Metaverse-based virtual reality and spatial learning in cervicofacial anatomy: A curriculum-embedded comparative study in undergraduate medical students.

To compare a metaverse-based interactive virtual reality (VR) session with a conventional 2D online lecture for learning cervicofacial anatomy. Single-center, curriculum-embedded, nonrandomized comparative study. Fourth-year students attended a Zoom lecture (Conventional, n = 73); sixth-year students completed an interactive VR session using Meta Quest 2 on the Spatial platform (VR, n = 40), delivered in small groups. Immediately after teaching, students completed a 12-item test (9 spatial-relational, 3 factual/topographic). Group differences were analyzed with Welch's t-tests. VR students scored higher overall than Conventional students (66.0% ± 18.3% vs. 43.6% ± 18.0%; mean difference 22.4 percentage points, 95% CI 15.3-29.6; p < 0.0001), driven by spatial items (68.6% ± 20.1% vs. 40.6% ± 18.9%; difference 28.0, 95% CI 20.3-35.7; p < 0.0001). Factual/topographic scores were similar (58.3% ± 25.9% vs. 52.5% ± 30.4%; difference 6.9, 95% CI -3.4 to 17.2; p = 0.19). Optional free-text comments suggested high engagement and perceived spatial benefits; barriers included headset ergonomics and occasional motion sickness. Metaverse-based interactive VR was associated with substantially better spatial learning than a conventional online lecture, with comparable factual recall. Given the nonrandomized design and small-group VR delivery, future studies should use size-matched randomized designs with baseline testing and richer qualitative methods to isolate immersion effects and evaluate generalizability to other anatomical regions.