An integrated teaching method of gross anatomy and computed tomography radiology

Using design thinking to create and implement a 3D digital library of anatomical specimens

Design thinking (DT) is a five-stage process (empathize, define, ideate, prototype, and test) that guides the creation of user-centered solutions to complex problems. DT is in common use outside of science but has rarely been applied to anatomical education. The use of DT in this study identified the need for flexible access to anatomical specimens outside of the anatomy laboratory and guided the creation of a digital library of three-dimensional (3D) anatomical specimens (3D Anatomy Viewer). To test whether the resource was fit for purpose, a mixed-methods student evaluation was undertaken. Student surveys (n = 46) were employed using the system usability scale (SUS) and an unvalidated acceptability questionnaire. These verified that 3D Anatomy Viewer was usable (SUS of 72%) and acceptable (agreement range of 77%-93% on all Likert-type survey statements, Cronbach's alpha = 0.929). Supplementary interviews (n = 5) were analyzed through content analysis and revealed three main themes: (1) a credible online supplementary learning resource; (2) learning anatomy with 3D realism and interactivity; (3) user recommendations for expanding the number of anatomical models, test questions, and gamification elements. These data demonstrate that a DT framework can be successfully applied to anatomical education for creation of a practical learning resource. Anatomy educators should consider employing a DT framework where student-centered solutions to learner needs are required.

Student's perception of three-dimensional atlas interactive system beside traditional cadaveric dissection in learning human anatomy

PURPOSE

As digital education is encroaching on the traditional method, it is important to get, the feedback of medical students. The current study has been proposed to investigate the perception of first-year MBBS students, regarding the use of 3D atlas for gross anatomy study as adjunct along with cadaveric dissection.

METHODS

The feedback of 91 first-year MBBS students, regarding the incorporation of a 3D atlas in the dissection lab along with traditional cadaveric dissection was collected. A self-structured questionnaire, along with a consent form, was made available via Google forms and the responses were analysed.

RESULTS

97% of students agreed that the orientation and understanding of different anatomical structures improved for dissection with 3D atlas usage along with cadaveric dissection and enhanced peer discussion. The majority of students agreed that the usage of the 3D atlas created enthusiasm and motivation toward anatomy learning and encouraged them to participate actively in the lab. Some suggestions by the students like the free availability of the app for anywhere and anytime usage, lesser number of students for each batch, and the conduction of substage viva on a 3D atlas, etc. may be tailored as per institutional infrastructure.

CONCLUSIONS

The results of the study validate that the use of a 3D atlas along with dissection is an effective method of teaching anatomy. The current analysis will provide feedback for future decisions to incorporate 3D learning tools for gross anatomy in dissection labs. The authors believe that it is a useful tool that merits inclusion in anatomy.

Perception of First-Year MBBS Students Toward Virtual Dissection in Learning Anatomy: A Comparative Study Between High and Low Academic Achievers

Introduction Anatomy, as a crucial subject in the medical curriculum, demands continuous efforts to adopt innovative teaching methods to make it a student-friendly subject. One of the new educational technologies is the virtual anatomy dissection. This high-tech tool allows students to perform some hands-on manipulation of a digital cadaver through an electronic screen in the form of a table. The objectives of the study are to determine the perceptions of first-year MBBS students toward virtual anatomy dissection and to compare the responses of high and low academic achievers. Methodology This cross-sectional study was carried out at AIIMS, Guwahati, India, with the approval of the Institutional Ethics Committee (IEC). A validated questionnaire was distributed via Google Forms to 99 students in June 2024. The study used a questionnaire of 20 closed-ended items with a five-point Likert scale and 15 open-ended items to collect data on students' perceptions toward virtual dissection effectiveness, engagement and interactivity, accessibility, technical usability, learning outcomes, and comparison with traditional dissection. Independent t-test was done to identify statistically significant differences between the responses of high and low academic achievers. Results Out of 99 students, 89 (89.89%) responded. Most of the students agreed that virtual dissection is an effective tool for better understanding lectures (65, 73.03%), providing motivation to study (55, 61.79%), making learning a continuous process (57, 64.04%), facilitating deep learning (70, 78.65%), systematic knowledge gain (52, 58.42%), better memorization (72, 80.89%), improved academic performance (63, 70.78%), and reducing anxiety in learning anatomy (42, 47.19%). Sixty-seven (75.28%) stated that virtual dissection should only be a supplement to cadaver dissection for learning Anatomy. Among 20 items (closed-ended questions), only six items showed a statistically significant difference between high and low academic achievers. Conclusion The positive feedback from students presents a sound argument that justifies its incorporation into the anatomy curriculum as a supplement for cadaveric dissection.

