Advertisement

Learning Cardiac Embryology—Which Resources Do Students Use, and Why?

  • Jane C. HollandEmail author
  • Teresa Pawlikowska
Original Research

Abstract

With increasing class sizes, small group activities for learning embryology are present in few institutions. How then do students supplement their lectures in order to ask and answer questions, or delve into concepts in detail? Arguably, animations and videos are ideal for visualizing four-dimensional anatomy, but how do students find and filter these? First-year medical students were surveyed with respect to the cardiac embryology component of their course and asked their opinions regarding the clinical relevance of this content and the resources they used to enhance learning. Students indicated that they considered cardiac embryology to be of relevance to clinical practice and that videos are a useful resource in helping them to learn this material. However, when seeking videos or resources, it emerged that students tended to Google information in preference to accessing online resources (or textbooks) specifically recommended by their instructor, despite students’ recognition that “accuracy of information” was paramount when choosing what resource to use. While all students seemed reluctant to contact a staff member with questions, those with less proficiency in English were less likely to approach faculty for assistance. While acknowledging students as adult learners, self-regulated learning skills do not develop automatically and the development of these skills should be viewed as a “shared responsibility” between students and staff. Likewise, students also need to be taught critical appraisal of learning resources, especially in the complex online environment, with design of their bespoke institutional virtual learning environment facilitating easy identification and access of recommended resources.

Keywords

Anatomy and medical education Embryology Cardiac embryology Educational methodology E-learning Teaching of embryology 

Notes

Acknowledgements

The authors are grateful to the staff of RCSIs Quality Enhancement Office, particularly Ms. Joanna Zawadzka & Professor Richard Arnett, for their expertise and assistance with regard to data collection, anonymization and analysis from the Student Feedback Survey. The authors are also grateful to Dr. Fiona Boland, lecturer in Biostatistics and Research Methods in RCSI, for her advice and assistance in reviewing the survey data.

Authors’ Contributions

Dr. Holland had full access to all of the anonymized data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Holland, Pawlikowska. Acquisition of data: Holland Analysis and interpretation of data: Holland, Pawlikowska. Drafting of the manuscript: Holland. Critical revision of the manuscript for important intellectual content: Pawlikowska. Statistical analysis: Holland.

Funding

No funding was received for this study.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval and Informed Consent

RCSI’s Human Research Ethics Committee (reference REC1478) approved this research. Students were invited by e-mail to complete questions in an optional survey and explicitly informed that questions within the survey may be used for research purposes, including research publications. Participation in the survey, and all responses received, was entirely anonymous, and students had the right to “opt-out” of the survey at any stage.

