Are radiologists the contemporary anatomists?

What works in radiology education for medical students: a systematic review and meta-analysis

BACKGROUND

Medical imaging related knowledge and skills are widely used in clinical practice. However, radiology teaching methods and resultant knowledge among medical students and junior doctors is variable. A systematic review and meta-analysis was performed to compare the impact of different components of radiology teaching methods (active versus passive teaching, eLearning versus traditional face-to-face teaching) on radiology knowledge / skills of medical students.

METHODS

PubMed and Scopus databases were searched for articles published in English over a 15-year period ending in June 2021 quantitatively comparing the effectiveness of undergraduate medical radiology education programs regarding acquisition of knowledge and/or skills. Study quality was appraised by the Medical Education Research Study Quality Instrument (MERSQI) scoring and analyses performed to assess for risk of bias. A random effects meta-analysis was performed to pool weighted effect sizes across studies and I2 statistics quantified heterogeneity. A meta-regression analysis was performed to assess for sources of heterogeneity.

RESULTS

From 3,052 articles, 40 articles involving 6,242 medical students met inclusion criteria. Median MERSQI score of the included articles was 13 out of 18 possible with moderate degree of heterogeneity (I2 = 93.42%). Thematic analysis suggests trends toward synergisms between radiology and anatomy teaching, active learning producing superior knowledge gains compared with passive learning and eLearning producing equivalent learning gains to face-to-face teaching. No significant differences were detected in the effectiveness of methods of radiology education. However, when considered with the thematic analysis, eLearning is at least equivalent to traditional face-to-face teaching and could be synergistic.

CONCLUSIONS

Studies of educational interventions are inherently heterogeneous and contextual, typically tailored to specific groups of students. Thus, we could not draw definitive conclusion about effectiveness of the various radiology education interventions based on the currently available data. Better standardisation in the design and implementation of radiology educational interventions and design of radiology education research are needed to understand aspects of educational design and delivery that are optimal for learning.

TRIAL REGISTRATION

Prospero registration number CRD42022298607.

On the added benefit of virtual anatomy for dissection-based skills

Technological approaches deploying three-dimensional visualization to integrate virtual anatomy are increasingly used to provide medical students with state-of-the-art teaching. It is unclear to date to which extent virtual anatomy may help replace the dissection course. Medical students of Johannes Kepler University attend both a dissection and a virtual anatomy course. This virtual anatomy course is based on Cinematic Rendering and radiological imaging and teaches anatomy and pathology. This study aims to substantiate student benefits achieved from this merged teaching approach. Following their dissection course, 120 second-year students took part in objective structured practical examinations (OSPE) conducted on human specimens prior to and following a course on Cinematic Rendering virtual anatomy. Likert-based and open-ended surveys were conducted to evaluate student perceptions of both courses and their utility. Virtual anatomy teaching was found to be unrelated to improvements in student's ability to identify anatomical structures in anatomical prosections, yielding only a 1.5% increase in the OSPE score. While the students rated the dissection course as being more important and impactful, the virtual anatomy course helped them display the learning content in a more comprehensible and clinically applicable way. It is likely that Cinematic Rendering-based virtual anatomy affects knowledge gain in domains other than the recognition of anatomical structures in anatomical prosections. These findings underline students' preference for the pedagogic strategy of the dissection course and for blending this classical approach with novel developments like Cinematic Rendering, thus preparing future doctors for their clinical work.

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.

An overview of the 35 years of research in the oral radiology: a bibliometric analysis

OBJECTIVES

The aim of this study was to provide a bibliometric overview of the oral radiology journal output, contents, and leading trends, and also include a detailed authorship analysis by evaluating the top contributors, and their geographic distributions between 1985 and 2020 years.

METHODS

The databases available on the Scopus and journal's Web Page were searched to identify the all published articles and reports with no restriction regarding publication year or study design. Seven hundred and seventy-seven articles were included and analyzed for the following bibliometric criteria: publication title, authorship, publication year, coauthors, institution of origin, country of origin, collaborating institution and countries, article category, study field, and number of citations based on the Scopus and Google Scholar.

