CWRU achieves global first in mixed- reality education during COVID-19 pandemic

Students using Hololens to study

Student survey responses support first remote-only HoloAnatomy course

The developers of Case Western Reserve University’s signature HoloAnatomy mixed-reality software for the Microsoft HoloLens knew they were likely achieving a global first this Spring when they quickly pivoted to the first-ever, all-remote anatomy course when the COVID-19 pandemic kept 185 first-year medical students from coming to campus.

Now, they have data reporting that an overwhelming majority of those students across the U.S. and Canada not only preferred the remote course, but believe they can effectively learn anatomy via the mixed-reality application.

Analysis of a survey of the students was published Sept. 17 in the journal JAMA Network Open, a monthly open access medical journal published by the American Medical Association covering the biomedical sciences.

“This really does have global implications for how education is delivered,” said Interactive Commons’ Faculty Director Mark Griswold, a professor of radiology at the Case Western Reserve University School of Medicine. “It represents the first significant push to deliver this kind of education broadly to a global audience as part of the overall Case Western Reserve strategic plan.”

Results of the post-course survey showed that:

  • 81% of the students who responded said the sessions were equal to or better than in-person instruction.
  • 84% said that they believe future students can “effectively learn human anatomy” via remote mixed-reality application.
  • When given a choice, 58% said that they preferred remote delivery to in-person classes.
  • And only 28 students (16%) reported experiencing technical issues that they had not previously experienced in the in-person class.

Among the 185 students, 177 (96%) responded to the post-instruction survey.

The survey also indicated that the most common advantages reported by students were the ability to study on their own time (51%) and having more physical space to move around the anatomical models (24%).

A quick pivot to remote learning

The remote-learning application of HoloAnatomy began in late March for all first-year students from Case Western Reserve University’s School of Medicine.

The entirely remote, mixed-reality course is believed to be the first of its kind and is considered the latest advance in the educational use of the holographic headset by Case Western Reserve.

“Where most medical schools did not have a remote alternative to cadaver-based dissection for anatomy learning, we did at Case Western Reserve,” said Erin Henninger, executive director of Interactive Commons, the university-wide entity that helps faculty, staff and students use a range of visualization technologies to enhance teaching and research.

“We’ve had an opportunity to imagine what the future of education will look like with devices like HoloLens, and we had always envisioned students using it to connect and collaborate-whether together in class or remotely” Henninger said. “It took a pandemic to realize that future is now, and fortunately we had the infrastructure in place to quickly pivot our software and successfully deploy this enable the largest, shared group experiences in Hololens in the world.”

Pre-pandemic, each student would enter the classroom, put on a HoloLens, and gather in small groups at one of eight pods set throughout the classroom. But on March 11, 2020, Henninger and staff at Interactive Commons began shipping the mixed-reality headsets to all the students to begin the process toward remote-only learning.

Sue Wish-Baratz teaching the HoloAnatomy course from her home in the Spring of 2020.

Then, during twice-a-week classes from late March through May, 185 students from Michigan to Florida to California to Ontario, Canada-each wearing their own Microsoft HoloLens mixed-reality devices loaded with the digital anatomy curriculum HoloAnatomy software-saw the same three-dimensional model “standing” next to them that anatomy professor Susanne Wish-Baratz was describing-and could see hovering above the floor of her home office in Cleveland.

By the end of the semester, groups of more than 90 students were participating in the remote class simultaneously through HoloLens.

A ‘seamless transition’

“To go from in-person to remote learning was remarkable,” Wish-Baratz said. “We really made a seamless transition and the students received the benefit.”

The HoloAnatomy® Software Suite, the first third-party application for the Microsoft HoloLens device, launched in fall 2019. Griswold and other Case Western Reserve colleagues were the first from any university to learn of the HoloLens technology, then still under confidential development at Microsoft.

Initial research has found comparable exam performance between medical students who learned anatomy using traditional methods, such as dissecting cadavers, and those who used HoloAnatomy’s mixed-reality program using Microsoft HoloLens headsets.

The survey results from this first all-remote instruction course adds to that body of research, Henninger said.

“Over the past six years, we’ve worked to establish a technical infrastructure and build a foundation of research to demonstrate that the HoloAnatomy Software Suite® is an effective anatomy learning tool,” Henninger said. “So, when we had to make a quick pivot in early March when it was clear that Covid-19 would become a pandemic, we were more than ready to go remote from a technological and educational standpoint.”

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