C-IVAL: A Longitudinal Study of Knowledge Retention and Technology Acceptance in Collaborative Virtual Reality-Based Medical Education

Anatomy education faces challenges in providing engaging, interactive, and collaborative learning experiences, particularly in understanding complex three-dimensional structures and maintaining long-term knowledge retention. Although virtual reality (VR) has shown promise in addressing spatial comprehension challenges, questions remain regarding its effectiveness in supporting collaborative learning and sustained knowledge retention. This longitudinal study examined Collaborative Immersive Virtual Anatomy Laboratory (C-IVAL), an innovative VR platform designed to enhance traditional anatomy learning through integrated collaborative features, immersive technology, and serious game elements. We conducted an experimental study with 65 medical students to evaluate their knowledge acquisition and technology acceptance compared to its non-collaborative predecessor, the Immersive Virtual Anatomy Laboratory (IVAL). Our evaluation framework combined quantitative assessments (knowledge tests, comprising pre-test, immediate post-test, and delayed post-test) with Technology Acceptance Model (TAM) analysis. Knowledge assessment revealed significant cognitive improvements, with mean knowledge scores increasing from 2.48 to 3.94 in the immediate post-tests, while long-term retention of anatomy knowledge showed sustained engagement for over two months. Importantly, C-IVAL demonstrated significantly higher scores across all TAM dimensions than the non-collaborative IVAL system, particularly for perceived usefulness and intention to use. Post-session feedback analysis showed 73.8% positive responses, highlighting enhanced social presence, immersive engagement, and effective collaboration, with 26.2% of constructive feedback focusing on system refinement and feature enhancement. This study contributes to the understanding of the effectiveness of collaborative features in virtual reality education by offering insights into designing and implementing virtual learning environments that enhance both knowledge retention and user acceptance.