Transforming Anatomy Education with Mixed Reality: A CurriculumBased Study Using a Holographic Anatomy Software Suite

Introduction: Medical education faces increasing content demands, and digital anatomy atlases have become valuable adjuncts to traditional anatomy courses. However, most available atlases are limited to two-dimensional displays, restricting the interactive, spatial learning that is essential for deep anatomical understanding. In response, we developed and implemented a year-long anatomy course for first-year medical students at Jagiellonian University Medical College that integrated a mixed reality-based holographic anatomy software suite with mixed reality (MR) technology. This curriculum aimed to complement traditional anatomy education by offering interactive 3D holographic representations of anatomical structures, allowing realtime exploration and manipulation in a spatial context. Methods: A series of MR-enhanced anatomy lessons was created in alignment with the existing first-year anatomy curriculum. Sessions were conducted in a dedicated mixed reality laboratory, each led by an anatomy instructor trained in MR equipment and accommodating up to 9 students (with the instructor present as the 10th person). A total of 98 first-year medical students participated in the course. After each session, students were asked to complete a structured survey evaluating their experiences and perceptions of the MR learning environment. Ninety-four students (96% of participants) responded to at least one survey, and complete data from 85 students were included in the final analysis. Results: The vast majority of participants reported positive experiences with the MR- -based curriculum. Students indicated that the MR sessions enhanced their understanding of anatomical structures and spatial relationships. No significant differences in overall satisfaction were observed between student subgroups. For example, when grouped by prior anatomy coursework, 100% of students without prior anatomy experience and 95% of those with prior experience reported that they could identify anatomical structures after the MR sessions. Similarly, 90% vs. 93% of these groups, respectively, noted improved recognition of anatomical spatial relationships. When grouped by prior use of 3D visualization tools, some differences emerged in self-assessed proficiency: students with previous 3D experience reported greater ease in identifying structures (95% vs. 81%, p = 0.03) and understanding anatomical relationships (97% vs. 81%, p = 0.03), compared to those without such experience. In contrast, students without prior 3D experience found certain MR features more useful than did experienced students – for instance, 88% vs. 70% rated the layer toggle function as helpful (p = 0.048). Despite these subgroup variations, there was broad agreement on the value of MR: 71.8% of all respondents preferred a hybrid learning model combining MR with traditional methods, unanimously emphasizing that MR should supplement rather than replace cadaveric dissection. Discussion: Our findings suggest that MR technology is a valuable tool for enhancing anatomy education, particularly by enabling visualization of spatial relationships that are difficult to achieve with textbooks or cadaveric dissection alone. Students appreciated the interactive 3D features of the MR software, which fostered engagement and helped them explore complex anatomical details more intuitively. At the same time, participants recognized the continued importance of hands-on cadaveric labs for tactile learning experiences, indicating that an optimal approach is a hybrid, model integrating MR with traditional anatomy instruction. Notably, this study’s conclusions are drawn from self-reported student data, so any assumptions about long-term learning outcomes must be made cautiously. Future research should evaluate the impact of MR on objective learning measures (such as exam performance and knowledge retention over time) and explore best practices for integrating MR technology into anatomy curricula in diverse educational settings. Conclusions: Mixed reality technology was well-received by first-year medical students and effectively enhanced their spatial understanding of anatomical structures. MR sessions were found to be engaging, intuitive and supportive of traditional cadaveric dissection. Students strongly favored a hybrid learning model, suggesting that MR should supplement - not replace - classical methods in anatomy education.