Stereoscopic three-dimensional visualisation technology in anatomy learning: A meta-analysis

Objectives: The features that contribute to the apparent effectiveness of three-dimensional visualisation technology [3DVT] in teaching anatomy are largely unknown. The aim of this study was to conduct a systematic review and meta-analysis of the role of stereopsis in learning anatomy with 3DVT. Methods: The review was conducted and reported according to PRISMA Standards. Literature search of English articles was performed using EMBASE, MEDLINE, CINAHL EBSCOhost, ERIC EBSCOhost, Cochrane CENTRAL, Web of Science and Google Scholar databases until November 2019. Study selection, data extraction and study appraisal were performed independently by two authors. Articles were assessed for methodological quality using the Medical Education Research Study Quality Instrument and the Cochrane Collaboration's tool for assessing the risk of bias. For quantitative analysis, studies were grouped based on relative between-intervention differences in instructional methods and type of control conditions. Results: A total of 3934 citations were obtained of which 67 underwent a full-text review. Ultimately, 13 randomised controlled trials were included in the meta-analysis. When interactive, stereoscopic 3D models were compared to interactive, monoscopic 3D models within a single level of instructional design, for example isolating stereopsis as the only true manipulated element in the experimental design, an effect size [ES] of 0.53 (95% confidence interval [CI] 0.26-0.80; P <.00001) was found. In comparison with 2D images within multiple levels of instructional design, an effect size of 0.45 (95% CI 0.10-0.81; P <.002) was found. Stereopsis had no effect on learning when utilised with non-interactive 3D images (ES = −0.87, 95% CI −2.09-0.35; P =.16). Conclusion: Stereopsis is an important distinguishing element of 3DVT that has a significant positive effect on acquisition of anatomical knowledge when utilised within an interactive 3D environment. A distinction between stereoscopic and monoscopic 3DVT is essential to make in anatomical education and research

Anatomy: The Relationship Between Internal and External Visualizations

This dissertation explored the relationship between internal and external visualizations and the implications of this relationship for comprehending visuospatial anatomical information. External visualizations comprised different computer representations of anatomical structures, including: static, animated, non-interactive, interactive, non-stereoscopic, and stereoscopic visualizations. Internal visualizations involved examining participants’ ability to apprehend, encode, and manipulate mental representations (i.e., spatial visualization ability or Vz). Comprehension was measured with a novel spatial anatomy task that involved mental manipulation of anatomical structures in three-dimensions and two-dimensional cross-sections. It was hypothesized that performance on the spatial anatomy task would involve a trade-off between internal and external visualizations available to the learner. Results from experiments 1, 2, and 3 demonstrated that in the absence of computer visualizations, spatial visualization ability (Vz) was the main contributor to variation in spatial anatomy task performance. Subjects with high Vz scored higher, spent less time, and were more accurate than those with low Vz. In the presence of external computer visualizations, variation in task performance was attributed to both Vz and visuospatial characteristics of the computer visualization. While static representations improved performance of high- and low-Vz subjects equally, animations particularly benefited high Vz subjects, as their mean score on the SAT was significantly higher than the mean score of low Vz subjects. The addition of interactivity and stereopsis to the displays offered no additional advantages over non-interactive and non-stereoscopic visualizations. Interactive, non-interactive, stereoscopic and non-stereoscopic visualizations improved the performance of high- and low-Vz subjects equally. It was concluded that comprehension of visuospatial anatomical information involved a trade-off between the perception of external visualizations and the ability to maintain and manipulate internal visualizations. There is an inherent belief that increasing the educational effectiveness of computer visualizations is a mere question of making them dynamic, interactive, and/or realistic. However, experiments 1, 2, and 3 clearly demonstrate that this is not the case, and that the benefits of computer visualizations vary according to learner characteristics, particularly spatial visualization ability

