OBJECTIVE: Immersive virtual reality (IVR) technology is transforming medical education. Our aim was to compare the effectiveness of IVR with cadaveric bone models in teaching skeletal anatomy. DESIGN: A randomized crossover noninferiority trial was conducted. SETTING: Anatomy laboratory of a large medical school. PARTICIPANTS: Incoming first-year medical students. Participants were randomized to IVR or cadaveric groups studying upper limb skeletal anatomy, and then were crossed over to use the opposite tool, to study lower limb skeletal anatomy. Participants in both groups completed a pre-and postintervention knowledge test. The primary endpoint of the study was change in performance from the pre-to postintervention knowledge test. Surveys were completed to assess participant's impressions on IVR as an educational tool. RESULTS: Fifty first-year medical students met inclusion criteria and were randomized. Among all students, the average score on the preintervention knowledge test was 14.6% (standard deviation (SD) = 18.2%) and 25.0% (SD = 17%) for upper and lower limbs, respectively. Percentage increase in scores between pre-and postintervention knowledge test, was 15.0% in the upper limb IVR group, and 16.7% for upper limb cadaveric bones (p = 0.286). For the lower limb, score increase was 22.6% in the IVR and 22.5% in the cadaveric bone group (p = 0.936). 79% of participants found that IVR was most valuable for teaching 3-dimensional orientation, anatomical relationships, and key landmarks. Majority of participants were favorable towards combination use of traditional methods and IVR technology for learning skeletal anatomy (LSM>3). CONCLUSIONS: In this randomized controlled trial, there was no significant difference in knowledge after using IVR or cadaveric bones for skeletal anatomy education. These findings have further implications for medical schools that face challenges in acquiring human cadavers and cadaveric parts.

David Geffen School of Medicine University of California Los Angeles Los Angeles California

Division of Anatomy University of Toronto Ontario Canada; Department of Anatomy 3rd Faculty of Medicine Charles University Prague Czechia

Institute of Biomedical Engineering Toronto Ontario Canada

Institute of Biomedical Engineering Toronto Ontario Canada; Division of Orthopaedic Surgery University of Toronto Ontario Canada

Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada

Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada; Division of Anatomy University of Toronto Ontario Canada

Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada; Division of Orthopaedic Surgery University of Toronto Ontario Canada; Department of Orthopaedic Surgery Mount Sinai Hospital Toronto Ontario Canada

Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada; Institute of Biomedical Engineering Toronto Ontario Canada

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