Development of an Experimental
Paradigm
In Which to Examine Human Learning
Using Two Computer-Based Formats
Ariel Haas and Helene M. Hoffman
University of California at San Diego (UCSD), School of Medicine
Office of Educational Computing
INTRODUCTION
Human anatomy is extremely challenging to teach and learn. Traditionally,
anatomy is taught through a combination of textbooks, lectures, and
laboratory dissections. While still considered the "gold standard" against
which alternatives are judged, the above practices in anatomy education do
not fully support students’ need to develop the necessary conceptual
understanding of spatial-anatomic relationships and to apply anatomic
knowledge to clinical problem-solving scenarios. Pedagogical challenges
are further complicated by reduced hours available to anatomy education
and a growing need to find alternatives for cadaver and animal specimens.
Computer-based instructional programs are frequently promoted as a
means to augment or replace the traditional anatomy curriculum. The most
commonly used are multimedia programs range from static slide shows to
interactive dissection manuals.
Virtual reality (VR)-based environments, increasingly advocated as a
means to practice surgical and procedural skills, have not yet gained
widespread acceptance with anatomy educators. This reluctance to
embrace the newer simulation-based applications may be due to:
•Reservations about embracing new technology without scientific proof
that it improves learning and retention
•Fear that students will avoid traditional classroom and didactic teaching
methods in favor of computer-based learning
•Costs
Each of these valid concerns must be addressed before technology-based
resources are considered for today’s educational context.
AIMS
The UCSD School of Medicine is embarking on a series of studies to compare
the efficacy and efficiency of new and conventional computer-based learning
formats. The initial study, which will commence shortly at UCSD, will compare
knowledge acquisition and problem solving among medical students who are
learning an anatomy lesson using one of two different computer-based
instructional modalities: Multimedia, a 2-dimensional (2D) learning environment
with pre-selected idealized views of anatomic structures or VR, a 3-dimensional
(3D) learning module with student-selected visualization options. Each modality
will provide equivalent lesson content, but will differ in their level of interactivity.
This poster describes the content and process of lesson building and the overall
experimental strategy that will be employed in subsequent studies.
METHODS
Learning Module Design:
o A self-instructional lesson on lung anatomy, consistent with an
introductory medical school anatomy curriculum
o Able to be completed by students in one hour or less
o Deliverable via both the Multimedia and VR formats
o Using anatomic models derived from NLM’s Visible Human database or
developed at UCSD
o Incorporating digital still and video images to provide clinical context and
introduce anatomic structures from a variety of clinically relevant
viewpoints
o Text used only to stimulate student exploration and promote learning
through self-discovery.
Virtual Reality Lesson:
o Implemented using UCSD’s Anatomic VisualizeR’s Lesson Editor [1].
o Virtual Study Guide used to organize the lesson into primary topics,
deliver short action phrases and questions, and provide selectable links
for feedback and additional information.
o An example of the VR implementation is shown in Figure 1.
Figure 1: The learning module as implemented in Anatomic VisualizeR. These
images represent one scene from the lung module, captured at different times in
the exercise. The image on the left is the initial scene presented to the student
upon entering into the Lung section of the lesson. Students are able to directly
interact with the 3D models, use tools to link/unlink structures, dynamically create
cross-sectional views, change opacity and view interior structures. The image on
the right demonstrates the additional resources (an explanatory text file and
clinical images) requested by the student during the exploratory exercise.
Multimedia Lesson
o Developed using Microsoft PowerPoint
o Index page used to organize lesson topics and provide a cognitive
framework
o Anatomic images found in the multimedia lesson created by screen
captures of 3D models in the virtual environment.
o Supporting 2D imagery (diagrams, clinical photographs, etc.) and the
descriptive text (with only slight modification of the short action phrases)
are identical in both lessons.
o The implementation of the multimedia-based lesson is shown in Figure 2.
Figure 2: The learning module as implemented in Microsoft PowerPoint. These
images are sequential screens from the multimedia version of the lung anatomy
learning module. The image on the left is the first screen of the Lung section and
the image on the right shows the additional resources (explanatory text and
clinical images) in the following screen of this lesson.
