Development of a computer-assisted cranial nerve simulation from the visible human dataset

Visualizing Anatomy in Dental Morphology Education

Tooth morphology is a foundation course for all dental healthcare students including dentists, dental hygiene, dental therapy, and dental nursing students. This chapter explores the conventional and innovative teaching methods to deliver tooth morphology educational modules. The teaching tools are explored with a 2D and 3D lens, with a particular focus on visualization, student understanding, and engagement. Traditional methods of teaching tooth morphology must be complemented with innovative pedagogical approaches in order to maintain student's attention and accommodate their diverse learning methods. Teaching 3D anatomy enables students to visualize and spatially comprehend the link between various anatomical components. Online tests and quizzes motivate students and are also beneficial in preparing students for exams. Online self-examinations offering visualization with 3D teeth enable students to evaluate their knowledge and offers immediate feedback, which aids in the long-term retention of information. These tools can be as efficient as other teaching methods, allowing the students to study at their own pace and with repetition. The authors conclude that blended and innovative teaching methods should supplement student learning and not replace, traditional face-to-face educational methods.

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.

E-Learning Three-Dimensional Anatomy of the Brainstem: Impact of Different Microscopy Techniques and Spatial Ability

Polarized light imaging (PLI) is a new method which quantifies and visualizes nerve fiber direction. In this study, the educational value of PLI sections of the human brainstem were compared to histological sections stained with Luxol fast blue (LFB) using e-learning modules. Mental Rotations Test (MRT) was used to assess the spatial ability. Pre-intervention, post-intervention, and long-term (1 week) anatomical tests were provided to assess the baseline knowledge and retention. One-on-one electronic interviews after the last test were carried out to understand the students' perceptions of the intervention. Thirty-eight medical students, (19 female and 19 males, mean age 21.5 ± SD 2.4; median age: 21.0 years) participated with a mean MRT score of 13.2 ± 5.2 points and a mean pre-intervention knowledge test score of 49.9 ± 11.8%. A significant improvement in both, post-intervention and long-term test scores occurred after learning with either PLI or LFB e-learning module on brainstem anatomy (both P < 0.001). No difference was observed between groups in post-intervention test scores and long-term test scores (P = 0.913 and P = 0.403, respectively). A higher MRT-score was significantly correlated with a higher post-intervention test score (rk  = 0.321; P < 0.05, respectively), but there was not a significant association between the MRT- and the long-term scores (rk = -0.078; P = 0.509). Interviews (n = 10) revealed three major topics: Learning (brainstem) anatomy by use of e-learning modules; The "need" of technological background information when studying brainstem sections; and Mnemonics when studying brainstem anatomy. Future studies should assess the cognitive burden of cross-sectional learning methods with PLI and/or LFB sections and their effects on knowledge retention.

Medical Students' Opinions of Anatomy Teaching Resources and Their Role in Achieving Learning Outcomes

Several teaching resources are used to enhance the learning of anatomy. The purpose of this study was to examine the preference of medical students on the use of various resources to learn anatomy and their link to 12 learning outcomes. A selected response item questionnaire was administered that asked students to rank six laboratory teaching resources from most to least preferred, and rate how useful these six resources were towards achieving 12 learning outcomes. These learning outcomes covered many of the learning domains such as demonstrating an understanding of anatomy, visualizing structures, appreciating clinical correlations, and understanding anatomical variations. Medical students ranked cadaveric prosections paired with an active learning clinical tutorial as the highest rank and most useful resource for learning anatomy, followed by dissection videos, electronic resources, and printed material, followed by plastinated specimens and plastic models. Overall, cadaveric prosections were also rated as the most helpful teaching resource in achieving various learning outcomes. In conclusion, anatomy teachers should provide prosections coupled with clinical tutorials as well as electronic resources as students prefer these and think they help them learn anatomy. Future studies will investigate the impact of using these resources on students' performance.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01436-2.

