Web-Based Software to Assist in the Localization of Neuroanatomical Lesions

Abstract

Localization of neurological lesions is an essential skill in neurology requiring the analysis of clinical history and physical examination findings that lead neurologists to a particular lesion. Medical students are often overwhelmed by this concept, so much so that Jozefowicz 1 coined the term "neurophobia" to describe student attitudes towards the study of neurology. Risdale et al 2 suggested that brief and unfocussed neurology training in medical school contributes to neurophobia. They emphasized the need for the development of innovations in neurology education to improve competency among medical students.Computer technology is an integral component of modern medical school curricula 3 . Due to the complexity of neuro-ABSTRACT: Objective: To evaluate the educational effectiveness of a novel, web-based neuroanatomical localization application. Methods: A prototype version of a neuroanatomical localization application was developed, limited to lesions involving Cranial Nerve (CN) VII. Second year medical students at the University of Ottawa were recruited to participate in the study. Participants were exposed to a didactic teaching session on CN VII anatomy. They were subsequently randomized to two groups -one group was granted access to the localization application (the "intervention group"), while the other group was given a booklet of standard textbook resources (the "control group"). Participants then completed a case-based multiple choice test on localization of neurologic lesions associated with CN VII, followed by a questionnaire regarding the experience. Results: Thirty-nine students volunteered to participate. Twenty were randomized to the intervention group and 19 to the control group. There was a mean test score difference of 1.3 (CI. 95 = 0.2, 2.3) that was significantly higher in the intervention group when compared to the control group. Significance was determined by a Wilcoxon rank test (p = 0.028). Questionnaire results were similar for both groups, showing an overall favourable evaluation of the localization application. Conclusions: The results support our hypotheses that students using the application would perform better on the multiple choice question (MCQ) test and there would be an overall preference for its use. The demonstrated educational benefit of the application, in addition to the demand for such a resource expressed by the participants, warrant further investigation into the development of a neurological localization application. RÉSUMÉ: Logiciel Web pour aider à localiser les lésions neuroanatomiques.Objectif : Le but de l'étude était d'évaluer l'efficacité au point de vue didactique d'une application nouvelle d'un logiciel Web de localisation neuroanatomique. Méthode : Un prototype d'une application de localisation neuroanatomique, limité aux lésions du septième nerf crânien (VII NC), a été développé. Des étudiants de deuxième année de médecine de l'Université d'Ottawa ont été recrutés pour participer à cette étude. Les participants étaient exposés à des sessions d'enseignemen...

Online eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction

“…Most studies were conducted among undergraduate university students apart from 9 studies [27,29–31,33,42,53,54,79] that investigated the effect of network–based eLearning for vocational training. Out of the 20 (33%) studies [30,32,33,40,45,47–49,52,53,55,57,64,65,71,73,75,76,83]that specified the age of the students, the lowest mean age of participants in a control group was 20.0 years [55] and the oldest was 30.0 years [76]. The lowest mean age in an intervention group was 19.9 years [75] and the highest was 30.0 years [76].…”

“…Overall, 53 [25–27,29–33,35–46,48–52,54,56–67,69,70,72–83] out of the 60 studies looked at a knowledge as an outcome. Nineteen of these studies [25,32,35,40,43,45,48–50,56,57,60,69,72,74,75,77,80,82] used only multiple choice questions (MCQs) to test students’ knowledge and understanding. Six studies used MCQs as a knowledge assessment tool together with an adaptive spaced test [36], gap text questions [51], matching and short answer questions [61], open ended and true/false questions [64], short essay questions [81] and a key features test [59].…”

“…Seven studies reported using test questions [31,39,40,44,67,70,78] to assess knowledge of study participants. Six other studies used open ended [30,33,63,66] or Likert type questionnaires [29] or even “fill in the blank” questions [73].…”

“…Seventeen of these studies [33,34,38,40,51,52,55,57,59,61,64–66,68,73,75,76] mentioned that student satisfaction was evaluated with Likert scale questionnaires. The 16 remaining studies comparing student satisfaction among the students [25,32,37,39,41,43,46–48,50,58,60, 69,74,80,82] used different types of questionnaires or surveys without mentioning the use of Likert scales.…”

“…Two of these studies [29,80] used full online eLearning as the main intervention while the other 1 [40] used blended learning.…”