Browsing by Author "Robertson, Taylor"
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Item An Analysis of Student Satisfaction with Active Learning Techniques in an Online Graduate Anatomy Course: Consideration of Demographics and Previous Course Enrollment(2023) Bradley, Libby; Meyer, Kim; Robertson, Taylor; Kerr, Marcel; Maddux, Scott D.; Heck, Amber; Reeves, Rustin; Handler, EmmaPurpose: Online learning has become an essential part of mainstream higher education, allowing greater access for students. With the increase in online course enrollment, specifically that of anatomy, understanding online teaching best practices is critical. Active learning has previously shown many benefits in face-to-face anatomy courses, including increases in student satisfaction. Currently, no research has measured the satisfaction of several active learning techniques implemented in an asynchronous, online graduate anatomy course. Methods: This study compared the student satisfaction achieved by four active learning techniques with consideration of demographics and previous course enrollment. Survey questions consisted of multiple-choice and Likert-style that asked students to indicate their level of satisfaction with the active learning techniques. One hundred seventy (170) students completed the online anatomy course and surveys. Results: Students were more satisfied with question constructing and jigsaw than with concept mapping and team-learning module. Additionally, historically excluded student groups (underrepresented racial minorities) were more satisfied with active learning than White students. Age, gender, previous anatomy experience and/or online course experience did not influence the satisfaction of the active learning techniques. However, students with higher GPAs and those who had no graduate degree were more satisfied with the active learning techniques than students who had lower GPAs and those with a graduate degree. Conclusion: These findings provide evidence that students enrolled in an online graduate anatomy course were satisfied with the active learning techniques, dependent on the specific technique, demographics, and previous course enrollment. Results provide anatomy educators with a better understanding of which techniques work best in an online anatomy course. Currently, there is a lack of research comparing active learning techniques in an online learning environment. These findings provide online anatomy educators with evidence that active learning techniques improve satisfaction, with consideration of student demographics and previous course enrollment.Item Impact of gross anatomy review on ultrasound learning in first-year medical students: A pilot study(2024-03-21) Robertson, Taylor; Reeves, Rustin; Meyer, Kimberly; Satsky Kerr, Marcel; Handler, EmmaIntroduction: Ultrasound (US) integration in undergraduate medical education (UME) has been a popular topic for the past decade. Current literature indicates ultrasound inclusion in UME is commonly integrated in gross anatomy instruction or clinical skills courses. US inclusion in gross anatomy focuses on overall anatomy understanding, whereas US in clinical skills courses focuses on the diagnostic application of medical imaging. Although there is plenty of literature demonstrating the benefits of US inclusion in gross anatomy, there is little research looking at the use of gross anatomy reviews prior to learning clinical ultrasound. Further, there is little research investigating how transferable gross anatomy identification is to ultrasound anatomy identification. Therefore, this study's purpose is to assess the effects of gross anatomy review prior to learning clinical ultrasound. Methods: 22 first year medical students interested in joining the ultrasound interest group (USIG), an extracurricular student group, participated in the study in the spring semester of 2023. There were four ultrasound imaging modules taught during the semester: cardiopulmonary, liver/biliary, E-fast, and musculoskeletal. Students were divided into two groups where they were required to participate in a pre-module quiz, attend the ultrasound instruction, then complete a post-module quiz and survey after the ultrasound instruction. The EXP group had to participate in an additional anatomy review prior to the ultrasound instruction session. Pre- and post-module quizzes contained gross anatomy structures of the relevant anatomy for the module, along with paired ultrasound images of that anatomical structure. The quizzes for each module were identical to each other allowing repeated measures. This allows for tracking students ability to transfer knowledge from gross anatomy identification to ultrasound anatomy identification. Groups switched treatments for each module, allowing equal exposure to both treatments. Quiz scores were compared within and between groups, setting significance level at p<0.05. Results: Both CON and EXP groups significantly improved in their performance from pre-quiz to post-quiz in all four sub-scores for Module 1 (p<.001 for overall; d=1.3, US; d=1.16 and transfer; d=1.34, p<.05 for anatomy; d=.51) and Module 4 (p<.001 for overall; d=1.1,and transfer; d=.74, p<.01 for anatomy; d=.67, and US; d=1.47). Significant increases were seen in three sub-scores for module 2 (p<.01 for overall; d=.77, and US; d=.65, p<.05 for transfer; d=.46). There were no significant increases in performance from pre-quiz to post-quiz in module 3. Looking at self-improvement between groups, the EXP group did show higher mean gains than the CON group and mild to moderate effect sizes, although these comparisons were not significant. The EXP group showed higher mean scores on post-quiz assessments for most sub-scores, including mild to moderate effect sizes, although none of these were significant. Conclusion: Ultrasound is a valuable tool in all areas of medicine, especially in anatomy learning. This study shows that a gross anatomy review does have a positive impact on student performance when learning US. Medical students learning US may receive benefit from a gross anatomy review to reintroduce previously learned material and further reinforce US instruction.Item Incorporating ultrasound imaging in graduate gross anatomy labs improves learning(2023) Robertson, Taylor; Meyer, Kim; Kerr, Marcel; Reeves, Rustin; Handler, EmmaPurpose: Teaching ultrasound imaging is on the rise in both undergraduate and medical anatomy education. Despite the vast literature surrounding these areas, there is little research exploring the use of ultrasound in preparatory