Intensive mode delivery of a neuroanatomy unit: lower final grades but higher student satisfaction

In 2011, Macquarie University moved to a three-session academic year which included two 13-week sessions (traditional mode) and one seven-week session (intensive mode). This study was designed to compare the intensive and traditional modes of delivery in a unit of undergraduate neuroanatomy. The new intensive mode neuroanatomy unit provided the same quantity and quality of material to the same standard, delivered by the same teachers and over the same total hours, but in a shorter timeframe. All students enrolled in session 2 (traditional mode) and session 3 (intensive mode) were invited to participate in this study. The main outcome measures were the final course grades and level of satisfaction with the course. Although there was no significant difference between the two cohorts in self-rated level of knowledge (P = 0.148), the traditional mode cohort achieved significantly higher final grades compared to the intensive mode cohort (P = 0.001). Similarly, the distribution of final grades was also different between the two cohorts. The two cohorts were equally satisfied with the unit overall, and with the lectures and tutorials. However, the intensive mode cohort was more satisfied with the laboratory practical classes compared to the traditional mode cohort (P < 0.001). Thus this study demonstrates that in the case of neuroanatomy, which is high in content, when the course is taught to the same standards as exist in the traditional mode of delivery, the students do not do as well even though they enjoy the course equally.

The availability of teaching-pedagogical resources used for promotion of learning in teaching human anatomy

Five hundred students attending higher education institutions in northeastern Brazil responded to questionnaires about their anatomy classes; students represented a variety of different health sciences disciplines. Analysis of the responses revealed the participation of teaching assistants in a large percentage of classes and the use of teaching resources, particularly images, from conventional radiographs to magnetic resonance images. The number of classes for cadaver dissection and the number of students with access to that type of class were small. In most cases, dissection was performed according to anatomic regions or systems. Medicine and nursing students had the highest number of practical dissection classes. Most students were assessed using practical and theoretical tests. Findings revealed conditions similar to those found elsewhere. Resources should be renewed and used to improve teaching for students whose courses demand the study of human anatomy.

"Let's get physical": advantages of a physical model over 3D computer models and textbooks in learning imaging anatomy

Three-dimensional (3D) information plays an important part in medical and veterinary education. Appreciating complex 3D spatial relationships requires a strong foundational understanding of anatomy and mental 3D visualization skills. Novel learning resources have been introduced to anatomy training to achieve this. Objective evaluation of their comparative efficacies remains scarce in the literature. This study developed and evaluated the use of a physical model in demonstrating the complex spatial relationships of the equine foot. It was hypothesized that the newly developed physical model would be more effective for students to learn magnetic resonance imaging (MRI) anatomy of the foot than textbooks or computer-based 3D models. Third year veterinary medicine students were randomly assigned to one of three teaching aid groups (physical model; textbooks; 3D computer model). The comparative efficacies of the three teaching aids were assessed through students' abilities to identify anatomical structures on MR images. Overall mean MRI assessment scores were significantly higher in students utilizing the physical model (86.39%) compared with students using textbooks (62.61%) and the 3D computer model (63.68%) (P < 0.001), with no significant difference between the textbook and 3D computer model groups (P = 0.685). Student feedback was also more positive in the physical model group compared with both the textbook and 3D computer model groups. Our results suggest that physical models may hold a significant advantage over alternative learning resources in enhancing visuospatial and 3D understanding of complex anatomical architecture, and that 3D computer models have significant limitations with regards to 3D learning.

Thumb carpometacarpal ligaments inside and out: a comparative study of arthroscopic and gross anatomy from the robert a. Chase hand and upper limb center at stanford university

Purpose We propose to identify and correlate arthroscopic internal ligaments with external ligaments, providing an accurate roadmap for arthroscopic ligament and joint anatomy. Ligamentous laxity is considered an important risk factor in developing the common basilar arthritis of the thumb. Controversy exists as to the precise ligamentous anatomy of the thumb carpometacarpal (CMC) joint (CMC-I); description of the internal arthroscopic anatomy is limited. Methods We performed CMC-I joint arthroscopy using the 1-Ulnar (1U) and thenar portals in five cadavers, seeking to identify the following seven ligaments arthroscopically: the superficial anterior oblique ligament (sAOL), deep anterior oblique ligament (dAOL), ulnar collateral ligament (UCL), dorsal trapeziometacarpal ligament (DTM-1), posterior oblique ligament (POL), dorsal central ligament (DCL), and dorsal radial ligament (DRL). After grading articular changes of the trapezium, we passed Kirschner wires (K-wires) (0.028) outside-in to mark the arthroscopic insertion of each ligament on the trapezium. Gross dissection was performed to confirm the wire placement; the anatomic identity and position of joint stabilizing ligaments, and the location of frequently used portals. Results The volar ligaments-the sAOL, dAOL, and UCL-were highly variable in their arthroscopic appearance and precise location. The sAOL is a thin veil of membranous tissue that variably drapes across the anterior joint capsule. The reported dAOL and UCL, in our study, correlated to a thickened portion of this veil around the volar beak and was not consistently identified with gross dissection. In contrast, the arthroscopic appearance and location of the dorsal ligaments-DTM-I, POL, DCL, and DRL-were consistent in all specimens. Conclusion Our study further defines and correlates the arthroscopic and external ligamentous anatomy of the CMC-I joint.