Visual Perception and Cognition in Image-Guided Intervention

Surgical image visualization and interaction systems can dramatically affect the efficacy and efficiency of surgical training, planning, and interventions. This is even more profound in the case of minimally-invasive surgery where restricted access to the operative field in conjunction with limited field of view necessitate a visualization medium to provide patient-specific information at any given moment. Unfortunately, little research has been devoted to studying human factors associated with medical image displays and the need for a robust, intuitive visualization and interaction interfaces has remained largely unfulfilled to this day. Failure to engineer efficient medical solutions and design intuitive visualization interfaces is argued to be one of the major barriers to the meaningful transfer of innovative technology to the operating room. This thesis was, therefore, motivated by the need to study various cognitive and perceptual aspects of human factors in surgical image visualization systems, to increase the efficiency and effectiveness of medical interfaces, and ultimately to improve patient outcomes. To this end, we chose four different minimally-invasive interventions in the realm of surgical training, planning, training for planning, and navigation: The first chapter involves the use of stereoendoscopes to reduce morbidity in endoscopic third ventriculostomy. The results of this study suggest that, compared with conventional endoscopes, the detection of the basilar artery on the surface of the third ventricle can be facilitated with the use of stereoendoscopes, increasing the safety of targeting in third ventriculostomy procedures. In the second chapter, a contour enhancement technique is described to improve preoperative planning of arteriovenous malformation interventions. The proposed method, particularly when combined with stereopsis, is shown to increase the speed and accuracy of understanding the spatial relationship between vascular structures. In the third chapter, an augmented-reality system is proposed to facilitate the training of planning brain tumour resection. The results of our user study indicate that the proposed system improves subjects\u27 performance, particularly novices\u27, in formulating the optimal point of entry and surgical path independent of the sensorimotor tasks performed. In the last chapter, the role of fully-immersive simulation environments on the surgeons\u27 non-technical skills to perform vertebroplasty procedure is investigated. Our results suggest that while training surgeons may increase their technical skills, the introduction of crisis scenarios significantly disturbs the performance, emphasizing the need of realistic simulation environments as part of training curriculum

Instruction with 3D Computer Generated Anatomy

Research objectives. 1) To create an original and useful software application; 2) to investigate the utility of dyna-linking for teaching upper limb anatomy. Dyna-linking is an arrangement whereby interaction with one representation automatically drives the behaviour of another representation. Method. An iterative user-centred software development methodology was used to build, test and refine successive prototypes of an upper limb software tutorial. A randomised trial then tested the null hypothesis: There will be no significant difference in learning outcomes between participants using dyna-linked 2D and 3D representations of the upper limb and those using non dyna-linked representations. Data was analysed in SPSS using factorial analysis of variance (ANOVA). Results and analysis. The study failed to reject the null hypothesis as there was no signi cant di fference between experimental conditions. Post-hoc analysis revealed that participants with low prior knowledge performed significantly better (p = 0.036) without dyna-linking (mean gain = 7.45) than with dyna-linking (mean gain = 4.58). Participants with high prior knowledge performed equally well with or without dyna-linking. These findings reveal an aptitude by treatment interaction (ATI) whereby the effectiveness of dyna-linking varies according to learner ability. On average, participants using the non dyna-linked system spent 3 minutes and 4 seconds longer studying the tutorial. Participants using the non dyna-linked system clicked 30% more on the representations. Dyna-linking had a high perceived value in questionnaire surveys (n=48) and a focus group (n=7). Conclusion. Dyna-linking has a high perceived value but may actually over-automate learning by prematurely giving novice learners a fully worked solution. Further research is required to confirm if this finding is repeated in other domains, with different learners and more sophisticated implementations of dyna-linking

Human factors and performance considerations of visual spatial skills in medical context tasks

