Best teaching practices in anatomy education: A critical review

Presentation of Preclinical Gastrointestinal Anatomy via Laparoscopic Simulation

In this report, the authors examine the integration of teaching anatomical science with clinical implications in minimally invasive surgery. The authors hypothesized that implementation of integrated laparoscopic simulation during undergraduate medical education would improve student learning of anatomical structures from in situ, laparoscopic orientations; and subsequently improve student preparation for clinical rotations and clerkships. During the fall of 2020 and 2021, 260 (130 students/year) second year medical students at the University of Nebraska Medical Center participated in a six‐week gastrointestinal curriculum. Following a traditional anatomy dissection experience, students completed a laparoscopic event consisting of narrated laparoscopic videos and hands‐on laparoscopic simulation. To examine the integrated curricular event, outcome measures focused on technical performance using grasping forceps, anatomical knowledge, and perception of the educational innovation. Outcomes were analyzed via timed performance and a pre and post assessment that was designed to assess student anatomical knowledge and perception. Completion of the technical performance assessment ranged from 1 min, 17 s to 6 min. Student knowledge of anatomical structures from in situ, laparoscopic orientations following the laparoscopic simulation sessions was significantly improved (53.3% pre vs 81.0% post), and almost all students (98.9%) agreed that the simulation sessions improved their understanding of laparoscopic anatomy and procedures. This report demonstrates the implementation of a multidisciplinary, integrated simulation that satisfied basic science anatomy teaching objectives, while enhancing student enthusiasm for the content. Future studies will examine the subsequent impact of the innovation on student preparedness for clinical rotations and clerkships.

Benefits of a bilingual web-based anatomy atlas for nursing students in learning anatomy

BACKGROUND

Registered nurses are required for high-quality healthcare. Thus, the anatomy course is essential regarding professional knowledge of the human body during the nursing training process. However, previous studies have indicated that anatomy teaching time and anatomy teachers were reduced and insufficient. Therefore, to improve the learning of practical anatomy in response to these difficulties, a bilingual National Taiwan University web-based anatomy atlas (NTU-WAA) was created as a cross-platform application and its feasibility was evaluated.

METHODS

The comparison of anatomy examination scores between nursing students of two cohorts (66 from the 2018-2019 cohort, whom was without NTU-WAA application; 54 from the 2019-2020 cohort, to whom NTU-WAA was offered) and the evaluation of questionnaires collected from nursing students of the 2019-2020 cohort and 4 anatomy teachers were carried out to define the feasibility of this strategy.

RESULTS

Results obtained by nursing students for the 2019-2020 cohort showed a significant increase in anatomy learning performance compared with that of the 2018-2019 cohort with reference to the laboratory midterm [2018-2019 cohort vs. 2019-2020 cohort, mean (standard deviation, SD): 77.20 (16.14) vs. 81.80 (12.03); p = 0.043], the laboratory final examination [59.68 (15.28) vs. 80.35 (13.74); p < 0.001] and the theory final examination [80.85 (10.10) vs. 84.33 (6.925); p = 0.017]. Moreover, results of the questionnaires indicated that the new bilingual cross-platform atlas was highly accepted by students and teachers.

CONCLUSIONS

The NTU-WAA, a bilingual web-based atlas, was evaluated as a beneficial anatomy-learning tool that may enhance self-study of nursing students with consequent amelioration of their anatomy-related performance in both theoretical and laboratory examinations. This reflection suggests the future implementation of the bilingual web-based atlas on a large scale.

Full color 3D printing of anatomical models

INTRODUCTION

We propose an effective method for manufacturing human anatomical specimens in response to the shortage of cadaver specimens and the poor simulation results of anatomical specimen substitutes.

METHODS

Digital human data with high precision were used to create digital models and corresponding mapped textures. Different materials were chosen to print the digital models with full-color and multimaterial 3D-printing technology on the basis of the histological characteristics of the anatomical structures. Anatomy experts and surgeons were then invited to compare the 3D printed models with authentic anatomical specimens in terms of morphological appearance, anatomical detail, and textural properties.

RESULTS

The skull, brain, hand muscles, blood vessels and nerves of the hand, and the deep structure of the head and face were printed. The skull model used hard material, and the brain and hand muscles models used flexible and hard materials combined. The blood vessels, nerves of the hand, and the superficial and deep structure of the head and face used transparent materials, revealing the small vessels and nerves in the interior. In all the models there were no significant differences from anatomical specimens in morphological appearance and anatomical detail. They also affected vision and touch in the same way as authentic specimens in the textural properties of color, roughness, smoothness, and fineness.

CONCLUSION

Full-color and multi-material 3D printed anatomical models have the same visual and tactile properties as anatomical specimens and could serve to complement or supplement them in anatomy teaching to compensate for the shortage of cadavers. This article is protected by copyright. All rights reserved.

Effectiveness of Pedagogical Tools for Teaching Medical Gross Anatomy During the COVID-19 Pandemic

Medical institutions have been forced to modify gross anatomy pedagogy to comply with the health restrictions imposed by the novel coronavirus (COVID-19). Boston University School of Medicine (BUSM) is one such institution that temporarily restructured its course. We replaced cadaveric dissection activities with prosections and placed a greater emphasis on a flipped classroom model. This study investigates the effectiveness of new course materials developed to aid these curriculum changes. Course materials were developed for three purposes: (1) preparation before laboratory sessions (orientation videos and Complete Anatomy (3D4Medical, Elsevier) screens); (2) guidance during laboratory sessions (laboratory guides); and (3) review after laboratory sessions (Zoom recitation sessions). We performed a grounded theory thematic analysis of students' responses (80/160, 50% response) to qualitative survey questions and to focus group questions (16 students who self-selected between 4 different sessions). Data from both the survey and focus groups demonstrated that the vast majority of students agreed that the materials helped them navigate through learning gross anatomy. However, laboratory guides were used mostly for post-lab review as opposed to the intended direction during laboratory sessions. Students within all focus groups overwhelmingly touted the value of Zoom recitation sessions, with many stating that they were imperative to course success. When comparing performance data between 2019 (pre-COVID) and 2020 students, we found that the students who took the anatomy course during the onset of COVID had a slightly higher overall average score in all three modules of the course than compared to the 2019 students. We propose that the utilization of course materials that students perceived as time saving and pertinent to their exam performance, when combined with cadaveric prosection, emphasized the benefits of flipped-classroom learning to help students learn gross anatomy effectively and efficiently during the pandemic and beyond.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01524-x.

The Association Between Preclinical Medical Students' Perceptions of the Anatomy Education Environment and Their Learning Approaches

This study aimed to measure medical students' perceptions of the anatomy education environment and determine its association with their learning approaches. First- and second-year undergraduate medical students (N = 234) completed the Anatomy Education Environment Measurement Inventory and the Approaches and Study Skills Inventory for Students. Results revealed that the students' perceptions of all the factors in the anatomy education environment were positive except for two areas-the anatomy learning resources and quality of histology learning facilities. The majority of students in the first year (62.3%) and second year (43.7%) adopted a deep learning approach. There was no significant association between most of the factors in the anatomy education environment and the students' learning approaches, except for the students' intrinsic interest in learning anatomy factor (p = 0.032). The anatomy education environment was positive for the medical students, and there was a prevalence of a deep learning approach among them. However, most of the factors in the anatomy education environment did not influence the students' learning approach. Given that the students' learning approach is a multifactorial construct, investigating the relationship between these two variables in longitudinal time points would provide better insight into the association between the anatomy educational climate and students' learning approaches.

The question of dissection in medical training: Not just "if," but "when"? A student perspective

While debate about the use of-and alternatives to-human cadaveric dissection in medical training is robust, little attention has been paid to questions about timing. This study explores the perspectives of medical students and recent graduates with regard to two key questions: when in the degree program do students prefer dissection opportunities and what are the students getting out of participating in dissection? Self-report survey data from students in preclinical years (n = 105), clinical years (n = 57), and graduates (n = 13) were analyzed. Most (89%) preferred dissection during the preclinical years, with no effect by training year (χ²  = 1.98, p = 0.16), previous anatomy (χ²  = 3.64, p = 0.31), or dissection (χ²  = 3.84, p = 0.26) experience. Three key findings emerged. First, the majority of students prefer to dissect in the preclinical years because they view dissection as important for developing foundation knowledge and delivering an opportunity for consolidation prior to transitioning to primarily clinical studies. In addition, students recognize that it is a time-consuming activity requiring specialized facilities. Second, three main understandings of the purpose of dissection were reported: depth of learning, learning experience, and real-world equivalence. Third, these student perspectives of the purpose of dissection are associated with timing preferences for dissection opportunities. The results identify the preclinical phase as the optimal time to strategically integrate dissection into medical training in order to maximize the benefits of this unique learning opportunity for students and minimize its impact upon curricular time.

