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Jacobs E, Wainman B, Bowness J. Applying artificial intelligence to the use of ultrasound as an educational tool: A focus on ultrasound-guided regional anesthesia. ANATOMICAL SCIENCES EDUCATION 2024; 17:919-925. [PMID: 36880869 DOI: 10.1002/ase.2266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/10/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Emma Jacobs
- Department of Anaesthesia, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK
| | - Bruce Wainman
- Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Science, McMaster University, Hamilton, Ontario, Canada
| | - James Bowness
- Department of Anaesthesia, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK
- OxSTaR Center, Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Bilella A, Eppler E, Link K, Filgueira L. Body painting, ultrasound, clinical examination, and peer-teaching: A student-centered approach to enhance musculoskeletal anatomy learning. ANATOMICAL SCIENCES EDUCATION 2024; 17:157-172. [PMID: 37670412 DOI: 10.1002/ase.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 07/12/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023]
Abstract
The presented course, established 2016 as a compulsory elective for 22nd-year bachelor medical students, aimed to enhance deep learning of upper and lower limb anatomy from a clinical perspective by a maximum of student-centered activities combining hands-on skills training with team-learning. Three cohorts (in total 60 students) participated in this study. Students rotated through body painting, ultrasound, and clinical investigation supervised by faculty or an experienced clinician. Teams of 3-4 students prepared presentations on clinical anatomy and pathological conditions, which by teacher- and peer assessments on average achieved >85% (mean 17.8/20 points ± 1.06). After each activity session, the students reported their learning experience through a reflective diary. Fifty students (83%) evaluated the course by a voluntary anonymous questionnaire combining Likert-type scale and free-text questions to assess, predominantly, perception of course activities and their perceived influence on learning anatomy. Journal reports and questionnaires revealed that the students highly valued the course, and 92% (29 females, 17 males) rated group work satisfying or well-perceived. The highest appreciation achieved ultrasound followed by clinical examination and body painting, which one third proposed to integrate into the regular dissection course. All students recommended the course to their younger peers. This course was feasible to integrate in the pre-existing curriculum. Limiting factors to offer this elective course to more students are availability of clinical teachers, technical equipment, and education rooms. Being student-directed tasks, body painting and reflective diary-writing would be feasible to implement without additional faculty, which we recommend to educators for student engagement activation.
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Affiliation(s)
- Alessandro Bilella
- Anatomy, University of Fribourg, Fribourg, Switzerland
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | | | - Karl Link
- Anatomy, University of Fribourg, Fribourg, Switzerland
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Kulas P, Schick B, Helfrich J, Bozzato A, Hecker DJ, Pillong L. Assessing the Use of Telepresence-Guided Video-Based Head and Neck Ultrasound Training: A Step towards Minimizing Dependence on Human Resources? Diagnostics (Basel) 2023; 13:2828. [PMID: 37685366 PMCID: PMC10487032 DOI: 10.3390/diagnostics13172828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The acquisition of ultrasound skills is an essential part of any medical student's education. University access restrictions in the context of the COVID-19 pandemic have highlighted the need for digitization in teaching. However, teaching manual skills in online courses has proven to be challenging, not least in terms of human resources. Therefore, the aim of this study was to set up a hybrid head and neck ultrasound course consisting of a preface of video-based self-study followed by supportive instruction by a tutor in telepresence and to evaluate the quality, effectiveness, and feasibility of this teaching method. Thirty-five students were shown video tutorials on systematic ultrasound of the neck course. Learning outcomes were analyzed using self-assessment questionnaires and external assessment by an experienced ultrasonographer. All participants demonstrated statistically significant learning improvement (p < 0.001) when comparing self-assessment scores before and after training. The mean self-assessment scores increased from 13.8 to 26.6 for the telepresence-guided group, from 16.6 to 27.3 for the web-based group, and from 14.0 to 26.2 for the in-person group. The external observer assessment also showed improvement, with mean scores of 46.7, 48.1, and 46.5, respectively. Overall results did not significantly differ when comparing different instruction modalities. A telepresence-guided video-based ultrasound course is well suited to teaching ultrasound skills similar to in-person courses and allows a more resource-efficient targeting of student needs.
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Affiliation(s)
| | | | | | | | | | - Lukas Pillong
- Department for Otorhinolaryngology and Head- and Neck-Surgery, Saarland University Medical Center, Kirrbergerstraße 100, 66421 Homburg, Germany; (P.K.); (B.S.); (J.H.); (A.B.); (D.J.H.)
