Charlotte Silén

Advanced 3D visualization in student-centred medical education

Background: Healthcare students have difficulties achieving a conceptual understanding of 3D anatomy and misconceptions about physiological phenomena are persistent and hard to address. 3D visualization has improved the possibilities of facilitating understanding of complex phenomena. A project was carried out in which high quality 3D visualizations using high-resolution CT and MR images from clinical research were developed for educational use. Instead of standard stacks of slices (original or multiplanar reformatted) volume-rendering images in the quicktime VR format that enables students to interact intuitively were included. Based on learning theories underpinning problem based learning, 3D visualizations were implemented in the existing curricula of the medical and physiotherapy programs. The images/films were used in lectures, demonstrations and tutorial sessions. Self-study material was also developed. Aims: To support learning efficacy by developing and using 3D datasets in regular health care curricula and enhancing the knowledge about possible educational value of 3D visualizations in learning anatomy and physiology. Method: Questionnaires were used to investigate the medical and physiotherapy students’ opinions about the different formats of visualizations and their learning experiences. Results: The 3D images/films stimulated the students will to understand more and helped them to get insights about biological variations and different organs size, space extent and relation to each other. The virtual dissections gave a clearer picture than ordinary dissections and the possibility to turn structures around was instructive. Conclusions: 3D visualizations based on authentic, viable material point out a new dimension of learning material in anatomy, physiology and probably also pathophysiology. It was successful to implement 3D images in already existing themes in the educational programs. The results show that deeper knowledge is required about students’ interpretation of images/films in relation to learning outcomes. There is also a need for preparations and facilitation principles connected to the use of 3D visualizations.

Lectures in problem-based learning—Why, when and how? An example of interactive lecturing that stimulates meaningful learning

Even though opinions differ as to whether lecturing is compatible with problem-based learning (PBL) or not, lectures are still a common form of instruction in PBL curricula. This paper discusses the lecture in the framework of theories of learning in general and the medical problem-based learning tradition in particular. An example of how theories of learning can be implemented in the lecture hall is presented. Theories that underpin PBL as an educational philosophy rather than as a method of instruction are reviewed. A lecture form, organized in introductory, in depth and application lectures, that responds to important factors for stimulating deep processing of knowledge and meaningful learning is discussed. Examples of and practical points about how to renew and restructure lectures in a way that counteracts surface approaches to learning, teacher centring and student passivity are presented. We argue that, with proper awareness of possible drawbacks of the large format, lectures can be used as valuable tools for learning also in a PBL curriculum.

Student approaches to achieving understanding—approaches to learning revisited

This article presents a phenomenographic study that investigates students’ approaches to achieving understanding. The results are based on interviews, addressing physiological phenomena, with 16 medical students in a problem‐based curriculum. Four approaches—sifting, building, holding and moving—are outlined. The holding and moving approaches describe variations in deep‐level processing. The moving approach is characterised by an intention to continuously refine understanding in an open‐ended process. The student strives for a change in perspective and deliberately creates actions that are rich in variation and challenge. The holding approach is characterised by an intention to reach a final goal. This is achieved by high degrees of structure and control in the learning act. Understanding is sometimes sealed, ‘held on to’ and can be threatened by new input and other students’ viewpoints. The study also shows how students deal with details when constructing understanding of wholes.

Students' experiences of learning manual clinical skills through simulation.

Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students’ experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten third-year undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision™, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in three themes: what the students learn, how the students learn, and the simulator’s contribution to the students’ learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.

Examination involving students as peer examiners

The main interest in this article is students’ involvement in assessment as a part of growth towards self‐directedness in learning. In order to enhance students’ development of autonomy in learning, a project involving ‘older’ students as peer examiners for ‘younger’ students was designed and carried out. Students in the sixth semester in a PBL‐based Master’s program of Medical Biology participated, together with faculty, as examiners of fifth‐semester students. The examination and the assessment situation was carefully designed based on learning theories, empirical evidence and experiences underpinning student‐centred learning, especially in the form of PBL used at the faculty. The project was evaluated and analysed in order to understand students’ learning processes related to the responsibility for assessing peers. The situation of the peer examiners was interpreted based on their own experiences with statements from the students assessed and faculty involved in the assessment. Evaluations from six occasions, spring and fall, 2003–2005, were included in the study. The findings suggest that involving students in assessment as equal partners with faculty makes it is possible for students to apprehend the metacognitive competences needed to be responsible and autonomous in learning. The peer examiners experience motivation to learn about learning, they acquire tacit knowledge about assessment and they learn through being involved and trusted. The student‐centred educational context, which requires responsibility throughout the programme, is recognized as very important.