Mapping the rest of the human connectome: Atlasing the spinal cord and peripheral nervous system

The emergence of diffusion, structural, and functional neuroimaging methods has enabled major multi-site efforts to map the human connectome, which has heretofore been defined as containing all neural connections in the central nervous system (CNS). However, these efforts are not structured to examine the richness and complexity of the peripheral nervous system (PNS), which arguably forms the (neglected) rest of the connectome. Despite increasing interest in an atlas of the spinal cord (SC) and PNS which is simultaneously stereotactic, interactive, electronically dissectible, scalable, population-based and deformable, little attention has thus far been devoted to this task of critical importance. Nevertheless, the atlasing of these complete neural structures is essential for neurosurgical planning, neurological localization, and for mapping those components of the human connectome located outside of the CNS. Here we recommend a modification to the definition of the human connectome to include the SC and PNS, and argue for the creation of an inclusive atlas to complement current efforts to map the brain's human connectome, to enhance clinical education, and to assist progress in neuroscience research. In addition to providing a critical overview of existing neuroimaging techniques, image processing methodologies and algorithmic advances which can be combined for the creation of a full connectome atlas, we outline a blueprint for ultimately mapping the entire human nervous system and, thereby, for filling a critical gap in our scientific knowledge of neural connectivity.

Comparison of Magnetic Resonance Angiography and Computed Tomography Angiography Stereoscopic Cerebral Vascular Models

In this paper, we will discuss and compare the stereoscopic models developed from two types of radiographic data, Magnetic Resonance Angiography (MRA) images and Computed Tomography Angiography (CTA) images. Stereoscopic models were created using surface or volume segmentation and semi-auto combined segmentation techniques. Although, the CTA data were found to improve the speed and quality of constructing virtual vascular models compared to conventional CT data, small blood vessels were difficult to capture during the imaging and reconstruction process thereby limiting the fidelity of the stereoscopic models. Thus, high contrast Magnetic Resonance Angiography (MRA) images offer better resolution to visualize and capture the smaller branches of the cerebral vasculature than CTA images.

Use Stereoscopic Model in Interventional and Surgical Procedures

The 3-dimensional (3D) stereoscopic modeling software allows anatomists to create high-resolution 3D models from computed tomography (CT) images. In this paper, we used high resolution CT images from a cadaver and a patient to develop clinically relevant anatomic models that can be used to teach surgical trainees different surgical procedures and approaches. The model facilitates visualization, manipulation, and interaction. It can be presented in stereoscopic 3D in a virtual environment, either in a classroom setting or immediately preceding a surgical procedure.

Anatomy Visualizations Using Stereopsis: Current Methodologies in Developing Stereoscopic Virtual Models in Anatomical Education

Technology for developing three-dimensional (3D) virtual models in anatomical sciences education has seen a great improvement in recent years. Various data used for creating stereoscopic virtual models have also been constantly improving. This paper focuses specifically on the methodologies of creating stereoscopic virtual models and the techniques and materials used in developing stereoscopic virtual models from both our previous studies and other published literature. The presentation and visualization of stereoscopic models are highlighted, and the benefits and limitations of stereoscopic models are discussed. The practice of making 3D measurements on the lengths, angles, and volumes of models can potentially be used to help predict typical measurement parameters of anatomical structures and for the placement of surgical instruments. Once stereoscopic virtual models have been constructed, their visualization and presentation can be implemented in anatomy education and clinical surgical trainings.

Evaluation of an animation tool developed to supplement dental student study of the cranial nerves

INTRODUCTION

The structure/function of the cranial nerves is a core topic for dental students. However, due to the perceived complexity of the subject, it is often difficult for students to develop a comprehensive understanding of key concepts using textbooks and models. It is accepted that the acquisition of anatomical knowledge can be facilitated by visualisation of structures. This study aimed to develop and assess a novel cranial nerve animation as a supplemental learning aid for dental students.

