Virtual reality and brain anatomy: a randomised trial of e-learning instructional designs

Teaching bovine abdominal anatomy: use of a haptic simulator

Traditional methods of teaching anatomy to undergraduate medical and veterinary students are being challenged and need to adapt to modern concerns and requirements. There is a move away from the use of cadavers to new technologies as a way of complementing the traditional approaches and addressing resource and ethical problems. Haptic (touch) technology, which allows the student to feel a 3D computer-generated virtual environment, provides a novel way to address some of these challenges. To evaluate the practicalities and usefulness of a haptic simulator, first year veterinary students at the Royal Veterinary College, University of London, were taught basic bovine abdominal anatomy using a rectal palpation simulator: "The Haptic Cow." Over two days, 186 students were taught in small groups and 184 provided feedback via a questionnaire. The results were positive; the majority of students considered that the simulator had been useful for appreciating both the feel and location of key internal anatomical structures, had helped with their understanding of bovine abdominal anatomy and 3D visualization, and the tutorial had been enjoyable. The students were mostly in favor of the small group tutorial format, but some requested more time on the simulator. The findings indicate that the haptic simulator is an engaging way of teaching bovine abdominal anatomy to a large number of students in an efficient manner without using cadavers, thereby addressing some of the current challenges in anatomy teaching.

E-learning may improve adherence to alcohol-based hand rubbing: a cohort study

BACKGROUND

Since 2004, we have promoted alcohol-based hand rubbing (HR) with an e-learning program (ELP) among hospital staff. This study sought to determine whether an ELP improves adherence to correct HR.

METHODS

This was a cohort study of staff members at Aarhus University Hospital, Skejby, Denmark who completed the ELP and were repeatedly observed for correct HR before and after clinical procedures in 2006 and/or 2007.

RESULTS

Of the 496 participants, 13% completed the ELP in both 2006 and 2007, 29% completed the ELP only in 2006, 15% completed the ELP only in 2007, and 43% never completed the ELP. Compared with noncompleters, completers of the 2006 and 2007 ELP had a significantly higher adherence to correct HR both before clinical procedures (odds ratio [OR] = 1.54; 95% confidence interval [CI] = 1.11 to 2.13) and after clinical procedures (OR = 1.40; 95% CI = 1.03 to 1.89). Time since completing the ELP seemed to be inversely associated with adherence to correct HR.

CONCLUSION

Completion of an ELP may have a positive impact on the performance of correct HR. The demands of lifelong education and training of hospital staff may call for the use of an ELP as a supplement to existing efforts aimed at improving HR to help prevent health care-related infections.

Computer animations in medical education: a critical literature review

CONTEXT

Animations can depict dynamic changes over time and location, and illustrate phenomena and concepts that might otherwise be difficult to visualise. However, animations may not always be effective and educators who use animations must understand the principles that govern their use.

OBJECTIVES

This review aims to illustrate potential applications of animations in medical education, to identify evidence-based principles for their design and use, and to propose an agenda for future research.

METHODS

We searched MEDLINE, PsychINFO and EMBASE for articles describing the use of computer animations in medical education. We reviewed and summarised all identified original research studies comparing animations with an alternative computer-based or non-computer-based format. We also selectively reviewed non-medical education research on the use of computer animations.

RESULTS

Medical educators have used animations in a variety of computer-assisted learning applications, but few comparative studies have been published and the evidence is inconclusive. Research outside medical education shows conflicting results for studies comparing animations with static images. This may reflect differences in cognitive load induced by animation, or differences in the type of motion being illustrated. The benefits of animations may also vary according to learner characteristics such as prior knowledge and spatial ability. Features of animation that appear to facilitate learning include permitting learner control over the animation's pace, allowing learners to interact with animations and splitting the animation activity into small chunks (segmenting).

CONCLUSIONS

Existing medical education research does little to inform the use of animations. Research is needed to confirm and extend non-medicine research to ascertain when to use animations and how to use them effectively.

