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Medical image interpretation is moving from using 2D- to volumetric images, thereby changing the cognitive and perceptual processes involved. This is expected to affect medical students' experienced cognitive load, while learning image interpretation skills. With two studies this explorative research investigated whether measures inherent to image interpretation, i.e. human-computer interaction and eye tracking, relate to cognitive load. Subsequently, it investigated effects of volumetric image interpretation on second-year medical students' cognitive load. Study 1 measured human-computer interactions of participants during two volumetric image interpretation tasks. Using structural equation modelling, the latent variable ‘volumetric image information’ was identified from the data, which significantly predicted self-reported mental effort as a measure of cognitive load. Study 2 measured participants' eye movements during multiple 2D and volumetric image interpretation tasks. Multilevel analysis showed that time to locate a relevant structure in an image was significantly related to pupil dilation, as a proxy for cognitive load. It is discussed how combining human-computer interaction and eye tracking allows for comprehensive measurement of cognitive load. Combining such measures in a single model would allow for disentangling unique sources of cognitive load, leading to recommendations for implementation of volumetric image interpretation in the medical education curriculum. [ABSTRACT FROM AUTHOR]

Rationale and objectives Current radiology practice increasingly involves interpretation of volumetric data sets. In contrast, most radiology tests still contain only 2D images. We introduced a new testing tool that allows for stack viewing of volumetric images in our undergraduate radiology program. We hypothesized that tests with volumetric CT-images enhance test quality, in comparison with traditional completely 2D image-based tests, because they might better reflect required skills for clinical practice. Materials and methods Two groups of medical students ( n = 139; n = 143), trained with 2D and volumetric CT-images, took a digital radiology test in two versions (A and B), each containing both 2D and volumetric CT-image questions. In a questionnaire, they were asked to comment on the representativeness for clinical practice, difficulty and user-friendliness of the test questions and testing program. Students’ test scores and reliabilities, measured with Cronbach's alpha, of 2D and volumetric CT-image tests were compared. Results Estimated reliabilities (Cronbach's alphas) were higher for volumetric CT-image scores (version A: .51 and version B: .54), than for 2D CT-image scores (version A: .24 and version B: .37). Participants found volumetric CT-image tests more representative of clinical practice, and considered them to be less difficult than volumetric CT-image questions. However, in one version (A), volumetric CT-image scores (M 80.9, SD 14.8) were significantly lower than 2D CT-image scores (M 88.4, SD 10.4) ( p < .001). The volumetric CT-image testing program was considered user-friendly. Conclusion This study shows that volumetric image questions can be successfully integrated in students’ radiology testing. Results suggests that the inclusion of volumetric CT-images might improve the quality of radiology tests by positively impacting perceived representativeness for clinical practice and increasing reliability of the test. [ABSTRACT FROM AUTHOR]

Rationale and Objectives In current practice, radiologists interpret digital images, including a substantial amount of volumetric images. We hypothesized that interpretation of a stack of a volumetric data set demands different skills than interpretation of two-dimensional (2D) cross-sectional images. This study aimed to investigate and compare knowledge and skills used for interpretation of volumetric versus 2D images. Materials and Methods Twenty radiology clerks were asked to think out loud while reading four or five volumetric computed tomography (CT) images in stack mode and four or five 2D CT images. Cases were presented in a digital testing program allowing stack viewing of volumetric data sets and changing views and window settings. Thoughts verbalized by the participants were registered and coded by a framework of knowledge and skills concerning three components: perception, analysis, and synthesis. The components were subdivided into 16 discrete knowledge and skill elements. A within-subject analysis was performed to compare cognitive processes during volumetric image readings versus 2D cross-sectional image readings. Results Most utterances contained knowledge and skills concerning perception (46%). A smaller part involved synthesis (31%) and analysis (23%). More utterances regarded perception in volumetric image interpretation than in 2D image interpretation (Median 48% vs 35%; z = −3.9; P < .001). Synthesis was less prominent in volumetric than in 2D image interpretation (Median 28% vs 42%; z = −3.9; P < .001). No differences were found in analysis utterances. Conclusions Cognitive processes in volumetric and 2D cross-sectional image interpretation differ substantially. Volumetric image interpretation draws predominantly on perceptual processes, whereas 2D image interpretation is mainly characterized by synthesis. The results encourage the use of volumetric images for teaching and testing perceptual skills. [ABSTRACT FROM AUTHOR]

