Testing the Educational Potential of 3D Visualization Software in Oral Radiographic Interpretation

Apprendre l’anatomie radiographique en présentiel ou en ligne ? Une étude randomisée contrôlée

Résumé

L’enseignement de l’anatomie repose sur diverses techniques: les cours, les dissections, les modèles 3D ou encore les supports en ligne. Ces derniers sont généralement considérés comme des moyens d’apprentissage complémentaires. Cette étude vise à comparer les performances des étudiants vétérinaires (N=83) en anatomie radiographique (radioanatomie) après un apprentissage en ligne ou conventionnel, et de voir dans quelle mesure ces méthodes sont interchangeables. Trois stratégies sont comparées : apprentissage en ligne exclusif, apprentissage en ligne avec des os de chevaux, apprentissage sur radiographies conventionnelles avec des os de chevaux. Les performances au test de rotation mentale et au test de connaissance en radioanatomie sont similaires entre les 3 groupes à la base, lors du test préliminaire. Après l’apprentissage (test final), les scores de rotation mentale et de radioanatomie augment significativement de 6.7/40 points (CI : 5.2–8.2; p < .001) et de 5.1/20 points (CI: 4.3–5.9; p< .001). Il n’y a pas de différence entre les groupes pour les scores de rotation mentale et de radioanatomie après l’apprentissage. Le score de rotation mentale est influencé par le genre, et significativement plus élevé chez les hommes que chez les femmes au test préliminaire (M= 23.0, SD = 8.8 vs. M= 16.5, SD= 6.9; p= .001) et au test final (M= 32.1, SD= 5.5 vs. M= 22.7, SD= 8.6; p< .001). Les performances en radioanatomie ne sont pas influencées par le genre. Ces résultats suggèrent que l’enseignement de la radioanatomie peut être réalisé en présentiel avec des radiographies conventionnelles ou en ligne. Cette interchangeabilité entre apprentissage en présentiel et en distanciel est intéressante au regard des impératifs liés aux crises sanitaires, et des besoins d’adaptation rapide en distanciel.

This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0153

Can Online Teaching of Radiographic Anatomy Replace Conventional On-Site Teaching? A Randomized Controlled Study

Different modalities such as lectures, dissections, 3D models, and online learning are used for teaching anatomy. To date, online learning has been considered a useful additional didactic tool. This study aimed to compare veterinary students' performance in radiographic anatomy (radio-anatomy) after online or classroom-based teaching to assess the extent to which the two methods were interchangeable. Three strategies were compared in a cohort of 83 learners. Students were committed to online learning only, online learning with the use of specimen equine bones, or learning on conventional radiographs with specimen equine bones. At baseline (pre-test), scores from a mental rotation test and radio-anatomy knowledge test were similar between groups. After training (post-test), scores in mental rotation and radio-anatomy significantly increased by 6.7/40 units (95% CI: 5.2-8.2; p < .001) and 5.1/20 units (95% CI: 4.3-5.9; p < .001), respectively. There was no difference in scores for mental rotation and radio-anatomy knowledge between groups at post-test. Gender influenced the mental rotation, with men scoring significantly higher than women at pre-test (M = 23.0, SD = 8.8 vs. M = 16.5, SD = 6.9; p = .001) and post-test (M = 32.1, SD = 5.5 vs. M = 22.7, SD = 8.6; p < .001). However, radio-anatomy knowledge was not influenced by gender. These results suggest radio-anatomy teaching can be safely achieved with either conventional radiographs or online resources. This is of interest since, due to the COVID-19 outbreak, rapidly changing from on-site to online methods for teaching veterinary medical education proved necessary.

Spatial ability and anatomy learning performance among dental students

PURPOSE

Spatial perception is an essential skill for professional dentists. The objective of this study was to observe the spatial ability, as well as anatomy module grades, of dental students at a dental education center in Indonesia and relate these to gender and cohort.

