1
|
Södervik I, Hanski L, Boshuizen HPA, Katajavuori N. Clinical reasoning in pharmacy: What do eye movements and verbal protocols tell us about the processing of a case task? ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:45-65. [PMID: 37273029 PMCID: PMC10240483 DOI: 10.1007/s10459-023-10242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/14/2023] [Indexed: 06/06/2023]
Abstract
This study investigates pharmacy students' reasoning while solving a case task concerning an acute patient counselling situation in a pharmacy. Participants' (N = 34) reasoning processes were investigated with written tasks utilizing eye-tracking in combination with verbal protocols. The case was presented in three pages, each page being followed by written questions. Eye movements were recorded during case processing. Success in the task required differentiating the relevant information from the task redundant information, and initial activation of several scripts and verification of the most likely one, when additional information became available. 2nd (n = 16) and 3rd (n = 18)-year students' and better and worse succeeding students' processes were compared. The results showed that only a few 2nd-year students solved the case correctly, whereas almost all of the 3rd-year students were successful. Generally, the average total processing times of the case material did not differ between the groups. However, better-succeeding and 3rd-year students processed the very first task-relevant sentences longer, indicating that they were able to focus on relevant information. Differences in the written answers to the 2nd and 3rd question were significant, whereas differences regarding the first question were not. Thus, eye-tracking seems to be able to capture illness script activation during case processing, but other methods are needed to depict the script verification process. Based on the results, pedagogical suggestions for advancing pharmacy education are discussed.
Collapse
Affiliation(s)
- Ilona Södervik
- Centre for University Teaching and Learning (HYPE), Faculty of Educational Sciences, University of Helsinki, Siltavuorenpenger 5B, 00170 Helsinki, Finland
| | - Leena Hanski
- Faculty of Pharmacy, University of Helsinki, Biocenter 2, PO Box 56, 00014 Helsinki, Finland
| | - Henny P. A. Boshuizen
- Faculty of Educational Sciences, Open University of the Netherlands, Valkenburgerweg 177, 6419 AT Heerlen, The Netherlands
| | - Nina Katajavuori
- Centre for University Teaching and Learning (HYPE), Faculty of Educational Sciences, University of Helsinki, Viikinkaari 9, 00140 Helsinki, Finland
| |
Collapse
|
2
|
Shafiei SB, Shadpour S, Sasangohar F, Mohler JL, Attwood K, Jing Z. Development of performance and learning rate evaluation models in robot-assisted surgery using electroencephalography and eye-tracking. NPJ SCIENCE OF LEARNING 2024; 9:3. [PMID: 38242909 PMCID: PMC10799032 DOI: 10.1038/s41539-024-00216-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
The existing performance evaluation methods in robot-assisted surgery (RAS) are mainly subjective, costly, and affected by shortcomings such as the inconsistency of results and dependency on the raters' opinions. The aim of this study was to develop models for an objective evaluation of performance and rate of learning RAS skills while practicing surgical simulator tasks. The electroencephalogram (EEG) and eye-tracking data were recorded from 26 subjects while performing Tubes, Suture Sponge, and Dots and Needles tasks. Performance scores were generated by the simulator program. The functional brain networks were extracted using EEG data and coherence analysis. Then these networks, along with community detection analysis, facilitated the extraction of average search information and average temporal flexibility features at 21 Brodmann areas (BA) and four band frequencies. Twelve eye-tracking features were extracted and used to develop linear random intercept models for performance evaluation and multivariate linear regression models for the evaluation of the learning rate. Results showed that subject-wise standardization of features improved the R2 of the models. Average pupil diameter and rate of saccade were associated with performance in the Tubes task (multivariate analysis; p-value = 0.01 and p-value = 0.04, respectively). Entropy of pupil diameter was associated with performance in Dots and Needles task (multivariate analysis; p-value = 0.01). Average temporal flexibility and search information in several BAs and band frequencies were associated with performance and rate of learning. The models may be used to objectify performance and learning rate evaluation in RAS once validated with a broader sample size and tasks.