References

  1. 1.
    Carlson BM. Embryology in the medical curriculum. Anat Rec. 2002;269(2):89–98.CrossRefGoogle Scholar
  2. 2.
    Gartner LP. Anatomical sciences in the allopathic medical school curriculum in the United States between 1967–2001. Clin Anat. 2003;16(5):434–9.CrossRefGoogle Scholar
  3. 3.
    Drake RL, McBride JM, Pawlina W. An update on the status of anatomical sciences education in United States medical schools. Anat Sci Educ. 2014;7(4):321–5.CrossRefGoogle Scholar
  4. 4.
    Cassidy KM. Embryology in medical education: a mixed methods study and phenomenology of faculty and first year medical students. 2016, faculty of the university graduate school in partial fulfillment of the requirements for the degree doctor of philosophy in the Department of Anatomy and Cell Biology. Indiana University.Google Scholar
  5. 5.
    Drake RL, Lowrie DJ, Prewitt CM. Survey of gross anatomy, microscopic anatomy, neuroscience, and embryology courses in medical school curricula in the United States. Anat Rec. 2002;269(2):118–22.CrossRefGoogle Scholar
  6. 6.
    Moraes SG, Pereira LAV. A multimedia approach for teaching human embryology: development and evaluation of a methodology. Ann Anat. 2010;192(6):388–395.Google Scholar
  7. 7.
    McBride JM, Drake RL. National survey on anatomical sciences in medical education. Anat Sci Educ. 2018;11(1):7–14.CrossRefGoogle Scholar
  8. 8.
    Yamada S, Uwabe C, Nakatsu-Komatsu T, Minekura Y, Iwakura M, Motoki T, et al. Graphic and movie illustrations of human prenatal development and their application to embryological education based on the human embryo specimens in the Kyoto collection. Dev Dyn. 2006;235(2):468–77.CrossRefGoogle Scholar
  9. 9.
    Upson-Taboas CF, Montoya R, O’Loughlin VD. Impact of cardiovascular embryology animations on short-term learning. Adv Physiol Educ. 2019;43(1):55–65.CrossRefGoogle Scholar
  10. 10.
    Nieder GL, Nagy F. Analysis of medical students' use of web-based resources for a gross anatomy and embryology course. Clin Anat. 2002;15(6):409–18.CrossRefGoogle Scholar
  11. 11.
    Marsh KR, Giffin BF, Lowrie DJ. Medical student retention of embryonic development: impact of the dimensions added by multimedia tutorials. Anat Sci Educ. 2008;1(6):252–7.CrossRefGoogle Scholar
  12. 12.
    Evans DJR. Using embryology screencasts: a useful addition to the student learning experience? Anat Sci Educ. 2011;4(2):57–63.CrossRefGoogle Scholar
  13. 13.
    Zaletel I, Marić G, Gazibara T, Rakočević J, Borović ML, Puškaš N, et al. Relevance and attitudes toward histology and embryology course through the eyes of freshmen and senior medical students: Experience from Serbia. Ann Anat. 2016;208(Supplement C):217–221.Google Scholar
  14. 14.
    Shirky C. Web 2.0 expo NY: It’s not information overload, it’s filter failure. 2008, video. September.Google Scholar
  15. 15.
    Drake RL, McBride JM, Lachman N, Pawlina W. Medical education in the anatomical sciences: the winds of change continue to blow. Anat Sci Educ. 2009;2:253–9.CrossRefGoogle Scholar
  16. 16.
    Heylings DJA. Anatomy 1999–2000: the curriculum, who teaches it and how? Med Educ. 2002;36(8):702–10.CrossRefGoogle Scholar
  17. 17.
    Gidding SS, Anisman P. What pediatric residents should learn (or what pediatricians should know) about congenital heart disease. Pediatr Cardiol. 2003;24(5):418–23.CrossRefGoogle Scholar
  18. 18.
    Scott KM, Charles AR, Holland AJA. Clinical embryology teaching: is it relevant anymore? ANZ J Surg. 2013;83(10):709–12.Google Scholar
  19. 19.
    Nieder GL, Borges NJ. An eight-year study of online lecture use in a medical gross anatomy and embryology course. Anat Sci Educ. 2012;5(6):311–20.CrossRefGoogle Scholar
  20. 20.
    Prober CG, Khan S. Medical education reimagined: a call to action. Acad Med. 2013;88(10):1407–10.CrossRefGoogle Scholar
  21. 21.
    Beale EG, Tarwater PM, Lee VH. A retrospective look at replacing face-to-face embryology instruction with online lectures in a human anatomy course. Anat Sci Educ. 2014;7(3):234–41.CrossRefGoogle Scholar
  22. 22.
    Boghossian P. Behaviorism, Constructivism, and Socratic pedagogy. Educ Philos Theory. 2006;38(6):713–22.Google Scholar
  23. 23.
