School of Medical Education, Newcastle University, Newcastle upon Tyne, UK.
GKT School of Medical Education, King's College London, London, UK.
Adv Exp Med Biol. 2020;1235:103-116. doi: 10.1007/978-3-030-37639-0_6.
Clinical image interpretation is one of the most challenging activities for students when they first arrive at medical school. Interpretation of clinical images concerns the identification of three-dimensional anatomical features in two-dimensional cross-sectional computed tomography (CT) and magnetic resonance imaging (MRI) images in axial, sagittal and coronal planes, and the recognition of structures in ultrasound and plain radiographs. We propose that a cognitive transition occurs when initially attempting to interpret clinical images, which requires reconciling known 3D structures with previously unknown 2D visual information. Additionally, we propose that this 3D-2D transition is required when integrating an understanding of superficial 2D surface landmarks with an appreciation of underlying 3D anatomical structures during clinical examinations.Based on educational theory and research findings, we recommend that 3D and 2D approaches should be simultaneously combined within radiological and surface anatomy education. With a view to this, we have developed and utilised digital and art-based methods to support the 3D-2D transition. We outline our observations and evaluations, and describe our practical implementation of these approaches within medical curricula to serve as a guide for anatomy educators. Furthermore, we define the theoretical underpinnings and evidence supporting the integration of 3D-2D approaches and the value of our specific activities for enhancing the clinical image interpretation and surface anatomy learning of medical students.
临床影像解读是医学生刚入学时面临的最具挑战性的活动之一。临床影像解读涉及在轴位、矢状位和冠状位的二维计算机断层扫描(CT)和磁共振成像(MRI)图像中识别三维解剖特征,以及识别超声和普通 X 光片中的结构。我们提出,当最初尝试解读临床影像时,会发生认知转变,这需要将已知的三维结构与以前未知的二维视觉信息协调一致。此外,我们还提出,在临床检查中,将对浅层二维表面标志的理解与对深层三维解剖结构的理解结合起来时,也需要进行这种 3D-2D 转换。基于教育理论和研究结果,我们建议在放射学和表面解剖学教育中同时结合 3D 和 2D 方法。有鉴于此,我们开发并利用了数字和基于艺术的方法来支持 3D-2D 转换。我们概述了我们的观察和评估,并描述了我们在医学课程中实施这些方法的实际情况,为解剖学教育工作者提供指导。此外,我们还定义了支持 3D-2D 方法整合的理论基础和证据,以及我们特定活动对增强医学生临床影像解读和表面解剖学习的价值。