ABSTRACT
INTRODUCTION AND OBJECTIVE: Given widespread disruptions to healthcare during the COVID-19 pandemic, the objective was to assess the national case logs of graduating Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellows for effects on surgical volume. METHOD(S): The nationally aggregated Accreditation Council for Graduate Medical Education case logs were obtained for graduating FPMRS fellows, both urology and obstetrics and gynecology (OBGYN), for available academic years (AYs) 2018-2019, 2019-2020, and 2020- 2021. Standard deviation was derived from percentile data. Case volume differences for tracked index category averages were compared between AYs with one-way analysis of variance. RESULT(S): Graduating fellows logged an average of 517.4 (SD 28.6) and 818.0 (SD 37.9) cases, for urology and OBGYN respectively, over their fellowship training during the examined period. Total surgical procedures were not statistically different between pre-COVID AY 2018- 2019 and COVID-affected AYs 2019-2020 and 2020-2021 for either specialty. For urology fellows, the only index case category with a statistically significant difference was a decrease in AY 2020-2021 compared to 2019-2020 in GI procedures (8.9 vs 4.2, p=0.04). Reclassification of mesh removal cases to genital procedures in 2020- 2021 resulted in a statistical decrease for both specialties of graft/mesh augmentation prolapse cases for that same AY. There were no other statistically significant differences between AYs for OBGYN fellows. CONCLUSION(S): Compared to pre-pandemic case volumes, FPMRS urology and FPMRS OBGYN graduating fellow surgical volume remained stable. Both total surgical procedures and index case categories showed no statistically significant difference between pre-COVID and COVID-affected years. Despite nationwide disruptions in health care, FPMRS trainee case volumes remained consistent.
ABSTRACT
Educational technologies in veterinary medicine aim to train veterinarians faster and improve clinical outcomes. COVID-19 pandemic, shifted face-to-face teaching to online, thus, the need to provide effective education remotely was exacerbated. Among recent technology advances for veterinary medical education, extended reality (XR) is a promising teaching tool. This study aimed to develop a case resolution approach for radiographic anatomy studies using XR technology and assess students' achievement of differential diagnostic skills. Learning objectives based on Bloom's taxonomy keywords were used to develop four clinical cases (3 dogs/1 cat) of spinal injuries utilizing CT scans and XR models and presented to 22 third-year veterinary medicine students. Quantitative assessment (ASMT) of 7 questions probing 'memorization', 'understanding and application', 'analysis' and 'evaluation' was given before and after contact with XR technology as well as qualitative feedback via a survey. Mean ASMT scores increased during case resolution (pre 51.6% (±37%)/post 60.1% (± 34%); p < 0.01), but without significant difference between cases (Kruskal-Wallis H = 2.18, NS). Learning objectives were examined for six questions (Q1-Q6) across cases (C1-4): Memorization improved sequentially (Q1, 2 8/8), while Understanding and Application (Q3,4) showed the greatest improvement (26.7%-76.9%). Evaluation and Analysis (Q5,6) was somewhat mixed, improving (5/8), no change (3/8) and declining (1/8).Positive student perceptions suggest that case studies' online delivery was well received stimulating learning in diagnostic imaging and anatomy while developing visual-spatial skills that aid understanding cross-sectional images. Therefore, XR technology could be a useful approach to complement radiological instruction in veterinary medicine.
