Augmented Reality in anatomy education and training

Traditional vs. modern medical education and training strategy
Why are AR programs useful for students and teachers?
AR-based programs for anatomical studies
Future prospects
References
Read further


Augmented reality (AR) is a relatively new technology that has received a lot of attention in medical education and training. This technology is based on the integration of digitally generated three-dimensional (3D) representations with real environmental stimuli.1 By offering more realistic experiences and remote learning opportunities, AR has gained significant popularity among medical students.

This article focuses on how AR use has aided in medical education and training. AR is defined as ‘an interactive virtual layer on top of reality’.1 Advances in smartphone technology and tablet devices have increased the usefulness and accessibility of AR-based programs.

Traditional vs. modern medical education and training strategy

Learning about human anatomy is an important part of medical training. Traditionally, human anatomy has been taught using preserved specimens, anatomical models, lectures, cadaver dissections, two-dimensional (2D) image representations (e.g., tomographic scans and textbook illustrations), and living patients.2

Image credits: Anatomy Educatio/Shutterstock.com

Image credits: Anatomy Educatio/Shutterstock.com

The recent rise of computational technologies, such as virtual reality (VR) technology and AR, have replaced several traditional teaching methods.3 In the 1990s, basic computer-aided anatomy programs were developed and implemented in educational institutions. Continued advances in software and hardware and the advent of computer-based stereoscopy have paved the way for the future development of virtual reality (VR) and AR.4

In the field of medicine, several AR-based programs have been designed and divided into two subgroups, namely treatment programs and training programs. The treatment programs assist patients and practitioners within a clinical or hospital setting, such as surgical procedures, therapies and rehabilitation. The training program is specifically designed for medical education and training in academic settings. To run an AR application, tablets or smartphones, as well as AR glasses, are required.5

Why are AR programs useful for students and teachers?

AR programs are increasingly used in medical education and training due to their flexibility in integrating physical and virtual environments. The improvement of reality in education is achieved through auditory, haptic (touch) and even olfactory information and feedback.6 Importantly, a partial extension of the real environment allows exposure levels to be controlled, which helps shape the learning experience.1

Instead of the traditional use of silicone or physical models, teachers are encouraging students to download AR applications on their smartphones/tablets or use websites to study human anatomy.7 In addition to the educational institutions’ own AR programs, there are also many free AR applications available online, such as visiblebody.com.8

Using this technology, a student can visualize various anatomical structures online. As the teacher describes the model and its features, students can point the camera marker at a specific spot to enlarge the image and better understand the anatomical structures described in the lecture. A parse button is also available to remove layers and view underlying anatomical features. The Undo command allows the student to undo the changes and explore the topic further.

Image credits: Roman Zaiets/Shutterstock.com

Image credits: Roman Zaiets/Shutterstock.com

Using AR-based medical applications, a medical student can be exposed to actual stressful conditions without the risk of improper patient treatment.1 Other advantages of using AR simulators include low cost per use, absence of ethical concerns, and safe learning practice compared to training on live patients. AR platforms improve users’ skills in dealing with diverse, complex situations.9 They offer teletext monitoring of laparoscopic surgical training. The supervisor can train a student by indicating the correct surgical movements, paths and actions via the AR screens.10

AR-based programs for anatomical studies

The vast availability of online databases of human images obtained via computed tomography and magnetic resonance imaging (CT/MRI) scanning techniques has greatly stimulated the development of AI programs for studying human anatomy.11 The Visible Human Project was developed by the University of Colorado in 1991 and could serve as a basis for AR programs.

The Visible Human Project offered more than 7,000 digital anatomical images that could be accessed for free.12 Other databases that offer digital images of human bodies Are Visible Korean human, the virtual human embryo, the virtual body and the visible human server.

Smartphone/tablet-based AR applications provide extensive information about human anatomy, along with 3D visual structures. Often these images are linked to traditional pages of anatomy books. Recent hardware improvements, such as Microsoft’s development of the Hololens glasses, have improved the application of these programs.13 AR-based applications enable 3D exploration of the human brain with interactive capabilities. These applications are developed based on MRI data.

