Exploring Virtual Reality as a Tool for Enhancing Teaching and Learning Anatomy to Medical Students: A Feasibility and Acceptability Study

ABSTRACT

Background

Virtual reality (VR) provides an immersive, interactive 3D learning environment with increasing use in medical education. It benefits surgical training and, increasingly more so in anatomy education, particularly where access to human body dissection is limited. Although VR can enhance engagement and knowledge retention, concerns remain regarding usability, feasibility and cybersickness. This study explores the acceptability of VR for anatomy learning among medical students with ongoing access to traditional anatomy laboratories.

Approach

A qualitative cross‐sectional pilot study was conducted with 38 medical students at the ASSERT Simulation Centre, University College Cork. Participants took part in a guided VR session using human anatomy software. Afterwards, they completed an online survey assessing ease of use, enjoyment, immersion, educational usefulness, interaction, understanding, intention for future use and cybersickness. The survey was adapted from two validated questionnaires. Feature engineering combined related items into eight dimensions for streamlined analysis and visualisation.

Evaluation

Results showed high acceptance and enthusiasm for VR. All participants reported enjoying the experience, finding it educationally useful, and that it enhanced their understanding. Between 95% and 98% found VR easy to use, immersive and reported ease in interacting with 3D objects. Although 8% experienced cybersickness, all expressed interest in future VR‐based education. Potential novelty bias must also be considered. VR is a feasible and well‐accepted tool for anatomy education, even among students with ongoing access to anatomy dissection facilities. With minimal cybersickness and high enjoyment, engagement and immersion, VR shows strong potential as a complementary educational method. Further research should explore long‐term learning outcomes in terms of knowledge retention and clinical implementation strategies within educational institutions.

1. Background

Virtual reality (VR) is a technology that creates an immersive 3D environment, separating the user from physical reality. It is typically experienced through a head‐mounted display (HMD), which enhances depth perception and generates a stereoscopic 3D effect [1].

In healthcare, VR has proven to be an effective training tool, particularly for surgical skills. One example is a randomised double‐blind study, which found that doctors trained using VR made fewer errors, were less likely to injure the gallbladder and showed consistent progress throughout a laparoscopic cholecystectomy [2]. VR has also shown promise in the early stages of university medical education [3]. Studies demonstrate that VR environments improve student retention and motivation and are associated with significantly greater knowledge gains compared to screen‐based learning [3, 4]. Because medical training requires learning both factual knowledge and practical skills across multiple disciplines, it is essential to learn efficiently and retain information accurately [3, 4]. The principles underpinning VR's educational potential often involve leveraging interactive elements akin to serious games to foster engagement and deeper understanding of complex subjects like anatomy [5].

Anatomy is a core subject in medical education; it is traditionally taught using human donors, which is considered the gold standard. However, financial, ethical and supervisory constraints can in some cases limit their use [6]. Establishing and maintaining an anatomy laboratory facility is costly, and ethical considerations must be addressed when handling human remains. VR offers a safe and ethical alternative, unrestricted by supply or the need for expert staff.

Despite its benefits, VR also presents limitations, most notably the potential for ‘cybersickness’. This condition, a physiological response to VR, may cause nausea, dizziness and cold sweats [7]. Evidence regarding its prevalence and impact is mixed. Contributing factors may include gender, prior VR experience and the type of virtual environment. The specific immersive elements that trigger cognitive discomfort remain unclear. Additionally, not all users experience cybersickness, as symptoms may also stem from hardware quality, content design or user‐specific factors [8].

For VR to be a viable tool in anatomy education, it must be both feasible and accessible. Research indicates that although healthcare professionals often lack experience with VR, they recognise its broad utility and support its application in hospitals [9, 10, 11]. A study involving 136 health science students reported high acceptance and strong preference for future VR use [11]. However, limited research exists on medical students' perspectives, particularly concerning the impact of cybersickness.

Existing research shows that medical students perceive VR and augmented reality (AR) as more useful than traditional methods. Two recent meta‐analyses have reported variable degrees of superior learning outcomes with VR interventions [3, 4] However, a critical gap persists in that most studies do not evaluate VR in contexts where learners already have regular access to human body dissection or prosection. In fact, among recent reviews, few, if any, directly compare VR's acceptability in such high‐resource settings [3].

