Learning objects in medical education

Perceptions towards online learning among medical students during the COVID-19 pandemic

Social distancing has been essential during the COVID-19 pandemic to slow the spread of the disease. Online learning ensures students can participate in learning activities while also maintaining a physical distance from other students. Although online learning was used to prevent the spread of COVID-19, the development of online learning has also been promoted. Here, we sought to explore the perceptions and responses of students to online learning during the pandemic using a cross-sectional study. Electronic questionnaire was used for data collection. Statistical analyses were performed for 1614 valid questionnaires and P < 0.05 was considered statistically significant. Overall, COVID-19 had more effect on female students, such as fear of COVID-19 (2.4 times higher than the number of male students) and length of time spent learning (H = 42.449, P < 0.05). However, the higher the students' grades were, the less the impact of COVID-19. For the style of lessons, all students would prefer shorter lessons (P < 0.05). Female and fifth-grade students were more prefer combined online and face-to-face learning, and male and freshmen students were more likely to prefer face-to-face learning after the pandemic. More than 50% of students thought the main advantage of online learning was convenience, with low efficiency being a disadvantage. The main factors negatively influencing online learning were eyestrain, poor network connections, and poor learning environments at home. In conclusion, synchronous online and face-to-face learning may become more common in future curricula, however the efficiency of online learning and the female students more attentions.

Perspectives toward e-learning system during Covid-19 pandemic among medical Colleagues, Egypt: A Cross-sectional survey.. [DOI: 10.21203/rs.3.rs-2413281/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: WHO declared the outbreak of COVID-19, which affected the educational system stopping it in Egypt. To maintain the educational process, E-learning was a suggested solution. This study aimed to assess students' satisfaction regarding e-learning experience and effectiveness of this system on medical education in Egyptian universities. Methods: A cross-sectional survey was conducted among medical schools in Egypt during 2020–2021. It was conducted through an online questionnaire composed of four sections: Demographic characteristics, quality of internet connection, the academic characteristics of the participants, and evaluation of the effectiveness of e-learning. We compared the effectiveness of e learning among the clinical and the academic students, and private and governmental universities. Results: Among 90592 medical students in Egypt, 6393 students from 28 universities filled out the questionnaire with a 96.6% response rate. The age of participants ranged from 16 to 29 years old. Also, about 59.3% of them were females. The blended e-learning was the most applied by universities (43.1%), followed by partial type (33.4%), and full type (23.6%). About 73.7% of students had "always/often" constant internet connection. Forty percent of students were "dissatisfied/not satisfied at all", 38.3% showed "neutral" satisfaction, while 21.7% were "satisfied or highly satisfied". There was a significant difference regarding internet connection and availability favoring urban areas compared to rural areas (p<0.001). There was a significant difference favoring the academic education over the clinical education regarding the effectiveness of online learning (p<0.01) and private education over governmental regarding the effectiveness of online learning (p<0.001). Conclusion: E-learning was better for academic education than for clinical education. It was better for private universities than governmental ones. Also, students in rural areas had worse availability and quality internet connection compared with those in urban areas.

Community engagement education in academic health centers, colleges, and universities

Community engagement (CE) is critical for advancing health equity and a key approach for promoting inclusive clinical and translational science. However, it requires a workforce trained to effectively design, implement, and evaluate health promotion and improvement strategies through meaningful collaboration with community members. This paper presents an approach for designing CE curricula for research, education, clinical care, and public health learners. A general pedagogical framework is presented to support curriculum development with the inclusion of community members as facilitators or faculty. The overall goal of the curriculum is envisioned as enabling learners to effectively demonstrate the principles of CE in working with community members on issues of concern to communities to promote health and well-being. We highlight transformations needed for the commonly used critical service-learning model and the importance of faculty well-versed in CE. Courses may include didactics and practicums with well-defined objectives and evaluation components. Because of the importance of building and maintaining relationships in CE, a preparatory phase is recommended prior to experiential learning, which should be guided and designed to include debriefing and reflective learning. Depending on the scope of the course, evaluation should include community perspectives on the experience.

Detecting latent topics and trends in blended learning using LDA topic modeling

With the rapid application of blended learning around the world, a large amount of literature has been accumulated. The analysis of the main research topics and development trends based on a large amount of literature is of great significance. To address this issue, this paper collected abstracts from 3772 eligible papers published between 2003 and 2021 from the Web of Science core collection. Through LDA topic modeling, abstract text content was analyzed, then 7 well-defined research topics were obtained. According to the topic development trends analysis results, the emphasis of topic research shifted from the initial courses about health, medicine, nursing, chemistry and mathematics to learning key elements such as learning outcomes, teacher factors, and presences. Among 7 research topics, the popularity of presences increased significantly, while formative assessment was a rare topic requiring careful intervention. The other five topics had no significant increase or decrease trends, but still accounted for a considerable proportion. Through word cloud analysis technology, the keyword characteristics of each stage and research focus changes of research were obtained. This study provides useful insights and implications for blended learning related research.

Effect of distance learning on the quality of life, anxiety and stress levels of dental students during the COVID-19 pandemic

BACKGROUND

The long-term psychological effects of COVID-19 on dental students are unclear. The aim of this cross-sectional online study was to investigate the psychological effects of the COVID-19 pandemic on dental students.

METHOD

The Quality of Life Scale (WHOQOL-BREF) was sent to all dental students through Google Forms to evaluate their quality of life (QoL), and the DASS-21 scale was used to evaluate their psychosocial status due to distance learning during the COVID-19 pandemic. The answers were analyzed both on the basis of year of education and type of education (online versus classroom learning). One-way ANOVA was used for comparison of students in the different years of education; post hoc LSD test was used for pairwise comparisons. Sample t-test was used to compare the two groups separated as classroom/face-to-face learning and distance/online learning.

RESULT

The questionnaire was completed by 580 students with a response rate of 87.74%. According to the QoL scale results, there was no significant difference between the groups regarding general health, physical health, and psychology, both between different years and learning methods (p > 0.05). According to the results of the DASS-21 scale, anxiety and depression in the 3rd year students were significantly higher than the other years. The stress level of the 2nd year students was statistically significantly different from the other years (p < 0.05). Evaluation of anxiety, stress and the QoL showed an overall detrimental effect of distance learning on the dental students, although the evaluation did not reach statistical significance.

CONCLUSION

Anxiety, stress and factors affecting the quality of life negatively affected dental students who received online/distance learning, although the difference did not reach statistical significance when compared to students who received in-classroom learning.

