Effectiveness of Exposure to Virtual Learning before Cadaveric Dissection to Study Anatomy for Students in Health Sciences at DMIMSU Wardha, Maharashtra

Background: Anatomage dissection table offers detailed and interactive anatomical images which complement the anatomy textbook and the cadaveric studies. In this regard, the study was carried out to assess the effectiveness of exposure to virtual learning on the Anatomage table before cadaveric dissection and to assess the perception of students about the virtual dissection. Methods: A comparative cross-sectional study was conducted on 200 first phase medical students from Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Sawangi, Meghe, Wardha. Study participants were divided into two groups, group A and group B. Group A performed dissection of the triangle of the neck on the Anatomage table before performing the traditional dissection of the same region while group B performed traditional only. Pre and post-tests were conducted for both group participants using a pre-validated questionnaire. 5 point Likert scale was used for obtaining feedback from study participants. The student's t-test was used for statistical analysis. Results: Observation Post-test score in group A, exposed to virtual dissection prior to cadaveric dissection was 9.18 (Std = 0.84) as compared to the post-test score of 7.11 (Std = 7.01) in group A which was not exposed to the virtual dissection table. 144 (72 %) of students agreed that virtual dissection helps in better understanding of the complex relation of structure with each other and 152 (76 %) students feel that prior exposure to virtual dissection develops an interest in cadaveric dissection. Conclusions: Exposure to virtual dissection before cadaveric dissection was very effective way to learn anatomy for students of first MBBS as students were used to enjoy learning anatomy when virtual dissection was complemented with used before real cadaveric dissection.

Implementation of use of hand-made three-dimensional models to teach Anatomy with supplement to traditional methods with limited resources

The status of anatomical education in modern medical programs is a cornerstone of medicine. Anatomy is one of the basic subjects in First Year MBBS curriculum. Apart from important it is also a lengthy subject to complete in allocated time duration of First MBBS. There are various subdivisions of anatomy like gross anatomy, developmental anatomy, microscopic anatomy, genetics, surface anatomy, radiological anatomy etc. Out of which gross anatomy is difficult to understand as time constraint is there in duration of First MBBS. In medical and allied branches total hours allocated for anatomy teaching and laboratory practical hours have reduced. Result in triggered the emergence of innovative ideas to maximize students learning. While studying the gross anatomy three-dimensional orientation is must to learn actual structure and relation with other viscera and vessels. Traditional way of teaching anatomy uses wall charts, books, slides, anatomical specimens, and practical anatomy as teaching resources and methods. It is fact that in most institutes, three dimensional models are available in their Anatomy Museum, but many Anatomists have complained about fault in exact structure, labelling and it’s relationship in these models because sometime these models are made by amateur technicians. As the medical education expanded and the reduction in human anatomical specimens due to shortage of dead body donations, as well as the limitations of time, place and other resources for anatomical training, the quality of anatomy teaching has been seriously affected. Apart from shortage of these resources, another big issue with development of skill laboratory which is now mandatory as per new NMC guidelines. Establishment of skill lab requires ample amount of finance. Though, skill lab can provide excellent resources to meet the existing lacunae in teaching Anatomy to students by virtual media and simulations. Latest innovations in better teaching aids in Anatomy, in market virtual dissection table is available now, which can provide in depth understanding and orientation of three-dimensional body structures. But as mentioned above, the cost of this virtual dissection table is too high that every institute can not able to afford it. In this situation, to provide better understanding and three-dimensional orientation to students making hand made models from cheap and easily available materials are better options for teachers and students as they can make themselves.Anatomy is a discipline where spatial visualization is of importance. Even anatomy textbooks and atlases provide two-dimensional static anatomical illustrations. To teach some anatomical structures by traditional cadaveric dissection or by traditional lectures is difficult. Some of the structures like gross anatomy of urinary bladder or facial nerve anatomy are difficult to learn by textbook which cannot give exact perception of real anatomy. Additionally, many structure get distorted while removing from cadaver or not able to trace even. In some cases, specific models are also not available for instance course of facial nerve from origin to its termination where hand-made models give excellent three-dimensional understanding. For students’ proper anatomical knowledge of anatomy/organs help them to improve surgical skills. Finally, surgical outcome will be better with less morbidity and mortality.

An atlas of white matter anatomy, its variability, and reproducibility based on Constrained Spherical Deconvolution of diffusion MRI

Virtual dissection of white matter (WM) using diffusion MRI tractography is confounded by its poor reproducibility. Despite the increased adoption of advanced reconstruction models, early region-of-interest driven protocols based on diffusion tensor imaging (DTI) remain the dominant reference for virtual dissection protocols. Here we bridge this gap by providing a comprehensive description of typical WM anatomy reconstructed using a reproducible automated subject-specific parcellation-based approach based on probabilistic constrained-spherical deconvolution (CSD) tractography. We complement this with a WM template in MNI space comprising 68 bundles, including all associated anatomical tract selection labels and associated automated workflows. Additionally, we demonstrate bundle inter- and intra-subject variability using 40 (20 test-retest) datasets from the human connectome project (HCP) and 5 sessions with varying b-values and number of b-shells from the single-subject Multiple Acquisitions for Standardization of Structural Imaging Validation and Evaluation (MASSIVE) dataset. The most reliably reconstructed bundles were the whole pyramidal tracts, primary corticospinal tracts, whole superior longitudinal fasciculi, frontal, parietal and occipital segments of the corpus callosum and middle cerebellar peduncles. More variability was found in less dense bundles, e.g., the first segment of the superior longitudinal fasciculus, fornix, dentato-rubro-thalamic tract (DRTT), and premotor pyramidal tract. Using the DRTT as an example, we show that this variability can be reduced by using a higher number of seeding attempts. Overall inter-session similarity was high for HCP test-retest data (median weighted-dice = 0.963, stdev = 0.201 and IQR = 0.099). Compared to the HCP-template bundles there was a high level of agreement for the HCP test-retest data (median weighted-dice = 0.747, stdev = 0.220 and IQR = 0.277) and for the MASSIVE data (median weighted-dice = 0.767, stdev = 0.255 and IQR = 0.338). In summary, this WM atlas provides an overview of the capabilities and limitations of automated subject-specific probabilistic CSD tractography for mapping white matter fasciculi in healthy adults. It will be most useful in applications requiring a highly reproducible parcellation-based dissection protocol, as well as being an educational resource for applied neuroimaging and clinical professionals.

Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education

OBJECTIVE Virtual reality (VR) is increasingly being used for education and surgical simulation in neurosurgery. So far, the 3D sources for VR simulation have been derived from medical images, which lack real color. The authors made photographic 3D models from dissected cadavers and integrated them into the VR platform. This study aimed to introduce a method of developing a photograph-integrated VR and to evaluate the educational effect of these models. METHODS A silicone-injected cadaver head was prepared. A CT scan of the specimen was taken, and the soft tissue and skull were segmented to 3D objects. The cadaver was dissected layer by layer, and each layer was 3D scanned by a photogrammetric method. The objects were imported to a free VR application and layered. Using the head-mounted display and controllers, the various neurosurgical approaches were demonstrated to neurosurgical residents. After performing hands-on virtual surgery with photographic 3D models, a feedback survey was collected from 31 participants. RESULTS Photographic 3D models were seamlessly integrated into the VR platform. Various skull base approaches were successfully performed with photograph-integrated VR. During virtual dissection, the landmark anatomical structures were identified based on their color and shape. Respondents rated a higher score for photographic 3D models than for conventional 3D models (4.3 ± 0.8 vs 3.2 ± 1.1, respectively; p = 0.001). They responded that performing virtual surgery with photographic 3D models would help to improve their surgical skills and to develop and study new surgical approaches. CONCLUSIONS The authors introduced photographic 3D models to the virtual surgery platform for the first time. Integrating photographs with the 3D model and layering technique enhanced the educational effect of the 3D models. In the future, as computer technology advances, more realistic simulations will be possible.

Facilitating Student Understanding through Incorporating Digital Images and 3D-Printed Models in a Human Anatomy Course

Combining classical educational methods with interactive three-dimensional (3D) visualization technology has great power to support and provide students with a unique opportunity to use them in the study process, training, and/or simulation of different medical procedures in terms of a Human Anatomy course. In 2016, Rīga Stradiņš University (RSU) offered students the 3D Virtual Dissection Table “Anatomage” with possibilities of virtual dissection and digital images at the Department of Morphology. The first 3D models were printed in 2018 and a new printing course was integrated into the Human Anatomy curriculum. This study was focused on the interaction of students with digital images, 3D models, and their combinations. The incorporation and use of digital technologies offered students great tools for their creativity, increased the level of knowledge and skills, and gave them a possibility to study human body structures and to develop relationships between basic and clinical studies.

The Anatomy Table – Is it the Future Learning Tool for Regional Anaesthesiologists?

Cadaveric dissection has been the main stay of anatomy training for regional anaesthesia over the years. Advent of advance visualisation hardware and software has revolutionised anatomy teaching and it is only a matter of time before this technology transcends into regional anaesthesia training. This article demonstrates the innumerable capabilities of virtual dissection table using one specific use case- the supraclavicular approach to the brachial plexus block. Keywords: Simulation, Virtual dissection, Virtual anatomy

USE OF SECTRA VIRTUAL DISSECTION TABLE IN THE EDUCATIONAL PROCESS

The article features the research of the effectiveness of using the virtual dissection table in medical higher educational institutions. The theoretical and methodological foundations of the use of the virtual dissection table in the training of future medical specialists are determined, practical aspects are described. Laboratory works have been created on the use of the virtual dissection table in teaching theoretical and clinical disciplines in medical higher education institutions. The authors considered the formation of the following components of students’ experimental competence through the use of Sectra Virtual Dissection Table during the lessons: cognitive-intellectual, diagnostic, prognostic, information, analytical and research. The cross-curricular links between the disciplines "Human Anatomy" and "Medical and Biological Physics" in view of the formation of the aforementioned experimental competences are considered. The algorithm for work with the muscular system in the Human Anatomy Atlas program on the Sectra Table F18 Virtual Dissection Table is described in detail. The authors showed the capabilities of the Sectra Virtual Dissection Table: viewing realistic human anatomy; simulation of the human body in combination with 3D touch control when viewing, panning, rotating and zooming in an image; distance measurement in 3D volume and arbitrary clipping plane; cropping a part of 3D volume etc. The authors point out that the use of a virtual anatomical table should take into account students’ and teachers’ information and digital competence to work with modern virtual equipment and the educational environment of the medical educational institution. Extended clinical cases with unique pathologies in the Sectra Table library contribute to the formation of medical students’ professional competencies. The authors conclude that the use of medical computer programs allows the teacher to organize innovative types of educational activities and to form students’ experimental competence components. The prospects for further research might involve conducting a pedagogical experiment on the effectiveness of using the created system of laboratory works and demonstrations on the basis of Sectra Table F18 Virtual Dissection Table.