UH Med Now

One of the most valuable lessons for a first-year medical student happens within the walls of the anatomy lab. Traditionally, students sit in a lecture before splitting into small groups where they respectfully learn from their first patients, silent teachers in a cadaver lab. When the COVID-19 pandemic forced many schools to provide hybrid and distance learning options, the University of Hawaiʻi (UH) medical school was tasked with finding a way to teach the intricacies of the human body online. They decided to repurpose green screen equipment to enhance the delivery of online anatomy classes.

Dr. Scott Lozanoff, anatomy professor at the UH John A. Burns School of Medicine (JABSOM) quoted the old proverb “Necessity is the mother of invention.” Previously, the Department of Anatomy, Biochemistry and Physiology, in collaboration with Lozanoff’s startup company Rad3D, had been using green screens to produce anatomical structures in “augmented reality” and literally make a 3D image of an organ pop off the pages of a book.

“While they (green screens) were great at removing the background, they were unfortunately also great at tinting bones green. We now scan against black and white,” said Technical Director of Anatomical Imaging Jesse Thompson. “When we moved to all virtual and then hybrid learning, we could repurpose it to superimpose faculty onto media to engage with the student audience and media on screen.”

This technique is called chroma keying and uses a select color to separate the background and replace it with any image while maintaining the foreground. Through this process, JABSOM was able to overlay instructor images and physical models onto digital images, powerpoint presentations, videos and real-time 3D models. The intention was to allow course content to be delivered in a more personalized and interactive fashion. Putting this all together was a time-consuming and complex process.

“Basically we almost storyboarded the whole thing, in other words, we would outline and set up a flowchart which we would project in the lab so we knew what the sequence was for everything we were doing. It was pretty complicated and there were a number of people involved,” Dr. Lozanoff said.

As of now, anatomy lectures are pre-recorded and students are able to access the videos online at any time. Attending the cadaver lab in-person is optional and medical students use a web app reservation system that is integrated with Google Calendar to maintain safe occupancy limits in the lab at all times.

Lozanoff says that many students seem to really like the online nature of the lecture so that they can access it on their own time. One of the comments received in a student survey stated that they liked the hybrid learning approach because the online dissection can be used as a visual guide, allowing them to be more efficient with their time and “more focused” for when they physically go into the lab.

“The thing about COVID-19 is it’s forced us to rethink a lot of stuff. Now the question is, how much of this do we keep post-COVID? There are portions we are definitely going to keep,” said Lozanoff.

More use for green screens

Witnessing the effective and novel approach to digital learning through the use of chroma keying technology, Nicole Nakamatsu, MD 2023 candidate, sought to use the green screens and a teleprompter to deliver poster presentations online. Recently, she pre-recorded a green screen poster presentation for an anatomy conference in Europe. This method allowed her to maintain eye contact with the camera, preserving the personal, interactive effect of traditional poster presentations. Her research involving this technology won “best poster presentation” at the JABSOM Annual Biosciences and Health Disparities Symposium. (Read: Analyzing the use of case-based anatomy education delivered virtually using extended reality)

The department hopes to install more permanent green screens in the lab with the goal of making this technology more easily available to educators and students and to help them create more compelling educational media in addition to live presentations.

As for the rest of the new normal in distance and hybrid learning, Thompson said, “I’m hoping we can bust through the negatives of Zoom fatigue and come out the other side with positive improvements for classes.”

-By Deborah Manog Dimaya, Interim Communications Director
Featured courtesy photo: Dr. Scott Lozanoff demonstrates how the green screen can be used in an educational setting.