Rationale and Objectives Radiology practice has become increasingly based on volumetric images (VIs), but tests in medical education still mainly involve two-dimensional (2D) images. We created a novel, digital, VI test and hypothesized that scores on this test would better reflect radiological anatomy skills than scores on a traditional 2D image test. To evaluate external validity we correlated VI and 2D image test scores with anatomy cadaver–based test scores. Materials and Methods In 2012, 246 medical students completed one of two comparable versions (A and B) of a digital radiology test, each containing 20 2D image and 20 VI questions. Thirty-three of these participants also took a human cadaver anatomy test. Mean scores and reliabilities of the 2D image and VI subtests were compared and correlated with human cadaver anatomy test scores. Participants received a questionnaire about perceived representativeness and difficulty of the radiology test. Results Human cadaver test scores were not correlated with 2D image scores, but significantly correlated with VI scores ( r = 0.44, P < .05). Cronbach's α reliability was 0.49 (A) and 0.65 (B) for the 2D image subtests and 0.65 (A) and 0.71 (B) for VI subtests. Mean VI scores (74.4%, standard deviation 2.9) were significantly lower than 2D image scores (83.8%, standard deviation 2.4) in version A ( P < .001). VI questions were considered more representative of clinical practice and education than 2D image questions and less difficult (both P < .001). Conclusions VI tests show higher reliability, a significant correlation with human cadaver test scores, and are considered more representative for clinical practice than tests with 2D images. [ABSTRACT FROM AUTHOR]

Abstract: This study aims to explore the relationship between the occurrence of reflection (and non-reflection) and thinking activities (e.g., orientating, selecting, analysing) during portfolio-based conversations. Analysis of 21 transcripts of portfolio-based conversations revealed that 20% of the segments were made up of reflection (content reflection (6%), process reflection (10%), and premise reflection (4%)). The thinking activities comparing, analysing and concluding occurred significantly more often during reflection than during non-reflection. Orientating on the task, selecting and describing, occurred significantly less often during reflection. The outcomes show that the occurrence of certain thinking activities can be an indication of reflection. [Copyright &y& Elsevier]

This study concerns the relation between teachers’ beliefs towards teaching behaviour and their actual teaching behaviour in teacher portfolio assessment. We analysed the beliefs and behaviour of 18 teachers as described in their portfolios. In addition, each portfolio was independently assessed by two trained raters on eight content standards and the teachers’ classroom behaviour was assessed by their own students in a questionnaire (n=317). Linear multilevel analysis showed that part of the raters’ assessments of the teachers’ beliefs and their behaviour as described in their portfolios was significantly related to the students’ assessments of their teachers’ behaviour. Teachers with high raters’ assessments on the content standard about ‘choosing and arguing for teaching strategies that meet students’ knowledge, abilities and experience’ had significantly higher student assessments than teachers who were judged low on this standard. Implications of the results and suggestions for further research are discussed. [Copyright &y& Elsevier]

What makes an expert university teacher? Answers to this question can be found in a multitude of publications, but so far there has been little insight into what these answers have in common. More common ground regarding what teacher expertise entails is necessary for research and support of the professional development of university teachers. To this end, this study aims to find consensus regarding what constitutes teacher expertise in higher education by identifying teacher tasks. We conducted a systematic review in which 46 frameworks for teacher expertise from research and practice contexts were identified, analysed, and synthesised. Six teacher tasks were distinguished: 'teaching and supporting learning', 'educational design', 'assessment and feedback', 'educational leadership and management', 'educational scholarship and research', and 'professional development'. Additionally, the following three dimensions for task-related development were found: 'better task performance', 'ability to carry out a greater variety of tasks', and 'a larger sphere of influence'. We present and visualise these tasks and task-related dimensions for development as the UNIversity Teacher Expertise (UNITE) synthesis. The synthesis both reflects and contributes to consensus about teacher expertise in higher education, which further research can build on. In academic practice, this synthesis could support teachers' reflection on their professional development and inform faculty development programmes and career policies. Further research is required to validate the results of this study, in particular the dimensions for development. Other suggested areas for future research are to explore how development in different teacher tasks is interrelated, as well as developing and investigating tools and interventions based on the perspective and findings of this study. • Consensus is lacking on what constitutes teacher expertise in higher education. • Teacher expertise frameworks were reviewed and synthesised to identify consensus. • Six teacher tasks were found, including leadership and scholarship. • Three developmental dimensions were found, including task variety and influence. • Higher education policies should incorporate the various tasks and dimensions. [ABSTRACT FROM AUTHOR]

• Scoping review on the assessment notions AaL, AfL, and AoL. • A synthesis is presented of common characteristics of AaL, AfL, and AoL. • The synthesis emphasizes an integrative view for successful educational assessment. Associations between assessment and learning are widely studied and often organized around the notions of Assessment as Learning (AaL), Assessment for Learning (AfL), and Assessment of Learning (AoL). Although these notions are appealing in theory, the notions are unclear constructs to comprehend, as both their definitions and their practice are used inconsistently in educational research. We present a synthesis of common characteristics among these notions, based on a scoping review on definitions and descriptions of AaL, AfL, and AoL (131 studies). The synthesis of common characteristics consists of nine themes that refer to how educational assessment relates to learning. The themes are grouped into: 1) Student-teacher roles and relationships within assessment; 2) Assessment learning environment; and 3) Educational outcomes of assessment. Then, we used the themes within the synthesis to analyze the results of the included empirical studies on their contributions to practice (84 studies). The synthesis provides stakeholders with a clear and integrative view of how educational assessment relates to learning and may be beneficial to educators to support and design their assessment practices. We argue that the notions of AaL, AfL, and AoL should be seen in coherence with one another in order to establish an assessment culture that facilitates students' learning maximally. [ABSTRACT FROM AUTHOR]