Mobile technology: Creation and use of an iBook to teach the anatomy of the brachial plexus

Learning technology in health professions education: Realising an (un)imagined future

CONTEXT

Technology is being introduced, used and studied in almost all areas of health professions education (HPE), often with a claim of making HPE better in one way or another. However, it remains unclear if technology has driven real change in HPE. In this article, we seek to develop an understanding of the transformative capacity of learning technology in HPE.

METHODS AND OUTCOMES

We first consider the wider scholarship highlighting the intersection between technology and pedagogy, articulating what is meant by transformation and the role of learning technology in driving educational transformation. We then undertake a synthesis of the current high visibility HPE-focused research. We sampled the literature in two ways-for the five highest impact factor health professional education journals over the past decade and for all PubMed indexed journals for the last 3 years-and categorised the extant research against the Substitution, Augmentation, Modification, Redefinition model. We found that the majority of research we sampled focussed on substituting or augmenting learning through technology, with relatively few studies using technology to modify or redefine what HPE is through the use of technology. Of more concern was the lack of theoretical justification for pedagogical improvement, including transformation, underpinning the majority of studies.

CONCLUSIONS

While all kinds of technology use in learning have their place, the next step for HPE is the robust use of technology aiming to lead transformation. This should be guided by transformational educational theory and aligned with pedagogical context. We challenge HPE practitioners and scholars to work thoughtfully and with intent to enable transformation in education for future health professionals.

A scoping review on the trends of digital anatomy education

Digital technologies are changing the landscape of anatomy education. To reveal the trend of digital anatomy education across medical science disciplines, searches were performed using PubMed, EMBASE, and MEDLINE bibliographic databases for research articles published from January 2010 to June 2021 (inclusive). The search was restricted to publications written in English language and to articles describing teaching tools in undergraduate and postgraduate anatomy and pre-vocational clinical anatomy training courses. Among 156 included studies across six health disciplines, 35% used three-dimensional (3D) digital printing tools, 24.2% augmented reality (AR), 22.3% virtual reality (VR), 11.5% web-based programs, and 4.5% tablet-based apps. There was a clear discipline-dependent preference in the choice and employment of digital anatomy education. AR and VR were the more commonly adopted digital tools for medical and surgical anatomy education, while 3D printing is more broadly used for nursing, allied health and dental health education compared to other digital resources. Digital modalities were predominantly adopted for applied interactive anatomy education and primarily in advanced anatomy curricula such as regional anatomy and neuroanatomy. Moreover, there was a steep increase in VR anatomy combining digital simulation for surgical anatomy training. There is a consistent increase in the adoption of digital modalities in anatomy education across all included health disciplines. AR and VR anatomy incorporating digital simulation will play a more prominent role in medical education of the future. Combining multimodal digital resources that supports blended and interactive learning will further modernize anatomy education, moving medical education further away from its didactic history.

Effects of tablet-based drawing and paper-based methods on medical students' learning of gross anatomy

The way medical students learn anatomy is constantly evolving. Nowadays, technologies such as tablets support established learning methods like drawing. In this study, the effect of drawing on a tablet on medical students' anatomy learning was investigated compared to drawing or summarizing on paper. The quality of drawings or summaries was assessed as a measure of the quality of strategy implementation. Learning outcome was measured with an anatomy test, both immediately afterward and after 4-6 weeks to assess its sustainability. There were no significant group differences in learning outcome at both measurement points. For all groups, there was a significant medium strength correlation between the quality of the drawings or summaries and the learning outcome (p < 0.05). Further analysis revealed that the quality of strategy implementation moderated outcomes in the delayed test: When poorly implemented, drawing on a tablet (M = 48.81) was associated with lower learning outcome than drawing on paper (M = 58.95); The latter (M = 58.89) was related to higher learning outcome than writing summaries (M = 45.59). In case of high-quality strategy implementation, drawing on a tablet (M = 60.98) outperformed drawing on paper (M = 52.67), which in turn was outperformed by writing summaries (M = 62.62). To conclude, drawing on a tablet serves as a viable alternative to paper-based methods for learning anatomy if students can make adequate use of this strategy. Future research needs to identify how to support student drawing, for instance, by offering scaffolds with adaptive feedback to enhance learning.