Collapse
Affiliation(s)
- Somayeh B Shafiei
- Intelligent Cancer Care Laboratory, Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA.
| | - Saeed Shadpour
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Farzan Sasangohar
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, 77843, USA
| | - James L Mohler
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA
| | - Kristopher Attwood
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA
| | - Zhe Jing
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA
| |
Collapse
|
3
|
Koh MY, Tan GJS, Mogali SR. Spatial ability and 3D model colour-coding affect anatomy performance: a cross-sectional and randomized trial. Sci Rep 2023; 13:7879. [PMID: 37188811 DOI: 10.1038/s41598-023-35046-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
Photorealistic 3D models (PR3DM) have great potential to supplement anatomy education; however, there is evidence that realism can increase cognitive load and negatively impact anatomy learning, particularly in students with decreased spatial ability. These differing viewpoints have resulted in difficulty in incorporating PR3DM when designing anatomy courses. To determine the effects of spatial ability on anatomy learning and reported intrinsic cognitive load using a drawing assessment, and of PR3DM versus an Artistic colour-coded 3D model (A3DM) on extraneous cognitive load and learning performance. First-year medical students participated in a cross-sectional (Study 1) and a double-blind randomised control trial (Study 2). Pre-tests analysed participants' knowledge of anatomy of the heart (Study 1, N = 50) and liver (Study 2, N = 46). In Study 1, subjects were first divided equally using a mental rotations test (MRT) into low and high spatial ability groups. Participants memorised a 2D-labeled heart valve diagram and sketched it rotated 180°, before self-reporting their intrinsic cognitive load (ICL). For Study 2, participants studied a liver PR3DM or its corresponding A3DM with texture-homogenisation, followed by a liver anatomy post-test, and reported extraneous cognitive load (ECL). All participants reported no prior anatomy experience. Participants with low spatial ability (N = 25) had significantly lower heart drawing scores (p = 0.001) than those with high spatial ability (N = 25), despite no significant differences in reported ICL (p = 0.110). Males had significantly higher MRT scores than females (p = 0.011). Participants who studied the liver A3DM (N = 22) had significantly higher post-test scores than those who studied the liver PR3DM (N = 24) (p = 0.042), despite no significant differences in reported ECL (p = 0.720). This investigation demonstrated that increased spatial ability and colour-coding of 3D models are associated with improved anatomy performance without significant increase in cognitive load. The findings are important and provide useful insight into the influence of spatial ability and photorealistic and artistic 3D models on anatomy education, and their applicability to instructional and assessment design in anatomy.
Collapse
Affiliation(s)
- Ming Yi Koh
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11, Mandalay Road, Singapore, 308232, Singapore
| | | | - Sreenivasulu Reddy Mogali
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11, Mandalay Road, Singapore, 308232, Singapore.
| |
Collapse
|
4
|
Homfray B, Attwood A, Channon SB. Anatomy in Practice: How Do Equine and Production Animal Veterinarians Apply Anatomy in Primary Care Settings? JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 50:e20220074. [PMID: 36198110 DOI: 10.3138/jvme-2022-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
To successfully prepare veterinary undergraduates for the workplace, it is critical that anatomy educators consider the context in which developing knowledge and skills will be applied. This study aimed to establish how farm animal and equine general practitioners use anatomy and related skills within their daily work. Qualitative ethnographic data in the form of observations and semi-structured interviews were collected from 12 veterinarians working in equine or farm animal first-opinion practice. Data underwent thematic analysis using a grounded theory approach. The five themes identified were relevant to both equine and farm animal veterinarians and represented the breadth and complexity of anatomy, its importance for professional and practical competence, as well as the requirement for continuous learning. The centrality and broad and multifaceted nature of anatomy was found to challenge equine and farm animal veterinarians, highlighting that essential anatomy knowledge and related skills are vital for their professional and practical competence. This aligns with the previously described experiences of companion animal clinicians. In equine practice, the complexity of anatomical knowledge required was particularly high, especially in relation to diagnostic imaging and assessing normal variation. This resulted in greater importance being placed on formal and informal professional development opportunities. For farm animal clinicians, anatomy application in the context of necropsy and euthanasia was particularly noted. Our findings allow anatomy educators to design appropriate and effective learning opportunities to ensure that veterinary graduates are equipped with the skills, knowledge, and resources required to succeed in first-opinion veterinary practice.