The Effect of Mobile Learning on Student Success and Anxiety in Teaching Genital System Anatomy

The widespread use of smartphones has led to the emergence of new mobile learning tools. The aim of this study was to compare traditional methods to mobile learning applications, and their effect on the academic achievement and anxiety levels of students learning genital system anatomy. This research study was a randomized controlled study conducted with students who took anatomy between November and December 2018. The cohort consisted of 63 students who met the sampling criteria. Groups (control = 31, experimental = 32) were randomly selected using a simple number table. The mobile application developed for the experimental group was installed on the students' mobile devices with the extension "genitalsystem.apk." The anatomy of the genital system was taught to the control group using the standard curriculum and to the experimental group using the mobile application. After teaching the anatomy of the genital system, the state anxiety levels of the students in the control group were determined to be higher at 45.6 (±8.7) than the experimental group at 40.4 (±8.3) as measured by the 20-80 point STAI scale. The posttest examination average of the control group was 8.9 (±6.9) out of 22 or 40.4 (±6.9)% and the posttest average of the experimental group using mobile application was 14.9 (±5.5) or 67.7 (±5.5)%. State anxiety levels and examination grades showed a highly significant difference in favor of the experimental group. These results indicate that using mobile applications when teaching anatomy may be an effective method to enhance learning and reduce anxiety levels when compared to the traditional teaching methods.

Generation of reusable learning objects from digital medical collections: An analysis based on the MASMDOA framework

Learning Objects represent a widespread approach to structuring instructional materials in a large variety of educational contexts. The main aim of this work consists of analyzing the process of generating reusable learning objects followed by Clavy, a tool that can be used to retrieve data from multiple medical knowledge sources and reconfigure such sources in diverse multimedia-based structures and organizations. From these organizations, Clavy is able to generate learning objects that can be adapted to various instructional healthcare scenarios with several types of user profiles and distinct learning requirements. Moreover, Clavy provides the capability of exporting these learning objects through standard educational specifications, which improves their reusability features. The analysis proposed is conducted following criteria defined by the MASMDOA framework for comparing and selecting learning object generation methodologies. The analysis insights highlight the importance of having a tool to transfer knowledge from the available digital medical collections to learning objects that can be easily accessed by medical students and healthcare practitioners through the most popular e-learning platforms.

Effective Large Group Teaching for General Surgery

Large group settings display no signs of disappearing. Most surgeons charged with this education have received no formal training. Lecturing remains the most common method of educating large groups. Even though factors required for an excellent lecture are known, their inconsistent application results in variation of effectiveness. Long-standing principles of rhetoric and recent advances in neuroscience, cognitive science, learning models, and teaching theory play a role in achieving effectiveness. This article makes recommendations for creating and delivering lectures, including active learning opportunities and modern innovations in information technology supporting teaching methods. Effective lecturing skills are acquired by persistent deliberate practice.

Students' and lecturers' perspective on the implementation of online learning in dental education due to SARS-CoV-2 (COVID-19): a cross-sectional study

BACKGROUND

On account of physical distancing measures, universities worldwide are strongly affected by SARS-CoV-2 (COVID-19). Thus, the dental school of Justus-Liebig-University Giessen (Germany) transferred the established "face-to-face" learning to online learning in the spring term 2020. The aim of this study was to assess the students' and lecturers' perspectives on the implementation of online learning due to COVID-19, using a questionnaire survey.

METHODS

After the online period, all students and lecturers were asked to fill out an online questionnaire containing evaluative statements regarding handling, didactic benefit, motivation, and overall assessment. Furthermore, the questionnaire for lecturers contained additional aspects regarding knowledge gain in terms of providing online learning. Besides that, students and lecturers were asked for the amount of online learning in the future curriculum (independent of COVID-19). Data were subjected to regression analysis and T-test (p < .05).

RESULTS

36.8% of students preferred "face-to-face" learning instead of sole online learning. An increase of know how concerning online teaching was observable for lecturers. Both, students and lecturers, want to keep up with online courses in the future curriculum. However, in terms of the optimal amount of online learning a significant difference between students' and lecturers' perspective was observed. While students suggested 53.2% (24.9) (mean (standard deviation)) lecturers only stated 38.6% (21.5).

CONCLUSIONS

Within the limitation of this study, students' and lecturers' showed a predominantly positive perspective on the implementation of online learning, providing the chance to use online learning even beyond COVID-19 in the future curriculum.

The Wooden Skull: An Innovation through the Use of Local Materials and Technology to Promote the Teaching and Learning of Human Anatomy

Skeleton models are important in facilitating a student's easy retention and recollection of information in the future. These may assist students carry out hands-on practice in order to acquire and practice new skills that are relevant to first aid. The increasing number of medical institutions and medical students attracts the challenge of inadequate facilitation of the teaching and learning processes. This warrants a study and/or an exploration of an alternative solution such as wooden models in order to solve the problem of scarce and ethically restricted human teaching aids. Wooden pieces (50 cm length × 20 cm diameter) from a Jacaranda mimosifolia tree were prepared for the carving process, and wooden replicas of human skulls were made. Two experimental groups of randomly selected medical students (60: active and 60: control) were separately taught using wooden and natural skull models, respectively. The two groups were assessed and evaluated using the natural skull models to compare their understanding of the anatomy of the skull. Additionally, opinion statements were collected from participants in the active group during the oral examination. Six (6) wooden skull models were produced and used for experimental study. Comparisons of academic scores (mean and median) between active (students using the wooden skull) and control (students using natural skull) groups showed no statistically significant difference (P ≥ 0.05). Concerning the enhancement of learning skills, the wooden model was constructed in a way that would be able to enhance learning as it would be the natural skull. The wooden skull model, with more improvement in structural formation, can adequately facilitate the teaching and learning of anatomy of the human skull. This project and the experimental study about utilization of the wooden skull model provide a good potential of using the wooden models to supplement the use of the natural human skull.

