Medical students’ experiences of mixed-reality-based anatomy instruction in a non-cadaveric curriculum: a qualitative case study

Anatomy education requires students to understand complex three-dimensional relationships, yet traditional resources such as textbooks and static images may not fully support spatial learning for all learners, particularly in reduced- or non-cadaveric curricula. Mixed-reality technologies, including the HoloAnatomy application delivered through Microsoft HoloLens 2, have emerged as promising instructional supplements for anatomy education. However, qualitative research examining how students experience these tools within non-cadaveric curricula remains limited. This study explored first-year medical students’ perceptions of HoloAnatomy mixed-reality-based anatomy instruction within a non-cadaveric osteopathic medical curriculum, with attention to perceived benefits, challenges, engagement, spatial understanding, and knowledge recall. We conducted semi-structured interviews with 12 volunteer first-year medical students from an eligible cohort of 160 students at a single osteopathic medical school in California. All participants had completed nine months of required, non-cadaveric anatomy laboratory sessions that integrated faculty-led instruction, Microsoft PowerPoint slide presentations, and HoloAnatomy mixed-reality instruction delivered through Microsoft HoloLens 2. Interviews were audio-recorded, transcribed, de-identified, and returned to participants for verification. Data were analyzed in NVivo using Braun and Clarke’s six-phase framework for thematic analysis. Students perceived the mixed-reality sessions as especially valuable for three-dimensional visualization, spatial orientation, collaborative learning, and review of anatomical structures. However, they also identified important limitations, including technical instability, physical discomfort, limited anatomical realism, and restricted ability to manipulate the models. Overall, students viewed HoloAnatomy delivered through HoloLens 2 as a useful supplement to anatomy learning rather than a replacement for other instructional approaches. The HoloAnatomy mixed-reality experience may enrich anatomy education most effectively when used as a supplementary instructional tool within a multimodal curriculum. Continued refinement of the technology, stronger technical infrastructure, and careful curricular integration may further enhance its perceived educational value in medical anatomy teaching.