In the medical field, stereoscopic applications are present in diagnosis, pre-operative planning, minimally invasive surgery, instruction, and training. The use of stereoscopic applications has afforded new ways to interact with patient data, such as immersive virtual environments. This increased usage of stereoscopic applications also raises many basic research questions on human perception and performance. Current studies show mixed results on the benefits of stereoscopic applications with regards to general performance. The benefits depend on the specific task as well as the application domain. The work presented here attempts to answer the general question: How would adding the stereopsis depth cue affect the performance of visual spatial tasks in a medical context? Visual spatial tasks are needed in medicine to understand the relationships between shapes and organs for a variety of activities in patient diagnosis and treatment. The general research question was decomposed into specific hypotheses and three studies were conducted to study them. These studies measured performance of a visual spatial computer task using medical imaging data. Participants assessed the relative positions of three different objects located inside a 3D volumetric representation of a patient\u27s anatomy. The first study consisted of static views and recognition of the position of color objects. The second study consisted of static views using gray objects. The third study consisted of animated views of color objects. In all three studies the task was basically the same: To select which of two objects was closest to a reference object. In all three studies participants were first and second year medical students. Thirty-four participants completed the first study. The results of this study showed some emerging patterns in which the stereoscopic display condition had a positive benefit on performance. The stereoscopic condition had a positive effect on performance for the most difficult cases but did not yield higher results under every case and condition. The second study, completed by 44 participants, showed the stereoscopic condition had a positive benefit on performance in 20 out of the 40 tasks completed. These 40 tasks were divided into four cases, with varying degrees of difficulty, depending on the distances between the objects being judged (i.e. cylinders in this study). At distances between 5-15 mm, the stereoscopic condition yielded statistically significant higher performance. At other distance ranges, while stereopsis showed improvement it was not statistically significant. Thirty-one participants completed the third study. These participants completed a visual spatial task with the addition of an animation to the volume. This allowed the representation to be viewed from multiple angles before the task was completed. Overall the stereoscopic condition had a benefit in performance over the monoscopic condition. As in the previous studies tasks that had the objects between 5 - 15 mm apart had higher performance in the stereoscopic condition. Females performance in the stereoscopic condition was higher and statistically significant than for the monoscopic condition. Participants over 25 years also had a statistically significant higher performance under the stereoscopic condition. It was also observed that the stereoscopic condition did not outperform the monoscopic one in every condition. The results of these studies show that, in general, stereopsis has a positive benefit in performance for visual spatial tasks in medical contexts. This benefit certainly has a relationship with the difficulty of the task as well as age and gender. These initial insights are a step into further work to help generate design guidelines when developing stereoscopic applications

The Role of Spatial Ability in Learning with Virtual Reality: A Literature Review

No research has systematically reviewed the role of spatial ability in virtual reality (VR) learning. This has resulted in inefficiencies in educators’ ability to adopt personalized teaching strategies based on learners’ spatial ability to maximize the effectiveness of VR. Therefore, this study conducted a literature review on spatial ability in VR learning to provide researchers and educators with a comprehensive understanding of how spatial ability affects VR learning. After searching Scopus with keywords and applying inclusion and exclusion criteria, the researchers identified 30 relevant research articles for the review. This literature review mainly analyzed research trends, contexts, theories, methodologies, and findings from the identified articles. The contradictory role of spatial ability in VR learning was also summarized. Based on the literature analysis, this study identified research gaps and indicated directions for future research

The effect of stereoscopic Augmented Reality visualization on learning anatomy and the modifying effect of visual-spatial abilities: a double-center randomized controlled trial

Health and self-regulatio

Exploring individual user differences in the 2D/3D interaction with medical image data

User-centered design is often performed without regard to individual user differences. In this paper, we report results of an empirical study aimed to evaluate whether computer experience and demographic user characteristics would have an effect on the way people interact with the visualized medical data in a 3D virtual environment using 2D and 3D input devices. We analyzed the interaction through performance data, questionnaires and observations. The results suggest that differences in gender, age and game experience have an effect on people’s behavior and task performance, as well as on subjective\ud user preferences