Assessing the effects of 3D videos and structured peer discussions on anatomy learning: A four-arm randomized controlled trial.

Anatomy is fundamental to safe clinical practice, yet conventional teaching methods may no longer meet learners' needs and often rely on passive learning techniques that are increasingly misaligned with modern learning approaches and fail to provide sufficient spatial clarity. This study tested whether combining 3D visualizations with structured peer discussions produces greater learning gains than either approach alone or lecture-based instruction. First-year students enrolled in the Preparatory Year for Medical College at Damascus University (N = 380; n = 95 per group) were allocated to four different pedagogical configurations: control (standard lecture), standard plus 3D video, standard plus structured peer discussion, and combined (Standard + 3D Video + Discussion). Knowledge was measured using an assessment focused on factual recall and spatial relationships. Group means and subset scores were compared using One-way Analysis of Covariance (ANCOVA) and Linear Mixed-Effects Models (LMM). All supplemental interventions outperformed the control alone. All four teaching methods led to statistically significant gains in knowledge from pre-test to post-test (p < 0.001). The combined intervention (Standard + 3D + Discussion) produced the highest pre- to posttest improvement, representing a 115% gain in raw scores (mean gain = 3.00 ± 0.44, Cohen's d = 6.86), followed by Standard + Discussion (2.10 ± 0.40, d = 5.20), Standard + 3D video (2.10 ± 0.42, d = 4.94), and Standard methods alone (1.50 ± 0.38, d = 3.92). These findings suggest that integrating visual and verbal strategies creates a synergistic effect that significantly enhances anatomical learning. The combined intervention produced the largest advantage on spatial-relationship items, statistically higher than both the 3D-only and discussion-only groups. Pairing 3D visualization with structured peer discussion yields synergistic benefits for anatomy learning, producing larger educational gains than either method alone. Prioritizing blended strategies that couple accessible visual tools with active, social learning offers a practical solution to strengthen foundational medical education.