MATERIALS AND METHODS

A multidisciplinary team of anatomists, neuroscientists and a computer scientist developed a novel animation depicting the cranial nerves. The animation was viewed by newly enrolled first-year dental students, graduate entry dental students (year 1) and dental hygiene students (year 1). A simple life scenario employing the use of the cranial nerves was developed using a cartoon-type animation with a viewing time of 3.58 minutes. The animation was developed with emphasis on a life scenario. The animation was placed online for 2 weeks with open access or viewed once in a controlled laboratory setting. Questionnaires were designed to assess the participants' attitude towards the animation and their knowledge of the cranial nerves before and after visualisation. This study was performed before the delivery of core lectures on the cranial nerves.

RESULTS

Our findings indicate that the use of the animation can act as a supplemental tool to improve student knowledge of the cranial nerves. Indeed, data indicate that a single viewing of the animation, in addition to 2-week access to the animation, can act as a supplemental learning tool to assist student understanding of the structure and function of cranial nerves. The animation significantly enhanced the student's opinion that their cranial nerve knowledge had improved. From a qualitative point of view, the students described the animation as an enjoyable and useful supplement to reading material/lectures and indicated that the animation was a useful tool in understanding the cranial nerves.

CONCLUSION

Overall, these findings indicate that an animation demonstrating the cranial nerves in a simple, everyday functional scenario may act as a learning aid in the study of cranial nerves.

Visualization of stereoscopic anatomic models of the paranasal sinuses and cervical vertebrae from the surgical and procedural perspective

Recent improvements in three-dimensional (3D) virtual modeling software allows anatomists to generate high-resolution, visually appealing, colored, anatomical 3D models from computed tomography (CT) images. In this study, high-resolution CT images of a cadaver were used to develop clinically relevant anatomic models including facial skull, nasal cavity, septum, turbinates, paranasal sinuses, optic nerve, pituitary gland, carotid artery, cervical vertebrae, atlanto-axial joint, cervical spinal cord, cervical nerve root, and vertebral artery that can be used to teach clinical trainees (students, residents, and fellows) approaches for trans-sphenoidal pituitary surgery and cervical spine injection procedure. Volume, surface rendering and a new rendering technique, semi-auto-combined, were applied in the study. These models enable visualization, manipulation, and interaction on a computer and can be presented in a stereoscopic 3D virtual environment, which makes users feel as if they are inside the model. Anat Sci Educ 10: 598-606. © 2017 American Association of Anatomists.

Histology in 3D: development of an online interactive student resource on epithelium

Epithelium is an important and highly specialised tissue type that makes up the lining of inner and outer surfaces of the human body. It is proposed that a self-study tool adds to efficient learning and lecturing on this complicated topic in medical curricula. This paper describes the development and evaluation of an online interactive 3D resource on epithelium for undergraduate medical students. A first evaluation was carried out by means of an online survey (n = 37). The resource was evaluated positively on the website in general, its visual contents and its value and potential for the medical curriculum.

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.

Evaluation of the effectiveness of 3D vascular stereoscopic models in anatomy instruction for first year medical students

The head and neck region is one of the most complex areas featured in the medical gross anatomy curriculum. The effectiveness of using three-dimensional (3D) models to teach anatomy is a topic of much discussion in medical education research. However, the use of 3D stereoscopic models of the head and neck circulation in anatomy education has not been previously studied in detail. This study investigated whether 3D stereoscopic models created from computed tomographic angiography (CTA) data were efficacious teaching tools for the head and neck vascular anatomy. The test subjects were first year medical students at the University of Mississippi Medical Center. The assessment tools included: anatomy knowledge tests (prelearning session knowledge test and postlearning session knowledge test), mental rotation tests (spatial ability; presession MRT and postsession MRT), and a satisfaction survey. Results were analyzed using a Wilcoxon rank-sum test and linear regression analysis. A total of 39 first year medical students participated in the study. The results indicated that all students who were exposed to the stereoscopic 3D vascular models in 3D learning sessions increased their ability to correctly identify the head and neck vascular anatomy. Most importantly, for students with low-spatial ability, 3D learning sessions improved postsession knowledge scores to a level comparable to that demonstrated by students with high-spatial ability indicating that the use of 3D stereoscopic models may be particularly valuable to these students with low-spatial ability. Anat Sci Educ 10: 34-45. © 2016 American Association of Anatomists.

