Embryorigami: The Educational Impact of 4D Virtual Folding Embryo Model on Student Learning and Confidence

Abstract

In human development, normal formation of the body cavity involves intricate interplay of tissues folding from a flat disc form into a complex tube-within-tube 3D structure over a short period of time Understanding the normal body cavity formation is imperative to understanding anatomic organizations, variations and congenital conditions Unfortunately, resources that effectively demonstrate changing body cavity anatomy during the folding process are sparse and their educational effectiveness is not well understood Therefore, an interactive digital resource, the ?Virtual Folding Embryo? (VFE), demonstrating the 4-dimensional transformation of the folding embryo (Figure 1) was created and its educational value was assessed in a COMIRB exempt (#20-2125) randomized single blind study As a part of the flipped curriculum, 155 first-year medical students enrolled in an integrated anatomy course first viewed a pre-recorded lecture on embryology of the thorax then completed a quiz to test their foundational knowledge before attending a synchronous online active learning session conducted on the Zoom platform Students were randomized into small breakout groups of 4-5 students and half of the groups were given access to the VFE (Figure 2), while the other half were given access to a resource demonstrating a different embryonic process After 15 minutes, all students completed a quiz and an optional survey A one-way repeated measures ANOVA revealed a significant increase in the post-quiz performance compared to the pre-quiz in both groups (F (1, 306) =21 06, p<0 05, effect size h2 = 0 06, Tukey HSD, p < 0 05) However, there was no significant difference in the improved performance between the experimental and the control groups (F (1,150) = 0 46, p=0 50) Descriptive statistics on the qualitative survey analysis indicate that students positively perceived the VFE for visually elucidating the transformation of the body cavity (n=74 mean Likert score = 4 on 5 point agreement scale;sd=0 81) and its spatial relationship to organ systems (mean=3 83;sd=0 93) Despite the favorable perception of VFE and improved quiz performance, students rated their level of confidence in the material low (mean=2 18, sd=0 37) Thematic analysis of survey comments reinforced positive perception of the VFE and indicated desire for more time for VFE interaction These results do not conclusively demonstrate direct correlation between the VFE and learning outcomes However, qualitative results warrant further development and investigation of the VFE under different educational circumstances to determine efficacy Virtual 4D resource such as VFE, designed for active learning may hold potential to enrich student engagement in the post COVID-19 era, and serve as a model for creating similar resources in the future