Development of a Novel Peer-sharing Application to Supplement Learning from Cadaveric Dissection

Gross anatomy dissection in contemporary medical education must balance the traditional value of learning from the cadaver with the possibilities created by the use of digital tools as supplemental resources that personalize and deepen the student learning experience. This study broadly examined the design, implementation, and use of AnatomyShare, a novel iPad application employing learner-generated content that allows students to securely share annotated images of their dissections with each other and take faculty-generated image-based quizzes during their first-year medical school gross anatomy course. Almost all students enrolled in the course used the application (N = 176; 91% use based on analytics). Seventy-five students responded to a survey asking how and when they used the application, along with their perceptions of its usefulness and contribution to learning. More students reported using the application outside of laboratory (97.3%) than during laboratory (85.3%), despite only in-laboratory use being required. Taking quizzes using the "Exam" feature was the highest rated use of AnatomyShare, and students cited that the application exposed them to anatomical variation and motivated them to correctly identify structures during dissection. While steps need to be taken to combat low-quality learner-generated content and to enhance meaningful student interaction and collaboration, AnatomyShare was a feasible and highly rated supplement to dissection that provided valuable assessment opportunities for students. Future research will examine the impact of use on course grades and engagement in gross anatomy dissection.

Use of a Digital, Profession-Specific Dissection Guide Is Associated with Improved Examination Performance and Student Satisfaction

Anatomical knowledge is requisite for effective physical therapy (PT) practice. Cadaver dissection is a popular teaching method employed in PT anatomy courses. Limited time in the laboratory requires effective dissection instructions. Several limitations of a printed, non-discipline specific dissection guide have been identified by students and instructors in anatomy curricula. The objective of this project was to evaluate the effect of using a digital, PT specific dissection guide on examination performance and student satisfaction. A digital guide was developed that incorporated improvements based on observations of student experiences using a printed guide. The digital guide covered two lower extremity regional dissections and was distributed for use during the summer 2017 course. Enhancements included clarification of dissection procedures, formative quizzes, image galleries, embedded videos, and a glossary of terms. Students used a printed guide for all other dissections in the course. The percentage of correct answers from practical examinations was calculated and compared between summer of 2015 (print) and 2017 (digital) courses. A survey consisting of nineteen five-point Likert items was distributed. The percentage of correct answers was significantly higher for the digital guide (91.7 ± 7.11%) compared with the print guide (84.2 ± 9.51%, P < 0.0001). On the survey, the median item rating was strongly agree for two, agree for fifteen, and neither agree or disagree for two. These results suggest that developing a curriculum specific, digital guide was effective in improving student knowledge and satisfaction. These results encourage development of additional content specific guides in a digital format.

Outcomes of Introducing a Mobile Interactive Learning Resource in a Large Medical School Course

Mobile devices are an integral part of modern medical education, as convenient platforms for access to online interactive learning resources; students' use of textbooks has correspondingly declined. We designed an interactive iBook^© for pre-clinical students encompassing the content of the pulmonary segment in an organ-based multidisciplinary course. We found, via a survey-based study, that students preferred the iBook to other faculty-supplied materials (PowerPoints and PDFs), mainly due to its interactive images, animations, and study questions. Students' test performance did not change significantly after introducing the iBook. This study suggests that expanded use of interactive learning resources may enhance students' engagement with pre-clinical courses.

Assessing the Role of Screencasting and Video Use in Anatomy Education

The subject of anatomy, commonly taught with applied clinical focus on medical programmes, is frequently brought to life alongside art, imagery and visualization. Yet, despite being continually hailed as the cornerstone of medicine, the cyclic revalidation of its curricula has often found its educators in the unenviable position of maintaining knowledge standards in the face of reduced contact time. However, the gravity of such challenges has created an opportunity for creative and innovative solutions to these problems. The ease by which educational technology can now be used by non-experts is constantly increasing and the use of technology enhanced learning has now become universal within Higher Education. Many anatomical science educators have turned to building bespoke interactive and engaging online supplementary material which can be blended with face to face delivery as a way to circumvent the time pressure issues. Today's students appear to have a growing preference for visualising moving images and audio explanations as opposed to older traditional static resources, underpinned by vast pages of unattractive dense text and pictures. One such technique being used to provide flexible and student-centred learning is screencast videos. These digital recordings of screen captured drawings, with accompanying narration are overwhelmingly popular with students and on the ascendance. However, as new tools emerge, it becomes increasingly important to determine their impact on both the student experience and knowledge gain. It is also valuable for educators to share their classroom experiences or instructional techniques to optimise their use for learning. This chapter explores the rise of this application in anatomy education and discusses the evidence available investigating student engagement and learning outcomes in the context of well-established learning theories.

