Learning the concepts of clinical radiology, including lesion identification and formulation of differential diagnosis lists, can be challenging for veterinary students. A series of educational puzzles with an overarching narrative was developed to help students learn the fundamental concepts of urogenital, thoracic, and spine imaging. Third-year veterinary students had the opportunity to use as many of the puzzles as they wished as a part of their studies in a semester-long imaging course, and students completed surveys to indicate which puzzle sections they used and provide their opinions of the activities. Graded performance in the course was correlated with how many puzzle activities students used. A small but statistically significant correlation was found between the number of puzzle sections used and midterm exam score, final exam score, and overall course score. Although most students who used the puzzles as a part of their studies enjoyed the activities, there was a dramatic decrease in usage over the semester, from 74% of survey respondents using the initial topic to a low of 27% utilization of the sixth topic, followed by a small rebound to 37% for the eighth topic (the review for the final exam). Thus, while developing a puzzle series is achievable and beneficial to student learning, possibly because of improved student engagement through increased variety in learning opportunities, further steps are necessary to encourage continued student engagement throughout the semester.
Question
Learning the concepts of clinical radiology, including lesion identification and formulation of differential diagnosis lists, can be challenging for veterinary students. A series of educational puzzles with an overarching narrative was developed to help students learn the fundamental concepts of urogenital, thoracic, and spine imaging. Third-year veterinary students had the opportunity to use as many of the puzzles as they wished as a part of their studies in a semester-long imaging course, and students completed surveys to indicate which puzzle sections they used and provide their opinions of the activities. Graded performance in the course was correlated with how many puzzle activities students used. A small but statistically significant correlation was found between the number of puzzle sections used and midterm exam score, final exam score, and overall course score. Although most students who used the puzzles as a part of their studies enjoyed the activities, there was a dramatic decrease in usage over the semester, from 74% of survey respondents using the initial topic to a low of 27% utilization of the sixth topic, followed by a small rebound to 37% for the eighth topic (the review for the final exam). Thus, while developing a puzzle series is achievable and beneficial to student learning, possibly because of improved student engagement through increased variety in learning opportunities, further steps are necessary to encourage continued student engagement throughout the semester.
Solution
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This study demonstrates that the development of educational puzzles is readily feasible, and the use of a set of puzzles as an adjunct learning and studying tool can be useful for improving students’ understanding of radiographic interpretive principles. While students who used a given puzzle topic did not perform better on the associated quiz than students who did not use the puzzles, students who used at least two of the puzzle topics during the semester demonstrated longer-term improvements in terms of higher scores on the midterm exam and the course as a whole. The reason for the lack of differences in scores on the individual quizzes is unclear. However, it is suspected that the open-book nature of the quizzes and the relatively low number of questions limited variation in student scores and thus limited the power of the exercise to identify differences between groups.Of particular note is the declining utilization of the puzzle activities by students over the course of the semester, despite the vast majority of students stating that they found the activities both useful and entertaining. Usage of the sixth topic, near the end of the semester, was only approximately one-third the rate of usage of the first topic at the beginning of the semester. Although there was a slight rebound at the conclusion of the semester as students studied the final topic, which was specifically geared toward preparation for the final examination, the rate of utilization of this topic was still only half of the utilization of the first topic. This correlates with experiences in utilization of mobile game apps; for example, according to a 2019 benchmark report on the mobile gaming industry, the median 1-day user retention is approximately 25%, and median 7-day user retention is approximately 6%.10 User engagement drops rapidly with repetitive gameplay unless new content is introduced.10 Similar findings have been described in a gamified portion of an engineering course, where gameplay for learning dramatically decreased over the course of a semester.11 The use of different types of puzzles was intended in part to provide students greater variety and reduce repetitive activities; however, in light of the identified decline in student participation over the semester, it is unclear if the variation mitigated what could have been a more precipitous decline or if it had minimal or no effect on student participation.We could question if the puzzle activities should be required throughout the semester, especially if there is evidence that they may be beneficial to student learning. Answering such a question is certainly beyond the scope of this study, and a decision in either direction would require a consideration of the benefits of the puzzles and the additional time required of all students to complete the activities. It is also necessary to acknowledge that different students have different preferences in terms of learning styles (visual vs. verbal perception, sequential vs. global understanding)12—the variety of puzzles was intended to provide options to students regardless of their preferences, so to mandate puzzle use against a given student’s learning preferences could have negative consequences.The primary limitation of this study is that student participation was voluntary, so it is possible that any differences in scores between students who used the puzzles and those who did not are actually due to other factors. Students who had a stronger inclination toward imaging may have been more likely to use the puzzles, thus artifactually increasing scores in that group. Alternatively, students who found imaging more challenging could have been more likely to use the activities as an additional study guide, which would, in turn, depress the scores for the puzzle-use group. To better assess the effects of puzzle use on student outcomes, a randomized prospective study could be performed to compare puzzle use to conventional studying.
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What is radiology?
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When the vet requests lateral radiographs, he wants images of the animal’s:AbackBfrontCsideDtail
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