Therapeutic Patient Education with Learning Objects Improves Asthma Control in Mexican Children

One of the most common chronic diseases that causes missed school days and workdays is pediatric asthma, producing education, health and economic delays in low and middle-income countries. A patient-centered remarkable therapeutic strategy in the prevention and treatment of chronic diseases is the Therapeutic Patient Education (TPE) which denotes an outstanding difference in the outcomes, from the awareness, to the personal treatment adaption to prevent crises. In this paper, an intervention of TPE with learning objects (LOs) of a pediatric asthma course, designed to train the uncontrolled patient and the caregiver as a team on the specific knowledge to self-control the disease, was carried out at a health facility in Mexico. The Asthma Control Test (ACT) was used and the learning performance was evaluated with formative quizzes. A randomized controlled trial was designed, with pairs of children patients and caregivers during 60 days; the control group was trained with the usual approach, receiving general information about the disease. ACT measures showed statistical significance for the TPE group after the use of the LOs, achieving a controlled state, while the control group did not show difference. Also, the intervention group obtained a higher score in learning performance assessment. The users learned how to avoid risks, the personal triggers of the patient, how to correctly use the different treatments and accessories, consequently, they learned how to self-manage the disease. Our study also confirmed that control of asthma is not only a matter of knowledge, but financial issues to afford the treatment.

Utilization of an online module bank for a research training curriculum: development, implementation, evolution, evaluation, and lessons learned

BACKGROUND

Students enter Oakland University William Beaumont School of Medicine's required research program, Embark, with variable levels of experience. Recognizing this, Embark allows for progression through the individual research project with flexibility. Since 2014, student self-directed curriculum personalization is promoted through a menu of online modules.

OBJECTIVE

This evaluation sought to understand student usage of the modules, identified strengths of the modules and preferred attributes of the modules. Gaining this evidence will provide information on how to best meet students' needs in a just-in-time format.

METHODS

A retrospective mixed methods analysis of the module library was conducted. The library was constructed using best practices as an educational tool. The retrospective evaluation included analysis of students' viewing patterns and answers to required course evaluations during the fall semesters of 2014 to 2017. Students' preference for modules was determined by viewing records and conjoint analysis.

RESULTS

Students' milestone preparation was not negatively impacted by relocation of curricular content from lecture to modules. Changes in module implementation within the course (2016) resulted in an increase of students viewing modules beyond only the minimum course requirements (71% (2016) from 10% (2014)). Data from both quantitative and qualitative evaluation questions show an increase in students' identifying the modules as a strength to individualize the course. The identified module strengths include content individualization, just-in-time access, while identified needs included a desire for additional modules. Students preferred modules that were animated, shorter in duration and curated from an external source.

CONCLUSIONS

Online modules provide students with a rich set of resources allowing for individualized learning. Lessons learned in the implementation of the online modules may be transferable to many educational topics. When implementing similar technology projects, usage rates, learner feedback, and effect on appreciation of the content are important to frequently monitor.

Using an Adaptive, Self-Directed Web-Based Learning Module to Enhance Residents' Medical Knowledge Prior to a New Clinical Rotation

BACKGROUND

The effect of self-directed adaptive learning on internal medicine residents' knowledge prior to a new clinical rotation is not known.

METHODS

We developed an adaptive, online, self-directed spaced repetition module and determined the effect on medical knowledge acquisition. We randomized postgraduate year 1 internal medicine residents into two groups. The intervention group (n = 27) received an electronic version of the clinical rotation curriculum as portable document format (PDF) files and participated in the online module, delivered via Moodle, a free, open-source learning management system. The non-intervention group (n = 27) only received the PDF files. All residents participated in a medical knowledge test at baseline and 3 months later.

RESULTS

Both groups were similar at study baseline in terms of age, trainee type, years since graduation, results at United States Medical Licensing Examination (USMLE) Step 1, 2, In-Training Examination (ITE), and pre-intervention evaluation. There was a statistically significant improvement in scores on the post-intervention medical knowledge assessment for the intervention group when compared with the non-intervention group (24.2 ± 15.4% vs. 8.6 ± 9.9%, p < 0.001).

CONCLUSION

An online, self-directed, adaptive spaced repetition-learning module can offer a simple and effective method to increase the medical knowledge present at the start of residents' clinical rotations.

Twelve tips for medical students to establish a collaborative flashcard project

Medical students employ various study strategies to master large amounts of information during their medical education. Digital flashcards are an interactive, self-directed study stool that may improve knowledge retention by combining the principles of active recall and spaced-repetition. They may be studied during and beyond undergraduate medical education. However, making flashcards can be an onerous task. In this article, we describe twelve tips on how to establish and maintain a collaborative digital flashcard project based on the undergraduate medical curriculum.

Serious Gaming and Gamification Education in Health Professions: Systematic Review

Background

There is a worldwide shortage of health workers, and this issue requires innovative education solutions. Serious gaming and gamification education have the potential to provide a quality, cost-effective, novel approach that is flexible, portable, and enjoyable and allow interaction with tutors and peers.

Objective

The aim of this systematic review was to evaluate the effectiveness of serious gaming/gamification for health professions education compared with traditional learning, other types of digital education, or other serious gaming/gamification interventions in terms of patient outcomes, knowledge, skills, professional attitudes, and satisfaction (primary outcomes) as well as economic outcomes of education and adverse events (secondary outcomes).

Methods

A comprehensive search of MEDLINE, EMBASE, Web of Knowledge, Educational Resources Information Centre, Cochrane Central Register of Controlled Trials, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature was conducted from 1990 to August 2017. Randomized controlled trials (RCTs) and cluster RCTs were eligible for inclusion. Two reviewers independently searched, screened, and assessed the study quality and extracted data. A meta-analysis was not deemed appropriate due to the heterogeneity of populations, interventions, comparisons, and outcomes. Therefore, a narrative synthesis is presented.

Results

A total of 27 RCTs and 3 cluster RCTs with 3634 participants were included. Two studies evaluated gamification interventions, and the remaining evaluated serious gaming interventions. One study reported a small statistically significant difference between serious gaming and digital education of primary care physicians in the time to control blood pressure in a subgroup of their patients already taking antihypertensive medications. There was evidence of a moderate-to-large magnitude of effect from five studies evaluating individually delivered interventions for objectively measured knowledge compared with traditional learning. There was also evidence of a small-to-large magnitude of effect from 10 studies for improved skills compared with traditional learning. Two and four studies suggested equivalence between interventions and controls for knowledge and skills, respectively. Evidence suggested that serious gaming was at least as effective as other digital education modalities for these outcomes. There was insufficient evidence to conclude whether one type of serious gaming/gamification intervention is more effective than any other. There was limited evidence for the effects of serious gaming/gamification on professional attitudes. Serious gaming/gamification may improve satisfaction, but the evidence was limited. Evidence was of low or very low quality for all outcomes. Quality of evidence was downgraded due to the imprecision, inconsistency, and limitations of the study.

