Learning facial muscle anatomy using virtual reality simulation: a randomized controlled study among medical students in Iraq

Abstract Background Virtual reality (VR) is increasingly used in medical education, particularly for teaching anatomically complex content. However, evidence comparing learning outcomes with conventional screen-based instruction remains limited. This study examined differences in learning outcomes between an immersive, interactive VR-based learning experience and a smart-screen lesson in facial muscle anatomy. Methods A randomized controlled trial was conducted with 48 second-year medical students at the University of Sumer, Iraq. Participants completed a 15-item multiple-choice test and were randomly assigned to a VR or smart-screen group. Both groups studied identical content during a 15-minute session. Knowledge was assessed before, immediately after, and two weeks later. Presence and enjoyment were also measured. Data were analysed using repeated measures ANOVA, with additional analyses of learning gain and retention. Results Both groups improved after the session. However, the VR condition resulted in significantly higher post-test and follow-up scores. A significant time-by-group interaction indicated different learning trajectories. Additional analyses showed greater learning gains in the VR group, while no significant difference was found in retention. Students in the VR group also reported higher presence and enjoyment. Conclusion Immersive and interactive environments may improve short-term learning of complex anatomy. However, retention patterns were similar across conditions, suggesting that differences are mainly due to initial learning rather than sustained retention.