Int. J. Cur. Tr.

Res (2015)4(1):54-62
ISSN:2278-8042
www.injctr.com

Exploring Web pages and publications

related to 3D medical animations and
discussing its scopes of implications in
medical education
Akbari G.G1*., A.D. Fefar2, K.M. Vyas3, P.S. Jivani4 and S.P. Rathod5

Department of Anatomy1, Department of ENT2, Department of Obstetrics &

Gynaecology3, Department of Physiology4, Department of Anatomy5, P.D.U.
Medical College, Civil Hospital, Rajkot, Gujarat, India

Received: 5 July, 2015 Accepted: 29 August 25 2015/ Published online 30 Oct 2015.

© INJCTR – 2015

Abstract

The study aimed at discovering the available materials in the field of 3D medical animations over the
internet and their current uses; simultaneously evaluating their possible integration in medical education
and Practice. The study was performed at Department of Anatomy, P.D.U. Medical College, Civil Hospital,
Rajkot, Gujarat, India in June 2015, which consisted of a series of keyword searching into Google and
exploring various web pages related to 3D animations in medical facilities. Additionally, it was
supplemented by use of browsing assistant tools called browser plugins. The websites were bookmarked,
classified and arranged into bookmark folders according to their categories. Most of the websites belong
to commercial categories operated by various animation institutes, commercial, pharmaceutical or related
companies, and developers in waiting period of bulk orders, also promoting their works in YouTube and
other video websites to expand them. These results were interpreted based on the contents they wrote in
their pages. Only one website found as an open source developed using wordpress.org platform which
provided free animations for educational purpose. So more extended versions of this study are planned
to serve the study objective. It was concluded that(1) Bigger web based start-upswho follow usually their
own strategies of delivering contents into education field needs to be integrated. A handful of webs
actually serve THE GOOGLE WAY, i.e. delivering services free to their terminal users.(2)Animations are
very useful educational tools.

Keywords: Webpages, 3D medical animations, E-learning, and medical education.

Introduction
In the everyday practice, CT and MRI provide
only a 2D image of the necessary anatomy.
Physicians have to mentally reconstruct the
volume by scrolling through the images while
trying to locate any target structures. To help
physicians, developed techniques include
rendering of slices and extracted 3D anatomical
objects separately or together. However, most
physicians use 2D slice or 2D+3D visualizations.
While radiologists explore orthogonal slices by
scrolling through them and mentally
reconstructing the volumes, surgeons may
prefer to see slices that can provide an
improved understanding of the areas that make
up the taken exploratory path. Moreover,
radiologists may use 3D volume rendering to
explore the whole dataset or the target object.
Surgeons may use 3D renderings to identify

