Rotation of 3D Anatomy Models Is Associated with Underperformance of Students with Low Visual-Spatial Abilities: A Two-Center Randomized Crossover Trial

Virtual 3D models can be an animal-free alternative to cadaveric dissection to learn spatial anatomy. The aim of this study was to investigate if the learning outcome differs when studying 3D models with a 360 degrees rotatable interactive monoscopic 3-dimensional (iM3D) or an interactive monoscopic 2-dimensional (iM2D) visualization, and whether the level of visual-spatial ability (VSA) influences learning outcome. A two-center randomized crossover trial was conducted during the Laboratory Animals Science Course (March 2021-March 2022). Participants studied a 3D rat model using iM3D and iM2D. VSA was assessed by a 24-item mental rotation test and learning outcome by two knowledge tests. Data from 69 out of 111 recruited participants were analyzed using linear regression. Participants with low VSA performed significantly worse compared to participants with medium or high VSA when using iM3D, but equally well when using iM2D. When VSA level was disregarded, participants performed equally well with both visualizations. Rotation in iM3D requires the student to construct a mental 3D image from multiple views. This presumably increases cognitive load, especially for students with low VSA who might become cognitively overloaded. Future research could focus on adapting the visualization technique to students' personal needs and abilities.