Radiology education for medical students: a qualitative exploration of educational topics, teaching methods and future strategies

BACKGROUND

Imaging techniques play a central role in modern medicine and therefore it would be beneficial for all medical students to incorporate radiology education in medical school curricula. However, a formal undergraduate radiology curriculum with well-defined learning objectives remains lacking in The Netherlands. This study aims to qualitatively ascertain opinions from clinicians (radiologists and non-radiologists) with regard to radiology education in the medical school curricula, including topics, teaching methods and strategies.

METHODS

A qualitative study with in-depth semi-structured interviews was conducted. Inclusion was carried out until saturation was achieved, after which 2 additional interviews were held. Interviews were conducted using open-ended questions, following a predefined topic list. The constant comparative method was applied in order to include new questions when unexpected topics arose during the interviews. All interviews were transcribed verbatim and coded using a thematic analysis approach. Codes were organized into categories and themes by discussion between the researchers.

RESULTS

Forty-four clinicians were interviewed (8 radiologists, 36 non-radiologists). The three main themes that were derived from the interviews were: (1) expectations of indispensable knowledge and skills on radiology, (2) organization of radiology education within the medical curriculum and (3) promising educational innovations for the radiology curriculum. The qualitative study design provides more in-depth knowledge on clinicians' views on educational topics.

CONCLUSIONS

The themes and statements of this study provided new insights into educational methods, timing of radiology education and new topics to teach. More research is needed to gain consensus on these subjects and inclusion of the opinion of medical students with regard to radiology education is needed.

Doing more with less: Realistic stereoscopic three-dimensional anatomical modeling from smartphone photogrammetry

Traditional teaching methods struggle to convey three-dimensional concepts effectively. While 3D virtual models and virtual reality platforms offer a promising approach to teaching anatomy, their cost and specialized equipment pose limitations, especially in disadvantaged areas. A simpler alternative is to use virtual 3D models displayed on regular screens, but they lack immersion, realism, and stereoscopic vision. To address these challenges, we developed an affordable method utilizing smartphone-based 360° photogrammetry, virtual camera recording, and stereoscopic display (anaglyph or side-by-side technique). In this study, we assessed the feasibility of this method by subjecting it to various specimen types: osteological, soft organ, neuroanatomical, regional dissection, and a dedicated 3D-printed testing phantom. The results demonstrate that the 3D models obtained feature a complete mesh with a high level of detail and a realistic texture. Mesh and texture resolutions were estimated to be approximately 1 and 0.2 mm, respectively. Additionally, stereoscopic animations were both feasible and effective in enhancing depth perception. The simplicity and affordability of this method position it as a technique of choice for creating easily photorealistic anatomical models combined with stereoscopic depth visualization.

Use of Clinically Oriented Laboratory Manuals in a Prosection Gross Anatomy Laboratory during COVID-19

Gross anatomy is a critical course for the development of a variety of skills such as anatomical knowledge and spatial, critical, and clinical reasoning. There have been few attempts to integrate clinical applications in gross anatomy, with the majority of these being in the lecture hall and not in the laboratory. Clinical cases and guided questions were added to a laboratory manual (Clinically Oriented Laboratory Manuals (COLMs)) in a first-year medical gross anatomy prosection course during COVID-19. The effectiveness of the COLMs was analyzed using in-laboratory assessments between treatment and control groups, as well as student perceptions. There was no significant difference between in-lab assessment scores between students with or without the COLMs in 2020 (t1304.735= 0.647, p ;= 0.518). Student perceptions demonstrated that 61.6% strongly agreed or agreed that the COLMs were a good way to learn anatomy and 32.0% desired more COLMs in the lab. Overall, COLMs did not increase student knowledge by the end of a session. Students thought the COLMs were a good tool to learn anatomy because they helped become more clinically aware; however, students desired better implementation of the COLMs. The addition of COLMs in the laboratory is a potential method to address the need for clinical applications within the gross anatomy laboratory.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01970-1.