Experiences with using e-learning tools in orthopedics in an uncontrolled field study application

BACKGROUND

E-learning is widely used in undergraduate medical education and often in blended learning settings for students learning at home. This study should assess the educative value of e-learning tools in orthopedics and traumatology when used under "field" conditions, in comparison with a controlled laboratory-like setting.

MATERIALS AND METHODS

Medical students were invited for their voluntary online participation in an uncontrolled study (UCS). They were randomly exposed to digital book chapters or podcasts on four different orthopedic diseases, and then filled in pre-/post-tests and evaluations. Test results indicating insufficient study participation were not included in the subsequent analysis. Results in a gain of knowledge and student's satisfaction were compared to existing data of a randomized controlled trial with the same tools in a laboratory environment (RCT).

RESULTS

Among 84 included UCS students and 130 RCT students, podcast learners showed a significantly higher gain of knowledge compared to text learners independent of the learning setting (UCS p<0.011; RCT p<0.001). There were no significant differences in the gain of knowledge for the two different learning tools when comparing each the UCS and RCT settings. Evaluations showed positive ratings for both tools, while podcasts were on the average rated higher than texts were. Significantly more UCS participants (n=46) compared to the RCT (n=34) showed signs of disengagement with the study (p<0.05).

DISCUSSION

The findings suggest that it is possible to achieve a similar gain of knowledge with e-learning tools in uncontrolled settings and in RCTs. The role of e-learning materials in voluntary and formative learning settings is of value and should be explored in future studies.

LEVEL OF EVIDENCE

III, case-control study.

Implementation of an Innovative Tablet-based Curriculum for Radiology Resident Education

RATIONALE AND OBJECTIVES

The aim of this study was to prospectively examine the impact of a tablet-based curriculum on the radiology resident educational experience.

MATERIALS AND METHODS

A comprehensive tablet-based curriculum was developed by creating subspecialty modules with appropriate content level for each required rotation at our diagnostic radiology residency program. Daily assignments included key learning points, readings, and reference presentation slides, covering all objectives published by the ABR Core Exam Study Guide. Residents were provided with iPad devices preconfigured with the curriculum and online access to most major radiology textbooks available in our institutional digital library. Assessment surveys were administered at baseline and 12 months following curriculum implementation.

RESULTS

Twenty-two residents completed both surveys. In comparing the pre versus postsurvey results, 32% versus 73% residents agreed or strongly agreed that study resources were well-organized, 41% versus 91% agreed or strongly agreed that study resources were easily accessible, 27% versus 77% agreed or strongly agreed that the modules encouraged active learning, 18% versus 82% agreed or strongly agreed that resources motivate them to study daily, 36% versus 82% agreed or strongly agreed that the resources adequately prepared the resident for the radiology board exam, and 36% versus 82% agreed or strongly agreed that they were satisfied with the resources provided by the residency program (p < 0.05).

CONCLUSION

Our study demonstrated the positive impact of implementing a complete tablet-based curriculum on radiology resident motivation, satisfaction, and engagement. Use of mobile tablet devices has the potential to dramatically transform content delivery in residency education.

Exploring anatomy and physiology using iPad applications

This study examined the use of iPads with anatomy applications (apps) in the laboratory sections of the largest undergraduate course at the university, Anatomy and Physiology, serving more than 300 students. The majority of these students were nursing, exercise science/physical education and biology majors. With a student survey (student opinion) and student practicum grades as metrics, this study determined whether the introduction of this novel mobile technology improved student grades and aided the students in learning the course material. The results indicated that students' grades improved with the introduction of the iPads, and 78% of the students reported that the iPads facilitated their ability to learn the course material. There was a positive association between frequency of app use and standardized mastery of the course material, as students who used the apps more frequently scored higher and indicated that they felt as though they had learned the material more comprehensively. Owning or having an iPad at home did not have a significant effect on the learning of the material. The general consensus by students was that iPad anatomy apps should be used frequently to better develop student understanding of the course material. Anat Sci Educ 11: 336-345. © 2017 American Association of Anatomists.

