The Development of Clinical Laboratory Exercises for Veterinary Neuroanatomy Classes
J. K. Daniloff
From the Department of Veterinary Anatomy and Cell Biology
School of Veterinary Medicine, Louisiana State University
South Stadium Drive, Baton Rouge, LA 70803.
The ultimate success of teaching depends upon numerous factors. These include: translating material to the appropriate student level, practicing the subject in small groups, encouraging feedback, and relaying subject matter in course laboratories (1, 2). A poll of veterinary teaching faculty established this hierarchical list of the contributions made by student laboratories in teaching Veterinary Pharmacology: enhance understanding of important concepts, provide long-lasting impressions, increase clinical confidence, improve student-instructor contact, encourage individual and group discussion, and stimulate cooperation and leadership (3).
In compliance with factors that support effective teaching, the Louisiana State University School of Veterinary Medicine has established teaching goals that incorporate problem-based learning and clinical relevance into basic science curriculum. Faculty also encourage students to actively participate in their education and interact with peers. With these goals in mind, a laboratory technique for Veterinary Correlative Neuroanatomy was developed to support student learning in laboratory sessions. This course consisted of 21 hour-long lectures and 7 three-hour laboratory sessions, leaving each component with 21 contact hours. Due to this format, exam questions were derived in equal quantity from laboratory and lecture material.
The goal of each laboratory session was to reinforce and build upon lecture material through dissection and visualization of brain regions presented in lectures. Exercises for each laboratory were developed from case reports to demonstrate the clinical relevance of the current laboratory and related lecture subject matter (Figure 1). Themes included localizing brain lesions, matching structures with function, diagnostics, and integration of lecture materials. Exercises were created from numerous sources that included clinical faculty, local practitioners, textbooks and reference materials. Groups of four students were assigned to laboratory tables for each 3-hour laboratory session. All were encouraged to integrate the current laboratory material with related lecture information to complete the exercises. Although faculty were present during each laboratory session, they did not assist students in answering any exercise questions.
Figure 1. Example of a laboratory exercise. A group of 4 students must assign an injury site to each described behavior and answer 2 questions to the best of their combined abilities.
Laboratory Exercise: Date:
A young, black Labrador Retriever is brought to your Emergency Clinic bleeding from a small wound to the head. While hunting, the patient was hit by a bullet fragment.
Complete the statements to the best of your knowledge.
Behavior Site of Brain Injury
1. There is a loss of sensation on the left side of face.
2. The dog has difficulty chewing.
3. There appears to be partial loss of vision.
4. The gait is abnormal, with unilateral paresis of the left side of the body.
5. The left eye cannot move.
6. The dog fails to turn its head toward the sound when your associate drops his keys behind the dog on its left side.
7. What area of the brain is damaged and what side? (2 points)
8. Please explain why many of the observed deficits could change during the next 3 days. (2 points)
Each student received a copy of the exercise during the final 30 minutes of the session. Doors to the laboratory were closed to restrict both incoming and outgoing activity. Every group was responsible for completing the exercise jointly and submitting one copy signed by each participant. Exercises were evaluated with written comments by faculty and returned during the final 15 minutes of the following session for class review. In many cases, more than one appropriate answer existed and care was taken to assign credit when an accurate rationale was provided. All correct responses were announced and explained. Students were then encouraged to interact with the faculty to discuss queries, misunderstandings and related topics. Each exercise was worth up to 10 points for each participant and the accumulated scores contributed to approximately 10% of the final grade.
With laboratory exercises, each laboratory session concluded with the clinical application of the neuroanatomy topics that were presented in the laboratory session and preceding lectures. The format promoted peer interactions because groups of four students were required to submit one representative response sheet. Integrating instructional information into clinical cases helped elucidate the relevance of each topic. After graded laboratory exercises were returned, small groups or individual students were given the opportunity to interact with faculty to discuss the exercises and related topics.
Signatures were required to encourage consistent and active participation. Reliable attendance records were generated for 275 veterinary students over a 4-year period (Figure 2). Eighty-six percent of the students that received cumulative final course scores above 91 points (A) attended all laboratory sessions. In sharp contrast, no students with final scores below 74 points (D, F) had perfect attendance. While 56% of the students within the B range (91-83 points) attended all sessions, only 11% of students within the 74-82 point range (C) achieved perfect attendance.
Figure 2. Student attendance in laboratory sessions and final grade scores. Columns depict the percentage of students with perfect attendance (vertical axis) within 4 ranges of final course grades (horizontal axis).
The incorporation of problem ssolving and critical thinking into veterinary curricula has been recognized as essential for the future health of veterinary education (4). Therefore, laboratory exercises were designed to augment understanding of lecture information by integrating clinical material. Incorporating the relevance of basic science has been reported to support group discussion, peer interactions and achievement (3).
Attendance records for laboratory sessions correlated positively with final grades achieved. The data, however, did not definitively prove that laboratory participation optimized final scores, because student presence in lectures was not monitored. One cannot deny the possibility that students destined to receive high grades tend to participate consistently in scholastic activities regardless of subject matter and potential profit. This correlation, however, did support claims by others that student participation in classes (1, 2) and laboratory sessions (3, 4) can enhance education. If this is true, faculty should be encouraged to develop methods that optimize participation in laboratory sessions by incorporating clinical material. Nonetheless, it provides faculty with opportunities to incorporate clinical relevance, problem-based learning, peer interactions and integration of lecture and laboratory materials into entertaining experiences.
Clinically-relevant laboratory exercises were developed over a 4-year period for use in a veterinary basic science course called Correlative Neuroanatomy. Groups of four students were required to work together and integrate lecture information to solve clinical questions. Records of individual attendance and participation suggested that the highest final grades tended to occur in students with the greatest attendance in laboratory sessions. Faculty should consider developing methods that encourage participation in their courses to enhance understanding of important concepts.
References and Endnotes
1. Gordon J: Techniques used by successful teachers. Jour Vet Med Educ 10:20-22, 1983.
2. Herring J: The characteristics of good college teaching. Educ Resour 4:29-37, 1983.
3. Aronson C and Short C: The student laboratory and its role in teaching veterinary pharmacology as a basic science. Jour Vet Med Educ 15:7-10, 1988.
4. Herron M, Alexander P and Dibrito W: A proposal for problem-solving instruction in veterinary education programs. Jour Vet Med Educ 17:21-24, 1990.
5. The author acknowledges the contributions of Drs. M. Neer, S. Zuckerman, D. Hillmann and M. Littlefield-Chabaud.