Anatomical self-efficacy of undergraduate students improves during a fully online biology course with at-home dissections

Student enrollments in online college courses have grown steadily over the past decade, and college administrators expect this trend to continue or accelerate. Despite the growing popularity of online education, one major critique in the sciences is that students are not trained in the hands-on skills they may need for the workforce, graduate school, or professional school. For example, the Association of American Medical Colleges has recommended that medical schools evaluate applicants on their motor skills and observation skills, yet many online biology programs do not offer opportunities for students to develop these skills. In on-campus biology programs, students commonly develop these skills through hands-on animal dissections, but educators have struggled with how to teach dissections in an online environment. We designed a fully online undergraduate biology course that includes at-home, hands-on dissections of eight vertebrate specimens. Over three course offerings, we evaluated changes in four student outcomes: anatomical self-efficacy, confidence in laboratory skills, perceptions of support, and concerns about dissections. Here, we describe how we implemented at-home dissections in the online course and show that students taking the course gained anatomical self-efficacy and confidence in multiple laboratory skills. Based on open-ended responses, the students perceived that their experiences with the at-home dissections facilitated these gains. These results demonstrate that at-home, hands-on laboratories are a viable approach for teaching practical skills to students in fully online courses. We encourage science instructors to introduce at-home laboratories into their online courses, and we provide recommendations for instructors interested in implementing at-home laboratories.

Enhancing Anatomical Instruction: Impact of a Virtual Canine Anatomy Program on Student Outcomes

Innovative reforms in medical education will require instructional tools to support these changes and to give students more flexibility in where and how they learn. At Colorado State University, the software program Virtual Canine Anatomy (VCA) was developed to assist student learning both inside and outside the anatomical laboratory. The program includes interactive anatomical photographs of dissected canine cadavers, dissection instructions with accompanying videos and diagrams, radiographs, and three-dimensional models. There is a need to evaluate the effectiveness of instructional tools like VCA so that decisions on pedagogical delivery can be evidence-based. To measure the impact of VCA on student outcomes in a dissection laboratory, this study compared student attitudes, quiz scores, dissection quality and accuracy, and instructor reliance between students with and without access to VCA. Students with VCA needed less time with teaching assistants (P < 0.01), asked teaching assistants fewer questions (P = 0.04), felt that the dissection was easier (P = 0.02), and were in stronger agreement that they had access to adequate resources (P = 0.02). No differences were found in the dissection quality or accuracy, quiz scores, or attitudes regarding overall enjoyment of the activity between the two groups. This study shows that VCA increases student independence and can be used to enhance anatomical instruction.

Comparison of sheep scapula models created with polylactic acid and thermoplastic polyurethane filaments by three-dimensional modelling

Three-dimensional (3D) printing technology is a rapid prototyping method that has recently been increasingly used in anatomy education. Magnetic resonance imaging, computed tomography, and 3D scanners are generally used to create 3D models. The aim of this study, which was performed without using the aforementioned devices, is to design sheep scapula models in a computer environment and compare bone models created with different filaments printed by a 3D printer with real bone. Photographs of sheep scapula were taken for modelling, and measurements were made from certain points. After the photographs were transferred to a computer environment, they were transformed into 3D using the Cinema 4D software, a computer-aided design program. Models were created using a 3D printer employing polylactic acid (PLA) and thermoplastic polyurethane (TPU) filaments. By comparing the models created with PLA and TPU filaments to the real bone, it was found that they have a similar anatomical structure, with dimensional-morphometric differences found at some points. It was also observed that the scapula model created with PLA filaments was more resistant to impacts than the real bone and that the model created with TPU filaments was more flexible, with very low fragility as compared to PLA and real bone. Therefore, this method allows obtaining a large number of durable models as an alternative to the real bone without the need for much manpower or equipment and without the need for a 3D reconstruction device.

Factors impacting the rapid transition of anatomy curricula to an online environment in response to Covid-19

Due to the Covid-19 pandemic, many academic institutions had to rapidly transition education to a remote online environment. While a hurdle for most educators, this transition posed an even greater challenge for anatomy educators, many of whom were forced to depart from the traditional cadaver-based laboratory to a virtual format. Recent publications have discussed the rapid transition to online formats necessitated by Covid-19 and the accompanying difficulties, but none have identified specific factors that influenced the difficulty of this transition. Anatomy educators were surveyed to examine how this transition was accomplished and perceived. Of the 165 educators who responded, the majority utilized cadaver-based laboratory instruction. Educators felt that transitioning the laboratory portion of their courses was significantly more difficult and required more time than converting lecture materials. Factors that impacted the difficulty of the transition included a number of pedagogical aspects of the pre-Covid-19 curricula, including the delivery format of prior content, availability of pre-existing electronic materials, and the laboratory technique previously used. Additionally, the length of time an educator had been teaching prior to Covid-19 impacted their perception of difficulty, with newer and more senior educators finding this much more challenging than mid-tenure educators. Ease of transition may be related to previous exposure to curricular reform, experience with multiple anatomy pedagogies, and educator adaptability. While not surprising that converting a cadaver-based laboratory to an online format was challenging, knowledge of the alignment of this difficulty with prior educator pedagogy can help guide future innovations to anatomy education.

Evolving anatomy education strategies for surgical residents: A scoping review

INTRODUCTION

Dedicated anatomy educational time in medical schools has decreased significantly, disproportionately affecting surgical residents. In this scoping review, we aim to consolidate existing evidence, describe ongoing research, and highlight future directions for surgical anatomy education.

METHODS

Two independent investigators searched MEDLINE, EMBASE, and the Cochrane library, for educational interventions targeting anatomy knowledge in surgical residents. English articles until October 28, 2021, were reviewed.

RESULTS

1135 abstracts were considered, and 59 (5.2%) included. Agreement on inclusion was excellent (k = 0.90). The majority were single-cohort studies (53%) and prospective cohort studies (17%). The most common disciplines were General Surgery (17%) and Obstetrics and Gynecology (17%).

DISCUSSION

Cadavers consistently produce positive knowledge gains and are heavily favored by residents. They remain the educational method to which new educational models are compared. New technologies do not yet match cadaver fidelity. Research showing knowledge translation from cadaver labs to patient outcomes remains limited.

Visualization of complicated fractures by 3D-printed models for teaching and surgery: hands-on transitional fractures of the ankle

Aims

Understanding the orientation of fracture lines and mechanisms is the essential key to sufficient surgical therapy, but there is still a lack of visualization and teaching methods in traumatology and fracture theory. 3D-printed models offer easy approach to those fractures. This paper explains the use of the teaching possibility with 3-dimensional models of transitional fractures of the ankle.

Methods and results

For generating 3D printable models, already obtained CT data were used and segmented into its different tissues, especially parts concerning the fracture. After the segmentation process, the models were produced with FFF (fused filament fabrication) printing technology. The fracture models then were used for hands-on teaching courses in AO course (Arbeitsgemeinschaft für Osteosynthesefragen) of pediatric traumatology in 2020 in Frankfurt. In the course fracture anatomy with typical fracture lines, approaches, and screw placement could be shown, discussed and practiced.

Conclusion

The study shows the use of 3D-printed teaching models and helps to understand complicated fractures, in this case, transitional fractures of the ankle. The teaching method can be adapted to numerous other use cases.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00068-022-01879-1.

The impact of using an "anatomy escape room" on nursing students: A comparative study

BACKGROUND

Anatomy is an important part of health science education. In teaching anatomy, new teaching strategies have been studied in comparison with traditional-based approaches. In this manner, strategies such as the escape room-based approach have been used as an innovative learning approach in nursing education, but little is known about its application in an Anatomy module.

