Exploring spatial ability in veterinary students and the relationship to teaching methods

Abstract

Anatomy is the foundation to most medical disciplines, and a sound understanding is required to underpin many aspects ranging from routine physical examination to complex surgical procedures. For qualified veterinary surgeons, anatomy knowledge is pivotal. The vast number of species dealt with, along with the fact that immediately after graduation veterinary graduates are permitted as a ‘Day One’ competency to perform surgical procedures further emphasises the necessity for strong anatomy knowledge. Anatomy by its very nature is a spatial subject; the human or animal body lives in a three-dimensional space and is, in itself, three-dimensional. It requires the mental manipulation of complex structures and an understanding of their topographical relationships. This spatially demanding aspect of anatomy is challenging to veterinary students, yet, despite the importance of the subject and the known challenges of learning anatomy, limited studies have researched the possible relationship of spatial ability to anatomy learning in veterinary medical students. The overall aim of this project was to investigate the possible relationship of spatial ability to the learning of anatomy, and the influence of different teaching methods on this learning in first-year veterinary medical students. Three well-validated tests of spatial ability (Card Rotation Test, Mental Rotation Test, and Surface Development Test) were given to four cohorts of undergraduate first-year students. Of the four cohorts, two cohorts were first-year veterinary medical students from the same academic institution but different academic year (University of Edinburgh first-year veterinary medical students cohort 1 (UoE Vet 1) and cohort 2 (UoE Vet 2)), one cohort of first-year veterinary medical students from a different academic institution to allow for between academic institution comparisons (University of Bristol first-year veterinary medical students (UoB Vet)), and lastly, one control cohort of first-year students studying psychology (University of Edinburgh first-year psychology students (UoE Psych)) to account for the re-test effect. All four cohorts were given the exact same spatial ability tests at the start of the academic year and 15-16 weeks later. The cohorts UoE Vet 1 and UoE Vet 2 additionally received a two-dimensional teaching method and a novel three-dimensional spatial teaching method respectively, and scores on an in-course spatial MCQ assessment and their end-of-course examinations were collected for comparison. The first study of this project aimed to investigate the baseline spatial ability of veterinary students to assess how consistent this ability is within one academic institution (UoE Vet 1 and UoE Vet 2), across institutions (UoB Vet), and to a control cohort of students who do not learn anatomy (UoE Psych). The second study compared a two-dimensional teaching method (UoE Vet 1) to a novel teaching method purposefully designed to teach anatomy spatially (UoE Vet 2), with the aim of improving anatomy knowledge and understanding. The third study involved the design and validation of a multiple choice question (MCQ) assessment to examine anatomy knowledge spatially and non-spatially and examined whether teaching spatially impacted on performance on the MCQ (UoE Vet 1 and UoE Vet 2). The fourth study investigated whether spatial ability improved in students who learn anatomy from two academic institutions (UoE Vet 1, UoE Vet 2, and UoB Vet) to a control cohort of psychology students (UoE Psych) who do not learn anatomy to account for the re-test effect observed with spatial ability tests. The fourth study also investigated whether the novel spatial teaching method had any additional significant impact on spatial ability improvement. The fifth study of this project qualitatively analysed student views and experiences of anatomy learning, the MCQ assessment, and spatial ability to provide a more in-depth qualitative insight (UoE Vet 1 and UoE Vet 2). The novel results of this project are as follows. An understanding that spatial ability appears to be relatively consistent across first-year veterinary medical students from the same academic institution and two different institutions (UoE Vet 1, UoE Vet 2, and UoB Vet) (p > 0.05). Comparison of spatial ability test scores of veterinary students to a control group of psychology students showed veterinary students scored higher on the Surface Development Test and exhibited a ceiling effect (OR = 1.85 – 1.69, p £ 0.004). The Mental Rotation Test exhibited gender differences with males scoring higher than females (p < 0.01) except for the UoB Vet cohort. The UoE Psych cohort exhibited a gender difference for all three spatial ability tests (p < 0.05). No statistical differences were observed for the demographic parameters handedness or age for each cohort. The successful design and delivery of a novel spatial teaching method resulted in improved student experience and improved anatomy test scores for short answer questions (OR = 1.18, p = 0.040) and an in-course oral exam (OR = 1.26, p = 0.005) compared to a two-dimensional teaching method. While the two-dimensional teaching method showed improved scores for interpretation style questions (OR = 1.35, p < 0.001) and in-course workbooks documenting dissection practicals (OR = 1.44, p < 0.001). The successful design of a novel MCQ containing items testing anatomy spatially, with the MCQ significantly predicting student performances on end-of-course examinations (OR 0.86 – 1.09, p < 0.05), and thus providing useful formative information to students on their progress. Student spatial ability scores for cohorts UoE Vet 2 and UoB Vet improved for the Card Rotation Test (RR = 1.05, p = 0.049 and RR = 1.06, p = 0.047, respectively). No improvement in spatial ability test scores was identified with the Mental Rotation Test for all four cohorts (p > 0.389). While cohorts UoE Vet 1 and 2 exhibited improvement for the Surface Development Test (OR = 1.46, p = 0.014 and OR = 1.86, p < 0.001, respectively). Overall indicating the 3D spatial teaching method improved spatial ability more than the 2D teaching method for the Card Rotation Test and Surface Development Test. However, post-hoc Tukey analysis directly comparing the post test scores of the two teaching methods identified no statistically significant differences. Further research should be carried out to investigate the 3D spatial teaching methods effect to improve spatial ability. The last novel finding of this project is the first identification and proposal, through student views and experiences, that spatial thinking is a threshold concept for anatomy learning. Overall, this research makes a novel contribution to veterinary anatomy education by exploring spatial ability in first-year veterinary medical students and relating it to their learning of anatomy both quantitatively and qualitatively. As one of the first detailed investigations into this aspect of cognitive ability in the context of Veterinary Medical Education, this work highlights the potential for this area of research to provide valuable insights into veterinary students learning and furthermore to inform curriculum and assessment development accordingly.