Valerie Dean O'Loughlin

Comparative endocranial vascular changes due to craniosynostosis and artificial cranial deformation

The processes of craniosynostosis (premature fusion of one or more of the calvarial sutures) and artificial cranial deformation are similar since both can alter the shape of the craniofacial complex. Most research exploring these processes has focused on the ectocranium, although it is obvious that these processes also modify the endocranium. Endocranial changes due to either craniosynostosis or artificial cranial deformation have not been as thoroughly examined. Silicone rubber endocasts were made from 11 craniosynostotic archaeologically derived specimens from North and South America. For comparative purposes, endocasts were made from 22 normal and 17 occipitally deformed crania that were archaeologically derived from North and South America. With all samples, middle meningeal vessel patterns and venous sinus impressions were qualitatively and quantitatively analyzed. Depth, width, and convolution of the middle meningeal vessels were recorded, and the direction of vessel branches was noted. Both artificial cranial deformation and craniosynostosis altered the endocranial vasculature. Middle meningeal vessel and venous sinus impressions of the craniosynostotic group differed when compared to both the undeformed and artificially cranially deformed samples. Sinuses traversing under synostosed sutures became wider and deeper. In contrast, sinuses directly underneath the greatest artificial deformational stress were shallower, while there was compensatory enlargement of sinuses further away from the greatest deformational effects. Such compensatory enlargement also was shown by the high incidence of enlarged occipital/marginal sinuses in artificially deformed skulls. Increased intracranial pressure is hypothesized to be the cause of the venous sinus changes found in craniosynostotic individuals. Middle meningeal vessel patterns from craniosynostotic and artificially deformed specimens were similar in that their direction paralleled the direction of altered cranial growth. These findings demonstrate that the endocranial vasculature is developmentally plastic and responds to deformation in a predictable pattern.

Optical versus Virtual: Teaching Assistant Perceptions of the Use of Virtual Microscopy in an Undergraduate Human Anatomy Course

Many studies that evaluate the introduction of technology in the classroom focus on student performance and student evaluations. This study focuses on instructor evaluation of the introduction of virtual microscopy into an undergraduate anatomy class. Semi‐structured interviews were conducted with graduate teaching assistants (TA) and analyzed through qualitative methods. This analysis showed that the teaching assistants found the virtual microscope to be an advantageous change in the classroom. They cite the ease of use of the virtual microscope, access to histology outside of designated laboratory time, and increasing student collaboration in class as the primary advantages. The teaching assistants also discuss principal areas where the use of the virtual microscope can be improved from a pedagogical standpoint, including requiring students to spend more time working on histology in class. Anat Sci Educ.

The Blooming Anatomy Tool (BAT): A discipline-specific rubric for utilizing Bloom's taxonomy in the design and evaluation of assessments in the anatomical sciences

Blooms taxonomy is a resource commonly used to assess the cognitive level associated with course assignments and examination questions. Although widely utilized in educational research, Blooms taxonomy has received limited attention as an analytical tool in the anatomical sciences. Building on previous research, the Blooming Anatomy Tool (BAT) was developed. This rubric provides discipline‐specific guidelines to Blooming anatomy multiple‐choice questions (MCQs). To test the efficacy of the BAT, a group of volunteers were randomly split up and asked to Bloom a series of anatomy MCQs using either the BAT or a traditional Blooms reference called Blooms Learning Objectives (BLO). Both groups utilized each rubric for a different series of MCQs. Examination question categorizations made using each rubric were tested for accuracy and interrater reliability. In addition, previous experience in anatomy and Blooms taxonomy were considered. Results demonstrated that volunteers using the BAT had consistently higher levels of interrater reliability, but accuracy varied and was similar between rubrics. Neither measure was substantially impacted by experience in Blooms taxonomy or anatomy. A poststudy survey indicated that volunteers strongly preferred the BAT and felt it was more helpful in categorizing anatomy MCQs than the BLO. These results suggest that the BAT can be useful in educational research in the anatomical sciences to aid in aligning observer judgment on Bloom taxonomic levels and improve consistency, especially when used in conjunction with a norming session prior to data collection. Anat Sci Educ 8: 493–501.

