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Bui D, Benavides E, Soki F, Ramaswamy V, Kosecki B, Bonine B, Kim-Berman H. A comparison of virtual reality and three-dimensional multiplanar educational methods for student learning of cone beam computed tomography interpretations. J Dent Educ 2024. [PMID: 38938068 DOI: 10.1002/jdd.13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 04/16/2024] [Accepted: 06/02/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES The purpose of this study was to compare student learning of cone beam computed tomography (CBCT) interpretation using immersive virtual reality (VR) and three-dimensional multiplanar (MP) reconstructions. METHODS Sixty first-year dental students were randomly allocated to two groups, VR and MP, and underwent a one-on-one educational intervention to identify anatomic structures using CBCT data. All participants completed three multiple-choice questionnaires (MCQs) before (T1), immediately after (T2), and 2 weeks following (T3) the intervention. Additionally, pre-survey, post-survey, NASA Task Load Index (NASA-TLX), and presence questionnaires were completed. Analysis of objective measures of performance on MCQs and subjective data from the questionnaires was completed (α = 0.05). RESULTS There was a significant increase in test performance and informational recall between T1-T2 and T1-T3 for VR and MP groups (p < 0.001). However, there were no significant differences in performance on MCQs between T2 and T3. Analysis of the Presence questionnaire indicated that the VR group felt decreased distraction (p = 0.013), increased realism (p = 0.035), and increased involvement (p = 0.047) during the educational intervention when compared with the MP group. Analysis of the NASA-TLX indicated that the VR group experienced more physical demand (p < 0.01) but similar cognitive demand when compared with the MP group. Qualitative responses indicated that the VR group had a more dynamic sense of visualization and manipulation compared to the MP group. CONCLUSION Results from this study show that VR is as effective as traditional MP methods of CBCT interpretation learning. Further benefits of VR educational intervention include increased involvement, realism and less distraction.
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Affiliation(s)
- Duy Bui
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Fabiana Soki
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Vidya Ramaswamy
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Brianna Kosecki
- School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Brandon Bonine
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hera Kim-Berman
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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García-Robles P, Cortés-Pérez I, Nieto-Escámez FA, García-López H, Obrero-Gaitán E, Osuna-Pérez MC. Immersive virtual reality and augmented reality in anatomy education: A systematic review and meta-analysis. ANATOMICAL SCIENCES EDUCATION 2024; 17:514-528. [PMID: 38344900 DOI: 10.1002/ase.2397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 04/04/2024]
Abstract
The purpose of this review was to (1) analyze the effectiveness of immersive virtual reality (iVR) and augmented reality (AR) as teaching/learning resources (collectively called XR-technologies) for gaining anatomy knowledge compared to traditional approaches and (2) gauge students' perceptions of the usefulness of these technologies as learning tools. This meta-analysis, previously registered in PROSPERO (CRD42023423017), followed PRISMA guidelines. A systematic bibliographical search, without time parameters, was conducted through four databases until June 2023. A meta-analytic approach investigated knowledge gains and XR's usefulness for learning. Pooled effect sizes were estimated using Cohen's standardized mean difference (SMD) and 95% confidence intervals (95% CI). A single-group proportional meta-analysis was conducted to quantify the percentage of students who considered XR devices useful for their learning. Twenty-seven experimental studies, reporting data from 2199 health sciences students, were included for analysis. XR-technologies yielded higher knowledge gains than traditional approaches (SMD = 0.40; 95% CI = 0.22 to 0.60), especially when used as supplemental/complementary learning resources (SMD = 0.52; 95% CI = 0.40 to 0.63). Specifically, knowledge performance using XR devices outperformed textbooks and atlases (SMD = 0.32; 95% CI = 0.10 to 0.54) and didactic lectures (SMD = 1.00; 95% CI = 0.57 to 1.42), especially among undergraduate students (SMD = 0.41; 95% CI = 0.20 to 0.62). XR devices were perceived to be more useful for learning than traditional approaches (SMD = 0.54; 95% CI = 0.04 to 1), and 80% of all students who used XR devices reported these devices as useful for learning anatomy. Learners using XR technologies demonstrated increased anatomy knowledge gains and considered these technologies useful for learning anatomy.
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Affiliation(s)
- Paloma García-Robles
- FRATERNIDAD Muprespa, Linares, Spain
- Department of Health Sciences, University of Jaén, Jaén, Spain
| | | | - Francisco Antonio Nieto-Escámez
- Department of Psychology, University of Almeria, Almeria, Spain
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), Almeria, Spain
| | - Héctor García-López
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
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Aridan N, Bernstein-Eliav M, Gamzo D, Schmeidler M, Tik N, Tavor I. Neuroanatomy in virtual reality: Development and pedagogical evaluation of photogrammetry-based 3D brain models. ANATOMICAL SCIENCES EDUCATION 2024; 17:239-248. [PMID: 37997182 DOI: 10.1002/ase.2359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/29/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
Anatomy studies are an essential part of medical training. The study of neuroanatomy in particular presents students with a unique challenge of three-dimensional spatial understanding. Virtual Reality (VR) has been suggested to address this challenge, yet the majority of previous reports have implemented computer-generated or imaging-based models rather than models of real brain specimens. Using photogrammetry of real human bodies and advanced editing software, we developed 3D models of a real human brain at different stages of dissection. Models were placed in a custom-built virtual laboratory, where students can walk around freely, explore, and manipulate (i.e., lift the models, rotate them for different viewpoints, etc.). Sixty participants were randomly assigned to one of three learning groups: VR, 3D printed models or read-only, and given 1 h to study the white matter tracts of the cerebrum, followed by theoretical and practical exams and a learning experience questionnaire. We show that following self-guided learning in virtual reality, students demonstrate a gain in spatial understanding and an increased satisfaction with the learning experience, compared with traditional learning approaches. We conclude that the models and virtual lab described in this work may enhance learning experience and improve learning outcomes.