Collapse
|
5
|
Harrell KM, McGinn MJ, Edwards CD, Warren Foster K, Meredith MA. Crashing from cadaver to computer: Covid-driven crisis-mode pedagogy spawns active online substitute for teaching gross anatomy. ANATOMICAL SCIENCES EDUCATION 2021; 14:536-551. [PMID: 34236764 DOI: 10.1002/ase.2121] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
In early 2020, the Covid-19 crisis forced medical institutions worldwide to convert quickly to online platforms for content delivery. Although many components of medical education were adaptable to that format, anatomical dissection laboratory lost substantial content in that conversion, including features of active student participation, three-dimensional spatial relationships of structures, and the perception of texture, variation, and scale. The present study aimed to develop and assess online anatomy laboratory sessions that sought to preserve benefits of the dissection experience for first-year medical students. The online teaching package was based on a novel form of active videography that emulates eye movement patterns that occur during processes of visual identification, scene analysis, and learning. Using this video-image library of dissected materials, content was presented through asynchronous narrated laboratory demonstrations and synchronous/active video conference sessions and included a novel, video-based assessment tool. Data were obtained using summative assessments and a final course evaluation. Test scores for the online practical examination were significantly improved over those for previous in-person dissection-based examinations, as evidenced by several measures of performance (Mean: 2015-2019: 82.5%; 2020: 94.9%; P = 0.003). Concurrently, didactic test scores were slightly, but not significantly, improved (Mean: 2015-2019: 88.0%; 2020: 89.9%). Student evaluations of online sessions and overall course were highly positive. Results indicated that this innovative online teaching package can provide an effective alternative when in-person dissection laboratory is unavailable. Although this approach consumed considerable faculty time for video editing, further development will include video conference breakout rooms to emulate dissection small-group teamwork.
Collapse
Affiliation(s)
- Kelly M Harrell
- Department of Anatomy and Neurobiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Melissa J McGinn
- Department of Anatomy and Neurobiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Cherie D Edwards
- Office of Assessment, Evaluation and Scholarship, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Kenneth Warren Foster
- Office of Faculty Affairs, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - M Alex Meredith
- Department of Anatomy and Neurobiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| |
Collapse
|
6
|
Chen IHA, Ghazi A, Sridhar A, Stoyanov D, Slack M, Kelly JD, Collins JW. Evolving robotic surgery training and improving patient safety, with the integration of novel technologies. World J Urol 2021; 39:2883-2893. [PMID: 33156361 PMCID: PMC8405494 DOI: 10.1007/s00345-020-03467-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/21/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Robot-assisted surgery is becoming increasingly adopted by multiple surgical specialties. There is evidence of inherent risks of utilising new technologies that are unfamiliar early in the learning curve. The development of standardised and validated training programmes is crucial to deliver safe introduction. In this review, we aim to evaluate the current evidence and opportunities to integrate novel technologies into modern digitalised robotic training curricula. METHODS A systematic literature review of the current evidence for novel technologies in surgical training was conducted online and relevant publications and information were identified. Evaluation was made on how these technologies could further enable digitalisation of training. RESULTS Overall, the quality of available studies was found to be low with current available evidence consisting largely of expert opinion, consensus statements and small qualitative studies. The review identified that there are several novel technologies already being utilised in robotic surgery training. There is also a trend towards standardised validated robotic training curricula. Currently, the majority of the validated curricula do not incorporate novel technologies and training is delivered with more traditional methods that includes centralisation of training services with wet laboratories that have access to cadavers and dedicated training robots. CONCLUSIONS Improvements to training standards and understanding performance data have good potential to significantly lower complications in patients. Digitalisation automates data collection and brings data together for analysis. Machine learning has potential to develop automated performance feedback for trainees. Digitalised training aims to build on the current gold standards and to further improve the 'continuum of training' by integrating PBP training, 3D-printed models, telementoring, telemetry and machine learning.
Collapse
Affiliation(s)
- I-Hsuan Alan Chen
- Division of Surgery and Interventional Science, Research Department of Targeted Intervention, University College London, London, UK.
- Department of Surgery, Division of Urology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying District, Kaohsiung, 81362, Taiwan.
