Scan and Learn: Quick Response Code Enabled Museum for Mobile Learning of Anatomy and Pathology

Effects of the individual three-dimensional printed craniofacial bones with a quick response code on the skull spatial knowledge of undergraduate medical students

Understanding the three-dimensional (3D) structure of the human skull is imperative for medical courses. However, medical students are overwhelmed by the spatial complexity of the skull. Separated polyvinyl chloride (PVC) bone models have advantages as learning tools, but they are fragile and expensive. This study aimed to reconstruct 3D-printed skull bone models (3D-PSBs) using polylactic acid (PLA) with anatomical characteristics for spatial recognition of the skull. Student responses to 3D-PSB application were investigated through a questionnaire and tests to understand the requirement of these models as a learning tool. The students were randomly divided into 3D-PSB (n = 63) and skull (n = 67) groups to analyze pre- and post-test scores. Their knowledge was improved, with the gain scores of the 3D-PSB group (50.0 ± 3.0) higher than that of the skull group (37.3 ± 5.2). Most students agreed that using 3D-PSBs with quick response codes could improve immediate feedback on teaching (88%; 4.41 ± 0.75), while 85.9% of the students agreed that individual 3D-PSBs clarified the structures hidden within the skull (4.41 ± 0.75). The ball drop test revealed that the mechanical strength of the cement/PLA model was significantly greater than that of the cement or PLA model. The prices of the PVC, cement, and cement/PLA models were 234, 1.9, and 10 times higher than that of the 3D-PSB model, respectively. These findings imply that low-cost 3D-PSB models could revolutionize skull anatomical education by incorporating digital technologies like the QR system into the anatomical teaching repertoire.

In jars: The integration of historical anatomical and pathological potted specimens in undergraduate education

INTRODUCTION

Across the UK, many anatomy departments possess historical potted wet cadaveric specimen collections, such as organs preserved in fluid-filled jars. Although considered obsolete by some for anatomical education, there is immense potential for their utilisation in teaching, particularly in institutes that have limited access to cadavers or have had body donation rates impacted by the Covid-19 pandemic. Another benefit of historical potted cadaveric specimens is that severe pathology, often not seen today, can be observed by the student.

MATERIAL AND METHODS

The aim of this study was to understand students' opinions and attitudes towards the use of historical anatomical and pathological potted wet specimen collections in undergraduate science teaching. Following their integration into the anatomy program of a Clinical Sciences degree, seventy-seven undergraduate students completed a five-point Likert questionnaire on their perspective for the integration of the historical potted specimens in anatomical education. This study was approved by the Research Ethics committee at the University of Bradford RESULTS: The study demonstrated that 90 % of students found the collection useful in teaching, 92 % would like to see the collection used more in teaching, and 76 % of students found that the collection encouraged them to consider medical ethics and the donor.

CONCLUSIONS

In conclusion, the survey findings suggest that further utilisation of historical potted wet specimen collections would be useful in the teaching of anatomy and that these collections could potentially encourage conversations on post-mortem bodily integrity, ethics, and organ donation.

Reviving the anatomic past: Breathing new life into historic anatomical teaching tools

The last two decades have seen a shift in the way anatomy education is delivered. With the introduction of blended learning, cadaveric dissection is no longer the be all and end all and, in many cases, the continuing role of anatomical teaching artefacts has declined after decades of prominence. While some institutions have abandoned their archaic anatomical collections and medical museums completely, others have invested in their technological enhancement. We describe the integration of historical teaching artefacts into contemporary anatomy education through the development of an interactive online e-platform and shed light on the enduring pedagogic value of past anatomical teaching specimen.

Impact of the COVID-19 Pandemic on Students' Motivation in Relation to Asynchronous Anatomy Video Lectures

OBJECTIVES

This study aimed to investigate medical students' motivation in relation to asynchronous anatomy video lectures, carried out during COVID-19 remote teaching.

METHODS

Repeated cross-sectional modified Instructional Materials Motivation Survey questionnaire, validated in Brazil, was applied to 255 students attending the first semester of the undergraduate medical course at the José do Rosário Vellano University, in June 2020 and November 2020. The data were analyzed considering the 95% confidence level as significant (p < 0.05).

RESULTS

The overall score of motivation attributed by the students was moderate to high (3.7/5, 74%). The same occurred in relation to all dimensions of the instrument: Interest (3.6/5, 72%), Confidence (3.7/5, 74%), Attention (3.5/5, 70%), and Expectation (3.7/5, 74%). Cluster analysis showed that 78% (n = 168) of the students had moderate (72% of the maximum score) or high (86% of the maximum score) degrees of motivation. The influence of social isolation on the students' emotional state did not affect the overall motivation scores (p = 0.217) or the dimensions of motivation: Interest (p = 0342), Confidence (p = 0.061), Attention (p = 0.625), and Expectation (p = 0.094).