OBJECTIVE

To evaluate the effectiveness of the escape room for anatomy-related knowledge retention in nursing and the perceived value of the game.

DESIGN

In the first semesters of the academic years 2017-2018 and 2018-2019, a comparative cross-sectional study was conducted.

SETTINGS

This study took place at the University of Almeria with students enrolled in the Anatomy module.

PARTICIPANTS

A total of 248 first-year nursing students took part in the study.

METHODS

The study included two groups: an experimental group (EG) that participated in an escape room in the final session of their Anatomy module, and a control group (CG) that received a traditional-based teaching approach in their final lesson.

RESULTS

Students enrolled in the Anatomy module were randomly assigned to either the experimental (EG, n = 128) or control groups (CG, n = 120). The escape room was conducted in groups of four and lasted no more than 15 min. In terms of satisfaction with the escape room, EG scored above the mean. The item "I enjoyed playing" received the highest score (4.88 ± 0.35). Taking the final scores of each group into account, the EG had a final average score of 8.94 ± 0.96, while the CG had a final average score of 7.70 ± 1.25 (p = 0.001).

CONCLUSIONS

According to the findings, the "Anatomy Escape Room" is a game-based approach that motivates students and constitutes a down-to-earth resource for anatomy learning in healthcare students.

Digital anatomy table in teaching-learning process of the temporomandibular joint anatomy

INTRODUCTION

The use of teaching resources and digital objects has gradually been incorporated into dental schools. This study aimed to evaluate the digital anatomy table in teaching-learning process of the temporomandibular joint (TMJ) anatomy and the student's perception regarding this resource.

MATERIALS AND METHODS

A cross-sectional study was conducted on 41 undergraduate dental students. Knowledge assessment tests were applied at different time intervals: before and after the TMJ theoretical class, after the practical class on prosected specimens and after the use of digital anatomy table. The medians of the scores obtained in the three groups (theoretical class, practical class and digital table) were descriptively analysed and submitted to Wilcoxon, Kruskal-Wallis and Student-Newman-Keuls statistical tests. The perception survey was conducted at the end of the study.

RESULTS

When the teaching strategies were compared amongst each other, the medians of the scores with the digital anatomy table were significantly higher than after the theoretical and practical classes. At the end of the research, there were no differences amongst the three groups (theoretical class, practical class and digital table). Regarding the perception, the majority of the students reported that the digital anatomy table helped them to understand the content of the theoretical class.

CONCLUSION

It was concluded that learning with the use of the digital anatomy table did not increase the knowledge of dental students with respect to the TMJ anatomy. The students' perceptions of the digital anatomy table were positive and that it could be used as an additional resource in the teaching-learning process.

AEducaAR, Anatomical Education in Augmented Reality: A Pilot Experience of an Innovative Educational Tool Combining AR Technology and 3D Printing

Gross anatomy knowledge is an essential element for medical students in their education, and nowadays, cadaver-based instruction represents the main instructional tool able to provide three-dimensional (3D) and topographical comprehensions. The aim of the study was to develop and test a prototype of an innovative tool for medical education in human anatomy based on the combination of augmented reality (AR) technology and a tangible 3D printed model that can be explored and manipulated by trainees, thus favoring a three-dimensional and topographical learning approach. After development of the tool, called AEducaAR (Anatomical Education with Augmented Reality), it was tested and evaluated by 62 second-year degree medical students attending the human anatomy course at the International School of Medicine and Surgery of the University of Bologna. Students were divided into two groups: AEducaAR-based learning ("AEducaAR group") was compared to standard learning using human anatomy atlas ("Control group"). Both groups performed an objective test and an anonymous questionnaire. In the objective test, the results showed no significant difference between the two learning methods; instead, in the questionnaire, students showed enthusiasm and interest for the new tool and highlighted its training potentiality in open-ended comments. Therefore, the presented AEducaAR tool, once implemented, may contribute to enhancing students' motivation for learning, increasing long-term memory retention and 3D comprehension of anatomical structures. Moreover, this new tool might help medical students to approach to innovative medical devices and technologies useful in their future careers.

Virtual Reality and Three-Dimensional Printed Models Improve the Morphological Understanding in Learning Mandibular Sagittal Split Ramus Osteotomy: A Randomized Controlled Study

Background: The mandibular sagittal split ramus osteotomy (SSRO) is a routine operation performed to correct mandibular deformity including mandibular retrusion, protrusion, deficiency, and asymmetry. The SSRO remains a challenging procedure for junior surgeons due to a lack of adequate morphological knowledge necessary for success in clinical practice. Virtual reality (VR) and three-dimensional printed (3DP) models have been widely applied in anatomy education. The present randomized, controlled study was performed to evaluate the effect of traditional educational instruments, VR models, and 3DP models on junior surgeons learning the morphological information required to perform SSRO.

Methods: Eighty-one participants were randomly assigned to three learning groups: Control, VR, and 3DP. Objective and subjective tests were used to evaluate the learning effectiveness of each learning instrument. In the objective test, participants were asked to identify 10 anatomical landmarks on normal and deformed models, draw the osteotomy line, and determine the description of SSRO. In the subjective test, participants were asked to provide feedback regarding their subjective feelings about the learning instrument used in their group.

Results: The objective test results showed that the VR and 3DP groups achieved better accuracy in drawing the osteotomy line (p = 0.027) and determining the description of SSRO (p = 0.023) than the Control group. However, there was no significant difference among the three groups regarding the identification of anatomical landmarks. The VR and 3DP groups gave satisfactory subjective feedback about the usefulness in learning, good presentation, and enjoyment. The Control and 3DP groups reported positive feelings about ease of use.

Conclusion: The current findings suggest that VR and 3DP models were effective instruments that assisted in the morphological understanding of SSRO-related anatomical structures. Furthermore, 3DP models may be a promising supplementary instrument to bridge the gap between conventional learning and clinical practice.

Practice and exploration of the "student-centered" multielement fusion teaching mode in human anatomy

Purpose

Human anatomy is a core course of basic medicine and the first professional course for medical students. Traditional teaching includes "teacher-centered" instruction, passive learning, and a lack of interaction between teachers and students as well as between students. The aim of this study was to develop a "student-centered" multielement fusion teaching mode to address the mentioned drawbacks.

Methods

A total of 141 clinical medical students from grades 2016 and 2017 of Chengde Medical University participated in this study. The students were randomly divided into four classes: two experimental classes and two control classes. The experimental classes experienced a "student-centered" multielement fusion teaching mode, while the control classes experienced a traditional teaching method. Formative assessments and questionnaires were used to assess the students' preferences and obtain feedback. Theoretical and experimental tests were carried out to detect the students' scores at the end of the semester.

Results

The results of the questionnaires demonstrated that 100% of the students agreed that the multielement teaching mode was better. In the experimental test, the students in the experimental group achieved a mean score of 16.50 ± 0.3203, which was significantly higher than that of the control group 12.65 ± 0.4731 (P < 0.01). In the theoretical test, the average score of the experimental group was 45.86 ± 0.6273 and that of the control group was 46.59 ± 0.6636; thus, there was no significant difference between the two groups (P > 0.05).

Conclusion

The application of a "student-centered" multielement fusion teaching mode obtained strong approval from the students. This teaching mode not only improved students' interest in learning and increased the interaction between teachers and students as well as between students but also enhanced students' competence and will lay a solid foundation for their future careers.

