Browsing by Author "McNamara, John P."

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    Anatomy of the physical examination: A small group learning approach for increasing engagement and learning in a medical gross anatomy course
    McNamara, John P.; Nolan, Michael F. (Wiley, 2021-12-31)
    The ability to perform and interpret the physical examination requires an understanding of human anatomy and how to apply that content in the clinical setting. Previous work has shown that students understand and retain information more effectively when they are actively engaged in the learning process and it is clearly linked to other coursework and their future needs. We developed a series of learning activities, based on the general physical examination, designed to enhance engagement and encourage durable learning of anatomical principles that are important in performing and interpreting the physical examination. Activities were designed for use in small group settings with faculty supervision and input as needed. We describe these activities and provide comments from students regarding the perceived value of these learning activities. Students reported that the applied anatomy learning activities were engaging and aided in their learning of human anatomy. Additionally, students appreciated the connection between the applied anatomy activities and the skills being learned in concurrent coursework focusing on the physical examination. We observed that applied human anatomy exercises modeled after components of the general physical examination and embedded in an anatomy course enhanced student engagement and helped students appreciate the importance of anatomical principles. We note that sensitivity to and acceptance of personal preferences and religious matters must be shown when using learning activities that involve close physical interactions to teach anatomical topics.
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    Applied Human Neuroanatomy
    Nolan, Michael F.; McNamara, John P. (Virginia Tech Publishing, 2022-12-15)

    This 155-page manual is comprised of two types of learning activities: 1. Free response fill-in-the blank questions focused of the facts and principles of neuroanatomy and neurophysiology that underpin the neurologic examination and specifically developed exercises that demonstrate how the facts and principles are related to the particular tests and procedures that comprise the neurologic examination. Free response questions form the bulk of the Neuroscience Review section of each chapter and are intended as a review of information previously or concurrently being learned regarding the structure, function and organization of the nervous system. Some questions focus on anatomical or physiological facts and relationships that help explain why certain techniques are performed as they are, such as why non-nociceptive tactile stimuli are required in order to activate nerve impulse transmission in the lemniscal system. Other questions are intended to revisit facts and concepts that are needed to properly interpret the elicited findings. 2. The application exercises of each chapter are designed to demonstrate how neuroanatomical and neurophysiological information is used in the design of particular clinical tests of neurologic function. The application exercises are also intended to help users learn how to perform and become comfortable with the various clinical maneuvers and tests that comprise the routine neurologic examination. An important outcome of performing these exercises is that, as a member of a learning group, each individual has the opportunity to experience the neurologic examination from the point of view of the subject (patient)—an experience that arguably provides insight and understanding that can be gained in no other way. The questions and exercises in the manual are designed as group learning exercises that might complement and reinforce learning acquired in more traditionally structured courses dealing with the clinical examination of a patient. The “group activity” approach, in which the student performs each exercise on a small number of “normal” subjects (classmates), is founded on the belief that the ability to recognize an abnormal finding on clinical examination requires a familiarity with the range of normal findings in the otherwise healthy population. This is particularly true for new learners who may be for the first time, learning about the structure and function of the nervous system. The clinical assessment of neurologic function is often viewed as an exercise involving difficult to master techniques that frequently generate difficult to interpret findings. The authors argue that the neurologic examination is a reasonable and logical exercise involving the clinical application of basic principles of neuroanatomy and neurophysiology. One of the goals in developing this manual is to convince the reader of the truth of this perspective. DOI: https://doi.org/10.21061/applied-human-neuroanatomy Table of contents 1. Sensory Systems 2. Motor Systems 3. Reflexes 4. Cranial Nerves 5. Mental Status 6. Answer Key About the authors
    Michael F. Nolan     is professor of Basic Science Education at the Virginia Tech Carilion School of Medicine in Roanoke. He received his Physical Therapy training at Marquette University and his PhD in Human Anatomy from the Medical College of Wisconsin. Nolan spent the first 34 years of his career teaching gross anatomy and neuroanatomy to medical students and resident physicians at the University of South Florida. He has received more than 20 awards for excellence in teaching including the Master Teacher Award in 2014 from the International Association of Medical Science Educators and the John M. Thompson Outstanding Teacher Award in Neurosurgery in 2006. He has published over 40 peer-reviewed articles and book chapters as well as four textbooks in human gross anatomy and neuroanatomy. John P. McNamara is the Director of Anatomy and Assistant Professor of Basic Science Education at the Virginia Tech Carilion School of Medicine in Roanoke. His doctoral training is in chiropractic from Life University (Marietta, GA) with undergraduate (Lock Haven University of Pennsylvania) and graduate (Shippensburg University of Pennsylvania) degrees. He is also ABD from Virginia Tech in Educational Leadership and Policy Studies. For nearly the past 30 years, McNamara has maintained a private practice in Salem, VA, and taught full-time anatomy and physiology, gross anatomy, neuroanatomy, and pathophysiology at the College of Health Sciences (Jefferson College) in Roanoke. From 2013 to 2017 he taught the gross anatomy course for the Doctor of Physical Therapy program at Radford University in Roanoke. He is licensed to practice as a Doctor of Chiropractic in both Virginia and Pennsylvania, and he is certified as an Emergency Medical Technician in Virginia.
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    An approach to determining, delivering, and assessing essential course content in a medical human anatomy course
    McNamara, John P.; Nolan, Michael F. (Wiley, 2022-05-07)
    Learning objectives typically indicate subject matter judged to be important or that represents essential material to be learned during a course. We report here on our efforts to identify essential course content and determine our effectiveness teaching and assessing this content in our preclinical human anatomy course. Using a consensus driven approach, we identified anatomical structures, relationships, and functional concepts judged to represent essential material in our unit on the thorax that students were expected to be familiar with. We then determined performance on specific examination questions that focused directly on the essential material. Thirty-seven of 48 students (77%) correctly answered all 34 of 51 questions that directly focused on content we defined as essential. The remaining 11 students answered the majority of these questions correctly. The overall mean score was 86% (range 61%-98%). Our review of student performance on the End of Block thorax examination confirmed our belief that we were successful in helping students learn material we defined as essential. We found the process described here to be helpful in defining essential content and for helping focus and improve medical education and learning assessment based on that material. We believe the idea of defining essential content that can be efficiently taught and effectively learned within a proscribed period of time is an important and necessary objective. We believe the approach used here might be successfully utilized in other programs in efforts aimed at quality improvement.
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    COVID-19 modifications to a first year medical human anatomy course: Effects on student performance on summative examinations
    McNamara, John P.; Nolan, Michael F. (Wiley, 2023-01)
    The COVID-19 (COVID) pandemic forced changes in how medical curricula are organized and delivered. In addition to disease mitigation strategies, other curricular modifications were required to maintain educational effectiveness and student and faculty safety. While these changes appear to be successful in their primary goal, their effect on learning and other important educational outcomes is less well understood. We describe changes to our anatomy course and describe their effects on summative examination scores. We compared anatomy examination scores from 4 years prior to COVID with scores from the 2 years following COVID mandated changes in an effort to determine the effectiveness of our course modifications. Examination scores for the first of four successive Blocks of instruction following the implementation of curricular changes demonstrated a lower mean score and greater range of scores than for the four pre-COVID years. Pre-COVID and post-COVID scores for Blocks II, III, and IV were comparable. Our results indicate that our changes to the anatomy curriculum did not prevent a performance decline during the first Block of instruction only. However, students were able to successfully adapt to these changes during the remainder of the course. We discuss factors that may have accounted for the Block I performance decline and call attention to changes within the larger curriculum that may have affected student performance.
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    Human Anatomy Self-Assessment Review Questions
    Nolan, Michael F.; McNamara, John P. (2022-07-15)