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.

Stereoscopic vascular models of the head and neck: A computed tomography angiography visualization

Computer-assisted 3D models are used in some medical and allied health science schools; however, they are often limited to online use and 2D flat screen-based imaging. Few schools take advantage of 3D stereoscopic learning tools in anatomy education and clinically relevant anatomical variations when teaching anatomy. A new approach to teaching anatomy includes use of computed tomography angiography (CTA) images of the head and neck to create clinically relevant 3D stereoscopic virtual models. These high resolution images of the arteries can be used in unique and innovative ways to create 3D virtual models of the vasculature as a tool for teaching anatomy. Blood vessel 3D models are presented stereoscopically in a virtual reality environment, can be rotated 360° in all axes, and magnified according to need. In addition, flexible views of internal structures are possible. Images are displayed in a stereoscopic mode, and students view images in a small theater-like classroom while wearing polarized 3D glasses. Reconstructed 3D models enable students to visualize vascular structures with clinically relevant anatomical variations in the head and neck and appreciate spatial relationships among the blood vessels, the skull and the skin.

The development of a virtual 3D model of the renal corpuscle from serial histological sections for E-learning environments

Histology is a core subject in the anatomical sciences where learners are challenged to interpret two-dimensional (2D) information (gained from histological sections) to extrapolate and understand the three-dimensional (3D) morphology of cells, tissues, and organs. In gross anatomical education 3D models and learning tools have been associated with improved learning outcomes, but similar tools have not been created for histology education to visualize complex cellular structure-function relationships. This study outlines steps in creating a virtual 3D model of the renal corpuscle from serial, semi-thin, histological sections obtained from epoxy resin-embedded kidney tissue. The virtual renal corpuscle model was generated by digital segmentation to identify: Bowman's capsule, nuclei of epithelial cells in the parietal capsule, afferent arteriole, efferent arteriole, proximal convoluted tubule, distal convoluted tubule, glomerular capillaries, podocyte nuclei, nuclei of extraglomerular mesangial cells, nuclei of epithelial cells of the macula densa in the distal convoluted tubule. In addition to the imported images of the original sections the software generates, and allows for visualization of, images of virtual sections generated in any desired orientation, thus serving as a "virtual microtome". These sections can be viewed separately or with the 3D model in transparency. This approach allows for the development of interactive e-learning tools designed to enhance histology education of microscopic structures with complex cellular interrelationships. Future studies will focus on testing the efficacy of interactive virtual 3D models for histology education.

It's all in the mime: Actions speak louder than words when teaching the cranial nerves

Cranial nerve (CN) knowledge is essential for students in health professions. Gestures and body movements (e.g., mime) have been shown to improve cognition and satisfaction with anatomy teaching. The aim of this pilot study was to compare the effectiveness of didactic lecturing with that of miming lecturing for student learning of the CNs. The research design involved exposure of the same group of students to didactic followed by miming lecturing of CNs. The effectiveness of each lecturing strategy was measured via pre- and post-testing. Student perceptions of these strategies were measured by a survey. As an example of miming, gestures for CN VII included funny faces for muscles of facial expression, kangaroo vocalization for taste, spitting action for saliva production, and crying for lacrimal gland production. Accounting for extra duration of the miming lecture, it was shown that pre- to post-test improvement was higher for the miming presentation than for the didactic (0.47 ± 0.03 marks/minute versus 0.33 ± 0.03, n = 39, P < 0.005). Students perceived that the miming lecture was more interactive, engaging, effective, and motivating to attend (mean on five-point Likert scale: 4.62, 4.64, 4.56, 4.31, respectively) than the didactic lecture. In the final examination, performance was better (P < 0.001, n = 39) on the CN than on the non-CN questions-particularly for students scoring ≤60%. While mediating factors need elucidation (e.g., learning due to repetition of content), this study's findings support the theory that gestures and body movements help learners to acquire anatomical knowledge.

