Evaluating Kinesthetic Activities for Learning the Skull Base Neurovasculature Across the Preclinical Medical School Continuum

Abstract Body : Learning neurovascular structures and foramina at the skull base often relies on rote memorization using traditional methods such as didactics or a model skull with a single wire. However, a more detailed understanding of structure and function is required to apply knowledge to novel clinical scenarios. The current study addressed this gap by designing a guided activity for learning neurovascular structures of the skull base in which students labeled foramina and used pre-made structure/function tags and air-dry clay to simulate space-occupying lesions and predict patient signs and symptoms. The activity was compared with two traditional methods during a learning session. We hypothesized that the guided activity would result in higher quiz scores and more positive perceptions compared with the lecture and single-wire skull lab. Master of Medical Science and First Year Medical Student volunteers (n= 95) were semi-randomized into three treatment groups (lecture, single wire skull lab, skull-based guided activity) based on VARK learning style and prior anatomy experience. Each group participated in a 30-minute learning session using their assigned resource. Learning was assessed using a pre-, post-, 2-week retention test format. Quiz scores for each treatment group were compared across time using a Friedman test. Perceptions were assessed using a 5-point Likert scale survey and were analyzed using Kruskal-Wallis. Second year medical student volunteers (n= 215) provided feedback about the learning tools on a perceptions survey. Novice participants in the single wire skull group scored higher than those in the guided activity group (p= .0043). There was no difference in quiz scores for participants with prior experience (p= .874); however, this cohort showed increased retention using the guided activity compared with traditional learning methods. Both first and second year students perceived the guided activity more positively than the lecture (p= .0421 and p= .0019, respectively), reporting that it was more engaging (p= .0003) and stimulated interest in the learning content (p< .0001). For second year students, the guided activity was also preferred over the single-wire skull lab (p= .0005). The most effective and preferred learning resource differed based on prior exposure to the learning content. Novice learners had higher academic achievement using the single-wire skull lab while learners with prior experience benefited from the guided activity. The single-wire activity is recommended as a learning tool for novice students while the guided activity is recommended for learners with prior knowledge of supportive structures at the skull base. This study highlights the importance of testing educational tools with different levels of preclinical learners to tailor resources to student needs. Future research will explore use of the guided activity as a board review tool as well as the relationship between learning style and academic achievement for various learning resources.