Interactive multimedia package seen as a benchmark achievement in teaching anatomy

Image showing Dr Irica Grkovic, Associate Professor Chris Brigg, Ms Priscilla Barker and Dr Norm Eizenberg

International acclaim: From left, Dr Irica Grkovic, Associate Professor Chris Brigg, Ms Priscilla Barker and Dr Norm Eizenberg.

Photo: Michael Silver

By Norm Eizenberg, Chris Briggs, Priscilla Barker and Ivica Grkovic

Radical changes in medical education, including a shift to more problem-based and independent learning, have seen interactive multimedia teaching play a strategic and expanding role at the University of Melbourne. A highlight of the University’s successful integration of multimedia teaching and learning in medical education is its development of An@tomedia, an internationally acclaimed teaching tool adopted (to date) by 10 other universities in Australia and overseas. Recognition of An@tomedia as a benchmark achievement includes a recent ‘rave’ review from the President of the World Association of Medical Editors writing in the international medical journal The Lancet. Behind An@tomedia is a multidisciplinary team led by four medical scientists who have worked together for more than eight years to bring the concept to fruition. Dr Norm Eizenberg, Associate Professor Chris Briggs, Ms Priscilla Barker and Dr Ivica Grkovic, based in the Department of Anatomy and Cell Biology, outline here the vision and innovation that have helped drive and shape An@tomedia as a teaching tool of the 21st century.

Development and integration of interactive multimedia teaching and learning into university curricula has accelerated rapidly over the past decade, bringing with it a need for strategic decisions involving inevitably major investment and commitment of resources.

The dilemma faced by teaching staff in the University of Melbourne’s School of Medicine and its Department of Anatomy and Cell Biology in the mid 1990s was no doubt one familiar to academics across a range of disciplines at many other universities – whether to buy ready-made products or to develop especially tailored resources in-house.

The main reasons why Melbourne decided on the second option were the limited educational value and lack of interactivity of what was available at that time. Additionally, our aim was to develop a fully comprehensive program covering all aspects of human anatomy (particularly an understanding of anatomical concepts and principles) that could be applied in future clinical contexts.

We saw An@tomedia largely as a resource to transform rather than replace teaching – to be used as a learning material before, during or after lectures and practical classes, but not as a curriculum. In particular, we saw it complementing rather than substituting for particular teaching methods, such as dissection.

The initiation and progression of such an ambitious, long-term project arose out of the framework the University set up for the development of quality learning materials. This provided stability coupled with encouragement at all levels. Also essential was a determined team effort and the collegial support provided in Anatomy and Cell Biology and by the Department of Teaching, Learning and Research Support (TeLARS) and across the University generally.

An@tomedia, among many other initiatives, is thus seen as a tangible outcome of the vision the University has put forward for revolutionising learning.

The package is a self-learning resource which enables exploration at any level, rate, order and degree of detail. It consists of nine modules, each containing approximately 20 hours of core educational activities (including key principles and applications) and 20 hours of advanced activities (including comprehensive details) if desired. Currently available modules are General Anatomy, Thorax, Back and Abdomen. Planned modules, for which much work has already been done, are Pelvis, Upper Limb, Lower Limb, Neck and Head.

Anyone can use An@tomedia. It enables exploration at any level of difficulty from the beginner to a specialist surgeon, including all medical and allied health practitioners and students. The program is an appropriate self-learning resource for both discipline-based and problem-based courses, where it can be used to provide an entire anatomy learning program or, preferably, be used in conjunction with existing learning programs as a resource for practical classes, tutorials, lectures and self-directed learning. Layer-by-layer dissections offer an excellent alternative when users are unable to perform actual dissections.

The name of the package is an acronym for ‘A New Approach to Medical Education: Developments in Anatomy’. The program contains interactive images (or movies) complemented by text. Structures and regions in each image may be labelled and/or highlighted with colour overlays, enabling the user to focus on what is critically important. The user is also engaged to integrate text with the images, through identifications and clinically oriented questions. Immediate feedback is provided via rollover labels and pop-up windows with many explanatory diagrams.

An@tomedia combines the benefits of a photographic atlas of anatomy, overlaid with colour illustrations. Users can choose their desired combination of overlays on serial dissections of real human bodies. Specific information may be easily accessed via the index or search engine and users can make rapid comparisons within or between perspectives. For example, a stomach may be viewed on dissection or post mortem, laparoscopy, radiograph or gastroscopy as well as compared with images of its structure, supply, position and relations.

Users benefit from multiple perspectives, incorporating all types of anatomy books and atlases, linked in one self-learning resource. The user can construct a body via two theoretical perspectives (‘Regions’ and ‘Systems’) and deconstruct it via two practical perspectives (‘Dissection’ and ‘Imaging’).

The four perspectives appear on the main menu as four interlocking forearms, which also represent the principal authors, each of whom assumed responsibility for the content of a perspective. Key input came also from an extensive group of consultants in related clinical specialties associated with the University. Images were developed together with photographers, digital imagers and medical illustrators from Anatomy and Cell Biology, while software, interface and graphics were developed by programmers and graphic designers from the University’s Courseware Development Services within TeLARS.

An@tomedia has been formally evaluated by medical students, anatomy tutors and international experts in anatomy, surgery and education with outstanding results. The product has also been awarded ‘Best CD Project’ and ‘Best Paper’ at the ASCILITE (Australasian Society for Computers In Learning In Tertiary Education) conference in 1999, and ‘Best General Multimedia’ at the ATOM (Australian Teachers of Media) awards in 2003.

Internationally also, An@tomedia is winning recognition. A recent review for The Lancet by Professor Ana Marusic began with the statement: “….An@tomedia would have revolutionised my student days”. Other international reviewers have commented: “The best feature is the layered approach to dissection combined with the superb quality of the images”; and “This is unquestionably the best CD ROM relating to gross anatomy that I have seen and I eagerly await the development of new modules”.

Medical and health science students at Melbourne use the four completed modules in problem-based learning as well as in the traditional science anatomy program. An@tomedia is also used by 10 other universities including McGill (Canada), Cape Town (South Africa) and King’s College London (UK).

When complete, An@tomedia will contain a total of 360 hours of learning activities and will have taken 100,000 hours of work to create. When the total numbers of students who may use the program are taken into consideration, this is indeed an efficient use of resources. Furthermore, An@tomedia can be revisited throughout the clinical years and subsequently in clinical practice or in postgraduate training programs. It provides a valuable life-long learning resource for postgraduates and practitioners in continuing medical education, self-education and even patient education.

Vol. 13, No. 3, 8-22 March 2004