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Abstract Physicians have difficulty recognizing and diagnosing disorders of primary hemostasis. The root of this may lie in their education, where students are often taught hemostasis using static graphics. We aimed to create a didactic animation on primary hemostasis for medical students to be used in North American medical schools. To promote widespread use of the animation, we surveyed hemostasis educators from Canada and the US regarding the animation's learning objectives. The animation's script and storyboard were developed using the Animation Processing Model (APM), a psychological processing model that addresses the perceptual limitations of learners. This animation is the first biomedical animation to use the APM in its design. Furthermore, this is the first didactic hemostasis animation, which sought peer consensus for its learning objectives.

 



Introduction

Physicians have difficulty recognizing and diagnosing primary hemostatic disorders like von Willebrand disease. In medical school, hemostasis is often taught using static graphics, which may fail to capture the temporal and structural complexity of the subject, leading to incorrect mental models. As compared to static graphics, animation has been shown to improve learning outcomes. Learning outcomes are statistically higher with medical education digital tools, which are developed using a specific learning theory. Furthermore, it is recommended that development of these tools follows establishment of learning objectives for the tool. The purpose of this project is to develop an animation for medical students, which presents an introduction to primary hemostasis. To inform the animation's content, we aimed to survey educators with experience in teaching hemostasis in North American medical schools regarding learning objectives for the animation. We elected to use the Animation Processing Model (APM) as the learning theory, which would guide the animation's pre-production and production. The APM is a psychological processing model that addresses the perceptual limitations of learners viewing educational animations for which the learner has little or no experience with the animation's content.


Materials and Methods

Learning objectives were abstracted from Robbins and Cotran Pathologic Basis of Disease.

 

A Likert scale survey was sent via SurveyMonkey (www.surveymonkey.com) to the Association of Hemophilia Clinic Directors of Canada (AHCDC; www.ahcdc.ca) and the Foundation for Women and Girls with Blood Disorders (FWGBD; www.fwgbd.org).

 

For each proposed learning objective, the survey participant was asked: 1. The degree which the educator supported using each learning objective for the animation. 2. The difficulty faced by a typical medical student in learning the concept posed by the objective.

 

Objectives underwent an event unit analysis according to the APM, pairing the entities of primary hemostasis with each of their discrete actions (movement, appearance, or state change).

 

Following this analysis, a script and storyboard were developed.

 

The final animation was created using two techniques: 1. Frame-by-frame animation (Rough Animator and Adobe Photoshop) 2. 2D plus animation (Maxon Cinema 4D [Sketch and Toon Module], Adobe After Effects, Adobe Audition, Adobe Premiere Pro)



To view the complete results of this study, select the above image or this "PDF" link.

Vesalius Trust logo

This Vesalius Trust research poster was presented at the Association of Medical Illustrators' 2020 Virtual Conference.



Conclusion
This is the first biomedical animation to use the Animation Processing Model to inform its design.

 

This is the first educational animation on primary hemostasis that sought consensus for its learning objectives.

 

This manuscript and results will be submitted for publication.

 

Future plans include: 1. Producing a control animation using a script and storyboard developed prior to the event unit analysis. 2. Performing a randomized study with medical students on learning outcomes between control and APM animations.

 

 

Acknowledgements

We gratefully recognize Nicholas Woolridge (Biomedical Communications, Dept. of Biology, University of Toronto) for his technical support with Cinema 4D, the generous support of the Vesalius Trust, and the AHCDC and FWGBD for their participation in our survey and feedback on the survey instrument.


References

1. Kirtava A, Crudder S, Dilley A, Lally C, Evatt B. Trends in clinical management of women with von Willebrand disease: A survey of 75 women enrolled in Haemophilia Treatment Centres in the United States. Haemophilia. 2004;10(2): 158-161.

 

2. Lowe RK, Schnotz W. Animation Principles in Multimedia Learning. In: Mayer RE, ed. The Cambridge Handbook of Multimedia Learning, Second Edition. Cambridge: Cambridge University Press; 2014: 513-546.

 

3. Berney S, B├ętrancourt M. Does animation enhance learning? A meta-analysis. Comput Educ. 2016;101: 150-167.

 

4. Bajpai S, Semwal M, Bajpai R, Car J, Ho AHY. Health Professions' Digital Education: Review of Learning Theories in Randomized Controlled Trials by the Digital Health Education Collaboration. J Med Internet Res. 2019;21(3): e12912.

 

5. Lowe R, Boucheix JM. A Composition Approach to Design of Educational Animations. In: Lowe R, Ploetzner R, eds. Learning from Dynamic Visualization: Innovations in Research and Application. New York City: Springer International Publishing; 2017: 5-30.

 

6. Kumar V, Abbas AK, Aster JC. Robbins and Cotran Pathologic Basis of Disease. In: Kumar V, Abbas AK, Aster JC, eds. 9th ed. Philadelphia: Elsevier Saunders; 2015.

 

 

Licensing

The primary author has chosen to license this content under a Creative Commons Attribution, NonCommercial, NoDerivatives 4.0 International License.




Conflict of Interest Statement

The Journal of Biocommunication Management Board and Editors believe that transparency in academic research is essential. Our JBC authors are now required to disclose any possible conflict of interest when submitting a manuscript. In accordance with the Journal of Biocommunication's editorial policy, no potential conflict of interest has been reported or declared by these authors.