Moderated by Baatar Dologor
Session Coordinator: Mildred López

Presentation 1 - Untying the Gordian Knot: Scaffolding Using Software Tools as an Instructional Wand for the Educator Wizard    
Deborah Dalmeida    
American University of Antigua College of Medicine

Purpose
Scaffolding is essential for building metacognitive skills and providing an optimal balance of challenge and support. For complex topics where reasoning is difficult, the impact of software tools in scaffolding by providing additional structure to the task and enabling productive problem solving encounters needs to be explored. We determined, "Does inclusion of interactive modules as a form of instructional scaffolding achieve improved examination scores?"

Methods
Three modules in renal pathology for year two undergraduate medical students were deployed. Effect on academic performance in the end-of-course MCQ-based NBME summative examination, for topics covered within the modules in Fall 2022 was compared with the Fall 2021 cohort that did not receive these modules, using an unpaired t test and calculation of effect size. Learner perception was assessed using a five-point (Agree-Disagree) Likert scale survey and focus group.

Results
50 students completed all three modules. An overall 10 point difference between both cohorts (P value<0.0001) and an effect size of 0.6 was found in the end-of-course MCQ-based NBME summative examination. For two of three modules, a 20 and 23 point difference (P value<0.0001) with effect sizes of 0.8 and 0.7 respectively was detected. Survey and focus group analysis revealed that a significant majority of the learners found the modules easy to navigate, it stimulated prior recall and closed gaps in foundational knowledge, clarified complex concepts, helped organize their learning, found the variety of exercises memorable, and the open ended questions challenged them to apply content knowledge to new situations.

Conclusions
Interactive modules that check for understanding, provide feedback, and allow for retrieval fosters development of strong foundational knowledge of core concepts and provides learners multiple ways to reach a learning goal.

Presentation 2 - Preparing Distance Learning Graduate Students: Effects of an Innovative Online Orientation Program
Michael Leger
University of Texas Medical Branch

Purpose
New graduate nursing students in distance, or fully online, education programs often face hurdles that differ from those facing students enrolled in conventional, in-person programs. In an effort to meet the growing demand for advanced practice nurses, this program aims to reduce attrition while improving rates of on-time graduation. We introduced a 4-week faculty-facilitated, asynchronous online orientation program that is designed to reduce barriers to students' successful completion of online programs. This abstract describes the project and its outcomes.

Methods
The program has been in place since 2016 and is now with its 5th cohort. The 4-module program, provided at no cost to students, introduces students to a simulated online classroom environment. Activities and assignments offer the students hands-on, no-risk activities with the tools and resources they need to help them respond to four identified contributors to student attrition from online learning programs: technology knowledge deficit, student awareness of resources, preparedness for online learning, and socialization. Module topics and subject matter experts offer students a realistic preview of how to interact in an online course and the entry-level skills needed to be successful in an online program.

Results
Students from the first cohort who participated in the program perceive they are better prepared (&gt;75%) for the demands of an online learning program. Students who successfully completed the program demonstrated a 3% higher on-time graduation rate and a 4% lower rate of program withdrawals.

Conclusion
Incoming students positively perceived the program helping to increase their level of competency with the skill set expected of them in the online learning environment. Both students and faculty have realized improvements in student performance and preparedness in their online courses compared to students who do not participate in the orientation program.

Presentation 3 - Handling Tiny Components of Big Concepts: The Use of 3-D Printed Molecular Models to Enhance Students’ Medical Knowledge and Engagement with Learning    
John Chilton   
University of Plymouth 

Purpose
Students have access to a wide range of anatomical models to enhance their understanding of the 3-D nature of the body's structures. Few comparable resources are available for them to visualise processes at the molecular scale. In the case of receptors, transporters, channels and enzymes this is crucial to a full understanding of biochemical mechanisms, pharmacological modulation and clinical application. We have created custom 3-D molecular models to enhance teaching of a range of medical science disciplines including biochemistry, pharmacology, immunology and microbiology. Our models are not static 3-D representations but tailor-made tools harnessing multiple learning modalities to promote learning and retention of molecular concepts. 

Methods
We commissioned custom-printed 3-D models of key proteins encountered in the undergraduate medical curriculum, each chosen to exemplify important concepts. Models were rendered in PyMol using data from rcsb.org. Protein domains were coloured to match corresponding publications, key functional residues were also highlighted. This approach synergises linkage of kinaesthetic experience with visual and written learning. Mini-magnets were embedded in models to dynamically attach components and demonstrate intramolecular binding of domains and intermolecular association with 3-D printed ligands.

Results
Student feedback was obtained through focus groups. Models were compared to 3-D graphical rendering by computer (current best technological option) and 2-D paper-based representation (traditional teaching method). We present here illustrative examples of models with intended learning outcomes and analysis of the accompanying student feedback in terms of their engagement and learning. We explore its application to ideas for future refinement of this educational approach.

Conclusion
3-D printing offers a cost-effective and bespoke means to enhance traditional teaching of cellular and molecular sciences in biomedical curricula. There is great potential to expand this to many clinically relevant macromolecules to help medical students make deeper conceptual links between molecular mechanisms and patient outcomes.

Presentation 4 - Modernizing the Anatomical Variation Catalog
Katherine Colón Reyes 
University of Colorado Anschutz Medical Campus

Purpose
Classically, anatomical variations are cataloged in various two-dimensional mediums, such as print, illustrations, or photographs. While technology has significantly progressed, anatomic records have not followed suit. Digital preservation of anatomy through three-dimensional (3D) surface scanning technology provides an opportunity to not only improve record keeping but disseminate true to life cadaveric resources. In this project, we demonstrate a streamlined approach to modern anatomy preservation.

Methods
A 34-year-old female cadaveric donor from the Colorado State Anatomical Board was dissected into organ blocs for medical education. This donor presented a unique opportunity to study a premenopausal uterus. The uterus was digitally preserved using an Artec Space Spider in two separate presentations, within the body cavity (in-situ) and removed from the body cavity (ex-situ). The surface scans were processed in Artec Studio 15 using automatic and manual tools. The resultant meshes have an average geometric resolution of 0.15mm and a 4K texture resolution. The 3D models were annotated using Maya, the textures were refined using Substance Painter, and deployed using Unreal Engine 5.

Results
The 34-year-old uterus was successfully scanned and processed to create two novel 3D models. These models are now available in the Graduate School's anatomical variation catalog. Through digital cadaver preservation, this unique uterus has both physical and virtual versatility in student education as it is capable of being 3D printed and interacted with in an application developed using Unreal Engine 5.

Conclusions
Learning from a premenopausal uterus is a rare circumstance not many students are fortunate enough to encounter. Modernizing how unique presentations of anatomy are cataloged in partnership with projects such as the Modern Human Anatomy Open Educational Resource (OER) Hub will facilitate greater access and equity of cadaveric resources. Virtual models can also better preserve anatomical detail far beyond the average lifetime of a cadaver or plastination.