The virtual anatomy laboratory: usability testing to improve an online learning resource for anatomy education.

An increasing number of instructors are seeking to provide students with online anatomy resources. Many researchers have attempted to identify associations between resource use and student learning but few studies discuss the importance of usability testing in resource design and modification. Usability testing provides information about ease of use and resource flexibility and indicates navigational issues that contribute to extraneous cognitive load for the user. An example of usability testing for modification of an online anatomy resource called the “Virtual Lab” is presented. Usability testing was used to determine whether increased content would impair navigation through the interface. Subjects with varying levels of experience with anatomy content were recruited to assess efficiency and effectiveness (defined by usability standards) of the original resource and of the redesigned resource. Comparisons between usability evaluation of the original “Virtual Lab” (OVL) and of the redesigned “Virtual Lab” (RVL) revealed that subjects were better able to successfully complete tasks using the RVL than they were with the OVL. Results also demonstrated that subjects did not take significantly more time to successfully complete tasks with the RVL. Additionally, usability testing revealed that subjects were able to successfully complete tasks using the RVL regardless of whether they possessed prior experience with anatomy content or not. Results of this study suggest that the modified resource is more effective for users. The example presented here underscores the need for usability testing prior to resource implementation and whenever significant changes are made to a resource interface. Anat Sci Educ.

A comparison of student performance on discipline-specific versus integrated exams in a medical school course

Curricular reform is a widespread trend among medical schools. Assessing the impact that pedagogical changes have on students is a vital step in review process. This study examined how a shift from discipline-focused instruction and assessment to integrated instruction and assessment affected student performance in a second-year medical school pathology course. We investigated this by comparing pathology exam scores between students exposed to traditional discipline-specific instruction and exams (DSE) versus integrated instruction and exams (IE). Exam content was controlled, and individual questions were evaluated using a modified version of Blooms taxonomy. Additionally, we compared United States Medical Licensing Examination (USMLE) step 1 scores between DSE and IE groups. Our findings indicate that DSE students performed better than IE students on complete pathology exams. However, when exam content was controlled, exam scores were equivalent between groups. We also discovered that the integrated exams were composed of a significantly greater proportion of questions classified on the higher levels of Blooms taxonomy and that IE students performed better on these questions overall. USMLE step 1 exam scores were similar between groups. The finding of a significant difference in content complexity between discipline-specific and integrated exams adds to recent literature indicating that there are a number of potential biases related to curricular comparison studies that must be considered. Future investigation involving larger sample sizes and multiple disciplines should be performed to explore this matter further.

Endocranial vascular patterns in a familial rabbit model of coronal suture synostosis

OBJECTIVE The present study investigates the potential relationship between craniosynostosis and any changes in endocranial vasculature. The hypothesis that crania from rabbits with familial, nonsyndromic coronal suture synostosis and crania from rabbits with experimental immobilization of the coronal suture are associated with altered form of the middle meningeal vessels and dural venous sinuses is tested. DESIGN Silicone rubber endocasts from 14 adult New Zealand white rabbits (Oryctolagus cuniculus) with familial nonsyndromic coronal suture synostosis (five with bilateral coronal suture synostosis and nine with unilateral coronal suture synostosis) were made to assess middle meningeal vessel and dural venous sinus form. For comparative purposes, endocasts were made from 25 rabbits with normal, patent coronal sutures and 10 rabbits with experimental immobilization of the coronal suture. Impressions of the dural venous sinuses were assessed for depth and width. The area of the confluens of sinuses was also assessed. Impressions of the middle meningeal vessels were assessed for depth, width, and degree of convolution. For width of the dural venous sinuses and area of the confluens of sinuses, comparisons among groups were made with a one-way analysis of variance (ANOVA). For depth of the dural venous sinuses and impressions of the middle meningeal vessels, comparisons among groups were made using a Kruskal-Wallis one-way ANOVA. RESULTS Crania with familial coronal suture synostosis had significantly (p <.05) reduced posterior dural venous sinus dimensions when compared with both crania from rabbits with experimental immobilization of the coronal suture and rabbits with normal coronal sutures. Crania with both coronal suture synostosis and experimental immobilization had significant increases in dimensions of the middle meningeal vessels relative to normal crania. In addition, casts from rabbits with unicoronal suture synostosis showed marked asymmetry in the dural venous sinuses. CONCLUSIONS These results support the hypothesis that craniosynostosis is associated with alterations in endocranial vasculature. These changes are most likely a secondary response to synostosis rather than a causal factor and may reflect increased intracranial pressure, decreased intracranial volume, and local accumulations and reductions of cerebrospinal fluid in the posterior region of the skull and immediately deep to the coronal suture.