METHODS

A cross-sectional study was carried out where dental students in years (cohorts) 1, 2, 4-6 were invited to take the Revised Purdue Spatial Visualization Test (PSVT-R) and the redrawn Vandenberg and Kuse Mental Rotation Test (MRT) in order to assess spatial ability. In addition, the 1st- and 2nd-year dental students carried out gross anatomy assessments. Spatial ability test results were compared using an independent t-test to detect gender differences, one-way analysis of variance to inspect cohort differences, and correlation relative to anatomy module scores.

RESULTS

A total of 326 dental students voluntarily participated. Statistically significant gender differences were found in both spatial ability tests in the overall sample (PSVT-R: p&lt;0.001; MRT: p=0.001). When the 1st- and 2nd-year dental students were pooled, significant gender differences were detected, in which males scored higher than females in both spatial ability tests (PSVT-R: p&lt;0.001; MRT: p=0.003). In anatomy, however, females scored higher than the males (p=0.005). In addition, there were weak to moderate, but significant correlations between spatial ability tests and anatomy scores.

CONCLUSION

This study indicated that spatial ability may not be the only factor predicting the academic performance of dental students. However, dental students with low spatial ability scores may need supplementary educational techniques when learning specific spatial tasks.

The Anatomy Course During COVID-19: The Impact of Cadaver-Based Learning on the Initiation of Reflection on Death

BACKGROUND

During the COVID-19 pandemic, in-person cadaveric dissection laboratories for teaching anatomy were omitted by many schools around the world. While knowledge domains can be easily evaluated via remote exams, non-traditional discipline-independent skills such as those encouraged through reflection on the topic of death are often overlooked. This study investigated how different anatomy course formats played a role in initiating students' reflections on death during the COVID-19 pandemic.

METHOD

In fall 2020, 217 medical, dental, premedical, and health sciences students from 13 international universities discussed differences in their anatomy courses online. Formats of anatomy courses ranged from dissection-based, prosection-based, hybrid (combination of dissection and prosection) to no laboratory exposure at all. Students' responses to the question, "Did/does your anatomy course initiate your thinking about life's passing?" were collected, and they self-reported themes that were present in their reflections on death using a multiple-choice prompt. Statistical analyses to detect differences between students with and without exposure to cadavers were performed using the chi-squared test.

RESULTS

When comparing students who had exposure to human anatomical specimens to those who had no exposure, the majority of students with exposure thought that the course did initiate thoughts about life's passing, compared to students without exposure (P < 0.05). Reflection themes were consistent across groups.

DISCUSSION

These findings indicate that anatomy dissection courses are important for the initiation of students' feelings about the topic of death. Omission of cadaveric dissection- or prosection-based laboratories will decrease the likelihood that students initiate reflection on this topic and gain important transferable skills.

Modelling and visualization for the analysis and comprehension of the acoustic performance of buildings through the implementation of a building information modelling-based methodology

Technical and technological advances have revolutionised the architecture, engineering, and construction industries in recent decades. Building information modelling (BIM) methodology has become essential in the process of information management and the development of building projects. This study aims to analyse the potential advantages of the implementation of BIM-based models for the acquisition of theoretical and procedural knowledge about building acoustics. This procedure was implemented as part of a problem-solving exercise in Science, Technology, Engineering, and Mathematics (STEM) university degrees. For this purpose, three-dimensional (3D) BIM models were generated to assess the contribution of their implementation in the process of visualization, comprehension, and analysis of the acoustic behaviour of buildings. The participants' experiences and satisfaction with the BIM models were measured through a questionnaire. The results showed a high level of satisfaction among the participants and good potential for the application of 3D models based on BIM methodology for the acquisition of knowledge and practical skills in building acoustics. These results highlight the potential of BIM models to provide information for understanding the procedure followed during data collection in the experimental analysis and to facilitate the understanding of system behavior.

Exploring spatial ability in healthcare students and the relationship to training with virtual and actual objects

INTRODUCTION

The relationship between the spatial ability levels of students and anatomy education is not well established in the literature, but it was stated that students should take short-term training during the first years of their education. There is limited number of studies on this topic. In that respect, the aim of this study was to determine the spatial ability levels of medical, dental and nursing students and to evaluate whether this ability level showed difference with respect to faculty, anatomy courses attended or short-term training, or not.