    Massingham P, Herrington T. Does attendance matter? An examination of student attitudes, participation, performance and attendance. J Univ Teach Learn Pract. 2006;3(2):3.Google Scholar
  24. 24.
    Twenge JM. Generational changes and their impact in the classroom: teaching generation me. Med Educ. 2009;43(5):398–405.CrossRefGoogle Scholar
  25. 25.
    Flynn L, Jalali A, Moreau KA. Learning theory and its application to the use of social media in medical education. Postgrad Med J. 2015;91:556–60.CrossRefGoogle Scholar
  26. 26.
    Henderson M, Selwyn N, Aston R. What works and why? Student perceptions of ‘useful’ digital technology in university teaching and learning. Stud High Educ. 2017;42:1567–79.CrossRefGoogle Scholar
  27. 27.
    O’Carroll AM, Westby EP, Dooley J, Gordon KE. Information-seeking behaviors of medical students: A cross-sectional web-based survey. JMIR Med Educ. 2015;1(1):e4.Google Scholar
  28. 28.
    Mayer RE, Moreno R. Animation as an aid to multimedia learning. Educ Psychol Review. 2002;14(1):87–99.CrossRefGoogle Scholar
  29. 29.
    Mayer RE, Moreno R. Nine ways to reduce cognitive load in multimedia learning. Educ Psychol. 2003;38(1):43–52.CrossRefGoogle Scholar
  30. 30.
    Ruiz JG, Cook DA, Levinson AJ. Computer animations in medical education: a critical literature review. Med Educ. 2009;43(9):838–46.CrossRefGoogle Scholar
  31. 31.
    Mayer RE. Applying the science of learning to medical education. Med Educ. 2010;44(6):543–9.CrossRefGoogle Scholar
  32. 32.
    Mayer RE. Cognitive theory of multimedia learning, in the Cambridge handbook of multimedia learning, R.E. Mayer, editor. 2014. Cambridge University Press.Google Scholar
  33. 33.
    Dong C, Goh PS. Twelve tips for the effective use of videos in medical education. Med Teach. 2015;37(2):140–5.CrossRefGoogle Scholar
  34. 34.
    Schleich JM, Dillenseger JL, Houyel L, Almange C, Anderson RH. A new dynamic 3D virtual methodology for teaching the mechanics of atrial septation as seen in the human heart. Anat Sci Educ. 2009;2(2):69–77.CrossRefGoogle Scholar
  35. 35.
    Helsper EJ, Eynon R. Digital natives: where is the evidence? BERJ. 2010;36(3):503–20.Google Scholar
  36. 36.
    Holland J, Clarke E, Glynn M. Out of sight, out of mind: do repeating students overlook online course components? Anat Sci Educ. 2016;9(6):555–64.CrossRefGoogle Scholar
  37. 37.
    Gikas J, Grant MM. Mobile computing devices in higher education: student perspectives on learning with cellphones, smartphones & social media. Internet High Educ. 2013;19:18–26.CrossRefGoogle Scholar
  38. 38.
    Cook DA. Web-based learning: pros, cons and controversies. Clin Med. 2007;7(1):37–42.CrossRefGoogle Scholar
  39. 39.
    Mattick K, Crocker G, Bligh J. Medical student attendance at non-compulsory lectures. Adv Health Sci Educ. 2007;12(2):201–10.CrossRefGoogle Scholar
  40. 40.
    Davis DA, Rayburn WF, Smith GA. Continuing professional development for faculty: an elephant in the house of academic medicine or the key to future success? Acad Med. 2017;92(8):1078–81.CrossRefGoogle Scholar
  41. 41.
    Lucieer SM, Jonker L, Visscher C, Rikers RMJP, Themmen APN. Self-regulated learning and academic performance in medical education. Med Teach. 2016;38(6):585–93.CrossRefGoogle Scholar
  42. 42.
    Brydges R, Butler D. A reflective analysis of medical education research on self-regulation in learning and practice. Med Educ. 2012;46(1):71–9.CrossRefGoogle Scholar
  43. 43.
    Zhu Y, Au W, Yates G. University students' self-control and self-regulated learning in a blended course. Internet High Educ. 2016;30:54–62.CrossRefGoogle Scholar
  44. 44.
    Barry DS, Marzouk F, Chulak-Oglu K, Bennett D, Tierney P, O'Keeffe GW. Anatomy education for the YouTube generation. Anat Sci Educ. 2016;9(1):90–6.CrossRefGoogle Scholar
  45. 45.
    Carifio J, Perla RJ. Ten common misunderstandings, misconceptions, persistent myths and urban legends about Likert scales and Likert response formats and their antidotes. J Social Sciences. 2007;3(3):106–16.CrossRefGoogle Scholar
  46. 46.
    Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Health Sci Educ. 2010;15(5):625–32.CrossRefGoogle Scholar
  47. 47.
    Conroy RM. What hypotheses do" nonparametric" two-group tests actually test? Stata J. 2012;12(2):182–90.CrossRefGoogle Scholar
  48. 48.
