Skip to main content
Erschienen in: International Journal of Computer Assisted Radiology and Surgery 12/2016

01.12.2016 | Original Article

Successful learning of surgical liver anatomy in a computer-based teaching module

verfasst von: Felix Nickel, Jonathan D. Hendrie, Thomas Bruckner, Karl F. Kowalewski, Hannes G. Kenngott, Beat P. Müller-Stich, Lars Fischer

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 12/2016

Einloggen, um Zugang zu erhalten

Abstract

Aim

To analyze factors influencing the learning of surgical liver anatomy in a computer-based teaching module (TM).

Methods

Medical students in their third to fifth year of training (N \(=\) 410) participated in three randomized trials, each with a different primary hypothesis, comparing two- (2D) and three-dimensional (3D) presentation modes in a TM for surgical liver anatomy. Computed tomography images were presented according to the study and allocation group. Students had to answer eleven questions on surgical liver anatomy and four evaluative questions. Scores and time taken to answer the questions were automatically recorded. Since the three studies used the same 15 questions in the TM, a pooled analysis was performed to compare learning factors across studies.

Results

3D groups had higher scores (7.5 ± 1.7 vs. 5.6 ± 2.0; p < 0.001) and needed less time (503.5 ± 187.4 vs. 603.1 ± 246.7 s; p < 0.001) than 2D groups. Intensive training improved scores in 2D (p < 0.001). Men gave more correct answers than women, independent of presentation mode (7.2 ± 2.0 vs. 6.5 ± 2.1; p \(=\) 0.003). An overall association was found between having fun and higher scores in 11 anatomical questions (p < 0.001). In subgroup analysis, 3D groups had more fun than 2D groups (84.7 vs. 65.1 %; p < 0.001). If given the option, more students in the 2D groups (58.9 %) would have preferred a 3D presentation than students in the 3D group (35.9 %) would have preferred 2D (p  < 0.001).