    Human anatomy is one of the foundational disciplines in the training of health care professionals. Knowledge of human structure at both the macroscopic and microscopic levels serves as a framework for the study of normal function and dysfunction. This workbook presents a series of questions related to a particular area of anatomy. Answers to those questions are included at the end of the book. This approach to self-assessment in basic human anatomy will be helpful to students in preparing for clinical-based learning activities as well as for other types of knowledge assessment and evaluation. Instructors and students reviewing, adopting, or adapting this textbook are encouraged to provide feedback (or report errors) by filling out this form. Suggested citation
    Nolan, Michael, F. and John P. McNamara. (2022). Human Anatomy Self-Assessment Review Questions. Virginia Tech Carilion School of Medicine, Blacksburg https://doi.org/10.21061/human-anatomy-self-assessment. A print version is available for purchase
    Click here to purchase a print copy
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    A method for rewarding collaborative efforts in preclinical assessments
    Nolan, Michael F.; McNamara, John P. (Wiley, 2023-05)
    Student success in basic medical science courses is typically determined by their individual performance on examinations of various types. Previous research both within and outside medical education has shown that the use of educational assessment activities can increase learning as demonstrated by performance on subsequent examinations, a phenomenon known as the testing effect. Activities primarily designed and used for assessment and evaluation purposes can also be used as teaching opportunities. We developed a method for measuring and evaluating student accomplishment in a preclinical basic science course that incorporates both individual and collaborative efforts, encourages and rewards active participation, does not compromise the reliability of the assessment outcome and is perceived by the students as helpful and valuable. The approach involved a two-part assessment activity composed of an individual examination and a small group examination with each component differentially weighted in determining an overall examination score. We found that the method was successful in encouraging collaborative efforts during the group component and provided valid measures of student grasp of the subject matter. We describe the development and implementation of the method, provide data derived from its use in a preclinical basic science course and discuss factors to be addressed when utilizing this approach to ensure fairness and reliability of the outcome. We include brief summary comments from students regarding their impressions of the value of this method.
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    Small group learning/assessment sessions: A method using test enhanced learning to increase engagement in a basic medical science neuroanatomy course
    Nolan, Michael F.; McNamara, John P. (Wiley, 2022-02-04)
    Previous research has shown that test-enhanced learning with structured feedback facilitates durable learning. We describe a small group learning/assessment activity using these approaches intended to increase engagement and engagement with the course material. We divided our class into six groups of seven students each that worked together in the activity. During each weekly session, course related multiple choice questions were projected and each group instructed to work independently to arrive at a consensus answer for each question. After each question is considered, a faculty facilitator then randomly selects one group to share their choice with the other groups and provide and rationale for their choice. A different group or groups are then called upon to share their choice. When differences emerge, the instructor then facilitates discussion among the groups in an effort to resolve confusion or incomplete or incorrect understanding that becomes evident. We found that attendance for these sessions was greater than for the more traditional lecture based session also included in the course and that students were actively engaged in this learning activity. The success of the small group learning/assessment session is dependent on several factors including the difficulty of the questions and their relatedness to the course objectives, the timing and placement of the session or sessions within the course and the skill of the faculty facilitator in encouraging active participation while ensuring a safe environment in which students can openly share their sometimes incomplete or incorrect understanding of the material.