Strengths and Weaknesses of Non-enhanced and Contrast-enhanced Cadaver Computed Tomography Scans in the Teaching of Gross Anatomy in an Integrated Curriculum

Cadaver-specific postmortem computed tomography (PMCT) has become an integral part in anatomy teaching at several universities. Recently, the feasibility of contrast-enhanced (CE)-PMCT has been demonstrated. The purpose of this study was to identify particular strengths and weaknesses of both non-enhanced and contrast-enhanced PMCT compared to conventional cadaver dissection. First, the students' perception of the learning effectiveness of the three different modalities have been assessed using a 34-item survey (five-point Likert scale) covering all anatomy course modules. Results were compared using the nonparametric Friedman Test. Second, the most frequent artifacts in cadaver CT scans, were systematically analyzed in 122 PMCT and 31 CE-PMCT data sets to quantify method-related limitations and characteristics. Perfusion quality was assessed in 57 vascular segments (38 arterial and 19 venous). The survey was answered by n = 257/320 (80.3%) students. Increased learning benefits of PMCT/ CE-PMCT compared to cadaver dissection were found in osteology (2/3 categories, P < 0.001), head and neck (2/5 categories, P < 0.01), and brain anatomy (3/3 categories, P < 0.01). Contrast-enhanced-PMCT was perceived particularly useful in learning vascular anatomy (10/10 categories, P < 0.01). Cadaver dissection received significantly higher scores compared to PMCT and CE-PMCT in all categories of the abdomen and thorax (7/7 categories, P < 0.001), as well as the majority of muscular anatomy (5/6 categories, P < 0.001). Frequent postmortem artifacts (total n = 28, native-phase n = 21, contrast injection-related n = 7) were identified and assessed. The results of this work contribute to the understanding of the value of integrating cadaver-specific PMCT in anatomy teaching.

Designing a 3D Printed Model of the Skull-Base: A Collaboration Between Clinicians and Industry

INTRODUCTION

The role of three dimensional (3D) printing in neurosurgical education is becoming increasingly common. Notably, 3D printing can simulate complex anatomical pathways that may be difficult to regularly and accurately reproduce in cadavers. One such example is the course of the facial nerve within the temporal bone and its relation to the labyrinth. This can aid pre-surgical planning and minimise surgical complications. Here we aim to develop a novel anatomically accurate model of the skull base which demonstrates key neuro vascular components and the course of the facial nerve within the temporal bone by developing a 3D printed model of the skull-base that can be used for medical education and pre-surgical planning.

MATERIALS AND METHODS

We utilised a combination of Computed Tomography (CT) and angiography scans to reconstruct the skull base and its vascular contents. Neural components were digitally incorporated under the guidance of the Oxford neurosurgical team and the anatomy department. The model was integrated and printed using polymer jetting.

RESULTS

The model was successfully printed, with all neurovascular components included. Notably we were able to highlight the intra-temporal course of the facial nerve by creating a bony window within the temporal bone.

CONCLUSION

Through a collaboration with industry and a multidisciplinary team, we were able to reproduce the base of the skull from patient neuro-imaging. Our model is both cost-effective, reproducible and can aid both medical students and neurosurgical trainees in their training/education.

Perceptions, satisfactions, and performance of undergraduate students during Covid-19 emergency remote teaching

Due to the Covid-19 pandemic, the education system worldwide faced sudden and unforeseen challenges. Many academic institutions closed their doors, forcing both educators and students to transition to Emergency Remote Teaching (ERT) for the remainder of the semester. This transition eliminated hands-on experiences, increased workload, and altered curricula. However, these aspects, as well as students' perceptions, study habits, and performance in response to ERT remain poorly documented. This contribution describes changes in the curriculum of an undergraduate cadaver-based laboratory, and explores students' performance, self-perceived learning, and overall satisfaction during this educational crisis. Online content delivery for this course included both asynchronous instruction and synchronous discussion sessions. While formative assessments remained the same, online spotter examinations included short answer, multiple choice, multiple answer, ordering, and true and false questions. Despite examination grades improving 20% during ERT, students reported lower levels of learning, confidence, and engagement with the course materials when compared to the face-to-face portion of the class. The most prevalent challenges identified by students were those related to the loss of access to cadaver-based learning, including difficulty identifying and visualizing structures in three dimensions, and the loss of context and sensorial cues. Flexibility in taking examinations and learning the material at their own pace were recognized as positive outcomes of the ERT transition. While the resulting student perceptions and performances are unsurprising, they offer insight into the challenges of fostering a productive learning environment in a future threatened by epidemic outbreak and economic uncertainty.

Integration of innovative educational technologies in anatomy teaching: new normal in anatomy education

COVID-19 pandemic has created a lot of turmoil in medical teaching, the magnitude of impact is many folds in the subject of anatomy, as it is practical based. A major challenge for anatomy teachers is to replicate the experience of practical exposures. These exposures range from cadaveric dissection to demonstration of bones, museum specimens, and histology slides, where they will have interactive communication with students, and thus help in the enhancement of communication and clinical skills among them. In recent days, anatomy teachers throughout the globe started using various advanced technology to make the teaching-learning session more interesting. In pre-pandemic era, usage of such advancements in information and communication technology was a 'choice'. But pandemic has changed the situation drastically, what was a 'choice' earlier is now an 'obligation.' Presently although infection rate is low, vaccination rate is high, most of the medical schools re-opened for usual offline teaching, still body donation is all time low making the situation 'back to square one'. Keeping such unprecedented situations in mind, we need to incorporate various innovative educational technologies in day-to-day teaching-learning methodologies.

Instructional Approaches: Anatomy Education of Physical Therapists

The profession of physical therapy has undergone an evolution since its inception. Since the early 1900s it has grown from a technical training program to a doctorate level degree. Human anatomy courses remain a requirement for physical therapist educational curricula. However, changes in anatomy pedagogy have been trending within health profession educational models, leading to questions regarding which method is best for student learning. The objective of this study was to determine if anatomy instructional method used within physical therapist educational curricula impacted current anatomy knowledge. Licensed physical therapists were recruited to complete a demographic survey and a questionnaire to demonstrate their knowledge of anatomy topics. Anatomy topics included six regional components: (1) upper limb; (2) lower limb; (3) thorax and abdomen; (4) pelvis; (5) spine; and (6) head. Each regional component contained five questions regarding systemic subsets related to joints and osteology, muscles, nervous system, vasculature, and special areas (e.g., spatial orientations, structures within spaces, pathways of nerves). Within the thorax and abdominal region, data analysis indicated that the dissection instruction method, when compared to no laboratory instruction, led to statistically significant greater anatomical knowledge (P = 0.02). Dissection also showed greater means when compared to the no laboratory method (P = 0.02) and the prosection method in the head region (P = 0.01). However, the variance explained by instructional method was small. This study adds empirical evidence regarding current anatomy knowledge exhibited by physical therapists as the level of anatomical knowledge exhibited small differences based on instructional methods.

Issues in Teaching Vascular Anatomy: Thoughts and Suggestions from the Clinician's Point of View

The role of anatomy in modern curricula is under reform due to competency of other rapidly evolving subjects and the rapid evolution of several practical aspects and applications dictating modernization of teaching methods as well as of teaching demands. Moreover, modern practice of medicine has put the arterial and vascular system in the center of numerous minimally invasive techniques. Therefore, regardless of their specialty, most doctors should have a very clear and precise knowledge of the vascular anatomy and the basic access techniques from the early years. This viewpoint commentary reflects the experience of the two authors in applying the principles and content of surgical vascular anatomy in undergraduate anatomy teaching and discusses the rationale of this. Moreover, it is suggested that cadaveric dissections should be modified with emphasis on standard surgical vascular exposures and the multidisciplinary teaching of vascular anatomy as a means not only to gain optimal long-term knowledge retention, but also to emphasize through realistic examples on the practical clinical value of vascular anatomy.

Efficacy of Video-Based Forearm Anatomy Model Instruction for a Virtual Education Environment

INTRODUCTION

As virtual education becomes more widespread, particularly considering the recent COVID-19 pandemic, studies that assess the impact of online teaching strategies are vital. Current anatomy curriculum at Paul L. Foster School of Medicine consists of self-taught PowerPoint material, clinical vignette-centered team-based learning (dry lab), and prosection-based instruction (wet lab). This study examined the impact of video-based muscle model (VBMM) instruction using a student-designed forearm muscle model on anatomy quiz scores and student perceptions of its effectiveness with regards to learning outcomes.

METHODS

Students divided into Group 1 (54 students) and Group 2 (53 students) were assessed prior to and following a 3.5-minute video on anterior forearm compartment musculature using the muscle model. Group 1 began by completing a pretest, then received VBMM instruction, and then completed a posttest prior to participating in the standard dry lab and 1 hour wet lab. Group 2 completed the wet lab, then received the pretest, VBMM instruction, and posttest prior to participating in the dry lab. Both groups took an identical five-question quiz covering locations and functions of various anterior forearm muscles each time.

