Although cadavers constitute the gold standard for teaching anatomy to medical and health science students, there are substantial financial, ethical, and supervisory constraints on their use. In addition, although anatomy remains one of the fundamental areas of medical education, universities have decreased the hours allocated to teaching gross anatomy in favor of applied clinical work. The release of virtual (VR) and augmented reality (AR) devices allows learning to occur through hands-on immersive experiences. The aim of this research was to assess whether learning structural anatomy utilizing VR or AR is as effective as tablet-based (TB) applications, and whether these modes allowed enhanced student learning, engagement and performance. Participants (n = 59) were randomly allocated to one of the three learning modes: VR, AR, or TB and completed a lesson on skull anatomy, after which they completed an anatomical knowledge assessment. Student perceptions of each learning mode and any adverse effects experienced were recorded. No significant differences were found between mean assessment scores in VR, AR, or TB. During the lessons however, VR participants were more likely to exhibit adverse effects such as headaches (25% in VR P < 0.05), dizziness (40% in VR, P < 0.001), or blurred vision (35% in VR, P < 0.01). Both VR and AR are as valuable for teaching anatomy as tablet devices, but also promote intrinsic benefits such as increased learner immersion and engagement. These outcomes show great promise for the effective use of virtual and augmented reality as means to supplement lesson content in anatomical education. Anat Sci Educ 10: 549-559. © 2017 American Association of Anatomists.

/pdf/the-effectiveness-of-virtual-and-augmented-reality-in-health-3r4g1nh7ts.pdf

The effectiveness of virtual and augmented reality in health sciences and medical anatomy.

∗The book reviewed is Benchmarks for Scientific Literacy, American Association for the Advancement of Science, Project 2061, Oxford University Press, New York and Oxford (1993), pp. 448, $21‐95 (pbk), ISBN 0‐19‐508986‐3.

Benchmarks for Science Literacy: a review symposium∗

Many medical graduates are deficient in anatomy knowledge and perhaps below the standards for safe medical practice. Three-dimensional visualization technology (3DVT) has been advanced as a promising tool to enhance anatomy knowledge. The purpose of this review is to conduct a meta-analysis of the effectiveness of 3DVT in teaching and learning anatomy compared to all teaching methods. The primary outcomes were scores of anatomy knowledge tests expressed as factual or spatial knowledge percentage means. Secondary outcomes were perception scores of the learners. Thirty-six studies met the inclusion criteria including 28 (78%) randomized studies. Based on 2,226 participants including 2,128 from studies with comparison groups, 3DVTs (1) resulted in higher (d = 0.30, 95%CI: 0.02–0.62) factual knowledge, (2) yielded significant better results (d = 0.50, 95%CI: 0.20–0.80) in spatial knowledge acquisition, and (3) produced significant increase in user satisfaction (d = 0.28, 95%CI = 0.12–0.44) and in learners' perception of the effectiveness of the learning tool (d = 0.28, 95%CI = 0.14–0.43). The total mean scores (out of five) and ±SDs for QUESTS's Quality and Strength dimensions were 4.38 (±SD 1.3) and 3.3 (±SD 1.7), respectively. The results have high internal validity, for the improved outcomes of 3DVTs compared to other methods of anatomy teaching. Given that anatomy teaching and learning in the modern medical school appears to be approaching a crisis, 3DVT can be a potential solution to the problem of inadequate anatomy pedagogy. Anat Sci Educ 8: 525–538. © 2014 American Association of Anatomists.

A Meta-Analysis of the Educational Effectiveness of Three-Dimensional Visualization Technologies in Teaching Anatomy.

Background Surgeons in the operating theatre deal constantly with high-demand tasks that require simultaneous processing of a large amount of information. In certain situations, high cognitive load occurs, which may impact negatively on a surgeon's performance. This systematic review aims to provide a comprehensive understanding of the different methods used to assess surgeons' cognitive load, and a critique of the reliability and validity of current assessment metrics. Methods A search strategy encompassing MEDLINE, Embase, Web of Science, PsycINFO, ACM Digital Library, IEEE Xplore, PROSPERO and the Cochrane database was developed to identify peer-reviewed articles published from inception to November 2016. Quality was assessed by using the Medical Education Research Study Quality Instrument (MERSQI). A summary table was created to describe study design, setting, specialty, participants, cognitive load measures and MERSQI score. Results Of 391 articles retrieved, 84 met the inclusion criteria, totalling 2053 unique participants. Most studies were carried out in a simulated setting (59 studies, 70 per cent). Sixty studies (71 per cent) used self-reporting methods, of which the NASA Task Load Index (NASA-TLX) was the most commonly applied tool (44 studies, 52 per cent). Heart rate variability analysis was the most used real-time method (11 studies, 13 per cent). Conclusion Self-report instruments are valuable when the aim is to assess the overall cognitive load in different surgical procedures and assess learning curves within competence-based surgical education. When the aim is to assess cognitive load related to specific operative stages, real-time tools should be used, as they allow capture of cognitive load fluctuation. A combination of both subjective and objective methods might provide optimal measurement of surgeons' cognition.

