The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this

Objective Structured Clinical Examinations (OSCEs) and written tests are commonly used to assess health professional students, but it remains unclear whether the additional human resources and expenses required for OSCEs, both in-person and online, are worthwhile for assessing competencies. This scoping review summarized literature identified by searching MEDLINE and EMBASE comparing 1) OSCEs and written tests and 2) in-person and online OSCEs, for assessing health professional trainees’ competencies. For Q1, 21 studies satisfied inclusion criteria. The most examined health profession was medical trainees (19, 90.5%), the comparison was most frequently OSCEs versus multiple-choice questions (MCQs) (18, 85.7%), and 18 (87.5%) examined the same competency domain. Most (77.5%) total score correlation coefficients between testing methods were weak ( r < 0.40). For Q2, 13 articles were included. In-person and online OSCEs were most used for medical trainees (9, 69.2%), checklists were the most prevalent evaluation scheme (7, 63.6%), and 14/17 overall score comparisons were not statistically significantly different. Generally low correlations exist between MCQ and OSCE scores, providing insufficient evidence as to whether OSCEs provide sufficient value to be worth their additional cost. Online OSCEs may be a viable alternative to in-person OSCEs for certain competencies where technical challenges can be met.

Introduction Cognitive load refers to the amount of working memory that is being used in a task, like memorizing the anatomical landmarks on distinct boney specimens. Critically, cognitive load may be compromised when the load imposed by the environment and the content to be learned together exceeds a student’s capacity. Previous research shows that stereoscopic materials delivered in virtual reality (VR) can be more mentally taxing compared to desktop (i.e., two dimensional) delivery but may be similar to that encountered in real life. There is no data on the cognitive load of autostereoscopic displays. Given the increased reliance upon digital media for teaching in learning in anatomy classrooms, it is prudent to better understand the cognitive load imposed on learners across a variety of modalities employed. Methods Cognitive load will be compared across three different learning modalities: immersive virtual reality (VR, displayed on the Oculus Quest 2TM), autostereoscopic (displayed on the AlioscopyTM screen), and an identical printed, physical model. During a four‐minute learning phase, undergraduate students, with no prior formal anatomy education, will learn 10 anatomical landmarks on a displayed bony model (calcaneus, zygomatic bone, or hemipelvis) in each of the three modalities. A Stroop test will be administered as a secondary task throughout the learning phase to evaluate cognitive load. Stroop test reaction time, and accuracy of the participants' responses to the Stroop test will be recorded. After the learning phase, an untimed, recognition‐based test will be administered wherein participants will be asked to recall the ten landmarks learned with the aid of a 3D‐printed bone identical to the one used in the learning phase. Performance will be evaluated based on landmarks correctly identified and the results will be correlated with cognitive load measured in each learning modality. Results We hypothesize that the cognitive load will be highest for VR when compared to the cognitive load on the AlioscopyTM and physical model modalities which would manifest as lower reaction times and/or accuracy on the Stroop test. Further, we hypothesize that cognitive load will inversely correlate with the recognition test performance. Conclusion The results of this study will allow educators and students to make informed decisions when deciding which learning modalities should be used for anatomy education or any other education that requires nominative learning on complex objects. Understanding which modalities minimize cognitive load and improve learning will help improve outcomes and allow for more efficient anatomical education.

Introduction Traditional anatomy learning relies on models and cadaveric specimens that are time and resource intensive to produce, which compromises their accessibility. To mitigate this, the use of three‐dimensional visualization technology (3DVT) to learn anatomy has substantially increased. Still, learning in an immersive virtual reality (VR) environment may pose new challenges, including increased self‐reported levels of cognitive load and cybersickness likely due to its immersive nature that isolates the learner from their surroundings. Autostereoscopy is a novel and potential solution, as it provides a headset‐free stereoscopic view of a three‐dimensional (3D) model. There is, however, a paucity of information about the use and educational efficacy of autostereoscopic 3DVT. The purpose of this study is to examine the strengths and limitations of implementing a non‐immersive autostereoscopic (AlioscopyTM) screen for learning anatomy. Methods A large‐scale study on the efficacy of VR, autostereoscopy, and 3D printed physical models for learning anatomy is currently underway. We suspect that cognitive load and cybersickness may compete with learning capacity. Based on the literature, we hypothesize the AlioscopyTM screen to represent a sort of middle‐of‐the‐road option, with moderate cognitive load and cybersickness levels (VR>AlioscopyTM>physical), that supports large‐group learning (as opposed to single‐user immersive VR) yet retains the accessibility associated with digital assets (as compared to physical specimens). As such, it is prudent to consider the feasibility of implementing an AlioscopyTM screen for anatomical teaching and summarize the strengths and limitations of the technology. Results According to the company’s website, 3D images on the 42” AlioscopyTM display we are using can be viewed from 2.5m to 9.0m away, with optimal results at 4.0m, by a theoretical maximum of “20 to 50 people spread over an area of 90°”. We suspect a practical limit of 14 people per display (2 people for each of the 7 viewing zones) and a comfortable limit of 7 (1 per zone). This allows viewers to comfortably situate themselves in a “sweet spot” where each of their eyes receives a clear, distinct image, which is required for the stereoscopic effect. The stereo‐3D effect is prominent, with objects allowed to both protrude from and recess into the display considerably. Display content was created using a plugin (provided by AlioscopyTM) for the videogame engine Unity, allowing existing Unity content to function on the modality easily. Conclusion The AlioscopyTMscreen represents a novel approach to promoting material accessibility and viewing 3D stereoscopic images in a group setting. The nature of this set up may both decrease the inherent issues most immersive 3DVT impose and offer an opportunity for collaborative learning not available with the use of single‐user headsets.