A recommended workflow methodology in the creation of an educational and training application incorporating a digital reconstruction of the cerebral ventricular system and cerebrospinal fluid circulation to aid anatomical understanding

BACKGROUND

The use of computer-aided learning in education can be advantageous, especially when interactive three-dimensional (3D) models are used to aid learning of complex 3D structures. The anatomy of the ventricular system of the brain is difficult to fully understand as it is seldom seen in 3D, as is the flow of cerebrospinal fluid (CSF). This article outlines a workflow for the creation of an interactive training tool for the cerebral ventricular system, an educationally challenging area of anatomy. This outline is based on the use of widely available computer software packages.

METHODS

Using MR images of the cerebral ventricular system and several widely available commercial and free software packages, the techniques of 3D modelling, texturing, sculpting, image editing and animations were combined to create a workflow in the creation of an interactive educational and training tool. This was focussed on cerebral ventricular system anatomy, and the flow of cerebrospinal fluid.

RESULTS

We have successfully created a robust methodology by using key software packages in the creation of an interactive education and training tool. This has resulted in an application being developed which details the anatomy of the ventricular system, and flow of cerebrospinal fluid using an anatomically accurate 3D model. In addition to this, our established workflow pattern presented here also shows how tutorials, animations and self-assessment tools can also be embedded into the training application.

CONCLUSIONS

Through our creation of an established workflow in the generation of educational and training material for demonstrating cerebral ventricular anatomy and flow of cerebrospinal fluid, it has enormous potential to be adopted into student training in this field. With the digital age advancing rapidly, this has the potential to be used as an innovative tool alongside other methodologies for the training of future healthcare practitioners and scientists. This workflow could be used in the creation of other tools, which could be developed for use not only on desktop and laptop computers but also smartphones, tablets and fully immersive stereoscopic environments. It also could form the basis on which to build surgical simulations enhanced with haptic interaction.

Three-dimensional structure of seminiferous tubules in the adult mouse

Seminiferous tubules develop from sex cords, which are embryonic structures with simple C-shaped arches. Histologically, the epithelium of adult mouse seminiferous tubules has been divided into 12 stages based on the associations of spermatogenic cells in four cycles of spermatogenesis. However, the gross characteristics of the seminiferous tubules themselves, including their number, length, run, and mutual relationships remain largely unknown. In the present study, we analyzed all seminiferous tubules in a single adult mouse testis with high resolution using serial paraffin sections and high-perfomance three-dimensional reconstruction software. There were 11 seminiferous tubules with an average length of 140 mm. Each tubule ran along circular paths within the testis while making convolutions with cranial and caudal hairpin turns. The cranial turns of all tubules were in contact with the tunica albuginea, whereas the caudal turns were not, resulting in funnel-shaped networks of these tubules with tapered caudal portions. The caudally located networks surrounded the preceding cranially located networks from the bottom and outside, similar to stacked paper cups. Five out of the 11 seminiferous tubules were continuous from one end to the other both connected with the rete testis (10 connection points). Nine branching points, one blind end, and 18 more connection points with the rete testis were detected in the remaining six seminiferous tubules, making the paths of these tubules complicated to various degrees. The present study revealed that the 3D structures of seminiferous tubules were highly regular as a whole in the adult mouse testis.

Teaching medical anatomy: what is the role of imaging today?

PURPOSE

Medical anatomy instruction has been an important issue of debate for many years and imaging anatomy has become an increasingly important component in the field, the role of which has not yet been clearly defined. The aim of the paper was to assess the current deployment of medical imaging in the teaching of anatomy by means of a review of the literature.

MATERIALS

A systematic search was performed using the electronic database PubMed, ScienceDirect and various publisher databases, with combinations of the relevant MeSH terms. A manual research was added.

RESULTS

In most academic curricula, imaging anatomy has been integrated as a part of anatomical education, taught using a very wide variety of strategies. Considerable variation in the time allocation, content and delivery of medical imaging in teaching human anatomy was identified. Given this considerable variation, an objective assessment remains quite difficult.

