Scroll Away! Understanding the Utility of Multi-Planar Anatomical Images in Instructional Cases for Medical Students

Ariel J. VanLeuven, Thomas R. Howdieshell, Jayabala Pamidimukkala

Research output: Contribution to journalArticlepeer-review


Many medical schools employ the use of single, static images from various anatomical imaging modalities during instructional activities and assessments because they provide a realistic and powerful tool for learning human anatomy. Previous reports have shown 3-dimensional and multiple, scrollable anatomical images to be beneficial for practicing physicians in making diagnoses and guiding treatments, but there are few reports on the utility of such scrollable images for medical student learning. This project uses a multi-planar, scrollable imaging file in an instructional clinical case to investigate its effect on student performance and their perception of this learning instrument. We hypothesize that after viewing multi-planar images, students will have an improvement in their ability to correctly recognize spatial anatomy in an assessment setting and they will report a benefit in their understanding of anatomy and their ability to diagnose a patient's pathology. Study participants are first- and second-year medical students at the AU/UGA Medical Partnership campus in Athens, Georgia (N=17). Each student received an anonymous link by e-mail containing the clinical case, a set of assessment questions, and a survey. Students worked through the case, took the assessment, then got to view a multi-planar computerized tomography (CT) file before taking the assessment again and completing a survey. Participants' ability to correctly identify the critical clinical anatomy and to identify the abnormality on the assessment were unchanged after viewing the multi-planar imaging file. Despite this quantitative finding, 100% of participants reported on the survey that the scrollable imaging file improved their understanding of critical clinical anatomy and their ability to recognize an abnormal clinical finding. In terms of clinical reasoning, 24% of the participants made the correct diagnosis from a static image before viewing the scrollable imaging file. Additionally, 30% of the participants originally made an incorrect diagnosis from the static image, but changed their response to the correct diagnosis after viewing the scrollable anatomical imaging file. All participants reported that they would prefer multiple, scrollable images compared to a single, static image when working with case-based learning materials. Additionally, all participants reported wanting more scrollable anatomical imaging incorporated into clinical cases in the curriculum. Even though participants could consistently identify anatomical structures, the scrollable imaging files notably improved their ability to make an accurate diagnosis. This result is supported by participant feedback reporting the great benefit of scrollable images in improving spatial discrimination and the relationships between pertinent anatomy. Given these findings, medical educators should consider adopting scrollable anatomical images into case studies and instructional materials, particularly in the pre-clerkship years.

ASJC Scopus subject areas

  • Biotechnology
  • Biochemistry
  • Molecular Biology
  • Genetics


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