Urs-vito Albrecht*, P.L.R. Institute for Medical Informatics, Hannover Medical School, Hannover, Germany, Hannover, Germany Marianne Behrends, P.L.R. Institute for Medical Informatics, Hannover Medical School, Hannover, Germany, Hannover, Germany Herbert K. Matthies, P.L.R. Institute for Medical Informatics, Hannover Medical School, Hannover, Germany, Hannover, Germany Ute Von Jan, P.L.R. Institute for Medical Informatics, Hannover Medical School, Hannover, Germany, Hannover, Germany Track: Research Presentation Topic: Digital Learning Presentation Type: Oral presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: C-Rotunda Room Date: 2012-09-16 11:00 AM – 11:45 AM Last modified: 2012-09-12 Free Full Paper

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Background:
Augmented reality (AR) has the potential to significantly increase the attractiveness of mobile learning applications by adding a new level of experience for learners and thus improving the learning situation, especially in areas such as forensic medicine where ethical constraints may have to be placed on learning the subject in a real-life scenario.

Objective:
Little is known about the psychological effects this heightened realism has when learners become an integral part of the learning experience, e.g. when using our self-developed mobile Augmented Reality blended learning environment (mARble®) which allows students to practice the recognition of forensic findings by overlaying them on their own bodies, accompanied with additional multimedia content.

Methods:
To evaluate mARble’s usability, its learning effects and possible emotional impact in comparison to traditional textbook-based learning, a randomized, controlled and analyst blinded trial was conducted.
Initially, the emotional status and previous knowledge about the subject matter in the learning module of ten 3rd-year medical students were captured using a validated POMS questionnaire followed by a 10-item single-choice (SC) knowledge test. For the following 30-minute learning period, the students were randomized into two groups using either mARble® or textbook based material respectively. Subsequently, both groups were asked to complete the POMS and AttrakDiff2 questionnaires to assess their learning experience and another SC-test to determine the knowledge gain. The data evaluation was conducted anonymously. Descriptive statistics for the score in total and the subgroups were calculated before and after the intervention. The scores of the mARble® group were tested against those of the textbook group using paired and unpaired signed-rank tests. Additionally, the SC test results were subjected to an item analysis to objectify its difficulty and selectivity.

Results:
With statistical significance (Wilcoxon, Z=-2.232, p<0.032), the improvement is generally higher in the mARble® group (n=6) than in the control group (n=4). The item analysis of the SC-test before the learning period showed a difficulty of p= 0.768 (s= 0.09) and a selectivity of rpb= 0.2.
When comparing pre- and post-tests, the mARble® group showed a statistically significant decrease of fatigue (Z=-2.214, p<0.027) and numbness (Z=-2,07, p<0.038); vigour rose slightly. Irritability did not increase significantly. In the control group, there were no significant changes.
The hedonic quality (identification, stimulation, attractiveness) shows a significant difference between mARble® (m=1.179, CI +/- 0.440) and the book chapter (m= 1.179, CI +/- 0.959); the pragmatic quality mean only differs slightly.

Conclusions:
Regarding learning effectiveness, the mARble® group showed considerably better results than the conservative learning group. There are hints for activating components of the augmented reality concept. Integrating mARble® in regular classes will fascinate the participants and possibly boost interest in the topic for the rest of the class.
While the small sample size reduces the current study’s conclusiveness, its design seems appropriate for determining the effects of interactive elearning material with respect to emotions, learning efficiency, hedonic and pragmatic qualities using a larger group.