Active Learning of the Floor of Mouth Anatomy with Ultrasound

Ultrasound technology as a tool to teach basic concepts of physiology and anatomy in undergraduate and graduate courses: a systematic review

Many publications describe use of ultrasound imaging in teaching of clinical courses, primarily integrated with clinical applications. More recently there have been increasing numbers of papers describing ultrasound as a tool primarily for teaching basic anatomy and physiology concepts rather than clinical applications. Of these, many have described qualitative analysis with a consensus that its use is viewed very positively by students for aiding learning. Far fewer studies have attempted quantitative analysis to support this belief, and conclusions have been varied. A review of studies was conducted that included those that used ultrasound to teach physiology and anatomy concepts. Studies were excluded if they did not contain quantitative or qualitative assessment of efficacy. Medline and Embase databases were searched (11/16/22) and screened by two independent reviewers. Forty-six studies were included, with data extracted relating to cohort characteristics, ultrasound intervention, quantitative or qualitative assessments, and any barriers to implementation. It was confirmed that both student and teacher opinions are extremely favorable in most cases. Although conclusions from quantitative studies were not as clear, there was evidence that ultrasound is at least as effective as more conventional teaching methods and could have significantly better performances in short-term assessments. However, varied methods of teaching intervention, experimental protocols, and assessment of learning may have contributed to the lack of clarity. Within this context, some of the problems encountered with implementing ultrasound as an educational tool (such as financial and temporal constraints), and in conducting more definitive studies, are discussed.NEW & NOTEWORTHY This first systematic review of ultrasound use as a teaching tool in basic anatomy and physiology confirmed that students and staff believe incorporation is beneficial to learning and is highly popular. Quantitative data are scarcer but show that it is at least as effective as more conventional teaching methods and can enhance short-term recall. Good-quality studies with adequate comparisons and assessment methods are still lacking, so further work in this area is needed.

Impact of the educational setting on the teaching and learning of the equine distal limb ultrasonography

The use of immersive methodologies is a trend in the educational environment, but their outcomes in the teaching-learning process need to be better understood. This study aimed to assess the impact of the educational environment on learning equine distal limb ultrasonography, comparing immersive classroom, traditional classroom, and virtual classroom. A total of 153 veterinary medicine students from the first to the third semester participated in this study. The students were divided into four groups: traditional (n = 22), immersive (n = 100), online (n = 31), and traditional-immersive (n = 15). The students completed a questionnaire before and immediately after the class. The online group had a lower average gain in correct answers compared to the others (p < 0.01). Regarding student perception, it was observed that the virtual group had the lowest satisfaction score (p < 0.001), and students in the immersive and online environments were more satisfied with the resources used compared to the traditional classroom (p = 0.01). Concluding, in the present study students showed a greater interest in environments associated with technology, and that in-person modalities resulted in significantly superior learning outcomes compared to online ones.

Anatomical knowledge enhancement through echocardiography and videos, with a spotlight on cognitive load, self-efficacy, and motivation

In recent years, there has been a growing recognition of the importance of integrating ultrasound into undergraduate medical curricula. However, empirical evidence is lacking as to its effect on anatomy learning and related student cognition. Therefore, the present study compared the impact of echocardiography-based instruction with narrated videos on students' understanding of anatomical relationships, as well as the interaction with students' autonomous motivation, self-efficacy beliefs, mental load, and attitudes. Second-year medical students were given the opportunity to enroll in a supplementary booster course about cardiac anatomy. On the base of a randomized controlled trial with a cross-over design, we studied the effect of taking this course on spatial anatomical knowledge. After completing a pre-test (T0), students were allocated randomly to either the echocardiography-based teaching condition (cohort A) or the narrated anatomy video condition (cohort B). Next, participants were crossed over to the alternative intervention. Immediately after each phase in the intervention, students were asked to rate their mental load. Additionally, a spatial anatomical knowledge test, an autonomous motivation scale, and a self-efficacy scale were administered before (T0) and after the first intervention (T1) and at the end of the study (T2). Finally, each student completed a perception-based survey. The study design allowed a comparative evaluation of both interventions at T1, while the cross-over design facilitated the assessment of the most optimal sequencing in the interventions at T2. A total of 206 students participated (cohort A: n = 99, cohort B: n = 107). At T1, no significant differences in the knowledge test and the autonomous motivation scale were observed between cohorts A and B. However, cohort A showed higher self-efficacy beliefs compared to cohort B (p = 0.043). Moreover, cohort A reported higher levels of perceived mental load (p < 0.001). At T2, the results showed that neither sequence of interventions resulted in significant differences in anatomy scores, autonomous motivation, or self-efficacy. However, a significant difference in mental load was found again, with students in cohort B reporting a higher level of mental load (p < 0.001). Finally, based on the perception-based survey, students reported favorably on the echocardiography experience. In conclusion, the hands-on echocardiography sessions were highly appreciated by the medical students. After participating in the ultrasound sessions, they reported higher levels of self-efficacy beliefs compared to the video-based condition. However, despite embodied cognition principles, students in the echocardiography condition did not outperform students in the narrated anatomy video condition. The reported levels of mental load in the ultrasound condition could explain these findings.

