"Visualization matters" - stereoscopic visualization of 3D graphic neuroanatomic models through AnaVu enhances basic recall and radiologic anatomy learning when compared with monoscopy.

BACKGROUND: The authors had previously developed AnaVu, a low-resource 3D visualization tool for stereoscopic/monoscopic projection of 3D models generated from pre-segmented MRI neuroimaging data. However, its utility in neuroanatomical education compared to conventional methods (specifically whether the stereoscopic or monoscopic mode is more effective) is still unclear. METHODS: A three-limb randomized controlled trial was designed. A sample (n = 152) from the 2022 cohort of MBBS students at Government Medical College, Thiruvananthapuram (GMCT), was randomly selected from those who gave informed consent. After a one-hour introductory lecture on brainstem anatomy and a dissection session, students were randomized to three groups (S - Stereo; M - Mono and C - Control). S was given a 20-min demonstration on the brainstem lesson module in AnaVu in stereoscopic mode. M was given the same demonstration, but in monoscopic mode. The C group was taught using white-board drawn diagrams. Pre-intervention and post-intervention tests for four domains (basic recall, analytical, radiological anatomy and diagram-based questions) were conducted before and after the intervention. Cognitive loads were measured using a pre-validated tool. The groups were then swapped -S→ M, M →S and C→S, and they were asked to compare the modes. RESULTS: For basic recall questions, there was a statistically significant increase in the pre/post-intervention score difference of the S group when compared to the M group [p = 0.03; post hoc analysis, Bonferroni corrections applied] and the C group [p = 0.001; ANOVA test; post hoc analysis, Bonferroni corrections applied]. For radiological anatomy questions, the difference was significantly higher for S compared to C [p < 0.001; ANOVA test; post hoc analysis, Bonferroni corrections applied]. Cognitive load scores showed increased mean germane load for S (33.28 ± 5.35) and M (32.80 ± 7.91) compared with C (28.18 ± 8.17). Subjective feedbacks showed general advantage for S and M compared to C. Out of the S and M swap cohorts, 79/102 preferred S, 13/102 preferred M, and 6/102 preferred both. CONCLUSIONS: AnaVu tool seems to be effective for learning neuroanatomy. The specific advantage seen when taught with stereoscopy in basic recall and radiological anatomy learning shows the importance of how visualization mode influences neuroanatomy learning. Since both S and M are preferred in subjective feedbacks, these results have implications in choosing methods (stereoscopic - needs 3D projectors; monoscopic - needs web based or hand-held devices) to scale AnaVu for anatomy teaching in medical colleges in India. Since stereoscopic projection is technically novel and cost considerations are slightly higher compared to monoscopic projection, the specific advantages and disadvantages of each are relevant in the Indian medical education scenario.

Teaching Cellular Architecture: The Global Status of Histology Education.

Histology or microanatomy is the science of the structure and function of tissues and organs in metazoic organisms at the cellular level. By definition, histology is dependent on a variety of microscope techniques, usually light or more recently virtual, as well as electron microscopy. Since its inception more than two centuries ago, histology has been an integral component of biomedical education, specifically for medical, dental, and veterinary students. Traditionally, histology has been taught in two sequential phases, first a didactic transfer of information to learners and secondly a laboratory segment in which students develop the skill of analyzing micrographic images. In this chapter, the authors provide an overview of how histology is currently taught in different global regions. This overview also outlines which educational strategies and technologies are used, and how the local and cultural environment influences the histology education of medical and other students in different countries and continents. Also discussed are current trends that change the teaching of this basic science subject.

Virtual Microscopy Goes Global: The Images Are Virtual and the Problems Are Real.

For the last two centuries, the scholarly education of histology and pathology has been based on technology, initially on the availability of low-cost, high-quality light microscopes, and more recently on the introduction of computers and e-learning approaches to biomedical education. Consequently, virtual microscopy (VM) is replacing glass slides and the traditional light microscope as the main instruments of instruction in histology and pathology laboratories. However, as with most educational changes, there are advantages and disadvantages associated with a new technology. The use of VM for the teaching of histology and pathology requires an extensive infrastructure and the availability of computing devices to all learners, both posing a considerable financial strain on schools and students. Furthermore, there may be valid reasons for practicing healthcare professionals to maintain competency in using light microscopes. In addition, some educators may be reluctant to embrace new technologies. These are some of the reasons why the introduction of VM as an integral part of histology and pathology instruction has been globally uneven. This paper compares the teaching of histology and pathology using traditional or VM in five different countries and their adjacent regions, representing developed, as well as developing areas of the globe. We identify general and local roadblocks to the introduction of this still-emerging didactic technology and outline solutions for overcoming these barriers.

Extent of knowledge and attitudes on plagiarism among undergraduate medical students in South India - a multicentre, cross-sectional study to determine the need for incorporating research ethics in medical undergraduate curriculum.

