gms | German Medical Science

14. Workshop der gmds-Arbeitsgruppe "Computerunterstützte Lehr- und Lernsysteme in der Medizin (CBT)" und des GMA-Ausschusses "Neue Medien"

Institut für Didaktik & Bildungsforschung im Gesundheitswesen (IDBG),
Private Universität Witten/Herdecke

16.04. - 17.04.2010, Witten

Recognition of anatomical structures in CT images – relevance of cognitive load and spatial ability for the e-learning instructional design of dynamic and static visualizations

Analyse anatomischer Strukturen in CT-Bildern – Bedeutung des Cognitive Load und des räumlichen Vorstellungsvermögens für das e-learning Design dynamischer und statischer Visualisierungen

Meeting Abstract

  • corresponding author Britta Fricke - Institut für Diagnostische Radiologie, Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Knappschaftskrankenhaus Bochum-Langendreer Universitätsklinik, Ruhr-Universität, Bochum, Deutschland
  • author Ferdinand Stebner - Lehrstuhl für Lehr-Lernforschung, Ruhr-Universität, Bochum, Deutschland
  • author Joachim Wirth - Lehrstuhl für Lehr-Lernforschung, Ruhr-Universität, Bochum, Deutschland
  • author Thorsten Schäfer - Medizinische Fakultät, Studiendekanat, Ruhr-Universität, Bochum, Deutschland
  • author Martin Fischer - Institut für Didaktik und Bildungsforschung im Gesundheitswesen, Witten-Herdecke, Deutschland
  • author Rolf Dermietzel - Abteilung für Neuroanatomie und Molekulare Hirnforschung, Institut für Anatomie, Ruhr-Universität, Bochum, Deutschland

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Gesellschaft für Medizinische Ausbildung. 14. Workshop der gmds-Arbeitsgruppe "Computerunterstützte Lehr- und Lernsysteme in der Medizin (CBT)" und des GMA-Ausschusses "Neue Medien". Witten, 16.-17.04.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10cbt31

doi: 10.3205/10cbt31, urn:nbn:de:0183-10cbt313

Published: April 13, 2010

© 2010 Fricke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Learning cross-sectional anatomy on CT (computed tomography) images is a complex task for students in gross anatomy computer-based training. In current research there is evidence, that for the evaluation of e-learning instructional designs more criteria are relevant than the measurement of the test performance. Up to now few studies exist, that take learner specific factors as learning strategies and cognitive processing into consideration.

Aim: Focus of this research was to analyze, if learner specific factors as the spatial ability and the cognitive load play a role in the learning process.

Method: 233 undergraduate medical students participated in the training of CT images of the human heart in an e-learning setting. In a 2x2 factorial design the effects of visualization (static versus dynamic images) and practical training with a 3D-model of the heart were analyzed. Data collection included: (1) students performance (knowledge); (2) spatial ability evaluated with the Logical Ordering Test (LOT), the Paper Folding Test (PFT) and Closure Flexibility (CF); (3) mental effort and mental efficiency.

Results: Spatial ability (LOT, PF, CF) significantly correlated with the students performance. The LOT showed a high potential in differentiating between static and dynamic visualizations. Analyzing mental efficiency and mental effort aptitude-treatment interactions were found for visualization method (static-dynamic) and spatial ability. Students with high LOT levels had an advantage in learning with static visualizations, whereas for students with low LOT levels static visualizations induced high levels of mental effort. Their individual learning was supported by dynamic visualization (high mental efficiency and low mental effort). For the practical training (3D-heart model) the test for CF was more relevant than LOT and PFT. Students with low CF levels showed more efficient learning with dynamic whereas those with high CF level with static visualizations.

Conclusions: Learner specific factors as spatial ability and cognitive load interfere in an e-learning scenario and should be measured in research on the effectiveness of learning with visualizations. In addition to the test performance these factors play an important role in the evaluation of instructional designs. In complex tasks like CT image analysis demands on learners are so complex that more than one factor of spatial ability are crucial for learning. Specific spatial ability tests should be selected dependend on the instructional design of the e-learning environment.


Khalil MK, Paas F, Johnson TE, Su YK, Payer AF. Effects of instructional strategies using cross sections on the recognition of anatomical structures in correlated CT and MR images. Anat Sci Educ. 2008;1(2):75-83.
Hegarty M, Keehner M, Cohen C, Montello DR, Lippa Y. The role of spatial cognition in medicine: Applications for selecting and training professionals. In: Allen G, editor. Applied Spatial Cognition. Mahwah NJ: Lawrence Erlbaum Associates; 2007.
Paas F, van Merriënboer JJ. Instructional control of cognitive load in the training of complex cognitive tasks. Educ Psychol Rev. 1994;6:51-71.
Stebner F, Lebens M, Wirth J, Opfermann M. Learning from animations and static pictures: The impact of spatial ability and cognitive load In: 3rd International Cognitive Load Theory Conference; Open University of the Netherlands, Heerlen, The Netherlands; 2009.
Stebner F, Fricke B, Lebens M, Wirth J. Die Bedeutung verschiedener Aspekte räumlichen Vorstellungsvermögens beim Lernen mit statischen und dynamischen Visualisierungen. 2009; 12. In: Fachgruppentagung Pädagogische Psychologie der Deutschen Gesellschaft für Psychologie, Universität des Saarlandes, Saarbrücken, Deutschland; 2009.