Psychological stress in first year medical students in response to the dissection of a human corpse

Objectives: Gross anatomy is one of the most important and time consuming subjects in the first preclinical part of medical school in Germany. In October 2007 186 students started the dissection course at Otto-von-Guericke-University Magdeburg. The objective of this study is to analyze the emotional aspect relating to the gross anatomy course. In order to address this issue, we investigated how medical students experience the first confrontation and the following exposure to the dead bodies and whether there are any differences between various groups (age, gender, experience) of students.

Methods: The study was carried out with a group of 155 first year medical students (112 female, 43 male, 21.4±2.9 years). Self-composed questionnaires were used to distinguish between concerns related to dissection and individual experiences and anxiety because of deceasing or death. In order to detect the changes of attitudes towards the dissection course, one questionnaire was answered by participants in the beginning of the course and one in the end (n=94, 66 female, 28 male). Additionally, personality traits of the students were analyzed using two scales of the “Freiburger Persönlichkeitsinventar (FPI-R)”.

Results: The self-composed questionnaires showed high reliability. For some students dissection was emotional stress; about 50% became anxious when coping the first confrontation, however, only 12% to large extent. Concerning the anxiety of dissection of individual body parts it was less for limbs, internal organs and skin and increased for head and genitals. Although hypothesized before, the correlation between age, extraversion, emotionality and the extent of anxiety were small. Almost 90% of the students approve the early beginning of the gross anatomy course. The follow-up study showed a marked decline of anxiety.

Conclusion: Our results show that about 50% of the students started the course with emotional stress and about one-tenth of them were very worried about the confrontation with corpses. Furthermore, personality tests were shown to be only partly reliable for selecting affected people in advance. With regard to these results capabilities to provide support to the first year medical students should be discussed.

A novel three-dimensional tool for teaching human neuroanatomy

Three-dimensional (3D) visualization of neuroanatomy can be challenging for medical students. This knowledge is essential in order for students to correlate cross-sectional neuroanatomy and whole brain specimens within neuroscience curricula and to interpret clinical and radiological information as clinicians or researchers. This study implemented and evaluated a new tool for teaching 3D neuroanatomy to first-year medical students at Boston University School of Medicine. Students were randomized into experimental and control classrooms. All students were taught neuroanatomy according to traditional 2D methods. Then, during laboratory review, the experimental group constructed 3D color-coded physical models of the periventricular structures, while the control group re-examined 2D brain cross-sections. At the end of the course, 2D and 3D spatial relationships of the brain and preferred learning styles were assessed in both groups. The overall quiz scores for the experimental group were significantly higher than the control group (t(85) = 2.02, P < 0.05). However, when the questions were divided into those requiring either 2D or 3D visualization, only the scores for the 3D questions were significantly higher in the experimental group (F₁(,)₈₅ = 5.48, P = 0.02). When surveyed, 84% of students recommended repeating the 3D activity for future laboratories, and this preference was equally distributed across preferred learning styles (χ² = 0.14, n.s.). Our results suggest that our 3D physical modeling activity is an effective method for teaching spatial relationships of brain anatomy and will better prepare students for visualization of 3D neuroanatomy, a skill essential for higher education in neuroscience, neurology, and neurosurgery.

Assessing the integration of audience response system technology in teaching of anatomical sciences

The goals of our study were to determine the predictive value and usability of an audience response system (ARS) as a knowledge assessment tool in an undergraduate medical curriculum. Over a three year period (2006-2008), data were collected from first year didactic blocks in Genetics/Histology and Anatomy/Radiology (n = 42-50 per class). During each block, students answered clinically oriented multiple choice questions using the ARS. Students' performances were recorded and cumulative ARS scores were compared with final examination performances. Correlation coefficients between these variables were calculated to assess the existence and direction of an association between ARS and final examination score. If associations existed, univariate models were then constructed using ARS as a predictor of final examination score. Student and faculty perception of ARS difficulty, usefulness, effect on performance, and preferred use were evaluated using a questionnaire. There was a statistically significant positive correlation between ARS and final examination scores in all didactic blocks and predictive univariate models were constructed for each relationship (all P < 0.0001). Students and faculty agreed that ARS was easy to use and a reliable tool for providing real-time feedback that improved their performance and participation. In conclusion, we found ARS to be an effective assessment tool benefiting the faculty and the students in a curriculum focused on interaction and self-directed learning.