Interactive iBook-Based Patient Education in a NeuroTrauma Clinic

BACKGROUND

Traumatic brain injury (TBI) is a leading cause of death and disability in the United States. Educational interventions may alleviate the burden of TBI for patients and their families. Interactive modalities that involve engagement with the educational material may enhance patient knowledge acquisition when compared to static text-based educational material.

OBJECTIVE

To determine the effects of educational interventions in the outpatient setting on self-reported patient knowledge, with a focus on iPad-based (Apple, Cupertino, California) interactive modules.

METHODS

Patients and family members presenting to a NeuroTrauma clinic at a tertiary care academic medical center completed a presurvey assessing baseline knowledge of TBI or concussion, depending on the diagnosis. Subjects then received either an interactive iBook (Apple) on TBI or concussion, or an informative pamphlet with identical information in text format. Subjects then completed a postsurvey prior to seeing the neurosurgeon.

RESULTS

All subjects (n = 152) significantly improved on self-reported knowledge measures following administration of either an iBook (Apple) or pamphlet (P < .01, 95% confidence interval [CI]). Subjects receiving the iBook (n = 122) performed significantly better on the postsurvey (P < .01, 95% CI), despite equivalent presurvey scores, when compared to those receiving pamphlets (n = 30). Lastly, patients preferred the iBook to pamphlets (P < .01, 95% CI).

CONCLUSION

Educational interventions in the outpatient NeuroTrauma setting led to significant improvement in self-reported measures of patient and family knowledge. This improved understanding may increase compliance with the neurosurgeon's recommendations and may help reduce the potential anxiety and complications that arise following a TBI.

How comprehensive are research studies investigating the efficacy of technology-enhanced learning resources in anatomy education? A systematic review

Anatomy education is at the forefront of integrating innovative technologies into its curricula. However, despite this rise in technology numerous authors have commented on the shortfall in efficacy studies to assess the impact such technology-enhanced learning (TEL) resources have on learning. To assess the range of evaluation approaches to TEL across anatomy education, a systematic review was conducted using MEDLINE, the Educational Resources Information Centre (ERIC), Scopus, and Google Scholar, with a total of 3,345 articles retrieved. Following the PRISMA method for reporting items, 153 articles were identified and reviewed against a published framework-the technology-enhanced learning evaluation model (TELEM). The model allowed published reports to be categorized according to evaluations at the level of (1) learner satisfaction, (2) learning gain, (3) learner impact, and (4) institutional impact. The results of this systematic review reveal that most evaluation studies into TEL within anatomy curricula were based on learner satisfaction, followed by module or course learning outcomes. Randomized controlled studies assessing learning gain with a specific TEL resource were in a minority, with no studies reporting a comprehensive assessment on the overall impact of introducing a specific TEL resource (e.g., return on investment). This systematic review has provided clear evidence that anatomy education is engaged in evaluating the impact of TEL resources on student education, although it remains at a level that fails to provide comprehensive causative evidence. Anat Sci Educ 11: 303-319. © 2017 American Association of Anatomists.

Linguistic Validation of Interactive Educational Interventions in Neurologic Trauma

BACKGROUND

Neurological surgeons oftentimes educate patients and their families on complex medical conditions and treatment options. Time constraints and varied linguistic and cultural backgrounds limit the amount of information that can be disbursed. In this study, we assessed the linguistic validity of interactive educational interventions in non-English-speaking patients with traumatic brain injury (TBI) and concussion and their families.

METHODS

A total of 273 English-, Spanish-, Korean-, and Vietnamese-speaking neurotrauma patients (n =124) and family members (n =149) completed a presurvey to evaluate their incipient understanding, interacted with an iPad-based iBook (Apple) on concussion or TBI in their native language, completed a postsurvey to gauge changes in understanding, and then consulted with their neurosurgeon.

RESULTS

All participants (124 patients and 149 family members) had significantly increased (95% confidence interval [CI], P < 0.01) postsurvey scores (average pre-iBook score, 2.810; average post-iBook score, 4.109), regardless of native language or cultural background. Caucasian participants scored significantly higher than the combination of all ethnicities on both the baseline survey (95% CI, P < 0.01) and the post-iBook survey (95% CI, P < 0.01), and Asian participants scored significantly lower (95% CI, P < 0.05) than the combination regardless of similar baseline scores.

