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Sendra-Portero F, Lorenzo-Álvarez R, Rudolphi-Solero T, Ruiz-Gómez MJ. The Second Life Metaverse and Its Usefulness in Medical Education After a Quarter of a Century. J Med Internet Res 2024; 26:e59005. [PMID: 39106480 PMCID: PMC11336510 DOI: 10.2196/59005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 08/09/2024] Open
Abstract
The immersive virtual world platform Second Life (SL) was conceived 25 years ago, when Philip Rosedale founded Linden Lab in 1999 with the intention of developing computing hardware that would allow people to immerse themselves in a virtual world. This initial effort was transformed 4 years later into SL, a universally accessible virtual world centered on the user, with commercial transactions and even its own virtual currency, which fully connects with the concept of the metaverse, recently repopularized after the statements of the chief executive officer of Meta (formerly Facebook) in October 2021. SL is considered the best known virtual environment among higher education professionals. This paper aimed to review medical education in the SL metaverse; its evolution; and its possibilities, limitations, and future perspectives, focusing especially on medical education experiences during undergraduate, residency, and continuing medical education. The concept of the metaverse and virtual worlds was described, making special reference to SL and its conceptual philosophy, historical evolution, and technical aspects and capabilities for higher education. A narrative review of the existing literature was performed, including at the same time a point of view from our teaching team after an uninterrupted practical experience of undergraduate and postgraduate medical education in the last 13 years with >4000 users and >10 publications on the subject. From an educational point of view, SL has the advantages of being available 24/7 and creating in the student the important feeling of "being there" and of copresence. This, together with the reproduction of the 3D world, real-time interaction, and the quality of voice communication, makes the immersive experiences unique, generating engagement and a fluid interrelation of students with each other and with their teachers. Various groups of researchers in medical education have developed experiences during these years, which have shown that courses, seminars, workshops and conferences, problem-based learning experiences, evaluations, teamwork, gamification, medical simulation, and virtual objective structured clinical examinations can be successfully carried out. Acceptance from students and faculty is generally positive, recognizing its usefulness for undergraduate medical education and continuing medical education. In the 25 years since its conception, SL has proven to be a virtual platform that connects with the concept of the metaverse, an interconnected, open, and globally accessible system that all humans can access to socialize or share products for free or using a virtual currency. SL remains active and technologically improved since its creation. It is necessary to continue carrying out educational experiences, outlining the organization, objectives, and content and measuring the actual educational impact to make SL a tool of more universal use.
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Affiliation(s)
- Francisco Sendra-Portero
- Department of Radiology and Physical Medicine, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Rocío Lorenzo-Álvarez
- Department of Emergency and Intensive Care, Hospital de la Axarquía, Vélez-Málaga, Spain
| | - Teodoro Rudolphi-Solero
- Department of Radiology and Physical Medicine, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Miguel José Ruiz-Gómez
- Department of Radiology and Physical Medicine, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
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Pierre K, Slater R, Raviprasad A, Griffin I, Talati J, Mathelier M, Sistrom C, Mancuso A, Sabat S. Enhancing Radiology Education With a Case-Based Intro to Radiology on the UF WIDI e-Learning Platform. Curr Probl Diagn Radiol 2024; 53:22-26. [PMID: 37690966 DOI: 10.1067/j.cpradiol.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/02/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
RATIONALE AND OBJECTIVES This study explores the implementation and efficacy of an online, interactive, case-based radiology education tool, Wisdom in Diagnostic Imaging (WIDI) Case-Based Intro to Radiology (CBIR). We hypothesize that the WIDI CBIR platform would enhance radiology teaching, foster critical thinking, and provide a comprehensive curriculum in imaging interpretation and utilization. MATERIALS AND METHODS A focus group consisting of 1 undergraduate, 7 medical students, 9 physician assistant students, and 3 PhD students participated in this study. We tested 3 different teaching methods: a didactic approach without WIDI, a proctored didactic approach using WIDI, and a flipped classroom approach using WIDI. An online survey was conducted to assess student preference and feedback on these methods and the use of WIDI in their curriculum. RESULTS Most students preferred the proctored didactic approach with WIDI. They reported that the platform complemented their curriculum and encouraged critical thinking. The modules covered adequate clinical and imaging details and enhanced their skills in imaging interpretation. Despite the limitations of a small sample size and reliance on self-reported outcomes, this study indicates that the WIDI platform could be integrated into PA and medical school curricula throughout the US, offering a standardized radiology curriculum. CONCLUSION The UF WIDI appears to be a promising tool for modernizing radiology education, improving imaging interpretation skills, and enhancing appropriate imaging selection among nonradiologist medical learners. WIDI offers case-based education in imaging use, workflow, search-pattern selection, and interpretation of common radiological findings, potentially bridging the gap in radiology education. Further research and larger studies are required to assess the long-term impact on performance and clinical practice.
