The aim of this thesis was to gain evidence-based insights to improve anatomical and surgical education by evaluating how various levels of visual-spatial abilities interacts with learning using... Show moreThe aim of this thesis was to gain evidence-based insights to improve anatomical and surgical education by evaluating how various levels of visual-spatial abilities interacts with learning using stereoscopic 3D visualization technology Show less
Bogomolova, K.; Merrienboer, J.J.G. van; Sluimers, J.E.; Donkers, J.; Wiggers, T.; Hovius, S.E.R.; Hage, J.A. van der 2021
Background: The effect of three-dimensional (3D) vs. two-dimensional (2D) video on performance of a spatially complex procedure and perceived cognitive load were examined among residents in... Show moreBackground: The effect of three-dimensional (3D) vs. two-dimensional (2D) video on performance of a spatially complex procedure and perceived cognitive load were examined among residents in relation to their visual-spatial abilities (VSA).Methods: In a randomized controlled trial, 108 surgical residents performed a 5-Flap Z-plasty on a simulation model after watching the instructional video either in a 3D or 2D mode. Outcomes included perceived cognitive load measured by NASA-TLX questionnaire, task performance assessed using Observational Clinical Human Reliability Analysis and the percentage of achieved safe lengthening of the scar.Results: No significant differences were found between groups. However, when accounted for VSA, safe lengthening was achieved significantly more often in the 3D group and only among individuals with high VSA (OR = 6.67, 95%CI: 1.23-35.9, p = .027).Conclusions: Overall, 3D instructional videos are as effective as 2D videos. However, they can be effectively used to enhance learning in high VSA residents. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Show less
Nazari, T.; Bogomolova, K.; Ridderbos, M.; Dankbaar, M.E.W.; Merrienboer, J.J.G. van; Lange, J.F.; ... ; Hage, J.A. van der 2021
Background: Task-specific checklists and global rating scales are both recommended assessment tools to provide constructive feedback on surgical performance. This study evaluated the most effective... Show moreBackground: Task-specific checklists and global rating scales are both recommended assessment tools to provide constructive feedback on surgical performance. This study evaluated the most effective feedback tool by comparing the effects of the Observational Clinical Human Reliability Analysis (OCHRA) and the Objective Structured Assessment of Technical Skills (OSATS) on surgical performance in relation to the visual-spatial ability of the learners. Methods: In a randomized controlled trial, medical students were allocated to either the OCHRA (n = 25) or OSATS (n = 25) feedback group. Visual-spatial ability was measured by a Mental Rotation Test. Participants performed an open inguinal hernia repair procedure on a simulation model twice. Feedback was provided after the first procedure. Improvement in performance was evaluated blindly using a global rating scale (performance score) and hand-motion analysis (time and path length). Results: Mean improvement in performance score was not significantly different between the OCHRA and OSATS feedback groups (P = .100). However, mean improvement in time (371.0 +/- 223.4 vs 274.6 +/- 341.6; P = .027) and path length (53.5 +/- 42.4 vs 34.7 +/- 39.0; P = .046) was significantly greater in the OCHRA feedback group. When stratified by mental rotation test scores, the greater improvement in time (P = .032) and path length (P = .053) was observed only among individuals with low visual-spatial abilities. Conclusion: A task-specific (OCHRA) feedback is more effective in improving surgical skills in terms of time and path length in novices compared to a global rating scale (OSATS). The effects of a task-specific feedback are present mostly in individuals with lower visual-spatial abilities. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Show less
Bogomolova, K.; Hierck, B.P.; Looijen, A.E.M.; Pilon, J.N.M.; Putter, H.; Wainman, B.; ... ; Hage, J.A. van der 2020
Objectives: The features that contribute to the apparent effectiveness of three-dimensional visualisation technology [3DVT] in teaching anatomy are largely unknown. The aim of this study was to... Show moreObjectives: The features that contribute to the apparent effectiveness of three-dimensional visualisation technology [3DVT] in teaching anatomy are largely unknown. The aim of this study was to conduct a systematic review and meta-analysis of the role of stereopsis in learning anatomy with 3DVT.Methods: The review was conducted and reported according to PRISMA Standards. Literature search of English articles was performed using EMBASE, MEDLINE, CINAHL EBSCOhost, ERIC EBSCOhost, Cochrane CENTRAL, Web of Science and Google Scholar databases until November 2019. Study selection, data extraction and study appraisal were performed independently by two authors. Articles were assessed for methodological quality using the Medical Education Research Study Quality Instrument and the Cochrane Collaboration's tool for assessing the risk of bias. For quantitative analysis, studies were grouped based on relative between-intervention differences in instructional methods and type of control conditions.Results: A total of 3934 citations were obtained of which 67 underwent a full-text review. Ultimately, 13 randomised controlled trials were included in the meta-analysis. When interactive, stereoscopic 3D models were compared to interactive, monoscopic 3D models within a single level of instructional design, for example isolating stereopsis as the only true manipulated element in the experimental design, an effect size [ES] of 0.53 (95% confidence interval [CI] 0.26-0.80;P < .00001) was found. In comparison with 2D images within multiple levels of instructional design, an effect size of 0.45 (95% CI 0.10-0.81;P < .002) was found. Stereopsis had no effect on learning when utilised with non-interactive 3D images (ES = -0.87, 95% CI -2.09-0.35;P = .16).Conclusion: Stereopsis is an important distinguishing element of 3DVT that has a significant positive effect on acquisition of anatomical knowledge when utilised within an interactive 3D environment. A distinction between stereoscopic and monoscopic 3DVT is essential to make in anatomical education and research. Show less
Bogomolova, K.; Ham, I.J.M. van der; Dankbaar, M.E.W.; Broek, W.W. van den; Hovius, S.E.R.; Hage, J.A. van der; Hierck, B.P. 2019