Living and post-mortem CT scans in the gross anatomy lab: A study investigating differences in first-year medical students' exam performance and perceptions

Basic competency in radiological imaging is essential for physicians to identify and manage diseases. An optimal place in which to include imaging in the medical curriculum is during anatomy as students can correlate the 3D anatomy from their body donors with the 2D cross-sectional anatomy. The goal of this project was to enhance first-year medical students' knowledge of cross-sectional imaging in the gross anatomy lab and to investigate whether there are benefits to learning cross sectional imaging via scans from body donors versus living individuals. Student participant performance was evaluated on laboratory practical examinations, CT image questions and spatial anatomical knowledge in the thorax and abdomen sections of gross anatomy. Students learned the cross-sectional imaging during dissections where they accessed the images relevant to their study on Pacsbin, a web-based Digital Imaging and Communication in Medicine viewer, via iPads. Results showed no statistically significant differences in practical examination scores, spatial anatomical knowledge, or identification of anatomical structures on CT image questions between participants who learned from images on body donors versus living individuals. In a questionnaire given at the end of the course, participants cited that the CT images improved their anatomical and imaging knowledge and that they felt better prepared to use imaging software and interpret diagnostic imaging results upon entering clerkships. While there were no differences in academic performance between the groups, positive outcomes regarding student perceptions of anatomical and imaging knowledge and preparedness for use of imaging software were identified in this study.

Learning technology in health professions education: Realising an (un)imagined future

CONTEXT

Technology is being introduced, used and studied in almost all areas of health professions education (HPE), often with a claim of making HPE better in one way or another. However, it remains unclear if technology has driven real change in HPE. In this article, we seek to develop an understanding of the transformative capacity of learning technology in HPE.

METHODS AND OUTCOMES

We first consider the wider scholarship highlighting the intersection between technology and pedagogy, articulating what is meant by transformation and the role of learning technology in driving educational transformation. We then undertake a synthesis of the current high visibility HPE-focused research. We sampled the literature in two ways-for the five highest impact factor health professional education journals over the past decade and for all PubMed indexed journals for the last 3 years-and categorised the extant research against the Substitution, Augmentation, Modification, Redefinition model. We found that the majority of research we sampled focussed on substituting or augmenting learning through technology, with relatively few studies using technology to modify or redefine what HPE is through the use of technology. Of more concern was the lack of theoretical justification for pedagogical improvement, including transformation, underpinning the majority of studies.

CONCLUSIONS

While all kinds of technology use in learning have their place, the next step for HPE is the robust use of technology aiming to lead transformation. This should be guided by transformational educational theory and aligned with pedagogical context. We challenge HPE practitioners and scholars to work thoughtfully and with intent to enable transformation in education for future health professionals.

Comparison between pre-mortem and post-mortem cadaveric images for use with augmented reality headsets during dissection

PURPOSE

Medical training has undergone many transformations to incorporate diagnostic imaging along side anatomical education. Post-mortem computed tomography (CT) scanning of body donors prior to dissection has been proposed. However, it poses challenges secondary to the embalming process and other post-mortem physiological changes that significantly alter the imaging quality. The purposes of this study were to compare the accuracy of pathology identification on pre- and post-mortem CT scans of body donors and to assess the integration of those scans in a dissection-based course, where these images were overlaid onto body donors using augmented reality (AR).

METHODS

Participants in this study included 35 fourth year medical students, 5 radiology residents and 3 radiologists. A convergent, parallel mixed methods design was employed with quantitative measures that included statistical analyses of a double-blinded comparison of pathological lesions recognition, on both image sets, the group responses to a study participant survey and the login access data from imaging repository. The study also included qualitative analysis of post-elective structured interviews.

