Uncontrolled pre–post study finds higher anatomy scores after seven days of 3D augmented reality use

First-year physiotherapy students who used a respiratory anatomy application with three-dimensional augmented reality for seven days had higher multiple-choice knowledge scores at post-test than at pre-test, according to a single-group quasi-experimental study at Srinakharinwirot University in Thailand. The study enrolled 80 students and reported a statistically significant within-group difference (p < 0.001), but it did not establish that the application caused the change because there was no control group.

The application was developed around defined respiratory anatomy learning objectives. It included interactive three-dimensional visualization, layered anatomical structures and real-time augmented-reality manipulation. Content validity was assessed by three subject experts using the Item–Objective Congruence index, with values ranging from 0.90 to 1.00 across the evaluated application components. Two additional experts reviewed the satisfaction and engagement questionnaires, bringing the number of contributors to these evaluation roles to five.

Students used the application for seven days alongside their usual learning activities. Respiratory anatomy knowledge was evaluated before and after this period with multiple-choice tests scored on a 0–10 scale. The tests had undergone expert review for content relevance and alignment between items and learning objectives. Differences between paired pre- and post-test scores were analyzed with the Wilcoxon matched-pairs signed-rank test. Engagement and satisfaction were measured separately through structured Likert questionnaires on a 1–5 range, and descriptive statistics were calculated for the study variables.

Learner-reported engagement averaged 4.08 ± 0.69, while satisfaction averaged 4.14 ± 0.82. The authors described these results as positive engagement and satisfaction ratings, while also emphasizing the study’s limited design. The observed score increase occurred in one cohort over seven days, and all participants received the application in addition to usual learning activities. Consequently, the findings cannot isolate the application’s effect from other instruction or from changes within the group. The researchers called for controlled studies to determine whether the tool is educationally effective and proposed further evaluation of it as a supplementary respiratory anatomy learning resource. The available report describes the study’s methods, results and limitations but does not provide evidence that the application produces learning gains when compared with another approach.

Subject of Research: Evaluation of a 3D augmented reality application for respiratory anatomy education in first-year physiotherapy students

Article Title: Development and evaluation of a 3D augmented reality application for respiratory anatomy education

Article References: Thongchote, K., Chainiramol, P., Tangapinun, P., Sirikulviwath, V., Srichaiwan, S., Sukheebot, N., & Lapmanee, S. (2026). Development and evaluation of a 3D augmented reality application for respiratory anatomy education. BMC Medical Education. https://doi.org/10.1186/s12909-026-10630-y

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10630-y

Keywords: augmented reality, respiratory anatomy, medical education, physiotherapy students, 3D visualization, pre–post study, knowledge assessment, student engagement, Thailand, Development, evaluation, augmented