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Affiliation(s)
- Nadav Aridan
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Michal Bernstein-Eliav
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Gamzo
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Maya Schmeidler
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Niv Tik
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Ido Tavor
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Knof H, Berndt M, Shiozawa T. The influence of collaborative learning and self-organisation on medical students' academic performance in anatomy. Ann Anat 2024; 251:152182. [PMID: 37879501 DOI: 10.1016/j.aanat.2023.152182] [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: 04/25/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND In 2021, university teaching at the Faculty of Medicine Tuebingen was transferred to a digital setting. Due to the discontinuation of face-to-face teaching, students lacked the temporal and spatial framework of the curriculum and the possibility to socialise with fellow students was extremely limited. Increased demands were placed on the students' self-organisation, and the possibility of collaborative learning was drastically limited. The present study investigated the extent to which these study conditions affected the academic performance of medical students in the oral exam after the 60-hour introductory anatomy lecture. Specifically, collaborative, and organisational learning strategies were considered. METHODS Learning strategies of 146 students were assessed by means of a questionnaire. The anatomy exam was used to assess the academic performance. In addition, students were asked to rate their own oral exam performance. RESULTS Students used strategies of collaborative learning (M = 3.30, SD = 0.88) and self-organisation (M = 3.28, SD = 0.72) about equally as often. A significant correlation was found between the use of collaborative learning strategies and the ability for realistic self-assessment (ρ = -0.22, P =.02). Collaborative behaviour could be divided into Initiative Collaborative Learning and Subordinate Collaborative Learning. Only the former had an influence on the ability for realistic self-assessment. Neither organisational learning strategies nor collaborative learning strategies had an influence on academic performance. DISCUSSION AND CONCLUSION Initiative collaborative learners showed a higher degree of realistic self-assessment. This could be explained through a more distinct social referencing, as fellow students' knowledge levels can be related early on to their own academic performance. There was no correlation between the learning strategies used and the exam result.
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Affiliation(s)
- Harald Knof
- Department of Anatomy, Institute of Clinical Anatomy and Cell Analysis, Faculty of Medicine, Eberhard Karls University of Tuebingen, Elfriede-Aulhorn-Straße 8, Tuebingen 72076, Germany
| | - Markus Berndt
- Institute of Medical Education, LMU University Hospital, LMU Munich, Pettenkoferstr. 8a, Munich 80336, Germany
| | - Thomas Shiozawa
- Department of Anatomy, Institute of Clinical Anatomy and Cell Analysis, Faculty of Medicine, Eberhard Karls University of Tuebingen, Elfriede-Aulhorn-Straße 8, Tuebingen 72076, Germany.
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Würstle S, Spanke LM, Mehlhase N, Stanley G, Koff J, Dimitriadis S, König S, Hann A. Evaluation of a Virtual Reality-Based Open Educational Resource Software. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241242220. [PMID: 38572090 PMCID: PMC10989036 DOI: 10.1177/23821205241242220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/28/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Virtual reality (VR) teaching methods have potential to support medical students acquire increasing amounts of knowledge. EVENT (Easy VR EducatioN Tool) is an open educational resource software for immersive VR environments, which is designed for use without programming skills. In this work, EVENT was used in a medical student VR course on pancreatic cancer. METHODS Medical students were invited to participate in the course. Before and after VR simulation, participants completed a multiple-choice knowledge assessment, with a maximum score of 10, and a VR experience questionnaire. The primary endpoint compared pre- and post-VR simulation test scores. Secondary endpoints included usability and factors that could affect learning growth and test results. RESULTS Data from 117 of the 135 participating students was available for analysis. Student test scores improved by an average of 3.4 points (95% CI 3.1-3.7, P < 0.001) after VR course. The secondary endpoints of gender, age, prior knowledge regarding the medical subject, professional training completed in the medical field, video game play, three-dimensional imagination skills, or cyber-sickness had no major impact on test scores or final ranking (top or bottom 25%). The 27 students whose post-VR simulation test scores ranked in the top 25% had no prior experience with VR. The average System Usability Scale score was 86.1, which corresponds to an excellent outcome for user-friendliness. Questionnaire responses post-VR simulation show students (81.2% [95/117]) interest in more VR options in medical school. CONCLUSIONS We present a freely available software that allows for the development of VR teaching lessons without programming skills.
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Affiliation(s)
- Silvia Würstle
- Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
- Department of Internal Medicine II, University Hospital rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lisa-Marie Spanke
- Interventional and Experimental Endoscopy (InExEn), Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
- Institute of Medical Teaching and Medical Education Research, University Hospital Würzburg, Würzburg, Germany
| | - Niklas Mehlhase
- Interventional and Experimental Endoscopy (InExEn), Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
| | - Gail Stanley
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Jonathan Koff
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Stavros Dimitriadis
- Department of Gastroenterology, University Hospital Coventry and Warwickshire, Coventry, CV2 2DX, UK
| | - Sarah König
- Institute of Medical Teaching and Medical Education Research, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Hann
- Interventional and Experimental Endoscopy (InExEn), Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
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Kleinbeck C, Schieber H, Kreimeier J, Martin-Gomez A, Unberath M, Roth D. Injured Avatars: The Impact of Embodied Anatomies and Virtual Injuries on Well-Being and Performance. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:4503-4513. [PMID: 37788205 DOI: 10.1109/tvcg.2023.3320224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Human cognition relies on embodiment as a fundamental mechanism. Virtual avatars allow users to experience the adaptation, control, and perceptual illusion of alternative bodies. Although virtual bodies have medical applications in motor rehabilitation and therapeutic interventions, their potential for learning anatomy and medical communication remains underexplored. For learners and patients, anatomy, procedures, and medical imaging can be abstract and difficult to grasp. Experiencing anatomies, injuries, and treatments virtually through one's own body could be a valuable tool for fostering understanding. This work investigates the impact of avatars displaying anatomy and injuries suitable for such medical simulations. We ran a user study utilizing a skeleton avatar and virtual injuries, comparing to a healthy human avatar as a baseline. We evaluate the influence on embodiment, well-being, and presence with self-report questionnaires, as well as motor performance via an arm movement task. Our results show that while both anatomical representation and injuries increase feelings of eeriness, there are no negative effects on embodiment, well-being, presence, or motor performance. These findings suggest that virtual representations of anatomy and injuries are suitable for medical visualizations targeting learning or communication without significantly affecting users' mental state or physical control within the simulation.
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7
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Zhang H, Zhu L, Zhang Q, Wang Y, Song A. Online view enhancement for exploration inside medical volumetric data using virtual reality. Comput Biol Med 2023; 163:107217. [PMID: 37450968 DOI: 10.1016/j.compbiomed.2023.107217] [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: 03/01/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Medical image visualization is an essential tool for conveying anatomical information. Ray-casting-based volume rendering is commonly used for generating visualizations of raw medical images. However, exposing a target area inside the skin often requires manual tuning of transfer functions or segmentation of original images, as preset parameters in volume rendering may not work well for arbitrary scanned data. This process is tedious and unnatural. To address this issue, we propose a volume visualization system that enhances the view inside the skin, enabling flexible exploration of medical volumetric data using virtual reality. METHODS In our proposed system, we design a virtual reality interface that allows users to walk inside the data. We introduce a view-dependent occlusion weakening method based on geodesic distance transform to support this interaction. By combining these methods, we develop a virtual reality system with intuitive interactions, facilitating online view enhancement for medical data exploration and annotation inside the volume. RESULTS Our rendering results demonstrate that the proposed occlusion weakening method effectively weakens obstacles while preserving the target area. Furthermore, comparative analysis with other alternative solutions highlights the advantages of our method in virtual reality. We conducted user studies to evaluate our system, including area annotation and line drawing tasks. The results showed that our method with enhanced views achieved 47.73% and 35.29% higher accuracy compared to the group with traditional volume rendering. Additionally, subjective feedback from medical experts further supported the effectiveness of the designed interactions in virtual reality. CONCLUSIONS We successfully address the occlusion problems in the exploration of medical volumetric data within a virtual reality environment. Our system allows for flexible integration of scanned medical volumes without requiring extensive manual preprocessing. The results of our user studies demonstrate the feasibility and effectiveness of walk-in interaction for medical data exploration.