- Wellcome/ESPRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK.
| | - Ahmed Ghazi
- Department of Urology, Simulation Innovation Laboratory, University of Rochester, New York, USA
| | - Ashwin Sridhar
- Division of Uro-Oncology, University College London Hospital, London, UK
| | - Danail Stoyanov
- Wellcome/ESPRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK
| | | | - John D Kelly
- Division of Surgery and Interventional Science, Research Department of Targeted Intervention, University College London, London, UK
- Wellcome/ESPRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK
- Division of Uro-Oncology, University College London Hospital, London, UK
| | - Justin W Collins
- Division of Surgery and Interventional Science, Research Department of Targeted Intervention, University College London, London, UK.
- Wellcome/ESPRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK.
- Division of Uro-Oncology, University College London Hospital, London, UK.
| |
Collapse
|
7
|
Roach VA, Mi M, Mussell J, Van Nuland SE, Lufler RS, DeVeau K, Dunham SM, Husmann P, Herriott HL, Edwards DN, Doubleday AF, Wilson BM, Wilson AB. Correlating Spatial Ability With Anatomy Assessment Performance: A Meta-Analysis. ANATOMICAL SCIENCES EDUCATION 2021; 14:317-329. [PMID: 33124194 PMCID: PMC9039732 DOI: 10.1002/ase.2029] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/17/2020] [Accepted: 10/23/2020] [Indexed: 05/05/2023]
Abstract
Interest in spatial ability has grown over the past few decades following the emergence of correlational evidence associating spatial aptitude with educational performance in the fields of science, technology, engineering, and mathematics. The research field at large and the anatomy education literature on this topic are mixed. In an attempt to generate consensus, a meta-analysis was performed to objectively summarize the effects of spatial ability on anatomy assessment performance across multiple studies and populations. Relevant studies published within the past 50 years (1969-2019) were retrieved from eight databases. Study eligibility screening was followed by a full-text review and data extraction. Use of the Mental Rotations Test (MRT) was required for study inclusion. Out of 2,450 screened records, 15 studies were meta-analyzed. Seventy-three percent of studies (11 of 15) were from the United States and Canada, and the majority (9 of 15) studied professional students. Across 15 studies and 1,245 participants, spatial ability was weakly associated with anatomy performance (rpooled = 0.240; CI at 95% = 0.09, 0.38; P = 0.002). Performance on spatial and relationship-based assessments (i.e., practical assessments and drawing tasks) was correlated with spatial ability, while performance on assessments utilizing non-spatial multiple-choice items was not correlated with spatial ability. A significant sex difference was also observed, wherein males outperformed females on spatial ability tasks. Given the role of spatial reasoning in learning anatomy, educators are encouraged to consider curriculum delivery modifications and a comprehensive assessment strategy so as not to disadvantage individuals with low spatial ability.
Collapse
Affiliation(s)
- Victoria A. Roach
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Oakland University. Rochester, Michigan
| | - Misa Mi
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Oakland University. Rochester, Michigan
| | - Jason Mussell
- Department of Cell Biology and Anatomy, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Sonya E. Van Nuland
- Department of Cell Biology and Anatomy, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Rebecca S. Lufler
- Department of Medical Education, Tufts University School of Medicine, Boston, Massachusetts
| | - Kathryn DeVeau
- Department of Anatomy and Cell Biology, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Stacey M. Dunham
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Bloomington, Indiana
| | - Polly Husmann
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Bloomington, Indiana
| | - Hannah L. Herriott
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Danielle N. Edwards
- Department of Cell, Developmental and Integrative Biology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alison F. Doubleday
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois
| | - Brittany M. Wilson
- Department of Cell and Molecular Medicine, Rush College of Medicine, Rush University, Chicago, Illinois
| | - Adam B. Wilson
- Department of Cell and Molecular Medicine, Rush College of Medicine, Rush University, Chicago, Illinois
- Correspondence to Dr. Adam B. Wilson, Department of Cell and Molecular Medicine, Rush University, Armour Academic Center, Suite 505A, 600 S. Paulina St., Chicago, IL 60612; telephone: 312-942-5903;