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Affiliation(s)
- Kevin Pierre
- Department of Radiology, College of Medicine - University of Florida, Gainesville, FL.
| | - Roberta Slater
- Department of Radiology, College of Medicine - University of Florida, Gainesville, FL
| | - Abheek Raviprasad
- Department of Radiology, College of Medicine - University of Florida, Gainesville, FL
| | - Ian Griffin
- College of Medicine, University of Florida, Gainesville, FL
| | - Jay Talati
- College of Medicine, University of Florida, Gainesville, FL
| | | | - Christopher Sistrom
- Department of Radiology, College of Medicine - University of Florida, Gainesville, FL
| | - Anthony Mancuso
- Department of Radiology, College of Medicine - University of Florida, Gainesville, FL
| | - Shyamsunder Sabat
- Department of Radiology, College of Medicine - University of Florida, Gainesville, FL
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Thormann M, Neumann H, Behme D, Surov A. Digital hands-on learning in radiology-design and evaluation of a PACS-based concept for medical students. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:82-89. [PMID: 37462750 DOI: 10.1007/s00117-023-01185-w] [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: 01/10/2023] [Accepted: 06/09/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND The reorganization of the medical curriculum has increased the demands on medical didactics. For interdisciplinary fields such as radiology this offers the opportunity to be more visible in clinical medical teaching and to emphasize its integrative role in patient care. We present a novel integrative learning concept based on the notion of PACS (picture archiving and communication system) learning. In the initial phase it was available to students in their final-year internships. METHODS We designed 100 case vignettes on a designated workstation. Vignettes were prepared in a patient-based format in Aycan PACS (Aycan Medical Systems, NY, USA). The first image of each case included the case description and background information. Students worked through the vignettes independently. Each imaging examination was followed by small quizzes or open questions. Short texts provided additional information on the case, leading to the next examination. The typical case included several imaging modalities (CT, MRI, X‑ray, etc.) in diagnosis and follow-up. After processing the cases, the students completed an evaluation form on a five-point Likert scale. RESULTS Students approved the learning concept in terms of knowledge level, didactic structure, and motivation for self-study. A large proportion of respondents indicated that the new concept had sparked their interest in radiology Almost all students stated that they had benefited from the concept and favored its continuation. CONCLUSION Our PACS workstation enjoyed high acceptance among students. This underlines the importance of integrative, competence-based teaching models in the medical curriculum. Radiology as a cross-disciplinary discipline is in particular suitable for encouraging students to combine theoretical and practical knowledge and can become a central component in student education through innovative concepts.
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Affiliation(s)
- Maximilian Thormann
- Clinic of Radiology and Nuclear Medicine, University Clinic Magdeburg, Magdeburg, Germany
| | - Hannes Neumann
- Clinic of Radiology and Nuclear Medicine, University Clinic Magdeburg, Magdeburg, Germany
| | - Daniel Behme
- Clinic for Neuroradiology, University Clinic Magdeburg, Magdeburg, Germany
| | - Alexey Surov
- Clinic of Radiology and Nuclear Medicine, University Clinic Magdeburg, Magdeburg, Germany.
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University, Bochum, Germany.
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Barger JB, Resuehr D, Edwards DN. Radiology for anatomy educators: Success of an online, 2-day course for radiology training. ANATOMICAL SCIENCES EDUCATION 2023; 16:958-968. [PMID: 37183970 DOI: 10.1002/ase.2284] [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: 04/21/2022] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023]
Abstract
Incorporation of radiology training into anatomy education from community college to health professional schools is becoming increasingly popular. However, anatomy educators generally lack training in common radiology modalities, including X-ray, CT, MRI, and ultrasound. Professional development or continuing education courses provide current and new educators the chance to gain new skills within a short timeframe. Here, a 2-day, online course for anatomy educators was created. The goals of which were for the participants: to gain basic knowledge of different radiology modalities, recognize normal radiographic images, and apply that information to common diseases or injuries in interactive case studies. Each day focused on different modalities, where Day 1 studied X-ray, CT, and MRI; and Day 2 studied Ultrasound. A 10-question pre- and post-test was taken by attendees for each day of instruction on a voluntary basis. Following the completion of the course, attendees were provided a survey to determine their perceptions on course content and knowledge acquired. Most attendees instructed undergraduates at 4-year universities, though several attendees came from community colleges and high schools. All attendees showed a significant improvement in knowledge from their pre- to post-test scores in X-ray, CT, MRI, and ultrasound following training. This was also reflected in their survey responses, where attendees felt the course was effective in increasing their knowledge and confidence in radiology. Overall, this study demonstrates the effectiveness of online continuing education courses and the need for more introductory radiology courses for anatomy educators.
