Staffan Wirell

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.

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.

Visual grading of 2D and 3D functional MRI compared with image-based descriptive measures

ObjectiveA prerequisite for successful clinical use of functional magnetic resonance imaging (fMRI) is the selection of an appropriate imaging sequence. The aim of this study was to compare 2D and 3D fMRI sequences using different image quality assessment methods. MethodsDescriptive image measures, such as activation volume and temporal signal-to-noise ratio (TSNR), were compared with results from visual grading characteristics (VGC) analysis of the fMRI results.ResultsSignificant differences in activation volume and TSNR were not directly reflected by differences in VGC scores. The results suggest that better performance on descriptive image measures is not always an indicator of improved diagnostic quality of the fMRI results.ConclusionIn addition to descriptive image measures, it is important to include measures of diagnostic quality when comparing different fMRI data acquisition methods.

Visual assessment of biliary excretion of Gd-EOB-DTPA in patients with suspected diffuse liver disease – A biopsy-verified prospective study

Highlights • MR using hepatocyte specific contrast may potentially assess liver function.• Covariance between contrast uptake and histo-pathological scoring of liver fibrosis.• No relationship between visually assessed biliary contrast excretion and fibrosis scoring.• No relationship between visually assessed biliary excretion and contrast uptake parameters.