Stereoscopic three-dimensional visualisation technology in anatomy learning: A meta-analysis

Katerina Bogomolova*, Beerend P. Hierck, Agnes E.M. Looijen, Johanne N.M. Pilon, Hein Putter, Bruce Wainman, Steven E.R. Hovius, Jos A. van der Hage

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Scopus)
13 Downloads (Pure)


Objectives: The features that contribute to the apparent effectiveness of three-dimensional visualisation technology [3DVT] in teaching anatomy are largely unknown. The aim of this study was to conduct a systematic review and meta-analysis of the role of stereopsis in learning anatomy with 3DVT. Methods: The review was conducted and reported according to PRISMA Standards. Literature search of English articles was performed using EMBASE, MEDLINE, CINAHL EBSCOhost, ERIC EBSCOhost, Cochrane CENTRAL, Web of Science and Google Scholar databases until November 2019. Study selection, data extraction and study appraisal were performed independently by two authors. Articles were assessed for methodological quality using the Medical Education Research Study Quality Instrument and the Cochrane Collaboration's tool for assessing the risk of bias. For quantitative analysis, studies were grouped based on relative between-intervention differences in instructional methods and type of control conditions. Results: A total of 3934 citations were obtained of which 67 underwent a full-text review. Ultimately, 13 randomised controlled trials were included in the meta-analysis. When interactive, stereoscopic 3D models were compared to interactive, monoscopic 3D models within a single level of instructional design, for example isolating stereopsis as the only true manipulated element in the experimental design, an effect size [ES] of 0.53 (95% confidence interval [CI] 0.26-0.80; P <.00001) was found. In comparison with 2D images within multiple levels of instructional design, an effect size of 0.45 (95% CI 0.10-0.81; P <.002) was found. Stereopsis had no effect on learning when utilised with non-interactive 3D images (ES = −0.87, 95% CI −2.09-0.35; P =.16). Conclusion: Stereopsis is an important distinguishing element of 3DVT that has a significant positive effect on acquisition of anatomical knowledge when utilised within an interactive 3D environment. A distinction between stereoscopic and monoscopic 3DVT is essential to make in anatomical education and research.

Original languageEnglish
Pages (from-to)317-327
Number of pages11
JournalMedical Education
Issue number3
Early online date13 Aug 2020
Publication statusPublished - Mar 2021

Bibliographical note

Funding Information:
The authors wish to thank Maarten F M Engel, Sabrina Gunput and Wichor Bramer from the Erasmus MC Medical Library for developing and updating the search strategies.

Publisher Copyright:
© 2020 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd


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