*Corresponding author
drgovinddas@gmail.com
55 Akbari et al.,
structures that lie along the resection path and
noises have to be either avoided or removed in
order to identify the target organ (Nadezhda
Radeva and Lucien Levy, 2014).3D imaging
sensors for the acquisition of three dimensional
(3D) shapes have created a considerable degree
of diagnostic & therapeutic interest for a
number of applications (Giovanna Sansoni and
Marco Trebeschi, 2009).
While reading, students have to imagine
various modes of anatomical structures at
various angles. So it may happen that sometimes
they initially get in parallel completely or
partially wrong idea about the concept, due to
individual’s variable imagination capacity. This
later on hinders their future fundamentals in
that particular topic. A full 3D animation of the
structure will maintain continuity of the concept
and will make sure that the concept of actual
thing is getting grasped. For example, the micro
anatomy of human trabecular bones in general
anatomy teaching if visualised in 3D needs the
minimal explanation (Larrue et al., 2011).
Evaluating the current scenario by exploring web
reveals the facts that there have been variety of
developments in the field of developing 3D
animations in medical fields, but they have at
the most focused over a selected area of
beneficiaries including some of the students of
various medical fraternities, and their purposes
appears to be an admixture of advertisement,
business and e-learning and many more.
ultimately there is a need of the network of
global system which initiates and maintains the
integrity between these developments and
directs the contents to fulfil the students’
fundamental need of grasping the subjects
quickly; simultaneously minimizing their need
of repetitive reading of texts. Sorden (2005)
concluded in their study that Baddeley’s model
of working memory and Paivio’s dual coding
theory suggested individual’s processing of
information through dual channels, one auditory
and the other visual (Sweller, 1994). Cognitive
theory and frameworks like Mayer’s Cognitive
Theory of Multimedia Learning provide
empirical guidelines that may help us to design
multimedia instruction more effectively (Aleven,
and Koedinger, 2002).Mayer et al argues that the
best way to present multimedia instruction is
through visual graphics and informal voice
narration, which takes advantage of both verbal
and visual working memories without
Int. J. Cur. Tr. Res (2015)4 (1): 54-62
overloading one or the other. This, combined
with Sweller’s Theory of Cognitive Load and
Anderson’s ACT-R cognitive architecture
(Anderson and Schunn, 2000) provides a
convincing argument for how humans learn,
which leads to the question of how multimedia
instruction can be designed to maximize
learning.
There has been a tremendous flow of
information in the medical education field, both
offline and online. Simultaneously there is also
a huge competition between newly admitted
medical students and their cognition and
intellectual level is also rising as a result of
elevated educational levels at primary and
secondary schools. Consequently these
students then continuously struggle & passively
follow the Darwin’s “survival of the fittest”
theory. A cognitive theory of multimedia
learning follows six principles of instructional
design which are derived and tested by various
workers: the split-attention principle, the
spatial contiguity principle, the temporal
contiguity principle, the modality principle, the
redundancy principle, and the coherence
principle (Interactive Multimedia Electronic
Journal of Computer Enhanced Learning). But as
the human brain possesses a very complex
pattern of thinking, these students finally feel
stressed out of their struggle into the larger
database processing during their education
journey. The relatively difficult contents being
updated and added day by day adds into their
stress and struggle every day. Moreover, our
teachers of medical fraternity also belong to the
So
similar students few years back in their time. So
they either don’t bother to modify their
teaching methodologies, or they are into the
continued stress generated very before time in
their own curricular days. There are also
presence of authoritative, financial and
administrative concerns in executing these
ideas at top to bottom level in the education
system, which stops the ultimate actions in
changing the teaching methods.
Materials and Methods
To undertake the study, we used a Lenovo
G50-70(59-436417) Notebook laptop, a USB
mouse and a Wi-Fi enabled USB internet service
provider device. As no patients or living
subjects are involved in the study, and it’s
totally performed with the help of inanimate
objects, permission of ethical committee was
not needed. Browser for internet surfing used
was Google chrome version 43.0.2357.130
obtained from Google’s website. To ease
& enhance our surfing experience and download
data quickly and in required formats, browser
Int. J. Cur. Tr. Res (2015)4 (1):54-62 Akbari et al.,
extensions were used. A browser extension is a
computer program that extends the
functionality of a web browser in some way.
Depending on the browser and the version, the
Table 1- Google chrome extensions and their uses during web exploration
Name of Chrome Extension
1) Google SIMILAR PAGES
2) Evernote web clipper
3) Pocket
4) Ublock ORIGIN
5) Nimbus screenshot
6) Bookmark checker
7) Goodwordguide instant
dictionary
8) Google SHORTCUTS
9) Videos downloader
10) Picmonkey
11) Betterbrowser for Google
homepage
12) Printer friendly & pdf
13) History finder
14) Chrome shortkeys
15) Clicky
16) Page MONITOR
17) Extension manager
Selection criteria
Starting with Google home page, Google
search function was used by series of 20
keywords (n=20) by both typing and voice
search function, depending upon the
complexity of the typing and articulation of the
keywords. Examples of such keywords are 3D
medical animation, medical education using 3D
animations, e-learning using 3D animations,
56
term may be distinct from similar terms such as
plug-in or add-on. Various Google chrome
extensions were installed and used from
chrome web store, which are tabulated here.
Use During Internet Surfing
To find web pages with related results
To export notes into notebooks
To instantly save pages in cloud storage
To block unwanted popups and
advertisements
For taking screenshot and instant editing
To remove & avoid duplicate bookmarks
To know meaning of unknown words
To go in various other Google products
To download various formats of videos
For quick processing of images within
browser
To auto-enlist next search pages in one tab
below
To remove extra text and save as pdf
afterwards
To check log of keywords searched
To quickly use extensions using hotkeys
To calculate no.of clicks in one search
page
To identify changes in pages being
monitored
To group and manage above extensions en
masse
role of 3D animations in teaching medical
science, massive open online course (MOOC)
with 3D animations etc. Google usually gives
10 results in every page (N=10), and we went
through all links in first page to find relevant
data (Total clicks C=N*n=20*10=200). The
clicky plugin also helped to correlate no. of
clicks.
57 Akbari et al., Int. J. Cur. Tr. Res (2015)4 (1): 54-62

