Project Objectives

• To produce 32 teaching sets suitable for physical examination with simultaneous superimposed 3D body projection (3D-BIP), involving 4 anatomical/functional areas¹ for clinical skills teaching in Years 1, 3, and 5.
• Software training for teachers to enable them to use an online Radiological anatomy Segmentation program (OSIRIX) so as to develop 3D image sets.
• Interactive 3D Neuroanatomy Resource to facilitate interpretation of Normal and Pathological anatomy in MRI imaging of the brain.
• A Web-based Resource for Interpretation of 3D anatomy with reference to Chest-CT Examination.
• A Web-based Resource for Interpretation of 3D anatomy with reference to Abdominal-CT Examination.

Description of process, outcomes or deliverable

We developed 3D anatomical reconstructions from patients CT and MR images and developed self-study resources for students to navigate and use as a supplement to clinical encounters. During their clinical modules in Orthopaedics, Plastic and Head-Neck Surgery students were also given the opportunity to use 3D anatomical presentation superimposed on volunteers, willing patients and or mannequins. A total of 312 Year 3 and Year 5 students made use of these learning resources and we reinforced this intervention with case-discussions and clinical-radiological interpretations at the bedside.

Evaluation

The original evaluation plan involves collecting data on the students’ ability to interpret radiological 3D imaging and to make the relevant Radiological-Clinical correlations. Data on student performance in radiological interpretation of patient-specific investigations was collected on 312 students through their performances at i) End of module examinations in Year 3 and Year 5, ii) At the Year 3 Final Examination OSCE and iii) Year 5 Final Examination OSCE. Comparisons were made with a previous batch of 280 students who were not exposed to this project. There was a statistically significant improvement in the study group students as compared to their unexposed contemporaries.

Dissemination, diffusion and impact

Our project has enabled students in our clinical years (Years 3-5) to interpret cross-sectional anatomy on radiological investigations during their clinical attachments. With the provision of our chest, abdominal and neuroanatomy interpretation resources, students feel confident in their ability to perform a systematic interpretation of such investigations in the context of a given patient’s presentation. We have also been able to change teaching practices so that almost all clinical teachers will put students through a learning loop in which students are asked to interpret patients’ clinical presentations on the basis of their relevant cross-sectional imaging investigations wherever possible.

This project has enabled us to re-organize our Year 1 curriculum, particularly with enabling students to understand three-dimensional anatomy in the context of a patient’s clinical presentation (clinical symptoms, and signs on examination). While in the past, the teaching of gross anatomy was limited to the panel of Human Structure (PHUS) in Year 1, we have now made cross-sectional anatomic co-relation as an integral feature of the Year 1 teaching.

This project has been presented at the following meetings:

• Medical faculty curriculum retreat in 2010, 2011 and 2012.
• This work has been accepted for presentation at the Asia Pacific Medical Education Conference (APMEC) in Singapore, January 2013. – as an invited presentation in section on Great Ideas in Medical Education
• This work was also presented in a workshop held during the Hong Kong-China-Taiwan Medical Education Conference on 25 November 2011. There has been keen interest expressed by a number of mainland Universities (Nanjing U, Peking U, and Guangzhou Medical University amongst others) in utilizing the resources we have developed towards teaching their students.
• This project has also been presented at the CUHK Learning Expo in 2009 and during the UGC visit in 2010.