RESULTS

The double-blinded comparison revealed that staff radiologists can only identify, on post-mortem images, 54.8% of the pathologies that they were able to detect on the pre-mortem scans. Analyses of the surveys and login access data reveal that 60% of radiology residents and 56% of students preferred pre-mortem scans and used those scans more often than post-mortem scans (67 access vs 36, respectively). However, post-mortem scans were significantly preferred when used to overlay onto body donors using AR (p = 0.0047).

CONCLUSION

These results show that post-mortem imaging can be valuable alongside pre-mortem imaging, as they represent the most concordance between the anatomical structures and pathologies seen on the images and what is being dissected.

Rehearsal-based digital serious boardgame versus a game-free e-learning tool for anatomical education: Quasi-randomized controlled trial

Serious games may resolve problems relating to low motivation in complex medical topics such as anatomy. However, they remain relatively novel introductions to the science of learning, and further research is required to ascertain their benefits. This study describes the overall development and testing of a digital serious boardgame designed to facilitate the rehearsal of musculoskeletal anatomy based on self-determination theory with considerations for the psychological state of Flow. It was hypothesized that students assigned to the intervention game condition would attain higher Flow scores, a measure of engagement and intrinsic motivation, than students assigned to the game-free control, and that the intervention condition would report either superior or non-superior, but not inferior, scores on a surprise recall test. A total of 36 second-year undergraduate medical students participated in the quasi-randomized controlled trial, where the intervention groups went first and randomly drew questions that were mirrored into the control groups. All students were administered an identical 10-question baseline assessment before their interventions, the Short Flow Scale immediately after, and a surprise test four-to-six weeks later. Independent samples t-tests indicated that students of both conditions were of similar baseline knowledge (t = 0.7, p = 0.47), significantly higher Flow scores in the game condition (t = 2.99, p = 0.01), and no significant differences between surprise test scores (t = -0.3, p = 0.75). The game appears to be an appropriate game-based tool for student rehearsal of anatomical education, stemming from a strong theoretical base that facilitates high engagement and intrinsic motivation.

The Use of Virtual Reality in Teaching Three-Dimensional Anatomy and Pathology on CT

While radiological imaging is presented as two-dimensional images either on radiography or cross-sectional imaging, it is important for interpreters to understand three-dimensional anatomy and pathology. We hypothesized that virtual reality (VR) may serve as an engaging and effective way for trainees to learn to extrapolate from two-dimensional images to an understanding of these three-dimensional structures. We created a Google Cardboard Virtual Reality application that depicts intracranial vasculature and aneurysms. We then recruited 12 medical students to voluntarily participate in our study. The performance of the students in identifying intracranial aneurysms before and after the virtual reality training was evaluated and compared to a control group. While the experimental group's performance in correctly identifying aneurysms after virtual reality educational intervention was better than the control's (experimental increased by 5.3%, control decreased by 2.1%), the difference was not statistically significant (p-value of 0.06). Significantly, survey data from the medical students was very positive with students noting they preferred the immersive virtual reality training over conventional education and believed that VR would be a helpful educational tool for them in the future. We believe virtual reality can serve as an important tool to help radiology trainees better understand three-dimensional anatomy and pathology.

Inclusion of cross-sectional and radiological images for better understanding of musculoskeletal anatomy and decreasing the risk of adverse events during dry needling in undergraduate physiotherapy students

Since there is an increasing rate of physiotherapists using invasive procedures during the clinical practice, understanding the cross-sectional anatomy and radiological images is essential for ensuring patients' safety during these interventions. Therefore, the aim of this study was to analyze the students' opinion of including cross-sectional and radiological images to traditional methodologies, to evaluate whether these additional resources improve their ability to identify musculoskeletal structures in radiological images and their understanding of neurovascular and visceral structures related with specific muscles to be avoided during invasive procedures. First-year undergraduate physiotherapy students were enrolled in the study. A brief online survey asking about their opinion about the use of cross-sectional and radiological images as complementary resources was built. In addition, two open-answer tests (before and after the inclusion of these resources) were conducted to evaluate their ability to identify correctly musculoskeletal structures in magnetic resonance and ultrasound images and to evaluate their awareness of high-risk structures related with specific muscles. One-hundred-thirty-two students returned the online survey and one-hundred-forty-eight completed all the tests. In general, students opined cross-sectional images to be of utility for learning anatomy (81.8%) and radiological images (93.9%) and felt they benefited from cross-sectional and ultrasound images (78.0%). All tests showed significant improvements after the inclusion of these complementary resources (all, p < 0.001) except for trunk structures in MRI (p = 0.777). The implementation of anatomical cross-sectional and radiological images resulted in better understanding of radiological images and better cognition of possible risk during invasive procedures.