MATERIALS AND METHODS

Study sample was composed of 1071 students. Data were collected by Personal Information Form, Visualization of Views Test (VoVT) and Cross Section Test (CST). Data analyses were done by SPSS 21 package software.

RESULTS

Students were determined to have medium level spatial ability. Medical and dental students were found to have higher spatial ability levels than nursing students. Medical and nursing students' CST scores showed significant difference after taking anatomy course. After short-term training, both CST and VoVT scores of students differed significantly.

CONCLUSION

Supporting anatomy courses with education materials appropriate for the spatial ability level of students and introducing spatial ability development trainings in small groups would aid in increasing spatial ability levels of students.

Pedagogical development in local anaesthetic training in paediatric dentistry using virtual reality simulator

PURPOSE

With the advancements in technology, dental pedagogy has also evolved, and new learning technologies have emerged. Virtual reality (VR) as an education tool in dentistry is underutilised. VR as an adjunct in local anaesthesia (LA) teaching in paediatric dentistry has not been investigated. The study aimed to investigate dental student's perception of dental LA VR simulation on a paediatric patient and to determine whether this can improve students learning experience.

METHODS

Seventy-one students participated in a self-administered questionnaire before and after the use of dental LA VR simulator. Descriptive analysis was performed to determine the perceptions of experience gained through VR. The data were tabulated, graphed, and analysed using SPSS and GraphPad Prism software.

RESULTS

The study noted that 89.9% of participants perceived that it would improve their LA skills. After using dental LA VR, 83.1% of participants experienced more engaged in the learning activity, and 55.0% of participants agreed/strongly agreed that it improved their understanding of anatomical landmarks. Around 56.4% of participants agreed/strongly agreed that it added value compared with traditional LA teaching methods.

CONCLUSION

It can be concluded that the use of VR simulation can enhance students engagement and learning experience in paediatric dentistry settings and can be used as an additional means of LA training.

Dry Skulls and Cone Beam Computed Tomography (CBCT) for Teaching Orofacial Bone Anatomy to Undergraduate Dental Students

Learning bone anatomy of the skull is a complex topic involving three-dimensional information. The impact of the use of human dry skulls and cone beam computed tomography (CBCT) imaging was investigated in the teaching of undergraduate dental students. Sixty-four first-year students in the University of Hong Kong were randomly divided into eight groups. Four teaching methods were tested: (1) CBCT followed by standard lecture, (2) CBCT followed by lecture with skulls, (3) standard lecture followed by CBCT, and (4) lecture with skulls followed by CBCT. After each, students were given a multiple-choice questionnaire to assess their objective learning outcome (20 questions) and a questionnaire for their subjective satisfaction (10 statements). Surveys were assessed with Cronbach's alpha, Kendall's tau-b, and principal components analysis. Data were analyzed with Student's t-test and a one-way ANOVA (significance α = 0.05). Standard lecture followed by CBCT showed the highest learning outcome score (81.6% ± 14.1%), but no significant difference was present among four teaching methods. Cone beam computed tomography followed by lecture with skulls scored the highest overall subjective satisfaction (4.9 ± 0.8 out of 6), but no significant difference was present among teaching methods. Nevertheless, students' perception of learning was positively influenced by the use of skulls (P = 0.018). The timing of administration of the CBCT did not affect students' subjective satisfaction or objective learning outcome. Students perceived to learn more by using skulls, but their objective learning outcomes were not significantly affected. A discrepancy seems to exist between students' perception of learning and their effective performance.

Use of interactive instructional tools in virtual 3D planning

OBJECTIVES

The aim of this study is to analyze the effectiveness of screencast training videos for users from different professional backgrounds on the basis of the quality and quantity of virtual 3D implant planning as evaluated using assessment software.

METHODS

Participants in the study were dental students (n = 21), dental technicians (n = 16), or practicing dentists (n = 16) with no knowledge of the implant planning software CoDiagnostiX or any experience in virtual implant planning. They were randomly divided into 2 groups: The participants of the control group were presented training videos on CBCT (cone beam computed tomography) and implant planning, additional to the traditional software manual. The participants of the experimental group received, additionally, a training video on the planning software, produced in the form of a screencast. Then 3 implant planning procedures were performed by all participants. The quality of implant planning was assessed using the Treatment Evaluation Tool software, and time for planning was measured.

