Confidence versus Performance as an Indicator of the Presence of Alternative Conceptions and Inadequate Problem‐Solving Skills in Mechanics

This study investigated the use of performance–confidence relationships to signal the presence of alternative conceptions and inadequate problem‐solving skills in mechanics. A group of 33 students entering physics at a South African university participated in the project. The test instrument consisted of 20 items derived from existing standardised tests from literature, each of which was followed by a self‐reported measure of confidence of students in the correctness of their answers. Data collected for this study included students’ responses to multiple‐choice questions and open‐ended explanations for their chosen answers. Fixed response physics and confidence data were logarithmically transformed according to the Rasch model to linear measures of performance and confidence. The free response explanations were carefully analysed for accuracy of conceptual understanding. Comparison of these results with raw score data and transformed measures of performance and confidence allowed a re‐evaluation of the model developed by Hasan, Bagayoko, and Kelley in 1999 for the detection of alternative conceptions in mechanics. Application of this model to raw score data leads to inaccurate conclusions. However, application of the Hasan hypothesis to transformed measures of performance and confidence resulted in the accurate identification of items plagued by alternative conceptions. This approach also holds promise for the differentiation between over‐confidence due to alternative conceptions or due to inadequate problem‐solving skills. It could become a valuable tool for instructional design in mechanics.     

MEASURING THE CONFIDENCE OF 8TH GRADE TAIWANESE STUDENTS’ KNOWLEDGE OF ACIDS AND BASES

The present study investigated whether gender differences were present on the confidence judgments made by 8th grade Taiwanese students on the accuracy of their responses to acid–base test items. A total of 147 (76 male, 71 female) students provided item-specific confidence judgments during a test of their knowledge of acids and bases. Using the correctness of the answer responses, a confidence rating score, an unweighted rating score, and a relative confidence rating score were calculated for each respondent. The correlations between the boys and girls for each score area showed girls as scoring higher than boys in their knowledge of acids and bases, were more confident in this knowledge, and more willing to express different levels of confidence among the test items.     

Study skills in anatomy and physiology: Is there a difference?

Many factors influence the way individual students study, including but not limited to: previous coursework, attitudes toward the class (motivation, intimidation, risk, etc.), metacognition, and work schedules. However, little of this research has involved medical students. The present article asks the question, “Do individual medical students study differently for different classes?” Study skills surveys were given to United States medical students at an allopathic medical school and an osteopathic medical school. Students were surveyed near the end of their first year gross anatomy course and again near the end of their first year physiology course. Survey items included Likert scale and open‐ended questions about study habits and basic demographic information. The survey responses were correlated with each student's final grade percentages in the courses. Analysis revealed that the four most common study habits were reviewing lecture notes, taking practice examinations, completing learning exercises, and making drawings and diagrams. The two surveys (anatomy and physiology) from each individual were also compared to see if students reported different study habits in anatomy versus physiology. A negative correlation was found between changing study habits between courses and final anatomy grade percentages. Additional analyses suggest that those students who do change their study habits between courses are increasing the number of study strategies that they attempt. This increase in the number of study strategies attempted may not allow the student to reach the same depth of understanding as their colleagues who utilize fewer strategies. Anat Sci Educ. © 2015 American Association of Anatomists.     

Exploring the validity of assessment in anatomy: Do images influence cognitive processes used in answering extended matching questions?

Assessment is an important aspect of medical education because it tests students' competence and motivates them to study. Various assessment methods, with and without images, are used in the study of anatomy. In this study, we investigated the use of extended matching questions (EMQs). To gain insight into the influence of images on the validity of test items, we focused on students' cognitive processes while they answered questions with and without images. Seventeen first‐year medical students answered EMQs about gross anatomy, combined with either labeled images or answer lists, while thinking aloud. The participants' verbal reports were transcribed verbatim and then coded. Initial codes were based on a task analysis and were adapted into final codes during the coding process. Results showed that students used more cues from EMQs with images and visualized more often in EMQs with answer lists. Ready knowledge and verbal reasoning were used equally often in both conditions. In conclusion, EMQs with and without images elicit different results in this think aloud experiment, indicating different cognitive processes. They seem to measure different skills, making them valid for different testing purposes. The take‐home message for anatomy teachers is that questions without images seem to test the quality of students' mental images while questions with images test their ability to interpret visual information. It makes sense to use both response formats in tests. Using images from clinical practice instead of anatomical drawings will help to improve test validity. Anat Sci Educ 7: 107–116. © 2013 American Association of Anatomists.     

