Computer‐based learning: Interleaving whole and sectional representation of neuroanatomy

The large volume of material to be learned in biomedical disciplines requires optimizing the efficiency of instruction. In prior work with computer‐based instruction of neuroanatomy, it was relatively efficient for learners to master whole anatomy and then transfer to learning sectional anatomy. It may, however, be more efficient to continuously integrate learning of whole and sectional anatomy. A study of computer‐based learning of neuroanatomy was conducted to compare a basic transfer paradigm for learning whole and sectional neuroanatomy with a method in which the two forms of representation were interleaved (alternated). For all experimental groups, interactive computer programs supported an approach to instruction called adaptive exploration. Each learning trial consisted of time‐limited exploration of neuroanatomy, self‐timed testing, and graphical feedback. The primary result of this study was that interleaved learning of whole and sectional neuroanatomy was more efficient than the basic transfer method, without cost to long‐term retention or generalization of knowledge to recognizing new images (Visible Human and MRI). Anat Sci Educ. © 2012 American Association of Anatomists.     

Performance equivalency between computer‐based and traditional pen‐and‐paper assessment: A case study in clinical anatomy

The time, material, and staff‐consuming nature of anatomy's traditional pen‐and‐paper assessment system, the increase in the number of students enrolling in medical schools and the ever‐escalating workload of academic staff have made the use of computer‐based assessment (CBA) an attractive proposition. To understand the impact of such shift in the assessment method, an experimental study evaluating its effect on students’ performance was designed. Additionally, students’ opinions toward CBA were gathered. Second‐year medical students attending a Clinical Anatomy course were randomized by clusters in two groups. The pen‐and‐paper group attended two sessions, each consisting of a traditional sectional anatomy steeplechase followed by a theoretical examination, while the computer group was involved in two similar sessions conducted in a computerized environment. At the end of each of the computer sessions, students in this group filled an anonymous questionnaire. In the first session, pen‐and‐paper group students scored significantly better than computer‐group students in both the steeplechase (mean ± standard deviation: 66.00 ± 14.15% vs. 43.50 ± 19.10%; P < 0.001) and the theoretical examination (52.50 ± 12.70% vs. 39.00 ± 21.10%; P < 0.001). In the second session, no statistically significant differences were found for both the steeplechase (59.50 ± 17.30% vs. 54.50 ± 17.00%; P = 0.085) and the theoretical examination (57.50 ± 13.70% vs. 54.00 ± 14.30%; P = 0.161). Besides, an intersession improvement in students’ perceptions toward CBA was registered. These results suggest that, after a familiarization period, CBA might be a performance equivalent and student accepted alternative to clinical anatomy pen‐and‐paper theoretical and practical examinations. Anat Sci Educ 11: 124–136. © 2017 American Association of Anatomists.     

A usability study of users' perceptions toward a multimedia computer‐assisted learning tool for neuroanatomy

This usability study evaluated users' perceptions of a multimedia prototype for a new e‐learning tool: Anatomy of the Central Nervous System: A Multimedia Course. Usability testing is a collection of formative evaluation methods that inform the developmental design of e‐learning tools to maximize user acceptance, satisfaction, and adoption. Sixty‐two study participants piloted the prototype and completed a usability questionnaire designed to measure two usability properties: program need and program applicability. Statistical analyses were used to test the hypothesis that the multimedia prototype was well designed and highly usable, it was perceived as: (1) highly needed across a spectrum of educational contexts, (2) highly applicable in supporting the pedagogical processes of teaching and learning neuroanatomy, and (3) was highly usable by all types of users. Three independent variables represented user differences: level of expertise (faculty vs. student), age, and gender. Analysis of the results supports the research hypotheses that the prototype was designed well for different types of users in various educational contexts and for supporting the pedagogy of neuroanatomy. In addition, the results suggest that the multimedia program will be most useful as a neuroanatomy review tool for health‐professions students preparing for licensing or board exams. This study demonstrates the importance of integrating quality properties of usability with principles of human learning during the instructional design process for multimedia products. Anat Sci Ed 2008. © 2008 American Association of Anatomists.     

