The Role of Anatomy Computer-Assisted Learning on Spatial Abilities of Medical Students

Investigation of factors that influence the relationship between mental rotation ability and anatomy learning

BACKGROUND

Mental rotation is a cognitive process that involves the rotation of a mental representation of an object. This ability is important for medical students in studying anatomy as this subject requires the understanding of positional relations between organs.

OBJECTIVES

To find the effect of video learning of anatomy, training, gender, and type of practical exam on mental rotation ability. Also, to find correlation between mental rotation and anatomy scores.

METHODS

Two groups were recruited: group A studied practical anatomy online using videos due to the COVID-19 pandemic lockdown; group B studied anatomy labs on-campus on plastic models. Both groups underwent a mental rotation test. Group A took labs on-campus during their second year and this was considered a training course for their mental rotation ability. Both groups, then, took a second mental rotation test. Group A was finally given a practical anatomy exam using plastic models.

RESULTS

Males scored higher than females, though not significantly. The intervention course produced no significant change in mental rotation score of group A. Mental rotation score was correlated more with the theoretical anatomy exams than the MCQ-based practical exam, for both groups. For group A, mental rotation was better correlated with the model-based than the MCQ-based practical exam, especially the post-training score.

CONCLUSION

For students to take full advantage of their mental rotation ability, not only their practical anatomy sessions but their practical anatomy exams should be on anatomical specimens and not just videos or images.

The Application of 3D Anatomy for Teaching Veterinary Clinical Neurology

Neuroanatomy is always a challenging topic for veterinary students. It is widely accepted that understanding the anatomy of the central nervous system (CNS) is essential to explain many of the pathological processes that affect the brain. Although its study has varied over time to achieve this goal, in human and veterinary medicine it is difficult to find a teaching method that associates normal anatomy with pathological alterations of the brain. For the first time, we have created an educational tool that combines neuroanatomy and neuropathology, using different magnetic resonance (MR) images as a basis and EspINA software as analyzer, to obtain segmented structures and 3D reconstructions of the dog brain. We demonstrate that this combination is an optimal tool to help anatomists to understand the encephalon, and additionally to help clinicians to recognize illness including a multitude of neurological problems. In addition, we have tried to see whether photogrammetry, which is a common technique in other sciences, for example geology, could be useful to teach veterinary neuroanatomy. Although we still need further investigations, we have been able to generate 3D reconstructions of the whole brain, with very promising results to date.

Apprendre l’anatomie radiographique en présentiel ou en ligne ? Une étude randomisée contrôlée

Résumé

L’enseignement de l’anatomie repose sur diverses techniques: les cours, les dissections, les modèles 3D ou encore les supports en ligne. Ces derniers sont généralement considérés comme des moyens d’apprentissage complémentaires. Cette étude vise à comparer les performances des étudiants vétérinaires (N=83) en anatomie radiographique (radioanatomie) après un apprentissage en ligne ou conventionnel, et de voir dans quelle mesure ces méthodes sont interchangeables. Trois stratégies sont comparées : apprentissage en ligne exclusif, apprentissage en ligne avec des os de chevaux, apprentissage sur radiographies conventionnelles avec des os de chevaux. Les performances au test de rotation mentale et au test de connaissance en radioanatomie sont similaires entre les 3 groupes à la base, lors du test préliminaire. Après l’apprentissage (test final), les scores de rotation mentale et de radioanatomie augment significativement de 6.7/40 points (CI : 5.2–8.2; p < .001) et de 5.1/20 points (CI: 4.3–5.9; p< .001). Il n’y a pas de différence entre les groupes pour les scores de rotation mentale et de radioanatomie après l’apprentissage. Le score de rotation mentale est influencé par le genre, et significativement plus élevé chez les hommes que chez les femmes au test préliminaire (M= 23.0, SD = 8.8 vs. M= 16.5, SD= 6.9; p= .001) et au test final (M= 32.1, SD= 5.5 vs. M= 22.7, SD= 8.6; p< .001). Les performances en radioanatomie ne sont pas influencées par le genre. Ces résultats suggèrent que l’enseignement de la radioanatomie peut être réalisé en présentiel avec des radiographies conventionnelles ou en ligne. Cette interchangeabilité entre apprentissage en présentiel et en distanciel est intéressante au regard des impératifs liés aux crises sanitaires, et des besoins d’adaptation rapide en distanciel.