Ultrasound versus videos: A comparative study on the effectiveness of musculoskeletal anatomy education and student cognition

Ultrasound imaging is a dynamic imaging technique that uses high-frequency sound waves to capture live images of the structures beneath the skin. In addition to its growing use in diagnosis and interventions, ultrasound imaging has the potential to reinforce concepts in the undergraduate medical curriculum. However, research assessing the impact of ultrasound on anatomy learning and student cognition is scarce. The purpose of this study was to compare the impact of ultrasound-based instruction versus narrated videos on students' understanding of anatomical relationships, as well as the role of intrinsic motivation, self-efficacy beliefs, and students' attitudes in this process. A booster course on anterior leg and wrist anatomy was offered to second-year medical students. A randomized controlled trial with a cross-over design allocated students to either an ultrasound-based teaching condition (cohort A) or a narrated anatomy video condition (cohort B). Next, participants were crossed to the alternative intervention. At the start of the study (T0), baseline anatomy knowledge, intrinsic motivation, self-efficacy beliefs, and spatial ability were measured. After the first intervention (T1) and at the end of the study (T2), both cohorts were administered an anatomy test, an intrinsic motivation scale, and a self-efficacy scale. In addition, each student was asked to fill out a perception survey after the ultrasound intervention. Finally, building on the cross-over design, the most optimal sequence of interventions was examined. A total of 181 students participated (cohort A: n = 82, cohort B: n = 99). Both cohorts performed comparably on the baseline anatomy knowledge test, spatial ability test, intrinsic motivation, and self-efficacy scale. At T1, cohort B outperformed cohort A on the anatomy test (p = 0.019), although only a small effect size could be detected (Cohen's d = 0.34). Intrinsic motivation and self-efficacy of both cohorts were similar at T1. At T2, the anatomy test, intrinsic motivation, and self-efficacy scale did not reflect an effect after studying either sequence of the interventions. Students reported favorably about the ultrasound experience, but also mentioned a steep learning curve. Medical students found the hands-on ultrasound sessions to be valuable, increasing their interest in musculoskeletal anatomy and ultrasound imaging. However, the addition of ultrasound did not result in superior spatial anatomy understanding compared to watching anatomy videos. In addition, ultrasound teaching did not have a major effect on student cognition. Ultrasound-based teaching of musculoskeletal anatomy is regarded as difficult to learn, and therefore it is hypothesized that too high levels of cognitive load might explain the presented results.

Barriers and Facilitators to the Learning and Acquisition of Research Competencies among Nursing Students through Active Methodologies: A Qualitative Study Using Reflective Writing

BACKGROUND

The development of educational research, critical thinking skills, and evidence-based practice requires proposals for educational innovation. The purpose of this study was to explore the perspectives of undergraduate nursing students on the barriers and facilitators after the implementation of a novel activity within the course of research methodology, composed of three active learning strategies: (a) project-based learning; (b) small-group learning; and (c) self-directed learning.

METHODS

A qualitative exploratory study using reflective writing was conducted at the Nursing Department of the Red Cross School (Spain). Seventy-four nursing students participated in the study, enrolled in the research methodology course. Purposive sampling was used. Online reflective notes were collected from a script of open-ended questions. An inductive thematic analysis was performed.

RESULTS

The new proposals facilitated learning of the subject matter and its contents. They were useful and enabled the students to put the contents into practice. In addition, they improved the students' organization, planning, and involvement. The barriers identified were a lack of time, ambiguity, inadequate tutoring or novelty of the work, and inequity in the distribution of tasks and workloads.

CONCLUSIONS

Our findings shed light on the barriers and facilitators identified by nursing students when implementing an educational innovation proposal, using three active learning methodologies as learning tools for the subject of nursing research.