Conclusions

Serious gaming/gamification appears to be at least as effective as controls, and in many studies, more effective for improving knowledge, skills, and satisfaction. However, the available evidence is mostly of low quality and calls for further rigorous, theory-driven research.

Medical Education Videos for the World: An Analysis of Viewing Patterns for a YouTube Channel

PURPOSE

Medical education videos can enhance learning and easily integrate into common instructional methods. YouTube permits worldwide access to high-quality medical education videos; however, no studies have described the reach of medical education videos on YouTube or what topics are preferred.

METHOD

One year of YouTube analytics data (February 1, 2016, to January 31, 2017) was collected for a medical-education-focused channel called Osmosis. Created December 20, 2015, the channel had 189 disease-focused videos by January 2017. Viewer and subscriber data were analyzed according to the World Bank's four income and seven region classifications. Topic viewing was analyzed according to income level.

RESULTS

The channel had accumulated 105,117 subscribers and 5,226,405 views for 20,153,093 minutes (38.3 years) from viewers located in 213/218 (97.7%) World Bank economies. While the number of videos increased 4.8-fold from February 2016 to January 2017, monthly views increased 50-fold and subscribers increased 117-fold. Low- or middle-income countries generated 2.2 million (42%) views and 52,942 (50%) subscribers, with similar view proportions across income level during the 12 months. A plurality of views (1.5 million; 29%) came from North America; Sub-Saharan Africa had the lowest number (150,065; 2.9%). Topic viewing generally corresponded to population health statistics.

CONCLUSIONS

Medical education content on YouTube can immediately and consistently reach a global viewership with relevant content. Educators may consider posting videos to YouTube to reach a broad audience. Future work should seek to optimize assessment of learning and investigate how videos may affect patients.

Development and Evaluation of a Web-Based Dermatology Teaching Tool for Preclinical Medical Students

INTRODUCTION

There is growing interest in, and emphasis on, electronic teaching tools in medicine. Despite relevant testing on the United States Medical Licensing Examination (USMLE), American medical schools offer limited training in skin disorders. Teaching visual topics like dermatology in classroom formats is challenging. We hypothesized that an electronic module would enhance students' dermatology competency.

METHODS

A self-directed, case-based module was created. To test its efficacy, 40 medical students were randomized to have module access (interventional group) or none (conventional group). Learning outcomes were compared using a multiple-choice exam, including questions relevant and irrelevant to the module. Outcomes included proportions of correctly answered module questions (module scores) and nonmodule questions (nonmodule scores). Difference scores were calculated: (module score) - (nonmodule score). Positive values indicated that knowledge of module questions surpassed that of nonmodule questions. If there were a training effect, the interventional group's difference score should exceed that of the conventional group.

RESULTS

The interventional group scored significantly higher than did the conventional group on module questions-75% (interquartile range [IQR], 69-88) versus 50% (IQR, 38-63), p < .001-and nonmodule questions-85% (IQR, 69-92) versus 69% (IQR, 54-77), p = .02. The Hodges-Lehman median difference estimate of the training effect was 13.0 (95% confidence interval, 0.5-25.5).

DISCUSSION

This e-module is effective at enhancing students' competency in dermatology while emphasizing detailed pathophysiology that prepares them for USMLE Step 1. A module-based curriculum may enhance learning in supplement to traditional teaching modalities.

What Are We Looking for in Computer-Based Learning Interventions in Medical Education? A Systematic Review

Background

Computer-based learning (CBL) has been widely used in medical education, and reports regarding its usage and effectiveness have ranged broadly. Most work has been done on the effectiveness of CBL approaches versus traditional methods, and little has been done on the comparative effects of CBL versus CBL methodologies. These findings urged other authors to recommend such studies in hopes of improving knowledge about which CBL methods work best in which settings.

Objective

In this systematic review, we aimed to characterize recent studies of the development of software platforms and interventions in medical education, search for common points among studies, and assess whether recommendations for CBL research are being taken into consideration.

Methods

We conducted a systematic review of the literature published from 2003 through 2013. We included studies written in English, specifically in medical education, regarding either the development of instructional software or interventions using instructional software, during training or practice, that reported learner attitudes, satisfaction, knowledge, skills, or software usage. We conducted 2 latent class analyses to group articles according to platform features and intervention characteristics. In addition, we analyzed references and citations for abstracted articles.

Results

We analyzed 251 articles. The number of publications rose over time, and they encompassed most medical disciplines, learning settings, and training levels, totaling 25 different platforms specifically for medical education. We uncovered 4 latent classes for educational software, characteristically making use of multimedia (115/251, 45.8%), text (64/251, 25.5%), Web conferencing (54/251, 21.5%), and instructional design principles (18/251, 7.2%). We found 3 classes for intervention outcomes: knowledge and attitudes (175/212, 82.6%), knowledge, attitudes, and skills (11.8%), and online activity (12/212, 5.7%). About a quarter of the articles (58/227, 25.6%) did not hold references or citations in common with other articles. The number of common references and citations increased in articles reporting instructional design principles (P=.03), articles measuring online activities (P=.01), and articles citing a review by Cook and colleagues on CBL (P=.04). There was an association between number of citations and studies comparing CBL versus CBL, independent of publication date (P=.02).

Conclusions

Studies in this field vary highly, and a high number of software systems are being developed. It seems that past recommendations regarding CBL interventions are being taken into consideration. A move into a more student-centered model, a focus on implementing reusable software platforms for specific learning contexts, and the analysis of online activity to track and predict outcomes are relevant areas for future research in this field.

Using reusable learning objects (rlos) in injection skills teaching: Evaluations from multiple user types

BACKGROUND

Clinical skills are a critical component of pre-registration nurse education in the United Kingdom, yet there is widespread concern about the clinical skills displayed by newly-qualified nurses. Novel means of supporting clinical skills education are required to address this.

METHODS

A package of Reusable Learning Objects (RLOs) was developed to supplement pre-registration teaching on the clinical skill of administering injection medication. RLOs are electronic resources addressing a single learning objective whose interactivity facilitates learning. This article evaluates a package of five injection RLOs across three studies: (1) questionnaires administered to pre-registration nursing students at University of Nottingham (UoN) (n=46) evaluating the RLO package as a whole; (2) individual RLOs evaluated in online questionnaires by educators and students from UoN; from other national and international institutions; and healthcare professionals (n=265); (3) qualitative evaluation of the RLO package by UoN injection skills tutors (n=6).

