Evaluation of Effectiveness of Digital Technologies During Anatomy Learning in Nursing School

Nursing students' experiences with test-enhanced learning in teams: A cross-sectional study

BACKGROUND

Many nursing students struggle with the disciplines of biosciences, particularly Anatomy, physiology, and biochemistry, which are introduced in the first year. Nursing students' motivation, prior knowledge, and academic performance matter, but teaching methods may also influence students' learning process. Retrieving knowledge through testing has previously proven to enhance learning to a greater extent than time spent on other classroom activities.

OBJECTIVE

The aim of this study was to explore nursing students' experiences with test-enhanced learning as a way of enhancing learning in Anatomy, physiology, and biochemistry.

DESIGN

The lectures in each topic were followed by testing five days later. The tests were typically multiple-choice tests with short reply-times. The effect was measured in terms of students' self-reported level of satisfaction with test-enhanced learning, and their performance on the final exam in Anatomy, physiology, and biochemistry. The tests were performed in teams to avoid stressful situations that could negatively affect the students' learning process.

RESULTS

A key achievement from introducing test-enhanced learning in the Anatomy, physiology, and biochemistry course was a perceived higher learning outcome and increased engagement and motivation among the students, resulting in resulting in more students achieving the highest grades (A and B). However, the students' academic results from upper secondary school also seemed to matter for their achievements on the final exam.

CONCLUSION

These results indicated that many students benefited from test-enhanced learning, suggesting that test-enhanced learning can be an important teaching strategy in nursing education, particularly for biosciences.

Determining the challenges and opportunities of virtual teaching during the COVID-19 pandemic: a mixed method study in the north of Iran

The aim of this study was to determine the challenges and opportunities of virtual education during the COVID-19 pandemic. This study was conducted in 2022-2023 with a mixed method. During the quantitative phase, we chose 507 students from Mazandaran Province medical universities (both governmental and non-governmental) by stratified random sampling and during the qualitative phase 16 experts were collected by purposive sampling until we reached data saturation. Data collecting tools consisted of questionnaires during the quantitative phase and semi-structured interview during the qualitative phase. Data was analyzed using SPSS21 and MAXQDA10. Mean scores of the total score was 122.28±23.96. We found a significant association between interaction dimension and background variables (P < 0.001). The most important privilege of virtual education is uploading the teaching material in the system so that students can access the material constantly and the most important challenge regarding virtual education is lack of proper network connection and limited bandwidth. Virtual education proved to be a suitable alternate to traditional methods of medical education during the COVID-19 pandemic in theoretical topics, we recommend that educational policymakers would take the necessary actions to provide the requirements and facilities needed to improve the quality of virtual education.

The influence of collaborative learning and self-organisation on medical students' academic performance in anatomy

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.

Virtual Reality and Augmented Reality in Plastic and Craniomaxillofacial Surgery: A Scoping Review

Virtual reality (VR) and augmented reality (AR) have evolved since their introduction to medicine in the 1990s. More powerful software, the miniaturization of hardware, and greater accessibility and affordability enabled novel applications of such virtual tools in surgical practice. This scoping review aims to conduct a comprehensive analysis of the literature by including all articles between 2018 and 2021 pertaining to VR and AR and their use by plastic and craniofacial surgeons in a clinician-as-user, patient-specific manner. From the initial 1637 articles, 10 were eligible for final review. These discussed a variety of clinical applications: perforator flaps reconstruction, mastectomy reconstruction, lymphovenous anastomosis, metopic craniosynostosis, dermal filler injection, auricular reconstruction, facial vascularized composite allotransplantation, and facial artery mapping. More than half (60%) involved VR/AR use intraoperatively with the remainder (40%) examining preoperative use. The hardware used predominantly comprised HoloLens (40%) and smartphones (40%). In total, 9/10 Studies utilized an AR platform. This review found consensus that VR/AR in plastic and craniomaxillofacial surgery has been used to enhance surgeons' knowledge of patient-specific anatomy and potentially facilitated decreased intraoperative time via preoperative planning. However, further outcome-focused research is required to better establish the usability of this technology in everyday practice.