BACKGROUND: Undergraduate medical students in India participate in various research activities However, plagiarism is rampant, and we hypothesize that it is the lack of knowledge on how to avoid plagiarism. This study's objective was to measure the extent of knowledge and attitudes towards plagiarism among undergraduate medical students in India. METHODS: It was a multicentre, cross-sectional study conducted over a two-year period (January 2018 - December 2019). Undergraduate medical students were given a pre-tested semi-structured questionnaire which contained: (a) Demographic details; (b) A quiz developed by Indiana University, USA to assess knowledge; and (c) Attitudes towards Plagiarism (ATP) questionnaire. RESULTS: Eleven medical colleges (n = 4 government medical colleges [GMCs] and n = 7 private medical colleges [PMCs]) participated. A total of N = 4183 students consented. The mean (SD) knowledge score was 4.54 (1.78) out of 10. The factors (adjusted odds ratio [aOR]; 95% Confidence interval [CI]; p value) that emerged as significant predictors of poor knowledge score were early years of medical education (0.110; 0.063, 0.156; < 0.001) and being enrolled in a GMC (0.348; 0.233, 0.463; < 0.001).The overall mean (SD) scores of the three attitude components namely permissive, critical and submissive norms were 37.56 (5.25), 20.35 (4.20) and 31.20 (4.28) respectively, corresponding to the moderate category. CONCLUSION: The overall knowledge score was poor. A vast majority of study participants fell in the moderate category of attitude score. These findings warrant the need for incorporating formal training in the medical education curriculum.

"Air Anatomy" - Teaching Complex Spatial Anatomy Using Simple Hand Gestures.

Spatial understanding of complex anatomical concepts is often a challenge for learners, as well as for educators. It is even more challenging for students with low mental spatial abilities. There are many options to teach spatial relationships, ranging from simple models to high-end three-dimensional (3D) virtual reality tools. Using a randomized controlled trial design, this study explored the use of a unique combination of deictic and iconic hand gestures to enhance spatial anatomical understanding, coining the term "Air Anatomy". The control group (n = 45) was given a lecture on the anatomy of extraocular muscles, while the intervention group (n = 49) received the same lecture including "Air Anatomy" hand gestures. When compared to the control group, the post-test scores for the intervention group were significantly higher for basic recall (P < 0.001; Mann-Whitney U test) and for the application of knowledge (P = 0.015; Mann-Whitney U test). Students with low to moderate spatial ability (as assessed by a mental rotation test) were found to benefit most by this technique. Students in the intervention group also reported a lower extrinsic cognitive load and higher germane load, when compared to the control group. An instructional skills questionnaire survey indicated the effectiveness of this technique in improving overall classroom experience. Feedback of the students in the intervention group was also favorable for instruction using "Air Anatomy". The study suggests that "Air Anatomy" is a useful, "no-cost", accessible method that aids spatial understanding of anatomical concepts.

Extent of awareness and attitudes on plagiarism among post-graduate resident doctors and junior medical faculty in India: a cross-sectional, multicentric study.

OBJECTIVES: Though dissertation is mandatory for postgraduates (PG), it is unknown if adequate knowledge on plagiarism exists at that level. Thus, we intended to study the knowledge and attitude towards plagiarism among junior doctors in India. DESIGN: Cross-sectional study SETTING: PG medical residents and Junior faculty from various teaching institutions across south India. PARTICIPANTS: A total of N=786 doctors filled the questionnaires of which approximately 42.7% were from government medical colleges (GMCs) and the rest from private institutions. METHODS: Participants were given a pretested semistructured questionnaire which contained: (1) demographic details; (2) a quiz developed by Indiana University, USA to assess knowledge and (3) Attitudes towards Plagiarism Questionnaire (ATPQ). OUTCOME MEASURES: The Primary outcome measure was knowledge about plagiarism. The secondary outcome measure was ATPQ scores. RESULTS: A total of N=786 resident doctors and junior faculty from across 11 institutions participated in this study. Of this, 42.7% were from GMCs and 60.6% were women. The mean (SD) knowledge score was 4.43 (1.99) out of 10. The factors (adjusted OR; 95% CI; p value) that emerged as significant predictors of knowledge were number of years in profession (-0.181; -0.299 to -0.062; 0.003), no previous publication (0.298; 0.099 to 0.498; 0.003) and working in a GMC (0.400; 0.106 to 0.694; 0.008). The overall mean (SD) scores of the three attitude components were: Permissive attitudes-37.33 (5.33), critical attitudes -20.32 (4.82) and subjective norms-31.05 (4.58), all of which corresponded to the moderate category. CONCLUSION: Participants lacked adequate knowledge on how to avoid plagiarism suggesting a need for a revamp in medical education curriculum in India by incorporating research and publication ethics.

Overcoming Barriers in a Traditional Medical Education System by the Stepwise, Evidence-Based Introduction of a Modern Learning Technology.

INTRODUCTION: Histology teaching in India and in other developing countries has not changed much over the past decades and has not joined the global movement of using virtual microscopy (VM). Many factors may have contributed to this academic inertia-including curricular requirements for traditional microscopy (TM) skills, assessments that are heavily based on TM, and unfamiliarity with modern technology among faculty, as well as infrastructural shortcomings. This study is aimed at overcoming these roadblocks by using a blended approach combining VM with TM in a tradition-centered curricular setting. METHODS: For validation of this approach, the authors conducted a non-randomized controlled trial with a crossover design on first year medical students at the Government Medical College, Thiruvananthapuram, India. Examination scores and responses of a student group taught with VM as an adjunct to TM were compared with a student group taught with TM only. RESULTS: The test group had significantly better results when compared to the control group for knowledge-based tests (p = 0.012; analysis of co-variance) and for an unannounced visual-based test conducted 1 month later (p = 0.001; Mann-Whitney U test). Feedback collected from students showed highly favorable responses to the use of VM for teaching histology. CONCLUSION: This study should encourage Indian medical colleges and schools in other developing countries to start using VM as a supplementary approach for their histology education programs. Furthermore, as the Medical Council of India recommends the introduction of new competency-based integrated curriculum in India starting in 2019, the use of VM may facilitate more effective learning in the new scenario. TRIAL REGISTRATION: CTRI/2018/04/012928.