Although we share the conventional view that human dissection and prosection remain the most effective methods for learning anatomy, we recognise that such facilities are not universally available. This study addresses that gap by investigating the feasibility and acceptability of VR for anatomy learning among medical students with continuous access to traditional dissection facilities. By exploring learner perspectives in this context, the study provides timely insights into the role of VR not as a replacement but as a complementary tool in anatomy education.

2. Approach

A qualitative cross‐sectional survey was conducted with 38 undergraduate medical students (Years 1–4) at the ASSERT Centre, University College Cork (UCC), between January and February 2024. None of the participants had prior VR experience. There were 13 first‐year, 8 second‐year, 6 third‐year and 11 fourth‐year students in all. The survey was anonymous to encourage honest feedback and minimise desirability bias, and the study was approved by UCC's Social Research Ethics Committee (Log No. SOM/SREC/2024/0701/1). No prior knowledge or experience was required to participate.

Using a convenience sampling method, participants were recruited via a social media group chat in January 2024. All participants engaged in the 30‐min session, which was delivered as a guided, immersive experience using a VR platform designed to facilitate exploration of musculoskeletal structures, including bones, muscles, tendons and other structures in both static and dynamic states. There was an instructor present during the 30‐min session; the same member of the team conducted all sessions. The instructor provided guidance on the key functionalities and navigational aspects of the software during the first 20 min, but the final 10 min was self‐directed. Notably, participants could still seek support from the instructor during this time if needed. A 30‐min time slot was allocated due to practical constraints, including room availability, limited access to headsets and the availability of the team member responsible for delivering the sessions.

Participants engaged in self‐directed interaction with VR 3D anatomical models, enabling them to manipulate and examine bones and joint structures and associated musculature in real time. The session was designed to be relevant and applicable to students of all years of medical school. The participants were able to rotate and inspect a full‐body skeleton. By hovering over specific structures, anatomical labels appeared, supporting recognition and recall. Participants were instructed to isolate and investigate specific bones and muscles using the VR interface to hide superficial structures and reveal those located deeper within the body. Additional interactive elements included toggling between skeletal and muscular systems, viewing anatomical actions and accessing animated and real cadaveric images for clinical relevance.

The session integrated a formative learning activity via a quiz module. Questions focused on anatomical identification, function and clinical relevance using a model‐based selection system where students answered by selecting the appropriate anatomical structure on the 3D model rather than choosing from a traditional text list. Immediate feedback was provided by the VR software, with correct answers and explanations displayed after each attempt to reinforce learning. The quiz did not contribute to formal assessment and served solely as an interactive learning reinforcement tool. No measurements of performance or summative assessment were conducted, and participation was voluntary. The activity was designed to explore the feasibility and engagement potential of VR in anatomy teaching and learning, with particular attention to learner interactivity, spatial understanding and clinical contextualisation.

The design of the VR session was informed by Kolb's experiential learning theory, which emphasises active engagement and reflection in constructing knowledge [12]. Learners were given the opportunity to engage in concrete experiences through immersive interaction with anatomical models, followed by reflective and conceptual learning through quiz feedback and clinical associations. Additionally, the use of visual–spatial models combined with text labels and narrative explanations reflects dual coding theory, which posits that learning is enhanced when verbal and visual information are presented together [12].

Afterwards, participants completed an electronic survey evaluating their experience with the technology, including aspects such as accessibility, feasibility and cybersickness. The survey consisted of 41 Likert scale questions aimed at assessing participants' attitudes towards VR in terms of accessibility, feasibility and cybersickness. It was developed using two validated questionnaires: one focusing on learner acceptance of VR in anatomy education [13] and the other on user acceptance of virtual learning environments [14]. Participants rated each question on a scale from 1 (strongly disagree) to 7 (strongly agree).

The sessions utilised the Oculus Meta Quest 2 VR HMD with two handheld controllers, offering a 90° horizontal and vertical field of view and a resolution of 20 pixels per degree [15]. The anatomy software used was 3D Organon, a comprehensive tool for anatomy education [16].

Data analysis was performed using Python 3 (Version 3.12.10) and descriptive statistics, with visualisations generated through Python's data science libraries (SciPy, NumPy, Matplotlib, Seaborn, Likert and Plotly) [17]. The 41‐question survey generated a large dataset, so feature engineering was applied to reduce its dimensionality (Figure S2). This process combined related questions to create new features that assessed feasibility and accessibility while reducing the number of data points for visualisation and communication.