Use of the Anatomage Virtual Table in Medical Education and as a Diagnostic Tool: An Integrative Review

Studies on human anatomy mainly depend on cadaver dissection. New technology devices have progressed to improve anatomy teaching, such as the 3D Anatomage virtual dissection table. There is a shortage and deficiency in information about the uses and benefits of the Anatomage table. The aim of this article was to review and assess the current evidence about the advantages of the Anatomage virtual table in medical education and curricula of medical courses, and its utility in diagnosis. The current study is a comprehensive systematic review. A search was conducted on online medical and scientific databases. Twenty-nine articles relevant to the content of the current research topic were selected. Based on this review, the use of the Anatomage table is valuable for anatomy learning outcomes, and most of the research supported it as an important anatomy tool in addition to cadaveric dissection. The Anatomage table in association with human dissection can improve knowledge retention of anatomy. It is an important tool for understanding organ variation. Anatomage is now considered an important tool for the educational training programs of medical students and residents and for disease diagnosis and prognosis. Anatomage can make the curriculum more interesting and valuable. Utilizing the Anatomage table can help medical and paramedical students and residents by assisting them to understand anatomy in a better way. It will also improve radiological knowledge and facilitate pre-planning for surgeries. Finally, it has a crucial role during exceptional circumstances such as pandemics.

Challenge-Based Learning in Dental Education

Challenge-based learning (CBL) is a novel learning framework for a collaborative and multidisciplinary learning experience. It allows students, teachers, stakeholders, researchers, families, and society to work together to identify and solve real-world challenges. CBL helps students develop a deeper knowledge of the subjects they are studying. The concepts of CBL originate from a variety of educational theories and approaches, such as problem-based learning and inquiry-based learning. The precursor to the CBL framework is problem-based learning. However, unlike in problem-based learning and other approaches, students formulate the challenges they will address in CBL. Furthermore, students need to create a solution resulting in concrete action. CBL takes into account the social impact of an idea rather than just the corporate benefits. Therefore, it can help students expand the scope and depth of learning, encourage teamwork capabilities, and raise their awareness about considering quality and ethics in decision-making. CBL is implemented in universities, schools, and institutions worldwide and its use is well-recognized in science, engineering, and medicine, but it has not been translated into dentistry. The aim of this paper is to describe the concept of inclusion, principles and design, implementation, and supervision of the CBL framework in a dental course for the adaption of this learning framework to dental education.

Nurses' perspectives on the application of humanistic anatomical knowledge in clinical practice

Knowledge of human anatomy is vital for nurses. Medical educators use a variety of educational pedagogies, including the use of cadavers, to cultivate nursing students into competent and professional care providers and to help them gain authentic experience and knowledge before entering the workplace. Studies have provided numerous examples of students with positive learning experiences in human-centric (humanistic) anatomy courses; however, whether these positive experiences translate into effective clinical practice remains largely unknown. This study explored nurses' perspectives on the effects of a humanistic anatomy program on their nursing practice. Focus groups with semi-structured interview guidelines were conducted to collect data. Twenty-one nurses working in hospitals in Taiwan participated and divided themselves into four groups on the basis of willingness to participate and availability. The interviews were recorded using smartphones, and the recordings were transcribed using a computer. The transcriptions were then checked word by word artificially and analyzed by hand. Three main themes emerged during the analysis: adapting to the professional journey, managing time when providing humanistic care, and cultivating professionalism. The results demonstrate educators' expectations that humanistic anatomy education for nursing students expands students' professional knowledge and helps them develop humanistic competencies as professional nurses.

Sociodemographic and Digital Education Factors Are Associated to General Health, Coping Strategies, and Academic Outcomes of Undergraduate Students during the Post-Pandemic Period

The COVID-19 pandemic suddenly and forever changed the lives of many undergraduate students around the globe, forcing them to switch to online learning while undergoing social confinement within their homes. It is now well-established that this prolonged period of uncertainty impacted students’ well-being, health, and academic achievement. However, how student-related factors, such as coping strategies as well as sociodemographic, contextual, and technological variables, are linked to digital education factors is currently less understood. Using multiple regression analysis, this study investigates the results of an online questionnaire administered to students from two universities in southern Italy, differing in positioning and size, as well as policies and attitude towards digital learning. The results of this study show the positive effects of expertise with digital devices and university digital learning policies on students’ perceived general health. Conversely, isolation and lack of relational connectedness negatively impacted students’ health. Furthermore, this study highlights the role of different coping strategies, demonstrating that active forms of coping have a positive effect on students’ health, whereas avoidance strategies have the opposite effect. Taken together, this study provides crucial links between the many factors influencing students’ experience with online learning and health, and provides useful indications to promote the uptake of and adaptation to online learning.

