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
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.