This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0153

Can Online Teaching of Radiographic Anatomy Replace Conventional On-Site Teaching? A Randomized Controlled Study

Different modalities such as lectures, dissections, 3D models, and online learning are used for teaching anatomy. To date, online learning has been considered a useful additional didactic tool. This study aimed to compare veterinary students' performance in radiographic anatomy (radio-anatomy) after online or classroom-based teaching to assess the extent to which the two methods were interchangeable. Three strategies were compared in a cohort of 83 learners. Students were committed to online learning only, online learning with the use of specimen equine bones, or learning on conventional radiographs with specimen equine bones. At baseline (pre-test), scores from a mental rotation test and radio-anatomy knowledge test were similar between groups. After training (post-test), scores in mental rotation and radio-anatomy significantly increased by 6.7/40 units (95% CI: 5.2-8.2; p < .001) and 5.1/20 units (95% CI: 4.3-5.9; p < .001), respectively. There was no difference in scores for mental rotation and radio-anatomy knowledge between groups at post-test. Gender influenced the mental rotation, with men scoring significantly higher than women at pre-test (M = 23.0, SD = 8.8 vs. M = 16.5, SD = 6.9; p = .001) and post-test (M = 32.1, SD = 5.5 vs. M = 22.7, SD = 8.6; p < .001). However, radio-anatomy knowledge was not influenced by gender. These results suggest radio-anatomy teaching can be safely achieved with either conventional radiographs or online resources. This is of interest since, due to the COVID-19 outbreak, rapidly changing from on-site to online methods for teaching veterinary medical education proved necessary.

Effect of binocular disparity on learning anatomy with stereoscopic augmented reality visualization: A double center randomized controlled trial

Binocular disparity provides one of the important depth cues within stereoscopic three-dimensional (3D) visualization technology. However, there is limited research on its effect on learning within a 3D augmented reality (AR) environment. This study evaluated the effect of binocular disparity on the acquisition of anatomical knowledge and perceived cognitive load in relation to visual-spatial abilities. In a double-center randomized controlled trial, first-year (bio)medical undergraduates studied lower extremity anatomy in an interactive 3D AR environment either with a stereoscopic 3D view (n = 32) or monoscopic 3D view (n = 34). Visual-spatial abilities were tested with a mental rotation test. Anatomical knowledge was assessed by a validated 30-item written test and 30-item specimen test. Cognitive load was measured by the NASA-TLX questionnaire. Students in the stereoscopic 3D and monoscopic 3D groups performed equally well in terms of percentage correct answers (written test: 47.9 ± 15.8 vs. 49.1 ± 18.3; P = 0.635; specimen test: 43.0 ± 17.9 vs. 46.3 ± 15.1; P = 0.429), and perceived cognitive load scores (6.2 ± 1.0 vs. 6.2 ± 1.3; P = 0.992). Regardless of intervention, visual-spatial abilities were positively associated with the specimen test scores (η² = 0.13, P = 0.003), perceived representativeness of the anatomy test questions (P = 0.010) and subjective improvement in anatomy knowledge (P < 0.001). In conclusion, binocular disparity does not improve learning anatomy. Motion parallax should be considered as another important depth cue that contributes to depth perception during learning in a stereoscopic 3D AR environment.

Universal design for learning in anatomy education of healthcare students: A scoping review

There are concerns among healthcare practitioners about poor anatomical knowledge among recent healthcare graduates. Universal Design for Learning (UDL) is a framework developed to enhance students' experience of learning and help students to become motivated learners. This scoping review identified whether UDL has been utilized in third level healthcare education and if so, whether it had been used to enhance student motivation to study anatomy. Seven online databases were searched for studies reporting the use of UDL in the curricula of medical, dental, occupational therapy (OT) or speech and language therapy (SLT) programs. Studies were screened for eligibility with set inclusion criteria. Data were extracted and analyzed. Analysis revealed that UDL was not specifically mentioned in any of the studies thus there are no published studies on UDL being formally applied in healthcare education. However, the authors identified 33 publications that described teaching methods which aligned with UDL in anatomy curricula and a thematic analysis yielded four main themes relating to teaching strategies being employed. Universal design for learning was not mentioned specifically, indicating that educators may not be aware of the educational framework, although they appeared to be utilizing aspects of it in their teaching. The review revealed that there is a lack of research concerning the anatomy education of OT and SLT students. The role of UDL in enhancing motivation to learn anatomy in medical, dental, OT and SLT programs has yet to be explored.

