The Anatomy of Traditional and E‐Learning Education: How the spatial ability of learners can impact learning outcomes

Technological innovation is changing the landscape of higher education, and the competing interests and responsibilities of today's learners have propelled the movement of post‐secondary courses into the online environment. In the anatomical sciences, computer‐aided instruction and online learning tools have become a critical component of teaching the intricacies of the human body when physical classroom space and cadaveric resources are limited. Our previous research (n=70) compared a simple 2‐dimensional e‐learning tool (A.D.A.M. Interactive Anatomy) to a more complex tool that allows for a more 3‐dimensional perspective (Netter's 3D Interactive Anatomy). Despite the differences in how these e‐learning tools present information, student ability to learn anatomical material, and their mental effort while doing so, known as cognitive load, were identical between e‐learning tools. However, when students with low spatial ability studied anatomical content with the more complex tool (Netter's 3D Interactive Anatomy), their performance scores were significantly lower than those students with high spatial ability (p=0.007). These results indicate that e‐learning tool software design can differentially influence students based on their spatial ability, but it remains to be determined if traditional kinesthetic‐tactile learning approaches, such as manipulating a skeleton, are also impacted by a student's spatial ability. Using a novel dual‐task methodology with a cross over design, undergraduate anatomy students from The University of Western Ontario, Canada (n=71) were evaluated as they studied a bony joint using a physical skeleton as well as a simple commercial software program (A.D.A.M. Interactive Anatomy). We hypothesized that the acquisition of anatomical knowledge by students, regardless of their spatial ability, would be superior when learning is associated with a real model, rather than currently available e‐learning tools. Students were assessed using a baseline knowledge test, Stroop observation task response times (a measure of cognitive load), MRT scores (a measure of spatial ability) and an anatomy post‐test (a measure of learning). Results suggested that while students may experience more cognitive load while studying using a physical skeleton (p<0.001), it does not detrimentally impact their performance; in fact student performance was significantly higher when they studied using the skeleton (p<0.001, R=0.46). Furthermore our results also demonstrated that students with low spatial ability are at a significant disadvantage when they learn the bony anatomy of a joint and are tested on images of the contralateral joint (p=0.023, R=0.326). This study highlights a major weakness in the strategy to move traditional anatomical education online, and suggests that students should be taught the anatomy of both sides of the human body, regardless of the reality that human limbs are mirror images of each other. These results can be further applied to the training of future surgeons and medical specialists, where surgical and medical procedures should be taught and practiced on both sides of the human body, to ensure that all students, regardless of spatial ability, can take their anatomical knowledge into the clinic and perform successfully. Support or Funding Information Social Science and Humanities Research Council, Government of Canada

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