We've known for some time that students in anatomy who use visual aids such as models or computer programs perform better on anatomy course examinations (McNulty et al., 2010; Sugand et al., 2010), and we can expect to see an increase in student reliance upon visual learning aids as curricula trend toward less classroom and laboratory didactic time. Over the next decade teaching medical school anatomy will likely rely more on independent learning aids and other distance-learning activities (Sugand et al., 2010).
With demand for new products in sight, interest in the development and use of new educational tools seems to be steadily growing. According to ASE metadata, the number of submissions, published articles, and downloads by our readers on this topic demonstrates this surge of interest. Furthermore, over the last five years we have published numerous articles describing the development of computer-based visual resources (Trelease and Nieder, 2013), results from usability testing (Doubleday et al., 2011), and educational outcomes (Choudhury and Gouldsborough, 2012) related to computer-based visual resources in anatomy.
But let's not get ahead of ourselves. Several studies have shown that digital media, such as dynamic presentations and virtual reality, may have mixed effects on learners, and not all positive (Garg et al., 1999, 2001, 2002; Brenton et al., 2007; Levinson, 2007). In the current issue of ASE, two undergraduate students, Zaid Khot and Kaitlyn Quinlan from Drs. Geoff Norman and Bruce Wainman laboratories at McMaster University compared learner outcomes among those using computer-based virtual reality materials and those using a static atlas-type compendium of photographic images and a solid 3D plastic model (Khot et al., 2013). In this simple and elegantly designed experimental study, three groups of students studied female pelvic anatomy. One group used a 3D computer-based virtual rendering of a pelvis reconstructed from CT scans, the second group used a plastic model of the pelvis, and the third group used two-dimensional photographs of the plastic model. After the learning phase, the students took a knowledge test. Surprisingly, the group of students that used the old classic plastic model outperformed both groups using either photographs or the 3D virtual CT-rendered model (Khot et al., 2013). And this is not an isolated finding. A second article in this issue by Daniel Preece, a recent graduate from The Royal Veterinary College at the University of London and his mentors Drs. Sarah Williams, Richard Lamb, and Renate Weller, also shows that students who use a plastic model of an equine foot learn significantly more than those using textbooks or 3D computer models (Preece et al., 2013). Also interesting is that in both studies computer-generated visual tools showed no advantages over two-dimensional media that included textbooks and atlases (Khot et al., 2013; Preece et al., 2013).
These two independent studies emerge at a time of great technologic imperative. Academic culture pressures anatomical science educators toward using more and more online and computer-based learning modules to the extent that plastic models and anatomy atlases may now seem like anachronisms in a modern laboratory. Perhaps, we should slow down. Why rush forward with blinding speed into a world exclusive to computer-assisted learning tools when there is evidence that the old-fashioned static models work just as well? There is something about anatomical models which provides an important yet elusive key that helps students unlock the door to understanding complex 3D anatomical structures (Khot et al., 2013; Preece et al., 2013). Perhaps it is a simple truth: putting one's hand on an object helps us to know it better.
So, remove those anatomical models from the glass cabinets. Take the plastic figures down from shelves, dust them off, and teach the students to learn them well. The future of anatomical education, if it is to be a truly multi-modal discipline, must remain hands-on.
Wojciech Pawlina, M.D.*
College of Medicine, Mayo Clinic
Richard L. Drake, Ph.D.*
Cleveland Clinic Lerner College of Medicine