RESULTS

Mean scores were higher than no formal intervention with exposure to VBMM instruction alone (0.73 points, P = .01), wet lab alone (0.88 points, P = .002), and wet lab plus VBMM instruction (1.35 points, P= <.001). No significant difference in scores was found between instruction with VBMM versus wet lab alone (P = 1.00), or between either instruction method alone compared to a combination of the two methods (P = .34, .09). Student survey opinions on the VBMM instruction method were positive.

CONCLUSION

VBMM instruction is comparable to prosection-based lab with regards to score outcomes and was well received by students as both an independent learning tool and as a supplement to cadaveric lab. When compared to either instruction method alone, the supplementation of VBMM with cadaveric prosection instruction was best. VBMM instruction may be valuable for institutions without access to cadaveric specimens, or those looking to supplement their current anatomy curriculum.

Multimodal Three-Dimensional Visualization Enhances Novice Learner Interpretation of Basic Cross-Sectional Anatomy

While integrated delivery of anatomy and radiology can support undergraduate anatomical education, the interpretation of complex three-dimensional spatial relationships in cross-sectional and radiological images is likely to be demanding for novices. Due to the value of technology-enhanced and multimodal strategies, it was hypothesized that simultaneous digital and physical learning could enhance student understanding of cross-sectional anatomy. A novel learning approach introduced at a United Kingdom university medical school combined visualization table-based thoracic cross-sections and digital models with a three-dimensional printed heart. A mixed-method experimental and survey approach investigated student perceptions of challenging anatomical areas and compared the multimodal intervention to a two-dimensional cross-section control. Analysis of seven-point Likert-type responses of new medical students (n = 319) found that clinical imaging (mean 5.64 SD ± 1.20) was significantly more challenging (P < 0.001) than surface anatomy (4.19 ± 1.31) and gross anatomy (4.92 ± 1.22). Pre-post testing of students who used the intervention during their first anatomy class at medical school (n = 229), identified significant increases (P < 0.001) in thoracic cross-sectional anatomy interpretation performance (mean 31.4% ± 15.3) when compared to the subsequent abdominal control activity (24.1% ± 17.6). Student test scores were independent of mental-rotation ability. As depicted on a seven-point Likert-type scale, the intervention may have contributed to students considering cross-sectional interpretation of thoracic images (4.2 ± 1.23) as significantly less challenging (P < 0.001) than comparable abdominal images (5.59 ± 1.14). These findings could have implications for how multimodal cross-sectional anatomy learning approaches are implemented within medical curricula.

A Scoping Review of Effective Teaching Strategies in Surface Anatomy

To become skilled physicians, medical students must master surface anatomy. However, the study of surface anatomy is less emphasized in medical and allied health science curricula, and the time devoted to direct engagement with the human body is limited. This scoping review was designed to answer one research question: "What are the elements and strategies that are effective in teaching surface anatomy?" The review was performed using a five-stage scoping review framework, including research question identification, relevant study identification, study selection, data charting, and result collating and reporting. Three databases were searched using two search terms combined with a Boolean operator: "teaching" and "surface anatomy." The initial pool of 3,294 sources was assessed for duplication, and study eligibility was evaluated using inclusion and exclusion criteria. Data were abstracted from 26 original articles by one researcher and verified by two other researchers. A thematic analysis was performed, and several elements of effective teaching strategies for surface anatomy were identified, namely contextualized teaching, embracing experiential learning, and learning facilitation. This review revealed that a multimodal approach was most commonly used in surface anatomy instruction. Hence, future research should explore the effectiveness of multimodal teaching strategies that adopt the three aforementioned primary elements of effective teaching in an authentic learning environment. It is pertinent to clarify the effectiveness of these teaching strategies by evaluating their impact on student learning, organizational changes, and benefits to other stakeholders.

From Tutoring Gross Anatomy to Pancreatic Surgery Innovation

The training for pancreatic surgery still is not conducted according to standardized protocols, and academic programs differ between countries and hospitals. Moreover, due to recent technological innovations such as minimally invasive and robotic surgery, and the broader indications for complex pancreatic procedures due to the use of neoadjuvant chemotherapy, training is continuously redefining itself. The historical paradigm of "see one, do one, teach one" has been challenged and might have become obsolete. Finally, the rising number of surgical residents along with the limited time required practicing during residency might represent a major limitation to becoming an independent surgeon. Gross anatomy is a solid practice for the active learning of human anatomy during medical school. With regards to the pancreas, it offers a unique opportunity to both actively study the pancreatic gland anatomy during dissection and simulate actual surgical procedures. A critical review of the literature was conducted, aiming to assess the role of gross anatomy in surgical training and possible future perspectives.

Three-Dimensional Virtual Anatomy as a New Approach for Medical Student's Learning

Most medical and health science schools adopt innovative tools to implement the teaching of anatomy to their undergraduate students. The increase in technological resources for educational purposes allows the use of virtual systems in the field of medicine, which can be considered decisive for improving anatomical knowledge, a requisite for safe and competent medical practice. Among these virtual tools, the Anatomage Table 7.0 represents, to date, a pivotal anatomical device for student education and training medical professionals. This review focuses attention on the potential of the Anatomage Table in the anatomical learning process and clinical practice by discussing these topics based on recent publication findings and describing their trends during the COVID-19 pandemic period. The reports documented a great interest in and a positive impact of the use of this technological table by medical students for teaching gross anatomy. Anatomage allows to describe, with accuracy and at high resolution, organ structure, vascularization, and innervation, as well as enables to familiarize with radiological images of real patients by improving knowledge in the radiological and surgical fields. Furthermore, its use can be considered strategic in a pandemic period, since it ensures, through an online platform, the continuation of anatomical and surgical training on dissecting cadavers.

Code of practice for medical autopsies: a minimum standard position paper for pathology departments performing medical (hospital) autopsies in adults

The medical autopsy (also called hospital or clinical autopsy) is a highly specialised medical procedure, which requires professional expertise and suitably equipped facilities. To ensure high standards of performance, the Working Group of Autopsy Pathology of the European Society of Pathology (ESP) suggests a code of practice as a minimum standard for centres performing medical autopsies. The proposed standards exclusively address autopsies in adults, and not forensic autopsies, perinatal/or paediatric examinations. Minimum standards for organisation, standard of premises, and staffing conditions, as well as minimum requirements for level of expertise of the postmortem performing specialists, documentation, and turnaround times of the medical procedure, are presented. Medical autopsies should be performed by specialists in pathology, or by trainees under the supervision of such specialists. To maintain the required level of expertise, autopsies should be performed regularly and in a number that ensures the maintenance of good practice of all participating physicians. A minimum number of autopsies per dedicated pathologist in a centre should be at least 50, or as an average, at least one autopsy per working week. Forensic autopsies, but not paediatric/perinatal autopsies may be included in this number. Turnaround time for final reports should not exceed 3 weeks (14 working days) for autopsies without fixation of brain/spinal cord or other time-consuming additional examinations, and 6 weeks (30 working days) for those with fixation of brain/spinal cord or additional examinations.

A Review of the Outcomes of the Implementation of Case-Based Anatomy Learning

Purpose: Clinically-oriented anatomy education has been proposed as an effective strategy in anatomy curricula. We aimed to explore the level of extent the literature supports the fact that case-based learning (CBL) can play a significant role in anatomy education.

Materials and methods: We searched PubMed, Scopus, Education Resources Information Center (ERIC), and Cochrane database to find articles with the purpose to explore the educational outcomes of case-based anatomy learning. We extracted from each paper authors, type of study (comparative or not), number of participants, level of outcome according to the Kirkpatrick hierarchy, outcomes of CBL concerning the acquisition of anatomical knowledge, and the participants’ perceived enjoyment, motivation, and aid to anatomy learning.

Results: Nine articles were included. Three of them evaluated the acquisition of anatomical knowledge, while six papers evaluated the participants’ perceptions. All studies showed positive outcomes regarding the students’ anatomy examination performances, reported confidence, enjoyment, motivation, and ability of CBL to facilitate anatomy learning.