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Affiliation(s)
- J Bradley Barger
- Department of Cell, Developmental, and Integrative Biology, Birmingham Heersink School of Medicine, University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - David Resuehr
- Department of Cell, Developmental, and Integrative Biology, Birmingham Heersink School of Medicine, University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - Danielle N Edwards
- Department of Cell, Developmental, and Integrative Biology, Birmingham Heersink School of Medicine, University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
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Belfi LM, Jordan SG. Web-Based Radiology Learning Module Design: The Author Perspective. Acad Radiol 2022; 29:584-590. [PMID: 33836944 DOI: 10.1016/j.acra.2021.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES Over recent years, e-learning has become an integral component of radiology education. While demands for innovative, interactive e-learning resources have increased, the availability of viable solutions have not kept pace. As a result, many educators are authoring their own e-learning content. This study describes the six-year experience of faculty clinician educators and residents who participated in this authoring process. MATERIALS AND METHODS From 2014 to 2020, 62 radiology faculty and residents created a total of 89 peer reviewed web-based learning modules. Authors were given instructions and materials to support their design process. Following completion of their module(s), authors were asked to complete an anonymous and voluntary survey on their perspective. RESULTS Hundred percent of survey respondents reported that they enjoyed creating their module and 97.8% would recommend the experience to others. Reported educational value of authoring a learning module was 4.18 per 5, with 65% of resident authors reporting that they felt more likely to retain the information they learned through authoring a module rather than reading a chapter on the same topic. A total of 77.3% of respondents reported that the experience would make them more likely to teach medical students in the future. CONCLUSION With the appropriate resources and support, radiology faculty and residents succeed in authorship of innovative e-learning modules for medical student learners. In addition to enhancing subject matter knowledge and satisfying Accreditation Council for Graduate Medical Education requirements for teaching and scholarly activity, authorship provides mentoring opportunities and cultivates interest in medical student education.
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Tudor Car L, Poon S, Kyaw BM, Cook DA, Ward V, Atun R, Majeed A, Johnston J, van der Kleij RMJJ, Molokhia M, V Wangenheim F, Lupton M, Chavannes N, Ajuebor O, Prober CG, Car J. Digital Education for Health Professionals: An Evidence Map, Conceptual Framework, and Research Agenda. J Med Internet Res 2022; 24:e31977. [PMID: 35297767 PMCID: PMC8972116 DOI: 10.2196/31977] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/07/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Health professions education has undergone major changes with the advent and adoption of digital technologies worldwide. OBJECTIVE This study aims to map the existing evidence and identify gaps and research priorities to enable robust and relevant research in digital health professions education. METHODS We searched for systematic reviews on the digital education of practicing and student health care professionals. We searched MEDLINE, Embase, Cochrane Library, Educational Research Information Center, CINAHL, and gray literature sources from January 2014 to July 2020. A total of 2 authors independently screened the studies, extracted the data, and synthesized the findings. We outlined the key characteristics of the included reviews, the quality of the evidence they synthesized, and recommendations for future research. We mapped the empirical findings and research recommendations against the newly developed conceptual framework. RESULTS We identified 77 eligible systematic reviews. All of them included experimental studies and evaluated the effectiveness of digital education interventions in different health care disciplines or different digital education modalities. Most reviews included studies on various digital education modalities (22/77, 29%), virtual reality (19/77, 25%), and online education (10/77, 13%). Most reviews focused on health professions education in general (36/77, 47%), surgery (13/77, 17%), and nursing (11/77, 14%). The reviews mainly assessed participants' skills (51/77, 66%) and knowledge (49/77, 64%) and included data from high-income countries (53/77, 69%). Our novel conceptual framework of digital health professions education comprises 6 key domains (context, infrastructure, education, learners, research, and quality improvement) and 16 subdomains. Finally, we identified 61 unique questions for future research in these reviews; these mapped to framework domains of education (29/61, 47% recommendations), context (17/61, 28% recommendations), infrastructure (9/61, 15% recommendations), learners (3/61, 5% recommendations), and research (3/61, 5% recommendations). CONCLUSIONS We identified a large number of research questions regarding digital education, which collectively reflect a diverse and comprehensive research agenda. Our conceptual framework will help educators and researchers plan, develop, and study digital education. More evidence from low- and middle-income countries is needed.
