A practical framework for developing a virtual reality-based anatomy education application: key content and technical requirements

This study aimed to identify the technical and content requirements for creating VR-based software designed to teach musculoskeletal anatomy. The identification of technical requirements resulted from a comprehensive library and software review. Moreover, some content requirements were determined by collecting the anatomy course curriculum for the undergraduate degree in paramedical fields. The identified technical and content criteria were distributed among experts in relevant fields in a researcher-made questionnaire format. As a result, we identified 57 technical requirements categorized into eight axes and 23 content requirements categorized into two axes.

The VR-based anatomy teaching software can offer an immersive, interactive, and collaborative learning experience that transforms students’ understanding of anatomical concepts by fulfilling these technical and content requirements. Our strategy for teacher knowledge transfer, particularly in anatomy, offers fresh approaches to evaluating learning objectives and tailoring instruction to the needs of each student, thereby enhancing engagement and comprehension. Combining VR with well-known e-learning platforms that teachers and students are familiar with enhances transparency and streamlines course administration, making academic learning more engaging and successful.

Numerous studies have underscored some valuable technical requirements for these kinds of software. Farajpour et al.²² conducted a study to investigate the creative application of VR as an interactive and immersive approach to anatomy education. This study illustrated that the instructor and the students were using VR headsets simultaneously and experiencing the same virtual environment. They believe VR-based software should enable students to manipulate and study virtual anatomy. This manipulation includes rotating, zooming in and out, and dissecting organs and systems. Also, 3D models of anatomical structures should be accurately generated using information obtained from MRI and CT scans. These results are consistent with ours. In this study, experts have emphasized the significance of students and professors being able to simultaneously be in the virtual environment. Furthermore, they think that in addition to the capability to resize, rotate, and zoom in and out of the model, it is important to take, hold, move, group select, and highlight the model. They also suggest considering models based on 3D scanning of real organs.

Górski et al.’s³⁵ study identified the visualization, human tissue data form, animations, object manipulation and interaction methods, collisions and force feedback, full immersion (HMD), required tracking and force accuracy, required computing power, and participation of specialists/medical doctors as features and requirements necessary for educational VR applications for medicine at different knowledge levels. These results are consistent with ours.

Falah et al.³⁶ developed a VR medical system to enhance the anatomy system process. The system includes a quiz interface with 25 questions designed to evaluate students’ understanding of the anatomical functionalities provided. The questions aimed to evaluate the capacity to accurately recognize the heart’s anatomical components, the anatomical connections between different elements, and a comprehensive comprehension of this vital organ’s organization. Additionally, the user interacts with the VR heart model by choosing various functions from the toolbar. For example, they can rotate, enlarge, mark, or minimize structures, and make them visible or invisible, similar to our results. In our study, a text-based multiple-choice test allows the user to assemble the parts and complete the system, similar to a puzzle.

Pedram et al.’s³⁷ study identified 92 requirement statements across 11 essential areas for VR‑HMD training systems for medical education. This study indicated that freedom of movement is a critical requirement, and the equipment should not restrict the typical range of physical motion needed to complete a task. Moreover, the study of Fairén González et al.³⁸ suggested that a tracking device could be integrated to allow for natural movement and interaction in the virtual environment. Similarly, our study identified the ability to take, hold, and move the model as a critical requirement.

In another study, Fairén et al.³⁹ introduced VR-based software for anatomy teaching. The software features a menu displaying all available anatomical structures for exploration. Users can choose a specific structure to explore, at which point the virtual environment transforms to represent the selected anatomical structure, similar to our results. This software also could support multiple languages (Catalan, Spanish, and English), making it easy to configure additional languages. Bilingual support, which enables smooth transitions between Persian and English, is one of our primary software design needs. This feature guarantees that all textual material and messages are presented in the chosen language and features a bilingual user interface with the ability to switch the language via a menu or settings.

Some studies have identified important content requirements for this software. Fairén González et al., in a study³⁸, selected ten distinct anatomical regions of the human body for students to investigate using VR. The selected anatomical parts included the heart, encephalon, eye, ear, lung, circulatory system, digestive system, reproductive and urinary system, chest, and aneurysm. In another study, Fairén et al.³⁹ developed a VR-based application that represented seven 3D anatomical models, including the heart, eye, ear, circulatory system, digestive system, lungs, and brain. Conversely, our study did not consider the internal organs; only musculoskeletal anatomical parts were included for 3D visualization.

Abundez Toledo et al.⁴⁰ conducted a study investigating the potential application of VR as an innovative tool for learning anatomy. They visualized the skeletal system (head to toe), cardiovascular system (heart, main arteries, and veins), and lymphatic and nervous systems (such as cervical lymph nodes, inguinal lymph nodes, vagus, and sciatic nerves) in their VR-based anatomy teaching system. In contrast, experts in our study deemed the anatomical parts related to the musculoskeletal systems essential for this software.

Limitations

Our study’s limitation is the lack of cooperation from some participants in completing questionnaires. One hundred twenty-four questionnaires were distributed among the experts, of which only 35 cooperated. To address this issue, the researcher provided detailed oral explanations to the participants about the study’s goals, benefits, and significance to persuade them to cooperate. Additionally, the questionnaire was distributed electronically via the Porsline platform to facilitate accurate and efficient data collection.

Implication for practice

The education industry has undergone many changes in recent years. The purpose of VR is that the user enters a virtual world with his/her physical body and senses, and his/her movements in the real world can be seen and understood by others and himself. In this way, his/her hardware is responsible for translating his/her movements, words, and feelings in the virtual world. Every person in VR has a personality or character that can be designed or prepared in advance. We are all familiar with the benefits of virtual education. Reducing time and financial costs, ease of communication, and removal of location restrictions are among the significant benefits that policymakers in the field of education can pay for. However, as we know, this method of education has a fundamental challenge, which is the reduction of sensory and physical communication. The use of VR in education was initially created to solve this problem, but after some time, its other added values ​​were also identified. A VR platform for educational purposes can take many forms to be useful.