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Affiliation(s)
- Hongkun Zhang
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, Jiangsu, PR China
| | - Lifeng Zhu
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, Jiangsu, PR China.
| | | | - Yunhai Wang
- Department of Computer Science, Shandong University, Shandong, PR China
| | - Aiguo Song
- State Key Laboratory of Digital Medical Engineering, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, Jiangsu, PR China
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Khan J, Baatjes KJ, Layman-Lemphane JI, Correia J. Online anatomy education during the Covid-19 pandemic: Opinions of medical, speech therapy, and BSc Anatomy students. ANATOMICAL SCIENCES EDUCATION 2023; 16:892-906. [PMID: 36924347 DOI: 10.1002/ase.2271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
With the emergence of the Covid-19 pandemic in 2020, it was difficult to predict if the "cadaveric-based (golden) standard" of teaching anatomy would be possible in the unforeseeable future. This forced traditional anatomical teaching and learning practices to be transitioned to remote online platforms. This study explored the opinions of anatomy students (n = 51), on their online learning experience of anatomy during the Covid-19 pandemic. A mixed methods approach using a descriptive, exploratory study design was conducted, by use of an online survey. The survey consisted of a six-point Likert scale and was assembled into four sub-categories. Likert scale options ranged from; strongly disagree, to strongly agree, and not applicable. Results obtained seem to tally with expectations, indicating an adequate theoretical course component with room to improve practical online teaching. Most participants had a positive perception of the theoretical course content, duration, and platforms of communication. Virtual classes were simple to navigate with few technical difficulties experienced by the participants. Students also noted having access to sufficient study material, videos, and additional online material. Overall, more than half of all participants reported adapting well to the remote learning environment, however, the greatest challenge experienced highlighted a sense of deprivation from the lack of cadaver exposure and hands-on instruction. This research highlighted the effects of the pandemic on the modality of anatomy education and how it affected students. Although anatomy is multi-modal, it can be concluded that it is possible to achieve academic success by using online learning methods.
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Affiliation(s)
- Johara Khan
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karin J Baatjes
- Dean's Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jodie I Layman-Lemphane
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Janine Correia
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Allison S, Mueller C, Lackey-Cornelison W. Structure and function: how to design integrated anatomy and physiology modules for the gross anatomy laboratory. Front Physiol 2023; 14:1250139. [PMID: 37614758 PMCID: PMC10442568 DOI: 10.3389/fphys.2023.1250139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023] Open
Abstract
Physicians must be able to integrate knowledge across disciplines. Therefore, educators need to provide opportunities for students to cognitively integrate information across the medical school curriculum. Literature has shown that specifically pointing out these connections helps students create cause and effect models and ultimately improve their performance. The gross anatomy laboratory provides an excellent environment for students to integrate information by establishing structure and function relationships. This article presents simple steps to create modules which help students cognitively integrate physiology and anatomy at the session level in the gross anatomy laboratory. Driven by backward design, these steps include establishing objectives, creating assessments, and developing activities that can be implemented in a specific learning environment. An example of a flexible module which could be implemented in a number of gross anatomy lab settings (e.g., prosection, dissection, models, virtual) is presented along with a template for the design of future modules. This is followed by a discussion of challenges encountered by educators attempting to integrate structure and function in the gross anatomy lab. Each of these considerations will be addressed with potential solutions for educators seeking to implement these types of integrated activities.
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Affiliation(s)
- Sara Allison
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Caroline Mueller
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, United States
| | - Wendy Lackey-Cornelison
- Department of Medical Education, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
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Koucheki R, Lex JR, Morozova A, Ferri D, Hauer TM, Mirzaie S, Ferguson PC, Ballyk B. Immersive Virtual Reality and Cadaveric Bone are Equally Effective in Skeletal Anatomy Education: A Randomized Crossover Noninferiority Trial. JOURNAL OF SURGICAL EDUCATION 2023; 80:1028-1038. [PMID: 37150701 DOI: 10.1016/j.jsurg.2023.04.005] [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: 10/28/2022] [Revised: 02/10/2023] [Accepted: 04/09/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Immersive virtual reality (IVR) technology is transforming medical education. Our aim was to compare the effectiveness of IVR with cadaveric bone models in teaching skeletal anatomy. DESIGN A randomized crossover noninferiority trial was conducted. SETTING Anatomy laboratory of a large medical school. PARTICIPANTS Incoming first-year medical students. Participants were randomized to IVR or cadaveric groups studying upper limb skeletal anatomy, and then were crossed over to use the opposite tool, to study lower limb skeletal anatomy. Participants in both groups completed a pre-and postintervention knowledge test. The primary endpoint of the study was change in performance from the pre-to postintervention knowledge test. Surveys were completed to assess participant's impressions on IVR as an educational tool. RESULTS Fifty first-year medical students met inclusion criteria and were randomized. Among all students, the average score on the preintervention knowledge test was 14.6% (standard deviation (SD) = 18.2%) and 25.0% (SD = 17%) for upper and lower limbs, respectively. Percentage increase in scores between pre-and postintervention knowledge test, was 15.0% in the upper limb IVR group, and 16.7% for upper limb cadaveric bones (p = 0.286). For the lower limb, score increase was 22.6% in the IVR and 22.5% in the cadaveric bone group (p = 0.936). 79% of participants found that IVR was most valuable for teaching 3-dimensional orientation, anatomical relationships, and key landmarks. Majority of participants were favorable towards combination use of traditional methods and IVR technology for learning skeletal anatomy (LSM>3). CONCLUSIONS In this randomized controlled trial, there was no significant difference in knowledge after using IVR or cadaveric bones for skeletal anatomy education. These findings have further implications for medical schools that face challenges in acquiring human cadavers and cadaveric parts.