The relative effectiveness of computer‐based and traditional resources for education in anatomy

There is increasing use of computer–based resources to teach anatomy, although no study has compared computer‐based learning to traditional. In this study, we examine the effectiveness of three formats of anatomy learning: (1) a virtual reality (VR) computer‐based module, (2) a static computer‐based module providing Key Views (KV), (3) a plastic model. We conducted a controlled trial in which 60 undergraduate students had ten minutes to study the names of 20 different pelvic structures. The outcome measure was a 25 item short answer test consisting of 15 nominal and 10 functional questions, based on a cadaveric pelvis. All subjects also took a brief mental rotations test (MRT) as a measure of spatial ability, used as a covariate in the analysis. Data were analyzed with repeated measures ANOVA. The group learning from the model performed significantly better than the other two groups on the nominal questions (Model 67%; KV 40%; VR 41%, Effect size 1.19 and 1.29, respectively). There was no difference between the KV and VR groups. There was no difference between the groups on the functional questions (Model 28%; KV, 23%, VR 25%). Computer‐based learning resources appear to have significant disadvantages compared to traditional specimens in learning nominal anatomy. Consistent with previous research, virtual reality shows no advantage over static presentation of key views. Anat Sci Educ 6: 211–215. © 2013 American Association of Anatomists.     

Understanding neurophobia: Reasons behind impaired understanding and learning of neuroanatomy in cross‐disciplinary healthcare students

Recent studies have highlighted a fear or difficulty with the study and understanding of neuroanatomy among medical and healthcare students. This has been linked with a diminished confidence of clinical practitioners and students to manage patients with neurological conditions. The underlying reasons for this difficulty have been queried among a broad cohort of medical, dental, occupational therapy, and speech and language sciences students. Direct evidence of the students’ perception regarding specific difficulties associated with learning neuroanatomy has been provided and some of the measures required to address these issues have been identified. Neuroanatomy is perceived as a more difficult subject compared to other anatomy topics (e.g., reproductive/pelvic anatomy) and not all components of the neuroanatomy curriculum are viewed as equally challenging. The difficulty in understanding neuroanatomical concepts is linked to intrinsic factors such as the inherent complex nature of the topic rather than outside influences (e.g., lecture duration). Participants reporting high levels of interest in the subject reported higher levels of knowledge, suggesting that teaching tools aimed at increasing interest, such as case‐based scenarios, could facilitate acquisition of knowledge. Newer pedagogies, including web‐resources and computer assisted learning (CAL) are considered important tools to improve neuroanatomy learning, whereas traditional tools such as lecture slides and notes were considered less important. In conclusion, it is suggested that understanding of neuroanatomy could be enhanced and neurophobia be decreased by purposefully designed CAL resources. This data could help curricular designers to refocus attention and guide educators to develop improved neuroanatomy web‐resources in future. Anat Sci Educ 11: 81–93. © 2017 American Association of Anatomists.     

Evaluation of computer‐aided instruction in a gross anatomy course: A six‐year study

Web‐based computer‐aided instruction (CAI) has become increasingly important to medical curricula. This multi‐year study investigated the effectiveness of CAI and the factors affecting level of individual use. Three CAI were tested that differed in specificity of applicability to the curriculum and in the level of student interaction with the CAI. Student personality preferences and learning styles were measured using the Meyers Briggs Type Indicator (MBTI) and Kolb's Learning Style Inventory (LSI). Information on “computer literacy” and use of CAI was collected from student surveys. Server logs were used to quantify individual use of respective CAI. There was considerable variability in the level of utilization of each CAI by individual students. Individual use of each CAI differed and was associated with gender, MBTI preferences and learning style, but not with “computer literacy.” The majority of students found the CAI useful for learning and used the CAI by themselves. Students who accessed the CAI resources most frequently scored significantly higher on exams compared with students who never accessed the resources. Our results show that medical students do not uniformly use CAI developed for their curriculum and this variability is associated with various attributes of individual students. Our data also provide evidence of the importance of understanding student preferences and learning styles when implementing CAI into the curriculum. Anat Sci Ed 2:2–8, 2009. © 2009 American Association of Anatomists.     

The value of neurosurgical and intraoperative magnetic resonance imaging and diffusion tensor imaging tractography in clinically integrated neuroanatomy modules: A cross‐sectional study

Neuroanatomy is considered to be one of the most difficult anatomical subjects for students. To provide motivation and improve learning outcomes in this area, clinical cases and neurosurgical images from diffusion tensor imaging (DTI) tractographies produced using an intraoperative magnetic resonance imaging apparatus (MRI/DTI) were presented and discussed during integrated second‐year neuroanatomy, neuroradiology, and neurosurgery lectures over the 2008–2011 period. Anonymous questionnaires, evaluated according to the Likert scale, demonstrated that students appreciated this teaching procedure. Academic performance (examination grades for neuroanatomy) of the students who attended all integrated lectures of neuroanatomy, was slightly though significantly higher compared to that of students who attended these lectures only occasionally or not at all (P=0.04). Significantly better results were obtained during the national progress test (focusing on morphology) by students who attended the MRI/DTI‐assisted lectures, compared to those who did so only in part or not at all, compared to the average student participating in the national test. These results were obtained by students attending the second, third and, in particular, the fourth year (P≤0.0001) courses during the three academic years mentioned earlier. This integrated neuroanatomy model can positively direct students in the direction of their future professional careers without any extra expense to the university. In conclusion, interactive learning tools, such as lectures integrated with intraoperative MRI/DTI images, motivate students to study and enhance their neuroanatomy education. Anat Sci Educ 6: 294–306. © 2013 American Association of Anatomists.     