CONCLUSIONS

Interactive iBook-based interventions on concussion and TBI can increase participants' comprehension, improve their comfort with their medical condition and the follow-up care, and enhance communication with their physicians. These findings are linguistically valid irrespective of the participants' native language or cultural background.

Measuring learning gain: Comparing anatomy drawing screencasts and paper-based resources

The use of technology-enhanced learning (TEL) resources is now a common tool across a variety of healthcare programs. Despite this popular approach to curriculum delivery there remains a paucity in empirical evidence that quantifies the change in learning gain. The aim of the study was to measure the changes in learning gain observed with anatomy drawing screencasts in comparison to a traditional paper-based resource. Learning gain is a widely used term to describe the tangible changes in learning outcomes that have been achieved after a specific intervention. In regard to this study, a cohort of Year 2 medical students voluntarily participated and were randomly assigned to either a screencast or textbook group to compare changes in learning gain across resource type. Using a pre-test/post-test protocol, and a range of statistical analyses, the learning gain was calculated at three test points: immediate post-test, 1-week post-test and 4-week post-test. Results at all test points revealed a significant increase in learning gain and large effect sizes for the screencast group compared to the textbook group. Possible reasons behind the difference in learning gain are explored by comparing the instructional design of both resources. Strengths and weaknesses of the study design are also considered. This work adds to the growing area of research that supports the effective design of TEL resources which are complimentary to the cognitive theory of multimedia learning to achieve both an effective and efficient learning resource for anatomical education. Anat Sci Educ 10: 307-316. © 2016 American Association of Anatomists.

Educational software usability: Artifact or Design?

Online educational technologies and e-learning tools are providing new opportunities for students to learn worldwide, and they continue to play an important role in anatomical sciences education. Yet, as we shift to teaching online, particularly within the anatomical sciences, it has become apparent that e-learning tool success is based on more than just user satisfaction and preliminary learning outcomes-rather it is a multidimensional construct that should be addressed from an integrated perspective. The efficiency, effectiveness and satisfaction with which a user can navigate an e-learning tool is known as usability, and represents a construct which we propose can be used to quantitatively evaluate e-learning tool success. To assess the usability of an e-learning tool, usability testing should be employed during the design and development phases (i.e., prior to its release to users) as well as during its delivery (i.e., following its release to users). However, both the commercial educational software industry and individual academic developers in the anatomical sciences have overlooked the added value of additional usability testing. Reducing learner frustration and anxiety during e-learning tool use is essential in ensuring e-learning tool success, and will require a commitment on the part of the developers to engage in usability testing during all stages of an e-learning tool's life cycle. Anat Sci Educ 10: 190-199. © 2016 American Association of Anatomists.

Use of interactive iBooks for patient education in otology

INTRODUCTION

Physicians in the ambulatory setting face challenges in adequately educating patients in a brief office encounter.

OBJECTIVE

To evaluate the efficacy of an iPad-based interactive educational module (iBook) in various otologic pathologies.

METHODS

Patients presenting with symptoms of tinnitus, dizziness, hearing loss, or cochlear implant evaluation were included. In total, 44 patients received the iBook and 22 patients served as controls. Prior to viewing the iBook, patients completed a pre-survey to assess baseline knowledge. After viewing the iBook, patients completed a post-survey to assess changes in perception and knowledge of their disease. Results were compared to that of the control group who did not receive iBook supplementation prior to being seen by the physician.

RESULTS

Paired t-test analysis showed significant improvements (p<0.01) in both self-reported perception and concrete understanding in various concepts when compared to pre-iBook results. This was further compared to the control group, which showed a significant gain in factual knowledge (p=0.02).

CONCLUSION

Patients who viewed the iBook, personalized to their diagnosis, displayed significantly improved understanding of their condition. Increased use of interactive educational modalities, such as the iBook, can be of benefit to an otologic practice in improving patient education and satisfaction.

Googling in anatomy education: Can google trends inform educators of national online search patterns of anatomical syllabi?