LapMentor is used to teach the basic skills of laparoscopic techniques in advanced laparoscopic operations. This application is equipped with a rating system that provides statistics to the user. In addition to standard laparoscopic homicides, LapMentor is also used to train students for laparoscopic cholecystectomy, gastric bypass, ventral hernia and gynecological cases.14

LapSim is another AR simulator used for anastomosis, suture, and laparoscopic cholecystectomy scenarios. This simulator can transfer functions between instructors and institutions. AR simulators are also popularly used in neurosurgery training. These simulators are affordable, extremely realistic, and represent detailed neurosurgical structures.15

ImmersiveTouch is used for training in multiple disciplines, including neurosurgery, ophthalmology, spine surgery and ENT surgery. NeuroTouch Cranio is another AR simulator for brain tumor resection. Anatomical simulator for pediatric neurosurgery, RoboSim and ANGIO Mentor are commonly used AR simulators in medical training.

Future prospects

It is imperative to validate the credibility of AR simulators using diverse and large cohorts. To date, no standard design is available for all simulators. More studies need to be conducted to manage the affordability of the simulators so that they can be implemented in more medical training facilities.

Future improvements should focus on integrating olfactory stimuli within the existing platforms. Scents can be used as a diagnostic tool or to create stressful conditions to create the operating room with greater reality. There is a need to improve the resolution and processing power of existing programs. Better design of clinical scenarios with greater realism is also required. More advanced haptic devices are also essential for training purposes.

Greater compatibility of AR programs across devices is needed to expand their use. It has been observed that the image resolution of the same AR program is different on different devices. Reducing the cost of hardware and software would improve the affordability of AR, increasing its usability at different levels of education.

References

  1. Dhar P, Rocks T, Samarasinghe RM, Stephenson G, Smith C. Augmented reality in medical education: student experiences and learning outcomes. Medical education online. 2021;26(1):1953953.
  2. Chen S. et al. Can virtual reality improve traditional anatomy education programs? A mixed-methods investigation into the use of a 3D skull model. BMC Medical education. 2020; 20, 395.
  3. Al-Ansi AM. et al. Analysis of recent developments in augmented reality (AR) and virtual reality (VR) in education. Social Sciences and Humanities Open. 2022; 8(1), 100532.
  4. Khot Z, Quinlan K, Norman GR, Wainman B. The relative effectiveness of computer-based and traditional resources for anatomy education. Anat Sci-Educ. 2013;6(4):211-215.
  5. Wang PH, Wang YJ, Chen YW, Hsu PT, Yang YY. An Augmented Reality (AR) app improves lung function and the potential/feasibility of perioperative rehabilitation in patients undergoing orthopedic surgery. Int J Environ Public Health Research. 2022;20(1):648.
  6. Barsom, EZ, Graafland, M. & Schijven, Member of Parliament Systematic review on the effectiveness of augmented reality applications in medical training. Surg Endosc. 2016; 30, 4174-4183.
  7. Bölek KA, De Jong G, Henssen D. The effectiveness of using augmented reality in anatomy education: a systematic review and meta-analysis. Scientific representative. 2021;11(1):15292.
  8. Aland RC. et al. A plethora of choices: anatomists’ practical perspectives for digital anatomy resource selection. Smart learning. Environment.2023; 10, 66.
  9. Gasteiger N, van der Veer SN, Wilson P, Dowding D. How, for whom and in what contexts or circumstances Augmented and Virtual Reality training works in upskilling healthcare professionals: realistic synthesis. JMIR Serious Games. 2022;10(1):e31644.
  10. Vera AM, Russo M, Mohsin A, Tsuda S. Augmented reality telementoring (ART) platform: a randomized controlled trial to assess the efficacy of a new surgical education technology. Surg Endosc. 2014;28(12):3467-3472.
  11. Zhang Y, Feng H, Zhao Y, Zhang S. Research on the application of artificial intelligence integrated platform 3D Slicer in medical imaging education. Diagnostics (Basel). 2024;14(2):146.
  12. Ackerman MJ. The visible human project. Inf Serv usage. 2022;42(1):129-136. Published on May 10, 2022.
  13. Palumbo A. Microsoft HoloLens 2 in medical and healthcare context: state of the art and future prospects. Sensors (Basel). 2022;22(20):7709.
  14. Andreatta PB, Woodrum DT, Birkmeyer JD, et al. Laparoscopic skills are improved with LapMentor training: results from a randomized, double-blind study. Ann Surg. 2006;243(6):854-863.
  15. Kantamaneni K, Jalla K, Renzu M, et al. Virtual Reality as an Affirmative Spin-off of Laparoscopic Training: An Updated Review. Cureus. 2021;13(8):e17239.

Read further