ILP z3212774

From CellBiology

MedEd L&T Forum December 2009

Data shown as a % of all Major Abnormalities based upon published statistics using the same groupings as Congenital Malformations Australia 1981-1992 P. Lancaster and E. Pedisich ISSN 1321-8352

Phoebe Norville and Mark Hill, School of Medical Sciences


  • There is currently a lack of cardiac embryology in the Undergraduate Medicine Programme. This reflects a similar paucity in both textbook and online cardiac embryology resources directed at medical students.
  • In order to understand the common clinical presentations of patients with congenital heart defects it is necessary to understand basic cardiac development.
  • The Cardiac Embryology wiki resource aims to make information on cardiac embryology available to medical students.

Links: Current Online Resources for Medical Students |



Wiki format

  • Consistent with new embryology site
  • Familiar to medical students

Three-tiered approach

  • Basic
  • Intermediate
  • Advanced

Animations and images

Links: Cardiac Embryology Module | Basic | Intermediate | Advanced


Preliminary evaluation of the Cardiac Embryology module with science students outlined the following issues:

  • Problems with animation formatting and technology
  • Quantity and format of text
  • Problems with jargon and explanation of terms

Links: Science Student Questionnaire

(--Mark Hill 03:47, 25 November 2009 (UTC) Content shown below is not part of the L&T MedEd presentation)

Cardiac Embryology

--Mark Hill 23:01, 25 August 2009 (EST) Sandbox test entry page Cardiac Embryology and I will now be discussing the project and providing feedback on the actual project pages discussion tabs.

Online Module

The online module will be divided into basic, intermediate and advanced sections with the images depicted here indicating which section the learner is in.


The content to be included in the module can be summarised by the following table:

Content of Cardiac Embryology Module

Primary Results Analysis

Data was colleted from 19 students however one student left partway through the class so did not complete Quiz 2 or the Evaluation Questionnaire. Therefore their results were omitted from this analysis leaving 18 subjects.

Quiz Results

There were 12 questions in the quiz. The mean for Quiz 1 was 3.22 while the mean for Quiz 2 was 5.06 thus having a mean improvement of 1.833. A paired-samples t-test showed this was a statistically significant improvement in students’ results (p = 0.018; Upper CI = -1.105, Lower CI = -2.562).

Some questions showed more improvement than others:

Question Improvement
1 7
2 6
3 9
4 Negative 1
5 3
6 Negative 1
7 3
8 Negative 5
9 2
10 1
11 8
12 1

Question Content Tested
1 Location of the cardiogenic fields
2 The first day the heart tube begins to beat
3 Predominant type of mesoderm forming the heart tube
4 Parts of the heart tube and their corresponding locations during cardiac looping
5 Cardiac looping timeline
6 Corresponding septa and foramen in the atria and ventricles
7 Adult and embryological correlations of parts of the atria and sinus venosus
8 Fusion of the conotruncal ridges: timeline and direction
9 Valve formation
10 CHD proportion of all embryological abnormalities
11 CHD epidemiology: VSD
12 Foetal circulation & septa of the atria and ventricles

It seems from here that looping and septation are the areas in the module that need the most work. This was again noted in the comments gathered (see below) which identified looping as the most difficult concept to grasp.

Evaluation Questionnaire Results

NB Methods: A scale of strongly agree, agree, neutral, disagree and strongly disagree was used with strongly agree results recorded as a ‘5’ and strongly disagree as ‘1’.

There was no statistically significant correlation between the students’ overall enjoyment (recorded with the Questionnaire) and the level of their improvement in the quizzes (p = 0.698).

The following statements from the questionnaire are ranked below from the highest level of agreement to the lowest. The highest average was 4.5 and the lowest was 3.61, indicating that the students were on average of some agreement with all the statements.

Rank Statement
1 The module was easy to navigate
2 The module was easy to use
3 The module increased my understanding of CE
4 The formatting made things easy to read
5 I enjoyed using the Cardiac Embryology (CE) module
6 The animations increased my understanding of CE
7 The images were enjoyable to look at
8 The module was an appropriate length
9 The images increased my understanding of CE
10 The language was familiar and simple to understand
11 The animations were enjoyable to watch
12 There was an appropriate amount of text on the pages
13 The final quiz was suitable for the module content
14 I found it easy to concentrate on the information

Qualitative data in the form of comments was collected. The main data extracted from the comments is summarised below:

The best aspects of the module:

  • Division of the content in terms of separate pages for different concepts and navigation between these
  • Separation of Basic, Intermediate and Advanced and navigation between these
  • Colour
  • Varied use of images and animations
  • When there was smaller paragraphs of text on the page

The worst aspects of the module:

  • Animation speeds and labels
  • Too much text in some places
  • Excessive jargon/lack of explanation of terms

Improvements to be made:

  • Animation speeds/labels/fading
  • Break up large paragraphs of text
  • Introductions/overviews
  • Glossary and links to other explanations of concepts
  • More information/images relating to the clinical environment associated with abnormalities
  • Timelines/flowcharts
  • Audio with animations to explain them better

The order of statements ranked above correlates with the best and worst aspects of the module identified in the comments. Hence the list of improvements extracted from the comments creates a fairly comprehensive list of areas I will begin to work on now.

Online Information

There is some online information directed at teaching medical students cardiovascular embryology. See: Online Resources for Medical Students

Project Information

Project Code: F3E-CB4 Project Title: Cardiac Embryology

Aims of the project

Develop an online module on cardiac development as part of the UNSW Embryology educational resource.


The current undergraduate medicine course lacks content coverage on cardiac development, which is key to future understanding of newborn, infant and later postnatal abnormalities of cardiac development. The project would allow a student to develop using the existing online material and newly developed content a module for students to access and work through key features of both normal and abnormal cardiac development.

Project outcomes

1. Normal cardiac development will be described.

2. The typical abnormalities of cardiac development will be described.

3. The current clinical treatments for abnormal cardiac development will be identified and illustrated.

Learning outcomes

1. Understanding of existing literature on cardiac development and clinical practice. 2. Understanding the basis of presenting medical information and education. 3. Develop an understanding and interaction with both clinical experts and patients affected by cardiac developmental abnormalities.

Key References

1. Hill MA. UNSW Embryology version 7.5 2008 (online) 2. Hill MA. Early human development. Clin Obstet Gynecol. 2007 Mar;50(1):2-9. 3. Mohun T, Sparrow D. Early steps in vertebrate cardiogenesis. Curr Opin Genet Dev. 1997 Oct;7(5):628-33. Review. 4. Tanner K, Sabrine N, Wren C. Cardiovascular malformations among preterm infants. Pediatrics. 2005 Dec;116(6):e833-8.

--Mark Hill 11:05, 16 May 2009 (EST) Basic project information and my comments on the project will be added to discussion page.