DISCUSSION

In most publications, students' perceptions regarding anatomical courses including imaging anatomy were investigated by means of questionnaires and, regardless of the method of teaching, it was globally concluded that imaging anatomy enhanced the quality and efficiency of instruction in human anatomy. More objective evaluation based on an increase in students' performance on course examinations or on specific tests performed before and after teaching sessions showed positive results in numerous cases, while mixed results were also indicated by other studies.

CONCLUSION

A relative standardization could be useful in improving the teaching of imaging anatomy, to facilitate its assessment and reinforce its effectiveness.

Constructing three-dimensional detachable and composable computer models of the head and neck

The head and neck region has a complex spatial and topological structure, three-dimensional (3D) computer model of the region can be used in anatomical education, radiotherapy planning and surgical training. However, most of the current models only consist of a few parts of the head and neck, and the 3D models are not detachable and composable. In this study, a high-resolution 3D detachable and composable model of the head and neck was constructed based on computed tomography (CT) serial images. First, fine CT serial images of the head and neck were obtained. Then, a color lookup table was created for 58 structures, which was used to create anatomical atlases of the head and neck. Then, surface and volume rendering methods were used to reconstruct 3D models of the head and neck. Smoothing and polygon reduction steps were added to improve 3D rendering effects. 3D computer models of the head and neck, including the sinus, pharynx, vasculature, nervous system, endocrine system and glands, muscles, bones and skin, were reconstructed. The models consisted of 58 anatomical detachable and composable structures and each structure can be displayed individually or together with other structures.

Development of an interactive anatomical three-dimensional eye model

The discrete anatomy of the eye's intricate oculomotor system is conceptually difficult for novice students to grasp. This is problematic given that this group of muscles represents one of the most common sites of clinical intervention in the treatment of ocular motility disorders and other eye disorders. This project was designed to develop a digital, interactive, three-dimensional (3D) model of the muscles and cranial nerves of the oculomotor system. Development of the 3D model utilized data from the Visible Human Project (VHP) dataset that was refined using multiple forms of 3D software. The model was then paired with a virtual user interface in order to create a novel 3D learning tool for the human oculomotor system. Development of the virtual eye model was done while attempting to adhere to the principles of cognitive load theory (CLT) and the reduction of extraneous load in particular. The detailed approach, digital tools employed, and the CLT guidelines are described herein.

The cranial nerve skywalk: A 3D tutorial of cranial nerves in a virtual platform

Visualization of the complex courses of the cranial nerves by students in the health-related professions is challenging through either diagrams in books or plastic models in the gross laboratory. Furthermore, dissection of the cranial nerves in the gross laboratory is an extremely meticulous task. Teaching and learning the cranial nerve pathways is difficult using two-dimensional (2D) illustrations alone. Three-dimensional (3D) models aid the teacher in describing intricate and complex anatomical structures and help students visualize them. The study of the cranial nerves can be supplemented with 3D, which permits the students to fully visualize their distribution within the craniofacial complex. This article describes the construction and usage of a virtual anatomy platform in Second Life™, which contains 3D models of the cranial nerves III, V, VII, and IX. The Cranial Nerve Skywalk features select cranial nerves and the associated autonomic pathways in an immersive online environment. This teaching supplement was introduced to groups of pre-healthcare professional students in gross anatomy courses at both institutions and student feedback is included.

Gesture-controlled interactive three dimensional anatomy: a novel teaching tool in head and neck surgery

Background

There is a need for innovative anatomic teaching tools. This paper describes a three dimensional (3D) tool employing the Microsoft Kinect™. Using this instrument, 3D temporal bone anatomy can be manipulated with the use of hand gestures, in the absence of mouse or keyboard.

Methods

CT Temporal bone data is imported into an image processing program and segmented. This information is then exported in polygonal mesh format to an in-house designed 3D graphics engine with an integrated Microsoft Kinect™. Motion in the virtual environment is controlled by tracking hand position relative to the user’s left shoulder.