AV. A Novel Online Dissection Course on Lower Limb Anatomy During the COVID-19 Pandemic

Introduction: The teaching of human anatomy, a medical subject that relies heavily on live teaching, teacher-student interactivity, and visuospatial skills, has suffered tremendously since the COVID-19 pandemic mandated the shutting down of medical institutions. The medical education fraternity was compelled to replace the traditional teaching method of hands-on cadaveric dissections (HOCDs) with online education to overcome this new challenge, but it came at the cost of reduced student engagement and lesser spatial orientation.

Method: In this cross-sectional, questionnaire-based study, we designed a novel online dissection course on lower limb anatomy and collected student feedback on the same from consenting Phase I Bachelor of Medicine, Bachelor of Surgery (MBBS) students of Symbiosis Medical College for Women, Pune, India. The course design consisted of three different modes: a live Zoom session using a handheld camera phone, a pre-recorded video dissection uploaded on the institute learning management system, and a Powerpoint presentation with high-resolution photographs of each dissected layer; and the feedback intended to find out what works best for the students. Overall feedback regarding their preferences in terms of presentation design, use of background music in pre-recorded videos, and overall learning experience was also collected. The course consisted of six two-hour teaching sessions. The first three sessions each used a different mode of teaching, repeating the same pattern in the next three sessions. The first mode of teaching implemented was a live Zoom session where instructors used a hand-held cell phone camera to show specimens that had been dissected a day prior. The second mode involved a pre-recorded video showing step-by-step dissection performed by the instructor which was then uploaded on the Institute Learning Management System. Of the two pre-recorded videos, background music consisting of a low-volume instrumental track was added to the second video. The third mode utilized Powerpoint presentations containing high-resolution photographs of each dissected layer on a separate slide along with labeling. The presentations were shown to the students over a Zoom call. A Google Form (GF) questionnaire was created after validation by subject experts to gather the students’ feedback on the teaching and learning of anatomy via these sessions. The GF responses were collected and analyzed using Microsoft Excel.

Results: 41.7% of students recommended the use of a combination of all three modes in the same session, while 36.7% favored pre-recorded videos. 86.7% of students said that a good quality presentation design helps in keeping them engaged and only 23% of students favored the use of background music for increasing their ability to concentrate. 63.3% of students found the learning experience highly satisfactory.

Conclusion: Although virtual dissection teaching methods may not be able to completely replace HOCDs, a well-planned online dissection course incorporating multiple modes of online dissections with an emphasis on good quality presentation design and frequent teacher-student interactivity can provide a strong impetus for learning in the absence of live teaching methods.

Dental Students’ Experiences during the COVID-19 Pandemic—A Cross-Sectional Study from Norway

The purpose of this cross-sectional study was to map dental students’ experience of the study situation throughout the pandemic. All clinical dental students (year 3 to 5) at the Faculty of Medicine, Department of Clinical Dentistry (IKO), University of Bergen (UiB), Norway, were invited. Participation was anonymous and voluntary, and the response rate was 63%. Questions regarding stress-related factors were divided into three categories. In the category «Stressors/learning», a statistically significant difference was observed between both the genders (p = 0.001) and years of study (p = 0.028). Statistically significant differences between the genders were also observed in the category «Stressors/infection» (p = 0.008). Women were significantly more stressed due to lack of clinical skills (p = 0.048), not receiving as good theoretical teaching as before the pandemic (p = 0.016), and uncertain issues around the exams (p = 0.000). Fourth year students were significantly more stressed due to lack of clinical skills (p = 0.012), for not passing the clinic/skills courses due to lack of study progression (p = 0.005), and worries about not being a good enough dentist after graduation (p = 0.002). In conclusion, the pandemic had a major impact on dental students. The most prominent stressors in relation to the study situation were experienced by students from the fourth year and female students. Clinical and theoretical learning outcomes among students were regarded as worse than before the pandemic. The students preferred in presence lectures, but experienced digital asynchronous video lectures as a good alternative. The pandemic negatively affected the students’ social life. Dental schools should be aware that students have been exposed to increased distress and burden through the pandemic and should provide support for those in need.