RESULTS

Paired sample tests showed significantly shorter planning times for the experimental groups consisting of dentists and students (P < 0.001). A comparison of the results of the individual groups reveals that students and dental technicians who had not received prior screencast training were significantly less precise in their planning (P < 0.001).

CONCLUSION

This study suggests a promising outcome for the future use of screencasts in the acquisition of software skills for dental software. There is a need for tools for objective self-assessment of effectiveness in software training.

Effect of computer-assisted-learning and simulation clinics on dental students' cognitive and performance skills: panoramic image errors related to patient's head position

OBJECTIVES

To assess dental students' ability to recognize head positioning errors in panoramic (PAN) images after individual learning via computer-assisted-learning (CAL) and in a simulation clinic (SIM). Both cognitive skills and performance in patient examination were assessed.

METHODS AND MATERIALS

60 students (mean age 23.25 years) participated in lectures on the relation between PAN-image errors and patient's head position. Immediately after they took a test, based on which they were randomized to three groups: control (CON) group, CAL group, and SIM group (both CAL and training in a simulation clinic with a phantom). 4-5 weeks after intervention/no intervention, all students individually examined a patient with PAN-exposure. A blinded rater, not knowing group allocation, supervised patient exposure and assessed student's performance (correct/incorrect head position in three planes). 1-2 weeks after, the students scored positioning errors in 40 PAN-images. Differences in cognitive test scores between groups were evaluated by ANOVA and in patient examination by χ² tests, and within-group differences by sign-tests.

RESULTS

No statistically significant difference in cognitive test scores was seen between the SIM and CAL group, while the CON group scored lower (p < 0.003). In all groups, several students positioned the patient incorrectly in the Frankfort horizontal plane. All students performed well in the sagittal plane. Students in SIM group positioned the patient more correctly in the coronal plane.

CONCLUSIONS

Training with CAL increased students' cognitive skills compared with a control group. Simulated patient exposure with a phantom increased to some extent their performance skills in examination of patients.

An Alternative Method for Anatomy Training: Immersive Virtual Reality

The aim of this study was to investigate the effect of immersive three-dimensional (3D) interactive virtual reality (VR) on anatomy training in undergraduate physical therapy students. A total of 72 students were included in the study. The students were randomized into control (n = 36) and VR (n = 36) group according to the Kolb Learning Style Inventory, sex, and Purdue Spatial Visualization Test Rotations (PSVT-R). Each student completed a pre-intervention and post-intervention test, consisting of 15 multiple-choice questions. There was no significant difference between the two groups in terms of age, sex, Kolb Learning Style Inventory distribution, and the PSVT-R (P > 0.05). The post-test scores were significantly higher compared to pre-test scores in both the VR group (P < 0.001) and the control group (P < 0.001). The difference between the pre-test and post-test results was found to be significantly higher in favor of the VR group (P < 0.001). In this study, anatomy training with a 3D immersive VR system was found to be beneficial. These results suggest that VR systems can be used as an alternative method to the conventional anatomy training approach for health students.

3D Technology Development and Dental Education: What Topics Are Best Suited for 3D Learning Resources?

The aim of this study is to identify topics (knowledge and skills) from the dental curricula that would benefit from having a 3D learning resource using an exploratory sequential design method. The first phase targeted stakeholders from a Scottish dental school. Seven focus groups and three interviews disclosed 97 suitable topics for 3D technology development. These results were used to construct a survey that was sent to final year dental students, newly dental graduates and academics from three Scottish universities. The survey asked participants to rank each item based on the perceived benefit that a 3D learning resource would have for dental education. Results revealed that detailed anatomy of the temporomandibular joint, dental anaesthesiology, dental clinical skills techniques, dental occlusion and mandibular functioning were top priorities. Gender differences only appeared in relation to ‘Extraction techniques: movements and force’ (p < 0.05), this topic was considered to be more beneficial by females than by males. No statistical difference was found when comparing results of graduates with undergraduates. These results serve as a starting point when developing a new 3D technology tool for dental education, considering users demands and perceived needs has the potential to benefit dental students and dental education directly.

