Optimizing biomedical science learning in a veterinary curriculum: a review

Pathologists aren't pigeons: exploring the neural basis of visual recognition and perceptual expertise in pathology

Visual (perceptual) reasoning is a critical skill in many medical specialties, including pathology, diagnostic imaging, and dermatology. However, in an ever-compressed medical curriculum, learning and practicing this skill can be challenging. Previous studies (including work with pigeons) have suggested that using reward-feedback-based activities, novices can gain expert levels of visual diagnostic accuracy in shortened training times. But is this level of diagnostic accuracy a result of image recognition (categorization) or is it the acquisition of diagnostic expertise? To answer this, the authors measured electroencephalographic data (EEG) and two components of the human event-related brain potential (reward positivity and N170) to explore the nature of visual expertise in a novice-expert study in pathology visual diagnosis. It was found that the amplitude of the reward positivity decreased with learning in novices (suggesting a decrease in reliance on feedback, as in other studies). However, this signal remained significantly different from the experts whose reward positivity signal did not change over the course of the experiment. There were no changes in the amplitude of the N170 (a reported neural marker of visual expertise) in novices over time. Novice N170 signals remained statistically and significantly lower in amplitude compared to experts throughout task performance. These data suggest that, while novices gained the ability to recognize (categorize) pathologies through reinforcement learning as quantified by the change in reward positivity, increased accuracy, and decreased time for responses, there was little change in the neural marker associated with visual expertise (N170). This is consistent with the multi-dimensional and complex nature of visual expertise and provides insight into future training programs for novices to bridge the expertise gap.

Impact of Expert Commentary and Student Reflection on Veterinary Clinical Decision-Making Skills in an Innovative Electronic-Learning Case-Based Platform

One challenge in veterinary education is bridging the divide between the nature of classroom examples (well-defined problem solving) and real world situations (ill-defined problem solving). Solving the latter often relies on experiential knowledge, which is difficult to impart to inexperienced students. A multidisciplinary team including veterinary specialists and learning scientists developed an interactive, e-learning case-based module in which students made critical decisions at five specific points (Decision Points [DPs]). After committing to each decision (Original Answers), students reflected on the thought processes of experts making similar decisions, and were allowed to revise their decisions (Revised Answers); both sets of answers were scored. In Phase I, performance of students trained using the module (E-Learning Group) and by lecture (Traditional Group) was compared on the course final examination. There was no difference in performance between the groups, suggesting that the e-learning module was as effective as traditional lecture for content delivery. In Phase II, differences between Original Answers and Revised Answers were evaluated for a larger group of students, all of whom used the module as the sole method of instruction. There was a significant improvement in scores between Original and Revised Answers for four out of five DPs (DP1, p =.004; DP2, p =.04; DP4, p <.001; DP5, p <.001). The authors conclude that the ability to rehearse clinical decision making through this tool, without direct individual feedback from an instructor, may facilitate students' transition from problem solving in a well-structured classroom setting to an ill-structured clinical setting.

iCBLS: An interactive case-based learning system for medical education

Medical students should be able to actively apply clinical reasoning skills to further their interpretative, diagnostic, and treatment skills in a non-obtrusive and scalable way. Case-Based Learning (CBL) approach has been receiving attention in medical education as it is a student-centered teaching methodology that exposes students to real-world scenarios that need to be solved using their reasoning skills and existing theoretical knowledge. In this paper, we propose an interactive CBL System, called iCBLS, which supports the development of collaborative clinical reasoning skills for medical students in an online environment. The iCBLS consists of three modules: (i) system administration (SA), (ii) clinical case creation (CCC) with an innovative semi-automatic approach, and (iii) case formulation (CF) through intervention of medical students' and teachers' knowledge. Two evaluations under the umbrella of the context/input/process/product (CIPP) model have been performed with a Glycemia study. The first focused on the system satisfaction, evaluated by 54 students. The latter aimed to evaluate the system effectiveness, simulated by 155 students. The results show a high success rate of 70% for students' interaction, 76.4% for group learning, 72.8% for solo learning, and 74.6% for improved clinical skills.

Merging Clinical Cases, Client Communication, and Physiology to Enhance Student Engagement, Learning, and Skills

Understanding disease processes, making diagnoses, and guiding clinical therapy are predicated on an understanding of normal physiologic function. However, we have observed that many first-year students fail to appreciate the important role that a clear understanding of normal function plays in becoming well-prepared, practicing veterinarians. Students also struggle with application of basic knowledge to the diagnosis and treatment of disease, as evidenced by poor performance on exam questions requiring application. The purpose of this project was to help students link the physiologic concepts in the classroom with clinical application, as well as to improve their ability to explain those concepts to a client. We found that, as a result of this assignment, students developed a deeper understanding of physiologic processes and their clinical relevance and, subsequently, felt more confident conveying this knowledge to simulated clients. Implementation of this case project has been very well received by the students. Students improved their grasp of the material, and they indicated that the project contributed positively to their motivation to study and learn physiology.

Microscope use in clinical veterinary practice and potential implications for veterinary school curricula

Microscopy (skill of using a microscope) and the concepts of cytology (study of cells) and histology (study of tissues) are most often taught in professional veterinary medicine programs through the traditional method of glass slides and light microscopes. Several limiting factors in veterinary training programs are encouraging educators to explore innovative options for teaching microscopy skills and the concepts of cytology and histology. An anonymous online survey was administered through the Colorado Veterinary Medical Association to Colorado veterinarians working in private practice. It was designed to assess their current usage of microscopes for cytological and histological evaluation of specimens and their perceptions of microscope use in their veterinary education. The first part of the survey was answered by 183 veterinarians, with 104 indicating they had an onsite diagnostic lab. Analysis pertaining to the use of the microscope in practice and in veterinary programs was conducted on this subset. Most respondents felt the amount of time spent in the curriculum using a microscope was just right for basic microscope use and using the microscope for viewing and learning about normal and abnormal histological sections and clinical cytology. Participants felt more emphasis could be placed on clinical and diagnostic cytology. Study results suggest that practicing veterinarians frequently use microscopes for a wide variety of cytological diagnostics. However, only two respondents indicated they prepared samples for histological evaluation. Veterinary schools should consider these results against the backdrop of pressure to implement innovative teaching techniques to meet the changing needs of the profession.