Evaluating a computer‐based reading programme with children with Intellectual Disabilities: feasibility and pilot research

Increasing evidence indicates that individuals with Intellectual Disabilities (ID) might benefit from phonics‐based reading instruction. However, research and instruction in this field has predominantly focused on sight word reading. Models for complex interventions recommend that feasibility research be conducted prior to conducting randomised studies to assess efficacy of interventions (Thabane et al., 2010). The aim of the current paper is therefore to investigate feasibility questions relating to conducting a full‐scale randomised controlled trial (RCT) evaluation of an online, phonics‐based reading programme (Headsprout^? Early Reading; HER) with children with ID. Employing a randomised pre‐test post‐test group design, this study explores and trials important aspects of a RCT evaluation to inform a full‐scale RCT. We also found that HER had a significant effect on reading skills when compared with ‘education as usual’, with large effect sizes on the main outcome measure. This indicates that further, more robust evaluations using HER with children with ID are a worthwhile pursuit.     

Impact and educational outcomes of a small group self‐directed teaching strategy in a clinical neuroscience curriculum

The complexity of the material being taught in clinical neuroscience within the medical school curriculum requires creative pedagogies to teach medical students effectively. Many clinical teaching strategies have been developed and are well described to address these challenges. However, only a few have been evaluated to determine their impact on the performance of students studying clinical neuroscience. Interactive, 2‐hour, self‐directed small‐group interactive clinical case‐based learning sessions were conducted weekly for 4 weeks to integrate concepts learned in the corresponding didactic lectures. Students in the small groups analyzed cases of patients suffering from neurological disease that were based on eight learning objectives that allowed them to evaluate neuroanatomical data and clinical findings before presenting their case analysis to the larger group. Students’ performances on the formative quizzes and summative tests were compared to those of first‐year medical students in the previous year for whom the self‐directed, small‐group interactive clinical sessions were not available. There was a significant improvement in the summative performance of first‐year medical students with self‐directed clinical case learning in the second year (Y2) of teaching clinical neuroscience (P < 0.05) when compared with first‐year students in the first year (Y1) for whom the self‐directed learning approach was not available. Student performance in the formative assessments between Y1 and Y2 was not significantly different (P = 0.803). A target of ≥70% student scoring above 80% in the final summative examination was met. The current study revealed evidence for the impact and educational outcomes of a self‐directed, clinical teaching strategy in a clinical neuroscience curriculum for first‐year medical students. Anat Sci Educ 11: 478–487. © 2017 American Association of Anatomists.     

Measuring learning gain: Comparing anatomy drawing screencasts and paper‐based resources

The use of technology‐enhanced learning (TEL) resources is now a common tool across a variety of healthcare programs. Despite this popular approach to curriculum delivery there remains a paucity in empirical evidence that quantifies the change in learning gain. The aim of the study was to measure the changes in learning gain observed with anatomy drawing screencasts in comparison to a traditional paper‐based resource. Learning gain is a widely used term to describe the tangible changes in learning outcomes that have been achieved after a specific intervention. In regard to this study, a cohort of Year 2 medical students voluntarily participated and were randomly assigned to either a screencast or textbook group to compare changes in learning gain across resource type. Using a pre‐test/post‐test protocol, and a range of statistical analyses, the learning gain was calculated at three test points: immediate post‐test, 1‐week post‐test and 4‐week post‐test. Results at all test points revealed a significant increase in learning gain and large effect sizes for the screencast group compared to the textbook group. Possible reasons behind the difference in learning gain are explored by comparing the instructional design of both resources. Strengths and weaknesses of the study design are also considered. This work adds to the growing area of research that supports the effective design of TEL resources which are complimentary to the cognitive theory of multimedia learning to achieve both an effective and efficient learning resource for anatomical education. Anat Sci Educ 10: 307–316. © 2016 American Association of Anatomists.     