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Affiliation(s)
- Robert Koucheki
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Biomedical Engineering, Toronto, Ontario, Canada.
| | - Johnathan R Lex
- Institute of Biomedical Engineering, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, University of Toronto, Ontario, Canada
| | - Alexandra Morozova
- Division of Anatomy, University of Toronto, Ontario, Canada; Department of Anatomy, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Dario Ferri
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tyler M Hauer
- Institute of Biomedical Engineering, Toronto, Ontario, Canada
| | - Sarah Mirzaie
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Peter C Ferguson
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, University of Toronto, Ontario, Canada; Department of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Barbara Ballyk
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Anatomy, University of Toronto, Ontario, Canada
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Zhang S, Wang J, Zhang J, Xu G, Zhang Z, Wang Y, Chang C, Chen X, Li M, Cao J, Zang W. The impact of enhancing publicity and commemoration of body donors at Zhengzhou University, China. ANATOMICAL SCIENCES EDUCATION 2023; 16:405-414. [PMID: 36744983 DOI: 10.1002/ase.2259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/24/2023] [Accepted: 02/01/2023] [Indexed: 05/11/2023]
Abstract
As a fundamental subject of medical education, human anatomy plays a critical role in the development of medical science. However, because of multiple factors including cultural conservativism and limited social understanding, China is facing a particularly severe shortage of bodies donated for anatomy education. Zhengzhou University (ZZU) has continued to uphold whole-body dissection as the preferred method for medical students to learn anatomy. For this study, records of registered individuals (who have signed a body donation agreement) and donors (whose bodies have been received) from 2001 to 2020 were collected and analyzed. The aim of this study was to explore the factors influencing the body donation program (BDP) at ZZU, and then reinforce the social understanding for the BDP. The results showed a significant increase in the numbers of both registered individuals and donors since 2015, which is the year the publicity and commemoration in honor of donors were increased. There were no significant differences between the biological male and female sexes in the registered individuals, but the number of male donors (12.85 ± 10.86, per year) was significantly higher than that of female donors (4.75 ± 4.53, per year). The current donor profile at ZZU is male in his 60/70s, while the profile of registered individuals is male or female in their 60s. Strengthening the publicity and commemoration in honor of donors may contribute to the implementation of BDPs.
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Affiliation(s)
- Shiqiang Zhang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jiannan Wang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
- Red Cross Society of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jingjing Zhang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Gaolei Xu
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zhenhua Zhang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yongkui Wang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Cheng Chang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xuemei Chen
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Ming Li
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jing Cao
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Weidong Zang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
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12
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Augmented Reality in HBP surgery. Technology at your fingertips. Cir Esp 2023; 101:312-318. [PMID: 36781048 DOI: 10.1016/j.cireng.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/30/2022] [Indexed: 02/13/2023]
Abstract
Augmented reality is a technology that opens new possibilities in surgery. We present our experience in a hepatobiliary-pancreatic surgery unit in terms of preoperative planning, intraoperative support and teaching. For surgical planning, we have used 3D CT and MRI reconstructions to evaluate complex cases, which has made the interpretation of the anatomy more precise and the planning of the technique simpler. At an intraoperative level, it provides for remote holographic connection between specialists, the substitution of physical elements for virtual elements, and the use of virtual consultation models and surgical guides. In teaching, new lessons include sharing live video of surgery with the support of virtual elements for a better student understanding. As the experience has been satisfactory, augmented reality could be applied in the future to improve the results of hepatobiliary-pancreatic surgery.
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13
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Curran VR, Xu X, Aydin MY, Meruvia-Pastor O. Use of Extended Reality in Medical Education: An Integrative Review. MEDICAL SCIENCE EDUCATOR 2023; 33:275-286. [PMID: 36569366 PMCID: PMC9761044 DOI: 10.1007/s40670-022-01698-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Extended reality (XR) has emerged as an innovative simulation-based learning modality. An integrative review was undertaken to explore the nature of evidence, usage, and effectiveness of XR modalities in medical education. One hundred and thirty-three (N = 133) studies and articles were reviewed. XR technologies are commonly reported in surgical and anatomical education, and the evidence suggests XR may be as effective as traditional medical education teaching methods and, potentially, a more cost-effective means of curriculum delivery. Further research to compare different variations of XR technologies and best applications in medical education and training are required to advance the field. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01698-4.
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Affiliation(s)
- Vernon R. Curran
- Office of Professional and Educational Development, Faculty of Medicine, Health Sciences Centre, Memorial University of Newfoundland, Room H2982, St. John’s, NL A1B 3V6 Canada
| | - Xiaolin Xu
- Faculty of Health Sciences, Queen’s University, Kingston, ON Canada
| | - Mustafa Yalin Aydin
- Department of Computer Sciences, Memorial University of Newfoundland, St. John’s, NL Canada
| | - Oscar Meruvia-Pastor
- Department of Computer Sciences, Memorial University of Newfoundland, St. John’s, NL Canada
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14
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Sinha S, DeYoung V, Nehru A, Brewer-Deluce D, Wainman BC. Determinants of Learning Anatomy in an Immersive Virtual Reality Environment - A Scoping Review. MEDICAL SCIENCE EDUCATOR 2023; 33:287-297. [PMID: 36573211 PMCID: PMC9774061 DOI: 10.1007/s40670-022-01701-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Given the decline of cadavers as anatomy teaching tools, immersive virtual reality (VR) technology has gained popularity as a potential alternative. To better understand how to maximize the educational potential of VR, this scoping review aimed to identify potential determinants of learning anatomy in an immersive VR environment. A literature search yielded 4523 studies, 25 of which were included after screening. Six common factors were derived from secondary outcomes in these papers: cognitive load, cybersickness, student perceptions, stereopsis, spatial understanding, and interactivity. Further objective research investigating the impact of these factors on anatomy examination performance is required. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01701-y.
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Affiliation(s)
- Sakshi Sinha
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, 1280 Main St. W. HSC 1R1, Hamilton, ON L8S 4L8 Canada
| | - Veronica DeYoung
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, 1280 Main St. W. HSC 1R1, Hamilton, ON L8S 4L8 Canada
| | - Amit Nehru
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, 1280 Main St. W. HSC 1R1, Hamilton, ON L8S 4L8 Canada
| | - Danielle Brewer-Deluce
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON Canada
| | - Bruce C. Wainman
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, 1280 Main St. W. HSC 1R1, Hamilton, ON L8S 4L8 Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
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15
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Guaraná JB, Aytaç G, Müller AF, Thompson J, Freitas SH, Lee UY, Lozanoff S, Ferrante B. Extended reality veterinary medicine case studies for diagnostic veterinary imaging instruction: Assessing student perceptions and examination performance. Anat Histol Embryol 2023; 52:101-114. [PMID: 36317584 DOI: 10.1111/ahe.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/07/2022] [Accepted: 08/31/2022] [Indexed: 01/17/2023]
Abstract
Educational technologies in veterinary medicine aim to train veterinarians faster and improve clinical outcomes. COVID-19 pandemic, shifted face-to-face teaching to online, thus, the need to provide effective education remotely was exacerbated. Among recent technology advances for veterinary medical education, extended reality (XR) is a promising teaching tool. This study aimed to develop a case resolution approach for radiographic anatomy studies using XR technology and assess students' achievement of differential diagnostic skills. Learning objectives based on Bloom's taxonomy keywords were used to develop four clinical cases (3 dogs/1 cat) of spinal injuries utilizing CT scans and XR models and presented to 22 third-year veterinary medicine students. Quantitative assessment (ASMT) of 7 questions probing 'memorization', 'understanding and application', 'analysis' and 'evaluation' was given before and after contact with XR technology as well as qualitative feedback via a survey. Mean ASMT scores increased during case resolution (pre 51.6% (±37%)/post 60.1% (± 34%); p < 0.01), but without significant difference between cases (Kruskal-Wallis H = 2.18, NS). Learning objectives were examined for six questions (Q1-Q6) across cases (C1-4): Memorization improved sequentially (Q1, 2 8/8), while Understanding and Application (Q3,4) showed the greatest improvement (26.7%-76.9%). Evaluation and Analysis (Q5,6) was somewhat mixed, improving (5/8), no change (3/8) and declining (1/8).Positive student perceptions suggest that case studies' online delivery was well received stimulating learning in diagnostic imaging and anatomy while developing visual-spatial skills that aid understanding cross-sectional images. Therefore, XR technology could be a useful approach to complement radiological instruction in veterinary medicine.
