Immersive medium for early clinical exposure - knowledge acquisition, spatial orientation and the unexpected role of annotation in 360° VR photos.

Aim: 360° VR photos could be a low-threshold possibility to increase early clinical exposure. Apart from granting insights into local routines and premises, the medium should facilitate knowledge acquisition and spatial orientation depending on its design. This assumption, however, is not yet substantiated empirically. Thus, three hypotheses were tested in consideration of Mayer's modality principle: 1) Providing 360° VR photos as visual reference improves retention and comprehension of information. 2) The annotation of text boxes in 360° VR photos compromises spatial orientation and presence. 3) Annotated audio commentary is superior to annotated text boxes in terms of cognitive load and knowledge acquisition.

Methods: Using head-mounted displays, students of human (N=53) and dental medicine (N=8) completed one of three virtual tours through a surgical unit, which were created with 360° VR photos. In the first two variants, information about the facilities, medical devices and clinical procedures was annotated either as text boxes or audio commentary comprising 67 words on average (SD=6.67). In the third variant, the same information was given separately on a printed handout before the virtual tour. Taking user experience and individual learner characteristics into account, differences between conditions were measured regarding retention, comprehension, spatial orientation, cognitive load, and presence.

Results: Concerning retention and comprehension of information, annotated text boxes outperformed annotated audio commentary and the handout condition. Although annotated audio commentary exhibited the lowest knowledge test scores, students preferred listening over reading. Students with an interest in VR and 360° media reported higher levels of enjoyment and presence. Regarding spatial orientation and presence, no significant group differences were found.

Conclusions: 360° VR photos can convey information and a sense of spatial orientation effectively in the same learning scenario. For students, their use is both enjoyable and instructive. Unexpectedly, the ideal mode of annotation is not dictated by Mayer's modality principle. For information like in this study, annotated text boxes are better for knowledge acquisition than the subjectively preferred audio commentary. This finding is probably contingent on the length and the quality of the annotated text. To identify boundary conditions and to validate the findings, more research is required on the design and educational use of 360° VR photos.