First Advisor

Aktunc, Özgür

Department

Counseling and Human Services

Degree

Master of Science in Engineering (MSE)

Date of Award

Winter 2025

Abstract

Understanding complex three-dimensional systems and spatial relationships is a recurring difficulty in healthcare education, where students are often expected to reason about internal structures and multi-system processes from 2D diagrams, textbook figures, and static mannequins. This thesis presents the design, implementation, and mixed-methods evaluation of Systems Simulation, a reusable mixed reality (MR) application intended to help undergraduate nursing students explore human anatomy and pathophysiology using immersive 3D visualization.

Built in C# with the StereoKit framework for Microsoft HoloLens 2, Systems Simulation organizes nine anatomical body systems within a shared application. Learners can select a system, anchor the model in their physical space, move around it, and manipulate the 3D view while observing simple animations such as a beating heart or diaphragm motion. The architecture separates content from interaction logic and provides a repeatable workflow for importing and aligning 3D models, enabling additional systems to be incorporated without redesigning the overall interface.

To examine how this framework functions in practice, the prototype was deployed in an undergraduate Introduction to Pathophysiology course at St. Mary’s University. Thirteen students from the course volunteered to participate; eight completed the full study sequence and were included in the analysis. Each participant completed a paper-based short-answer anatomy test, an MR-based short-answer test targeting the same underlying concepts, a Likert-scale survey about understanding, spatial relationships, engagement, usability, and future applications, and a brief set of reflection questions. Sessions were audio- and video-recorded, and the resulting quantitative and qualitative data were analyzed using a mixed-methods approach.

Across the eight participants with complete data, total accuracy scores were slightly higher in the MR condition: the mean paper-based score was 19.25 out of 24, compared to 20.19 on the MR-based test, with six of the eight students scoring higher in MR and two scoring lower. Likert-scale responses indicated that students found the mixed reality session engaging and helpful for visualizing anatomical structures and spatial relationships, while also revealing some friction with hand tracking and interface controls. Thematic analysis yielded five recurring themes—Spatial Understanding and 3D Relationships, Engagement and Motivation, Perceived Learning and Confidence, Usability and Interaction, and Future Nursing Applications/Feature Improvements—which together describe how students experienced the MR anatomy prototype and how they imagined extending it to real nursing tasks, simulation scenarios, and patient education.

Overall, the results suggest that a reusable mixed reality framework like Systems Simulation can support nursing students’ spatial reasoning, engagement, and perceived learning while highlighting design considerations for making MR a reliable, non-disruptive part of routine study. The thesis concludes by outlining how the same architecture and design principles could be extended to additional healthcare scenarios and future engineering case studies that require understanding of complex three-dimensional systems.

LCSH subject

Medical care -- Education; Medical Technology; Software Engineering; Mixed Reality

Document Type

Thesis

Format

pdf

Medium

manuscript

Proquest Document ID

32443772

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