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4
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Dissabandara LO, Nawaratna S, Nirthanan S. Fine-tuning the standard setting of objective structured practical examinations in clinical anatomy. ANATOMICAL SCIENCES EDUCATION 2023; 16:486-496. [PMID: 36622721 DOI: 10.1002/ase.2250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/04/2022] [Accepted: 12/24/2022] [Indexed: 05/11/2023]
Abstract
The objective structured practical examination (OSPE) is a reliable assessment of practical skills in anatomy teaching. It is often administered as low-stake assessments to track progress at multiple time points in anatomy curricula. Standard-setting OSPEs to derive a pass mark and to ensure assessment quality and rigor is a complex task. This study compared standard-setting outcomes of clinical anatomy OSPEs determined by traditional criterion-referenced (Ebel) and norm-referenced ("mean minus standard deviation") methods in comparison to hybrid methods which apply both criterion-referenced and norm-referenced approaches in setting examination standards. The hybrid approaches utilized included the "Cohen method" and an adaptation of the "Taylor's method," which is an improvement on the Cohen method. These diverse standard-setting methods were applied retrospectively to 16 anatomy OSPEs conducted over 4 years for first- and second-year medical students in a graduate Doctor of Medicine Program at Griffith Medical School, Australia; and the pass marks, failure rates, and variances of failure rates were compared. The application of the adaptation of Taylor's method to standard set OSPEs produced pass marks and failure rates comparable to the Ebel method, whereas the variability of failure rates was higher with the Ebel method than with the Cohen and Taylor's methods. This underscores this study's adaptation of Taylor's method as a suitable alternative to the widely accepted but resource intensive, panel-based criterion-referenced standard-setting methods such as the Ebel method, where panelists with relevant expertise are unavailable, particularly for the multiple low-stakes OSPEs in an anatomy curriculum.
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Affiliation(s)
- Lakal O Dissabandara
- School of Medicine and Dentistry, Griffith Health Group, Griffith University, Gold Coast, Queensland, Australia
| | - Sujeevi Nawaratna
- School of Medicine and Dentistry, Griffith Health Group, Griffith University, Gold Coast, Queensland, Australia
| | - Selvanayagam Nirthanan
- School of Medicine and Dentistry, Griffith Health Group, Griffith University, Gold Coast, Queensland, Australia
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5
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Kumar N, Rahman E. OSPE for non‐surgical aesthetic training programme. CLINICAL TEACHER 2022; 19:e13515. [DOI: 10.1111/tct.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Narendra Kumar
- Division of Biosciences, Department of Cell and Developmental Biology University College London London UK
| | - Eqram Rahman
- Department of Plastic Surgery, Royal Free Hospital University College London London UK
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Pillong L, Bozzato A, Hecker D, Bozzato V, Schick B, Kulas P. “A Head Start or a Pain in the Neck?”—Establishment and Evaluation of a Video-Based “Hands-On” Head and Neck Ultrasound Course. Diagnostics (Basel) 2022; 12:diagnostics12051239. [PMID: 35626394 PMCID: PMC9141540 DOI: 10.3390/diagnostics12051239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has strongly highlighted the need for more digitalization in healthcare. Teaching ultrasound skills in online courses is a key challenge in this context. The aim of this study was to establish an online video-based head and neck ultrasound course with an evaluation of the quality, effectiveness, and feasibility of this teaching method compared to in-person teaching. Twenty-two medical students were taught head and neck ultrasound in two groups: one group in an in-person course and the other one in a video-based course. Learning success was analyzed using self-evaluation forms and external assessment by an experienced ultrasonographer. Comparing pre- and post-training self-evaluation, all participants showed statistically significant learning progress. In the external assessment, the overall scores in both groups did not differ significantly. The courses themselves were positively evaluated by all participants. Herein, we present the first feasibility study of a web-based head and neck-ultrasound course for medical students. The methodology provides the potential for future changes in telemedical education and sustainable improvements in telemedical teaching and global intra-clinical and interdisciplinary patient care.
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DePhilip RM, Quinn MM. Adaptation of an anatomy graduate course in ultrasound imaging from in-person to live, remote instruction during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:493-507. [PMID: 35271761 PMCID: PMC9082486 DOI: 10.1002/ase.2177] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/26/2022] [Accepted: 03/07/2022] [Indexed: 05/28/2023]
Abstract
Health concerns during the Covid-19 pandemic required the adaptation of a lecture-laboratory course in ultrasound imaging for graduate students from an in-person to a live, remote learning format. The adaptation of in-person lectures to live, remote delivery was achieved by using videoconferencing. The adaptation of in-person laboratory sessions to live, remote instruction was achieved in the first half of the course by providing a hand-held ultrasound instrument to each student who performed self-scanning at their remote locations, while the instructor provided live instruction using videoconferencing. In the second half of the course, the students transitioned to using cart-based, hospital-type instruments and self-scanning in the ultrasound laboratory on campus. The aim of this study was to measure the success of this adaptation to the course by comparing assessment scores of students in the live, remote course with assessment scores of students in the in-person course offered in the previous year. There were no statistically significant differences in the assessment scores of students in the two courses. The adaptation of a course in ultrasound imaging from an in-person to a live, remote learning format during the Covid-19 pandemic described here suggests that contrary to the prevailing view, ultrasound imaging can be taught to students without in-person instruction. The adapted course can serve as a model for teaching ultrasound where instructors and learners are physically separated by constraints other than health concerns during a pandemic.