Anatomage - the virtual dissection tool and its uses: A narrative review

Advancement in technology has given students and institutes an educational, interactive, and diagnostic aid with virtual reality functionality known as the Anatomage table. This review analyses the various spheres of the medical field where the 3D virtual tool is being used and assesses its acceptability, convenience, and practical application. A search for relevant studies in various databases namely Pubmed, Embase, Wiley Library, and Google Scholar was performed, and the data was compiled to understand the use of the Anatomage table. The search yielded a total of 24 studies that focused on the use of the Anatomage table. Eleven articles focused on using Anatomage as a learning tool and 13 described the perception of the Table. Anatomage table offers an excellent tool for learning anatomy by virtual dissection. The tool is not only used as a teaching aid, but also as a diagnostic and planning tool in residency programs. Adding the tool as an educational aid boosts the existing curriculum and helps to counter the challenges with cadaveric dissection. The equipment cost and its maintenance charges may be a deciding factor for the underutilization of the tool in developing countries.

Self-Directed Learning versus Problem-Based Learning in Korean Nurse Education: A Quasi-Experimental Study

Effective teaching methods are vital for cultivating advanced professional skills in nurses and equipping them with the necessary training. Problem-based learning (PBL) and self-directed learning (SDL) have been consistently used in nurse education. Therefore, their effects on nursing students’ academic performance warrant comparison. This study compared the effects of PBL and SDL on an adult nursing university curriculum. Participants in this quasi-experimental study with a pre-post non-equivalent control group design were 106 third-year nursing students divided into the PBL and SDL groups. Data collection, conducted from April to June 2019, included a pre-test before an eight-week intervention, followed by a post-test. Changes in the scores of each group were analyzed for learning motivation, self-directed learning ability, self-efficacy, learning confidence, learning satisfaction, and academic performance using paired and independent t-tests. The PBL group scored higher on learning motivation, self-directed learning ability, and academic performance than the SDL group. Based on these results, the PBL method was more effective than the SDL method in an adult nursing curriculum. To maximize the learning effect in adult nursing education, it is necessary to apply SDL education, including the PBL method, with a clearer learning process.

Assessing the Impact of Unfolding Case Study Scenarios during High-Fidelity Pediatric Simulation among Undergraduate Nursing Students

Simulation helps to prepare prelicensure nursing students for practice by providing opportunities to perform clinical skills and make decisions in a safe environment. The integration of nursing knowledge, skills, and decision-making abilities during simulated unfolding case-study scenarios may enhance student self-confidence and foster clinical judgement skills. The purpose of this study was to assess the impact of simulation using unfolding case-study scenarios on undergraduate nursing students’ self-confidence in pediatric nursing knowledge, skills, and clinical judgment/decision-making abilities. This mixed methods study included a pre- and post-survey design to evaluate undergraduate nursing students’ confidence in pediatric nursing knowledge, skills, and decision-making abilities after participation in both an instructor-led (guided) and a student-led (decision-making) simulation involving unfolding case-study scenarios. Friedman’s ANOVA analyses revealed that all 16-items demonstrated statistically significant differences between the three measured responses (pre-simulation and both post-simulation surveys). Post-hoc Wilcoxon signed-rank tests revealed statistically significant differences in student ratings pre-simulation and post-instructor-led (guided) experience for all 16-scored items. The qualitative themes identified were perception of experience, pediatric nursing care, assimilation of knowledge, and critical thinking. Unfolding case-study simulation experiences positively impact the learning, self-confidence, and clinical judgement of undergraduate nursing students.

The effect of COVID-19 pandemic on final year dental students' self-confidence level in performing clinical procedures

BACKGROUND

The outbreak of COVID-19 pandemic in 2020 has dramatically changed teaching approach in dental schools due to the switch to distance learning and the lack of practice training in direct contact with patients with possible impact on clinical skills of students. The aim of the study was to assess the level of the 2020 final year dental students' self-confidence in performing different dental procedures through specially designed questionnaire and compare it to self-confidence of the 2019 final year students.

MATERIALS AND METHODS

An anonymous questionnaire consisting of 40 questions regarding self-confidence level in performing 40 different dental procedures and based on five points Likert-like scale was distributed during November 2020 to final year dental students whose studies were disrupted by the COVID-19 pandemic lockdown in one semester. The study group comprised their answers. The comparison was done with the control group that consisted of students' answers on the same questionnaire from previous 2019 year conducted as a part of regular internal educational evaluation.