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Affiliation(s)
- Julia B Guaraná
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo (USP), São Paulo, Brazil
| | - Güneş Aytaç
- Department of Anatomy, Biochemistry & Physiology, John A. Burns School of Medicine, University of Hawaii (UH), Honolulu, Hawaii, USA
| | - Alois F Müller
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo (USP), São Paulo, Brazil
| | - Jesse Thompson
- Department of Anatomy, Biochemistry & Physiology, John A. Burns School of Medicine, University of Hawaii (UH), Honolulu, Hawaii, USA
| | - Silvio H Freitas
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo (USP), São Paulo, Brazil
| | - U-Young Lee
- Department of Anatomy, College of Medicine, The Catholic University of Korea (CUK), Seoul, South Korea
| | - Scott Lozanoff
- Department of Anatomy, Biochemistry & Physiology, John A. Burns School of Medicine, University of Hawaii (UH), Honolulu, Hawaii, USA
| | - Bruno Ferrante
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo (USP), São Paulo, Brazil.,Veterinary Clinical and Surgery Department of Veterinary School, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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16
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Govender S, Cronjé JY, Keough N, Oberholster AJ, van Schoor AN, de Jager EJ, Naicker J. Emerging Imaging Techniques in Anatomy: For Teaching, Research and Clinical Practice. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1392:19-42. [DOI: 10.1007/978-3-031-13021-2_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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17
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Lee J, Kwon KH. The significant transformation of life into health and beauty in metaverse era. J Cosmet Dermatol 2022; 21:6575-6583. [PMID: 35686389 DOI: 10.1111/jocd.15151] [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: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND In 2019, coronavirus disease-19 (COVID-19) continues, and it is evolving and starting again. It is a situation to keep in mind that now is the era of With Corona (WC) and Long-COVID. "WC" will be a transformation of the quarantine system. The current situation is associated with health and beauty. Sustainability of healthy beauty is giving new meaning to well-being and well-dying. OBJECTIVES Therefore, in this study, we empirically analyzed the changes in the perception of health and beauty among cosmetic consumers in the metaverse, which are recently becoming an issue in the WC era. METHODS It was created by searching keywords such as "With Corona," "Health," "Life Beauty," "Customized inner beauty," "Customized cosmetics," "Metaverse," "DTC GT," etc. This study was conducted with reference to PubMed, Google Scholar, Riss, Scopus, and ResearchGate. Accordingly, a total of 472 papers were researched, and among them, 32 papers, which are the focus of the study, were finally included in this study. RESULTS As the era of WC changes, a new paradigm of converting the customer experience of the beauty market into a metaverse will be beginning. Accordingly, it is necessary to pay attention to changes in the cosmetic industry by reflecting the needs of consumers. CONCLUSION It is necessary to create a new mobile platform that encompasses three-dimensional health and beauty life using direct-to-customer genetic testing (DTC GT) with Web 3.0 in the metaverse that integrates life health and beauty in the WC era. Accordingly, it is expected that this article will be used as an invaluable marketing material in preparation for new changes in the metaverse cosmetics market in the future by clearly understanding the needs of consumers in the cosmetics industry, which are changing as they transformation to WC era.
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Affiliation(s)
- Jinkyung Lee
- Division of Beauty Arts Care, Department of Beauty Arts Care, Graduate School, Dongguk University, Seoul, Republic of Korea.,Department of Beauty and Health Care, Namseoul University, Cheonan, Republic of Korea
| | - Ki Han Kwon
- College of General Education, Kookmin University, Seoul, Republic of Korea
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18
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Augmented reality (AR) and fracture mapping model on middle-aged femoral neck fracture: A proof-of-concept towards interactive visualization. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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19
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Shojaei A, Feili A, Kojuri J, Norafshan A, Bazrafkan L. The blacksmith approach: a strategy for teaching and learning in the medical anatomy course (a qualitative study). BMC MEDICAL EDUCATION 2022; 22:728. [PMID: 36266705 PMCID: PMC9584281 DOI: 10.1186/s12909-022-03800-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/06/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Anatomy is a symbolic, essential core topic and one of the fundamental pillars of medical and paramedical knowledge. Nevertheless, few exploratory data analyses have focused on how students approach learning anatomy. This study examined how students perceive their learning experience during anatomy lessons and how to make a model which promotes their meaningful learning and professional identity. METHODS Using purposive sampling with maximum variation, we conducted a qualitative content analysis at the Shiraz University of Medical Sciences in Iran (2020 to 2021). Twenty-four medical students and twelve faculty members of Iran's medical science universities were enrolled in the study. The data were collected through semi-structured interviews and analyzed according to the theme. RESULTS A conceptual model emerged from the data analysis with the main theme called the blacksmith approach, which included Three sub-themes: (1) making a new forge (adequate preparation and mindful beginning), (2) heating the students' hearts (considering supporting systems that learners need) and (3) using Sledgehammer's approach (teaching anatomy by using more active methods and engaging all neuroanatomical regions) and (Using fun for enjoyable learning). All the concepts were related to each other. CONCLUSION Medical students experience a challenging fundamental evolution into professional doctors. Educational systems focus primarily on teaching and learning, while students' transition can be facilitated by a three-step model called the Blacksmith Approach. It best serves as an educational framework for any pivotal, preclinical course capable of helping students acquire new roles and tackle challenges. Further research should be conducted to confirm how hard work leads to satisfying results with the opportunity to create enjoyable learning.
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Affiliation(s)
- Arash Shojaei
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Feili
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Kojuri
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Norafshan
- Histomorphometry and Stereology Research Center, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Bazrafkan
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Shiraz University of Medical Sciences, Shiraz, Iran.
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Shiraz University of Medical Sciences, Shiraz, Iran.