RESULTS

Data from all studies were assessed for (1) access to, (2) usefulness, (3) impact and (4) integration of the RLOs. Study one found that pre-registration nursing students rate the RLO package highly across all categories, particularly underscoring the value of their self-test elements. Study two found high ratings in online assessments of individual RLOs by multiple users. The global reach is particularly encouraging here. Tutors reported insufficient levels of student-RLO access, which might be explained by the timing of their student exposure. Tutors integrate RLOs into teaching and agree on their use as teaching supplements, not substitutes for face-to-face education.

CONCLUSION

This evaluation encompasses the first years postpackage release. Encouraging data on evaluative categories in this early review suggest that future evaluations are warranted to track progress as the package is adopted and evaluated more widely.

Semantic Indexing of Medical Learning Objects: Medical Students' Usage of a Semantic Network

BACKGROUND

The Semantically Annotated Media (SAM) project aims to provide a flexible platform for searching, browsing, and indexing medical learning objects (MLOs) based on a semantic network derived from established classification systems. Primarily, SAM supports the Aachen emedia skills lab, but SAM is ready for indexing distributed content and the Simple Knowledge Organizing System standard provides a means for easily upgrading or even exchanging SAM's semantic network. There is a lack of research addressing the usability of MLO indexes or search portals like SAM and the user behavior with such platforms.

OBJECTIVE

The purpose of this study was to assess the usability of SAM by investigating characteristic user behavior of medical students accessing MLOs via SAM.

METHODS

In this study, we chose a mixed-methods approach. Lean usability testing was combined with usability inspection by having the participants complete four typical usage scenarios before filling out a questionnaire. The questionnaire was based on the IsoMetrics usability inventory. Direct user interaction with SAM (mouse clicks and pages accessed) was logged.

RESULTS

The study analyzed the typical usage patterns and habits of students using a semantic network for accessing MLOs. Four scenarios capturing characteristics of typical tasks to be solved by using SAM yielded high ratings of usability items and showed good results concerning the consistency of indexing by different users. Long-tail phenomena emerge as they are typical for a collaborative Web 2.0 platform. Suitable but nonetheless rarely used keywords were assigned to MLOs by some users.

CONCLUSIONS

It is possible to develop a Web-based tool with high usability and acceptance for indexing and retrieval of MLOs. SAM can be applied to indexing multicentered repositories of MLOs collaboratively.

Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework

BACKGROUND

Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics.

OBJECTIVE

This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs' rational use of antibiotics.

METHODS

The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge.

RESULTS

The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories-situated, experiential, and transformative learning-provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners' personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level. Suggestions for learning activities and the requirements of the learning environment form the foundation for AR to fill the gap between learning outcomes and medical learners' personal paradigms. With the design framework, the expected rational use of antibiotics by GPs is described and is easy to execute and evaluate. The comparison of specific expected abilities with the GP personal paradigm helps solidify the GP practical learning objectives and helps design the learning environment and activities. The learning environment and activities were supported by learning theories.

CONCLUSIONS

This paper describes a framework for guiding the design, development, and application of mobile AR for medical education in the health care setting. The framework is theory driven with an understanding of the characteristics of AR and specific medical disciplines toward helping medical education improve professional development from knowledge to practice. Future research will use the framework as a guide for developing AR apps in practice to validate and improve the design framework.

Undergraduate prosthetics and orthotics teaching methods: A baseline for international comparison

BACKGROUND

Education of Prosthetics and Orthotics is a relatively recent professional program. While there has been some work on various teaching methods and strategies in international medical education, limited publication exists within prosthetics and orthotics.

OBJECTIVES

To identify the teaching and learning methods that are used in Bachelor-level prosthetics and orthotics programs that are given highest priority by expert prosthetics and orthotics instructors from regions enjoying a range of economic development.

STUDY DESIGN

Mixed method.

METHODS

The study partly documented by this article utilized a mixed method approach (qualitative and quantitative methods) within which each phase provided data for other phases. It began with analysis of prosthetics and orthotics curricula documents, which was followed by a broad survey of instructors in this field and then a modified Delphi process.

RESULTS

The expert instructors who participated in this study gave high priority to student-centered, small group methods that encourage critical thinking and may lead to lifelong learning. Instructors from more developed nations placed higher priority on student's independent acquisition of prosthetics and orthotics knowledge, particularly in clinical training.

CONCLUSIONS

Application of student-centered approaches to prosthetics and orthotics programs may be preferred by many experts, but there appeared to be regional differences in the priority given to different teaching methods.

CLINICAL RELEVANCE

The results of this study identify the methods of teaching that are preferred by expert prosthetics and orthotics instructors from a variety of regions. This treatment of current instructional techniques may inform instructor choice of teaching methods that impact the quality of education and improve the professional skills of students.

Characterization of medical students recall of factual knowledge using learning objects and repeated testing in a novel e-learning system

BACKGROUND

Spaced-repetition and test-enhanced learning are two methodologies that boost knowledge retention. ALERT STUDENT is a platform that allows creation and distribution of Learning Objects named flashcards, and provides insight into student judgments-of-learning through a metric called 'recall accuracy'. This study aims to understand how the spaced-repetition and test-enhanced learning features provided by the platform affect recall accuracy, and to characterize the effect that students, flashcards and repetitions exert on this measurement.

METHODS

Three spaced laboratory sessions (s0, s1 and s2), were conducted with n=96 medical students. The intervention employed a study task, and a quiz task that consisted in mentally answering open-ended questions about each flashcard and grading recall accuracy. Students were randomized into study-quiz and quiz groups. On s0 both groups performed the quiz task. On s1 and s2, the study-quiz group performed the study task followed by the quiz task, whereas the quiz group only performed the quiz task. We measured differences in recall accuracy between groups/sessions, its variance components, and the G-coefficients for the flashcard component.

RESULTS

At s0 there were no differences in recall accuracy between groups. The experiment group achieved a significant increase in recall accuracy that was superior to the quiz group in s1 and s2. In the study-quiz group, increases in recall accuracy were mainly due to the session, followed by flashcard factors and student factors. In the quiz group, increases in recall accuracy were mainly accounted by flashcard factors, followed by student and session factors. The flashcard G-coefficient indicated an agreement on recall accuracy of 91% in the quiz group, and of 47% in the study-quiz group.

CONCLUSIONS

Recall accuracy is an easily collectible measurement that increases the educational value of Learning Objects and open-ended questions. This metric seems to vary in a way consistent with knowledge retention, but further investigation is necessary to ascertain the nature of such relationship. Recall accuracy has educational implications to students and educators, and may contribute to deliver tailored learning experiences, assess the effectiveness of instruction, and facilitate research comparing blended-learning interventions.