For example, the feature ‘Ease of Use’ was created by combining the following questions related to the ease of using the VR headset:

1. Learning to use the virtual headset was easy.

2. I did not find it difficult to get the VR headset to perform as expected.

3. I found the VR headset flexible to interact with.

4. It was easy for me to become skilful at using the headset and content.

5. I feel the system is easy to use.

6. The system is convenient for me.

7. Learning how to operate the system is easy.

The results for these questions were combined, generating a mean score for the newly engineered ‘Ease of Use’ feature, which was then used for descriptive statistics and visualisations.

This same method was applied to other groups of related questions, creating features to assess various aspects of VR's feasibility and accessibility for teaching anatomy, as well as the impact of cybersickness (Table S2). The following 8 features were analysed:

1. Ease of use

2. Enjoyment

3. Immersion

4. Perceived usefulness

5. Interaction

6. Spatial understanding

7. Intention to use

8. Motion sickness

Each feature was analysed separately, and descriptive statistics (mean, standard deviation, minimum, maximum, quartiles and interquartile ranges) were calculated for each.

The feature groups were informed by established frameworks such as the ‘Technology Acceptance Model’ (TAM) [18]. ‘Ease of Use’ and ‘Perceived Usefulness’ align with TAM. ‘Enjoyment’, ‘Immersion’, ‘Interaction’, ‘Spatial Understanding’ and ‘Intention to Use’ capture experiential engagement and future adoption likelihood. Motion Sickness captures potential barriers related to physical discomfort. These groupings allowed for clearer interpretation and more efficient analysis of participant responses.

3. Evaluation

The 38 participants who completed the guided interactive session and survey, 22 were female (57%), and 16 were male (43%). None reported significant prior use of VR educational technology.

The mean response for each question was calculated, and feature engineering combined related questions to generate 8 features assessing the technology's feasibility and accessibility.

Data analysis focused on these engineered features, with Table 1 presenting the mean, standard deviation, minimum, maximum and quartile values. Participants rated VR highly in terms of ease of use, enjoyment, immersion, perceived usefulness, environmental interaction and intention to use.

TABLE 1.

Engineered features, mean, SD and quartile ranges.

Feature	Mean	Standard deviation	Minimum	Maximum	Upper quartile	Lower quartile
Ease of use	5.95	0.80	4	7	6	6
Enjoyment	6.79	0.41	6	7	7	7
Immersion	6.08	0.75	4	7	7	6
Perceived usefulness	6.58	0.55	5	7	7	6
Interact with environment	6.53	0.68	4	7	7	6
Understanding	6.58	0.60	5	7	7	6
Intention to use	6.42	0.68	5	7	7	6
Motion sickness	2.29	1.54	1	7	3	1

The study found that all participants enjoyed the VR experience, with 79% strongly agreeing and 21% agreeing. Participants described the experience as ‘very interesting’ and ‘fun’. The mean score was 6.79 (Table 1), indicating strong agreement on the Likert scale, with a low standard deviation of 0.41, suggesting homogeneity in responses. A paired‐sample t‐test showed that Enjoyment (M = 6.79, SD = 0.41) was rated significantly higher than Intention to Use (M = 6.42, SD = 0.68), t(37) = 3.85, p = 0.0004. Cohen's d = 0.62 indicates a moderate to large effect size so that this rating is unlikely to be random; however, more research is warranted. It suggests that although participants highly valued the VR experience, their long‐term commitment to future use may be slightly more reserved, possibly reflecting the novelty of the experience or uncertainty about broader implementation. The positive responses in terms of enjoyment compared with the slightly more reserved response in terms of intention to use VR may partially reflect a novelty effect, where initial excitement influences engagement and perceptions, but is not maintained in terms of long‐term adoption of the technology. Students' hesitation about the broader implementation of VR may reflect a few concerns, such as technical reliability, limited availability due to cost or occasional physical discomfort from motion sickness. These considerations may lead to a more reserved view in terms of participants ‘intention to use’ the technology in academic settings.

The study found that all participants enjoyed the VR experience, with 79% strongly agreeing and 21% agreeing.