Exclusion criteria Methodology for Materials storage

All these clicks were not continuously in
succession, but over a period of time searches
were mixed up with our routine non-academic
searches of personal needs in-between, so
number of clicks for this work are 200 but
actually they were far more than that during
entire work span. Therefore, to separate our
work related searches, we utilized a plugin
called Google’s history tracker
(https://history.google.com /history / accessed
on 25 June, 2015),and by logging in using
author’s Gmail account username and password
we could trace laptops and mobile’s search
records and filter them by importing into
Microsoft excel 2013 and filtering our keyword
related searches offline. That way, we got
values of n and N mentioned above. We also
saved history files periodically into pdf format,
to keep tracking and propagating references in
future search works.
Table 2 – Research articles with title names and primary author’s countries
As we completed bookmarking of relevant
webpages, we arranged them into bookmark
folders according to their classification of
domain name extensions. Usually, there is an
arbitrarily prepared list of domain categories
being used by webmasters online
(http://www.livinginternet.com/i/iw_dns_name.
htm accessed on 25June,2015). For
example, .com extension suggests commercial
website, .biz suggests business, .in, .uk, .nz, .ca
etc. indicates their countries of origin,
whereas .gov.in suggests Government of that
country. During our exploration, we also found
many articles and books in pdf formats,
which narrated researches and eBooks in pdf
formats regarding uses of 3D animations in
various faculties in medical and other than
medical fields. Here is a list of medically related
articles with description of topics & countries of
first authors.

Sr. No. Name of the Topic Country

1) Advantage of three dimensional animated teaching over traditional surgical Austria
videos for teaching ophthalmic surgery: a randomised study
2) 3D Human Motion Editing and Synthesis: A Survey China
3) State-of-The-Art and Applications of 3D Imaging Sensors in Industry, Cultural Italy
Heritage, Medicine, and Criminal Investigation
4) Synchrotron Radiation Micro-CT at the Micrometre Scale for the Analysis of France
the Three-Dimensional Morphology of Micro cracks in Human Trabecular
Bone
5) Interactive Multimedia to Teach the Life Cycle of Trypanosoma cruzi, the Brazil
Causative Agent of Chagas Disease
6) Neuronvisio: a graphical user interface with 3D capabilities for NEURON UK
7) Advantage of three dimensional animated teaching over traditional surgical Vienna
videos for teaching ophthalmic surgery: a randomised study
8) An animated landscape representation of CD4+ T-cell differentiation, NY, USA
variability, and plasticity: Insights into the behaviour of populations versus
cells
9) The Value of Animations in Biology Teaching: A Study of Long-Term Memory Canada
Retention
10) Visual Reality: Using Computer Reconstruction to Magnify the Wisconsin
Microscopist’s Perception
11) Simplified Generation of Biomedical 3D Surface Model Data for Embedding Germany
into 3D Portable Document Format (PDF) Files for Publication and Education
12) Molecular and Cellular Biology Animations: Development and Impact on North
Student Learning Dakota
13) Human Body 3D Posture Estimation Using Significant Points Taiwan
and Two Cameras
14) Computer-Based Learning: Interleaving Whole and Sectional Representation Kentucky
of Neuroanatomy
15) Computer-Generated Animal Model Stimuli Cambridge
MA
16) Development and assessment of a multimedia computer program to teach Brazil
pleural drainage techniques
17) A hybrid blob-slice model for accurate and efficient detection of fluorescence NY, USA
labeled nuclei in 3D
18) Elderly Healthcare Monitoring Using an Avatar-Based 3D Virtual Environment Finland
19) Lattice Light Sheet Microscopy: Imaging Molecules to Embryos at High VA,USA
Spatiotemporal Resolution
Int. J. Cur. Tr. Res (2015)4 (1):54-62 Akbari et al., 58

