Abstract
ABSTRACT Objective to evaluate the effectiveness of the 3D virtual anatomical table as a complementary resource to the learning of the hepatobiliary anatomy by undergraduate medical students. Method A randomized controlled study comparing the anatomical learning of hepatobiliary structures, supported by a real model versus a virtual model, both three-dimensional (3D), by undergraduate medical students. The students’ perception of the resources used to teach anatomy was also evaluated. The students were submitted to a pre-test and to two evaluations after the interventions were applied. Results Overall, both the 3D virtual anatomical table and the real liver increased students’ knowledge of the hepatobiliary anatomy in relation to their previous knowledge (p = 0.001 and p = 0.01, respectively for second and third evaluations). In the longitudinal comparison between the pre-test and the second evaluation (hepatobiliary anatomy and Couinaud’s segmentation), this increase was significantly higher in the group allocated to the real liver (p = 0.002); in the comparison of the pre-test with the third evaluation (inclusion of adjacent organs in the anatomical table or in the real liver), the increase in knowledge was significantly higher in the group allocated to the anatomical table (p = 0.04). The perception of participants’ satisfaction regarding the learning resources was considered very good, with a minimum percentage of satisfaction of 80%. Conclusion the 3D virtual anatomical table provided more hepatobiliary anatomy knowledge than a real liver for undergraduate medical students, in comparison to their previous knowledge about these structures. In the cross-sectional comparison of the post-instruction evaluations, there was no difference between the two interventions. Moreover, the 3D platform had a positive impact on the level of satisfaction of study participants. This study shows that the 3D virtual anatomical table has the potential to improve both medical students’ understanding and interest in anatomy. It is recommended, however, that future protocols such as this be carried out with larger samples and exploring other anatomical structures.
Highlights
Medicine has domains that require complex learning.[1]
This study was approved by the Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio) Internal Ethics Committee (n. 2015-55) and by the UNIFESO Research Ethics Committee (REC) (CAAE: 54519415.0.0000.5247)
The research protocol was fully applied at the Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), in the city of Rio de Janeiro (RJ), which owns the 3D anatomical table
Summary
Medicine has domains that require complex learning.[1] The complexity of learning involves the understanding of intricate physiological systems, which can subsidize the development of adaptive expertise and the acquisition of technical skills necessary for good clinical practice, such as performing a physical examination, interpreting imaging examinations, and performing clinical and / or surgical reasoning.[1,2] Anatomy is at the core of some of these domains of knowledge and processes of clinical-surgical rationality, and this should not be discussed.[3] Over the past 400 years, anatomy has been one of the world’s leading health learning tools, traditionally taught through conventional lectures, textbooks, picture atlases, and cadaveric dissections.[4,5] Despite this scope, even nowadays, there are important educational problems related to the teaching of anatomy:4,5 1) Restriction of the acquisition of corpses by educational institutions, mainly because of budgetary, ethical, cultural, and social reasons, or even due to their unavailability;4,5 2) Significant shortage of qualified professionals for the dissection method; 3) Risk of acquiring serious diseases due to the use of chemicals (e.g., formaldehyde); 4) Great logistical and financial burden regarding the storage conditions of corpses;[6] and 5) The profound curriculum reformulation that many medical schools around the world have experienced, essentially characterized by the introduction of active learning methodologies.[2]. These measures have resulted in the proposal of a series of complementary innovative approaches to the teaching of anatomy, including: computational software; problem situations that simulate real clinical cases; simulator models; plastic models; and three-dimensional (3D) models.[7]
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