Effects of image‐based and text‐based active learning exercises on student examination performance in a musculoskeletal anatomy course

Research on the benefits of visual learning has relied primarily on lecture‐based pedagogy, but the potential benefits of combining active learning strategies with visual and verbal materials on learning anatomy has not yet been explored. In this study, the differential effects of text‐based and image‐based active learning exercises on examination performance were investigated in a functional anatomy course. Each class session was punctuated with an average of 12 text‐based and image‐based active learning exercises. Participation data from 231 students were compared with their examination performance on 262 questions associated with the in‐class exercises. Students also rated the helpfulness and difficulty of the in‐class exercises on a survey. Participation in the active learning exercises was positively correlated with examination performance (r = 0.63, P < 0.001). When controlling for other key demographics (gender, underrepresented minority status) and prior grade point average, participation in the image‐based exercises was significantly correlated with performance on examination questions associated with image‐based exercises (P < 0.001) and text‐based exercises (P < 0.01), while participation in text‐based exercises was not. Additionally, students reported that the active learning exercises were helpful for seeing images of key ideas (94%) and clarifying key course concepts (80%), and that the image‐based exercises were significantly less demanding, less hard and required less effort than text‐based exercises (P < 0.05). The findings confirm the positive effect of using images and active learning strategies on student learning, and suggest that integrating them may be especially beneficial for learning anatomy. Anat Sci Educ 10: 444–455. © 2017 American Association of Anatomists.     

Analysis of testing with multiple choice versus open‐ended questions: Outcome‐based observations in an anatomy course

The pedagogical approach for both didactic and laboratory teaching of anatomy has changed in the last 25 years and continues to evolve; however, assessment of student anatomical knowledge has not changed despite the awareness of Bloom's taxonomy. For economic reasons most schools rely on multiple choice questions (MCQ) that test knowledge mastered while competences such as critical thinking and skill development are not typically assessed. In contrast, open‐ended question (OEQ) examinations demand knowledge construction and a higher order of thinking, but more time is required from the faculty to score the constructed responses. This study compares performances on MCQ and OEQ examinations administered to a small group of incoming first year medical students in a preparatory (enrichment) anatomy course that covered the thorax and abdomen. In the thorax module, the OEQ examination score was lower than the MCQ examination score; however, in the abdomen module, the OEQ examination score improved compared to the thorax OEQ score. Many students attributed their improved performance to a change from simple memorization (superficial learning) for cued responses to conceptual understanding (deeper learning) for constructed responses. The results support the view that assessment with OEQs, which requires in depth knowledge, would result in student better performance in the examination. Anat Sci Educ 11: 254–261. © 2017 American Association of Anatomists.     

Reflections as near‐peer facilitators of an inquiry project for undergraduate anatomy: Successes and challenges from a term of trial‐and‐error

Near‐peer facilitators (senior students serving as facilitators to their more junior peers) bring a unique student‐based perspective to teaching. With fewer years of teaching experience however, students who become involved in a facilitator role typically develop related skills quickly through a process of trial‐and‐error within the classroom. The aim of this paper is to report on the authors' own experiences and reflections as student near‐peer facilitators for an inquiry‐based project in an undergraduate anatomy course. Three areas of the facilitator experience are explored: (1) offering adequate guidance as facilitators of inquiry, (2) motivating students to engage in the inquiry process, and (3) fostering creativity in learning. A practical framework for providing guidance to students is discussed which offers facilitators a scaffold for asking questions and assisting students through the inquiry process. Considerations for stimulating intrinsic motivations toward inquiry learning are made, paying attention to ways in which facilitators might influence feelings of motivation towards learning. Also, the role of creativity in inquiry learning is explored by highlighting the actions facilitators can take to foster a creative learning environment. Finally, recommendations are made for the development of formalized training programs that aid near‐peer facilitators in the acquisition of facilitation skills before entering into a process of trial‐and‐error within the classroom. Anat Sci Educ. 7: 64–70. © 2013 American Association of Anatomists.     