Sr. No. Name of the Topic Country

20) Knowledge-Based, Interactive, Custom Anatomical Scene Creation for Medical Seattle, WA
Education: The Biolucida System
21) Using Animation as an Information Tool to Advance Health Research Literacy LA,USA
among Minority Participants
22) ePMV Embeds Molecular Modelling into Professional Animation Software La Jolla, CA
Environments
23) Online Teaching Tool Simplifies Faculty Use of Multimedia and Improves LA, USA
Student Interest and Knowledge in Science
24) To Play or Not To Play: Leveraging Video in Medical Education OH,USA
25) Generalized Temporal Focus+Context Framework for Improved Medical Data DC, USA
Exploration
26) General practitioner residency consultations: video feedback analysis Portugal
27) SketchBio: a scientist’s 3D interface for molecular modelling and animation NC, USA
28) DBSolve Optimum: a software package for kinetic modelling which allows Russia
dynamic visualization of simulation results
29) Students’ performance during practical examination on whole slide images Poland
using view path
Tracking

30) Teaching Musculoskeletal Physical Diagnosis Using A Web based Tutorial and Florida,USA
Pathophysiology Focused Cases

31) Use of Animation in Teaching Cell Biology Denver, CO

32) The Effectiveness of an Interactive 3Dimensional Computer Graphics Model Japan

for Medical
Education

33) The Effectiveness of Health Animations in Audiences With Different Health Netherlands
Literacy Levels: An Experimental Study
34) User Generated Videos as Support for Teaching and Learning 3D Animation Malaysia
35) Virtual medical campus: the increasing importance of E-learning in medical Austria
education
36) The impact of the Virtual Ophthalmology Clinic on medical students’ Australia
learning: a randomised controlled trial
37) Visualizing Protein Interactions and Dynamics: Evolving a Visual Language Mississauga
for Molecular Animation
38) POLYVIEW-MM: web-based platform for animation OH,USA
and analysis of molecular simulations

39) WormGUIDES: an interactive single cell developmental atlas and tool for CT, USA
collaborative multidimensional data exploration

40) Designing a virtual learning environment with a learner centered approach New Zealand

While watching through YouTube animation
videos we traced it’s about page and discovered
web pages or related persons pages to locate
the chief source of those animations. Thereby
we collected watch list of such web pages which
provided their sample videos over YouTube for
social media publicity purpose. One click over
each different source of such video out of a
non-you tube web page led to one different
YouTube channel and webpage providing it. In
this way we collected total list of 40 web pages
providing medical animation videos out of such
work and it implied to us that there can be a
possibility of full time regular re-visit of such
channels to find new videos continuously being
uploaded. Therefore we also plan to continue
this work in future for keeping our database
updated. We also came across a large collection
of high definition animation videos webpage
prepared using Word Press, https: // doctor
prodigious. Word press.Com / hd-
animations/accessed on 24thJuly 2015, where a
large list of medical educational YouTube
videos was accessible. Moreover, there are
already many publications(Orientale E jr.et al,
2008) done indicating integration of videos in
verbal lectures and embedding them into power
point presentations to enhance quality of
contents delivery during medical lectures, and
medical animation videos are already a part
of them (Kalish et al., 2011; O’Day et al.,
2008b).
59 Akbari et al., Int. J. Cur. Tr. Res (2015)4 (1): 54-62

Results
From this study, we saw that the effective
clicks taken as 200 for finding articles resulted
in following variants:
1.No. of articles found related to 3D animation
(Aa)
2.Articles found describing other educational
aspects e.g., eLearning, videos, teaching
methodologies (Ao)
3.No. of effective clicks (Ec)
4.No. of effective percentage (Ep) of clicks
5.Random percentage (Rp) of each articles
found against Ec
As described earlier, Aa and Ao were found
after extensive reading through downloaded
articles, and Ec were calculated using Google’s
history finder webpage and google chrome’s
clicky plugin. So Ep is calculated by multiplying
As with Ep and dividing it by Ec, similarly Rp of
both Aa and Ao is obtained by dividing them
respectively by total of Aa and Ao. These
parameters are given in table 3.