Systematic review of measurement tools to assess surgeons' intraoperative cognitive workload

The head and neck region is one of the most complex areas featured in the medical gross anatomy curriculum. The effectiveness of using three-dimensional (3D) models to teach anatomy is a topic of much discussion in medical education research. However, the use of 3D stereoscopic models of the head and neck circulation in anatomy education has not been previously studied in detail. This study investigated whether 3D stereoscopic models created from computed tomographic angiography (CTA) data were efficacious teaching tools for the head and neck vascular anatomy. The test subjects were first year medical students at the University of Mississippi Medical Center. The assessment tools included: anatomy knowledge tests (prelearning session knowledge test and postlearning session knowledge test), mental rotation tests (spatial ability; presession MRT and postsession MRT), and a satisfaction survey. Results were analyzed using a Wilcoxon rank-sum test and linear regression analysis. A total of 39 first year medical students participated in the study. The results indicated that all students who were exposed to the stereoscopic 3D vascular models in 3D learning sessions increased their ability to correctly identify the head and neck vascular anatomy. Most importantly, for students with low-spatial ability, 3D learning sessions improved postsession knowledge scores to a level comparable to that demonstrated by students with high-spatial ability indicating that the use of 3D stereoscopic models may be particularly valuable to these students with low-spatial ability. Anat Sci Educ 10: 34-45. © 2016 American Association of Anatomists.

Evaluation of the Effectiveness of 3D Vascular Stereoscopic Models in Anatomy Instruction for First Year Medical Students.

Visualization of medical data in three-dimensional (3D) or two-dimensional (2D) views is a complex area of research. In many fields 3D views are used to understand the shape of an object, and 2D views are used to understand spatial relationships. It is unclear how 2D/3D views play a role in the medical field. Using 3D views can potentially decrease the learning curve experienced with traditional 2D views by providing a whole representation of the patient's anatomy. However, there are challenges with 3D views compared with 2D. This current study expands on a previous study to evaluate the mental workload associated with both 2D and 3D views. Twenty-five first-year medical students were asked to localize three anatomical structures—gallbladder, celiac trunk, and superior mesenteric artery—in either 2D or 3D environments. Accuracy and time were taken as the objective measures for mental workload. The NASA Task Load Index (NASA-TLX) was used as a subjective measure for mental workload. Results showed...

Evaluating mental workload of two-dimensional and three-dimensional visualization for anatomical structure localization

The anatomical sciences have seen a decrease in hours within U.S. medical education in recent years, most notably in the subject of embryology. With more changes to come, it is prudent to ask embry...

Embryology in the Medical Curriculum: The Perceptions and Opinions of CurrentAnatomy Faculty

Comprehension of geologic time does not come easily, especially for students who are studying the earth sciences for the first time. This project investigated the potential success of two teaching interventions that were designed to help non-science majors enrolled in an introductory geology class gain a richer conceptual understanding of the geologic time scale. Our research centered on the results of those interventions since we hypothesized that students who correctly answered exam questions on relative geologic time early in the semester would be able to respond with equal facility to exam questions at the end of the semester that asked them to apply relative geologic time to associated biologic events. The instructor of the course began this study by using the Decoding the Disciplines model (Pace & Middendorf, 1998). During the first step of the model, the instructor identified the place where a majority of students in previous classes had the greatest difficulty; that is, in addressing the relative geologic time scale.  Next, the instructor articulated the mental moves an expert geologist makes when solving problems using the geological time scale.  During lecture the instructor modeled those very same mental tasks for students. Students were then given the opportunity to practice those mental tasks by creating their own personal timeline. Later in the course students completed the second intervention, a categorization grid that also functioned as a classroom assessment of their learning. Students were given exams after both interventions were completed. Results from the first and second interventions indicated that students were able to understand the conceptual framework of the relative geological time scale. On an exam administered after both interventions were completed, 66% of the students answered correctly the questions about relative geologic time, an indication that they had gained conceptual knowledge of the subject. In contrast, only 36% of students answered correctly the exam questions at the end of the semester that focused on relative geologic time with associated biologic events. Pearson Chi-Square tests with P<0.05 were used to test our hypothesis.  Statistically significant results at P=0.00 were attained for all tests, indicating the hypothesis can be rejected. We conclude that a second, more prevalent, underlying problem exists for non-science majors, one that Thorndike and Woodworth (1901), Byrnes (1996), Bransford, Brown, and Cocking (2000) and Bransford and Schwartz (2001) describe as the learning transfer problem.  Similar problems have been discussed as a knowledge transfer problem (Graham et al., 2006). Learning transfer is problematic for students using the geological time scale and calls for additional classroom interventions – interventions designed and scaffolded to provide students the opportunity to practice the set of difficult mental moves required to apply biological events to the relative geological timeline.

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Geological time, biological events and the learning transfer problem

Accuracy of ultrasound-guided localization of the peripatellar plexus for knee pain management.

Anatomic variations of the dorsalis pedis artery: A cadaveric study

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