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20
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Geerlings-Batt J, Tillett C, Gupta A, Sun Z. Enhanced Visualisation of Normal Anatomy with Potential Use of Augmented Reality Superimposed on Three-Dimensional Printed Models. MICROMACHINES 2022; 13:1701. [PMID: 36296054 PMCID: PMC9608320 DOI: 10.3390/mi13101701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
Anatomical knowledge underpins the practice of many healthcare professions. While cadaveric specimens are generally used to demonstrate realistic anatomy, high cost, ethical considerations and limited accessibility can often impede their suitability for use as teaching tools. This study aimed to develop an alternative to traditional teaching methods; a novel teaching tool using augmented reality (AR) and three-dimensional (3D) printed models to accurately demonstrate normal ankle and foot anatomy. An open-source software (3D Slicer) was used to segment a high-resolution magnetic resonance imaging (MRI) dataset of a healthy volunteer ankle and produce virtual bone and musculature objects. Bone and musculature were segmented using seed-planting and interpolation functions, respectively. Virtual models were imported into Unity 3D, which was used to develop user interface and achieve interactability prior to export to the Microsoft HoloLens 2. Three life-size models of bony anatomy were printed in yellow polylactic acid and thermoplastic polyurethane, with another model printed in white Visijet SL Flex with a supporting base attached to its plantar aspect. Interactive user interface with functional toggle switches was developed. Object recognition did not function as intended, with adequate tracking and AR superimposition not achieved. The models accurately demonstrate bony foot and ankle anatomy in relation to the associated musculature. Although segmentation outcomes were sufficient, the process was highly time consuming, with effective object recognition tools relatively inaccessible. This may limit the reproducibility of augmented reality learning tools on a larger scale. Research is required to determine the extent to which this tool accurately demonstrates anatomy and ascertain whether use of this tool improves learning outcomes and is effective for teaching anatomy.
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Affiliation(s)
- Jade Geerlings-Batt
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia
| | - Carley Tillett
- Curtin HIVE (Hub for Immersive Visualisation and eResearch), Curtin University, Perth, WA 6845, Australia
| | - Ashu Gupta
- Department of Medical Imaging, Fiona Stanley Hospital, Perth, WA 6150, Australia
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA 6845, Australia
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6845, Australia
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21
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Are extended reality technologies (ERTs) more effective than traditional anatomy education methods? SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:1215-1218. [PMID: 35951086 DOI: 10.1007/s00276-022-02998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Reviews and meta-analyses concerning the effectiveness of extended reality technologies (ERTs) (namely virtual, augmented, and mixed reality-VR, AR, and MR) in anatomy education (AE) have resulted in conflicting outcomes. The current review explores the existing evidence provided by reviews of AE literature regarding the effectiveness of ERTs after their comparison with traditional (either cadaveric or two-dimensional) anatomy teaching modalities and sheds light on the factors associated with the conflicting outcomes. METHODS PubMed, SCOPUS, ERIC, and Cochrane databases were searched for review articles with the purpose to investigate the effectiveness of ERTs in AE. RESULTS Nine (four systematic with or without meta-analysis and five non-systematic) reviews were included. A lack of robust evidence provided by those reviews was noted, mainly due to a remarkable confusion in the definition of each ERT, along with confusion when authors referred to traditional AE (TAE) methods. CONCLUSIONS To clarify to what extent VR, AR, or MR can replace or supplement TAE methods, there is a primary need for addressing issues regarding the definition of each technology and determining which specific TAE methods are used as comparators.
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22
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Chandrasekaran R, Radzi S, Kai PZ, Rajalingam P, Rotgans J, Mogali SR. A validated instrument measuring students' perceptions on plastinated and three-dimensional printed anatomy tools. ANATOMICAL SCIENCES EDUCATION 2022; 15:850-862. [PMID: 34694750 DOI: 10.1002/ase.2147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
Due to the modernization of the medical curriculum and technological advancements, anatomy education has evolved beyond cadaveric dissection alone. Plastination techniques, three-dimensional (3D) modeling, and 3D printing technologies have progressively gained importance. However, there are limited valid and reliable surveys to evaluate students' perceptions of these new anatomy tools. Hence, this study aimed to develop a validated instrument to measure students' learning satisfaction, self-efficacy, humanistic values, and perceived limitations of plastinated and 3D printed models. A 41-item survey (five-point Likert scale, 1 = strongly disagree to 5 = strongly agree) was administered to Year 1 undergraduate medical students following a randomized controlled crossover study that evaluated plastinated and 3D printed cardiac and neck models. Ninety-six responses were received, and a factor analysis was performed with the Kaiser-Meyer-Olkin sampling adequacy of 0.878. The confirmatory factor analysis yielded a 4-factor, 19 items model that had a good fit with the latent constructs of x 2 (147) = 211.568, P < 0.001, root mean square error of approximation = 0.068, root mean square residual = 0.064, comparative fit index = 0.946, and Tucker Lewis index = 0.937. The Cronbach's alpha for the individual factors ranged from 0.74 to 0.95, indicating good internal consistency. This demonstrated a psychometrically valid and reliable instrument to measure students' perceptions toward plastinated and 3D printed models.
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Affiliation(s)
- Ramya Chandrasekaran
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Shairah Radzi
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Peh Zhen Kai
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Preman Rajalingam
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Jerome Rotgans
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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Vandenbossche V, Van de Velde J, Avet S, Willaert W, Soltvedt S, Smit N, Audenaert E. Digital body preservation: Technique and applications. ANATOMICAL SCIENCES EDUCATION 2022; 15:731-744. [PMID: 35578771 DOI: 10.1002/ase.2199] [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: 06/28/2021] [Revised: 02/25/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
High-fidelity anatomical models can be produced with three-dimensional (3D) scanning techniques and as such be digitally preserved, archived, and subsequently rendered through various media. Here, a novel methodology-digital body preservation-is presented for combining and matching scan geometry with radiographic imaging. The technique encompasses joining layers of 3D surface scans in an anatomical correct spatial relationship. To do so, a computed tomography (CT) volume is used as template to join and merge different surface scan geometries by means of nonrigid registration into a single environment. In addition, the use and applicability of the generated 3D models in digital learning modalities is presented. Finally, as computational expense is usually the main bottleneck in extended 3D applications, the influence of mesh simplification in combination with texture mapping on the quality of 3D models was investigated. The physical fidelity of the simplified meshes was evaluated in relation to their resolution and with respect to key anatomical features. Large- and medium-scale features were well preserved despite extensive 3D mesh simplification. Subtle fine-scale features, particular in curved areas demonstrated the major limitation to extensive mesh size reduction. Depending on the local topography, workable mesh sizes ranging from 10% to 3% of the original size could be obtained, making them usable in various learning applications and environments.