ABSTRACT
Due to the COVID-19 pandemic, there is increased interest to effectively deliver educational curricula remotely to diverse student populations. Case-based cadaveric MRI visualization and extended reality (XR) technology enhances learning experiences in medicine. The purpose of this study was to demonstrate that a virtual, multi-departmental workflow utilizing MRI, XR technology, and a “patient” group, represented by the John A. Burns School of Medicine (JABSOM) Willed Body Program, supplements case-based learning and promotes student exploration and engagement equally in cross-cultural cohorts represented by American and Turkish medical students. Virtual case-based learning activities were developed and presented to American medical students at JABSOM and Turkish medical students, selected based on education and English proficiency, via Zoom. Subject, medical history, and physical exam data were presented to students who were then divided into breakout rooms where hypotheses regarding cadaveric, neurological findings were generated. Students then reviewed radiology and pathology reports and accessed relevant 3D segmented, photogrammetric and illustrative models. An optional survey was completed to evaluate student opinion based on a 5-point Likert scale. Comparisons between groups were performed using a non-parametric Mann Whitney U test. Data was reported as mean, median (min-max), and percentile. Significant differences (two-tailed P) less than 0.05 were significant. Results revealed significant differences between American (n=40) and Turkish (n=16) student opinion. The Turkish scale was significantly higher when asked if MRI scans of cadavers were useful as online learning tools (p =0.002), if MRI scans of cadavers provided an understanding of relevant anatomy (p<0.001), if 3D models provided a better understanding of anatomical relationships (p<0.001), whether students would like more interactive sessions using MRI scans (p<0.001), and if students would use similar resources in the future (p<0.001). The American scale was higher when asked if students were able to communicate effectively with their breakout groups (p=0.037). The learning activity was positively received by both cohorts as shown by no average score less than a 4 out of 5 for each question. The American scales may have been lower due to having previous experience with similar activities, whereas the learning activity was novel and exciting to Turkish students. Differences in communicating effectively in breakout rooms can be explained by the fact that American students were broken into longitudinal dissection groups, whereas Turkish students were randomly assigned. Based on these results, case-based learning, utilizing MRI and XR technology, enhances the learning experience of medical students and can be expanded to cross-cultural student populations.
ABSTRACT
Collaborative online anatomy education has become increasingly utilized due to a trend toward student-centered independent learning, as well as the ongoing COVID-19 pandemic limiting in-person group activities. Anatomy education is heavily reliant on visuotactile experience and presents a challenge during online instruction. In an effort to provide an effective experience, the Head and Neck block (Fall Semester, 2020) was presented as an online activity that included extended reality anatomy models derived from three-dimensional medical illustrations (artistic), dissections, plastinates, and segmentations, and posted on the Sketchfab platform for student viewing. The purpose of this study was to assess student preference of anatomical models during online anatomy instruction. A photogrammetry workflow was developed to digitize the dissected and plastinated specimens that were posted to the sketchfab.com platform and presented via a secured university-based website hosting service (xrcore.jabsom.hawaii.edu). Segmented models were derived from MRI cadaveric scans, and artistic models were created based on segmented graphics primitives that are defined as nondivisible graphical elements, such as planes or spheres, for input or output within a computer-graphics system. Technical requirements were minimal and relied on several open-source or limited subscription software packages. Accession was recorded and compared using a chi-square analysis. A comparison of the preference of the models was conducted using student surveys (n = 79). When compared to all learning resources, actual dissections were most preferred (34.1%). However, plastinated models were considered most/more preferred (54.3%) compared to other assets suggesting a broader preference as a learning resource. These results suggest that plastinated models are effective and engaging tools for the instruction of gross anatomy for medical students. © 2021, International Society for Plastination. All rights reserved.
ABSTRACT
Anatomical analysis of conjoined twins provides important information concerning embryological development. Museum specimens provide a unique sample that can be analyzed non-intrusively using advanced biomedical imaging and displayed online which is currently important due to limited in-person learning opportunities as a result of the COVID-19 pandemic. The purpose of this study is to create an extended reality (XR) workflow for visualization of dicephalic parapagus full-term conjoined twins obtained by Dr. Jacob Henle sometime between 1844-1852 for use in anatomy education. The workflow comprised image capture, segmentation, and visualization. The cadaver twins were curated at the University of Heidelberg and were subjected to CT and MR imaging. Relevant bones and soft tissues were manually segmented to create XR models, post-processed for visualization using Unity-based systems. A learning module was created and posted to Rad3d.com for presentation to students including visualization on Z-space computers (zspace.com) and sketchfab.com online. Osteology analysis showed commonality in the upper limb and shared ribs. Two vertebral columns were identified, and a single pelvic girdle was present with a single set of lower limbs. Duplicated supradiaphragmatic structures included two hearts (one with situs inversus) and four lungs, but single subdiaphragmatic visceral organs were observed. In particular, the gut was continuous on the right, but terminated at the distal esophagus on the left. One large liver occupied the abdomen with one large spleen located on the left. These observations suggest zygote fission was blocked near the yolk sac during midgut formation, but with secondary fusion of midline upper extremities and ribs. A radiology report was developed and presented to medical students as an embryology clinical correlation. This application indicates that university based museum specimens are useful as supplemental instructional subjects and, in this case, almost 170 years after arriving in the Department of Anatomy at the University of Heidelberg.