Exploring spatial understanding and cognitive load using ultrasound in learning cardiac anatomy: A pilot study

Although ultrasound (US) appears to complement traditional anatomy teaching, limited objective data exist on its efficacy. Existing literature often relies on student perceptions rather than performance-based outcomes. Additionally, the role of spatial understanding (SU)-the ability to mentally manipulate and interpret 3D anatomical relationships-and cognitive load (CL)-the mental effort required to learn-remains underexplored in the context of US-based instruction. The study consisted of three parts, with assessments before and after the US session. Prior to the session, students completed two paper-based tests on SU and cardiovascular system (CVS) anatomy. During the session, cardiac anatomy was explored through an introduction to US physics, a practical demonstration, and hands-on practice. Post-session, SU and CVS knowledge were reassessed, and participants completed a CL Scale Questionnaire. Thirty-one students participated in the study. Pre- and post-testing of CVS anatomy knowledge showed a mean increase of 11.33% (p < 0.05), while participants' mean SU scores improved from 65.71% to 81.04% (p < 0.05). The highest student rating on the CL Scale was observed when measuring the germane load, specifically the item assessing perceived learning (8.55 ± 1.31), while the lowest rating was reported for measurement of extraneous load, particularly the item assessing distractions (1.23 ± 1.61). This study provided insightful reports on the efficacy of US on SU and CL in anatomy education, showing its potential to improve learning outcomes and prepare students for clinical practice.