Background: The COVID-19 pandemic resulted in a rapid shift from in-person to virtual care delivery for many medical specialties across Canada. The purpose of this study was to explore the lived experiences of resident physicians and faculty related to teaching, learning and assessment during ambulatory virtual care encounters within the competency-based medical education model. Methods: In this qualitative phenomenological study, we recruited resident physicians (postgraduate year [PGY] 1–5 trainees) and faculty from the Departments of Surgery and Medicine at Queen’s University, Ontario, via purposive sampling. Participants were not required to have exposure to virtual care. Interviews were conducted from September 2020 to March 2021 by 1 researcher, and 2 researchers conducted focus groups via Zoom to explore participants’ experiences with the transition to virtual care. These were audio-recorded and transcribed verbatim; qualitative data were analyzed thematically. Results: There were 18 male and 19 female participants; 20 were resident physicians and 17 were faculty; 19 were from the Department of Surgery and 18 from the Department of Medicine. All faculty participants had participated in virtual care during ambulatory care; 2 PGY-1 residents in surgery had not actively participated in virtual care, although they had participated in clinics where faculty were using virtual care. The mean age of faculty participants was 38 (standard deviation [SD] 8.6) years, and the mean age of resident physicians was 29 (SD 5.4) years. Overall, 28 interviews and 4 focus groups (range 2–3 participants per group) were conducted, and 4 themes emerged: teaching and learning, assessment, logistical considerations, and suggestions. Barriers to teaching included the lack of direct observations and teaching time, and barriers to assessment included an absence of specific Entrustable Professional Activities (EPAs) and feedback focused on virtual care–related competencies. Logistical challenges included lack of technological infrastructure, insufficient private office space and administrative burdens. Both resident physicians and faculty did not foresee virtual care limiting resident physicians’ ability to progress within competency-based medical education. Benefits of virtual care included increased accessibility to patients for follow-up visits, for disclosing patients’ results and for out-of-town visits. Suggestions included faculty development, improved access to technology and space, educational guidelines for conducting virtual care encounters, and development of virtual care–specific competencies and EPAs. Interpretation: In the postgraduate program we studied, virtual care imposed substantial barriers on teaching, learning and assessment during the first year of the COVID-19 pandemic. Adapting to new circumstances such as virtual care with suggestions from resident physicians and faculty may help to ensure the continuity of...
Introduction Neurophobia is the fear of neuroscience experienced by students who are learning and applying content. Although the cause remains unclear, neurophobia presents a major barrier to student success in neuroanatomy. A preliminary study suggested that individuals with low working memory capacity (WMC) benefit from using high‐contrast anatomical images when learning neuroanatomy. However, the reason for the improvement is unknown. Aim This study uses eye tracking technology to better understand how individuals of varying WMC and expertise study neuroanatomical images. We aim to: 1) assess differences in gaze patterns between students of high and low WMC when viewing high and low contrast brain slices and 2) compare novices and experts to uncover potential competency‐related differences. Methods Undergraduate students with no prior anatomical education (n=120) and neuroanatomical experts were recruited. During an eye tracking session, participants were given 5 minutes to study twelve structures on digital images of 4 brain slices (either coronal or transverse slices in high or low contrast) and were then tested on their ability to identify the learned structures on similar low‐contrast images. This procedure was repeated such that all participants were exposed to a set of coronal/transverse and high/low contrast images in a randomized fashion. All participants’ eye tracking data and test accuracy were recorded. After testing, participants completed the Automated Operation Span Task (OSPAN) to quantify WMC. Results Preliminary results show that students with high WMC are more accurate in identifying neuroanatomical structures when compared to low WMC students [F(1, 32), p =.088]. Dwell time was a significant predicting factor for accuracy [r(32)=40, p =.02]. High WMC students fixated longer on neuroanatomical structures when compared to low WMC students [F(1, 32)=6.50, p =.02]. Data collection from expert participants is ongoing. Discussion/Conclusion Overall, these results offer a quantitative measure of how neuroanatomical information is viewed and learned to gain insight into neurophobia and influence future teaching practices in neuroanatomy.