Conclusion: Although the existing research has mainly evaluated students’ perceptions, the outcomes of CBL in anatomy education encourage more extensive use of this method in anatomy curricula. Further research is expected to shed more light on the role that CBL can play in modern anatomy education and to clarify if it can replace or supplement didactic teaching.

Introduction of ultrasound-based living anatomy into the medical curriculum: a survey on medical students' perceptions

Background

Traditional anatomy teaching methods are based on the models and cadaveric dissections, providing fixed views of the anatomical structures. However, in the last few years, the emerging concept of ultrasound-based teaching in anatomy has started to gain ground among medical curricula. This study aims to evaluate the integration of ultrasound as an adjunct tool to traditional anatomy teaching methods and explore students’ perceptions of whether ultrasound-based teaching enhances their interest and knowledge of anatomy. A cross-sectional study was carried out among the students of the 6-year undergraduate entry (MD) and 4-year graduate entry (MBBS) program of the University of Nicosia. A questionnaire was distributed to them after the delivery of several twenty minutes ultrasound sessions by an expert in the field during anatomy practicals. The data were analyzed utilizing SPSS software, and the statistical significance was determined as p value < 0.05.

Results

107 MD and 42 MBBS students completed the questionnaire. Both groups agreed that their ultrasound-based learning experience was good or excellent (79.4% MD students; 92.9% MBBS students), that it enhanced their knowledge of anatomy (68.2% MD students; 90.5% MBBS students) and boosted their confidence regarding their examination skills practice (69.2% MD students; 85.7% MBBS students). Although most students desired more time allocated to the ultrasound station (72% MD students; 85.7% MBBS students), they believed that ultrasound-based teaching is a necessary adjunct to the traditional teaching methods of anatomy (89.7% MD students; 92.9% MBBS students).

Conclusions

Overall, MBBS students were more confident about the benefits of ultrasound-based teaching. Most of the students agreed that cross-sectional sessions of traditional teaching and ultrasound-based teaching strengthened their knowledge of anatomy and enhanced their confidence concerning their clinical examination skills. Medical schools should embrace the advantages that ultrasound-based teaching offers in order future doctors to be qualified to utilize ultrasound for procedural and diagnostical purposes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13089-021-00247-1.

Improving surgical training: Establishing a surgical anatomy programme in Scotland

BACKGROUND

It is well recognized that a sound foundation in surgical anatomy is a cornerstone of safe surgical practice, yet many trainees struggle with the upskilling in anatomy that is required to support their day-to-day practice. In the context of the UK-wide Improving Surgical Training pilot, we set out to establish a surgical anatomy programme for core surgical trainees in the Scotland Deanery. The aim was to enable all trainees to review the surgical anatomy of the whole body to MRCS level at least once during core surgical training.

MATERIALS AND METHODS

Teaching was delivered in Edinburgh, with trainees commuting from all parts of the Scotland Deanery. Individual teaching days focused on the surgical anatomy of the head and neck, trunk and limbs, using a combination of lectures (principles and cases) and interactive demonstrations on prosected specimens. Faculty comprised a balance of surgical demonstrators and senior academic staff, including MRCS examiners.

RESULTS

In total, 16 individual teaching sessions were attended by over 300 trainees across the first 2 years of the programme. Evaluation form response rate was nearly 80%. The programme was highly rated by trainees in relation to the method of delivery, level of teaching and surgical focus.

CONCLUSION

Surgical anatomy remains an integral part of surgical training. Our experience in developing a deanery-wide surgical anatomy programme highlights the crucial links between medical school, training deanery and surgical college. This collaborative approach can be extended to higher surgical training and continuing professional development, and the methods can be adapted to meet the needs of trainees in different parts of the globe.

Replicating Anatomical Teaching Specimens Using 3D Modeling Embedded Within a Multimodal e-Learning Course: Pre-Post Study Exploring the Impact on Medical Education During COVID-19

BACKGROUND

The COVID-19 pandemic has had significant effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal method of learning anatomy. We created and tested a customized congenital heart disease e-learning course for medical students that contained interactive 3D models of anonymized pediatric congenital heart defects.

OBJECTIVE

The aim of this study is to assess whether a multimodal e-learning course contributed to learning outcomes in a cohort of first-year undergraduate medical students studying congenital heart diseases. The secondary aim is to assess student attitudes and experiences associated with multimodal e-learning.

METHODS

The pre-post study design involved 290 first-year undergraduate medical students. Recruitment was conducted by course instructors. Data were collected before and after using the course. The primary outcome was knowledge acquisition (test scores). The secondary outcomes included attitudes and experiences, time to complete the modules, and browser metadata.

RESULTS

A total of 141 students were included in the final analysis. Students' knowledge significantly improved by an average of 44.6% (63/141) when using the course (SD 1.7%; Z=-10.287; P<.001). Most students (108/122, 88.3%) were highly motivated to learn with the course, and most (114/122, 93.5%) reported positive experiences with the course. There was a strong correlation between attitudes and experiences, which was statistically significant (rs=0.687; P<.001; n=122). No relationships were found between the change in test scores and attitudes (P=.70) or experiences (P=.47). Students most frequently completed the e-learning course with Chrome (109/141, 77.3%) and on Apple macOS (86/141, 61%) or Windows 10 (52/141, 36.9%). Most students (117/141, 83%) had devices with high-definition screens. Most students (83/141, 58.9%) completed the course in <3 hours.

CONCLUSIONS

Multimodal e-learning could be a viable solution in improving learning outcomes and experiences for undergraduate medical students who do not have access to cadavers. Future research should focus on validating long-term learning outcomes.

Differences Between Attached and Detached Cadaveric Prosections on Students' Identification Ability During Practical Examinations

Cadaveric prosections are effective learning tools in anatomy education. They range from a fully dissected, sometimes plastinated, complete cadaver (in situ prosections), to a single, carefully dissected structure detached from a cadaver (ex situ prosections). While most research has focused on the advantages and disadvantages of dissection versus prosection, limited information is available on the instructional efficacy of different prosection types. This contribution explored potential differences between in situ and ex situ prosections regarding the ability of undergraduate students to identify anatomical structures. To determine if students were able to recognize the same anatomical structure on both in situ and ex situ prosections, or on either one individually, six structures were tagged on both prosection types as part of three course summative examinations. The majority of students (61%-68%) fell into one of the two categories: those that recognized or failed to recognize the same structure on both in situ and ex situ prosections. The percentage of students who recognized a selected structure on only one type of prosection was small (1.6%-31.6%), but skewed in favor of ex situ prosections (P ≤ 0.01). These results suggest that overall students' identification ability was due to knowledge differences, not the spatial or contextual challenges posed by each type of prosection. They also suggest that the relative difficulty of either prosection type depends on the nature of the anatomical structure. Thus, one type of prosection might be more appropriate for teaching some structures, and therefore the use of both types is recommended.

Cone Beam Computed Tomography (CBCT) Technology and Learning Outcomes in Dental Anatomy Education: E-Learning Approach

E-learning is an educational method that improves knowledge innovation by sharing relevant images for advanced learning, especially in a pandemic state. Furthermore, cone-beam computed tomography (CBCT) is a method that gathers medical or dental diagnostic images. This study aimed to analyze the effectiveness of dental anatomy education through a CBCT technology tool, through teachers' and students' perspectives, adjusted according to the disruptions caused by the Covid-19 pandemic. A cohort study and longitudinal exploratory analysis were performed. Forty undergraduate first-year dental students, from the University of Coimbra in Portugal, were selected as per the inclusion and exclusion criteria. Two different teaching methods were applied during an identical time-period: face-to-face lectures complemented by physical models (T1 cohort) and webinar lectures complemented by CBCT images (T2 cohort). Learning outcomes were then studied according to theoretical and spatial orientation contexts. A self-reported survey that focused on students' satisfaction, stress, and support was studied. Both teaching methods were analyzed with paired sample student's t-test and Pearson Correlation Confidence intervals 95% with P < 0.05. Furthermore, exploratory factor analysis (EFA) was used for self-reported satisfaction survey validity and reliability analysis. The learning outcomes between T1 and T2 cohorts were statistically significant, (P < 0.001) corresponding to differences with a large effect degree (r > 0.60). Students' satisfaction, as measured on a six-point Likert scale, was positively influenced by the webinar lectures supplemented with CBCT images (T2 cohort) in a learning context (4.95 ± 0.5) and future applications (5.92 ± 0.27). In conclusion, the webinar approach with CBCT images was more effective and better learning method for teaching dental anatomy.