| |
Collapse
|
8
|
Koury HF, Leonard CJ, Carry PM, Lee LMJ. An Expert Derived Feedforward Histology Module Improves Pattern Recognition Efficiency in Novice Students. ANATOMICAL SCIENCES EDUCATION 2019; 12:645-654. [PMID: 30586223 DOI: 10.1002/ase.1854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 06/09/2023]
Abstract
Histology is a visually oriented, foundational anatomical sciences subject in professional health curricula that has seen a dramatic reduction in educational contact hours and an increase in content migration to a digital platform. While the digital migration of histology laboratories has transformed histology education, few studies have shown the impact of this change on visual literacy development, a critical competency in histology. The objective of this study was to assess whether providing a video clip of an expert's gaze while completing leukocyte identification tasks would increase the efficiency and performance of novices completing similar identification tasks. In a randomized study, one group of novices (n = 9) was provided with training materials that included expert eye gaze, while the other group (n = 12) was provided training materials with identical content, but without the expert eye gaze. Eye movement parameters including fixation rate and total scan path distance, and performance measures including time-to-task-completion and accuracy, were collected during an identification task assessment. Compared to the control group, the average fixation duration was 13.2% higher (P < 0.02) and scan path distance was 35.0% shorter in the experimental group (P = 0.14). Analysis of task performance measures revealed no significant difference between the groups. These preliminary results suggest a more efficient search performed by the experimental group, indicating the potential efficacy of training using an expert's gaze to enhance visual literacy development. With further investigation, such feedforward enhanced training methods could be utilized for histology and other visually oriented subjects.
Collapse
Affiliation(s)
- Hannah F Koury
- Master of Science in Modern Human Anatomy Program, University of Colorado, Graduate School, Aurora, Colorado
| | - Carly J Leonard
- Department of Psychology, University of Colorado Denver, Denver, Colorado
| | - Patrick M Carry
- Musculoskeletal Research Center, Department of Orthopedics, Colorado Children's Hospital, Aurora, Colorado
| | - Lisa M J Lee
- Master of Science in Modern Human Anatomy Program, University of Colorado, Graduate School, Aurora, Colorado
- Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, Colorado
| |
Collapse
|
9
|
Roach VA, Fraser GM, Kryklywy JH, Mitchell DGV, Wilson TD. Time limits in testing: An analysis of eye movements and visual attention in spatial problem solving. ANATOMICAL SCIENCES EDUCATION 2017; 10:528-537. [PMID: 28371467 DOI: 10.1002/ase.1695] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 03/13/2017] [Accepted: 03/13/2017] [Indexed: 06/07/2023]
Abstract
Individuals with an aptitude for interpreting spatial information (high mental rotation ability: HMRA) typically master anatomy with more ease, and more quickly, than those with low mental rotation ability (LMRA). This article explores how visual attention differs with time limits on spatial reasoning tests. Participants were assorted to two groups based on their mental rotation ability scores and their eye movements were collected during these tests. Analysis of salience during testing revealed similarities between MRA groups in untimed conditions but significant differences between the groups in the timed one. Question-by-question analyses demonstrate that HMRA individuals were more consistent across the two timing conditions (κ = 0.25), than the LMRA (κ = 0.013). It is clear that the groups respond to time limits differently and their apprehension of images during spatial problem solving differs significantly. Without time restrictions, salience analysis suggests LMRA individuals attended to similar aspects of the images as HMRA and their test scores rose concomitantly. Under timed conditions however, LMRA diverge from HMRA attention patterns, adopting inflexible approaches to visual search and attaining lower test scores. With this in mind, anatomical educators may wish to revisit some evaluations and teaching approaches in their own practice. Although examinations need to evaluate understanding of anatomical relationships, the addition of time limits may induce an unforeseen interaction of spatial reasoning and anatomical knowledge. Anat Sci Educ 10: 528-537. © 2017 American Association of Anatomists.