Results

The tool successfully tracked scene depth and user joint locations. This permitted gesture-based control over the entire 3D environment. Stereoscopy was deemed appropriate with significant object projection, while still maintaining the operator’s ability to resolve image details. Specific anatomical structures can be selected from within the larger virtual environment. These structures can be extracted and rotated at the discretion of the user. Voice command employing the Kinect’s™ intrinsic speech library was also implemented, but is easily confounded by environmental noise.

Conclusion

There is a need for the development of virtual anatomy models to complement traditional education. Initial development is time intensive. Nonetheless, our novel gesture-controlled interactive 3D model of the temporal bone represents a promising interactive teaching tool utilizing a novel interface.

Whole courses of the oculomotor, trochlear, and abducens nerves, identified in sectioned images and surface models

In medicine, the neuroanatomy of the oculomotor (III), trochlear (IV), and abducens nerves (VI) is learned essentially by cadaver dissection, histological specimens, and MRI. However, these methods have many limitations and it is necessary to compensate for the insufficiencies of previous methods. The aim of this research was to present sectioned images and surface models that allow the whole courses of III, IV, and VI and circumjacent structures to be observed in detail. To achieve this, the structures of whole courses of III, IV, and VI were traced on the sectioned images, and surface models of the structures were reconstructed. As a result, nucleus of III, Edinger-Westphal nucleus, nucleus of IV, and nucleus of VI and their fibers were identified on brainstem in the sectioned images. In the sectioned images, III, IV, and VI passed both sides of the cavernous sinus and entered at the orbit through the superior orbital fissure. In the sectioned images, III, IV, and VI innervated extraocular muscles in orbit. In surface models, the whole courses of III, IV, and VI and circumjacent structures could be explored freely three-dimensionally. The greatest advantage of the sectioned images was that they allowed the whole courses of III, IV, and VI and circumjacent structures to be observed as real colored in an unbroken line. In addition, the surface models allowed the stereoscopic shapes and positions of III, IV, and VI to be comprehended. The sectioned images and surface models could be applied for medical education purposes or training tools. All data generated during this study is available free of charge at anatomy.dongguk.ac.kr/cn/.

Perceptions of a mobile technology on learning strategies in the anatomy laboratory

Mobile technologies offer new opportunities to improve dissection learning. This study examined the effect of using an iPad-based multimedia dissection manual during anatomy laboratory instruction on learner's perception of anatomy dissection activities and use of time. Three experimental dissection tables used iPads and three tables served as a control for two identical sessions. Trained, non-medical school anatomy faculty observers recorded use of resources at two-minute intervals for 20 observations per table. Students completed pre- and post-perception questionnaires. We used descriptive and inferential analyses. Twenty-one control and 22 experimental students participated. Compared with controls, experimental students reported significantly (P < 0.05) less reliance on paper and instructor resources, greater ability to achieve anatomy laboratory objectives, and clarity of the role of dissection in learning anatomy. Experimental students indicated that the iPad helped them in dissection. We observed experimental students more on task (93% vs. 83% of the time) and less likely to be seeking an instructor (2% vs. 32%). The groups received similar attention from instructors (33% vs. 37%). Fifty-nine percent of the time at least one student was looking at the iPad. Groups clustered around the iPad a third of their time. We conclude that the iPad-manual aided learner engagement, achieved instructional objectives, and enhanced the effectiveness and efficiency of dissection education.

The LINDSAY Virtual Human Project: an immersive approach to anatomy and physiology