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Affiliation(s)
- Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Selina Poon
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Bhone Myint Kyaw
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - David A Cook
- Office of Applied Scholarship and Education Science, School of Continuous Professional Development, Mayo Clinic College of Medicine and Science, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Victoria Ward
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford, CA, United States
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard, Boston, MA, United States
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jamie Johnston
- Stanford Center for Health Education's Digital MedIC Initiative, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | | | - Mariam Molokhia
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Florian V Wangenheim
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Martin Lupton
- Faculty of Medicine, Imperial College London, London, United Kingdom
- The Chelsea and Westminster Hospital, Chelsea, London, United Kingdom
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Onyema Ajuebor
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Charles G Prober
- Stanford Center for Health Education's Digital MedIC Initiative, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | - Josip Car
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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van der Kolk B(BY, van den Wittenboer G(GJ, Warringa N, Nijholt IM, van Hasselt BA, Buijteweg LN, Schep NW, Maas M, Boomsma MF. Assessment of cervical spine CT scans by emergency physicians: A comparative diagnostic accuracy study in a non-clinical setting. J Am Coll Emerg Physicians Open 2022; 3:e12609. [PMID: 35079729 PMCID: PMC8776040 DOI: 10.1002/emp2.12609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/04/2021] [Accepted: 10/28/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To determine and compare the diagnostic accuracy of assessing injuries on cervical spine computed tomography (CT) scans by trained emergency physicians and radiologists, both in a non-clinical setting. METHODS In this comparative diagnostic accuracy study, 411 cervical spine CT scans, of which 120 contained injuries (fractures and/or dislocations), were divided into 8 subsets. Eight emergency physicians received focused training and assessed 1 subset each before and after training. Four radiologists assessed 2 subsets each. Diagnostic accuracy between both groups was compared. The reference standard used was a multiverified data set, assessed by radiologists, neurosurgeons, and emergency physicians. The neurosurgeons also classified whether an "injury in need of stabilizing therapy" (IST) was present. RESULTS Posttraining, the emergency physicians demonstrated increased sensitivity and specificity for identifying cervical spine injuries compared to pretraining: sensitivity 88% (95% confidence interval [CI] 80% to 93%) versus 80% (95% CI 72% to 87%) and specificity 89% (95% CI 85% to 93%) versus 86% (95% CI 81% to 89%). When comparing the trained emergency physicians to the group of radiologists, no difference in sensitivity was found, 88% (95% CI 80% to 83%); however, the radiologists showed a significantly higher specificity (P < 0.01): 99% (95% CI 96% to 100%). In the 12% (15 scans) with missed injuries, emergency physicians missed more ISTs than radiologists, 6 versus 4 scans; however, this difference was not significant (P = 0.45). CONCLUSION After focused training and in a non-clinical setting, no significant difference was found between emergency physicians and radiologists in ruling out cervical spine injuries; however, the radiologists achieved a significantly higher specificity.
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Affiliation(s)
- Brigitta (Britt) Y.M. van der Kolk
- Department of Emergency MedicineIsalaZwolleThe Netherlands
- Department of Radiology and Nuclear MedicineIsalaZwolleThe Netherlands
- Department of Radiology and Nuclear MedicineAmsterdam University Medical Centers, location Academic Medical CenterAmsterdamThe Netherlands
| | | | - Niek Warringa
- Department of Radiology and Nuclear MedicineIsalaZwolleThe Netherlands
| | - Ingrid M. Nijholt
- Department of Radiology and Nuclear MedicineIsalaZwolleThe Netherlands
| | | | | | - Niels W.L. Schep
- Department of Trauma SurgeryMaasstad HospitalRotterdamThe Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear MedicineAmsterdam University Medical Centers, location Academic Medical CenterAmsterdamThe Netherlands
- Amsterdam Movement SciencesAmsterdamThe Netherlands
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Practice-Based Learning Using Smart Class: A Competency-Based Model in Undergraduate Radiology Education. Acad Radiol 2022; 29:150-157. [PMID: 33158705 DOI: 10.1016/j.acra.2020.09.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 02/05/2023]
Abstract
RATIONALE AND OBJECTIVES A need for adequate and early exposure to radiology practice is rising in undergraduate students, taking competency development as the orientation. We aimed to develop a competency-based model of practice-based learning for undergraduate radiology education. MATERIALS AND METHODS The model of practice-based learning was constructed upon an e-learning smart class environment, with case-based learning and simulators for competency development. To assess the model effectiveness, a randomized controlled experiment was performed, where 57 third-year medical students received the model (Smart-Class group) and another 57 received traditional teaching (Traditional group). Seven quizzes, a final exam, and a survey were performed in both groups. RESULTS Smart-Class group achieved higher mean score in the quizzes (r = -0.4, p < 0.001) and application subscore in the final exam (r = -0.3, p = 0.005) compared to Traditional group. Smart-Class group also gave higher ratings in students' perceptions concerning promotion of learning interests, radiology skills, and diagnostic reasoning (r = -0.2 to -0.3, p = 0.001-0.034). CONCLUSION Practice-based learning using smart class improved students' application ability and satisfactions in undergraduate radiology education, suggesting it a practical model for early exposure to radiology practice and competency development for undergraduate medical students.