A novel collaborative e-learning platform for medical students - ALERT STUDENT

BACKGROUND

The increasing complexity of medical curricula would benefit from adaptive computer supported collaborative learning systems that support study management using instructional design and learning object principles. However, to our knowledge, there are scarce reports regarding applications developed to meet this goal and encompass the complete medical curriculum. The aim of ths study was to develop and assess the usability of an adaptive computer supported collaborative learning system for medical students to manage study sessions.

RESULTS

A study platform named ALERT STUDENT was built as a free web application. Content chunks are represented as Flashcards that hold knowledge and open ended questions. These can be created in a collaborative fashion. Multiple Flashcards can be combined into custom stacks called Notebooks that can be accessed in study Groups that belong to the user institution. The system provides a Study Mode that features text markers, text notes, timers and color-coded content prioritization based on self-assessment of open ended questions presented in a Quiz Mode. Time spent studying and Perception of knowledge are displayed for each student and peers using charts. Computer supported collaborative learning is achieved by allowing for simultaneous creation of Notebooks and self-assessment questions by many users in a pre-defined Group. Past personal performance data is retrieved when studying new Notebooks containing previously studied Flashcards. Self-report surveys showed that students highly agreed that the system was useful and were willing to use it as a reference tool.

CONCLUSIONS

The platform employs various instructional design and learning object principles in a computer supported collaborative learning platform for medical students that allows for study management. The application broadens student insight over learning results and supports informed decisions based on past learning performance. It serves as a potential educational model for the medical education setting that has gathered strong positive feedback from students at our school.This platform provides a case study on how effective blending of instructional design and learning object principles can be brought together to manage study, and takes an important step towards bringing information management tools to support study decisions and improving learning outcomes.

Developing an audiovisual notebook as a self-learning tool in histology: perceptions of teachers and students

Videos can be used as didactic tools for self-learning under several circumstances, including those cases in which students are responsible for the development of this resource as an audiovisual notebook. We compared students' and teachers' perceptions regarding the main features that an audiovisual notebook should include. Four questionnaires with items about information, images, text and music, and filmmaking were used to investigate students' (n = 115) and teachers' perceptions (n = 28) regarding the development of a video focused on a histological technique. The results show that both students and teachers significantly prioritize informative components, images and filmmaking more than text and music. The scores were significantly higher for teachers than for students for all four components analyzed. The highest scores were given to items related to practical and medically oriented elements, and the lowest values were given to theoretical and complementary elements. For most items, there were no differences between genders. A strong positive correlation was found between the scores given to each item by teachers and students. These results show that both students' and teachers' perceptions tend to coincide for most items, and suggest that audiovisual notebooks developed by students would emphasize the same items as those perceived by teachers to be the most relevant. Further, these findings suggest that the use of video as an audiovisual learning notebook would not only preserve the curricular objectives but would also offer the advantages of self-learning processes.

Adopting a blended learning approach to teaching evidence based medicine: a mixed methods study

BACKGROUND

Evidence Based Medicine (EBM) is a core unit delivered across many medical schools. Few studies have investigated the most effective method of teaching a course in EBM to medical students. The objective of this study was to identify whether a blended-learning approach to teaching EBM is more effective a didactic-based approach at increasing medical student competency in EBM.

METHODS

A mixed-methods study was conducted consisting of a controlled trial and focus groups with second year graduate medical students. Students received the EBM course delivered using either a didactic approach (DID) to learning EBM or a blended-learning approach (BL). Student competency in EBM was assessed using the Berlin tool and a criterion-based assessment task, with student perceptions on the interventions assessed qualitatively.

RESULTS

A total of 61 students (85.9%) participated in the study. Competency in EBM did not differ between the groups when assessed using the Berlin tool (p = 0.29). Students using the BL approach performed significantly better in one of the criterion-based assessment tasks (p = 0.01) and reported significantly higher self-perceived competence in critical appraisal skills. Qualitative analysis identified that students had a preference for the EBM course to be delivered using the BL approach.

CONCLUSIONS

Implementing a blended-learning approach to EBM teaching promotes greater student appreciation of EBM principles within the clinical setting. Integrating a variety of teaching modalities and approaches can increase student self-confidence and assist in bridging the gap between the theory and practice of EBM.

Lecture recording system in anatomy: possible benefit to auditory learners

The literature reports that using Learning Recording Systems (LRS) is usually well received by students but that the pedagogical value of LRS in academic settings remains somewhat unclear. The primary aim of the current study is to document students' perceptions, actual pattern of usage, and impact of use of LRS on students' grade in a dental gross and neuroanatomy course. Other aims are to determine if students' learning preference correlated with final grades and to see if other factors like gender, age, overall academic score on the Dental Aptitude Test (DAT), lecture levels of difficulty, type of lecture, category of lecture, or teaching faculty could explain the impact, if any, of the use of LRS on the course final grade. No significant correlation was detected between the final grades and the variables studied except for a significant but modest correlation between final grades and the number of times the students accessed the lecture recordings (r=0.33 with P=0.01). Also, after adjusting for gender, age, learning style, and academic DAT, a significant interaction between auditory and average usage time was found for final grade (P=0.03). Students who classified themselves as auditory and who used the LRS on average for fewer than 10 minutes per access, scored an average final grade of 16.43 % higher than the nonauditory students using the LRS for the same amount of time per access. Based on these findings, implications for teaching are discussed and recommendations for use of LRS are proposed.

Transforming clinical imaging and 3D data for virtual reality learning objects: HTML5 and mobile devices implementation

Web deployable anatomical simulations or "virtual reality learning objects" can easily be produced with QuickTime VR software, but their use for online and mobile learning is being limited by the declining support for web browser plug-ins for personal computers and unavailability on popular mobile devices like Apple iPad and Android tablets. This article describes complementary methods for creating comparable, multiplatform VR learning objects in the new HTML5 standard format, circumventing platform-specific limitations imposed by the QuickTime VR multimedia file format. Multiple types or "dimensions" of anatomical information can be embedded in such learning objects, supporting different kinds of online learning applications, including interactive atlases, examination questions, and complex, multi-structure presentations. Such HTML5 VR learning objects are usable on new mobile devices that do not support QuickTime VR, as well as on personal computers. Furthermore, HTML5 VR learning objects can be embedded in "ebook" document files, supporting the development of new types of electronic textbooks on mobile devices that are increasingly popular and self-adopted for mobile learning.