The study found that 95% of participants found the software easy to use: 24% strongly agreed, 53% agreed, and 18% somewhat agreed (Figure 1i). A paired‐sample t‐test showed that participants' Intention to Use VR (M = 6.42, SD = 0.68) was significantly higher than their perceived Ease of Use (M = 5.95, SD = 0.80), t(37) = −3.67, p = 0.0008. This suggests that students remained motivated to use the technology despite very minor usability challenges. Cohen's d of 0.59 reflects a moderate to large effect size, suggesting that there is also practical significance as well as statistical significance. Similarly, 95% felt immersed in the VR experience: 26% strongly agreed, 61% agreed, and 8% somewhat agreed (Figure 1iii). Moreover, 98% reported they could interact with their environment, manipulating and viewing 3D objects from multiple angles; 61% strongly agreed and 34% agreed (Figure 1v). Importantly, all participants found VR useful where 61% strongly agreed, 37% agreed and 3% somewhat agreed (Figure 1iv). Additionally, all participants believed VR enhanced their understanding of the subject, with 63% strongly agreeing, 32% agreeing and 5% somewhat agreeing. Furthermore, all participants said they would use VR again, with 53% strongly agreeing, 37% agreeing and 11% somewhat agreeing (Figure 1vii). The unanimous perception of VR as being both useful and a tool to enhance understanding highlights its promise for enriching educational experiences. Incorporating VR into the curriculum as a complementary tool could allow students to grasp concepts more thoroughly by providing a more interactive environment compared to traditional approaches.

FIGURE 1.

Engineered features.

The unanimous perception of VR as being both useful and a tool to enhance understanding highlights its promise for enriching educational experiences.

Motion sickness prevalence was assessed by looking at symptoms like headaches, nausea, and vomiting. Eight per cent of participants reported motion sickness where 3% strongly agreed and 5% agreed (Figure 1viii). The standard deviation for motion sickness was 1.5 (Table 1), indicating a wider range of responses compared to other features. Although 8% experienced symptoms, they may deter future VR use, complicating its integration into medical education for some students. A paired‐sample t‐test revealed that participants' Intention to Use VR (M = 6.42, SD = 0.68) was significantly higher than their reported Motion Sickness (M = 2.29, SD = 1.54), t(37) = −14.01, p < 0.001. Cohen's d = −2.27 indicates a very large effect, meaning that the difference between the two ratings is substantial. This suggests that despite minor symptoms reported by a small number of students, overall willingness to use VR remained high, and the difference is very large in magnitude. However, further research is required.

Overall, VR was highly rated for feasibility and acceptability. All participants reported enjoying the VR experience and expressed interest in using this approach again. Participants found the experience ‘very interesting’ and agreed that the technology supported their learning intentions. Cybersickness was reported by only 8% of participants, suggesting a low risk for most users.

Cybersickness was reported by only 8% of participants, suggesting a low risk for most users.

This study aligns with previous research highlighting high VR acceptance in education, with enjoyment being the most highly rated aspect [11, 19, 20]. The mean score of 6.79 (strongly agree) indicates that enjoyment is crucial for VR adoption. This suggests that enjoyment may positively influence attitudes towards VR use, as indicated in previous studies [11].

The study also provides new insights into cybersickness, showing lower prevalence than other research [21]. Cybersickness was assessed through participants' perceptions of common symptoms. Previous studies have linked physiological factors, such as heart rate and blood pressure, to VR‐induced cybersickness. The simulated environment may influence symptoms, with research indicating less cybersickness in pleasant environments [22]. The lower cybersickness rates in our study could be due to the software used.

One of the study's strengths was its high‐quality VR experience, delivered via the 3D Organon software and Oculus Meta Quest 2 headset. The 360° immersion and 20‐pixel‐per‐degree display resolution ensured an optimal experience, enhancing result reliability. The study also had a high response rate (100%), reducing non‐response bias. The 41‐question survey, based on validated instruments, was streamlined using data engineering principles to create 8 features, ensuring clearer communication of insights. While reducing dimensionality could obscure some details, the underlying features shared similar themes and scores, mitigating this issue.

As with any research, this study has limitations. Convenience sampling may have introduced bias, as participants were recruited through a social media group, potentially attracting those with more interest in VR. Additionally, the study did not control for the ‘novelty effect’, which may have temporarily heightened enthusiasm. This could affect long‐term perceptions of VR use. Another limitation was the subjective measurement of cybersickness, which could be improved by using objective measures like heart rate or blood pressure. Although the sample size was limited due to the pilot nature of the study, the findings provide valuable preliminary insights and lay the groundwork for future research with larger and more diverse populations.

