Spatial Learning Technologies for Inclusive Anatomy Education: A Systematic Literature Review of Virtual Reality, Augmented Reality, and Neurodiversity

Abstract

Anatomy education requires advanced spatial reasoning and increasingly incorporates technologies such as virtual reality (VR), augmented reality (AR), Anatomage, and 3D printing. Differences in visuospatial processing and executive functioning among learners with attention-deficit/hyperactivity disorder (ADHD) make the relevance of spatial technologies to inclusive education an important area of investigation. Objective. This study synthesizes evidence on the effectiveness of digital spatial anatomy learning modalities and their implications for neurodivergent learners, particularly those with ADHD. Methods. A systematic literature review following PRISMA 2020 was conducted on publications from 2021 to 2026. Studies were identified across multiple databases, selected using the PICOS framework, appraised using the Mixed Methods Appraisal Tool and AMSTAR-2, and synthesized narratively and thematically. Results. Twenty-six studies were grouped into five thematic clusters. Digital 3D modalities were generally comparable or superior to conventional methods in improving factual and spatial knowledge, with effectiveness influenced by learners' initial visuospatial ability. ADHD literature indicates differences in visuospatial processing, while AR and VR may reduce cognitive load and enhance engagement. However, no studies directly examined spatial anatomy technologies among medical students with ADHD. Conclusion. A significant evidence gap exists at the intersection of neurodiversity and spatial anatomy learning, highlighting the need for empirical research to support more inclusive anatomy education.