Another nail in the coffin for learning styles? Disparities among undergraduate anatomy students’ study strategies, class performance, and reported VARK learning styles

The concept and existence of learning styles has been fraught with controversy, and recent studies have thrown their existence into doubt. Yet, many students still hold to the conventional wisdom that learning styles are legitimate, and may adapt their outside of class study strategies to match these learning styles. Thus, this study aims to assess if undergraduate anatomy students are more likely to utilize study strategies that align with their hypothetical learning styles (using the VARK analysis from Fleming and Mills, , Improve Acad. 11:137–155) and, if so, does this alignment correlate with their outcome in an anatomy course. Relatedly, this study examines whether students’ VARK learning styles are correlated with course outcomes regardless of the students’ study strategies, and whether any study strategies are correlated with course outcomes, regardless of student‐specific VARK results. A total of 426 anatomy students from the 2015 and 2016 Fall semesters completed a study strategies survey and an online VARK questionnaire. Results demonstrated that most students did not report study strategies that correlated with their VARK assessment, and that student performance in anatomy was not correlated with their score in any VARK categories. Rather, some specific study strategies (irrespective of VARK results), such as use of the virtual microscope, were found to be positively correlated with final class grade. However, the alignment of these study strategies with VARK results had no correlation with anatomy course outcomes. Thus, this research provides further evidence that the conventional wisdom about learning styles should be rejected by educators and students alike. Anat Sci Educ.

Virtual microscopy is a superior and reputable pedagogical tool for histology learning: response to Xu.