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Affiliation(s)
- Vicky Vandenbossche
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Joris Van de Velde
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stind Avet
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wouter Willaert
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Gastrointestinal Surgery, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stian Soltvedt
- Department of Informatics, Institute for Informatics, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, Bergen, Norway
| | - Noeska Smit
- Department of Informatics, Institute for Informatics, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, Bergen, Norway
| | - Emmanuel Audenaert
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Orthopedic Surgery and Traumatology, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Op3Mech Research Group, Department of Electromechanics, Faculty of Applied Engineering, University of Antwerp, Antwerp, Belgium
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24
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Gelmini AYP, Duarte ML, da Silva MO, Guimarães JB, dos Santos LR. Augmented reality in interventional radiology education: a systematic review of randomized controlled trials. SAO PAULO MED J 2022; 140:604-614. [PMID: 35946678 PMCID: PMC9491476 DOI: 10.1590/1516-3180.2021.0606.r2.27122021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 12/27/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Augmented reality (AR) involves digitally overlapping virtual objects onto physical objects in real space so that individuals can interact with both at the same time. AR in medical education seeks to reduce surgical complications through high-quality education. There is uncertainty in the use of AR as a learning tool for interventional radiology procedures. OBJECTIVE To compare AR with other learning methods in interventional radiology. DESIGN AND SETTING Systematic review of comparative studies on teaching techniques. METHODS We searched the Cochrane Library, MEDLINE, Embase, Tripdatabase, ERIC, CINAHL, SciELO and LILACS electronic databases for studies comparing AR simulation with other teaching methods in interventional radiology. This systematic review was performed in accordance with PRISMA and the BEME Collaboration. Eligible studies were evaluated using the quality indicators provided in the BEME Collaboration Guide no. 11, and the Kirkpatrick model. RESULTS Four randomized clinical trials were included in this review. The level of educational evidence found among all the papers was 2B, according to the Kirkpatrick model. The Cochrane Collaboration tool was applied to assess the risk of bias for individual studies and across studies. Three studies showed an improvement in teaching of the proposed procedure through AR; one study showed that the participants took longer to perform the procedure through AR. CONCLUSION AR, as a complementary teaching tool, can provide learners with additional skills, but there is still a lack of studies with a higher evidence level according to the Kirkpatrick model. SYSTEMATIC REVIEW REGISTRATION NUMBER DOI 10.17605/OSF.IO/ACZBM in the Open Science Framework database.
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Affiliation(s)
| | - Márcio Luís Duarte
- MSc. Musculoskeletal Radiologist, Centro Radiológico e Especialidades Médicas São Gabriel, Praia Grande (SP), Brazil; and Doctoral Student in Evidence-based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil
| | | | | | - Lucas Ribeiro dos Santos
- MSc. Endocrinologist, Department of Physiology and Medical Clinic, and Professor of Physiology and Medical Clinic, Centro Universitário Lusíada (UNILUS), Santos (SP), Brazil; and Doctoral Student in Evidence-based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil
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25
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Wickramasinghe N, Thompson BR, Xiao J. The Opportunities and Challenges of Digital Anatomy for Medical Sciences: Narrative Review. JMIR MEDICAL EDUCATION 2022; 8:e34687. [PMID: 35594064 PMCID: PMC9166657 DOI: 10.2196/34687] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/23/2022] [Accepted: 03/25/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Anatomy has been the cornerstone of medical education for centuries. However, given the advances in the Internet of Things, this landscape has been augmented in the past decade, shifting toward a greater focus on adopting digital technologies. Digital anatomy is emerging as a new discipline that represents an opportunity to embrace advances in digital health technologies and apply them to the domain of modern medical sciences. Notably, the use of augmented or mixed and virtual reality as well as mobile and platforms and 3D printing in modern anatomy has dramatically increased in the last 5 years. OBJECTIVE This review aims to outline the emerging area of digital anatomy and summarize opportunities and challenges for incorporating digital anatomy in medical science education and practices. METHODS Literature searches were performed using the PubMed, Embase, and MEDLINE bibliographic databases for research articles published between January 2005 and June 2021 (inclusive). Out of the 4650 articles, 651 (14%) were advanced to full-text screening and 77 (1.7%) were eligible for inclusion in the narrative review. We performed a Strength, Weakness, Opportunity, and Threat (SWOT) analysis to evaluate the role that digital anatomy plays in both the learning and teaching of medicine and health sciences as well as its practice. RESULTS Digital anatomy has not only revolutionized undergraduate anatomy education via 3D reconstruction of the human body but is shifting the paradigm of pre- and vocational training for medical professionals via digital simulation, advancing health care. Importantly, it was noted that digital anatomy not only benefits in situ real time clinical practice but also has many advantages for learning and teaching clinicians at multiple levels. Using the SWOT analysis, we described strengths and opportunities that together serve to underscore the benefits of embracing digital anatomy, in particular the areas for collaboration and medical advances. The SWOT analysis also identified a few weaknesses associated with digital anatomy, which are primarily related to the fact that the current reach and range of applications for digital anatomy are very limited owing to its nascent nature. Furthermore, threats are limited to technical aspects such as hardware and software issues. CONCLUSIONS This review highlights the advances in digital health and Health 4.0 in key areas of digital anatomy analytics. The continuous evolution of digital technologies will increase their ability to reinforce anatomy knowledge and advance clinical practice. However, digital anatomy education should not be viewed as a simple technical conversion and needs an explicit pedagogical framework. This review will be a valuable asset for educators and researchers to incorporate digital anatomy into the learning and teaching of medical sciences and their practice.
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Affiliation(s)
- Nilmini Wickramasinghe
- School of Health Sciences, Swinburne University of Technology, Victoria, Australia
- Epworth Healthcare, Melbourne, Australia
| | - Bruce R Thompson
- School of Health Sciences, Swinburne University of Technology, Victoria, Australia
- Alfred Health, Melbourne, Australia
- School of Health Sciences, University of Melbourne, Parkville, Australia
| | - Junhua Xiao
- School of Health Sciences, Swinburne University of Technology, Victoria, Australia
- School of Allied Health, La Trobe University, Bundoora, Australia
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Yakura T, Hatayama N, Kawahara C, Ohmichi Y, Ohmichi M, Ban N, Hirai S, Nakano T, Naito M. The effect of simulation-based education before a cadaver dissection course. ANATOMICAL SCIENCES EDUCATION 2022; 15:392-402. [PMID: 34310844 DOI: 10.1002/ase.2124] [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: 07/01/2020] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
Although the methods for medical education continue to evolve due to the development of medicines, the cadaver dissection course still plays a fundamental role. The cadaver dissection course allows students to learn to handle instruments correctly while actively exploring three-dimensional anatomy. However, dissection comes with the risk of accidental injury. In recent years, the number of classes offered for the cadaver dissection course has decreased while the amount of knowledge required in clinical medicine has increased. Simulation-based education (SBE) has been proven to be an effective educational method that enhances the development of practical skills by integrating learners' knowledge and skills. This study aimed to investigate the effect of SBE as a preparatory education course when taken prior to a medical student's enrollment in the cadaver dissection course. In the present study, an SBE assuming practical cadaver dissection course was performed in the Clinical Simulation Center. The frequency of injury rates per 1000 h of cadaver dissection course was significantly less in 2017 and 2018 compared to that in 2016. Two years after the implementation of the SBE, average student self-efficacy scores and written examination scores significantly increased, whereas self-contentment scores were relatively unchanged. The results showed that the implementation of SBE decreased the incidence of injuries and improved students' overall self-efficacy scores and increased acquisition of knowledge evident on written examination score. Therefore, SBE as a preparatory education course may effectively promote the combined development of dissection skills and anatomical knowledge in the subsequent fundamental cadaver dissection course.