Bridging neuroradiology and neuroanatomy: NOWinBRAIN-a repository with sequences of correlated and labeled planar-surface neuroimages

Purpose: Integrating neuroradiology with neuroanatomy is essential in medical neuroeducation and neuroimage interpretation. To bridge 2D neuroradiology and 3D neuroanatomy, spatially correlated pairs of labeled images were employed, planar radiologic, and planar-surface combined. Research design: The method employs a 3D fully parcellated and labeled brain atlas extended to the head and neck with about 3000 3D components to create planar radiologic and surface neuroanatomic images. The atlas handles reformatted radiologic images as 3D objects using texture mapping which provides consistency with polygonal 3D neuroanatomic structures. This ensures a precise spatial correspondence of dual 2D-2D/3D images for any composed 3D scene reformatted in arbitrary orientation. The sequences of labeled dual images were created spanning a structure/system of interest in multiple orientations. To facilitate image searching, the image name encodes its content, orientation, and stereotactic location. Results: Labeled dual 2D-2D/3D neuroimage sequences in multiple orientations were created for the cerebrum, brainstem, deep nuclei, cerebral ventricles, intracranial arteries, dural sinuses, extracranial arteries, extracranial veins, trigeminal nerve, head muscles, glands, bones of cranium, and visual system. They all were hierarchically organized as a planar-surface gallery with 42 folders and 502 neuroimages. This gallery was integrated with a public NOWinBRAIN repository at www.nowinbrain.org with more than 7700 neuroimages. Conclusions: Owing to its advantages, simplicity, and free availability, this resource is useful for medical students, residents, educators, and clinicians to study the brain, head, and neck as well as to prepare presentations and teaching materials. The approach might potentially enhance image interpretation by integrating brain atlases with radiologic workstations.

Evaluation of the use of cadaveric computed tomography in anatomy education: An overview

OBJECTIVE

We aimed to explore to what extent the literature supports that the use of cadaveric computed tomography can play an important role in anatomy education.

MATERIALS AND METHODS

PubMed, SCOPUS, Education Resources Information Center and Cochrane Databases were searched for papers with purpose to explore the outcomes of the use of cadaveric computed tomography scans in anatomy education. The following data were obtained from each paper: authors, number of participants, type of study (comparative or not), level of outcome according to Kirkpatrick hierarchy, possible evaluation of statistical significance, acquisition of anatomical knowledge after the educational intervention and perceptions about the effectiveness of this intervention in anatomy learning.

RESULTS

Seven articles were included. Four of them evaluated students' knowledge after the use of cadaveric computed tomography scans in anatomy education and three papers evaluated only students' perceptions. Generally, the outcomes, which mainly concerned students' perceptions, were positive, while it was showed that students' academic performance may also be improved.

CONCLUSIONS

The outcomes of the use of cadaveric computed tomography scans in anatomy education encourage the implementation of this teaching modality in anatomy curricula. Further research, including comparative studies with evaluation of acquisition of students' knowledge, is needed to show if cadaveric computed tomography will be proved a remarkable supportive tool in anatomy educators' hands.

Operative Versus Nonoperative Management of Displaced Midshaft Clavicle Fractures: A Cost-effectiveness Analysis