Collapse
Affiliation(s)
- Victoria A Roach
- Department of Foundational Medical Studies, William Beaumont School of Medicine, Oakland University, Rochester, Michigan
| | - Graham M Fraser
- Cardiovascular Research Group, Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - James H Kryklywy
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Derek G V Mitchell
- Department of Psychiatry, Brain and Mind Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Timothy D Wilson
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
10
|
Sánchez-Ferrer ML, Grima-Murcia MD, Sánchez-Ferrer F, Hernández-Peñalver AI, Fernández-Jover E, Sánchez Del Campo F. Use of Eye Tracking as an Innovative Instructional Method in Surgical Human Anatomy. JOURNAL OF SURGICAL EDUCATION 2017; 74:668-673. [PMID: 28126379 DOI: 10.1016/j.jsurg.2016.12.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/14/2016] [Accepted: 12/26/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Tobii glasses can record corneal infrared light reflection to track pupil position and to map gaze focusing in the video recording. Eye tracking has been proposed for use in training and coaching as a visually guided control interface. The aim of our study was to test the potential use of these glasses in various situations: explanations of anatomical structures on tablet-type electronic devices, explanations of anatomical models and dissected cadavers, and during the prosection thereof. An additional aim of the study was to test the use of the glasses during laparoscopies performed on Thiel-embalmed cadavers (that allows pneumoinsufflation and exact reproduction of the laparoscopic surgical technique). The device was also tried out in actual surgery (both laparoscopy and open surgery). DESIGN We performed a pilot study using the Tobii glasses. SETTING Dissection room at our School of Medicine and in the operating room at our Hospital. PARTICIPANTS To evaluate usefulness, a survey was designed for use among students, instructors, and practicing physicians. RESULTS The results were satisfactory, with the usefulness of this tool supported by more than 80% positive responses to most questions. There was no inconvenience for surgeons and that patient safety was ensured in the real laparoscopy. CONCLUSION To our knowledge, this is the first publication to demonstrate the usefulness of eye tracking in practical instruction of human anatomy, as well as in teaching clinical anatomy and surgical techniques in the dissection and operating rooms.
Collapse
Affiliation(s)
- María Luísa Sánchez-Ferrer
- Department of Obstetrics and Gynecology, "Virgen delaArrixaca" University Clinical Hospital and Institute for Biomedical Research of Murcia, IMIB-Arrixaca, Murcia, Spain.
| | | | - Francisco Sánchez-Ferrer
- Department of Pediatrics, "San Juan" University Clinical Hospital, University Miguel Hernández, Alicante, Spain
| | - Ana Isabel Hernández-Peñalver
- Department of Obstetrics and Gynecology, "Virgen delaArrixaca" University Clinical Hospital and Institute for Biomedical Research of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Eduardo Fernández-Jover
- Department of Histology and Anatomy, Bioengineering Institute, Miguel Hernández University, Alicante, Spain
| | | |
Collapse
|
11
|
Roach VA, Fraser GM, Kryklywy JH, Mitchell DGV, Wilson TD. Different perspectives: Spatial ability influences where individuals look on a timed spatial test. ANATOMICAL SCIENCES EDUCATION 2017; 10:224-234. [PMID: 27706927 DOI: 10.1002/ase.1654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/02/2016] [Accepted: 09/03/2016] [Indexed: 06/06/2023]
Abstract
Learning in anatomy can be both spatially and visually complex. Pedagogical investigations have begun exploration as to how spatial ability may mitigate learning. Emerging hypotheses suggests individuals with higher spatial reasoning may attend to images differently than those who are lacking. To elucidate attentional patterns associated with different spatial ability, eye movements were measured in individuals completing a timed electronic mental rotation test (EMRT). The EMRT was based on the line drawings of Shepherd and Metzler. Individuals deduced whether image pairs were rotations (same) or mirror images (different). It was hypothesized that individuals with high spatial ability (HSA) would demonstrate shorter average fixation durations during problem solving and attend to different features of the EMRT than low spatial ability (LSA) counterparts. Moreover, question response accuracy would be associated with fewer fixations and shorter average response times, regardless of spatial reasoning ability. Average fixation duration in the HSA group was shorter than LSA (F(1,8) = 7.99; P = 0.022). Importantly, HSA and LSA individuals looked to different regions of the EMRT images (Fisher Exact Test: 12.47; P = 0.018); attending to the same locations only 34% of the time. Correctly answered questions were characterized by fewer fixations per question (F(1, 8) = 18.12; P = 0.003) and shorter average response times (F(1, 8) = 23.89; P = 0.001). The results indicate that spatial ability may influence visual attention to salient areas of images and this may be key to problem solving processes for low spatial individuals. Anat Sci Educ 10: 224-234. © 2016 American Association of Anatomists.
