Demystifying Ear Anatomy Through a 3D Virtual Simulation Game: An Exploratory Study Among First-Year MBBS Students

Background: Ear anatomy is difficult for first-year medical students to visualise using conventional methods alone, particularly given limited access to temporal bone specimens. Technology-enhanced resources and serious games may help bridge this gap, but evidence from Indian MBBS settings remains scarce. Objectives: To evaluate whether adding a 3D virtual simulation game to a standard lecture improves knowledge, spatial understanding and clinical performance in ear anatomy, and to explore students’ self-perceived learning, satisfaction, cognitive load, usage patterns and qualitative feedback. Methods: In this quasi-experimental study at Bhaarath Medical College & Hospital, 50 first-year MBBS students (2024 batch) were allocated by existing groups to lecture only (Group 1, n = 25) or lecture plus game (Group 2, n = 25). Both groups completed baseline questionnaires, a spatial ability test and a pre-test MCQ on ear anatomy, followed by a 75-minute lecture. The intervention group then underwent a supervised 30–35-minute 3D ear simulation game session. Immediate post-test, retention MCQ (after 1–2 weeks) and OSPE scores were recorded. Self-perception, satisfaction, cognitive load, sense of presence, game usage, technical issues, discomfort and short free-text comments were collected and analysed quantitatively and thematically. Results: Groups were comparable at baseline in demographics, academic performance, technology comfort, gaming habits, prior 3D exposure, spatial ability and attitudes. The lecture-plus-game group showed higher immediate post-test MCQ scores, greater pre–post gain and better retention, with a pronounced advantage in spatial sub-scores and OSPE performance. Students in the intervention arm reported greater understanding and exam confidence, high satisfaction and motivation, and moderate cognitive load. Game use was feasible on commonly available devices, with mostly minor technical issues and mild, infrequent discomfort. Correlation analysis suggested strong links between immediate and retained gains, but only weak associations with baseline spatial ability or raw game time. Qualitative comments highlighted improved 3D visualisation, exam-oriented practice and requests for additional clinical content and usability refinements. Conclusion: A 3D virtual simulation game, used alongside a traditional lecture, appears to enhance knowledge, spatial understanding and clinical performance in ear anatomy while being acceptable and feasible in an Indian undergraduate setting.