Cross-cultural classroom: Virtual case-based learning utilizing MRI and extendedreality technology delivered to American and Turkish medical students

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.