The American College of Chest Physicians evidence-based educational guidelines for continuing medical education interventions: a critical review of evidence-based educational guidelines

The American College of Chest Physicians comprehensive review of continuing medical education is an ambitious attempt to summarize a vast and heterogeneous literature. Nevertheless, there appear to be some consistencies; multiple media and instructional methods appear to be consistently better than single approaches, and multiple occasions work better than one-shot events. While this appears, at first glance, to be perfectly reasonable, one must be careful to treat media and method separately. Other research has shown that many media manipulations can reduce, not enhance, learning. In a similar vein, while the role of simulation in continuing medical education is largely unexplored, applications must be considered with clear understanding of what can and cannot be achieved with simulation.

The virtual gateway: opening doors in delirium teaching and learning

Delirium is a common, serious and potentially preventable problem. It is argued here that knowledge and skills for effective assessment and treatment of delirium cannot be considered 'specialist'. Rather, delirium is a problem that requires a healthcare team approach to assessing patients, identifying risks or symptoms and reducing precipitating factors. Research from the preceding decade suggests that the clinical reality is falling short of this ideal with the result that many cases of delirium go undetected and many precipitating factors are not reduced where this is indeed possible. This presents a challenge for the education of nursing and medical students and for the development of qualified staff in practice. The current paper outlines an educational approach, e-learning, which increases access for learners, integrates knowledge and skill development and promotes active, problem-based learning.

Effect of the use of instructional anatomy videos on student performance

Medical schools have reduced the time allotted to anatomy instruction. Consequently, schools engage students in more independent settings using information and communication technologies (ICT). There has been limited research in the use of video aids, a type of ICT, to enhance anatomy examination performance. The objective of this study is to describe the design, usage, and effect on examination performance of eight locally developed instructional anatomy videos. First-year UCSF medical students (n = 141) had access to the videos. They reported their video usage, reason for usage, and satisfaction. The prior year students (n = 141) served as a historical control group. Anatomy and radiology examination performance was compared between groups while controlling for prior performance. The students with and without access to the videos did not differ in examination performance. Sixty-one (43%) students in the experimental group responded to the survey. Of these, 79% reported using at least one video, viewing an average of 4.75 of the eight videos. They watched 3.27 (SD = 1.57, range 1-5) of the five anatomy videos and 1.48 (SD = 1.35; range 0-3) of the three radiology videos. In a regression analysis controlling for age and MCAT scores, using the anatomy videos at least once improved anatomy examination performance by 3.4% (P-value = 0.007). There was no relationship between radiology video usage and radiology exam score. Video resource availability did not enhance student performance in anatomy and radiology. However, when analyzing performance for those whom we knew level of video use, there was a statistically different and higher anatomy achievement.

The development of interactive online learning tools for the study of anatomy

BACKGROUND

The study of human anatomy is a core component of health science programs. However large student enrolments and the content-packed curricula associated with these programs have made it difficult for students to have regular access to cadaver laboratories.

METHODS

Adobe Flash MXwas used with cadaver digital photographs and textbook-derived illustrations to develop interactive anatomy images that were made available to undergraduate health science students enrolled in first-year combined anatomy and physiology (ANP) courses at the University of Ottawa. Colour coding was used to direct student attention, facilitate name-structure association, improve visualization of structure contours, assist students in the construction of anatomical pathways, and to reinforce functional or anatomical groupings. The ability of two-dimensional media to support the visualization of three-dimensional structure was extended by developing the fade-through image (students use a sliding bar to move through tissues) as well as the rotating image in which entire organs such as the skull were photographed at eight angles of rotation. Finally, students were provided with interactive exercises that they could repeatedly try to obtain immediate feedback regarding their learning progress.

RESULTS

Survey data revealed that the learning and self-testing tools were used widely and that students found them relevant and supportive of their self-learning. Interestingly, student summative examination outcomes did not differ between those students who had access to the online tools and a corresponding student group from the previous academic year who did not.

CONCLUSION

Interactive learning tools can be tailored to meet program-specific learning objectives as a cost-effective means of facilitating the study of human anatomy. Virtual interactive anatomy exercises provide learning opportunities for students outside the lecture room that are of especial value to visual and kinesthetic learners.