RESULTS

Response rate was 74.2% in study group and 89.3% in control group. Mean level of self-confidence reported by 115 students in study group was significantly lower than that reported by 100 students in control group (3.28±1.08 vs. 3.58±0.88, respectively) and the distribution of self-confidence scores were different in observed groups. Graduates from study group felt less confident than those from control in 8 clinical skills.

CONCLUSION

Abrupt changes in teaching modalities caused by COVID-19 pandemic had significant impact on final year dental students' self-confidence indicating additional educational needs in postgraduate period.

E-Learning as a Factor Optimizing the Amount of Work Time Devoted to Preparing an Exam for Medical Program Students during the COVID-19 Epidemic Situation

The COVID-19 pandemic had a huge impact on the learning and teaching processes, particularly in healthcare education and training, because of the principal position of the cutting-edge student-patient interaction. Replacing the traditional form of organization and implementation of knowledge evaluation with its web-based equivalent on an e-learning platform optimizes the whole didactic process not only for the unit carrying it out but, above all, for students. This research is focused on the effectiveness of the application of e-learning for computer-based knowledge evaluation and optimizing exam administration for students of medical sciences. The proposed approach is considered in two categories: from the perspective of the providers of the evaluation process, that is, the teaching unit; and the recipients of the evaluation process, that is, the students.

Psychometric Characteristics of Oral Pathology Test Items in the Dental Hygiene Curriculum-A Longitudinal Analysis

As the landscape of oral healthcare and the delivery of services continue to undergo change, the dental hygienist plays an increasing role in assisting dentists with oral diagnosis and preventive strategies. Hence, the dental hygiene curriculum standards require biomedical science instructions, including general and oral pathology. Student learning and cognitive competencies are often measured using multiple-choice questions (MCQs). The objectives of this study were to perform a longitudinal analysis of test items and to evaluate their relation to the absolute grades of the oral pathology course in the dental hygiene curriculum. A total of 1033 MCQs covering different concepts of oral pathology administered from 2015 through 2019 were analyzed for difficulty and discriminatory indices, and the differences between the years were determined by one-way ANOVA. Test reliability as determined by the average KR-20 value was 0.7 or higher for each exam. The mean difficulty index for all exams was 0.73 +/− 0.05, and that of the discriminatory index was 0.33 +/− 0.05. Wide variations were observed in the discriminatory indices of test items with approximately the same difficulty index, as well as in the grade distribution in each cohort. Furthermore, longitudinal data analyses identified low achieving cohorts amongst the groups evaluated for the same knowledge domain, taught with the same instruction, and using similar test tools. This suggest that comparative analyses of tests could offer feedback not only on student learning attributes, but also potentially on the admission processes to the dental hygiene program.

Dental Education Challenges during the COVID-19 Pandemic Period in Italy: Undergraduate Student Feedback, Future Perspectives, and the Needs of Teaching Strategies for Professional Development

The COVID-19 pandemic literally stopped most human movement and activities as it initially spread, which included dental practices and dental education. This defined the need for significative changes in teaching and learning with the use of “e-learning” methods, also for traineeships. This study was designed to determine the undergraduate student perception of these new methods as part of their education. This involved 353 students attending the Dental School of the G. D’Annunzio University of Chieti–Pescara, from the first to the sixth years. A questionnaire in Italian and was set-up using “Google Forms” and sent by email to the students. The questionnaire was divided into three parts: the first part included questions for general information, including age, sex and year of course; the second part had multiple choice questions related to their evaluation of the e-learning teaching, using a scale of opinion in the replies to each question (e.g., “scarce”, “fair”, “satisfying”, “very good” and “excellent”); and the third part included two open questions to indicate the strengths and limitations of these new teaching and learning approaches. The categorical variables in the first and second parts of the questionnaire were evaluated using Chi squared tests, setting significance at p < 0.05, while the comments were evaluated qualitatively. The student feedback showed significant appreciation (p < 0.05) of the new methods and the efforts that the lecturers put in to provide lectures of as high a quality as possible. However, a lack of practical training was significantly perceived as an important problem in the structure of their new curriculum (p < 0.05). COVID-19 has been an epic tragedy that has hit the human population not only in terms of health and healthcare, but also quality of life. This includes the quality of dental education within universities. However, the pandemic can be seen to also represent motivation to invest in the necessary technological innovation to deliver the best possible education to our future dentists.