Experimental Protocol Overview:
o Subjects: Twenty, first-year medical student volunteers
o Orientation: A one-hour session during which students have hands-on
introduction to the two computer-based formats and complete a
demographic questionnaire.
o Assignments: Students prospectively randomized into two groups: one
assigned the multimedia environment (PowerPoint), the other the VR
environment (Anatomic VisualizeR).
o Study Period: Each group given 60 minutes to complete their lesson.
o Post-Test: Immediately thereafter, students an identical written
examination and complete a short follow-up questionnaire
Evaluation
Assessment of these educational studies will be keyed to several levels of
cognitive performance and standardized sets of learning goals.
•Written examination to test factual knowledge, conceptual understanding of
spatial-anatomic relationships, and the ability to apply newly acquired knowledge
of lung anatomy to clinical problem-solving scenarios.
•Questionnaires to measure the perceived quality of the educational experience
as well as demographic and attitudinal dimensions.
DISCUSSION
Lesson Development: The challenges encountered in development and
implementation of the two computer-based learning modules were both
technical and pedagogic.
•3D materials, particularly creation of high-quality polygonal models of the
thorax.
•2D multimedia resource acquisition, editing, annotation, and cataloging.
•Text presentation intended to be an important catalyst in the learning
process, including the syntax for short action phrases / questions, and the
criteria for their placement within the lesson framework.
•Design of VR lesson that could compel students to actively explore the 3D
models, to ask and answer their own questions, yet contain sufficient
structure to ensure that the underlying learning objectives are realized.
•Creation of an equivalent multimedia lesson that would provide a highquality interface, interaction options, and access to the requisite
instructional elements.
Virtual Reality: The educational experiences afforded by VR are frequently
touted as superior to those of other computer-based learning modalities
and consistent with currently accepted best practices in education2,3.
Virtual environments, such as Anatomic VisualizeR are predicated on the
notion of student exploration, discovery, and active self-learning. Students
are able to disassemble and reconstruct spatial anatomic relationships
while participating actively in the virtual learning environment.
•The cognitive processes evoked in a virtual learning environment are
thought to be similar to those employed when people acquire knowledge
from authentic real-life experiences, and are therefore potentially superior.
•The direct physical links between the learner’s actions and effects within
the simulation (e.g., interacting with 3D models, using tools to link/unlink
structures, dynamically creating cross-sectional views, changing opacity to
view interior structures, etc.) are thought to enable a greater understanding
of complex spatial relationships4.
•This positive view of virtual learning and 3D visualization is not
universally accepted and one recent account has suggested that students
remember objects as limited 2D views, making 3D representation
extraneous and burdensome5.
Clearly, further investigation into the efficiency and effectiveness of
learning anatomy with computer-based formats is required. Only by
systematically comparing the efficacy of VR and multimedia formats, will
we hope to elucidate the appropriate roles for virtual and conventional
representations in anatomy education. The results of the pilot study
described here will be used to refine and improve the design of the
remainder of studies planned in this experimental series.
References
[1]
Hoffman H., Murray M., Anatomic VisualizeR: Realizing the Vision of a VRbased learning Environment. Studies in Health Technology and Informatics, 62:134-40,
1999.
[2]
Lake D. A., Active Learning: Student Performance And Perceptions Compared
With Lecture. Selected papers from the 11th International Conference on College
Teaching and Learning, Jacksonville, FL., 119-124, 2000.
[3]
Hetzroni O.E., Effects of Active versus Passive Computer Instruction on the
Learning of Element and Compound Blissymbols. Augmentative & Alternative
Communication. June 16 (2): 95-106, 2000.
[4]
Salzman M.C., Dede C., Bowen Loftin R., Chen J., A Model for Understanding
how Virtual Reality Aids Complex Conceptual Learning. Presence 8(3): 293-316, 1999.
[5]
Garg A., Norman G.R., Spero L., Maheshwari P., Do Virtual Computer Models
Hinder Anatomy Learning? Academic Medicine 74:S87-S89, 1999.