Teaching social studies to learning disabled high school students: effects of a hypertext study guide

This study investigated the effectiveness of a computer-based study guide using hypertext software to increase textbook comprehension among four learning disabled students enrolled in a remedial high school social studies class. The program provided four levels of instructional cues that matched students to their highest level of independent interaction with a textbook passage, based on item-to-item responses to computer-generated questions. Using alternative forms of a 45-item multiple-choice test, a pre-test/post-test design was arranged, with a retention test given after a 30-day period. Fifteen questions were designated as control items by placing them in the 45-item tests but not in the computer treatment. The computer program consisted of three separate lessons administered across consecutive class sessions, with each followed by a written 15-item multiple choice test containing 10 computer questions and 5 control items. Results indicated a significant gain for pupils on computer items from pre-test to post-test and from pre-test to retention test, while no significant change occurred on control items across measures. A single-case analysis revealed a consistent relationship between gain scores on computer items, reading time on computer, and the number of instructional cues required by students. Two types of non-linear pathways that teacher might consider when constructing study guides are discussed.     

Improvement in Student Performance and Perceptions through a Flipped Anatomy Classroom: Shifting from Passive Traditional to Active Blended Learning

One of the major challenges facing anatomy educators is delivering the anatomy materials in fewer hours with a reduction of anatomy courses in the integrated curricula. The flipped classroom modality may be an innovative solution. However, its effectiveness remains under debate due to a lack of outcome-based research and the mixed results of students' performance. The present study aimed to determine the outcome of the flipped classroom based upon the level of student cognition. The study investigated performance on 17 multiple-choice anatomy questions as a part of the final examination of the musculoskeletal system module. The results were compared between the first-year female students of Qassim Medical College, specifically the flipped classroom group (46 students) of the academic year (2018–2019) and the traditional group (49 students) of the academic year (2017–2018). The mean differences in the students' grades on the anatomy questions at the level of knowledge, application, and analysis using Cohen's d test were 0.43, 1.41, and 1.01, respectively. These results suggest the positive impact of flipping the students' classrooms on improving their levels of thinking according to Bloom's taxonomy. Perception surveys also revealed students' enthusiasm for the pre-class activities, leading to a better performance in the class with more engagement with their peers and teachers. The present study suggested that the flipped classroom modality can be performed to compensate for the reduction of anatomy educational hours. However, further studies are recommended to investigate the best practices of the flipped classroom that fit with the students' needs and workloads.     

Bringing anatomy to life: Evaluating a novel ultrasound curriculum in the anatomy laboratory

As point-of-care ultrasound (POCUS) invades medical specialties, more students covet earlier ultrasound (US) training programs in medical school. Determining the optimal placement and format in the curriculum remains a challenge. This study uses student perceptions and confidence in interpreting and acquiring images to evaluate the effectiveness of an US curriculum and assesses their performance on US content. A unique US curriculum was incorporated into first-year clinical anatomy at Tufts University School of Medicine (TUSM). Students completed surveys evaluating changes in US confidence and perceptions. Mean ratings on pre- and post-surveys were compared using Mann–Whitney U tests. Performance on US examination questions was evaluated. Two independent evaluators coded narrative responses and NVivo software was used to identify common themes. Two hundred eleven students completed the US curriculum. Students reported higher post-curriculum mean confidence ratings on US comprehension, operation, image acquisition, artifact recognition, and normal image interpretation (P < 0.0001). US reinforced anatomy concepts and clinical correlates (9.56, ±0.97 SD; 9.60, ±1.05). Students disagreed with items stating learning US is too difficult (1.2, ±2.2) and that it interferes with learning anatomy (0.68, ±1.7). Students scored above passing on practical US knowledge questions, supporting survey data, and the relation to learning spatial relationships. Qualitative analysis identified seven major themes and additional subthemes. Limited integration of US breaks barriers in students' perceptions and confidence in performing POCUS. The TUSM US curriculum is a natural marriage of anatomy and POCUS applications, serving as a template for medical schools.     