Awareness of Universal Design for Learning among anatomy educators in higher level institutions in the Republic of Ireland and United Kingdom

There is an increasing need to facilitate enhanced student engagement in anatomy education. Higher education students differ in academic preferences and abilities and so, not all teaching strategies suit all students. Therefore, it is suggested that curricula design and delivery adapt to sustain learner engagement. Enhanced learner engagement is a fundamental feature of Universal Design for Learning (UDL). The aim of this study is to determine if anatomy educators in the Republic of Ireland (ROI) and United Kingdom (UK) are aware of UDL and to assess if, and to what extent, it has been implemented in the design and delivery of anatomy curricula for healthcare students. An anonymous online questionnaire was administered to anatomy educators in higher level institutions in the ROI and UK. Inductive content analysis was used to identify the impact of UDL on student learning, engagement, and motivation, as perceived by the participants. The response rate was 23% (n = 61). Nineteen participants stated they knew of UDL. Of these, 15 had utilized UDL in their teaching of anatomy. Analysis indicated that the perception of UDL was mixed. However, the majority of responses relating to UDL were positive. The majority of the respondents were unaware of UDL but identified the frameworks' checkpoints within their curriculum, suggesting they have unknowingly incorporated elements of UDL in their curriculum design and delivery. There is a lack of information on the benefits of explicit utilization of UDL for engagement and motivation to learn anatomy in healthcare programs in the ROI and UK.

The Use of Ultrasound in Undergraduate Medical Anatomy Education: a Systematic Review with Narrative Synthesis

This systematic review aimed to synthesize the literature on how ultrasound is currently used in anatomy education within medical schools. A systematic search of Ovid MEDLINE, Scopus, and Educational Resources Information Centre was conducted. Thirty-four relevant unique articles were included from the 1,272 identified from the databases and analyzed via narrative synthesis. Thematic analysis generated two domain summaries: "Successful Aspects of Ultrasound Teaching" and "Barriers to Implementation," each with additional subthemes, aimed to help educators inform best teaching practices from the current evidence base in this field.

Musculoskeletal ultrasound training encourages self-directed learning and increases confidence for clinical and anatomical appreciation of first-year medical students

Best-practice guidelines have incorporated ultrasound in diagnostic and procedural medicine. Due to this demand, the Arizona College of Osteopathic Medicine initiated a comprehensive integration of ultrasound into its first-year anatomy course attended by more than 280 students. Ultrasound workshops were developed to enhance student conceptualization of musculoskeletal (MSK) anatomy through visualizing clinically important anatomical relationships, a simulated lumbar puncture during the back unit, carpal tunnel and shoulder evaluations during the upper limb unit, and plantar fascia, calcaneal tendon, and tarsal tunnel evaluations during the lower limb unit. A 5-point Likert scale survey evaluated if ultrasound improved students' self-perceived anatomical and clinical comprehension of relevant anatomy, improved students' ability to orient to ultrasound imagery, and prompted further independent investigation of the anatomical area. Ultrasound examination questions were added to the anatomy examinations. Two-tailed one-sample t-tests for the back, upper limb, and lower limb units were found to be significant across all Likert survey categories (P < 0.001). Positive student responses to the Likert survey in conjunction with examination question average of 84.3% (±10.3) demonstrated that the ultrasound workshops are beneficial to student education. Ultrasound enhances medical students' clinical and anatomical comprehension and ability to orient to ultrasound imagery for MSK anatomy. This study supports early ultrasound education as a mechanism to encourage students' independent learning as evidenced by many undertaking voluntary investigation of clinical concerns associated with MSK anatomy. This study establishes the successful integration of MSK ultrasound into a large medical school program and its benefit to student clinical education.

Veterinary anatomy teaching from real to virtual reality: An unprecedented shift during COVID-19 in socially distant era

Teaching Veterinary Anatomy in a virtual world is an utmost requirement of the ongoing era of COVID-19 pandemic. Due to sudden lockdown, all the educational institutes, professional medical and veterinary colleges were closed (except emergency services) and academic activities were suspended altogether. This situation was challenging as well as thought-provoking for various academicians and professors to rethink about the means to keep the conduit of imparting education unceasing. This review focuses on the virtual reality aids that are being adopted worldwide and the initiatives taken by academicians during this era to impart best practical anatomy lessons yet being in a socially distant world. However, during the lockdown and social distancing, face-to face interactions were not feasible, and therefore, number of distant learning methods were created on virtual platforms for continuing the process of teaching veterinary anatomy closer to reality available at their doorsteps where academic staff was actively involved to reconstruct and renovate resources, upgraded their digital competencies to develop new ways to shift from one on one and merged to remote online teaching, and anatomy teaching was transformed to an abrupt 'virtual mode'. Adopting virtual reality (VR) aids such as 3D animations, software packages, virtual dissections and E-museum serves as a great saviour throughout this unprecedented pandemic in a socially distant world to continue the teaching connexion.

A review of anatomy education during and after the COVID-19 pandemic: Revisiting traditional and modern methods to achieve future innovation

The coronavirus disease 2019 (COVID-19) pandemic has had enormous effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal way to learn anatomy since the 17th century. As it is difficult to predict future access to cadavers for students or in-person classes, anatomy educators are encouraged to revisit all possible teaching methods in order to develop innovations. Here, we review anatomy education methods to apply to current and future education.