The increasing number of digital anatomy teaching software packages challenges anatomy educators on how to best integrate these tools for teaching and learning. Realistically, there exists a complex interplay of design, implementation, politics, and learning needs in the development and integration of software for education, each of which may be further amplified by the somewhat siloed roles of programmers, faculty, and students. LINDSAY Presenter is newly designed software that permits faculty and students to model and manipulate three-dimensional anatomy presentations and images, while including embedded quizzes, links, and text-based content. A validated tool measuring impact across pedagogy, resources, interactivity, freedom, granularity, and factors outside the immediate learning event was used in conjunction with observation, field notes, and focus groups to critically examine the impact of attitudes and perceptions of all stakeholders in the early implementation of LINDSAY Presenter before and after a three-week trial period with the software. Results demonstrate that external, personal media usage, along with students' awareness of the need to apply anatomy to clinical professional situations drove expectations of LINDSAY Presenter. A focus on the software over learning, which can be expected during initial orientation, surprisingly remained after three weeks of use. The time-intensive investment required to create learning content is a detractor from user-generated content and may reflect the consumption nature of other forms of digital learning. Early excitement over new technologies needs to be tempered with clear understanding of what learning is afforded, and how these constructively support future application and integration into professional practice.

Computer-based learning: interleaving whole and sectional representation of neuroanatomy

The large volume of material to be learned in biomedical disciplines requires optimizing the efficiency of instruction. In prior work with computer-based instruction of neuroanatomy, it was relatively efficient for learners to master whole anatomy and then transfer to learning sectional anatomy. It may, however, be more efficient to continuously integrate learning of whole and sectional anatomy. A study of computer-based learning of neuroanatomy was conducted to compare a basic transfer paradigm for learning whole and sectional neuroanatomy with a method in which the two forms of representation were interleaved (alternated). For all experimental groups, interactive computer programs supported an approach to instruction called adaptive exploration. Each learning trial consisted of time-limited exploration of neuroanatomy, self-timed testing, and graphical feedback. The primary result of this study was that interleaved learning of whole and sectional neuroanatomy was more efficient than the basic transfer method, without cost to long-term retention or generalization of knowledge to recognizing new images (Visible Human and MRI).

Experimental evidence for improved neuroimaging interpretation using three-dimensional graphic models

Three-dimensional (3D) or volumetric visualization is a useful resource for learning about the anatomy of the human brain. However, the effectiveness of 3D spatial visualization has not yet been assessed systematically. This report analyzes whether 3D volumetric visualization helps learners to identify and locate subcortical structures more precisely than classical cross-sectional images based on a two dimensional (2D) approach. Eighty participants were assigned to each experimental condition: 2D cross-sectional visualization vs. 3D volumetric visualization. Both groups were matched for age, gender, visual-spatial ability, and previous knowledge of neuroanatomy. Accuracy in identifying brain structures, execution time, and level of confidence in the response were taken as outcome measures. Moreover, interactive effects between the experimental conditions (2D vs. 3D) and factors such as level of competence (novice vs. expert), image modality (morphological and functional), and difficulty of the structures were analyzed. The percentage of correct answers (hit rate) and level of confidence in responses were significantly higher in the 3D visualization condition than in the 2D. In addition, the response time was significantly lower for the 3D visualization condition in comparison with the 2D. The interaction between the experimental condition (2D vs. 3D) and difficulty was significant, and the 3D condition facilitated the location of difficult images more than the 2D condition. 3D volumetric visualization helps to identify brain structures such as the hippocampus and amygdala, more accurately and rapidly than conventional 2D visualization. This paper discusses the implications of these results with regards to the learning process involved in neuroimaging interpretation.

Item difficulty in the evaluation of computer-based instruction: an example from neuroanatomy

This article reports large item effects in a study of computer-based learning of neuroanatomy. Outcome measures of the efficiency of learning, transfer of learning, and generalization of knowledge diverged by a wide margin across test items, with certain sets of items emerging as particularly difficult to master. In addition, the outcomes of comparisons between instructional methods changed with the difficulty of the items to be learned. More challenging items better differentiated between instructional methods. This set of results is important for two reasons. First, it suggests that instruction may be more efficient if sets of consistently difficult items are the targets of instructional methods particularly suited to them. Second, there is wide variation in the published literature regarding the outcomes of empirical evaluations of computer-based instruction. As a consequence, many questions arise as to the factors that may affect such evaluations. The present article demonstrates that the level of challenge in the material that is presented to learners is an important factor to consider in the evaluation of a computer-based instructional system.