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Affiliation(s)
- Robert M. DePhilip
- Division of AnatomyDepartment of Biomedical Education and AnatomyThe Ohio State University College of MedicineColumbusOhioUSA
| | - Melissa M. Quinn
- Division of AnatomyDepartment of Biomedical Education and AnatomyThe Ohio State University College of MedicineColumbusOhioUSA
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Darici D, Missler M, Schober A, Masthoff M, Schnittler H, Schmitz M. "Fun slipping into the doctor's role"-The relationship between sonoanatomy teaching and professional identity formation before and during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:447-463. [PMID: 35274467 DOI: 10.1002/ase.2178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
The various psychological dimensions of professional identity formation (PIF) are an important aspect of the study course for undergraduate medical students. Anatomical learning environments have been repeatedly shown to play a critical role in forming such an identity; however, relevance of PIF during sonoanatomical training remains underexplored. At the end of their basic anatomy studies, third-semester medical students took part in a four-day block course on anatomy and imaging. Anatomical content was revised in small groups using peer teaching and imaging methods, including one hour of hands-on sonoanatomy sessions each day. On-site sonoanatomy was identified as an excellent format to support students' transition from the pre-clinical to clinical phase as medical experts-to-be. Students enjoyed practical exercises and the clinical input, which increased their interest in the medical profession and their academic studies. This study further examined the effects of the transition into an online-only format, necessitated by the current Covid-19 pandemic. A comparison was made between the quantitative and qualitative evaluation data, and the written results of examinations of several on-site (n = 1096, mean age = 22.4 years ± 2.18), and online-only cohorts (n = 230, mean age = 22.6 years ± 2.21). The online-only transition led to a reduction of all PIF-related variables measured, losing identity-related variables, increasing students' stress levels, and reducing their long-term academic performance. Together, this study demonstrates presence of PIF in undergraduate sonoanatomy teaching, and cautions against the uncritical online-only substitution of hands-on learning environments.
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Affiliation(s)
- Dogus Darici
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Markus Missler
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Anna Schober
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Max Masthoff
- Institute of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Hans Schnittler
- Institute of Anatomy and Vascular Biology, Westfälische Wilhelms-University, Münster, Germany
| | - Martina Schmitz
- Institute of Anatomy and Vascular Biology, Westfälische Wilhelms-University, Münster, Germany
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Lufler RS, Davis ML, Afifi LM, Willson RF, Croft PE. Bringing anatomy to life: Evaluating a novel ultrasound curriculum in the anatomy laboratory. ANATOMICAL SCIENCES EDUCATION 2022; 15:609-619. [PMID: 34714592 DOI: 10.1002/ase.2148] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/06/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
As point-of-care ultrasound (POCUS) invades medical specialties, more students covet earlier ultrasound (US) training programs in medical school. Determining the optimal placement and format in the curriculum remains a challenge. This study uses student perceptions and confidence in interpreting and acquiring images to evaluate the effectiveness of an US curriculum and assesses their performance on US content. A unique US curriculum was incorporated into first-year clinical anatomy at Tufts University School of Medicine (TUSM). Students completed surveys evaluating changes in US confidence and perceptions. Mean ratings on pre- and post-surveys were compared using Mann-Whitney U tests. Performance on US examination questions was evaluated. Two independent evaluators coded narrative responses and NVivo software was used to identify common themes. Two hundred eleven students completed the US curriculum. Students reported higher post-curriculum mean confidence ratings on US comprehension, operation, image acquisition, artifact recognition, and normal image interpretation (P < 0.0001). US reinforced anatomy concepts and clinical correlates (9.56, ±0.97 SD; 9.60, ±1.05). Students disagreed with items stating learning US is too difficult (1.2, ±2.2) and that it interferes with learning anatomy (0.68, ±1.7). Students scored above passing on practical US knowledge questions, supporting survey data, and the relation to learning spatial relationships. Qualitative analysis identified seven major themes and additional subthemes. Limited integration of US breaks barriers in students' perceptions and confidence in performing POCUS. The TUSM US curriculum is a natural marriage of anatomy and POCUS applications, serving as a template for medical schools.
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Affiliation(s)
- Rebecca S Lufler
- Department of Medical Education, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Margaret L Davis
- Emergency Medicine Department, University of Washington, Seattle, Washington, USA
| | - Linda M Afifi
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Robert F Willson
- Department of Medical Education, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Peter E Croft
- Emergency Medicine Department, Maine Medical Center, Portland, Maine, USA
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10
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Evans DJR. Assessing the Wider Outcomes of Anatomy Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:275-276. [PMID: 33768720 DOI: 10.1002/ase.2076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Darrell J R Evans
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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