To date, the optimal management of displaced midshaft clavicle fractures remains unknown. Operatively, plate or nail fixation may be used. Nonoperatively, the options are sling or harness. Given the equivocal effectiveness between approaches, the costs to the health care system and the patient become critical considerations. A decision tree model was constructed to study plate and sling management of displaced midshaft clavicle fractures. Primary analysis used 6 randomized controlled trials that directly compared open reduction and internal fixation with a plate to sling. Secondary analysis included 18 studies that studied either plate, sling, or both. Incremental cost-effectiveness ratios (ICERs) were calculated using quality-adjusted life-years (QALYs). Second-order Monte Carlo probabilistic sensitivity analysis (PSA) was subsequently conducted. In primary analysis, at a willingness-to-pay (WTP) threshold of $100,000, operative management was found to be less cost-effective relative to nonoperative management, with an ICER of $606,957/QALY (0.03 additional QALYs gained for an additional $16,120). In PSA, sling management was cost-effective across all WTP ranges. In secondary analysis, the ICER decreased to $75,230/QALY. Primary analysis shows that plate management is not a cost-effective option. In secondary analysis, the incremental effectiveness of plate management increased enough that the calculated ICER is below the WTP threshold of $100,000; however, the strength of evidence in secondary analysis is lower than in primary analysis. Thus, because neither option is dominant in this model, both plate and sling remain viable approaches, although the cost-conscious decision will be to treat these fractures with a sling until future data suggest otherwise. [Orthopedics. 2022;45(5):e243-e251.].

Extent of Utilization of Radiologic Images in Gross Anatomy Teaching, the Experience of Ethiopian Medical Schools

BACKGROUND

One of the greatest developments in modern medicine is the strides taken in radiology. Today, thanks to high-tech devices like computer tomography (CT), magnetic resonance imaging (MRI), and ultrasound, a noninvasive glimpse into the human interior has been made possible. These recent developments have revolutionized how doctors see anatomy. To keep pace with this progress, many medical school anatomy curriculums have undergone a facelift. In these new curriculums, radiology has been presented as a practical and sufficient alternative tool for learning anatomy. This study, therefore, aimed to determine the extent of the use of radiologic images in the teaching of anatomy in Ethiopian medical schools.

METHODS

An online questionnaire was used to collect, compile and analyze data from anatomy instructors in Ethiopian medical schools.

RESULTS

The survey showed that 55.9% of the instructors used radiologic images of one form or another in their teaching. However, it also revealed radiological images comprise <5% of the total images used in teaching. The majority (73.5%) of the instructors lacked any prior training or coursework in radiologic anatomy. Despite full-time radiology faculties existing in the schools, a relationship between the anatomy and radiology department is virtually unheard of.

CONCLUSION

The curriculum currently in use in Ethiopian medical schools is designed in a way both vertical and horizontal integration of the traditional subjects are achieved. This way, the introduction of clinical medicine early will provide context and relevance to the learning of basic science. Despite the curriculum's emphasis, we have observed limitations in the degree of integration of anatomy and radiology.

Three-Dimensional Immersive Photorealistic Layered Dissection of Superficial and Deep Back Muscles: Anatomical Study

Introduction

The distinct anatomy of the superficial and deep back muscles is characterized by complex layered courses, fascial planes, specific vascularization, and innervation. Knowledge of these anatomical parameters is important for some surgical approaches, including lumbar disc herniation, cerebrospinal fluid fistula repair, vascularized muscle pedicle flaps, and posterior fossa extra-intracranial bypass. In the present study, we use modern techniques of three-dimensional (3D) surface scanning to help better illustrate the layered anatomy of the back muscles.

Material and methods

We dissected in layers the back muscles of one cadaver. Every step of the dissection was 3D scanned using a technique called photogrammetry, which allows the extraction of 3D data from 2D photographs. The 3D data were processed using Blender software, and the 3D photorealistic models were uploaded to a dedicated website for 3D visualization. This allows users to see the 3D models from every desktop or mobile device, as well as augmented (AR) and virtual reality (VR) formats.

Results

The photorealistic 3D models present the back muscles' anatomy in a volumetric manner, which can be visualized on any computer device. The web 3D features, including AR and VR, allow users to zoom, pan, and rotate the models, which may facilitate learning.

Conclusion

The technology of photorealistic surface scanning, modern 3D visualization possibilities of web-dedicated formats, as well as advances in AR and VR, have the potential to help with a better understanding of complex anatomy. We believe that this opens the field for further research in the field of medical education.