The Novel Method of Teaching Physiology and Pathophysiology of Congenital Hypothyroidism to Medical Students: An Educational Intervention Study

Background: Teaching congenital hypothyroidism is a challenging aspect of medical education. Objectives: In this study, the authors implemented storytelling plus simulation (Double-S method) to make a new way of understanding the physiology and pathophysiology of the thyroid gland. Methods: An educational intervention study was conducted on 120 medical students in the third and fourth grades of medicine with little or no clinical experience. Participants were randomly divided into the Double-S and lecture-only groups and underwent the same pre-test and post-test. They attended a 120-minute class by the same pediatric endocrinologist. Results: The intragroup analysis showed no significant difference between the pre-test scores of the two groups (P-value = 0.843), but higher post-test scores were obtained in the Double-S method (7.6 vs. 5.3, respectively, P-value = 0.002). Conclusions: This study showed that teaching heavy physiological and pathophysiological content by unique incorporation of simulation and storytelling can improve learning basic and clinical courses in medical students. As our method had a novelty toward common simulation and storytelling methods, it helped medical students from the base to the bedside.

Veterinary Anatomy Education and Spatial Ability: Where Now and Where Next?

The expanding use of technology to support or replace dissection has implications for educators, who must first understand how students mentally manipulate anatomical images. The psychological literature on spatial ability and general intelligence is relevant to these considerations. This article situates current understandings of spatial ability in the context of veterinary anatomy education. As in medical education, veterinary courses are increasingly using physical and computer-based models and computer programs to supplement or even replace cadavers. In this article, we highlight the importance of spatial ability in the learning of anatomy and make methodological recommendations for future studies to ensure a robust evidence base is developed. Recommendations include ensuring that (a) studies aiming to demonstrate changes in spatial ability include anatomically naïve students and also account for previous anatomical knowledge, (b) studies employ a control group in order to account for the practice effect, and (c) the relationship between spatial ability and general intelligence, and thus other cognitive abilities, is acknowledged.

Development and Assessment of an Integrated Anatomy Mobile App

INTRODUCTION

Curricular hours for anatomical sub-disciplines (gross anatomy, embryology, histology, and neuroanatomy) continue to decline, while medical schools are simultaneously transitioning to systems-based, vertically integrated curricula. This requires students to learn and integrate all basic science content for a learning block prior to the summative assessment. Currently, no educational technology resource exists that integrates the four anatomical sub-disciplines into a single resource to supplement integrated curricula. The objective of this study was to assess a novel integrated anatomical sciences mobile app for medical students.

MATERIALS AND METHODS

The 4natomy mobile app was developed to integrate the four sub-disciplines for a single topic, the spinal cord. The app was distributed to first-year medical students during the neurological disorders learning. Following the learning block, assessment of the student acceptance and experience with the app was conducted through a technology acceptance model (TAM) framework survey.

RESULTS

The results indicated that students found the app to be useful (p < 0.001) and easy to use (p < 0.05), predicting continued future usage of the app. Students requested expanded anatomy content for the entire learning block, as well as more clinical correlations, videos, and animations.

CONCLUSIONS

The integrated anatomy mobile app developed in this study was useful and easy to use, indicating continued use within an integrated medical curriculum. This was the first study to utilize the TAM as a conceptual framework for technology assessment in medical education, suggesting that future studies that develop new technologies should adapt the TAM for user testing. This article is protected by copyright. All rights reserved.

The Association Between Preclinical Medical Students' Perceptions of the Anatomy Education Environment and Their Learning Approaches

This study aimed to measure medical students' perceptions of the anatomy education environment and determine its association with their learning approaches. First- and second-year undergraduate medical students (N = 234) completed the Anatomy Education Environment Measurement Inventory and the Approaches and Study Skills Inventory for Students. Results revealed that the students' perceptions of all the factors in the anatomy education environment were positive except for two areas-the anatomy learning resources and quality of histology learning facilities. The majority of students in the first year (62.3%) and second year (43.7%) adopted a deep learning approach. There was no significant association between most of the factors in the anatomy education environment and the students' learning approaches, except for the students' intrinsic interest in learning anatomy factor (p = 0.032). The anatomy education environment was positive for the medical students, and there was a prevalence of a deep learning approach among them. However, most of the factors in the anatomy education environment did not influence the students' learning approach. Given that the students' learning approach is a multifactorial construct, investigating the relationship between these two variables in longitudinal time points would provide better insight into the association between the anatomy educational climate and students' learning approaches.