Conclusion

3D was superior to 2D for learning of surgical liver anatomy. With training 2D showed similar results. Fun and gender were relevant factors for learning success.
Literatur
1.
Zurück zum Zitat Beermann J, Tetzlaff R, Bruckner T, Schoebinger M, Muller-Stich BP, Gutt CN et al (2010) Three-dimensional visualisation improves understanding of surgical liver anatomy. Med Educ 44(9):936–940CrossRefPubMed Beermann J, Tetzlaff R, Bruckner T, Schoebinger M, Muller-Stich BP, Gutt CN et al (2010) Three-dimensional visualisation improves understanding of surgical liver anatomy. Med Educ 44(9):936–940CrossRefPubMed
2.
Zurück zum Zitat Metzler R, Stein D, Tetzlaff R, Bruckner T, Meinzer HP, Buchler MW et al (2012) Teaching on three-dimensional presentation does not improve the understanding of according CT images: a randomized controlled study. Teach Learn Med 24(2):140–148CrossRefPubMed Metzler R, Stein D, Tetzlaff R, Bruckner T, Meinzer HP, Buchler MW et al (2012) Teaching on three-dimensional presentation does not improve the understanding of according CT images: a randomized controlled study. Teach Learn Med 24(2):140–148CrossRefPubMed
3.
Zurück zum Zitat Muller-Stich BP, Lob N, Wald D, Bruckner T, Meinzer HP, Kadmon M et al (2013) Regular three-dimensional presentations improve in the identification of surgical liver anatomy—a randomized study. BMC Med Educ 13:131CrossRefPubMedPubMedCentral Muller-Stich BP, Lob N, Wald D, Bruckner T, Meinzer HP, Kadmon M et al (2013) Regular three-dimensional presentations improve in the identification of surgical liver anatomy—a randomized study. BMC Med Educ 13:131CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Blavier A, Nyssen AS (2009) Influence of 2D and 3D view on performance and time estimation in minimal invasive surgery. Ergonomics 52(11):1342–1349CrossRefPubMed Blavier A, Nyssen AS (2009) Influence of 2D and 3D view on performance and time estimation in minimal invasive surgery. Ergonomics 52(11):1342–1349CrossRefPubMed
5.
6.
Zurück zum Zitat Keedy AW, Durack JC, Sandhu P, Chen EM, O’Sullivan PS, Breiman RS (2011) Comparison of traditional methods with 3D computer models in the instruction of hepatobiliary anatomy. Anat Sci Educ 4(2):84–91CrossRefPubMed Keedy AW, Durack JC, Sandhu P, Chen EM, O’Sullivan PS, Breiman RS (2011) Comparison of traditional methods with 3D computer models in the instruction of hepatobiliary anatomy. Anat Sci Educ 4(2):84–91CrossRefPubMed
7.
Zurück zum Zitat Manning DM, O’Meara JG, Williams AR, Rahman A, Myhre D, Tammel KJ et al (2007) 3D: a tool for medication discharge education. Qual Saf Health Care 16(1):71–76CrossRefPubMedPubMedCentral Manning DM, O’Meara JG, Williams AR, Rahman A, Myhre D, Tammel KJ et al (2007) 3D: a tool for medication discharge education. Qual Saf Health Care 16(1):71–76CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Mastrangelo MJ Jr, Adrales G, McKinlay R, George I, Witzke W, Plymale M et al (2003) Inclusion of 3-D computed tomography rendering and immersive VR in a third year medical student surgery curriculum. Stud Health Technol Inform 94:199–203PubMed Mastrangelo MJ Jr, Adrales G, McKinlay R, George I, Witzke W, Plymale M et al (2003) Inclusion of 3-D computed tomography rendering and immersive VR in a third year medical student surgery curriculum. Stud Health Technol Inform 94:199–203PubMed
9.
Zurück zum Zitat Fischer L, Cardenas C, Thorn M, Benner A, Grenacher L, Vetter M et al (2002) Limits of Couinaud’s liver segment classification: a quantitative computer-based three-dimensional analysis. J Comput Assist Tomogr 26(6):962–967CrossRefPubMed Fischer L, Cardenas C, Thorn M, Benner A, Grenacher L, Vetter M et al (2002) Limits of Couinaud’s liver segment classification: a quantitative computer-based three-dimensional analysis. J Comput Assist Tomogr 26(6):962–967CrossRefPubMed
10.
Zurück zum Zitat Fischer L, Tetzlaff R, Schobinger M, Radeleff B, Bruckner T, Meinzer HP et al (2010) How many CT detector rows are necessary to perform adequate three dimensional visualization? Eur J Radiol 74(3):e144–e148CrossRefPubMed Fischer L, Tetzlaff R, Schobinger M, Radeleff B, Bruckner T, Meinzer HP et al (2010) How many CT detector rows are necessary to perform adequate three dimensional visualization? Eur J Radiol 74(3):e144–e148CrossRefPubMed
11.
Zurück zum Zitat Fischer L, Thorn M, Neumann JO, Schobinger M, Heimann T, Grenacher L et al (2005) The segments of the hepatic veins-is there a spatial correlation to the Couinaud liver segments? Eur J Radiol 53(2):245–255CrossRefPubMed Fischer L, Thorn M, Neumann JO, Schobinger M, Heimann T, Grenacher L et al (2005) The segments of the hepatic veins-is there a spatial correlation to the Couinaud liver segments? Eur J Radiol 53(2):245–255CrossRefPubMed
