HoloAnatomy: A virtual view of the human body
The TCU School of Medicine is using holograms to study anatomy
The classroom is empty as the 20 first-year students file in, dropping their backpacks at the door.
They scatter throughout the room and wait for instruction.
Blue tape divides the gray patterned carpet into 10 squares; each about eight feet across. There's a large paper QR code in the middle of each square.
In this anatomy lab, students will wear a headset instead of gloves.
They pair off and stand within a square.
Gasps erupt throughout the room as they pull the goggles over their eyes: A life-sized holographic skeleton hovers over the floor.
Some students move their heads in circles, testing the technology; others reach out to try to touch the projection.
A student lies on the ground, questioning if what he is seeing is real.
Virtual anatomy learning
This is how the TCU School of Medicine teaches anatomy. The college uses HoloAnatomy software in addition to dissection labs to teach its students anatomy structures by way of interactive holograms. The school is one of the first medical institutions to use augmented reality and is witnessing firsthand how the technology transforms the classroom.
Since its establishment in 2019, the medical school has focused on "inspiring the physicians of tomorrow." Through innovative instruction techniques, the first classes of medical students are learning by doing.
HoloAnatomy software was implemented at TCU in 2020 and plays an integral part in the school's interactive curriculum. The school serves as a test subject for the effectiveness of the system.
Microsoft HoloLens is a mixed reality headset developed by Microsoft and initially released in March 2016. The "smart glasses," including the succeeding HoloLens 2, work under the Windows 10 operating system.
Mixed reality technology interacts with surrounding walls, people and objects to allow users to experience the real and virtual world simultaneously. HoloLens headsets contain environment sensors and an inertial measurement unit to accomplish a mixed reality perspective. Additionally, the glasses use gaze, gestures and voice inputs that allow users to interact with virtual elements.
The HoloAnatomy Software Suite was developed by Case Western Reserve University and began testing in 2016. The university created the HoloLens technology while building a new campus, and saw an opportunity to supplement their cadaver lab. The software was developed through 2019 as the university tested the incorporation of their anatomy curriculum with the technology.
In a Microsoft Customer Story, Mark Griswold, a professor at Case Western in the radiology department, said many professors were skeptical at the introduction of the software.
"'We got some of the first HoloLenses available,' says Dr. Griswold, 'and we sent an email out to anatomists to see if they wanted to check this out. We received many messages back that just said ‘no’ because they didn’t think it was possible.'"
Many professors came to support the system after initial testing proved to be successful. One of the most demanding tests was during the onset of COVID-19 in 2020.
When Case Western shifted classes online, the university shipped 97 HoloLens headsets to each of its anatomy students in order to hold a remote mixed reality class.
While at home, students could navigate the software and learn as though they were in the classroom.
A student trial from Case Western showed the HoloAnatomy software improved test scores and classroom performance. Students using HoloAnatomy improved by 50% on retention tests.
The scientific community has recognized the technology with top awards, including a victory in the “Virtual Reality and Augmented Reality” category at the Jackson Hole Science Media Awards in 2016.
TCU: Learning the software
The TCU School of Medicine received HoloLens headsets during the onset of the COVID-19 pandemic and had to store them for a year until students were back in the classroom.
At the return of in-person classes, Jonathan Babirak, a mixed reality specialist at the medical school, worked with professors to create "glorified PowerPoints" using HoloAnatomy.
Professors went through basic training provided by Case Western but had to adapt the software to meet their instruction goals.
Prasanna Abeyrathna, an assistant professor at the TCU School of Medicine, explained anatomy professors are often resistant to making their lessons virtual.
"There are certain times that cadaver works better, and there are certain times when virtual works better, or augmented reality works better, so I think if you go past that preconception, you can do a better job at teaching," said Abeyrathna.
Between 10 and 15 faculty members at the school have now been trained to use the software.
The virtual classroom
The HoloAnatomy application is cloud-based, so PowerPoint slides are sent to the server and accessed by headsets, then projected using QR codes on the ground.
Within the classroom are 11 "pods," or squares, each with an assigned QR code. Two students stand within each pod, wearing corresponding headsets.
Though each QR code projects its own set of holograms, they all link back to the instructor.
Anything seen on the faculty member's headset is viewed by the class. Students examine each set of slides and holograms as the instructor moves through the lesson.
The hologram
The main hologram in each pod is suspended about three feet above the floor. The projection shifts based on what the instructor sees.
When the headsets are a few inches from the projection, bones, organs and other systems peel back in order for students to observe the interior makeup of structures.
Holograms are color-coded based on the focus of the lesson. Isabella Amado, a first-year medical student at the TCU School of Medicine, explained the effectiveness of this tool.
"In the cadaver lab, where everything is the same color, it’s hard to visualize, so I think that this is a good way to see everything," said Amado. "Honestly my favorite part was how many different structures you can see and how selective you can be."
PowerPoint slides project at the edge of the pod to correspond with each hologram. Slides display supporting information and cadaveric images.
Using a zoom circle tool, the instructor can select an area of the structure to be projected on a larger, adjustable scale.
Kevin Chao, a first-year medical student at TCU, emphasized the aspects of HoloAnatomy that differ from traditional anatomy lessons.
"Being able to see things 3D instead of 2D is really helpful in anatomy. Being able to zoom in and out, being able to look around the body with a 360 view, it’s totally different," said Chao.
An innovative curriculum
The TCU School of Medicine integrates HoloAnatomy software into its unconventional curriculum.
Each week, students learn about structures that make up a specific area of the body. The HoloAnatomy lab takes place at the beginning of the week, introducing students to the anatomy that they will be focusing on during the week's "bootcamp."
Students later attend a cadaver lab, where they examine physical examples of structures. Some weeks, instruction only includes a HoloLens lab. Other times, virtual and cadaver labs take place on the same day.
Our 2nd-year medical students are seeing human anatomy from a whole new perspective using the @Microsoft @HoloLens.https://t.co/3AAu5q8IjM@TCU @UNTHSC #FWMDSchool #EmpatheticScholars pic.twitter.com/5PC93bIiVc
— TCU and UNTHSC School of Medicine (@fwmdschool) April 14, 2021
HoloAnatomy often saves time by way of clean and interactive models. Students can work with structures that get damaged by cadaveric dissecting.
Additionally, professors can simplify models to create a base for understanding. This foundation is accelerating students toward greater success in the classroom.
As one of the first schools to use HoloAnatomy, the TCU School of Medicine is leading a movement of virtual anatomy and improving holographic software for future institutions.