Health professional learner attitudes and use of digital learning resources

Background

Web-based digital repositories allow educational resources to be accessed efficiently and conveniently from diverse geographic locations, hold a variety of resource formats, enable interactive learning, and facilitate targeted access for the user. Unlike some other learning management systems (LMS), resources can be retrieved through search engines and meta-tagged labels, and content can be streamed, which is particularly useful for multimedia resources.

Objective

The aim of this study was to examine usage and user experiences of an online learning repository (Physeek) in a population of physiotherapy students. The secondary aim of this project was to examine how students prefer to access resources and which resources they find most helpful.

Methods

The following data were examined using an audit of the repository server: (1) number of online resources accessed per day in 2010, (2) number of each type of resource accessed, (3) number of resources accessed during business hours (9 am to 5 pm) and outside business hours (years 1-4), (4) session length of each log-on (years 1-4), and (5) video quality (bit rate) of each video accessed. An online questionnaire and 3 focus groups assessed student feedback and self-reported experiences of Physeek.

Results

Students preferred the support provided by Physeek to other sources of educational material primarily because of its efficiency. Peak usage commonly occurred at times of increased academic need (ie, examination times). Students perceived online repositories as a potential tool to support lifelong learning and health care delivery.

Conclusions

The results of this study indicate that today’s health professional students welcome the benefits of online learning resources because of their convenience and usability. This represents a transition away from traditional learning styles and toward technological learning support and may indicate a growing link between social immersions in Internet-based connections and learning styles. The true potential for Web-based resources to support student learning is as yet unknown.

Internet-based learning and applications for critical care medicine

PURPOSE

Recent changes in duty hour allowances and economic constraints are forcing a paradigm shift in graduate medical education in the United States. Internet-based learning is a rapidly growing component of postgraduate medical education, including the field of critical care medicine. Here, we define the key concepts of Internet-based learning, summarize the current literature, and describe how Internet-based learning may be uniquely suited for the critical care provider.

METHODS

A MEDLINE/PubMed search from January 2000 to July 2011 using the search terms: "e-learning," "Web-based learning," "computer-aided instruction," "adult learning," "knowledge retention," "intensive care," and "critical care."

RESULTS

The growth of the Internet is marked by the development of new technologies, including more user-derived tools. Nonmedical fields have embraced Internet-based learning as a valuable teaching tool. A recent meta-analysis described Internet-based learning in the medical field as being more effective than no intervention and likely as efficacious as traditional teaching methods. Web sites containing interactive features are aptly suited for the adult learner, complementing the paradigm shift to more learner-centered education. Interactive cases, simulators, and games may allow for improvement in clinical care. The total time spent utilizing Internet-based resources, as well as the frequency of returning to those sites, may influence educational gains.

CONCLUSION

Internet-based learning may provide an opportunity for assistance in the transformation of medical education. Many features of Web-based learning, including interactivity, make it advantageous for the adult medical learner, especially in the field of critical care medicine, and further work is necessary to develop a robust learning platform incorporating a variety of learning modalities for critical care providers.

Tutorial videos of bioinformatics resources: online distribution trial in Japan named TogoTV

In recent years, biological web resources such as databases and tools have become more complex because of the enormous amounts of data generated in the field of life sciences. Traditional methods of distributing tutorials include publishing textbooks and posting web documents, but these static contents cannot adequately describe recent dynamic web services. Due to improvements in computer technology, it is now possible to create dynamic content such as video with minimal effort and low cost on most modern computers. The ease of creating and distributing video tutorials instead of static content improves accessibility for researchers, annotators and curators. This article focuses on online video repositories for educational and tutorial videos provided by resource developers and users. It also describes a project in Japan named TogoTV (http://togotv.dbcls.jp/en/) and discusses the production and distribution of high-quality tutorial videos, which would be useful to viewer, with examples. This article intends to stimulate and encourage researchers who develop and use databases and tools to distribute how-to videos as a tool to enhance product usability.

Creating an e-learning module from learning objects using a commentary or 'personal learning assistant'

The use of learning objects (LOs), small chunks of learning stored digitally and reused or referenced to support learning, was described as a promising approach to the creation of e-learning modules or programmes. In practice, however, the early enthusiasm has waned and the approach has not been widely adopted. It is argued that this was due, at least in part, to a neglect of the pedagogy and an emphasis on the technical aspects of interoperability and reusability. This article describes a practical approach to constructing a learning module using LOs where a commentary links LOs selected for inclusion in the programme. The commentary tells the story of the e-learning module and provides the learner with a context for an LO. It can be viewed as a 'personal learning assistant' that advises students about the management of their learning and relates the e-learning module to the overall learning outcomes for the curriculum. The commentary also allows the lecturer to comment on LOs selected for inclusion in the programme which otherwise might have to be adapted or excluded when the programme was constructed. The use of a commentary to link and introduce LOs has been successfully adopted in the development of e-learning programmes. Teachers are encouraged to consider the approach and to look again at the use of LOs to create e-learning resources.

Effectiveness of an online pediatric primary care curriculum

OBJECTIVE

The aim of this study was to evaluate the effectiveness of a supplementary online pediatric primary care (PPC) curriculum in reaching pediatric residents and increasing knowledge in selected primary care topics.

METHODS

We conducted a nonrandomized, controlled, pre-test/post-test study comparing an online PPC curriculum supplement with the traditional formal, conference-based curriculum alone, both with identical content. We compared 2 groups of first-year categorical pediatric residents from 2 successive years: one group (from 2006-2007) was offered the online curriculum supplement (study group) and one (2005-2006) was not (control group). Comparisons were made using the following: 1) pre-testing and post-testing of knowledge; and 2) monitoring of attendance at the formal conferences and accessing the online curriculum.

RESULTS

The control group of 33 residents and the study group of 34 residents were similar with respect to gender, age, and first-year in-training exam scores. In the first quarter of the year, 93% (mean) of the study group accessed the online curriculum; 43% accessed it in the last quarter of the year. For the same time periods, 33% and 30% of all of the residents (intervention and control groups combined) attended the noon conferences. The pre-test and post-test scores of the study group showed a significant increase (P < .001), and the post-test score comparison of study versus control group was also significant (P = .035). There were no significant differences in the in-training exam scores between the 2 groups for exams given at the beginning of their second year.

CONCLUSION

An online PPC curriculum is an effective supplement to traditional resident education and reaches a significantly larger number of residents compared with the traditional conference-based format.