12.
Zurück zum Zitat Lamade W, Glombitza G, Fischer L, Chiu P, Cardenas CE Sr, Thorn M et al (2000) The impact of 3-dimensional reconstructions on operation planning in liver surgery. Arch Surg 135(11):1256–1261CrossRefPubMed Lamade W, Glombitza G, Fischer L, Chiu P, Cardenas CE Sr, Thorn M et al (2000) The impact of 3-dimensional reconstructions on operation planning in liver surgery. Arch Surg 135(11):1256–1261CrossRefPubMed
13.
Zurück zum Zitat Fischer L, Schoebinger M, Neumann JO, Muller S, Meinzer HP, Buchler MW et al (2008) Does preoperative analysis of intrahepatic venous anastomoses improve the surgeon’s intraoperative decision making? Pilot data from a case report. Patient Saf Surg 2:19CrossRefPubMedPubMedCentral Fischer L, Schoebinger M, Neumann JO, Muller S, Meinzer HP, Buchler MW et al (2008) Does preoperative analysis of intrahepatic venous anastomoses improve the surgeon’s intraoperative decision making? Pilot data from a case report. Patient Saf Surg 2:19CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Garg AX, Norman G, Sperotable L (2001) How medical students learn spatial anatomy. Lancet 357(9253):363–364CrossRefPubMed Garg AX, Norman G, Sperotable L (2001) How medical students learn spatial anatomy. Lancet 357(9253):363–364CrossRefPubMed
15.
Zurück zum Zitat Jansen-Osmann P, Heil M (2007) Suitable stimuli to obtain (no) gender differences in the speed of cognitive processes involved in mental rotation. Brain Cogn 64(3):217–227CrossRefPubMed Jansen-Osmann P, Heil M (2007) Suitable stimuli to obtain (no) gender differences in the speed of cognitive processes involved in mental rotation. Brain Cogn 64(3):217–227CrossRefPubMed
16.
Zurück zum Zitat Maleike D, Nolden M, Meinzer HP, Wolf I (2009) Interactive segmentation framework of the Medical Imaging Interaction Toolkit. Comput Methods Programs Biomed 96(1):72–83 Maleike D, Nolden M, Meinzer HP, Wolf I (2009) Interactive segmentation framework of the Medical Imaging Interaction Toolkit. Comput Methods Programs Biomed 96(1):72–83
17.
Zurück zum Zitat Stein D, Fritzsche KH, Nolden M, Meinzer HP, Wolf I (2010) The extensible open-source rigid and affine image registration module of the Medical Imaging Interaction Toolkit (MITK). Comput Methods Programs Biomed 100(1):79–86 Stein D, Fritzsche KH, Nolden M, Meinzer HP, Wolf I (2010) The extensible open-source rigid and affine image registration module of the Medical Imaging Interaction Toolkit (MITK). Comput Methods Programs Biomed 100(1):79–86
18.
Zurück zum Zitat Wolf I, Vetter M, Wegner I, Bottger T, Nolden M, Schobinger M et al (2005) The medical imaging interaction toolkit. Med Image Anal 9(6):594–604CrossRefPubMed Wolf I, Vetter M, Wegner I, Bottger T, Nolden M, Schobinger M et al (2005) The medical imaging interaction toolkit. Med Image Anal 9(6):594–604CrossRefPubMed
19.
Zurück zum Zitat Blavier A, Gaudissart Q, Cadiere GB, Nyssen AS (2006) Impact of 2D and 3D vision on performance of novice subjects using da Vinci robotic system. Acta Chir Belg 106(6):662–664CrossRefPubMed Blavier A, Gaudissart Q, Cadiere GB, Nyssen AS (2006) Impact of 2D and 3D vision on performance of novice subjects using da Vinci robotic system. Acta Chir Belg 106(6):662–664CrossRefPubMed
20.
Zurück zum Zitat Hermann M (2002) 3-dimensional computer animation-a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study-picture versus text. Chirurg 73(5):500–507CrossRefPubMed Hermann M (2002) 3-dimensional computer animation-a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study-picture versus text. Chirurg 73(5):500–507CrossRefPubMed
21.
Zurück zum Zitat Prinz A, Bolz M, Findl O (2005) Advantage of three dimensional animated teaching over traditional surgical videos for teaching ophthalmic surgery: a randomised study. Br J Ophthalmol 89(11):1495–1499CrossRefPubMedPubMedCentral Prinz A, Bolz M, Findl O (2005) Advantage of three dimensional animated teaching over traditional surgical videos for teaching ophthalmic surgery: a randomised study. Br J Ophthalmol 89(11):1495–1499CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Blavier A, Gaudissart Q, Cadiere GB, Nyssen AS (2007) Comparison of learning curves and skill transfer between classical and robotic laparoscopy according to the viewing conditions: implications for training. Am J Surg 194(1):115–121CrossRefPubMed Blavier A, Gaudissart Q, Cadiere GB, Nyssen AS (2007) Comparison of learning curves and skill transfer between classical and robotic laparoscopy according to the viewing conditions: implications for training. Am J Surg 194(1):115–121CrossRefPubMed