Anticipatory Feelings About Dissection: An Exercise for the First Day of a Gross Anatomy Course

Studies have demonstrated that students experience a variety of intense emotions in anticipation of human anatomical dissection, including enthusiasm, gratitude, responsibility, apprehension, detachment, anxiety, and spiritual or moral reflection. The exercise described here provides an opportunity to start a conversation about the complexity of students' emotional reactions to the anatomy experience. The intention of this exercise is to normalize the variety of emotions that anatomy students experience, both to demonstrate to students that their emotions are normal and to encourage the empathy for others' reactions which may differ from their own. In the lecture hall setting before the first day of dissection, students are asked to draw how they feel about the dissection experience and are provided an opportunity to discuss their drawings with their peers. The course director then provides a slide show demonstration of drawings from previous years, and experienced anatomy faculty facilitate a large group discussion in which students react to the drawing exercise and slide show and ask questions which are addressed by the faculty. This exercise provides an opportunity for students to practice appropriately communicating about emotionally complex experiences in a professional setting. The exercise is straightforward to implement and is easily modifiable for different class sizes and curricular structures.

A unique and effective method of anatomy education: Small-group learning with prosected plastinated specimens

OBJECTIVE

At the New York University College of Dentistry, we are faced with the challenge of teaching Head and Neck Anatomy to a class of approximately 380 first-year students. We have developed an innovative anatomy curriculum that has proven effective in facilitating students' learning and long-term retention of the material. It has the added benefit of being time- and cost-efficient. Here, we share the structure of our curriculum and examine the student outcomes and student feedback.

MATERIALS AND METHODS

In this paper, we describe the evidence-based methods used in our course and present measures of student success. We also surveyed students about aspects of the anatomy curriculum.

RESULTS

Our curriculum efficiently manages cost, instructional time, and classroom space, while promoting student success. Over the last 9 years, NYU Dentistry students have achieved a mean first-time pass rate of 98.6% and an average anatomy score of 1.74 standard deviations above the national mean on the National Board Dental Examination Part I. Students agree with instructor assessments of which features of the curriculum are valuable and state that the course helps them prepare for clinical courses.

CONCLUSION

We believe that the main factors in the success of our course are the small group setting, the benefits of spaced repetition and frequent quizzes, and the use of plastinated specimens in place of wet cadavers.

Implementation and evaluation of an online anatomy, radiology and contouring bootcamp for radiation therapists

BACKGROUND

As new treatments and technologies have been introduced in radiation oncology, the clinical roles of radiation therapists (RTs) have expanded. However, there are few formal learning opportunities for RTs. An online, anatomy, radiology and contouring bootcamp (ARC Bootcamp) originally designed for medical residents was identified as a prospective educational tool for RTs. The purpose of this study was to evaluate an RT edition of the ARC Bootcamp on knowledge, contouring, and confidence, as well as to identify areas for future modification.

METHODS

Fifty licensed RTs were enrolled in an eight-week, multidisciplinary, online RT ARC Bootcamp. Contouring practice was available throughout the course using an online contouring platform. Outcomes were evaluated using a pre-course and post-course multiple-choice quiz (MCQ), contouring evaluation and qualitative self-efficacy and satisfaction survey.

RESULTS

Of the fifty enrolled RTs, 30 completed the course, and 26 completed at least one of the post-tests. Nineteen contouring dice similarity coefficient (DSC) scores were available for paired pre- and post-course analysis. RTs demonstrated a statistically significant increase in mean DSC scoring pooled across all contouring structures (mean ± SD improvement: 0.09 ± 0.18 on a scale from 0 to 1, p=0.020). For individual contouring structures, 3/15 reached significance in contouring improvement. MCQ scores were available for 26 participants and increased after RT ARC Bootcamp participation with a mean ± SD pre-test score of 18.6 ± 4.2 (46.5%); on a 40-point scale vs. post-test score of 24.5 ± 4.3 (61.4%) (p < 0.001). RT confidence in contouring, anatomy knowledge and radiographic identification improved after course completion (p < 0.001). Feedback from RTs recommended more contouring instruction, less in-depth anatomy review and more time to complete the course.

CONCLUSIONS

The RT ARC Bootcamp was an effective tool for improving anatomy and radiographic knowledge among RTs. The course demonstrated improvements in contouring and overall confidence. However, only approximately half of the enrolled RTs completed the course, limiting statistical power. Future modifications will aim to increase relevance to RTs and improve completion rates.

Implementing Fabrication as a Pedagogical Tool in Vertebrate Anatomy Courses: Motivation, Inclusion, and Lessons

Increasing course structure by incorporating active learning and multimodal pedagogical strategies benefits all learners. Students of vertebrate anatomy can especially benefit from practicing fabrication, or "making", incorporating skills such as 3D digital modeling, 3D printing, and using familiar low-tech materials to construct informed replicas of animal anatomy. Student perceptions of active learning projects are shaped by motivation theories such as the expectancy-value theory and self-directed learning, both of which are briefly reviewed here. This paper offers inspiration and resources to instructors for establishing a makerspace in an anatomy lab and leveraging community partners to stimulate students to construct their own versions of nature's designs. Learning science in informal environments and specifically in makerspaces has been shown to promote equity and increase motivation to study science. Examples here emphasize accessibility for diverse learners, including strategies for instructors to ensure ease of student access to 3D technology. Scaffolding formative assessments builds student confidence and expertise, further closing opportunity gaps. Two specific cases are detailed where fabrication and the use of 3D digital models are used to augment student learning of vertebrate anatomy at a small liberal arts college. In a semester-long research project in an introductory biomechanics course, students investigate, write about, and build models of animal anatomy of their choice. They use simple materials, crafting supplies, household tools, and/or 3D printing to demonstrate structures of interest, enhancing understanding of the physical principles of animal form and function. Given increased availability of CT data online, students can download, analyze, and 3D print skeletal models of both common and endangered animals. Comparative anatomy students reported that they had increased motivation to study intricate skeletal anatomy simply by manipulating bones in a 3D software assignment. Students in both classes reported enjoying the use of fabrication in learning vertebrate anatomy and this may establish a pattern of lifelong learning.

Novel and Innovative Approaches to Teaching Human Anatomy Classes in an Online Environment During a Pandemic

In view of the current situation with a worldwide pandemic, the use of online teaching has become critical. This is difficult in the context of human anatomy, a subject contingent primarily on the use of human cadaveric tissues for learning through face-to-face practical laboratory sessions. Although anatomy has been taught using online resources including 3D models and anatomy applications, feedback from students and academic staff does not support the replacement of face-to-face teaching. At Charles Sturt University, we were obligated to cancel all classes on-campus in 2020 due to the COVID-19 pandemic. We ran exclusive online anatomy practical classes replacing classes usually run on campus. We designed an alternative program that consisted of twenty pre-recorded videos that were prepared in the anatomy laboratory using cadaveric tissues, and then discussed in live (and interactive) tutorials. Furthermore, innovative approaches to learning were shown and encouraged by the lecturer. Student survey responses indicated a positive response to both the anatomical videos and the innovative learning approaches. The results obtained by students showed a statistically significant increase in high distinctions and marked decrease in the amount of fail grades, compared with the previous three years (not online). The use of these videos and the encouragement of innovative learning approaches was a novel experience that will add valuable experiences for improved practice in online anatomy teaching. We propose that online anatomy videos of cadavers combined with innovative approaches are an efficient and engaging approach to replace face-to-face anatomy teaching under the current contexts.