RESULTS

Original article is by far the largest group of study outcome that more than half of the articles were in this category and followed by the case reports (19.8%). The leading countries according to number of the articles were Japan by far (59.8%) followed by Turkey (10.8%) and South Korea (5.2%). The article by Arnheiter, Scarfe, and Farman has received the highest number of citations overall. As first and/or coauthor, Ariji E emerged as a most productive author with 35 publications and Osaka University was determined as the most prominent institutions by publishing the greatest number of articles. More than half of the articles were in the "Diagnosis of Orofacial Diseases" study field.

CONCLUSION

This bibliometric analysis provides a comprehensive overall picture of the 35 years of research progress and publication trends in oral radiology.

TEL Methods Used for the Learning of Clinical Neuroanatomy

Ubiquity of information technology is undoubtedly the most substantial change to society in the twentieth and twenty-first centuries and has resulted in a paradigm shift in how business and social interactions are conducted universally. Information dissemination and acquisition is now effortless, and the way we visualise information is constantly evolving. The face of anatomy education has been altered by the advent of such innovation with Technology-Enhanced Learning (TEL) now commonplace in modern curricula.With the constant development of new computing systems, the temptation is to push the boundaries of what can be achieved rather than addressing what should be achieved. As with clinical practice, education in healthcare should be evidence driven. Learning theory has supplied educators with a wealth of information on how to design teaching tools, and this should form the bedrock of technology-enhanced educational platforms. When analysing resources and assessing if they are fit for purpose, the application of pedagogical theory should be explored and the degree to which it has been applied should be considered.

Effectiveness of Three-Dimensionally Printed Models in Anatomy Education for Medical Students and Resident Physicians: Systematic Review and Meta-Analysis

INTRODUCTION

Despite a surge in the use of three-dimensional printing (3DP) in medical education, a comprehensive evaluation of randomized trials in its effectiveness is lacking. Radiologic studies play an integral role in affording educators the ability to create customized realistic anatomic models. This systematic review and meta-analysis sought to assess the effect of 3DP versus traditional 2-D methods for anatomy education.

METHODS

PubMed, Scopus, Cochrane Library, ERIC, and IEEE Xplore were queried to identify randomized controlled trials that quantitatively investigated anatomy education via postintervention assessments of medical students or resident physicians who were exposed to 3DP versus traditional methods. Criteria for the meta-analysis required that studies additionally included a pre-intervention assessment.

RESULTS

A total of 804 articles were reviewed, identifying 8 and 7 studies for systematic reviews of medical students and resident physicians, respectively, of which 4 and 7 were included in the meta-analyses. 3DP models were associated with higher anatomy examination scores for medical students (P < .0001), but for resident physicians were statistically not significant (P = .53).

DISCUSSION

The 3DP models are shown to positively impact medical students especially given their limited fund of knowledge in anatomy. It is postulated that the lack of a statistically significant result for the resident physicians was multifactorial, in part because of the small test group sizes introducing noise and nonrepresentative samples, as well as relative simplicity of the 3DP models used with resident physicians, which were below their level of training. More trials are required to evaluate the usefulness of highly customized 3DP models.

Adaptive Tutorials Versus Web-Based Resources in Radiology: A Mixed Methods Analysis of Efficacy and Engagement in Senior Medical Students

RATIONALE AND OBJECTIVES

Radiology education is suited to delivery via e-learning which may be used to fill gaps in knowledge and help prepare medical students for internship. There is limited evidence of effectiveness of adaptive tutorials, a form of e-learning in a senior medical student cohort.

MATERIALS AND METHODS

A randomized mixed methods crossover trial was performed to assess effectiveness of adaptive tutorials on engagement and understanding of appropriate use and interpretation of basic imaging studies. Eighty-one volunteer medical students from years 5 and 6 of a 6-year program were randomly allocated to one of two groups. In the first phase of the trial on head CT, one group received access to adaptive tutorials and the other to peer-reviewed web-based resources. A cross over was performed and the second phase of the trial addressing chest CT commenced. Examination style assessments were completed at the end of each phase. At the trial's conclusion, an online questionnaire was provided to evaluate student perceptions of engagement and efficacy of each educational resource.

RESULTS

Adaptive tutorial groups in both phases achieved higher mean scores than controls which were statistically significant in the first phase only. Students reported higher engagement and overall perceived value of the adaptive tutorials than controls.

