Haptic and cognitive trade-offs of virtual reality–supported anatomy education: a retrospective multimethod cohort comparison

Abstract Background Immersive virtual reality (VR) can facilitate three-dimensional anatomy learning but may not reproduce the haptic information, representational variability, and retrieval demands encountered in physical anatomy learning. We examined performance beyond immediate recognition of standardized representations. Methods We integrated data from three routine educational-assessment modules at one medical school, with the comparative analysis framework specified post hoc. Forty first-year students without previous cadaver-dissection experience received pure-VR or cadaver-based instruction in two intact classes (20 per condition). The three focal outcomes, designated post hoc for the integrated analysis, were peak force during a standardized cadaver task, accuracy for noncanonical CT/MRI cases, and the condition-by-time interaction in knowledge scores from 30 min to four weeks. Estimates are reported with 95% confidence intervals (CIs) and effect sizes. Results The pure-VR condition showed greater peak force during transfer to cadaveric tissue (8.74 ± 2.31 vs. 4.52 ± 1.68 N; mean difference [MD], 4.22 N; 95% CI, 2.92–5.52; Cohen’s d = 2.09) and less controlled secondary performance. The standardized-model estimate included no difference (0.91 ± 0.06 vs. 0.87 ± 0.08; p = .082), whereas noncanonical-case accuracy was lower in the pure-VR condition (0.52 ± 0.14 vs. 0.71 ± 0.11; MD, − 0.19; 95% CI, − 0.27 to − 0.11). Immediate scores were compatible with no difference; at four weeks, the pure-VR condition scored lower (11.75 ± 4.63 vs. 17.20 ± 4.05; MD, − 5.45; 95% CI, − 8.24 to − 2.66). The reported condition-by-time interaction was F (2, 76) = 15.38, p < .001, partial η² = 0.29. Conclusions Pure-VR instruction showed no clear deficit in immediate learning or standardized recognition, but was associated with less controlled tissue handling, lower transfer to noncanonical images, and weaker delayed retrieval. Because condition was confounded with intact class, the sample was small, and the modules were analyzed post hoc, the findings are exploratory and noncausal. VR may be most useful within a competency-aligned blended curriculum.