This study suggests that medical students have positive attitudes and high acceptance of VR in their training, indicating its potential to enhance learning for future healthcare professionals. The current anatomy teaching methods involve lectures and practical sessions with human bodies in anatomy labs. The high enjoyment and perceived usefulness reported by students support the use of VR in anatomy teaching and learning in undergraduate medicine. However, further research is needed to investigate preferences for VR delivery methods, its impact on academic performance and cost–benefit analysis. Future investigations should also aim for comparative effectiveness studies, evaluating not only acceptability but also learning outcomes, such as exam scores and learning time, when this VR approach is compared directly with, or used to supplement, traditional anatomy teaching [23]. A recent review of 24 VR studies in anatomy education found positive knowledge gains in 20 of the studies; however, it concluded more research was also needed in this area [24].

4. Implications

In conclusion, this study highlights the effectiveness of VR as a tool for teaching and learning anatomy to medical students, addressing the growing need for innovative and engaging educational methods in medical training. The overwhelmingly positive feedback from participants underscores the potential of VR to enhance the learning experience by providing a more immersive and interactive approach compared to traditional methods. The study found VR to be both acceptable and feasible for use in medical education, which has important implications for the future of healthcare training.

The significance of this study lies in its ability to demonstrate how new technologies, such as VR, can help prepare future healthcare professionals more effectively, ultimately contributing to improved patient care. VR technology has the potential to do this without the financial, ethical and supervisory constraints associated with the traditional anatomy teaching model; it can offer a cost‐effective, safe alternative unrestricted by supply or the need for expert staff.

Moreover, although the study shows that VR can improve the learning experience, further research should explore the long‐term effects of VR on knowledge retention and clinical skills, and research should also aim for comparative effectiveness studies, evaluating not only acceptability but also learning outcomes, such as exam scores and learning time, when this VR approach is compared directly with or used to supplement traditional anatomy teaching. The potential applications of VR in other areas of medical education, beyond anatomy, also warrant further investigation. As previous studies have demonstrated, VR and other technologies have been linked to positive knowledge gains in anatomy teaching [4, 24], supporting the idea that VR could play a significant role in transforming the educational landscape.

For national and international educationalists, the results of this study offer a compelling argument for the adoption of VR technologies in medical schools worldwide. Expanding the use of VR in medical training could revolutionise the way complex subjects are taught, making learning more engaging, effective and accessible. Educational institutions should explore the feasibility of implementing VR in various courses while also considering potential barriers such as the cost of VR systems, the availability of content and the need for adequate training for both instructors and students.

Furthermore, institutions may consider the integration of VR into medical education. VR is designed to complement, rather than replace, traditional teaching methods, with the aim of enhancing both teaching and learning outcomes. At present, there is no intention for the exclusive use of this technology in anatomy education. Successful implementation will require an initial investment in headsets and software, as well as comprehensive training for educators. The operation of the VR technology necessitates only an open space, and once users are familiar with the system, they are able to engage with it independently, facilitating both self‐directed and instructor‐led learning. Moreover, the study highlights the importance of monitoring and addressing potential issues such as cybersickness. Although only a small percentage of participants reported symptoms of motion sickness, it remains an important consideration for the widespread adoption of VR. Educationalists should consider integrating solutions to mitigate cybersickness, such as improving VR hardware and adjusting the virtual environment to reduce discomfort.

VR is designed to complement, rather than replace, traditional teaching methods, with the aim of enhancing both teaching and learning outcomes.

Future work could involve investigating optimal integration by exploring how best to blend VR with traditional methods, for example, by timing specific VR activities to complement dissection. In addition, longitudinal studies would contribute to the field by tracking knowledge retention and application of anatomical knowledge in clinical settings.

VR has the potential to significantly enhance medical education by providing an engaging, effective and ethical alternative to traditional teaching methods. As this technology becomes more accessible and refined, it may play an increasingly important role in shaping the future of healthcare training.

Author Contributions

Aifric Walsh: investigation, writing – original draft, writing – review and editing, project administration, data curation, methodology, conceptualisation. Rory O'Brien: conceptualisation, methodology, writing – review and editing, supervision. Kevin McGuire: conceptualisation, methodology, writing – review and editing, software, formal analysis, project administration, resources. David Power: conceptualisation, investigation, writing – original draft, methodology, validation, visualisation, writing – review and editing, software, formal analysis, project administration, data curation, supervision.

Ethics Statement

Ethics approval was granted from the School of Medicine Ethics Committee, University College Cork, Ireland.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Figure S2: All measured features.

Table S2: Engineered features and component features with mean and standard deviation (SD).