CONCLUSIONS

The students showed high motivation for the asynchronous video lectures of human anatomy. Although the majority of students are highly affected regarding their emotional state, due to the social isolation imposed by the COVID-19 pandemic, this fact did not interfere with the motivation for video lectures, probably due to the high intrinsic motivation that students in the first year have in relation to anatomy. These findings alert to the importance of asynchronous video lectures as an adequate strategy for the teaching and learning of human anatomy.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01714-7.

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

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

Investigating the effectiveness of three-dimensionally printed anatomical models compared with plastinated human specimens in learning cardiac and neck anatomy: A randomized crossover study

Three-dimensional printing (3DP) technology has been increasingly applied in health profession education. Yet, 3DP anatomical models compared with the plastinated specimens as learning scaffolds are unclear. A randomized-controlled crossover study was used to evaluate the objective outcomes of 3DP models compared with the plastinated specimens through an introductory lecture and team study for learning relatively simple (cardiac) and complex (neck) anatomies. Given the novel multimaterial and multicolored 3DP models are replicas of the plastinated specimens, it is hypothesized that 3DP models have the same educational benefits to plastinated specimens. This study was conducted in two phases in which participants were randomly assigned to 3DP (n = 31) and plastinated cardiac groups (n = 32) in the first phase, whereas same groups (3DP, n = 15; plastinated, n = 18) used switched materials in the second phase for learning neck anatomy. The pretest, educational activities and posttest were conducted for each phase. Miller's framework was used to assess the cognitive outcomes. There was a significant improvement in students' baseline knowledge by 29.7% and 31.3% for Phase 1; 31.7% and 31.3% for Phase 2 plastinated and 3DP models. Posttest scores for cardiac (plastinated, 3DP mean ± SD: 57.0 ± 13.3 and 60.8 ± 13.6, P = 0.27) and neck (70.3 ± 15.6 and 68.3 ± 9.9, P = 0.68) phases showed no significant difference. In addition, no difference observed when cognitive domains compared for both cases. These results reflect that introductory lecture plus either the plastinated or 3DP modes were effective for learning cardiac and neck anatomy.

A validated instrument measuring students' perceptions on plastinated and three-dimensional printed anatomy tools

Due to the modernization of the medical curriculum and technological advancements, anatomy education has evolved beyond cadaveric dissection alone. Plastination techniques, three-dimensional (3D) modeling, and 3D printing technologies have progressively gained importance. However, there are limited valid and reliable surveys to evaluate students' perceptions of these new anatomy tools. Hence, this study aimed to develop a validated instrument to measure students' learning satisfaction, self-efficacy, humanistic values, and perceived limitations of plastinated and 3D printed models. A 41-item survey (five-point Likert scale, 1 = strongly disagree to 5 = strongly agree) was administered to Year 1 undergraduate medical students following a randomized controlled crossover study that evaluated plastinated and 3D printed cardiac and neck models. Ninety-six responses were received, and a factor analysis was performed with the Kaiser-Meyer-Olkin sampling adequacy of 0.878. The confirmatory factor analysis yielded a 4-factor, 19 items model that had a good fit with the latent constructs of x ² (147) = 211.568, P < 0.001, root mean square error of approximation = 0.068, root mean square residual = 0.064, comparative fit index = 0.946, and Tucker Lewis index = 0.937. The Cronbach's alpha for the individual factors ranged from 0.74 to 0.95, indicating good internal consistency. This demonstrated a psychometrically valid and reliable instrument to measure students' perceptions toward plastinated and 3D printed models.

Technological resources for teaching and learning about human anatomy in the medical course: Systematic review of literature

The consolidation of technology as an alternative strategy to cadaveric dissection for teaching anatomy in medical courses was accelerated by the recent Covid-19 pandemic, which caused the need for social distance policies and the closure of laboratories and classrooms. Consequently, new technologies were created, and those already been developed started to be better explored. However, information about many of these instruments and resources is not available to anatomy teachers. This systematic review presents the technological means for teaching and learning about human anatomy developed and applied in medical courses in the last ten years, besides the infrastructure necessary to use them. Studies in English, Portuguese, and Spanish were searched in MEDLINE, Scopus, ERIC, LILACS, and SciELO databases, initially resulting in a total of 875 identified articles, from which 102 were included in the analysis. They were classified according to the type of technology used: three-dimensional (3D) printing (n = 22), extended reality (n = 49), digital tools (n = 23), and other technological resources (n = 8). It was made a detailed description of technologies, including the stage of the medical curriculum in which it was applied, the infrastructure utilized, and which contents were covered. The analysis shows that between all technologies, those related to the internet and 3D printing are the most applicable, both in student learning and the financial cost necessary for its structural implementation.