Digital Feast and Physical Famine: The Altered Ecosystem of Anatomy Education due to the Covid-19 Pandemic

This article explores the effects of the coronavirus disease 2019 (Covid-19) pandemic on the evolution of both physical and digital cadavers within the unique ecosystem of the anatomy laboratory. A physical cadaver is a traditional and established learning tool in anatomy education, whereas a digital cadaver is a relatively recent phenomenon. The Covid-19 pandemic presented a major disturbance and disruption to all levels and types of education, including anatomy education. This article constructs a conceptual metaphor between a typical anatomy laboratory and an ecosystem, and considers the affordances, constraints, and changing roles of physical and digital cadavers within anatomy education through an ecological lens. Adaptation of physical and digital cadavers during the disturbance is analyzed, and the resiliency of digital cadaver technology is recognized. The evolving role of the digital cadaver is considered in terms of increasing accessibility and inclusivity within the anatomy laboratory ecosystem of the future.

How Computer-Assisted Learning Influences Medical Students' Performance in Anatomy Courses

Anatomy is an essential subject of the medical curriculum. Despite its relevance, the curricular time and logistical resources devoted to teaching anatomy are in decline, favoring the introduction of new pedagogical approaches based on computer-assisted learning (CAL). This new pedagogical approach provides an insight into students' learning profiles and features, which are correlated with knowledge acquisition. The aim of this study was to understand how training with CAL platforms can influence medical students' anatomy performance. A total of 611 medical students attending Musculoskeletal Anatomy (MA) and Cardiovascular Anatomy (CA) courses were allocated to one of three groups (MA Group, CA Group, and MA + CA Group). An association between the performance in these anatomy courses and the number of CAL training sessions was detected. In the MA Group (r = 0.761, P < 0.001) and the MA + CA Group (r = 0.786, P < 0.001), a large positive correlation was observed between musculoskeletal anatomy performance and the number of CAL training sessions. Similarly, in the CA Group (r = 0.670, P < 0.001) and the MA + CA Group (r = 0.772, P < 0.001), a large positive correlation was observed between cardiovascular anatomy performance and the number of CAL training sessions. Multiple linear regression models were performed, considering either musculoskeletal or cardiovascular anatomy performance as the dependent variable. The results suggest that using CAL platforms to study has a positive dose-dependent effect on anatomy performance. Understanding students' individual features and academic background may contribute to the optimization of the learning process.

Body Mass Index and Musculoskeletal Pain: A Cross-Sectional Study

Introduction

With obesity reaching pandemic proportions, its detrimental influence on many health-related conditions has recently become a focus of research. Musculoskeletal (MSK) pain is one of several disorders associated with obesity.

Materials and methods

This study was designed to identify MSK pain in individuals with severe obesity, recruited from a specialized obesity clinic, and to evaluate the correlation between the MSK symptoms and some individual criteria.

Results

In 466 patients (342 females and 124 males), with a mean BMI of 42,77 ± 5.64 kg/m², 90,3% reported MSK pain. Severe pain was reported by 57,8% of female vs 26,6% of male patients. Female patients showed higher mean pain level when compared with males. Body sites with a higher prevalence of pain were: knee (63.5%), lumbar region (46.8%), hip (29%) and ankle (23%), with a predominance of severe pain. BMI have shown a positive correlation to numeric rating scale score in female participants in three body regions: shoulder (P = 0.010), knee (P = 0.042) and ankle (P = 0.024). Body sites with higher pain prevalence were especially in areas of increased mechanical load.

Conclusions

Understanding the relationship between obesity and pain may provide insights into preventive measures and therapeutic strategies for MSK pain. Persistent MSK pain is a significant problem in obese patients that can have a negative relationship with quality of life and function. This fact highlights the importance that patients with obesity may have access to interdisciplinary care, for the prevention and rehabilitation of MSK disorders. To further understand this association, more robust studies are needed.

The Universal Design for Learning Framework in Anatomical Sciences Education

Over the past decades, teaching and learning within the discipline of anatomy has undergone significant changes. Some of these changes are due to a reduction in the number of teaching hours, while others are related to advancements in technology. Faced with these many choices for change, it can be difficult for faculty to decide on which new developments in anatomical education need or indeed can be integrated into their course to enhance student learning. This article presents the universal design for learning (UDL) framework-an informed, evidence-based, and robust approach to underpin new course design and pedagogical reform in anatomy education. Universal design for learning is not a theory but a framework grounded in cognitive neuroscience that focuses on engaging multiple brain networks. The guidelines for UDL are organized into three core principles: (1) provide multiple means of representation, (2) provide multiple means of action and expression, and (3) provide multiple means of engagement. The learning space within the anatomy laboratory provides an excellent opportunity in which to apply this framework. This article also describes current trends employed in the teaching of anatomy. The principles of UDL are then outlined, followed by a description of how UDL approaches have been applied in the design and delivery of anatomy practical teaching to first year medical students at University College Cork. Future implications for this work are a consideration and investigation of how a course designed with the principles of UDL at its heart ultimately benefits student learning.