The Integration of Prelaboratory Assignments within Neuroanatomy Augment Academic Performance, Increase Engagement, and Enhance Intrinsic Motivation in Students

The study of neuroanatomy imposes a significant cognitive load on students since it includes huge factual information and therefore demands diverse learning strategies. In addition, a significant amount of teaching is carried out through human brain demonstrations, due to limited opportunities for cadaveric dissection. However, reports suggest that students often attend these demonstrations with limited preparation, which detrimentally impacts their learning. In the context of student learning, greater levels of engagement and intrinsic motivation (IM) are associated with better academic performance. However, the maintenance of engagement and the IM of students in neuroanatomy is often challenging for educators. Therefore, this study aimed to explore the role of prelaboratory assignments (PLAs) in the improvement of academic performance, augmentation of engagement, and enhancement of IM in occupational therapy students enrolled in a human neuroanatomy course. One cohort of students in the course was expected to complete PLAs prior to each brain demonstration session. The PLAs contained a list of structures, and students were expected to write a brief anatomical description of each structure. Another cohort of students who were not provided with similar PLAs constituted the control group. Students who completed PLAs had a higher score on the final examinations as compared to students who were not required to complete PLAs. These students also demonstrated greater engagement and IM, and indicated that they perceived PLAs to be valuable in the learning of neuroanatomy. Therefore, PLAs represent a useful teaching tool in the neuroanatomy curriculum.

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.

Integrated anatomical practice combining cadaver dissection and matched cadaver CT data processing and analysis

PURPOSE

With the increasing significance of diagnostic imaging in clinical practice, long-term anatomical education and training is required to ensure that students can reliably distinguish anatomical structures and interpret images. To improve students' motivation and prospects for learning imaging anatomy, we developed an integrated anatomical practice program combining cadaveric dissection with cadaver CT data processing and analysis during undergraduate students' dissection courses.

METHODS

Workstations imported with post-mortem CT data of dissected cadavers and various forms of clinical CT/MRI data were set in the dissection room. Medical students had free access to the imaging data during cadaver dissection, and they were challenged to process and analyze the data for submission of voluntary imaging reports on their topics of interest. Finally, we surveyed the integrated anatomical education of 481 medical students.

RESULTS

The positive response rate to the integrated anatomical practice was 74.9%, and 79.4% of the students answered that this form of practice offered a suitable introduction to anatomical imaging. The usefulness of this approach in understanding the 2- to 3D arrangement of the human body and enhancing interest in anatomy was also confirmed. The submission rate of voluntary imaging reports also increased annually and is currently 97.4%.

CONCLUSION

Our integrated anatomical practice only allowed students to actively browse CT images and facilitated imaging processing and analysis of their region of interest. This practice may improve students' long-term ability to analyze images and deepen their understanding. A competitive imaging contest may help improve students' motivation when they begin learning imaging anatomy.

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.

3D Printing Applications for Radiology: An Overview

Three-dimensional (3D) printing technologies are part of additive manufacturing processes and are used to manufacture a 3D physical model from a digital computer-aided design model as per the required shape and size. These technologies are now used for advanced radiology applications by providing all information through 3D physical model. It provides innovation in radiology for clinical applications, treatment planning, procedural simulation, medical and patient education. Radiological advancements have been made in diagnosis and communication through medical digital imaging techniques like computed tomography, magnetic resonance imaging. These images are converted into Digital Imaging and Communications in Medicine in Standard Triangulate Language file format, easily printable in 3D printing technologies. This 3D model provides in-depth information about pathologic and anatomic states. It is useful to create new opportunities related to patient care. This article discusses the potential of 3D printing technology in radiology. The steps involved in 3D printing for radiology are discussed diagrammatically, and finally identified 12 significant applications of 3D printing technology for radiology with a brief description. A radiologist can incorporate this technology to fulfil different challenges such as training, planning, guidelines, and better communications.