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Alamer A, Alharbi F. Synchronous distance teaching of radiology clerkship promotes medical students' learning and engagement. Insights Imaging 2021; 12:41. [PMID: 33765254 PMCID: PMC7994478 DOI: 10.1186/s13244-021-00984-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/12/2021] [Indexed: 12/21/2022] Open
Abstract
Background The COVID-19 pandemic has impacted education in myriad ways, primarily leading to an abrupt paradigm shift in teaching and learning practices towards distance learning. The study aims to assess the effectiveness of teaching radiology to undergraduate medical students using synchronous distance learning compared to traditional on-campus learning through exploring students’ perceived satisfaction and concerns. Students’ perceptions were correlated with their attendance, grades, and frequency of technical difficulties. Methods The study was designed as an observational study involving fourth-year medical students (2019/2020) from two institutions. The cohort students were exposed to traditional learning, distance learning, or both. Students completed an online self-administered questionnaire concerning their perceptions of distance learning. Students’ attendance, engagement, technical difficulties, and post-clerkship knowledge assessments were analyzed using descriptive and inferential statistics. Results A total of 145 participants completed the clerkship using the following strategies: traditional learning (n = 66), both traditional and distance learning (n = 67), and distance learning alone (n = 12). The most important result indicates that the abrupt transition to distance learning was well perceived. Most students preferred distance learning over traditional learning in the radiology clerkship (p = .05). During the synchronous sessions, student attendance was high, reaching to 100%. Technical difficulties were limited (1.9%), and they did not affect learning. Conclusion Synchronous distance teaching promotes learning, interaction, and enjoyment in undergraduate radiology education, and it can be as effective as traditional on-campus learning. The technical difficulties encountered, although they were limited, can be overcome by recording the synchronous sessions.
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Affiliation(s)
- Ali Alamer
- Department of Radiology, College of Medicine, Qassim University, Buraidah, 6655-51452, Saudi Arabia.
| | - Fawaz Alharbi
- Department of Radiology, College of Medicine, Qassim University, Buraidah, 6655-51452, Saudi Arabia
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Borgbjerg J. Utilizing sectioned and segmented images of Visible Human datasets, comment on "Peeled images and sectioned images from real-color volume models of foot". Surg Radiol Anat 2021; 43:567-568. [PMID: 33689005 DOI: 10.1007/s00276-021-02720-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/18/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Jens Borgbjerg
- Department of Radiology, Ahus University Hospital, Lørenskog, Norway.
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The role of digital technology in providing education, training, continuing professional development and support to the rural health workforce. HEALTH EDUCATION 2021. [DOI: 10.1108/he-11-2020-0109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PurposeEducation, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector.Design/methodology/approachA scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases – Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac et al. (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature.FindingsThe literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found – Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals.Originality/valueTo date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.
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Diekhoff T, Kainberger F, Oleaga L, Dewey M, Zimmermann E. Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation. Eur Radiol 2020; 30:5684-5689. [PMID: 32435929 PMCID: PMC7476994 DOI: 10.1007/s00330-020-06942-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/17/2020] [Accepted: 05/07/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate ESR eGUIDE-the European Society of Radiology (ESR) e-Learning tool for appropriate use of diagnostic imaging modalities-for learning purposes in different clinical scenarios. METHODS This anonymized evaluation was performed after approval of ESR Education on Demand leadership. Forty clinical scenarios were developed in which at least one imaging modality was clinically most appropriate, and the scenarios were divided into sets 1 and 2. These sets were provided to medical students randomly assigned to group A or B to select the most appropriate imaging test for each scenario. Statistical comparisons were made within and across groups. RESULTS Overall, 40 medical students participated, and 31 medical students (78%) answered both sets. The number of correctly chosen imaging methods per set in these 31 paired samples was significantly higher when answered with versus without use of ESR eGUIDE (13.7 ± 2.6 questions vs. 12.1 ± 3.2, p = 0.012). Among the students in group A, who first answered set 1 without ESR eGUIDE (11.1 ± 3.2), there was significant improvement when set 2 was answered with ESR eGUIDE (14.3 ± 2.5, p = 0.013). The number of correct answers in group B did not drop when set 2 was answered without ESR eGUIDE (12.4 ± 2.6) after having answered set 1 first with ESR eGUIDE (13.0 ± 2.7, p = 0.66). CONCLUSION The clinical decision support tool ESR eGUIDE is suitable for training medical students in choosing the best radiological imaging modality in typical scenarios, and its use in teaching radiology can thus be recommended. KEY POINTS • ESR eGUIDE improved the number of appropriately selected imaging modalities among medical students. • This improvement was also seen in the group of students which first selected imaging tests without ESR eGUIDE. • In the student group which used ESR eGUIDE first, appropriate selection remained stable even without the teaching tool.
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Affiliation(s)
- Torsten Diekhoff
- Department of Radiology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universitat Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Franz Kainberger
- Department of Radiology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universitat Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Laura Oleaga
- Department of Radiology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universitat Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Marc Dewey
- Department of Radiology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universitat Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Elke Zimmermann
- Department of Radiology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universitat Berlin, Charitéplatz 1, 10117, Berlin, Germany
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Javaid MA, Schellekens H, Cryan JF, Toulouse A. Neuroanatomy of the spinal pathways: Evaluation of an interactive multimedia e-learning resource. MEDEDPUBLISH 2020; 9:88. [PMID: 38058892 PMCID: PMC10697498 DOI: 10.15694/mep.2020.000088.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
This article was migrated. The article was marked as recommended. Introduction: A diminished number of young doctors opt for specialty neurology training and show reduced confidence in managing neurology patients and interlink difficulties in managing neurology patients with impaired understanding of neuroanatomy and associated clinical correlates. Aim: To evaluate an interactive e-resource for the neuroanatomy of the spinal pathways based on cognitive theories of multimedia learning in aiding medical students learn neuroanatomy. Methods: Using a single-blinded controlled experimental design, knowledge of the spinal pathways was assessed prior and after usage of the novel e-resource compared to control web resource. The perceived usefulness of the tool used was gauged using Likert-scale questionnaires. Results: Performance in the second assessment improved for all users but the learning gain of participants in the experimental groups was higher compared to participants who did not use e-resources. Likert-scale ratings revealed a significantly higher appreciation for the novel tool compared to the control tool when learning clinical correlates. Conclusions: Stronger correlations between the students' perception of the tool used and their second assessment scores suggest that students favored the instructional design of the novel e-tool which shows promising results in bridging the gap between neuroanatomy knowledge and its clinical application.