The role of e-learning platforms in anatomy education continues to expand as self-directed learning is promoted in higher education. Although a wide range of e-learning resources are available, determining student use of non-academic internet resources requires novel approaches. One such approach that may be useful is the Google Trends^© web application. To determine the feasibility of Google Trends to gain insights into anatomy-related online searches, Google Trends data from the United States from January 2010 to December 2015 were analyzed. Data collected were based on the recurrence of keywords related to head and neck anatomy generated from the American Association of Clinical Anatomists and the Anatomical Society suggested anatomy syllabi. Relative search volume (RSV) data were analyzed for seasonal periodicity and their overall temporal trends. Following exclusions due to insufficient search volume data, 29 out of 36 search terms were analyzed. Significant seasonal patterns occurred in 23 search terms. Thirty-nine seasonal peaks were identified, mainly in October and April, coinciding with teaching periods in anatomy curricula. A positive correlation of RSV with time over the 6-year study period occurred in 25 out of 29 search terms. These data demonstrate how Google Trends may offer insights into the nature and timing of online search patterns of anatomical syllabi and may potentially inform the development and timing of targeted online supports to ensure that students of anatomy have the opportunity to engage with online content that is both accurate and fit for purpose. Anat Sci Educ 10: 152-159. © 2016 American Association of Anatomists.

The integration of an anatomy massive open online course (MOOC) into a medical anatomy curriculum

Massive open online courses (MOOCs) are designed as stand-alone courses which can be accessed by any learner around the globe with only an internet-enabled electronic device required. Although much research has focused on the enrolment and demographics of MOOCs, their impact on undergraduate campus-based students is still unclear. This article explores the impact of integrating an anatomy MOOC in to the anatomy curriculum of a year 1 medical degree program at the University of Leeds, United Kingdom. The course did not replace any teaching that was already being delivered, and was used to supplement this teaching to support the students' consolidation and revision. Analysis of student feedback indicates a high level of usage, with evidence to suggest that female learners may have approached the course in a more personalized manner. Although the video based resources and quizzes were greatly appreciated as learning tools, significant evidence suggests the students did not engage, or were inclined to engage, with the discussion fora. Furthermore, a significant majority of students did not want the MOOC to replace the existing teaching they received. Given the feedback provided, this research suggests that although the student population believe there to be value in having access to MOOC material, their role as replacements to campus-based teaching is not supported. Details regarding the enrolment and engagement of the general public with the MOOC during the two runs are also documented, with the suggestion that graduates employed in the healthcare sector were the primary users of the course. Anat Sci Educ 10: 53-67. © 2016 American Association of Anatomists.

Improvements in anatomy knowledge when utilizing a novel cyclical "Observe-Reflect-Draw-Edit-Repeat" learning process

Innovative educational strategies can provide variety and enhance student learning while addressing complex logistical and financial issues facing modern anatomy education. Observe-Reflect-Draw-Edit-Repeat (ORDER), a novel cyclical artistic process, has been designed based on cognitivist and constructivist learning theories, and on processes of critical observation, reflection and drawing in anatomy learning. ORDER was initially investigated in the context of a compulsory first year surface anatomy practical (ORDER-SAP) at a United Kingdom medical school in which a cross-over trial with pre-post anatomy knowledge testing was utilized and student perceptions were identified. Despite positive perceptions of ORDER-SAP, medical student (n = 154) pre-post knowledge test scores were significantly greater (P < 0.001) with standard anatomy learning methods (3.26, SD = ±2.25) than with ORDER-SAP (2.17, ±2.30). Based on these findings, ORDER was modified and evaluated in the context of an optional self-directed gross anatomy online interactive tutorial (ORDER-IT) for participating first year medical students (n = 55). Student performance was significantly greater (P < 0.001) with ORDER-IT (2.71 ± 2.17) when compared to a control tutorial (1.31 ± 2.03). Performances of students with visual and artistic preferences when using ORDER were not significantly different (P > 0.05) to those students without these characteristics. These findings will be of value to anatomy instructors seeking to engage students from diverse learning backgrounds in a research-led, innovative, time and cost-effective learning method, in the context of contrasting learning environments. Anat Sci Educ 10: 7-22. © 2016 American Association of Anatomists.

The influence of anatomy app use on chiropractic students' learning outcomes: a randomised controlled trial

Background

Anatomy apps supplement traditional learning; however, it is unknown if their use can improve students’ outcome. The present study examined whether the use of anatomy apps improved student performance on a neuroanatomy assessment.

