Introduction:
The internal physiological and anatomical changes in pregnancy are challenging for students to comprehend. Technologies, such as virtual reality (VR), have the potential to aid student visualisation and provide concrete learning experiences. However, the use of such technology in midwifery education is not fully established¹. Therefore, to support student learning, the University of Newcastle, Australia (UoN) has developed the ‘Road to Birth’ (RtB) VR, augmented reality (AR), PC and 3D mobile/tablet application. The RtB app provides a dynamic, immersive internal visualisation of pregnancy anatomy and physiology and fetal and placental positioning in utero. The UoN is engaged in various international collaborative research projects utilising the RtB app². UK participation, with the University of Surrey (UoS), is in two phases and is the subject of this abstract.

Aims:
Phase 1 evaluated the acceptability and usability of the RtB 3D mobile app as an additional learning aid. Phase 2 aims to determine the impact on knowledge, learning motivation and preparation for practice of the combined use of the RtB immersive VR version and the 3D mobile app as complementary learning tools, compared with use of the 3D mobile app only.

Methods:
Phase 1 is an international, cohort, technical feasibility study. N=97 UoN midwifery and medical students and n=81 UoS midwifery students participated. Students download the RtB 3D mobile app from a link to their mobile devices to use at any time. Surveys were used to understand student general technology use and their views of the usability and acceptability of the app as a learning tool. Phase 2 is a mixed methods, longitudinal, feasibility study involving UoS midwifery and paramedic science students (c.150). An intervention and comparator group are proposed to compare the effect of the RtB VR app in tutor-led sessions and also use the RtB 3D mobile app on phones/tablets for ongoing self-learning, compared to use of the 3D mobile app only. Students will engage in tests, surveys, focus groups, and self-reflection to evaluate the impact of the RtB app on knowledge, learning motivation and practice preparation. Additionally, lecturers will be interviewed to evaluate the feasibility of using the RtB app to complement traditional teaching methods.

Results:
Overall, Phase 1 findings indicate students are strongly supportive of the 3D mobile RtB app. 83% reporting the app enhanced their learning, with 90% indicating the app is more engaging than traditional methods, and 93% of finding the app convenient. 87% reported improved understanding of pregnancy anatomy and physiology and 98% indicated increased awareness of fetal positions in utero. In addition, 90% of students found the program easy to use, visually engaging and a fun aid to learning. The second phase has commenced and is scheduled to complete at the end of 2023.

Discussion:
This international project explores engagement with the RtB app and its impact on midwifery and healthcare student learning. The Phase 1 study provides evidence that the RtB 3D mobile app is a feasible, acceptable and usable educational tool. The Phase 2 study will explore the RtB app in VR and 3D modes to understand the effects of this technology on learning and preparation for practice.

Conclusion:
Research to understand the acceptability of the multi-platform RtB and its impact on learning, will aid the development of the app and identify how this technology can be effectively utilised in maternity education.