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Regmi K, Jones L. A systematic review of the factors - enablers and barriers - affecting e-learning in health sciences education. BMC MEDICAL EDUCATION 2020; 20:91. [PMID: 32228560 PMCID: PMC7106784 DOI: 10.1186/s12909-020-02007-6] [Citation(s) in RCA: 223] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/18/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Recently, much attention has been given to e-learning in higher education as it provides better access to learning resources online, utilising technology - regardless of learners' geographical locations and timescale - to enhance learning. It has now become part of the mainstream in education in the health sciences, including medical, dental, public health, nursing, and other allied health professionals. Despite growing evidence claiming that e-learning is as effective as traditional means of learning, there is very limited evidence available about what works, and when and how e-learning enhances teaching and learning. This systematic review aimed to identify and synthesise the factors - enablers and barriers - affecting e-learning in health sciences education (el-HSE) that have been reported in the medical literature. METHODS A systemic review of articles published on e-learning in health sciences education (el-HSE) was performed in MEDLINE, EMBASE, Allied & Complementary Medicine, DH-DATA, PsycINFO, CINAHL, and Global Health, from 1980 through 2019, using 'Textword' and 'Thesaurus' search terms. All original articles fulfilling the following criteria were included: (1) e-learning was implemented in health sciences education, and (2) the investigation of the factors - enablers and barriers - about el-HSE related to learning performance or outcomes. Following the PRISMA guidelines, both relevant published and unpublished papers were searched. Data were extracted and quality appraised using QualSyst tools, and synthesised performing thematic analysis. RESULTS Out of 985 records identified, a total of 162 citations were screened, of which 57 were found to be of relevance to this study. The primary evidence base comprises 24 papers, with two broad categories identified, enablers and barriers, under eight separate themes: facilitate learning; learning in practice; systematic approach to learning; integration of e-learning into curricula; poor motivation and expectation; resource-intensive; not suitable for all disciplines or contents, and lack of IT skills. CONCLUSIONS This study has identified the factors which impact on e-learning: interaction and collaboration between learners and facilitators; considering learners' motivation and expectations; utilising user-friendly technology; and putting learners at the centre of pedagogy. There is significant scope for better understanding of the issues related to enablers and facilitators associated with e-learning, and developing appropriate policies and initiatives to establish when, how and where they fit best, creating a broader framework for making e-learning effective.
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Affiliation(s)
- Krishna Regmi
- Faculty of Health and Social Sciences, Institute for Health Research, University of Bedfordshire, Luton, LU2 8LE UK
- Centre for Medical Education, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF UK
| | - Linda Jones
- Centre for Medical Education, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF UK
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Xiberta P, Boada I, Thió-Henestrosa S, Ortuño P, Pedraza S. Introducing Online Continuing Education in Radiology for General Practitioners. J Med Syst 2020; 44:55. [PMID: 31950280 DOI: 10.1007/s10916-019-1499-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/14/2019] [Indexed: 11/30/2022]
Abstract
The aim of this study was to determine whether e-learning as a new teaching methodology was acceptable for general practitioners in continuous education courses of radiology. Generally, these courses are face-to-face with the corresponding time and place limitations. To overcome these limitations, we transformed one of these courses to an online one evaluating its acceptance. The course was about thorax radiology and it was delivered to 249 participants. The experiment was carried out in two phases: Phase 1, as a pilot testing with 12 general practitioners (G1), and Phase 2, with 149 general practitioners (G2), 12 radiologists (G3) and 76 medical residents (G4). All participants evaluated the course design, the delivering e-learning platform, and the course contents using a five-point Likert scale (satisfaction level from 1 to 5). Collected data was analysed using t, Mann-Whitney U and Kruskal-Wallis tests. In Phase 1, the rounded scores of all questions except one surpassed 3.5. In Phase 2, all the rounded scores surpassed 4.0 indicating that a total agreement on all items was achieved. All collected impressions indicate the high acceptance of the proposed methodology.