Table 3:- Effective Percentage and Random Percentage of articles against effective clicks

Types of articles found No. of Effective Random percentage (Rp) of

articles found percentage (Ep) each articles against
(Aa=articles against effective effective clicks (Ec)
of animation) 200 clicks (Ec) (Ep (Rp of Aa =Aa / Aa + Ao )
(Ao=articles =Aa * Ep/Ec ) (Rp of Ao =Ao / Aa + Ao )
of other
topics)
No. of articles found related to
3D animation (Aa) 40 20 % 41 %

Articles found describing other

educational aspects (Ao) 56 28 % 58 %

From the observations plotted in table 3, we interpreted as follows :- (1) Ep suggested that
effective clicks resulted in a 50 % chances of getting desired results. (2) Rp of each Aa and Ao
suggested that even if Ep doesn’t give desired result, it is not entirely wasted, as it gives results of
secondary importance or some other related references. Most of the web pages having animated
videos are in common with Ao or higher than that; but as they can be already included under Ao
category, they don’t require to be separately analysed.

Discussion
Out of this work during our study
conducted in May-June 2015, we did not find a
single publication fulfilling our study objective
in INDIA, so we were inspired to conduct this
study here. The factors responsible for these
needs to be studied in our further workups and
this will also promote Indian researchers to
motivate themselves and interact globally for
this cause. From this study, out of available no.
of articles and no. of web pages visited, we
visualised that states of USA are comparatively
higher in research works and developmental
activities related to 3D animation in medical
fields, which might be due to various factors in
support or favour of such kinds of works within
the platforms provided by that region, and also
owing to motivation of their workers. These
observations are based upon the sample size we
calculated here. Possibility of this work in other
regions in the world can be assumed by
expanding this study further in future, which
we would be glad to plan to. The results of the
study suggested that there have been
significant developments in research of 3D
animations as an educational tool, and it
appears that if this or such related studies are
carried out in future, we can have significantly
large amount of animated contents as well as
related articles which can provide us massive
databases to direct into education and further
more researches. Furthermore, these figures
also indicated that Google search is very
effective for web based exploration of desired
data, but it can be specifically guided by
advanced add-ins or plugins, especially when
dealing with massive database exploration. Not
using them would not significantly alter the
effectivity of web based studies; though for
Int. J. Cur. Tr. Res (2015)4 (1):54-62 Akbari et al.,
large scale and long term studies to be
continued in future, such additional services
are must to use to achieve satisfactory and
desired results, and that’s why various
developers continuously work around it.
Animations communicate dynamic, complex
sequences of events more effectively than text
or a static graphic (McClean et al., 2005; O’Day
et al., 2008a ). Today we talk to an e-generation
of learners; the individuals whose daily
cognition is primarily based upon auditory and
visual communication and they prefer having
animations in lieu of reading the textbook
(O’Day et al., 2008). Although this may appear
different to teachers, it is a fact of academic life
Table 4 Benefits and challenges ahead in the future perspectives of the study
objectives
Benefits
Reading texts by learners are considerably
minimised
Better and quicker grasping of the topics are
achieved
Interest of the learning people can be
potentially aroused and maintained
Research work can be enhanced by promoting
content references amongst research fellows
Free content delivery to the beneficiaries is
possible by spread digital media
Continuously latest contents can be updated
by internet
Prompt & large scale interaction between
teachers and students is possible
Limitations of 2D imagination based
learnings are overcome
Teaching standards can be elevated
Learn with Fun can be maintained
And many more counting…!
Long term future Implications of
this work
 Study and teaching by readers as a FAST
AND QUICK READY REFERENCE.
 Explaining very difficult, complex and
much descriptive topics is virtually
impossible without a good 3D
animation.
 Research fellows who are busy with
their work can use them as a ready test
tool on the basis of probability, and
they also saves their time for referring
various books.
 Creation of public awareness about
general knowledge and pre-operative or
pre-medical expenses.
60
that needs to be considered as we develop new
courses. If animations assist students’