Collapse
Affiliation(s)
- Victoria A Roach
- Department of Biomedical Sciences, William Beaumont School of Medicine, Oakland University, Rochester, Michigan
| | - Graham M Fraser
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - James H Kryklywy
- Department of Psychiatry, Brain and Mind Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Derek G V Mitchell
- Department of Psychiatry, Brain and Mind Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Timothy D Wilson
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
12
|
Vilppu H, Mikkilä-Erdmann M, Södervik I, Österholm-Matikainen E. Exploring eye movements of experienced and novice readers of medical texts concerning the cardiovascular system in making a diagnosis. ANATOMICAL SCIENCES EDUCATION 2017; 10:23-33. [PMID: 27233108 DOI: 10.1002/ase.1621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 04/21/2016] [Accepted: 04/25/2016] [Indexed: 06/05/2023]
Abstract
This study used the eye-tracking method to explore how the level of expertise influences reading, and solving, two written patient cases on cardiac failure and pulmonary embolus. Eye-tracking is a fairly commonly used method in medical education research, but it has been primarily applied to studies analyzing the processing of visualizations, such as medical images or patient video cases. Third-year medical students (n = 39) and residents (n = 13) read two patient case texts in an eye-tracking laboratory. The analysis focused on the diagnosis made, the total visit duration per text slide, and eye-movement indicators regarding task-relevant and task-redundant areas of the patient case text. The results showed that almost all participants (48/52) made the correct diagnosis of the first patient case, whereas all the residents, but only 17 students, correctly diagnosed the second case. The residents were efficient patient-case-solvers: they reached the correct diagnoses, and processed the cases faster and with a lower number of fixations than did the students. Further, the students and residents demonstrated different reading patterns with regard to which slides they proportionally paid most attention. The observed differences could be utilized in medical education to model expert reasoning and to teach the manner in which a good medical text is constructed. Eye-tracking methodology appears to have a great deal of potential in evaluating performance and growing diagnostic expertise in reading medical texts. However, further research using medical texts as stimuli is required. Anat Sci Educ 10: 23-33. © 2016 American Association of Anatomists.
Collapse
Affiliation(s)
- Henna Vilppu
- Department of Teacher Education, Faculty of Education, University of Turku, Turku, Finland
- Centre for Learning Research, Faculty of Education, University of Turku, Turku, Finland
| | - Mirjamaija Mikkilä-Erdmann
- Department of Teacher Education, Faculty of Education, University of Turku, Turku, Finland
- Centre for Learning Research, Faculty of Education, University of Turku, Turku, Finland
| | - Ilona Södervik
- Department of Teacher Education, Faculty of Education, University of Turku, Turku, Finland
- Centre for Learning Research, Faculty of Education, University of Turku, Turku, Finland
| | - Erika Österholm-Matikainen
- Medical Education Research and Development Centre (TUTKE), Faculty of Medicine, University of Turku, Turku, Finland
| |
Collapse
|
13
|
Roach VA, Fraser GM, Kryklywy JH, Mitchell DGV, Wilson TD. The eye of the beholder: Can patterns in eye movement reveal aptitudes for spatial reasoning? ANATOMICAL SCIENCES EDUCATION 2016; 9:357-366. [PMID: 26599398 DOI: 10.1002/ase.1583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/02/2015] [Accepted: 10/27/2015] [Indexed: 06/05/2023]
Abstract
Mental rotation ability (MRA) is linked to academic success in the spatially complex Science, Technology, Engineering, Medicine, and Mathematics (STEMM) disciplines, and anatomical sciences. Mental rotation literature suggests that MRA may manifest in the movement of the eyes. Quantification of eye movement data may serve to distinguish MRA across individuals, and serve as a consideration when designing visualizations for instruction. It is hypothesized that high-MRA individuals will demonstrate fewer eye fixations, conduct shorter average fixation durations (AFD), and demonstrate shorter response times, than low-MRA individuals. Additionally, individuals with different levels of MRA will attend to different features of the block-figures presented in the electronic mental rotations test (EMRT). All participants (n = 23) completed the EMRT while metrics of eye movement were collected. The test required participants view pairs of three-dimensional (3D) shapes, and identify if the pair is rotated but identical, or two different structures. Temporal analysis revealed no significant correlations between response time, average fixation durations, or number of fixations and mental rotation ability. Further analysis of within-participant variability yielded a significant correlation for response time variability, but no correlation between AFD variability and variability in the number of fixations. Additional analysis of salience revealed that during problem solving, individuals of differing MRA attended to different features of the block images; suggesting that eye movements directed at salient features may contribute to differences in mental rotations ability, and may ultimately serve to predict success in anatomy. Anat Sci Educ 9: 357-366. © 2015 American Association of Anatomists.