graduate programs, which emphasize credential enhancement for professional school applications. The purpose of this study is to identify the effects of ultrasound imaging inclusion in a graduate gross anatomy course. Methods:Students in the Master of Medical Sciences program enrolled in the gross anatomy course, a prosection-based cadaver lab that included pinned cadaver stations and an ultrasound station. Using ultrasound, teaching assistants imaged live human volunteers to demonstrate anatomical structures that students previously learned at the cadaver stations. To assess learning, students were given one ultrasound image question on each lab practical exam. Students also completed a pre- and post-course survey regarding perceptions of ultrasound inclusion in the course. Student lab practical scores and final course grades from the 2019 cohort were used as a historical control. Students in the 2022 cohort’s lab practical grades, final course grades, and survey data were used in statistical analysis. Classes disrupted by Covid-19 were excluded (2020 & 2021 cohorts). Results: 205 students from the 2019 cohort and 167 students from the 2022 cohort participated in this study, with 29 students from the 2022 cohort responding to the surveys. Students in the 2022 cohort had significantly higher lab practical scores in practicals 2 (p<.001, d=.361), 3 (p<0.001, d=1.038), 4 (p<.001< d=.487) and 5 (p<.001, d= .412). Survey data revealed that there was a significant increase (p<.001, d=1.203) in learning outcome achievement from pre-survey to post-survey. Students who correctly answered the ultrasound question performed significantly better on practicals 3 (p=.005) and 4 (p=.005) than those who missed the ultrasound question. Conclusion: These findings suggest that ultrasound imaging in a gross cadaver lab is beneficial to masters' students’ learning and understanding of gross anatomy and structural relationships. The utilization of ultrasound during cadaveric anatomy courses improves learning and outcome achievement in these graduate students. This hands-on instructional procedure would likely have the same effect on other cadaveric anatomy courses such as those in health sciences and medical curricula.Item Massage application to increase spread of local anesthesia in sciatic nerve blocks: a cadaveric study(2021) Robertson, Taylor; Fisher, Cara; Handler, Emma; Nash, DanielIntroduction: Sciatic nerve blockades are essential for treatment of a variety of lower limb pathologies. Due to the complexity and variation of anatomical landmarks, ultrasound (US) is used to guide injection of local anesthesia. In patients with thicker thigh girth (i.e., obese patients) excess tissue can distort US penetration, diminishing efficacy of the nerve block and/or post-operative pain. Dye tracing techniques have been used to test the effectiveness of nerve blocks, but there is little research on using massage to increase anesthetic spread. Therefore, this study will assess whether local massage can spread anesthetic proximal to the injection site. Methods: Fresh cadaveric legs were injected with 15cc's of 25:75 mixture of methylene blue dye and 0.5% bupivacaine. The specimens were divided into control (non-massage) and experimental (massage) groups. Nerve blockades with dye were performed by an anesthetist using US guidance at the popliteal fossa traveling proximally until the formation of the sciatic nerve, where the location was tagged. Immediately following, experimental specimens received repeated, proximally directed massages with the US transducer head. Specimens from both groups were dissected to expose the sciatic nerve. Measurements of the distance traveled from marked site of injection to proximal end of dyed area were measured and compared using statistical analysis. Results: Researchers expect significant difference in distance of injected materials proximal to injection site in the massage group compared to the experimental group. Conclusion: Post-injection massage can be used in clinical settings to increase efficacy of higher risk local anesthetic injections.Item Massage application to increase the spread of local anesthesia in sciatic nerve blocks: A cadaver study(2022) Robertson, Taylor; Fisher, Cara L.; Handler, Emma; Nash, DanielIntroduction: Sciatic nerve blocks are essential for surgical treatment of various lower limb pathologies. Due to the complexity and variation of anatomical landmarks, ultrasound (US) guided injection of local anesthesia has become common practice. In patients with thicker thigh girth (i.e., obese patients) excess tissue may distort US penetration thereby diminishing efficacy of the nerve block and/or cause severe post-operative pain. Dye tracing techniques have been used to test the effectiveness of nerve blocks, but there is little research on using massage to manipulate anesthetic spread. Therefore, the aim of this study is to assess the effects of massage to manipulate local anesthesia spread in sciatic nerve blocks. We hypothesize massaging after injection will increase the spread of local anesthesia compared to non-massage post injection. Methods: Forty un-fixed cadaveric legs were injected with a mixture of methylene blue dye and 2% Lidocaine Hydrochloride. Specimens were divided into non-massage (control) (n=20) and massage (n=20) groups. Sciatic nerve blocks were performed by a nurse anesthetist using US guidance at the popliteal fossa traveling proximally until the sciatic nerve was identified and the location was tagged. Immediately following, massage group specimens received five repeated proximally directed massages with the US transducer head. Specimens from both groups were then dissected to expose the sciatic nerve. Measurements of the distance traveled from marked site of injection to proximal end of dyed area were measured and compared. Results: Spread of local anesthesia in the inferior-superior direction was significantly higher in the massage group than the control group (p≤0.05). Conclusions: Massaging post-injection caused a greater spread of local anesthesia during sciatic nerve block. Significance: Sciatic nerve block techniques often utilize nerve stimulation to identify the sciatic nerve location. This may be due to lack of US penetration through the gluteus maximus muscle. In patients with thicker thigh girth due to subcutaneous fat, imaging visibility may be more difficult as well. Our findings suggest that clinicians may block the sciatic nerve at a more distal location with US guidance and manipulate the anesthesia to the region of interest