Anatomy Dissection Course Improves the Initially Lower Levels of Visual-Spatial Abilities of Medical Undergraduates

Visual-spatial abilities are considered a successful predictor in anatomy learning. Previous research suggest that visual-spatial abilities can be trained, and the magnitude of improvement can be affected by initial levels of spatial skills. This case-control study aimed to evaluate (1) the impact of an extra-curricular anatomy dissection course on visual-spatial abilities of medical undergraduates and (2) the magnitude of improvement in students with initially lower levels of visual-spatial abilities, and (3) whether the choice for the course was related to visual-spatial abilities. Course participants (n = 45) and controls (n = 65) were first and second-year medical undergraduates who performed a Mental Rotations Test (MRT) before and 10 weeks after the course. At baseline, there was no significant difference in MRT scores between course participants and controls. At the end of the course, participants achieved a greater improvement than controls (first-year: ∆6.0 ± 4.1 vs. ∆4.9 ± 3.2; ANCOVA, P = 0.019, Cohen's d = 0.41; second-year: ∆6.5 ± 3.3 vs. ∆6.1 ± 4.0; P = 0.03, Cohen's d = 0.11). Individuals with initially lower scores on the MRT pretest showed the largest improvement (∆8.4 ± 2.3 vs. ∆6.8 ± 2.8; P = 0.011, Cohen's d = 0.61). In summary, (1) an anatomy dissection course improved visual-spatial abilities of medical undergraduates; (2) a substantial improvement was observed in individuals with initially lower scores on the visual-spatial abilities test indicating a different trajectory of improvement; (3) students' preferences for attending extracurricular anatomy dissection course was not driven by visual-spatial abilities.

Spatial abilities training in the field of technical skills in health care: A systematic review

Objective

To conduct a systematic review of the effect of interventions on spatial abilities in the field of technical skills in health care.

Methods

A literature search was conducted up to November 14, 2017 in Scopus and in several databases on EBSCOhost platform. Citations were obtained, articles related to retained citations were reviewed and a final list of included studies was identified. Methods in the field of technical skills relating an intervention to spatial abilities test scores between intervention groups or obtained before and after the intervention were identified as eligible. The quality of included studies was assessed and data were extracted in a systematic way.

Results

A series of 5513 citations was obtained. Ninety-nine articles were retained and fully reviewed, yielding four included studies. No difference in the Hidden Figure Test score after one year was observed after residency training in General Surgery of at least nine months. A first-year dental curriculum was not found to elevate the Novel Object Cross-Sections Test score (P = 0.07). A two-semester learning period of abdominal sonography was found to increase the Revised Minnesota Paper Form Board Test score (P < 0.05). A hands-on radiology course using interactive three-dimensional image post-processing software consisting of seven two-hour long seminars on a weekly basis was found to amplify the Cube Perspective Test score (P < 0.001).

Conclusion

Spatial abilities tests scores were enhanced by courses in abdominal sonography and hands-on radiology, but were not improved by residency training in General Surgery and first-year dental curriculum.

Modernising Anatomy Teaching: Which Resources Do Students Rely On?

The way in which we learn anatomy has changed exponentially over the decades and students now have access to lecture notes, textbooks, computer-assisted programmes, and a wide variety of internet based information. This study explored which resources were the most (and least) useful for a group of first year, undergraduate, medical students, with minimal prior content exposure (aged 18 and 19 years old, n = 76), over an 18 month period. Anatomy websites were found to be the most useful (30%), followed by tutorials (20%) and lectures (19%). A total of 13% found the university computer-assisted learning (CAL) platform least useful. We subsequently enhanced our 'urogenital' CAL anatomy module, with inclusion of new and updated images, videos and tutorials, as well as, digital and printed 3D-models. A post-intervention survey (n = 81) showed an increase from 12% to 27% for CAL as being most useful, and a decrease from 13% to 3% as being least useful. Our results provided a snapshot of students' preferences in studying anatomy, and highlighted the importance of digital platforms and the need for evaluating our own learning resources. We must be mindful that there is an increasing tendency for students to rely on the Internet for information, which may expose them to unfiltered and unreliable content. We conclude that educators must be aware of the spectrum of learning resources used by students, to ensure that our own Institutional eLearning platforms are optimised to meet the diverse needs of learners.