VCOM Carolinas Research Day 2023
CREATING AN ACCESSIBLE, LOW-COST NEUROLOGICAL SIMULATOR DISPLAYING THE NEURAL PATHWAYS AND EDUCATIONAL MODULE TO ENHANCE THE UNDERSTANDING OF NEUROLOGICAL ANATOMY IN PRE-CLINICAL MEDICAL TRAINING. Victoria Mae Koniuk, OMS-II, Shea Fincher, OMS-II, Jordan Paugh, OMS-II, Tom Lindsey, DO, FACOS, CHSE, Michael Parks, MPA, MREMT Edward Via College of Osteopathic Medicine-Carolinas Campus, Simulation Center, Spartanburg, SC.
Abstract # EDUC-9
Although the fields of neurology and simulation technology are rapidly expanding, there is a scarcity of integrative neuroscience simulation during preclinical medical education. To address this, we have created a low-cost simulator and educational module acting as a visual representation of the nervous system. • Simulation technology has been under utilized during didactic medical education for the learning of basic sciences and its integration with clinical pathology (9). • The limited use of neurological simulators is a consequence of functional limits and difficulty demonstrating neurological pathways (6). • Cost remains the major barrier as academic medical institutions are unable to fund the implementation of neurological simulators into didactic education without external financial assistance (7, 8). • Web-based learning is at least as effective as traditional teaching methods (3), and blended learning programs are preferred by students over stand-alone lecture or online learning (2). • Interactive case-based learning using either paper testing formats or online multi-media platforms will increase knowledge and skills pertaining to a learners’ ability to identify conditions (10).
Graph 1 . Bar graph of Class of 2025 Median Exam Grades during Block 3.
• Class of 2025 performance on all neuroscience exams, shows the median class average on Exam 2 to be one of the lowest . Therefore, the content in this exam has been chosen for our project focus. • Students showed difficulty with the content presented in Neuroscience Exam 2 as represented by the class average. We hope to show an increase in understanding these components as tested by our post-learning assessment. • With data to reject the null hypothesis, we hope to prove that medical students in their didactic years achieve a better understanding of neurological concepts relating to neural pathways as measured by the post-learning assessment. • The construction of the simulator is currently still in progress however, the anticipated cost will hopefully eliminate the monetary barrier between students and the implementation of simulation curriculum (8). • One confounding factor we have acknowledge thus far is the inability to control outside resources students partaking in this study may use. • As a future progression, we would like to test the simulator and integrative module separately as well as together, to prove, as previous research has shown, that blended programs are preferred methods of learning. • Increasing amounts of young doctors are not choosing the field of neurology based on the lack of confidence in neurological pathology and an impaired neuroanatomy understanding. We hope our simulator and module can provide the foundational knowledge for students to feel prepared to enter this field (4).
Table 1. Neuroscience Exam 2 Score Report (VCOM-Carolinas) indicating: educational component, questions per component, class average, and class weighted average.
Participation in the stimulation and integrative educational module will improve understanding of foundational neurological concepts as measured by a post-learning assessment. Development
Simulator Development • Our neurologic simulator is being developed using 3D imaging and printing technology. • Brain, brainstem and spinal cord cross-section imaging is being obtained from a donated cadaver. • Once assembled, our simulator will be an expandable cross-section
model with visual depictions of various neural pathways. • A basic rendering of the brainstem is pictured to the right.
Data Collection • We plan to test the efficacy of the simulator and module combination by performing a randomized control trial with OMS-1; half with access to these resources, and the other half with only traditional curriculum. • A 30 question post-learning assessment, reflecting the content seen in Table 1 , will be administered to both groups. • A Students’ T -Test will be used to determine if there is a statistically significant difference. • To prove our simulator and module content is relevant to the challenging neurology curriculum, we assessed the 2022 Examplify, Class of 2025 Exam 2 score report for corresponding objectives (Table 1). To prove usefulness, we accessed the Class of 2025 Neuroscience Exam statistics from Canvas by Instructure (Graph 2). Module Development • Our module is being produced in Microsoft PowerPoint and includes content found in our simulator, clinical pathology, and self-guided quizzes. • Content will be sourced from VCOM-Carolinas Neuroscience Lectures, NBOME-Blueprint Level 1, and other relevant resources.
• The Class of 2025’s performance on Neuroscience exams show that Exam 2, focused on neural pathways and brainstem correlations, is one of the hardest examinations for medical students in their Neurology Block (Graph1) . • The Neuroscience Exam 2, taken by the Class of 2025, had a total of 48 questions of which 30 were directly applicable to the content demonstrated by our simulator and integrative educational module. • The weighted class average on the 30 relevant questions on 15 learning components was 72.57% calculated using the values seen in Table 1 . • Once data has been collected, a Students’ T -Test will be used to determine if there is a statistically significant increase in the class average between the experimental and control groups. • Upon development completion a Cost-Benefit Analysis will be determined.
Thank you to the Edward Via College of Osteopathic Medicine – Carolinas Campus Anatomy Department for allowing us to have access to the cadavers and to the Simulation Center for funding our project.
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