Development of targeted online modules for recurring reference questions

When students are given assignments with specific information needs, they may turn to the library for help. The UNC Health Sciences Library developed three short online modules to teach first-year pharmacy students how to find early/animal studies, mechanism of action information, and specific study types in an effort to lessen demand on the reference desk. The modules filled two goals: to free up time that had been spent on three common low-level questions and to provide a pedagogically sound online tool to teach students how to find answers to these three questions. The modules were created using Adobe Captivate. Developing and promoting the modules took three hours of the pharmacy librarian's time compared with nearly 23 hours spent answering individual questions via e-mail, in consultations, and at the reference desk before the modules were introduced. After introducing the modules, only one student asked for help from the library compared to more than 60 who viewed the online modules at least once.

Medical education in Korea: the e-learning consortium

This article reports the latest development in e-learning in Korean medical education. The Korean Consortium for e-Learning in Medical Education was formed for collaboration in providing quality online learning resources for medical schools around the nation. This e-learning strategy is aimed at improving the quality of medical education at the national level by providing students with equal access to quality learning resources and fostering students' self-directed learning and, in doing so, enhancing the effectiveness and efficiency of developing online learning resources by sharing necessary resources among the medical schools. The consortium also plans to share e-learning content with medical schools in other countries by engaging more medical schools in the consortium and also by sharing e-learning content developed by other institutions or consortiums. The consortium is also dedicated to the research and development of effective online learning strategies for medical education, including interactive virtual patient cases and other innovative pedagogies using Web 2.0 technologies.

E-learning as evidence of educational scholarship: a survey of chairs of promotion and tenure committees at U.S. medical schools

PURPOSE

To ascertain the attitudes of chairs of U.S. medical school promotion committees toward e-learning and how their institutions recognize and reward faculty for e-learning as a scholarly activity.

METHOD

In 2007, the authors mailed a questionnaire to chairs of promotion and tenure committees at 123 U.S. medical schools. Chairs rated the importance of major areas of clinician-educators' e-learning performance using a five-point scale (1 = not important; 5 = extremely important). In another section, chairs rated the quality of information that is usually available to evaluate faculty performance in e-learning scholarship using a five-point scale (1 = low quality; 5 = excellent). Respondents were also able to enter qualitative comments about the role of e-learning and educational scholarship at their institution. Frequency distributions for each question were examined to identify any irregularities in the data, and descriptive statistics were used to summarize responses to questions. Themes were extracted from the qualitative data.

RESULTS

The response rate to the survey was 51% (63/123). Fifty-six (88.8%) participants indicated that educational scholarship was at least moderately important to a candidate's chances of promotion. Forty-eight (76%) respondents recognized e-learning as a meaningful contribution to scholarship. The chairs rated several levels of evaluation as well as types of e-learning activities and products: changing learner outcomes, developing and disseminating materials, authoring publications, receiving grant awards, serving on editorial boards, and directing a program.

CONCLUSIONS

Promotion chairs value selected e-learning activities and products as evidence of teaching scholarship.

A controlled trial of the effectiveness of internet continuing medical education

BACKGROUND

The internet has had a strong impact on how physicians access information and on the development of continuing medical education activities. Evaluation of the effectiveness of these activities has lagged behind their development.

METHODS

To determine the effectiveness of a group of 48 internet continuing medical education (CME) activities, case vignette surveys were administered to US physicians immediately following participation, and to a representative control group of non-participant physicians. Responses to case vignettes were analyzed based on evidence presented in the content of CME activities. An effect size for each activity was calculated using Cohen's d to determine the amount of difference between the two groups in the likelihood of making evidence-based clinical decisions, expressed as the percentage of non-overlap, between the two groups. Two formats were compared.

RESULTS

In a sample of 5621 US physicians, of the more than 100,000 physicians who participated in 48 internet CME activities, the average effect size was 0.75, an increased likelihood of 45% that participants were making choices in response to clinical case vignettes based on clinical evidence. This likelihood was higher in interactive case-based activities, 51% (effect size 0.89), than for text-based clinical updates, 40% (effect size 0.63). Effectiveness was also higher among primary care physicians than specialists.

CONCLUSION

Physicians who participated in selected internet CME activities were more likely to make evidence-based clinical choices than non-participants in response to clinical case vignettes. Internet CME activities show promise in offering a searchable, credible, available on-demand, high-impact source of CME for physicians.

Diffusion of innovations: smartphones and wireless anatomy learning resources

The author has previously reported on principles of diffusion of innovations, the processes by which new technologies become popularly adopted, specifically in relation to anatomy and education. In presentations on adopting handheld computers [personal digital assistants (PDAs)] and personal media players for health sciences education, particular attention has been directed to the anticipated integration of PDA functions into popular cellular telephones. However, limited distribution of early "smartphones" (e.g., Palm Treo and Blackberry) has provided few potential users for anatomical learning resources. In contrast, iPod media players have been self-adopted by millions of students, and "podcasting" has become a popular medium for distributing educational media content. The recently introduced Apple iPhone has combined smartphone and higher resolution media player capabilities. The author successfully tested the iPhone and the "work alike" iPod touch wireless media player with text-based "flashcard" resources, existing PDF educational documents, 3D clinical imaging data, lecture "podcasts," and clinical procedure video. These touch-interfaced, mobile computing devices represent just the first of a new generation providing practical, scalable wireless Web access with enhanced multimedia capabilities. With widespread student self-adoption of such new personal technology, educators can look forward to increasing portability of well-designed, multiplatform "learn anywhere" resources.

Transforming clinical imaging data for virtual reality learning objects

Advances in anatomical informatics, three-dimensional (3D) modeling, and virtual reality (VR) methods have made computer-based structural visualization a practical tool for education. In this article, the authors describe streamlined methods for producing VR "learning objects," standardized interactive software modules for anatomical sciences education, from newer high-resolution clinical imaging systems data. The key program is OsiriX, a free radiological image processing workstation software capable of directly reformatting and rendering volumetric 3D images. The transformed image arrays are then directly loaded into a commercial VR program to produce a variety of learning objects. Multiple types or "dimensions" of anatomical information can be embedded in these objects to provide different kinds of functions, including interactive atlases, examination questions, and complex, multistructure presentations. The use of clinical imaging data and workstation software speeds up the production of VR simulations, compared with reconstruction-based modeling from segmented cadaver cross-sections, while providing useful examples of normal structural variation and pathological anatomy.