Abstract
INTRODUCTION: The availability of different tools for teaching and learning has made it challenging for educators to determine which tools are more effective and appropriate for helping students achieve learning outcomes. This is particularly evident in teaching human anatomy, where a range of modalities is used to complement cadaveric dissection. Despite the positive reception of these tools, their impact on learning outcomes remains uncertain. To address this issue, we utilise the Activity Theory Framework to analyse students' interaction with two tools - a 3D-printed (3DP) model and a digital resource (DR) - to answer two clinical questions relating to the lower spine. METHOD: This study took place in a graduate medical school in Singapore. Forty-six students voluntarily signed up for the session. They were grouped in small teams of between 4 and 6 students, and interactions were video recorded. Using a cross-over design, five groups answered a clinical scenario using a 3DP lumbar spine model, while the other five groups used the DR. The teams then swapped the 3DP with the DR and vice versa to answer a second clinical scenario of similar difficulty. RESULTS: There was no significant performance difference in terms of scores. Using a case study approach, we found that students engaged in more authentic discussions using the 3DP compared to the DR. Despite having access to the system early in the semester, students appeared unfamiliar with using the DR, struggling initially to navigate the software. We found the 3DP model encouraged collaborative discussion as students could physically use it as a tool for discussion by pointing and manipulating the different components in three dimensions, which could not be done with the DR as it operates on a two-dimensional screen. CONCLUSION: This study used activity theory to understand the impact of two educational tools on learning. Activity theory allowed a better understanding of tools' dynamics in learning when looking beyond score performance. We found that 3DP better encouraged collaboration among students than DR. Educators must consider the ease of use of the learning tools when designing activities so that learners will utilise the system's affordances.