Anatomical knowledge retention in third‐year medical students prior to obstetrics and gynecology and surgery rotations

Surgical anatomy is taught early in medical school training. The literature shows that many physicians, especially surgical specialists, think that anatomical knowledge of medical students is inadequate and nesting of anatomical sciences later in the clinical curriculum may be necessary. Quantitative data concerning this perception of an anatomical knowledge deficit are lacking, as are specifics as to what content should be reinforced. This study identifies baseline areas of strength and weakness in the surgical anatomy knowledge of medical students entering surgical rotations. Third‐year medical students completed a 20–25‐question test at the beginning of the General Surgery and Obstetrics and Gynecology rotations. Knowledge of inguinal anatomy (45.3%), orientation in abdominal cavity (38.8%), colon (27.7%), and esophageal varices (12.8%) was poor. The numbers in parentheses are the percentage of questions answered correctly per topic. In comparing those scores to matched test items from this cohort as first‐year students in the anatomy course, the drop in retention overall was very significant (P = 0.009) from 86.9 to 51.5%. Students also scored lower in questions relating to pelvic organs (46.7%), urogenital development (54.0%), pulmonary development (17.8%), and pregnancy (17.8%). These data showed that indeed, knowledge of surgical anatomy is poor for medical students entering surgical clerkships. These data collected will be utilized to create interactive learning modules, aimed at improving clinically relevant anatomical knowledge retention. These modules, which will be available to students during their inpatient surgical rotations, connect basic anatomy principles to clinical cases, with the ultimate goal of closing the anatomical knowledge gap. Anat Sci Educ 7: 461–468. © 2014 American Association of Anatomists.     

Evaluation of the effectiveness of 3D vascular stereoscopic models in anatomy instruction for first year medical students

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.     

Perceived Benefits of Anatomy Coursework Prior to Medical and Dental School

Student struggles in gross anatomy coursework at the professional level can result in hours of remediation along with a need to allot time and other resources by both the student and the faculty. Since this course typically occurs in the first semester of the first year, programs can turn to admissions data to try to determine which of these students may struggle. This study looked at two years of medical (n = 280) and dental (n = 78) students to determine if there is a relationship between pre-admissions anatomy coursework and performance in gross anatomy at the professional school level. Students provided data regarding their past anatomy coursework and final grades in professional school gross anatomy courses were obtained. In addition, students responded to questions regarding their feelings of preparation and how they valued the prior anatomy coursework as it related to the professional course. Statistical analysis showed no difference in final course grade between students with and without prior anatomy in either program. Counter to the numerical data, 96.6% of the students in the study recommended an anatomy course prior to pursuing a health science degree. The primary reasons given for this recommendation were the benefits of repeated content exposure, knowledge of the anatomy terminology, and decreased stress regarding the course. The results from this study suggest that the benefits of prior anatomy may be seen more in the students’ stress and quality of life rather in the numerical performance of course grades.     

Immersive Anatomy Atlas: Learning Factual Medical Knowledge in a Virtual Reality Environment

In order to improve learning efficiency and memory retention in medical teaching, furthering active learning seems to be an effective alternative to classical teaching. One option to make active exploration of the subject matter possible is the use of virtual reality (VR) technology. The authors developed an immersive anatomy atlas which allows users to explore human anatomical structures interactively through virtual dissection. Thirty-two senior-class students from two German high schools with no prior formal medical training were separated into two groups and tasked with answering an anatomical questionnaire. One group used traditional anatomical textbooks and the other used the immersive virtual reality atlas. The time needed to answer the questions was measured. Several weeks later, the participants answered a similar questionnaire with different anatomical questions in order to test memory retention. The VR group took significantly less time to answer the questionnaire, and participants from the VR group had significantly better results over both tests. Based on the results of this study, VR learning seems to be more efficient and to have better long-term effects for the study of anatomy. The reason for that could lie in the VR environment's high immersion, and the possibility to freely and interactively explore a realistic representation of human anatomy. Immersive VR technology offers many possibilities for medical teaching and training, especially as a support for cadaver dissection courses.     

Doodling Effects on Junior High School Students’ Learning

The main purpose of this study was to assess the effects of doodling on the learning performance of high school female students in Tehran. The design of this research was a pre‐test–post‐test with a control group. A group of 169 junior high school 12–13 year‐old students was chosen for this study. After being taught a section of the Natural Science course, the students were asked to answer questions related to the lessons. After that, their grades were used as the pre‐test scores. The post‐test was carried out after the devised treatment. During ten sessions of the same course and teacher, the students were each given a blank sheet of paper and were asked for doodling if they felt like doing it. After each session, a couple of relevant written questions were asked to evaluate how well students had learned the lessons. The experiment and control group both consisted of 27 randomly selected students; participants in the experiment group were doodlers and those in the control group did not doodle. To evaluate the doodling effect a t‐test analysis was performed. Comparison of the grades showed that the experiment group outperformed the control group significantly.     