cognition, then making pedagogically
meaningful animations to include in our
teaching curricula would be worth considering
and hence works into that path would surely
provide guidance to developing such
animations. Considering practical and technical
aspects of the future of this concept, and also
in-depth analysis of materials and methods of
the studies, it is leading us to the view that
there can be variety of benefits and challenges
(Prinz and Bolz, 2005) of this concept’s
practical implications, which are considered
below.
Challenges
Resources for production of books en masse
needs to be redirected
Teachers need to be trained in newer
methodologies of implementing animations in
lectures.
Changes in teaching styles may need a
transition phase amongst content deliverers
A functional and effective network needs to
be constructed
Efficient and massive traffic online needs to
be generated and maintained
Key persons and resources should work
round the clock
Timely delivery of the needed contents
should be made
Technically expert developers should be
constantly available for the contribution
Content updating round the clock needs to be
performed and monitored
Needs highest contribution across the various
platforms worldwide
And many more counting…!
 Partial or complete replacement of
physical papered books with e-data -
saving a lot of trees.
 Quick and customised search of any
topic is possible with whole exact place
and point of action. Again referring
bigger reference books is saved.
 Surgeons in the operation theatre can
run in big LCD screen the virtual steps
and can quickly decide live for
structures coming across during
surgery.
 During OPD, doctors can explain
patients about disease and treatment
 Akbari et al.,
61
more effectively and powerfully to
educate patients and relatives.
 And many more counting..!
Who (and still many more!) can
be the PILLARS of the project?
 Subject experts from medical field,
specifically those connected with human
anatomy and human embryology.
 Animation developers who are
developing themselves in the field for
opportunities, like undergraduate
students of IT field and who are in search
of topics for their projects.
 Established stakeholders of animation
institutes who wants to contribute
society for this noble cause can guide the
developers wherever they finds
difficulties; in conjunction with subject
experts.
 The visionaries who have ultimate goals
to revolutionize education field in terms
of teaching methodology and ease of
extreme two way communication.
 The marketing and media persons who
want the real cream to serve to the
society actually in need of it.
 Resource managers who want to
contribute from their routine business,
by re-allocating the fund, manpower and
people in alignment of the ultimate
vision/purpose of the project.
 The people of medical field who wants to
ease their own current and upcoming
education and also that of the future
generations’ education.
 And many more counting....!!
Limitations of the study
We felt following limitations pertaining to
our work
We could not trace animations usage and
its feedbacks at user’s level. Though we
could just see figures wherever they were
downloaded and commented to relevant
pages. We saw that our results and objectives
matching with results would be constantly
changing round the clock, and its
effectiveness in future needs to be
reconstructed by changing study
Methodologies and styles, which will depend
upon internet itself. The method was not
used or suggested by another authors or we
did not use any internationally standardized
methods for performing such works. This
work has not been reviewed in real time by
the learners and teachers, i.e. their views
Int. J. Cur. Tr. Res (2015)4 (1): 54-62
regarding such work are not covered in this
study.
Conclusions
From these observations we see that
there is a need of integrating structure
which collects and mobilizes educational
resources of 3D animations and delivers
them to various educational institutions.
Such a noble project would need much
contributions like a perfect planning with
calculated timeline, team of professionals
involving those people whose fields are
benefitted like medical teachers, practicing
doctors, media developers, marketing
persons, fund raisers and sponsors, peer
reviewers, technically expert students of
various fields, a fully dedicated
infrastructure and combined anatomical
cum technical subject experts to review
every steps being developed, and also in
-market review persons to get full public
response. The vision should be to deliver
the material using computer animations by
THE GOOGLE WAY, i.e. providing
preliminary contents to the end users free
of cost! That would truly revolutionize the
teaching standards to next level.
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