Chiropractic students' experiences on the use of virtual radiography simulation: a pilot observational study.

BACKGROUND: Virtual radiography provides students with an opportunity to practise their clinical skills in patient positioning and evaluating radiographic images. The purpose of this pilot study was to introduce Projection VR™, a software radiography simulation program, into a student chiropractic program and evaluate its potential application as a teaching and learning tool. METHODS: Undergraduate chiropractic students, enrolled in a radiographic course (unit within the chiropractic program), were invited to attend a scheduled laboratory where they were introduced to, and undertook purposefully designed activities using the radiography simulation. At the end of this activity, students were asked to complete an online survey (see Virtual Radiography Survey) to describe their experiences of the educational value of the software program. Descriptive statistics were used to evaluate outcomes. Content analysis was performed for free-text comments provided by respondents with key themes provided by the predetermined quantitative categories of the questionnaire. RESULTS: Responses were received from 44 out of the 47 students who attended the scheduled laboratory (response rate 92%). Overall students were positive about this simulation identifying that it was easy to use (95%) and that they could control the equipment as needed (95%). The main reported benefits included students being enabled to repeat tasks until they were satisfied with the results (98%) and being able to quickly assess images and determine if changes needed to be made (98%). Participants reported improvement in their understanding of the effect of exposure factors on patient radiation dose (93%) as well as their technical image evaluation (84%) and problem-solving skills (80%). CONCLUSIONS: The results of this study suggest that virtual radiography is a valuable complementary resource in providing chiropractic students with radiographic knowledge and skills.

Association of Mild Leg Length Discrepancy and Degenerative Changes in the Hip Joint and Lumbar Spine.

OBJECTIVE: The purpose of this study was to evaluate the correlation between mild leg length discrepancy (LLD) and degenerative joint disease (DJD) or osteoarthritis. METHODS: We evaluated standard postural lumbopelvic radiographs from 255 adults (121 women and 134 men) who had presented with spinal pain for chiropractic care. Symmetry of femoral head diameters was used to exclude magnification errors. Pearson's partial correlation was used to control for age and derive effect sizes for LLD on DJD in the hip and lower lumbar motion segments. Krippendorff's α was used for intraobserver and interobserver reliability. RESULTS: A strong correlation was found between LLD and hip DJD in men (r = 0.532) and women (r = 0.246). We also found a strong correlation between LLD and DJD at the L5-S1 motion segment in men (r = 0.395) and women (r = 0.246). At the L4-5 spinal level this correlation was much attenuated in men (r = 0.229) and women (r = 0.166). CONCLUSIONS: These findings suggest an association between LLD and hip and lumbar DJD. Cause-effect relationships between mild LLD and DJD deserve to be properly evaluated in future longitudinal cohort studies.

Less is more: development and evaluation of an interactive e-atlas to support anatomy learning.

An Interactive electronic Atlas (IeA) was developed to assist first-year nursing students with interpretation of laboratory-based prosected cadaveric material. It was designed, using pedagogically sound principles, as a student-centered resource accessible to students from a wide range of learning backgrounds. It consisted of a highly simplified interactive interface limited to essential anatomical structures and was intended for use in a blended learning situation. The IeA's nine modules mirrored the body systems covered in a Nursing Biosciences course, with each module comprising a maximum of 10 pages using the same template: an image displaying a cadaveric specimen and, in most cases, a corresponding anatomical model with navigation panes (menus) on one side. Cursor movement over the image or clicking the menu highlighted the structure with a transparent overlay and revealed a succinct functional description. The atlas was complemented by a multiple-choice database of nearly 1,000 questions using IeA images. Students' perceptions of usability and utility were measured by survey (n = 115; 57% of the class) revealing mean access of 2.3 times per week during the 12-week semester and a median time of three hours of use. Ratings for usability and utility were high, with means ranging between 4.24 and 4.54 (five-point Likert scale; 5 = strongly agree). Written responses told a similar story for both usability and utility. The role of providing basic computer-assisted learning support for a large first-year class is discussed in the context of current research into student-centered resources and blended learning in human anatomy.