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Affiliation(s)
- Tomiko Yakura
- Department of Anatomy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Naoyuki Hatayama
- Department of Anatomy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Chikako Kawahara
- Clinical Simulation Center, Aichi Medical University, Aichi, Japan
| | - Yusuke Ohmichi
- Department of Anatomy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Mika Ohmichi
- Department of Anatomy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Nobutaro Ban
- Clinical Simulation Center, Aichi Medical University, Aichi, Japan
| | - Shuichi Hirai
- Department of Anatomy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Takashi Nakano
- Department of Anatomy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Munekazu Naito
- Department of Anatomy, Aichi Medical University School of Medicine, Aichi, Japan
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Baashar Y, Alkawsi G, Ahmad WNW, Alhussian H, Alwadain A, Capretz LF, Babiker A, Alghail A. The Effectiveness of Using Augmented Reality for Training in the Medical Professions: A Meta Analysis (Preprint). JMIR Serious Games 2021; 10:e32715. [PMID: 35787488 PMCID: PMC9297143 DOI: 10.2196/32715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 03/12/2022] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
Background Augmented reality (AR) is an interactive technology that uses persuasive digital data and real-world surroundings to expand the user's reality, wherein objects are produced by various computer applications. It constitutes a novel advancement in medical care, education, and training. Objective The aim of this work was to assess how effective AR is in training medical students when compared to other educational methods in terms of skills, knowledge, confidence, performance time, and satisfaction. Methods We performed a meta-analysis on the effectiveness of AR in medical training that was constructed by using the Cochrane methodology. A web-based literature search was performed by using the Cochrane Library, Web of Science, PubMed, and Embase databases to find studies that recorded the effect of AR in medical training up to April 2021. The quality of the selected studies was assessed by following the Cochrane criteria for risk of bias evaluations. Results In total, 13 studies with a total of 654 participants were included in the meta-analysis. The findings showed that using AR in training can improve participants' performance time (I2=99.9%; P<.001), confidence (I2=97.7%; P=.02), and satisfaction (I2=99.8%; P=.006) more than what occurs under control conditions. Further, AR did not have any effect on the participants’ knowledge (I2=99.4%; P=.90) and skills (I2=97.5%; P=.10). The meta-regression plot shows that there has been an increase in the number of articles discussing AR over the years and that there is no publication bias in the studies used for the meta-analysis. Conclusions The findings of this work suggest that AR can effectively improve performance time, satisfaction, and confidence in medical training but is not very effective in areas such as knowledge and skill. Therefore, more AR technologies should be implemented in the field of medical training and education. However, to confirm these findings, more meticulous research with more participants is needed.
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Affiliation(s)
- Yahia Baashar
- Faculty of Computing and Informatics, Universiti Malaysia Sabah, Labuan, Malaysia
| | - Gamal Alkawsi
- Institute of Sustainable Energy, Universiti Tenaga Nasional, Kajang, Malaysia
| | | | - Hitham Alhussian
- Department of Computer and Information Sciences, Universiti Teknologi Petronas, Seri Iskandar, Malaysia
| | - Ayed Alwadain
- Department of Computer Science, King Saud University, Riyadh, Saudi Arabia
| | - Luiz Fernando Capretz
- Department of Electrical & Computer Engineering, Western University, Ontario, ON, Canada
| | - Areej Babiker
- Department of Computer Engineering, Future University, Khartoum, Sudan
| | - Adnan Alghail
- Department of World Languages, Greece Central School District, New York, NY, United States
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Gelmini AYP, Duarte ML, de Assis AM, Guimarães Junior JB, Carnevale FC. Virtual reality in interventional radiology education: a systematic review. Radiol Bras 2021; 54:254-260. [PMID: 34393293 PMCID: PMC8354189 DOI: 10.1590/0100-3984.2020.0162] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/15/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to compare virtual reality simulation with other methods of teaching interventional radiology. We searched multiple databases-Cochrane Library; Medline (PubMed); Embase; Trip Medical; Education Resources Information Center; Cumulative Index to Nursing and Allied Health Literature; Scientific Electronic Library Online; and Latin-American and Caribbean Health Sciences Literature-for studies comparing virtual reality simulation and other methods of teaching interventional radiology. This systematic review was performed in accordance with the criteria established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Best Evidence Medical Education (BEME) Collaboration. Eligible studies were evaluated by using the quality indicators provided in the BEME Guide No. 11 and the Kirkpatrick model of training evaluation. After the eligibility and quality criteria had been applied, five randomized clinical trials were included in the review. The Kirkpatrick level of impact varied among the studies evaluated, three studies being classified as level 2B and two being classified as level 4B. Among the studies evaluated, there was a consensus that virtual reality aggregates concepts and is beneficial for the teaching of interventional radiology. Although the use of virtual reality has been shown to be effective for skill acquisition and learning in interventional radiology, there is still a lack of studies evaluating and standardizing the employment of this technology in relation to the numerous procedures that exist within the field of expertise.
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Affiliation(s)
| | - Márcio Luís Duarte
- Webimagem Telerradiologia, São Paulo, SP, Brazil
- Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - André Moreira de Assis
- Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
| | | | - Francisco César Carnevale
- Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
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29
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Skandalakis GP, Chytas D, Paraskevas G, Noussios G, Salmas M, Fiska A. Virtual and augmented reality in anatomy education: Need for comparison with other three-dimensional visualization methods. Morphologie 2021; 106:141-142. [PMID: 33762155 DOI: 10.1016/j.morpho.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/25/2022]
Affiliation(s)
- G P Skandalakis
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 10029-6574 New York, USA
| | - D Chytas
- Department of Anatomy, National School of Public Health, University of West Attica, 196, Alexandras Avenue, 11521 Athens, Greece.
| | - G Paraskevas
- Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - G Noussios
- Department of Physical Education and Sports Sciences of Serres, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - M Salmas
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 11527 Athens, Greece
| | - A Fiska
- Department of Anatomy, Medical School of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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