Evaluation of HoloHuman augmented reality application as a novel educational tool in dentistry

AIMS

To investigate dental student's perception of the augmented reality (AR) head and neck anatomy application and to determine whether the learning environment was beneficial for students compared with traditional cadaver learning.

METHODS

A total of 88 students participated in a self-administered questionnaire prior to and after the use of AR. This was conducted during anatomy classes for second-year dentistry students. Descriptive data analysis was performed to determine the perceptions of experience gained through AR.

RESULTS

The study revealed that over two-thirds of participants perceived that it would assist in their learning with 52.3% of participants who agreed and 35.2% of participants who strongly agreed. After the use of HoloHuman, it was found that 43.5% of participants agreed that the 3D anatomical structures improved their understanding of anatomy and 36.5% agreed that they felt more confident about their anatomy skills. The results also demonstrated that only 34.1% agreed that it added value in training compared with relying solely on traditional methods. Overall, 75.3% of participants agreed that HoloHuman teaching should not replace traditional cadaver training.

CONCLUSION

This study suggested that the use of AR offers an additional mean of dental anatomy training; however, it cannot be used as a replacement for traditional modes of cadaver anatomy training. AR has the potential to be used as an adjunct tool in the learning of dental head and neck anatomy as it has demonstrated increased student engagement and enjoyment; however, limitations with the device still remain.

Three-dimensional Visualization Software Assists Learning in Students with Diverse Spatial Intelligence in Medical Education

This study evaluated effect of mental rotation (MR) training on learning outcomes and explored effectiveness of teaching via three-dimensional (3D) software among medical students with diverse spatial intelligence. Data from n = 67 student volunteers were included. A preliminary test was conducted to obtain baseline level of MR competency and was utilized to assign participants to two experimental conditions, i.e., trained group (n = 25) and untrained group (n = 42). Data on the effectiveness of training were collected to measure participants' speed and accuracy in performing various MR activities. Six weeks later, a large class format (LCF) session was conducted for all students using 3D software. The usefulness of technology-assisted learning at the LCF was evaluated via a pre- and post-test. Students' feedback regarding MR training and use of 3D software was acquired through questionnaires. MR scores of the trainees improved from 25.9±4.6 points to 28.1±4.4 (P = 0.011) while time taken to complete the tasks reduced from 20.9±3.9 to 12.2±4.4 minutes. Males scored higher than females in all components (P = 0.016). Further, higher pre- and post-test scores were observed in trained (9.0±1.9 and 12.3±1.6) versus untrained group (7.8±1.8; 10.8±1.8). Although mixed-design analysis of variance suggested significant difference in their test scores (P < 0.001), both groups reported similar trend in improvement by means of 3D software (P = 0.54). Ninety-seven percent of students reported technology-assisted learning as an effective means of instruction and found use of 3D software superior to plastic models. Software based on 3D technologies could be adopted as an effective teaching pedagogy to support learning across students with diverse levels of mental rotation abilities.

Development and Assessment of a Three-Dimensional Tooth Morphology Quiz for Dental Students

Tooth morphology has a pivotal role in the dental curriculum and provides one of the important foundations of clinical practice. To supplement tooth morphology teaching a three-dimensional (3D) quiz application (app) was developed. The 3D resource enables students to study tooth morphology actively by selecting teeth from an interactive quiz, modify their viewpoint and level of zoom. Additionally, students are able to rotate the tooth to obtain a 3D spatial understanding of the different surfaces of the tooth. A cross-over study was designed to allow comparison of students' results after studying with the new application or traditionally with extracted/model teeth. Data show that the app provides an efficient learning tool and that students' scores improve with usage (18% increase over three weeks, P < 0.001). Data also show that student assessment scores were correlated with scores obtained while using the app but were not influenced by the teaching modality initially accessed (r²  = 0.175, P < 0.01). Comparison of the 2016 and 2017 class performance shows that the class that had access to the app performed significantly better on their final tooth morphology assessment (68.0% ±15.0 vs. 75.3% ±13.4, P < 0.01). Furthermore, students reported that the 3D application was intuitive, provided useful feedback, presented the key features of the teeth, and assisted in learning tooth morphology. The 3D tooth morphology app thus provides students with a useful adjunct teaching tool for learning dental anatomy. Anat Sci Educ 00: 000-000. © 2018 American Association of Anatomists.