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Affiliation(s)
- Pau Xiberta
- Graphics and Imaging Laboratory, Universitat de Girona, 17003, Girona, Catalonia.
| | - Imma Boada
- Graphics and Imaging Laboratory, Universitat de Girona, 17003, Girona, Catalonia
| | - Santiago Thió-Henestrosa
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, 17003, Girona, Catalonia
| | - Pedro Ortuño
- Department of Radiology-IDI and IDIBGI, Hospital Universitari Dr Josep Trueta, Ctra. França, 17007, Girona, Catalonia
| | - Salvador Pedraza
- Department of Radiology-IDI and IDIBGI, Hospital Universitari Dr Josep Trueta, Ctra. França, 17007, Girona, Catalonia
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ESR statement on new approaches to undergraduate teaching in Radiology. Insights Imaging 2019; 10:109. [PMID: 31745669 PMCID: PMC6863988 DOI: 10.1186/s13244-019-0804-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/10/2019] [Indexed: 01/25/2023] Open
Abstract
Medical education is evolving and electronic learning (e-Learning) strategies have now become an essential asset in radiology education. Radiology education is a significant part of the undergraduate medical curriculum and the use of e-Learning in radiology teaching in medical schools is on the rise. If coupled with clinical decision support systems, e-Learning can be a practical way of teaching students clinical decision making, such as selecting the diagnostic imaging tests that are best suited in certain clinical scenarios.The innovative concept of flipped classroom learning encourages students to work independently and maximises the application of learnt contents in interactive classroom sessions.For integrated curricula with their student-centred, problem-based, and community-based design, an approach to systematically integrate radiology may be to define diagnostic reasoning as one of the core goals. Radiologists as teachers and scholars may understand themselves as experts in diagnostic reasoning and in mentoring how to make medical decisions.Computer programs simulating the routine work are available and can be used to teach the recognition of anatomical structures and pathological patterns, and also to teach ultrasonography and interventional radiology, maximising patient safety.
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Borgbjerg J. MULRECON: A Web-based Imaging Viewer for Visualization of Volumetric Images. Curr Probl Diagn Radiol 2019; 48:531-534. [DOI: 10.1067/j.cpradiol.2018.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/12/2018] [Indexed: 11/22/2022]
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Gulati A, Schwarzlmüller T, du Plessis E, Søfteland E, Gray R, Biermann M. Evaluation of a new e-learning framework for teaching nuclear medicine and radiology to undergraduate medical students. Acta Radiol Open 2019; 8:2058460119860231. [PMID: 31360540 PMCID: PMC6640061 DOI: 10.1177/2058460119860231] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/08/2019] [Indexed: 11/29/2022] Open
Abstract
Background Radiology and nuclear medicine have traditionally been taught in a series of lectures and seminars concluded by an examination testing knowledge rather than skills. Purpose To emphasize skills in the students’ learning process, we developed and evaluated a new e-learning framework for teaching medical imaging. Material and Methods The framework consists of electronic lectures, a learning management system (LMS), and a diagnostic viewing system. Students were to review positron emission tomography/computed tomography (PET/CT) examinations of five cases of lung cancer. The framework was evaluated in an objective structured clinical examination (OSCE) taken by 139 undergraduate students at the end of their third year, and in a comparative survey of two groups of 85 and 84 students in the fifth and sixth year who were taught the same oncology course with and without mandatory PET/CT exercises, respectively. Results Of the 139 third-year students, 134 (96%) passed the OSCE PET/CT station according to the predefined criteria. While 85/85 (100%) of the fifth-year students had taken exercises when they were mandatory, only 2/84 (2%) of the sixth-year students had reviewed the cases on a voluntary basis (P < 0.001). Of the 25 survey responders in the fifth year, 24 (96%) agreed that the mandatory PET/CT exercises had promoted their learning while the sixth-year students, whose course concluded with a multiple-choice examination, emphasized the utility of online lectures. Conclusion The new e-learning framework teaches students basic competency in PET/CT navigation and interpretation and is associated with a high degree of student satisfaction.
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Affiliation(s)
- Ankush Gulati
- Nuclear Medicine/PET Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Thomas Schwarzlmüller
- Nuclear Medicine/PET Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway.,Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Elsa du Plessis
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Eirik Søfteland
- Section for Anesthesiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - Robert Gray
- Section for Pedagogy, Department of Psychology, University of Bergen, Bergen, Norway
| | - Martin Biermann
- Nuclear Medicine/PET Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway.,Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Jarrett-Thelwell FD, Burke JR, Poirier JN, Petrocco-Napuli K. A comparison of student performance and satisfaction between a traditional and integrative approach to teaching an introductory radiology course on the extremities. THE JOURNAL OF CHIROPRACTIC EDUCATION 2019; 33:21-29. [PMID: 30444635 PMCID: PMC6417870 DOI: 10.7899/jce-17-26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/01/2018] [Accepted: 03/29/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE: The purpose of the study was to compare student performance and student satisfaction ratings for an introductory extremities radiology course taught using 2 different educational methods. METHODS: One group of students was taught using a traditional face-to-face instruction method, and the other group received an integrative blended-learning approach. A multivariate analysis of scores on lecture and laboratory examinations was performed to detect differences in student performance between the 2 methods. An independent t test was performed to compare the final course averages between the 2 methods. χ2 Analysis was used to compare the distribution of letter grades and levels of satisfaction between the 2 groups. RESULTS: Test scores were higher for the integrative approach than for the traditional face-to-face method ( p < .05). However, the differences were not meaningful, as the greatest improvement in correct responses was only for 2 questions. Students appeared to be more satisfied with the integrative approach when compared to the traditional method ( p < .05). CONCLUSION: Student satisfaction with the educational delivery methods in an introductory extremities radiology course using an integrative approach was greater than for the traditional face-to-face instruction method. Student performance was similar between the 2 cohorts.
