Presented By: Ethan Snow, South Dakota State University
Co-Authors: Libby Gregg, South Dakota State University
Greg Heiberger, South Dakota State University
Jordan Neises, South Dakota State University

Purpose 
Students' confidence in their knowledge and certainty in their performances are two elements of metacognition that influence the efficacy of teaching and learning. Human anatomy taught via cadaver prosections (CAD) or virtual reality (VR) exemplifies visuospatial learning, but limited information is available about the effects these pedagogies have on student metacognition. The objective of this study is to compare the efficacy of two-point student metacognition (confidence and certainty) from VR and CAD learning experiences. 

Methods 
Twenty-five students were guided through comparable VR then CAD learning experiences (VR-CAD) while another 24 students were guided through the same experiences in reverse order (CAD-VR). The same learning assessment was administered after each learning experience, during which students were prompted to report their level of pre-assessment confidence about the learning objectives and post-response certainty for each assessment item using a 4-level Likert scale (4 = high, 3 = moderately high, 2 = moderately low, and 1 = low). 

Results 
Compared to a collective 1.47 (low) baseline mean confidence level in the learning objectives, mean student confidence after initial VR and CAD learning experiences increased to 3.09 and 3.17 (moderately high) and their corresponding mean certainty levels to the same learning assessment questions were 2.90 and 3.27 (moderately high), respectively. After encountering both experiences, VR-CAD students' mean confidence and certainty increased to 3.50 and 3.52 (high), and CAD-VR students' mean confidence and certainty increased to 3.31 (moderately high) and 3.51 (high), respectively. Select confidence and certainty breakdowns per assessment item and per student will also be presented. 

Conclusions 
CAD-VR students demonstrated higher-level and better-aligned two-point metacognition after the initial CAD experience, while VR-CAD students demonstrated higher-level and better-aligned two-point metacognition after encountering both learning experiences. This study may help educators integrate VR into anatomy curricula, evaluate pedagogical efficacy, and improve metacognition-based teaching and learning.