Peer teaching among physical therapy students during human gross anatomy: Perceptions of peer teachers and students

Despite nearly 200 accredited entry‐level physical therapist education programs in the United States that culminate in a doctoral degree, only a paucity of reports have been published regarding the efficacy of peer teaching in gross anatomy. No one has described the usefulness of peer teaching from the viewpoint of the peer teacher. An organized peer teaching method provided by four second‐year doctors of physical therapy (DPT) students in a semester course in gross anatomy had a positive impact on the academic performance in gross anatomy of first‐year DPT students. The unique feature of the weekly peer teaching sessions was a packet assembled by the second‐year peer teachers, which contained diagrams, fill‐in‐the blank questions, and helpful mnemonic devices. This study surveyed perceptions of first‐year DPT students in response to a peer teaching method, using a structured 10‐item questionnaire and a five‐point Likert scale. Second‐year DPT peer teachers provided written reflections about the benefits and challenges of serving as a peer teacher. Results revealed that 13 planned peer‐teaching experiences provided by four second‐year DPT students were valuable and promoted a firm understanding of anatomical relationships important for the clinical competence of physical therapist students. Moreover, peer teachers acknowledged acquiring clinically desirable teaching, academic, organizational, and time management skills from the experience. As a result, physical therapist educators may wish to consider this model of peer teaching to augment their teaching strategies for a class in gross human anatomy. Anat Sci Ed 1:199–206, 2008. © 2008 American Association of Anatomists.     

中国高中生留学地选择意愿的经济学分析

随着高等教育的国际化,中国的留学热持续升温,并趋于低龄化,高中生开始成为出国留学的主要潜在群体之一。那么他们将会去哪里留学？他们在考虑留学地的时候又会受到哪些因素的影响？在回顾消费者选择理论和人力资本投资理论的基础上,一项研究通过建构一个解释留学地选择的消费和投资混合模型,并应用中国高中生大样本调查数据,对上述问题进行了回答。研究发现,高中生选择留学地,不仅会考虑不同留学地所能带来的投资性效用,也会考虑在不同留学地上学的消费性效用,并且不同群体选择留学地时,还会受到家庭背景、学术能力、个人特征等方面的约束和影响。     

The effect of curricular reform on gross anatomy laboratory examination performance: An institutional analysis

Many medical schools have undergone curricular reform recently. With these reforms, time spent teaching anatomy has been reduced, and there has been a general shift to a pass/fail grading system. At Indiana University School of Medicine (IUSM), a new curriculum was implemented in fall 2016. The year-long human gross anatomy course taught in 2015 was condensed into an integrated, semester-long course starting in 2016. Additionally, the grading scale shifted to pass/fail. This study examined first-year medical student performance on anatomy practical laboratory examinations—specifically, among lower-order (pure identification) questions and higher-order (function, innervation) questions. Participants included medical students from a pre-curricular reform cohort (year 2015, 34 students) and two post-curricular reform cohorts (years 2016, 30 students and 2017, 33 students). A Kruskal–Wallis ANOVA test was used to determine differences of these questions among the three cohorts. Additionally, 40 of the same lower-order questions that were asked on gross anatomy laboratory examinations from medical student cohort year 2015 and year 2016 were further analyzed using an independent samples t-test. Results demonstrated that the pre-curricular reform cohort scored significantly higher on both lower-order (median = 81, p < 0.001) and higher-order questions (median = 82.5, p < 0.05) than both post-curricular reform cohorts. Additionally, when reviewing the selected 40 similar questions, it was found that the pre-curricular reform cohort averaged significantly higher (82.1 ± 16.1) than the post-curricular reform cohort from 2016 (69.3 ± 21.8, p = 0.004). This study provides evidence about the impact of curricular reform on medical student anatomical knowledge.     