Collapse
Affiliation(s)
- Victoria A Roach
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Graham M Fraser
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - James H Kryklywy
- Departments of Psychiatry and Psychology, The Brain and Mind Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Derek G V Mitchell
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Departments of Psychiatry and Psychology, The Brain and Mind Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Timothy D Wilson
- Department of Anatomy and Cell Biology, Corps for Research of Instructional and Perceptual Technologies, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| |
Collapse
|
14
|
Feasibility of eye-tracking technology to quantify expertise in ultrasound-guided regional anesthesia. J Anesth 2016; 30:530-3. [DOI: 10.1007/s00540-016-2157-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 02/21/2016] [Indexed: 01/24/2023]
|
15
|
Murphy KP, Crush L, O'Malley E, Daly FE, Twomey M, O'Tuathaigh CMP, Maher MM, Cryan JF, O'Connor OJ. Medical student perceptions of radiology use in anatomy teaching. ANATOMICAL SCIENCES EDUCATION 2015; 8:510-7. [PMID: 25516061 DOI: 10.1002/ase.1502] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 09/17/2014] [Accepted: 10/08/2014] [Indexed: 05/16/2023]
Abstract
The use of radiology in the teaching of anatomy to medical students is gaining in popularity; however, there is wide variation in how and when radiology is introduced into the curriculum. The authors sought to investigate students' perceptions regarding methods used to depict and teach anatomy and effects of integrated radiology instruction on students' abilities to correctly identify imaging modalities and anatomical structures on radiological images. First-year medical students completed questionnaires at the beginning and end of the first academic year that incorporated ten hours of radiologic anatomy teaching in the anatomy curriculum. Questions used a combination of Likert scales, rankings, and binary options. Students were tested on their ability to identify radiology modalities and anatomical structures on radiology images. Preresponse and postresponse rates were 93% (157/168) and 85% (136/160), respectively. Postmodule, 96.3% of students wanted the same or more radiology integration. Furthermore, 92.4% premodule and 96.2% postmodule agreed that "Radiology is important in medical undergraduate teaching." Modality and structure identification scores significantly increased from 59.8% to 64.3% (P < 0.001) and from 47.4% to 71.2% (P < 0.001), respectively. The top three preferred teaching formats premodule and postmodule were (1) anatomy laboratory instruction, (2) interactive sessions combining radiology with anatomy, and (3) anatomy lectures. Postmodule, 38.3% of students were comfortable reviewing radiology images. Students were positive about integrating radiology into anatomy teaching and most students wanted at least the same level of assimilation but that it is used as an adjunct rather than primary method of teaching anatomy.
Collapse
Affiliation(s)
- Kevin P Murphy
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- Department of Radiology, University College Cork, Cork, Ireland
| | - Lee Crush
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- Department of Radiology, University College Cork, Cork, Ireland
| | - Eoin O'Malley
- Department of Radiology, University College Cork, Cork, Ireland
| | - Fergus E Daly
- Department of Radiology, University College Cork, Cork, Ireland
| | - Maria Twomey
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- Department of Radiology, University College Cork, Cork, Ireland
| | | | - Michael M Maher
- Department of Radiology, University College Cork, Cork, Ireland
| | - John F Cryan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Owen J O'Connor
- Department of Radiology, University College Cork, Cork, Ireland
| |
Collapse
|