23.
Zurück zum Zitat Servos P, Goodale MA, Jakobson LS (1992) The role of binocular vision in prehension: a kinematic analysis. Vis Res 32(8):1513–1521CrossRefPubMed Servos P, Goodale MA, Jakobson LS (1992) The role of binocular vision in prehension: a kinematic analysis. Vis Res 32(8):1513–1521CrossRefPubMed
24.
Zurück zum Zitat Dees JW (1966) Accuracy of absolute visual distance and size estimation in space as a function of stereopsis and motion parallax. J Exp Psychol 72(3):466–476CrossRefPubMed Dees JW (1966) Accuracy of absolute visual distance and size estimation in space as a function of stereopsis and motion parallax. J Exp Psychol 72(3):466–476CrossRefPubMed
25.
Zurück zum Zitat Rogers B, Graham M (1979) Motion parallax as an independent cue for depth perception. Perception 8(2):125–134CrossRefPubMed Rogers B, Graham M (1979) Motion parallax as an independent cue for depth perception. Perception 8(2):125–134CrossRefPubMed
26.
Zurück zum Zitat Marotta JJ, Perrot TS, Nicolle D, Servos P, Goodale MA (1995) Adapting to monocular vision: grasping with one eye. Exp Brain Res 104(1):107–114CrossRefPubMed Marotta JJ, Perrot TS, Nicolle D, Servos P, Goodale MA (1995) Adapting to monocular vision: grasping with one eye. Exp Brain Res 104(1):107–114CrossRefPubMed
27.
Zurück zum Zitat Marotta JJ, DeSouza JF, Haffenden AM, Goodale MA (1998) Does a monocularly presented size-contrast illusion influence grip aperture? Neuropsychologia 36(6):491–497CrossRefPubMed Marotta JJ, DeSouza JF, Haffenden AM, Goodale MA (1998) Does a monocularly presented size-contrast illusion influence grip aperture? Neuropsychologia 36(6):491–497CrossRefPubMed
28.
Zurück zum Zitat Baxter N, Cohen R, McLeod R (1996) The impact of gender on the choice of surgery as a career. Am J Surg 172(4):373–376CrossRefPubMed Baxter N, Cohen R, McLeod R (1996) The impact of gender on the choice of surgery as a career. Am J Surg 172(4):373–376CrossRefPubMed
29.
Zurück zum Zitat Madan AK, Harper JL, Frantzides CT, Tichansky DS (2008) Nonsurgical skills do not predict baseline scores in inanimate box or virtual-reality trainers. Surg Endosc 22(7):1686–1689CrossRefPubMed Madan AK, Harper JL, Frantzides CT, Tichansky DS (2008) Nonsurgical skills do not predict baseline scores in inanimate box or virtual-reality trainers. Surg Endosc 22(7):1686–1689CrossRefPubMed
30.
Zurück zum Zitat Thorson CM, Kelly JP, Forse RA, Turaga KK (2011) Can we continue to ignore gender differences in performance on simulation trainers? J Laparoendosc Adv Surg Tech A 21(4):329–333CrossRefPubMed Thorson CM, Kelly JP, Forse RA, Turaga KK (2011) Can we continue to ignore gender differences in performance on simulation trainers? J Laparoendosc Adv Surg Tech A 21(4):329–333CrossRefPubMed
31.
Zurück zum Zitat Duque G, Fung S, Mallet L, Posel N, Fleiszer D (2008) Learning while having fun: the use of video gaming to teach geriatric house calls to medical students. J Am Geriatr Soc 56(7):1328–1332CrossRefPubMed Duque G, Fung S, Mallet L, Posel N, Fleiszer D (2008) Learning while having fun: the use of video gaming to teach geriatric house calls to medical students. J Am Geriatr Soc 56(7):1328–1332CrossRefPubMed
32.
Zurück zum Zitat Kanthan R, Senger JL (2011) The impact of specially designed digital games-based learning in undergraduate pathology and medical education. Arch Pathol Lab Med 135(1):135–142PubMed Kanthan R, Senger JL (2011) The impact of specially designed digital games-based learning in undergraduate pathology and medical education. Arch Pathol Lab Med 135(1):135–142PubMed
33.
Zurück zum Zitat Neef NA, Perrin CJ, Haberlin AT, Rodrigues LC (2011) Studying as fun and games: effects on college students’ quiz performance. J Appl Behav Anal 44(4):897–901CrossRefPubMedPubMedCentral Neef NA, Perrin CJ, Haberlin AT, Rodrigues LC (2011) Studying as fun and games: effects on college students’ quiz performance. J Appl Behav Anal 44(4):897–901CrossRefPubMedPubMedCentral
Metadaten
Titel
Successful learning of surgical liver anatomy in a computer-based teaching module
verfasst von
Felix Nickel
Jonathan D. Hendrie
Thomas Bruckner
Karl F. Kowalewski
Hannes G. Kenngott
Beat P. Müller-Stich
Lars Fischer
Publikationsdatum
01.12.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Computer Assisted Radiology and Surgery / Ausgabe 12/2016
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-016-1354-y

Weitere Artikel der Ausgabe 12/2016

International Journal of Computer Assisted Radiology and Surgery 12/2016 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.