Student‐centered integrated anatomy resource sessions at Alfaisal University

Alfaisal University is a new medical school in Riyadh, Kingdom of Saudi Arabia that matriculates eligible students directly from high school and requires them to participate in a hybrid problem‐based learning (PBL) curriculum. PBL is a well‐established student‐centered approach, and the authors have sought to examine if a student‐centered, integrated approach to learn human structures leads to positive perceptions of learning outcomes. Ten students were divided into four groups to rotate through wet and dry laboratory stations (integrated resource sessions, IRSs) that engaged them in imaging techniques, embryology, histology, gross anatomy (dissections and prosections), surface anatomy, and self‐directed learning questions. All IRSs were primarily directed by students. During two second‐semester organ system blocks, forty students responded to a structured questionnaire designed to poll students' perceptions of changes in their knowledge, skills, and attitudes as a result of IRS. The majority (60%) of students felt that the student‐centered approach to learning enhanced their medical knowledge. Most students also felt that the IRS approach was advantageous for formulating clear learning objectives (55%) and in preparing for examinations (65%). Despite their positive feelings toward IRS, students did not view this learning approach as an adequate replacement for the knowledge gained from lectures and textbooks. Students' performance on objective structured practical examinations improved significantly for the two curricular blocks that included IRS compared with earlier non‐IRS blocks. A student‐centered approach to teach human structure in a hybrid PBL curriculum may enhance understanding of the basic sciences in first‐year medical students. Anat Sci Educ 3:272–275, 2010. © 2010 American Association of Anatomists.     

Different Gender Students' Participation in the High- and Low-achieving Middle School Questioning-orientated Biology Classrooms in Taiwan

This case study investigated gender-based differences in classroom participation through examining teacher-student interactions between a female biology teacher and two groups of middle school students, namely high achievers and low achievers. The female teacher used a questioning-orientated instructional strategy as her major teaching style which creates greater opportunities for student participation in biology learning. Classroom sessions were videotaped for one school year, then analysed for gender differences in question-and-answer patterns. The results showed that more teacher-initiated questions, teacher-directed interactions, and teacher feedback were given to males than females in both groups, but a large difference was found between the two groups of students. Girls in the low-achieving biology class (LABC) were more likely to participate at a rate comparable with their male classmates; girls answered more procedure questions and an equal percentage of process questions, called out approximately the same percentage of answers to undirected teacher-initiated questions, and received more instances of praise and follow-up questions. Contrary to what was observed in the high-achieving biology class (HABC), LABC girls initiated more questions than LABC boys.     

Enhancement of anatomical learning and developing clinical competence of first‐year medical and allied health profession students

Hands‐on educational experiences can stimulate student interest, increase knowledge retention, and enhance development of clinical skills. The Lachman test, used to assess the integrity of the anterior cruciate ligament (ACL), is commonly performed by health care professionals and is relatively easy to teach to first‐year health profession students. This study integrated teaching the Lachman test into a first‐year anatomy laboratory and examined if students receiving the training would be more confident, competent, and if the training would enhance anatomical learning. First‐year medical, physician assistant and physical therapy students were randomly assigned into either the intervention (Group A) or control group (Group B). Both groups received the course lecture on knee anatomy and training on how to perform the Lachman test during a surface anatomy class. Group A received an additional 15 minutes hands‐on training for the Lachman test utilizing a lightly embalmed cadaver as a simulated patient. One week later, both groups performed the Lachman test on a lightly embalmed cadaver and later completed a post‐test and survey. Students with hands‐on training performed significantly better than students with lecture‐only training in completing the checklist, a post‐test, and correctly diagnosing an ACL tear. Students in Group A also reported being more confident after hands‐on training compared to students receiving lecture‐only training. Both groups reported that incorporating clinical skill activities facilitated learning and created excitement for learning. Hands‐on training using lightly embalmed cadavers as patient simulators increased confidence and competence in performing the Lachman test and aided in learning anatomy. Anat Sci Educ 7: 181–190. © 2013 American Association of Anatomists.     

The use of educational comics in learning anatomy among multiple student groups

Understanding basic human anatomy can be beneficial for all students, regardless of when, or if, they will later undertake a formal course in the subject. For students who are preparing to undertake a formal anatomy course, educational comics on basic anatomy can serve as a concise and approachable review of the material. For other students, these comics can serve as a helpful and fun introduction to the human body. The objective of the comics in this study was to promote an understanding of fundamental human anatomy through self‐learning among students. Based on the authors' previous teaching experience, these anatomy comics were produced in a simple, direct style. The comics were titled after the two main characters, “Anna” (a girl) and “Tommy” (a boy). These comics were then presented to groups of elementary school students, high school students, premedical students, and medical students to assess the comics' ability to enhance student interest and comprehension of basic anatomy. Quiz scores among high school students and premedical students were significantly higher among participants who read the educational comics, indicating a deeper comprehension of the subject. Among medical students, close reading of the comics was associated with improved course grades. These educational anatomy comics may be helpful tools to enrich a broad spectrum of different students in learning basic human anatomy. Anat Sci Educ 10: 79–86. © 2016 American Association of Anatomists.