Introduction Anatomy education is burdened by neurophobia, a student’s fear when learning neuroanatomy and clinical neurology. While neurophobia’s cause remains unknown, poor definition of structures in standard neurological specimens may affect students’ learning due to influences on cognitive load. In this study, we examined the effects of increased visual contrast between grey and white matter ‐ done via novel staining method ‐ with the goal of providing insight into how educators can adapt anatomical specimens to aid students during learning and application. Aim To determine if increasing contrast between grey and white matter on human brain slices aids students in learning neuroanatomy, and if the difference in contrast improves students’ performance during testing. Methods Undergraduate students at McMaster University with no prior neuroanatomical education (n = 102) were recruited for a 3‐day protocol. On Day 0, participants learned 12 neuroanatomical structures from a set of brain slices (transverse or coronal section, with low or high contrast). They were then asked to locate and recall these structures on unstained slices of the same section. The learn‐test phase was immediately repeated with a second set of slices counterbalancing section and contrast. Participants returned for a learning‐only session 24 hours later (Day 1) using the same specimens from Day 0, and were tested on unstained sets 48 hours after (Day 2). Participants then completed an Automated Operation Span Task (OSPAN) to assess working memory capacity (WMC), and a learning methods survey. Results Repeated Measures ANOVA tests were performed using Time (Day 0 v. Day 2) and Staining (stained v. unstained) as within‐subject variables. Though Time had an effect, with Day 0 performance being significantly better than that of Day 2 (F(1, 101) = 26.93, p < .001, ηp2 = 0.21), there was no effect of Staining. Participants performed relatively equally (F(1, 101) = 0.234, p = .629, ηp2 = .002). Participant data were sorted into quartiles based on WMC (OSPAN score). Independent sample t‐tests of the sorted data showed that participants with low WMC performed significantly worse than those with high WMC when learning from low‐contrast specimens, regardless of time (t(47) = −2.164, p = .036, d = (5.58−4.04) ⁄ 2.49 = .618). However, performance between these groups was equalized after learning from high‐contrast slices (t(47) = −0.53, p = .596, d = (5.38−4.92) ⁄ 2.98 = .154). Discussion/Conclusion Results show that increased contrast had little effect within individual results; however, it improved overall performance of low WMC participants, helping to match results of high WMC participants. This suggests that the use of high‐contrast brain slices may prove beneficial when teaching students with low WMC that struggle with neuroanatomy, potentially by reducing the cognitive load needed to locate structures so students can re‐allocate cognitive capacity towards learning. Further insight may be gained using eye‐tracking technology to observe student ga...
Introduction Neurophobia is the fear many students experience when faced with the task of learning neuroanatomy. This problem may partly result from the large number of poorly defined structures observed in unstained brain slices. There is little discussion in educational literature regarding the most effective way to learn neuroanatomy. In particular, the effect of increasing the contrast between gray and white matter on student learning has not been examined. We hypothesized that some neurophobia, particularly among those with low working memory, might be mitigated with our recently developed brain slice staining method. Aim To determine if increasing the contrast between gray and white matter on human brain slices would improve students' ability to learn neuroanatomy, and if the intervention especially helped students with a lower working memory capacity. Methods Participants were recruited from an introductory psych course at McMaster University and were required to not have any previous neuroanatomical education. Participants learned and were tested on 12 neuroanatomical structures each from two sets of brain slices (transverse stained and coronal unstained, or coronal stained and transverse unstained) on day 1, participated in a restudy period 24 hours later on day 2, and were tested again 48 hours later on day 3. In addition, all participants completed the Automated Operation Span Task (OSPAN) working memory test and a survey on learning methods. Results While data collection is still ongoing, interim analysis has been completed. A 2×2 repeated measures ANOVA revealed that there was no difference in test performance between stained and unstained slices on day 1 or day 3 in general (p=0.785). A linear regression analysis for both the stained and unstained groups revealed that working memory capacity was a significant predictor of performance in the unstained condition (p=0.001). However, working memory was not a predictor of performance in the stained condition (p=0.123). Students with low working memory performed 11.4% worse on unstained brain slices than on stained slices, while students with high working memory showed no significant difference. Discussion and Conclusion While data collection continues, the preliminary results reveal interesting possibilities. Initially, staining did not appear to facilitate neuroanatomy learning. However, students with low working memory showed a significant improvement when learning from stained brain slices compared to unstained. Therefore, the use of stained brain slices in the teaching of neuroanatomy may partially mitigate neurophobia, improve teaching, and particularly aid those students already struggling with the subject. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
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