Investigating Medical Student’s Technology Habits

May 5, 2010

My previous postings involved uses of technology in medical school curriculums. For this blog I am investigating if medical students are prepared for the technology infusion programs and how receptive students are to online learning management systems.

Many medical schools are in the process of constructing technological add-ons to support of content delivery. Technology has advanced so much that clinical simulations programs have evolved to the point where the software can provide instant feedback to students and instructors. The customized formats of on-line learning systems can be personalize by the instructor and developed into an individualized lesson plans for the students. This interactivity of on-line content delivery has created a paradigm shift in the relationship between students and teachers. Using technology and simulation resources in medical schools is preparing students to use the interactive, individualized and informative environment as a way to prepare for post-graduate activities, like treating patients or even adapting to the proposed changes in healthcare reform.

So, were the students ready for the technology infusion? Emory School of Medicine in Atlanta, Georgia created an Information Technology committee to investigate the medical school program of study during the 2004-05 scholastic year. The group’s recommendation was made to reform the program to include technology and simulation activities into the 2007-08 academic year. The committee members included a wide spectrum of individuals such:

Clinical and basic science faculty, librarians, IT staff, students,
University Administrators from the medical and nursing schools,
And affiliated hospitals.[1]

The committees where further divided into 6 general committees:

1. Learning spaces and technology infrastructures
2. Clinical enterprise
3. Office of Medical Education needs and perceptive
4. Student needs and perspective
5. Simulation
6. Library
7. Bioinformatics

Collectively the committee created a survey to examine demographics, existing technology intelligence, and attitude towards technology and simulation. The survey was sent to 440 medical students, out of which 214 questionnaires were returned, thus creating a response rate of 49%. The mean age was 25.7 years and was compromised of 54% male and 46% female. The class breakdown was 34% freshman, 31% sophomore, 18% juniors and 17% seniors who contributed to the survey.

Although the medical school did not require laptop equipment as a student aid, over 75% of the students owned them. Charted below is the breakdown of the weekly computer usage of the medical students.

Furthermore, the survey revealed little use of simulation technology employed in medical school courses during the 2004-05 academic school year.

Further committee discussion identified a few emerging trends to be included in medical school training.

1. Student’s dependence on technology and group learning
2. Lack of student confidence in medical informatics
3. Demand for simulation clinical technologies
4. Technology application for academic and personal use
5. Portable technology devices for wireless connectivity
6. The need to develop flexible platforms for emerging technologies

A series of questions in the survey inquired about the students opinions on how technology and simulation programs could facilitate learn processes with the medical school courses. More than 50% of the students believed technology would helped them with a ‘greater ability to recall information learned’, over 70% assumed technology would ‘builds confidence and knowledge in areas where students are less confident’, over 80% alleged technology ‘allows students to practice fundamental skills and receive feedback before entering the clinical environment’ and over 85% of the strongly thought technology infusion with medical school programs would ‘identifies strengths and weakness’ of the student.

Inclusion, medical students anticipate the use of technology to be included within their program of study. Incoming students are tech savvy; coming to school with technology skills learned through years of computerized social interaction. Medical schools around the country should be prepared to instruct and simulate the incoming classes through technology involvement built into the curriculum.

[1]

Assessment of student learning behaviors to guide the integration of technology in curriculum reform, Information Services, IOS Press, DOI 10.3233/ISU-2009-0591

3D visualization for medical education

5/1/2010

Linköping University in Sweden realized healthcare students were having problems with understanding the connection between physical anatomy and physiological processes. The University faculty members worked together with the Information Technology department to form a team to look at various learning tools to augment the health care curriculum. The objective of the educational development team was to enhance traditional methods of instruction, such as lectures, dissections, and textbooks with dynamic interactive visual content format. The decision to use 3D visualization as a delivery method to improve student understanding of complex materials was supported by the interactive components of the software.

Traditionally, meaning before the infusion of technology in the education, medical students learned about anatomy and physiology processes from static text book images or via dissecting corpses. The ability to study a live human body during tests was limited by the 2D inert images which in fact could hide structures or functions due to the flat format. Linköping University proposed to increase student learning by incorporating 3D visualizations into the medical and physiotherapy programs. Listed below are the goals of the educational development team:


(1) To develop different presentations formats of high quality 3D visualizations for educational use and integrate the technology in various learning situations in regular healthcare curriculum.

(2) To enhance the knowledge about students’ views and attitudes concerning the educational value of 3D visualizations in learning anatomy and physiology.[1]

The development team studied methods of incorporating CAT (Computer assisted tomography) and MRI (Magnetic resonance imaging) scans with ultrasound images. Recent strides in technology using computer graphics with diagnostic images created a 3D visualization solution called volume rendering. The technology was transformed into QuickTime VR (QTVR) format, thus enabling the user to mouse over and turn the image to gain an understanding of the spatial anatomic relationship of physiological processes. Click on the links below to see the examples of the technology:

http://pubimage.hcuge.ch:8080/ and http://cmiv.liu.se/

Two pilot studies were carried out at Linköping University during the years 2005 and 2006, using second and third year students studying the cardiovascular system. The study provided the following:

1. Education on how to interpreted visualizations
2. Opportunities to apply newly gained knowledge
3. Stimulate the students’ curiosity and interest to learn
4. Clinical evaluation of normal, normal variation and pathological structures of the heart and disease progression
5. Demonstration of virtual reality theatre
6. Demonstration of self-study modules

The self-study modules were designed to give the students the ability to view the visualizations by using interactivity methods to gain a deeper understanding of the complexities of the heart.

The results of the studies confirmed the aim of the 3D visualization project. The students noticed increase ease in reading images and found the presentation stimulating. Many of the students experienced an ‘aha’ moment when viewing the stimulations - which reinforced functional anatomy concepts. The students also found the visualizations aided in understanding anatomy more so than physiology and made the students realize supplemental resources were needed to expand the learning know-how.

Student follow-up questionnaires on 3D visualizations revealed the following:

1. Great product but lack of time prevented usage
2. Positive reaction to the ability to rotate images for different views
3. Unlimited access to visualizations materials
4. Self-pace capabilities
5. New appreciation for the spatial proximity of bones and organs
6. Repetitive viewing increased content understandingSome students indicated
requiring help with interpreting images and asked for tutors or written explanations

In conclusion, the use of 3D visualizations in conjunction with traditional teaching modalities provides medical students with the ability to interact electronically with course concepts.

See example of 3D visualization application using Osirix software on an iPhone.


[1] Web Paper Advance 3D visualizations in student-centered medical education, Charlotte Silén, Staffan Wirell, Joanna Kvist, Eva Nylander and Örjan Smebdy, Medical Teacher, 2008, 30: e115-e124.