Students' environmental NOS views,compassion, intent,and action: Impact of place‐based socioscientific issues instruction

Preparing students to achieve the lofty goal of functional scientific literacy entails addressing the normative and non‐normative facets of socioscientific issues (SSI) such as scientific processes, the nature of science (NOS) and diverse sociocultural perspectives. SSI instructional approaches have demonstrated some efficacy for promoting students' NOS views, compassion for others, and decision making. However, extant investigations appear to neglect fully engaging students through authentic SSI in several ways. These include: (i) providing SSI instruction through classroom approaches that are divorced from students' lived experiences; (ii) demonstrating a contextual misalignment between SSI and NOS (particularly evident in NOS assessments); and (iii) framing decision making and position taking analogously—with the latter being an unreliable indicator of how people truly act. The significance of the convergent parallel mixed‐methods investigation reported here is how it responds to these shortcomings through exploring how place‐based SSI instruction focused on the contentious environmental issue of wolf reintroduction in the Greater Yellowstone Area impacted sixty secondary students' NOS views, compassion toward those impacted by contentious environmental issues, and pro‐environmental intent. Moreover, this investigation explores how those perspectives associate with the students' pro‐environmental action of donating to a Yellowstone environmental organization. Results demonstrate that the students' NOS views became significantly more accurate and contextualized, with moderate to large effect, through the place‐based SSI instruction. Through that instruction, the students also exhibited significant gains in their compassion for nature and people impacted by contentious environmental issues and pro‐environmental intent. Further analyses showed that donating students developed and demonstrated significantly more robust and contextualized NOS views, compassion for people and nature impacted by contentious environmental issues, and pro‐environmental intent than their nondonating counterparts. Pedagogical implications include how place‐based learning in authentic settings could better prepare students to understand NOS, become socioculturally aware, and engage SSI across a variety of contexts.     

Developing an audiovisual notebook as a self‐learning tool in histology: Perceptions of teachers and students

Videos can be used as didactic tools for self‐learning under several circumstances, including those cases in which students are responsible for the development of this resource as an audiovisual notebook. We compared students' and teachers' perceptions regarding the main features that an audiovisual notebook should include. Four questionnaires with items about information, images, text and music, and filmmaking were used to investigate students' (n = 115) and teachers' perceptions (n = 28) regarding the development of a video focused on a histological technique. The results show that both students and teachers significantly prioritize informative components, images and filmmaking more than text and music. The scores were significantly higher for teachers than for students for all four components analyzed. The highest scores were given to items related to practical and medically oriented elements, and the lowest values were given to theoretical and complementary elements. For most items, there were no differences between genders. A strong positive correlation was found between the scores given to each item by teachers and students. These results show that both students' and teachers' perceptions tend to coincide for most items, and suggest that audiovisual notebooks developed by students would emphasize the same items as those perceived by teachers to be the most relevant. Further, these findings suggest that the use of video as an audiovisual learning notebook would not only preserve the curricular objectives but would also offer the advantages of self‐learning processes. Anat Sci Educ 7: 209–218. © 2013 American Association of Anatomists.     

“That's more like how they know me as a person”: one primary pre‐service teacher's stories of her personal and ‘professional’ digital practices

In contributing to debates about how student‐teachers might draw from personal experience in addressing digital literacy in the classroom, this paper explores the stories that one primary student‐teacher told of her digital practices during a larger study of the role of digital literacy in student‐teachers' lives. The paper investigates the ‘recognition work’ this student‐teacher did as she aligned herself with different discourses and notes how themes of ‘control’ and ‘professionalism’ seemed to pattern her stories of informal and formal practices both within and beyond her professional education. The paper calls for further research into how student‐teachers perceive the relevance of their personal experience to their professional role and argues for encouraging pre‐service and practising teachers to tell stories of their digital practices and reflect upon the discourses which frame them.     

Functional anatomy of the cardiovascular system: Professional development for PreK‐3 teachers using a “Train and equip” method results in learning opportunities for students

Preadolescent students are interested in learning the structure and function of the human body. However, their teachers are not trained in this content. The purpose of this project was to expand a successful outreach effort in the health sciences for grade 7–12 teachers to include PreK‐3 teachers. A “Healthy Hearts” workshop was offered to train the teachers in relevant content and also to give them a resource kit of supplies and equipment to facilitate the transference of the training into educational opportunities for their students. The workshop included many role‐playing activities and use of all items in the resource kit. A total of 25 workshops were conducted in 14 different community locations with 716 PreK‐3 teachers attending from 169 communities representing 59 (79%) of the state's 75 counties. African American (AA) teacher participation was 35%, twice the state AA population rate and 3.5× the AA public school teacher rate. Pre to Posttest scores increased an average of 15%. The results of the evaluation measures regarding the workshop and the transference of the training and use of resource kit items into learning opportunities for students were excellent. Universities have the capability, perhaps the responsibility, to provide the much‐needed professional development training to PreK‐12 teachers. Anatomists in medical and nonmedical school settings are well positioned to participate in this process and help close the gap between the interest young children have in learning about the human body and the lack of teacher training in this content. Anat Sci Ed 1:119–125, 2008. © 2008 American Association of Anatomists.