Twisted Development: Assessing the Educational Value of a 4D Interactive Embryonic Gut Tube Model
Authors: Zabalaga-Haberman MariaFrancisca , Amici Anna , Gritton Cory Buenting , Stratford Jennifer M. , Lee Lisa M.J. 
Published: April 2020

Embryology is a core component of medical education; however, it is often taught as a minimally integrated subject in other courses. This presents challenges for students to learn embryology due to the complex developmental changes that occur not only in 3 spatial dimensions, but also in the 4th dimension in time. To overcome these challenges, new interactive embryonic models were created to demonstrate the gastrointestinal development in 4D. In an IRB‐exempt, randomized single blind study (#19‐2135), first year medical students enrolled in an integrated gross anatomy course were randomly assigned into either experimental or control groups to work in teams of 6–8, during an active review session. Students in the experimental group were provided with the interactive 4D embryonic models demonstrating gut tube development (Figure
1), while students in the control group were provided with a series of 2D images modified from figures within an embryology textbook (Figure
2) depicting the same developmental process. All students completed pre and post‐quizzes before and after interacting with their assigned resource followed by a survey. After the survey, the two groups switched rooms to interact with the alternate resource. Student resource preference was assessed by exit poll. Two‐Way ANOVAs were completed to assess the learning outcomes and quantitative survey data. Thematic analysis was performed on the survey comments.A total of 156 students completed the study (experimental: n=80, control: n=76). Both groups improved their post‐quiz performance compared to the pre‐quiz (p<0.05; η2 = 0.27), but there was no difference in the post‐quiz improvement between the two groups (p=0.9), suggesting that learning occurred regardless of resource type. Survey analytics also revealed no significant difference between the two groups (p>0.05), with both groups rating the perceived educational value of the assigned resources high. Despite the lack of significant differences in learning outcomes and perceived resource value, over 60% of all participants expressed preference for the interactive 4D embryo model (60% experimental and 67% control) after using both resources. While similar themes regarding the resource values emerged from the two groups’ survey comments (resources being engaging and helpful for visualization, but needing more time for resource interaction), twice as many students from the experimental group remarked that the 4D model was helpful for visualizing the developmental process. A unique theme for the experimental group was a need for a more explicit instruction for interacting with the 4D model.The outcomes of this study suggest that an interactive embryonic model depicting complex 4D transformation may not be as effective in education as expected. However, a demand for a detailed instruction is worth considering for the 4D model, as well as assessing the teamwork effect on the learning outcomes and resource ratings in the future studies.Interactive 4D embryo model.Figure 12D images modified from Embryology textbook The Developing Human: Clinically Oriented Embryology. (Moore, 2020)Figure 2