CONCLUSION

Adaptive tutorials are overwhelmingly supported by senior medical students. Questionnaire responses suggest the engaging nature of the tutorials efficiently aids participation and knowledge retention which is in principle supported by test results.

Cognitive processing differences of experts and novices when correlating anatomy and cross-sectional imaging

The ability to correlate anatomical knowledge and medical imaging is crucial to radiology and as such, should be a critical component of medical education. However, we are hindered in our ability to teach this skill because we know very little about what expert practice looks like, and even less about novices' understanding. Using a unique simulation tool, this research conducted cognitive clinical interviews with experts and novices to explore differences in how they engage in this correlation and the underlying cognitive processes involved in doing so. This research supported what has been known in the literature, that experts are significantly faster at making decisions on medical imaging than novices. It also offers insight into the spatial ability and reasoning that is involved in the correlation of anatomy to medical imaging. There are differences in the cognitive processing of experts and novices with respect to meaningful patterns, organized content knowledge, and the flexibility of retrieval. Presented are some novice-expert similarities and differences in image processing. This study investigated extremes, opening an opportunity to investigate the sequential knowledge acquisition from student to resident to expert, and where educators can help intervene in this learning process.

The role of radiology in anatomy teaching in UK medical schools: a national survey

AIMS

To investigate the current use of radiology in anatomy teaching across the UK, and to determine the level of interest expressed in expanding its role in medical education.

MATERIALS AND METHODS

A 22-question electronic survey was distributed to the organisers of anatomy teaching at 35 UK medical schools. The questionnaire explored the use of radiology in their anatomy course, the different kinds of available resources, and attitudes towards integrating radiology into anatomy teaching.

RESULTS

Responses were received from 29/35 (83%) medical schools. Among the respondents, radiological anatomy featured in all but one of their curricula. Of those schools using radiology to aid anatomy teaching, 20/28 expressed a wish for more radiology in the curriculum. Timetabling constraints constituted one of the main difficulties in further implementation. In addition, 22/28 medical schools had already fostered collaborative links with local radiology departments, with 18 of these expressing a wish for further cooperation. Of the remaining six schools without current collaboration, four would like to establish connections.

CONCLUSION

Compared with previous studies, this national survey shows a definite increase in radiological anatomy in medical school curricula with a stronger presence of radiologists in anatomy teaching. Despite this, most anatomy departments still express a desire to increase the radiological component in their courses.

A brief history of topographical anatomy

This brief history of topographical anatomy begins with Egyptian medical papyri and the works known collectively as the Greco-Arabian canon, the time line then moves on to the excitement of discovery that characterised the Renaissance, the increasing regulatory and legislative frameworks introduced in the 18th and 19th centuries, and ends with a consideration of the impact of technology that epitomises the period from the late 19th century to the present day. This paper is based on a lecture I gave at the Winter Meeting of the Anatomical Society in Cambridge in December 2015, when I was awarded the Anatomical Society Medal.

Interactive anatomical teaching: Integrating radiological anatomy within topographic anatomy

INTRODUCTION

Hours attributed to teaching anatomy have been reduced in medical curricula through out the world. In consequence, changes in anatomical curriculum as well as in teaching methods are becoming necessary. New methods of teaching are being evaluated. We present in the following paper an example of interactive anatomical teaching associating topographic anatomy with ultrasonographic radiological anatomy. The aim was to explicitly show anatomical structures of the knee and the ankle through dissection and ultrasonography.

METHODS

One cadaver was used as an ultrasonographic model and the other was dissected. Anatomy of the knee and ankle articulations was studied through dissection and ultrasonography.

RESULTS

The students were able to simultaneously assimilate both anatomical aspects of radiological and topographic anatomy. They found the teaching very helpful and practical.

CONCLUSION

This body of work provides example of a teaching method combining two important aspects of anatomy to help the students understand both aspects simultaneously.

Twelve tips for enhancing anatomy teaching and learning using radiology

Anatomy is a keystone of many healthcare curricula and its understanding fundamental to patient care. The close relationship between clinical radiology and anatomy is well recognised and expanding. Imaging resources can be effectively integrated alongside traditional methods for learning anatomy in a resource efficient manner in order to enhance anatomy teaching. The following 12 tips have been divided into imaging tips, clinical tips and educational tips and offer practical advice and suggestions for designing and integrating radiological resources across the curriculum.