Virtual reality enhances ophthalmic anatomy learning: experimental evidence on comparable outcomes with peer and...

The aim of this study is to evaluate the effectiveness of virtual reality (VR) for learning ophthalmic anatomy and to determine whether peer-assisted facilitation produces learning outcomes comparable to expert-assisted facilitation among preclinical medical students. A secondary objective was to contextualize learning outcomes by comparing performance of preclinical students with that of senior medical students receiving expert-assisted VR instruction.

This is a prospective controlled experimental study with repeated-measures assessments. Second-year (preclinical) medical students without prior formal ophthalmic anatomy instruction were recruited voluntarily (peer-assisted n = 31, expert-assisted n = 32). Exclusion criteria included previous VR-based ophthalmic anatomy training, history of severe motion sickness or vertigo, or refusal to provide consent. In addition, fifth-year medical students undertaking their ophthalmology clerkship participated in a parallel prospective pre-post cohort (n = 61 baseline; n = 55 completed the intervention). All participants first attended a conventional didactic lecture on ophthalmic anatomy. Second-year students then completed an immersive VR learning session exploring a stereoscopic 3D model of the globe and adnexa using a head-mounted display. Sessions were facilitated either by an anatomy faculty expert or by trained peer facilitators. Fifth-year students completed the same instructional sequence with expert-assisted VR only. The primary outcome was change in anatomy knowledge measured by a 20-item assessment administered at baseline (T0), after didactic instruction (T1), and after VR (T2).

Among second-year students, knowledge scores improved significantly across timepoints (repeated-measures ANOVA: F(2,124) = 251.0, p<.001, η²ₚ=0.802). Post-VR scores were comparable between peer-assisted and expert-assisted groups (15.1 ± 3.1 vs. 15.2 ± 3.4; t(61 =-0.12, p=.905, d=-0.03). Simulator sickness scores were low and did not differ between groups (4.2 ± 4.0 vs. 3.7 ± 3.7; p=.649), and satisfaction ratings were high in both conditions. Among fifth-year students, knowledge scores also increased significantly across instructional stages (F(2,106) = 33.4, p<.001, η²ₚ=0.387). Despite higher baseline scores among senior students (t(121)=-3.17, p=.002), post-VR performance was comparable between cohorts (t(115) = 1.11, p=.269).

Peer-assisted facilitation produced learning outcomes comparable to expert-assisted instruction while maintaining high learner satisfaction and minimal simulator sickness. These findings suggest that peer facilitation may represent a scalable approach for implementing VR-based anatomy education.