An systematic review of e-learning outcomes in undergraduate dental radiology curricula-levels of learning and implications for researchers and curriculum planners

OBJECTIVES

To examine the outcomes of e-learning or blended learning interventions in undergraduate dental radiology curricula and analyze the nature of the knowledge levels addressed in learning interventions.

METHODS

A systematic literature review was performed using a search strategy based on MeSH key words specific to the focus question and indexed in the MEDLINE database. The search again was supplemented by hand-searching of selected journals. Data were extracted relating to outcomes of knowledge and student perceptions. Analysis of the e-learning intervention was performed using a new framework to examine the level of knowledge undertaken: (1) remember/understand (2) analysis or evaluation or diagnosis and (3) performance ("knows how" or "shows how").

RESULTS

From the selected 17 papers, 11 were positive about student reported outcomes of the interventions, and 8 reported evidence that e-learning interventions enhanced learning. Out of the included studies, 8 used e-learning at the level of remember/understand, 4 at the level of analysis/evaluate/diagnosis, and 5 at the level of performance ("knows how," "shows how").

CONCLUSIONS

The learning objectives, e-learning intervention, outcome measures and reporting methods were diverse and not well reported. This makes comparison between studies and an understanding of how interventions contributed to learning impractical. Future studies need to define "knowledge" levels and performance tasks undertaken in the planning and execution of e-learning interventions and their assessment methods. Such a framework and approach will focus our understanding in what ways e-learning is effective and how it contributes to better evidence-based e-learning experiences.

Increasing clinical relevance in oral radiology: Benefits and challenges when implementing digital assessment

AIMS

The aims of the study were to investigate benefits and challenges in implementing a digital examination and study the clinical relevance of the digital examination in relation to clinical training and practice.

MATERIAL AND METHOD

The study was based on semi-structured focus-group interviews from two distinct student populations (2016 and 2017) in a bachelor programme in dental hygiene. In addition, conversational data from a plenary discussion from the whole second student population (2017) were collected and analysed. The data were approached on basis of content analysis.

RESULTS

A benefit experienced in the digital examination was the ease in typing and editing answers on the computer. This suggests an increased effectiveness in computer-based compared to analogue examinations. An additional advantage was the experienced relevance of the examination related to the clinic. This finding refers not only to the digital presentations of images, but also to the entire setting in the clinic and dental practice. The limitations reported by the students were non-optimal viewing conditions for presenting radiographic images and difficulties in obtaining an overview of the assignments compared to paper-based examinations due to the linear digital examination format. The last finding on lacking overview revealed an influence on student performances which should be taken seriously in designing digital examinations.

CONCLUSION

In conclusion, the digital layout increases efficiency and clinical relevance of examinations to a certain extent. Obstacles were found in limitations related to image presentation and lack of overview of the examination. The latter challenge raises questions related to developing suitable assessment software.

The effectiveness of virtual and augmented reality in health sciences and medical anatomy

Although cadavers constitute the gold standard for teaching anatomy to medical and health science students, there are substantial financial, ethical, and supervisory constraints on their use. In addition, although anatomy remains one of the fundamental areas of medical education, universities have decreased the hours allocated to teaching gross anatomy in favor of applied clinical work. The release of virtual (VR) and augmented reality (AR) devices allows learning to occur through hands-on immersive experiences. The aim of this research was to assess whether learning structural anatomy utilizing VR or AR is as effective as tablet-based (TB) applications, and whether these modes allowed enhanced student learning, engagement and performance. Participants (n = 59) were randomly allocated to one of the three learning modes: VR, AR, or TB and completed a lesson on skull anatomy, after which they completed an anatomical knowledge assessment. Student perceptions of each learning mode and any adverse effects experienced were recorded. No significant differences were found between mean assessment scores in VR, AR, or TB. During the lessons however, VR participants were more likely to exhibit adverse effects such as headaches (25% in VR P < 0.05), dizziness (40% in VR, P < 0.001), or blurred vision (35% in VR, P < 0.01). Both VR and AR are as valuable for teaching anatomy as tablet devices, but also promote intrinsic benefits such as increased learner immersion and engagement. These outcomes show great promise for the effective use of virtual and augmented reality as means to supplement lesson content in anatomical education. Anat Sci Educ 10: 549-559. © 2017 American Association of Anatomists.