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Lorenzo-Alvarez R, Pavia-Molina J, Sendra-Portero F. Exploring the Potential of Undergraduate Radiology Education in the Virtual World Second Life with First-cycle and Second-cycle Medical Students. Acad Radiol 2018; 25:1087-1096. [PMID: 30782465 DOI: 10.1016/j.acra.2018.02.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/22/2018] [Accepted: 02/28/2018] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES Virtual worlds have a remarkable potential for effective teaching and learning, providing immersive, realistic, and engaging online events. Previous studies have explored online education of health professionals in Second Life (SL), the most widely used virtual world, but none of the previous learning experiences were related to radiology. The purpose of this study was to explore the potential use of SL for undergraduate radiology education and the involvement of students in SL learning activities. MATERIALS AND METHODS We delivered a 4-week voluntary undergraduate radiology education program in SL, based on synchronous sessions and asynchronous tasks, with two modalities: introduction to basic radiology for first-cycle (first- to third-year) students and case-based clinical radiology for second-cycle (fourth- to sixth-year) students. Participants completed an evaluation questionnaire about the experiences after the learning program. RESULTS Forty-six students (20 first-cycle and 26 second-cycle) participated in this study. They found the contents of the course appropriate (mean ≥ 4.53/5), the initiative interesting, and the environment attractive (mean ≥ 4.32/5), and they were willing to participate in future SL experiences (mean ≥ 4.63/5). All students highly rated the organization, the content, the benefit to their medical education, and the professor (mean ≥ 9.05/10). CONCLUSION Online radiology education using SL is feasible and well received by medical students of all year groups. The students participated and engaged in this activity very positively and rated the experience highly. The potential of using SL for radiology education includes promising expectations regarding collaborative learning and gamification.
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Affiliation(s)
- Rocio Lorenzo-Alvarez
- Department of Radiology and Physical Medicine, Facultad de Medicina, Universidad de Málaga, Bvd. Luis Pasteur 32, 29071, Málaga, Spain
| | - Jose Pavia-Molina
- Department of Pharmacology, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Francisco Sendra-Portero
- Department of Radiology and Physical Medicine, Facultad de Medicina, Universidad de Málaga, Bvd. Luis Pasteur 32, 29071, Málaga, Spain.
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McCarthy CJ, Yu AY, Do S, Dawson SL, Uppot RN. Interventional Radiology Training Using a Dynamic Medical Immersive Training Environment (DynaMITE). J Am Coll Radiol 2018; 15:789-793. [DOI: 10.1016/j.jacr.2017.12.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 12/11/2017] [Accepted: 12/22/2017] [Indexed: 02/07/2023]
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Cirigliano MM, Guthrie C, Pusic MV, Cianciolo AT, Lim-Dunham JE, Spickard A, Terry V. "Yes, and …" Exploring the Future of Learning Analytics in Medical Education. TEACHING AND LEARNING IN MEDICINE 2017; 29:368-372. [PMID: 29020521 DOI: 10.1080/10401334.2017.1384731] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Northeastern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. Commentators brainstormed "what's next" with learning analytics in medical education, including advancements in interaction metrics and the use of interactivity analysis to deepen understanding of perceptual, cognitive, and social learning and transfer processes.
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Affiliation(s)
- Matt M Cirigliano
- a Educational Communications and Technology Program , NYU Steinhardt , New York , New York , USA
| | - Charlie Guthrie
- b Graduate School of Arts and Sciences , New York University , New York , New York , USA
| | - Martin V Pusic
- c Ronald O. Perelman Department of Emergency Medicine and Institute for Innovations in Medical Education , NYU Langone Medical Center , New York , New York , USA
| | - Anna T Cianciolo
- d Department of Medical Education , Southern Illinois University School of Medicine , Springfield , Illinois , USA
| | - Jennifer E Lim-Dunham
- e Departments of Radiology, Pediatrics, and Medical Education , Loyola University Chicago Stritch School of Medicine , Maywood , Illinois , USA
| | - Anderson Spickard
- f Departments of Medicine and Biomedical Informatics , Vanderbilt School of Medicine , Nashville , Tennessee , USA
| | - Valerie Terry
- g Department of Medical Education , University of Texas-Rio Grande Valley School of Medicine , Harlingen , Texas , USA
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