive load theory (CLT), a psychological theory that explains how the brain processes new information to acquire knowledge, is one possible approach that could assist in the improvement of the adoption of this technology. Integrating CLT into the instructional design process could assist in avoiding improper instructional design, hence enhancing the learning efficiency. This study aimed to develop methodological framework guidelines for AR in conjunction with CLT, to address the challenges of neuroanatomical learning.<br> <br> <b>Materials and Methods</b><br> Using Unity, a leading game development platform, an AR neural pathway learning application was developed for Android operating system. This application was created in accordance with cognitive load reduction principles and was evaluated to develop the methodological framework. This study used quantitative methodology and a counter-balanced experimental design to compare the AR application to traditional teaching methods. Two learning modalities: the AR application, and a self-study PowerPoint presentation were assessed. 12 undergraduate medical and anatomy students from the University of Glasgow were randomly allocated to Group A (n = 6) or Group B (n = 6). Participants attended 2 learning sessions separated by 7-12 days. Group A used the AR application first, followed by traditional PowerPoint presentations in the second session to learn neuroanatomy. In contrast, Group B used the PowerPoint slides first and the AR application second. Participants completed a series of questionnaires before and after each session to assess the acquired neuroanatomy knowledge, cognitive load, usability and motivation.<br> <br> <b>Results</b><b> </b><br> There was no significant difference between the two groups' baseline knowledge (<i>t</i>(10)=1.000, <i>p</i> = 0.341). Paired-sample t-tests suggested that both learning resources promoted learning (group A, 1<sup>st</sup> session <i>t</i>(5)=-2.390, p = 0.062, 2<sup>nd</sup> session <i>t</i>(5)= -8.174, <i>p</i> &lt; 0.001),(Group B, 1<sup>st</sup> session <i>t</i>(5)= -2.697,<i> p</i> = 0.043, 2<sup>nd</sup> session <i>t</i>(5)= -2.712, <i>p</i> = 0.042). When comparing the two groups using an independent-sample t-test, there was no significant difference between the two learning modalities (1st session <i>t</i>(10)=1.557, <i>p</i> = 0.15, 2nd session <i>t</i>(10)=1.655,<i> p</i> = 0.13). Regarding cognitive load, independent-sample t-tests indicated that neither intrinsic load (IL) nor extraneous load (EL) differed significantly between groups (IL <i>t</i>(10)=-.336, p = 0.74, EL <i>t</i>(10)=-1.833, <i>p</i> = 0.09), however, there was a trend towards reduced extraneous load when using the AR app. However, germane load, which is refer to the mental effort required to learn the new knowledge, was significantly lower when used the AR application (Group A <i>M</i> = 4.05, <i>SD</i> = 1.08, Group B <i>M</i> = 7.61, <i>SD</i> = 2.12, <i>t</i>(10)=-3.652, <i>p</i> = 0.004).<br> <br> <b>Discussion and Conclusion</b><br> These preliminary results suggest that, although there was no significant difference between the AR learning resource and the traditional learning method (PowerPoint) in promoting knowledge, learning via the AR app could lessen the mental effort required to study a complex subject such as neural pathways. To be more specific, because there was no significant difference in the amount of Intrinsic load (difficulty of the subject). Both, the AR app and the PowerPoint presented the same level of complexity for knowledge. Moreover, the AR app generated less extraneous load (mental demand generated by the design of learning resource), freeing up more working memory space for the germane load (mental effort required to learn new information). Consequently, the student can understand the information while spending less mental effort when using the app. The AR app also received a high usability score (SUS = 79.5), which also can be qualified as “excellent”. This study shows that implementing CLT into AR instructional design could benefit technologically enhanced instructions for anatomical education in the future.<br> <br> <br> This study was conducted by the University of Glasgow and the School of Simulation and Visualisation at the Glasgow School of Art, with funding from the Faculty of Medicine Siriraj Hospital at Mahidol University