To the Editors, Anatomical Sciences Education My co-authors and I have read Dr. Xu’s letter to the editor (Xu, 2013) published in Anatomical Sciences Education about his concerns regarding virtual microscopy and address them below. Xu (2013) makes the assumption that with virtual microscopy, only perfect slides will be selected for observation, and this removes the opportunity to visualize variation and abnormality. This assumption is unfounded and not supported by the literature. We and others have scanned our entire optical microscope slide collections, so students visualize the same slides (imperfections and all) as they would with the optical microscope (Braun and Kearns, 2008; Husmann et al., 2009, Collier et al., 2012). Virtual microscopy has allowed others to expand their collections so they may access thousands of slides through collaborative networks or through commercial programs (e.g., Triola and Holloway, 2011; Nelson et al., 2012). Thus, rather than limiting the number of histology samples, virtual microscopy may actually increase the number of slides any one student may observe and so improve their understanding of the subject matter. Many studies have shown that virtual microscopy provides better opportunity for collaborative and team-based learning than optical microscopy. Improved collaboration among students using the virtual microscope has been documented by many (Braun and Kearns, 2008; Husmann et al., 2009, Paulsen et al., 2010; Triola and Holloway, 2011). In fact, we (Collier et al., 2012) noted that optical microscopy may inhibit collaborative learning (because only one student at a time may observe a structure through the microscope), whereas virtual microscopy allows multiple students and instructors to observe the same specific structures simultaneously. In addition, this collaborative learning may take place outside the classroom, as a student can access these digital slides anywhere s/he has an internet connection (Braun and Kearns, 2008; Husmann et al., 2009; Paulsen et al., 2010). These pedagogical advantages may account for the increase in the use of virtual microscopy in medical classrooms. Drake et al. (2009) noted that over 44% of US medical school survey respondents solely use virtual microscopy in their histology curricula, up from 14% in a similar 2002 survey (Drake et al., 2002). Contrary to popular belief, virtual microscopy does not mean greater improper use of computers in the classroom. That was an original concern of ours, but our research with both undergraduate anatomy students (Husmann et al., 2009) and graduate teaching assistants (Collier et al., 2012) demonstrated that students stayed on task and did not use the computer for non-classroom related work. In fact, the computer allowed students to take screen captures of histology slides and label the images on their own in PowerPoint or Photoshop, tasks that they would not have been able to do with the optical microscope. Xu (2013) was concerned that the use of virtual microscopy would represent a conflict between training and practice. However, virtual microscopy is increasingly being used in pathology clinical practice. Telepathology (the ability for different pathologists to examine the same glass slide over a distance) was first used in the 1980s, but its use has expanded to virtual slide analysis over the internet (Evans et al., 2009). Virtual slide telepathology allows for more rapid, accurate diagnosis, and collaboration among clinicians, and is becoming a popular method for pathologists in North America (Evans et al., 2009; Lopez et al., 2009). In fact, some residency programs are now assessing their surgical pathology residents using virtual microscopy (Bruch et al., 2009). As virtual microscopy is becoming more prominent in residency training and clinical practice, it is essential that we train our students using this innovative pedagogical tool. Virtual microscopy has proven to be an excellent learning tool in both undergraduate and medical education and has been shown to be superior to optical microscopy in many respects. We agree with Pratt (2009) and Xu (2013) that optical microscopy should not be abandoned, and we have stated before (Collier et al., 2012) that students should be given an opportunity to use the optical microscope, if possible. However, there is abundant evidence that virtual microscopy is an excellent learning tool in both undergraduate and medical education and we applaud its increased use in these curricula (Drake et al., 2002, 2009).

How do we train our future faculty to teach? A multidisciplinary comparison of graduate-level pedagogy courses offered at a large Midwestern university

ABSTRACT This study examines and documents graduate pedagogy courses offered at a large Midwestern research university. Thirty-three graduate pedagogy course instructors from 32 departments (a majority of those offering courses) completed an online survey. We report on enrollment demographics, preparation of faculty to teach such a course, and how a statement of teaching philosophy is presented to the class. This research connects the analyses of individual pedagogy courses with the few national studies on teacher training, outlines assumptions about an emerging field, and lays groundwork for a comprehensive study of the landscape and outcomes of graduate pedagogy courses nationwide.

Does team-based learning (TBL) format and administration influence second year medical students' attitudes toward this teaching modality?

Previous studies have examined team-based learning (TBL) efficacy in medical curricula, yet little research has been done to compare differences in TBL modalities (implementation and design). This study examines student perceptions of differing TBL modalities in two second-year medical courses (pathology and introduction to medicine) at Indiana University School of Medicine, Bloomington (IUSM-Bloomington). The medicine TBLs were traditional, standardized TBLs that use assigned groups and graded individual readiness assurance tests (IRATs) and group readiness assurance tests (GRATs), while the pathology TBLs were non-traditional in their use of self-selected groups and lack of graded IRATs and GRATs. At the end of the academic year, students were invited to complete an anonymous survey comparing and contrasting the two specific TBL designs. The survey contained both quantifiable Likert-scale questions and open-ended (qualitative) questions allowing students to provide feedback. Written comments were examined for common themes. Participants showed no preference for a specific TBL modality but did indicate preferences for particular aspects of each modality. Specifically, students preferred to be assigned to TBL groups, to have a non-graded IRAT/GRAT component, and they found TBLs the most effective when used as a review of material as opposed to a first exposure experience.