Methods

Second-year anatomy students, enrolled in a Bachelor of Science with Chiropractic Major program, were randomly allocated to experimental and control groups in July 2015. Students completed the Self-Directed Learning Readiness Scale (SDLRS). The experimental group had access to iPads with four anatomy apps for three weekly classes (1.5 h each). One week after the last class, students were assessed by an online 30-question neuroanatomy test. Linear regression was used to examine the association between test scores and app use, gender, previous anatomy unit score and SDLRS scores. Students’ views on apps were collected by focus group discussion immediately after the test.

Results

Completed questionnaires were obtained from n = 25 control and n = 25 experimental students. There was no association between app use and neuroanatomy assessment score (B = 1.75, 95 % CI: -0.340-3.840, p = 0.099). Only previous anatomy unit score (B = 0.348, 95 % CI: 0.214-0.483, p < 0.001) affected neuroanatomy assessment scores. Students favored apps with clinical images and features including identification pins, sliding bars and rotatable 3D images.

Conclusions

App use did not enhance learning outcomes in a second-year anatomy unit.

From chalkboard, slides, and paper to e-learning: How computing technologies have transformed anatomical sciences education

Until the late-twentieth century, primary anatomical sciences education was relatively unenhanced by advanced technology and dependent on the mainstays of printed textbooks, chalkboard- and photographic projection-based classroom lectures, and cadaver dissection laboratories. But over the past three decades, diffusion of innovations in computer technology transformed the practices of anatomical education and research, along with other aspects of work and daily life. Increasing adoption of first-generation personal computers (PCs) in the 1980s paved the way for the first practical educational applications, and visionary anatomists foresaw the usefulness of computers for teaching. While early computers lacked high-resolution graphics capabilities and interactive user interfaces, applications with video discs demonstrated the practicality of programming digital multimedia linking descriptive text with anatomical imaging. Desktop publishing established that computers could be used for producing enhanced lecture notes, and commercial presentation software made it possible to give lectures using anatomical and medical imaging, as well as animations. Concurrently, computer processing supported the deployment of medical imaging modalities, including computed tomography, magnetic resonance imaging, and ultrasound, that were subsequently integrated into anatomy instruction. Following its public birth in the mid-1990s, the World Wide Web became the ubiquitous multimedia networking technology underlying the conduct of contemporary education and research. Digital video, structural simulations, and mobile devices have been more recently applied to education. Progressive implementation of computer-based learning methods interacted with waves of ongoing curricular change, and such technologies have been deemed crucial for continuing medical education reforms, providing new challenges and opportunities for anatomical sciences educators. Anat Sci Educ 9: 583-602. © 2016 American Association of Anatomists.

Dose- and time-dependent benefits of iPad technology in an undergraduate human anatomy course

This study examined the impact of iPad integration on performance in an undergraduate gross anatomy course. Two out of six course sections were assigned to one of the following conditions: control (no iPad, n = 61); limited access (laboratory iPads, n = 58); and unlimited access (personal iPads, n = 47). Student knowledge was assessed over time during the semester with two practical examinations in laboratory and four multiple choice/essay examinations in lecture. The same PowerPoint presentations and examinations were utilized for all conditions. Mixed ANOVA analysis identified an interaction effect between time and condition for both laboratory (F2,153  = 16.12; P < 0.05) and lecture (F6,462  = 5.47; P < 0.05) performance. Between laboratory examinations, student performance was lower by 4.2% and higher by 3.0% in control and unlimited access conditions, respectively. Unlimited access students scored higher than control and limited access (82.8 ± 2.2 vs 71.5 ± 2.6 and 74.3 ± 1.7%; P < 0.05) and higher than control students (78.7 ± 2.1 vs 70.6 ± 2.0%; P < 0.05) on the third and fourth lecture examination, respectively. Postsemester surveys completed by experimental students (89.5% response rate) indicated that a greater percentage of unlimited vs limited access students agreed that laboratory (84.8 vs 56.3%, P < 0.05) and lecture (58.7 vs 14.6%, P < 0.05) performance was enhanced with the iPad. Results suggest that if students are given the opportunity to overcome the technology learning curve, tablet devices and relevant applications can be useful tools in human anatomy courses. Anat Sci Educ 9: 367-377. © 2015 American Association of Anatomists.