Evaluation of Anatomy Course Teaching and Learning Outcomes for Iraqi Pharmacy Students: Internet-based Learning versus Blended Learning During the Pandemic

BACKGROUND: Academic courses of human anatomy need to be reviewed periodically by students to ensure better learning outcomes, especially when the teaching process became internet-dependent during the pandemic. AIM: Our study aims to explore pharmacy students’ opinions concerning the theoretical and practical elements of the anatomy course taught in the College of Pharmacy at Al-Rafidain University. MATERIALS AND METHODS: The ethical committee of the College of Pharmacy at Al-Rafidain University approved the study. We prepared a questionnaire (Cronbach’s Alpha = 0.735) to evaluate the positive and negative aspects of the teaching process. The questionnaire was presented as an online survey to pharmacy students (n = 305) who finished their anatomy course in two learning modalities, Internet-based learning (n1 = 105, 34.43%) and blended learning (BL) (n2 = 200, 65.57%). RESULTS: Participants of both groups were satisfied with the syllabus, using internet-based materials, and problem-based learning concerning the theoretical aspect of the course. Concerning practical knowledge, both groups preferred using cadavers instead of dummies, and they verified the beneficial effect of online educational materials and computer-based applications. Pharmacy students demanded more than one anatomy course, while students from the BL group considered the anatomy course duration insufficient. Concerning the practical knowledge, students’ marks were superior for students using BL, and the opposite was the case with theoretical knowledge. CONCLUSIONS: BL is favored by Iraqi undergraduate pharmacy students; perhaps, it is attributed to the lively interaction between students and the teaching staff. We conclude that internet resources can be supportive of the classical teaching of anatomy.

Interprofessional Education: Medical Students Create a Cadaver Lab Workshop for Nursing Students at a Neutral Cost

Cadaver labs are one of the staples of medical education in the United States, yet it is relatively uncommon for nursing students to have the opportunity to engage in the direct observation, hands-on learning, and the efficiency of the immersive environment in a cadaver-based anatomy lab. The primary aim of this project was to determine if medical students could create and deliver a cadaver lab workshop for nursing students that would provide educational benefits to both groups of students at a neutral cost. The purpose of this activity was to evaluate how a cadaver lab for nursing students could increase understanding of clinically-relevant anatomy, disease, and indwelling medical devices, while enhancing overall clinical problem-solving skills. The participants, nursing and medical students, completed a five-hour workshop followed by completion of a four-question survey of their overall learning experience and the value of the workshop from an interprofessional perspective. The surveys were analyzed individually for qualitative central themes; similar central themes were compiled by question, and overarching themes were identified and reported. Self-reflections completed by the students revealed that this shared encounter between trainees resulted in a better understanding of the visualization of the size, spatial relations, and physical interactions between organ systems; increased confidence in patient care regarding the physical exam and medical device management; and a better-perceived understanding of each profession's approach in providing patient-centered care. Medical students may also benefit by participation in this interprofessional activity through the development of clinical teaching skills that are needed while working with patients and clinical colleagues.

"Dissection Educational Videos" (DEVs) and their contribution in anatomy education: a students' perspective

Purpose

The suspension imposed on Universities due to COVID-19 pandemic impeded students’ educational opportunities. Alternative teaching modalities have been used. Substitution of dissection courses on cadavers was a great challenge. Present study investigates students’ view on the efficacy of the “online” pre-recorded “dissection educational videos” (DEVs) in assisting anatomy teaching, aiming to modernize the lectures and reinforce comprehension.

Methods

The adequacy of the “online” anatomy courses and a possible new teaching modality were evaluated by the 2nd year pre-graduate students, employing an online questionnaire.

Results

One hundred and ninety-six volunteer students participated. Before the pandemic, 78.1% of the students constantly attended the “auditorium-based” lectures and 73% used self-teaching tools (STTs) for a better understanding of anatomy. During pandemic, a slight lower frequency (76%) attended the “online” lectures and a higher frequency (84.2%) used at least one STT. Up to 59.2% of the students disagreed with the permanent replacement of the “auditorium-based” by the “online” lectures, while 62.8% supported the idea of parallel conduction of the lectures. Combined teaching tools were the most preferred resources. 83.2% of the students stated that the dissection labs’ cancellation negatively affected their education, and 75.5% supported the permanent addition of the pre-recorded DEV series in the lectures.

Conclusions

COVID-19 pandemic created the temporary need for pure remote education. During lockdown, the use of STTs has significantly increased. A novel teaching modality (DEV series), presented in the study, can be used both as educational material and as a STT.

Reflective Writing on the Cadaveric Dissection Experience: An Effective Tool to Assess the Impact of Dissection on Learning of Anatomy, Humanism, Empathy, Well-Being, and Professional Identity Formation in Medical Students

Growing evidence supports the use of reflective writing activities centered around the human cadaveric dissection experience to support and assess elements of medical student wellness. Dissection may promote personal and professional development, increase resilience, and foster a sense of connection and community. This study employed a qualitative analysis of a reflective writing exercise to explore the question: "What is the impact of the cadaveric dissection anatomy experience on the personal and professional development of medical students?" This cross-sectional study was conducted at the conclusion of the first-year anatomy module. A total of 117 United States allopathic medical students were given a questionnaire designed to elicit the students' experiences and introspection. The exercise included four reflective questions that were provided to 20 groups of six students. Grounded theory analysis was used to explore themes that arose in students' responses. Participants exhibited several common reactions to cadaveric dissection. After analyzing all responses, 266 unique open codes were identified for all four questions. These open codes were sorted into ten distinct axial codes, which are broader categorical themes of open codes. The aims of our study were to identify themes that emerged as students reflected on the impact of their dissection experience using reflective writing as a tool to capture these themes and to gather information to inform pedagogical methodologies. The researchers observed that the educational effects of dissection captured in the reflective writing resembled those found in other areas of medical education that emphasize professional identity formation and important humanistic qualities.

Exploring the Utility and Student Perceptions of Synthetic Cadavers in an Undergraduate Human Anatomy Course

The synthetic cadaver is a high-fidelity model intended to replace or supplement other anatomy learning modalities. Academic attainment and student perceptions were examined in an undergraduate human anatomy course using a combination of plastic models and synthetic cadavers to learn lower body anatomy ("Experimental group"), compared to a Historical group who used only plastic models. Grades on an upper body test, for which both groups used only plastic models, were compared to ensure that no academic differences existed between groups (P = 0.7653). Students in the Experimental group performed better on the lower body test for which they used both plastic models and synthetic cadavers (median = 73.8% (95% CI: 72.0%-75.0%) compared to the Historical group (70.1% (95% CI: 68.3%-70.7%), P < 0.0001); however, less than half of students (49%) attributed this to the synthetic cadavers. Students' perception of laboratory resources (P < 0.0001) and learning experience (P < 0.0001) both improved with the addition of synthetic cadavers compared to using only plastic models, and 60% of students in the Experimental group agreed that the synthetic cadavers would be a key reason that they would choose that institution for undergraduate studies. This investigation showed improved student grades when plastic models and synthetic cadavers were combined, in addition to improved student perceptions of the learning experience. Results of the student questionnaires also suggested that although synthetic cadavers carry a notable up-front cost, they may be a useful recruitment tool for institutions.

The Effectiveness of Collaborative Augmented Reality in Gross Anatomy Teaching: A Quantitative and Qualitative Pilot Study

In the context of gross anatomy education, novel augmented reality (AR) systems have the potential to serve as complementary pedagogical tools and facilitate interactive, student-centered learning. However, there is a lack of AR systems that enable multiple students to engage in collaborative, team-based learning environments. This article presents the results of a pilot study in which first-year medical students (n = 16) had the opportunity to work with such a collaborative AR system during a full-day gross anatomy seminar. Student performance in an anatomy knowledge test, conducted after an extensive group learning session, increased significantly compared to a pre-test in both the experimental group working with the collaborative AR system (P < 0.01) and in the control group working with traditional anatomy atlases and three-dimensional (3D) models (P < 0.01). However, no significant differences were found between the test results of both groups. While the experienced mental effort during the collaborative learning session was considered rather high (5.13 ± 2.45 on a seven-point Likert scale), both qualitative and quantitative feedback during a survey as well as the results of a System Usability Scale (SUS) questionnaire (80.00 ± 13.90) outlined the potential of the collaborative AR system for increasing students' 3D understanding of topographic anatomy and its advantages over comparable AR systems for single-user experiences. Overall, these outcomes show that collaborative AR systems such as the one evaluated within this work stimulate interactive, student-centered learning in teams and have the potential to become an integral part of a modern, multi-modal anatomy curriculum.