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.

Augmented Reality Application for Handheld Devices: How to Make It hAPPen at the Pavia University History Museum

The Pavia University History Museum, which houses historic items mainly connected to the physics and medicine fields, has focused in the past years on new ways to involve its public and to attract new audiences. Among different approaches, digital technologies have proven important to both external and internal communication. Lately, an Augmented Reality application has been made available to visitors, offering in one tool multimedia material of a historical-scientific nature: stories, 3D animations, images and user-generated video storytelling (developed mainly by University students, one of our least present demographics before the App, and younger students, who typically participate in the annual co-creative project). The App was designed to be as non-intrusive and discreet as possible, to preserve the historic ambiance of the museum, to unite social and educational aspects, to register user behaviour and to make the museum experience more vibrant and active and therefore captivating.

A quasi-experimental study examining QR code-based video education program on anxiety, adherence, and satisfaction in coronary angiography patients

Background: QR (quick response) codes are a promising tool for health education, however effects of QR code application in providing peri-procedure education to patients with coronary angiography is unclear.Aim/Objective: This study investigated the effect of a QR code-based video education program on anxiety, adherence, and satisfaction in Chinese coronary angiography patients.Material and Methods: This prospective controlled clinical trial included 335 patients undergoing coronary angiography, including 166 patients in the experimental group and 169 patients in the control group. On the day before coronary angiography, patients in the experimental group had access to and could watch an educational video on their smartphones by scanning a QR code for multiple times, while patients in the control group watched the same video on a tablet once only. The primary outcome was anxiety assessed using the Chinese State Anxiety Inventory (C-SAI). Adherence to instructions and patient satisfaction with the information delivery method were also evaluated.Results: The C-SAI scores improved in the experimental group compared to the control group (F = 9.8, P < 0.001) over time. There is a significant difference in the changes of anxiety scores from baseline to pre-procedure (P < 0.001) and post-procedure (P < 0.01) between the two groups. Individuals in the experimental group showed better adherence to instructions on removing dentures and jewelry, and taking medicines before the procedure (P < 0.05), and limb activity, water consumption, and diet after the procedure (P < 0.001).Conclusion: Patient education programs on smartphone that can be accessed multiple times by scanning a QR code can be an effective and convenient approach to reducing anxiety and enhancing adherence to instructions among Chinese coronary angiography patients. Hospitals and clinicians should consider more investments in developing such patient education programs and also help improve ehealth literacy.

Development of flash cards to teach about lesions in the jaws and maxillary sinuses

OBJECTIVE

We sought to evaluate a set of flash cards to teach about lesions of the jaws and maxillary sinuses.

METHODS

We placed illustrations of 30 diseases of the jaws and maxillary sinuses on the front of the cards (7 cm × 5 cm). On the backs of the cards, a description of the radiological findings and the corresponding QR code for each disease were printed. Each QR code was linked to a website where actual X-ray images of the lesion could be viewed. Students and radiologists in training could easily access the website by scanning the QR code with a handheld device. The evaluation of the system by students was quite favorable and its utilization rate was high. After a 6-month trial, we conducted a questionnaire. The subjects were 94 fourth-year students at our college, and the questionnaire was anonymous.

RESULTS

The evaluation of the system by students was quite favorable and its utilization rate was high.

CONCLUSIONS

The learning content of our learning cards with QR codes was well received by students and was highly useful.

Uses of quick response codes in healthcare education: a scoping review

BACKGROUND

To review published literature on the use of quick response (QR) codes within healthcare education. In addition, the authors aimed to gain information on user perceptions and the challenges faced when implementing QR codes in an educational context.

METHODS

Medline, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HMIC (Healthcare Management Information Consortium) and HBE (Health Business Elite) were searched using specified search terms that included 'quick response code' and 'education'. Title and abstract review of 217 publications was performed. Papers which discussed the application of QR codes relevant to healthcare education were included. A total of 24 articles were reviewed and thematic analysis conducted to generate themes.

RESULTS

Use of QR codes in healthcare education were broadly aligned to four common themes. These included: to increase participant engagement, for simulation training, for just-in-time (JIT) learning and to facilitate with administrative tasks in training. Perceptions towards the use of QR codes was generally positive. Challenges identified, included: problems with technical infrastructure, unavailability of smartphones and resistance to use in certain environments.

CONCLUSIONS

The use of QR codes for healthcare education is increasing, and whilst they offer some advantages there are also some important considerations including: provision of the necessary technological infrastructure, patient and staff safety and governance and adherence to guidelines on safe and appropriate use of this technology in sensitive settings.