The development of a learning management system for dental radiology education: A technical report

PURPOSE

This study was conducted to suggest the development of a learning management system for dental radiology education using the Modular Object-Oriented Dynamic Learning Environment (Moodle).

MATERIALS AND METHODS

Moodle is a well-known and verified open-source software-learning management system (OSS-LMS). The Moodle software was installed on a server computer and customized for dental radiology education. The system was implemented for teaching undergraduate students to diagnose dental caries in panoramic images. Questions were chosen that could assess students' diagnosis ability. Students were given several questions corre-sponding to each of 100 panoramic images.

RESULTS

The installation and customization of Moodle was feasible, cost-effective, and time-saving. By having students answer questions repeatedly, it was possible to train them to examine panoramic images sequentially and thoroughly.

CONCLUSION

Based on its educational efficiency and efficacy, the adaptation of an OSS-LMS in dental school may be highly recommended. The system could be extended to continuing education for dentists. Further studies on the objective evaluation of knowledge acquisition and retention are needed.

A meta-analysis of the educational effectiveness of three-dimensional visualization technologies in teaching anatomy

Many medical graduates are deficient in anatomy knowledge and perhaps below the standards for safe medical practice. Three-dimensional visualization technology (3DVT) has been advanced as a promising tool to enhance anatomy knowledge. The purpose of this review is to conduct a meta-analysis of the effectiveness of 3DVT in teaching and learning anatomy compared to all teaching methods. The primary outcomes were scores of anatomy knowledge tests expressed as factual or spatial knowledge percentage means. Secondary outcomes were perception scores of the learners. Thirty-six studies met the inclusion criteria including 28 (78%) randomized studies. Based on 2,226 participants including 2,128 from studies with comparison groups, 3DVTs (1) resulted in higher (d = 0.30, 95%CI: 0.02-0.62) factual knowledge, (2) yielded significant better results (d = 0.50, 95%CI: 0.20-0.80) in spatial knowledge acquisition, and (3) produced significant increase in user satisfaction (d = 0.28, 95%CI = 0.12-0.44) and in learners' perception of the effectiveness of the learning tool (d = 0.28, 95%CI = 0.14-0.43). The total mean scores (out of five) and ±SDs for QUESTS's Quality and Strength dimensions were 4.38 (±SD 1.3) and 3.3 (±SD 1.7), respectively. The results have high internal validity, for the improved outcomes of 3DVTs compared to other methods of anatomy teaching. Given that anatomy teaching and learning in the modern medical school appears to be approaching a crisis, 3DVT can be a potential solution to the problem of inadequate anatomy pedagogy.

An integrated teaching method of gross anatomy and computed tomography radiology

It is essential for medical students to learn and comprehend human anatomy in three dimensions (3D). With this in mind, a new system was designed in order to integrate anatomical dissections with diagnostic computed tomography (CT) radiology. Cadavers were scanned by CT scanners, and students then consulted the postmortem CT images during cadaver dissection to gain a better understanding of 3D human anatomy and diagnostic radiology. Students used handheld digital imaging and communications in medicine viewers at the bench-side (OsiriX on iPod touch or iPad), which enabled "pixel-to-tissue" direct comparisons of CT images and cadavers. Students had lectures and workshops on diagnostic radiology, and they completed study assignments where they discussed findings in the anatomy laboratory compared with CT radiology findings. This teaching method for gross and radiological anatomy was used beginning in 2009, and it yielded strongly positive student perspectives and significant improvements in radiology skills in later clinical courses.