    Sullivan GM, Artino AR. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013;5(4):541–2.CrossRefGoogle Scholar
  49. 49.
    De Winter JC, Dodou D. Five-point Likert items: t test versus Mann-Whitney-Wilcoxon. Pract Assess Res Eval. 2010;15(11):1–12.Google Scholar
  50. 50.
    Zimmerman BJ. A social cognitive view of self-regulated academic learning. J Educ Psychol. 1989;81(3):329–39.CrossRefGoogle Scholar
  51. 51.
    Pizzimenti MA, Axelson RD. Assessing student engagement and self-regulated learning in a medical gross anatomy course. Anat Sci Educ. 2015;8(2):104–10.CrossRefGoogle Scholar
  52. 52.
    Selvig D, Holaday LW, Purkiss J, Hortsch M. Correlating students' educational background, study habits, and resource usage with learning success in medical histology. Anat Sci Educ. 2015;8(1):1–11.CrossRefGoogle Scholar
  53. 53.
    Holterman MJ, et al. Clinically relevant embryology: new approaches to education. Pediatrics. 1999;104(3):784.Google Scholar
  54. 54.
    Taylor RW. Pros and cons of online learning – a faculty perspective. J Eur Ind Train. 2002;26(1):24–37.CrossRefGoogle Scholar
  55. 55.
    Holland JC, Pawlikowska T. Undergraduate Medical Students' Usage and Perceptions of Anatomical Case‐Based Learning: Comparison of Facilitated Small Group Discussions and eLearning Resources. Anat Sci Educ. 2019;12(3):245–56.Google Scholar
  56. 56.
    Wynter L, Burgess A, Kalman E, Heron JE, Bleasel J. Medical students: what educational resources are they using? BMC Med Educ. 2019;19(1):36.CrossRefGoogle Scholar
  57. 57.
    Somyürek S, Coşkun BK. Digital competence: is it an innate talent of the new generation or an ability that must be developed? BJET. 2013;44(5):E163–6.CrossRefGoogle Scholar
  58. 58.
    Frandsen TF, Tibyampansha D, Ibrahim GR, von Isenburg M. Library training to promote electronic resource usage: a case study in information literacy assessment. Information and Learning Sciences. 2017;118(11/12):618–28.CrossRefGoogle Scholar
  59. 59.
    Brydges R, Manzone J, Shanks D, Hatala R, Hamstra SJ, Zendejas B, et al. Self-regulated learning in simulation-based training: a systematic review and meta-analysis. Med Educ. 2015;49(4):368–78.CrossRefGoogle Scholar
  60. 60.
    Puzziferro M. Online technologies self-efficacy and self-regulated learning as predictors of final grade and satisfaction in college-level online courses. Am J Dist Educ. 2008;22(2):72–89.CrossRefGoogle Scholar
  61. 61.
    Winston KA, Van der Vleuten CPM, Scherpbier AJJA. An investigation into the design and effectiveness of a mandatory cognitive skills programme for at-risk medical students. Med Teach. 2010;32(3):236–43.CrossRefGoogle Scholar
  62. 62.
    Chen Y-H, Chengalur-Smith I. Factors influencing students' use of a library web portal: applying course-integrated information literacy instruction as an intervention. Internet High Educ. 2015;26:42–55.CrossRefGoogle Scholar
  63. 63.
    Witthaus G.R. and C.L. Robinson, Lecture capture literature review: A review of the literature from 2012-2015. 2015, Loughborough University. Available at: https://dspace.lboro.ac.uk/dspace-jspui/bitstream/2134/25712/3/Witthaus_Lecture [Accessed 28/6/2019].
  64. 64.
    Edwards MR, Clinton ME. A study exploring the impact of lecture capture availability and lecture capture usage on student attendance and attainment. Higher Educ. 2019;77(3):403–21.CrossRefGoogle Scholar
  65. 65.
    Cleland J, Arnold R, Chesser A. Failing finals is often a surprise for the student but not the teacher: identifying difficulties and supporting students with academic difficulties. Med Teach. 2005;27(6):504–8.CrossRefGoogle Scholar
  66. 66.
    Mayer RE, Lee H, Peebles A. Multimedia learning in a second language: a cognitive load perspective. Appl Cogn Psychol. 2014;28(5):653–60.CrossRefGoogle Scholar
  67. 67.
    Porter SR, Whitcomb ME. Non-response in student surveys: the role of demographics, Engagement and Personality. Res High Educ. 2005;46(2):127–52.CrossRefGoogle Scholar

Copyright information

© International Association of Medical Science Educators 2019

Authors and Affiliations

  1. 1.Department of AnatomyRoyal College of Surgeons in IrelandDublinIreland
  2. 2.Health Professions Education CentreRoyal College of Surgeons in IrelandDublinIreland

Personalised recommendations