Cinematic Rendering in Anatomy: A Crossover Study Comparing a Novel 3D Reconstruction Technique to Conventional Computed Tomography

Integration of medical imaging into preclinical anatomy courses is already underway in many medical schools. However, interpretation of two-dimensional grayscale images is difficult and conventional volume rendering techniques provide only images of limited quality. In this regard, a more photorealistic visualization provided by Cinematic Rendering (CR) may be more suitable for anatomical education. A randomized, two-period crossover study was conducted from July to December 2018, at the University Hospital of Erlangen, Germany to compare CR and conventional computed tomography (CT) imaging for speed and comprehension of anatomy. Sixteen students were randomized into two assessment sequences. During each assessment period, participants had to answer 15 anatomy-related questions that were divided into three categories: parenchymal, musculoskeletal, and vascular anatomy. After a washout period of 14 days, assessments were crossed over to the respective second reconstruction technique. The mean interperiod differences for the time to answer differed significantly between the CR-CT sequence (-204.21 ± 156.0 seconds) and the CT-CR sequence (243.33 ± 113.83 seconds; P < 0.001). Overall time reduction by CR was 65.56%. Cinematic Rendering visualization of musculoskeletal and vascular anatomy was higher rated compared to CT visualization (P < 0.001 and P = 0.003), whereas CT visualization of parenchymal anatomy received a higher scoring than CR visualization (P < 0.001). No carryover effects were observed. A questionnaire revealed that students consider CR to be beneficial for medical education. These results suggest that CR has a potential to enhance knowledge acquisition and transfer from medical imaging data in medical education.

Student-Authored Autopsy Reports of Anatomical Donors: Their First Patients

The preparation of student-authored autopsy reports of anatomical donors was added to the Gross Anatomy course to integrate the basic and clinical sciences and determine whether students considered this early clinical exposure to be a valuable experience. All donors were scanned using computerized tomography (CT) and student groups received the scan of their donor and a report written by a radiologist. As students dissected, they took photographs and biopsies of pathological findings that were processed for microscopic evaluation. Following consultation with pathologists and radiologists, each group prepared an autopsy report that proposed a cause of death supported with macroscopic, microscopic, and CT images. Cardiovascular events and cancer were the most common. Autopsy reports were evaluated by the faculty and each student group received feedback with respect to content, accuracy, and completeness and whether faculty agreed with students' proposed cause of death. A majority of students answering an anonymous survey indicated that this exercise was valuable or somewhat valuable, but did not agree that preparation of the autopsy report resulted in their being more engaged during the course. Students agreed or somewhat agreed that the exercise should be repeated next year, that they gained insight into the clinical manifestations of disease, that they were able to interpret the CT scan themselves, that meeting with a pathologist was interesting, and that the time required to prepare the report was adequate. Since autopsy reports prepared by students are feasible and students found it to be a valuable experience, we suggest that medical schools add this to Gross Anatomy courses to introduce clinical material and increase clinical relevance.

Evaluating the integration of pre-mortem body donor imaging into a dissection-based medical anatomy course

BACKGROUND

Medical faculties are currently embracing a modernistic approach to anatomical education that integrates diagnostic imaging largely through post-mortem computed tomography scanning of body donors. Post-mortem imaging, however, poses a multitude of challenges. The purpose of this study was to assess the implementation of pre-mortem donor-specific diagnostic imaging on student learning and dissection experience in addition to understanding the potential impact on students' preparation for clinical practice.

METHODS

Students in a fourth-year medicine elective course were divided into groups; group 1 received pre-mortem donor-specific diagnostic imaging, while group 2 received pathology-specific diagnostic imaging, a collection of images relating to the type(s) of pathologies the donors exhibited, though not specific to the donors themselves. Both groups also received a donor-specific case vignette. A convergent, parallel mixed methods design was employed. This included integrating data from group responses to a study participant survey and students' academic assessment scores analyzed quantitatively through statistical analyses with data from focus group sessions investigating the psychosocial aspects of the student dissection experience and perceptions of the imaging use in the course analyzed qualitatively.

RESULTS

As compared to students receiving pathology-specific diagnostic imaging, the quantitative results demonstrated that students receiving pre-mortem donor-specific diagnostic imaging more positively supported the relevancy of diagnostic imaging to their understanding of anatomy, valued the integration for future practice, and suggested an earlier integration within their medical curriculum. Qualitatively, two main themes were observed: the influence of diagnostic imaging integration on dissection experience and on professional mindset. Although both student groups received imaging corresponding to their body donor, consideration towards the humanistic nature of the body donor as a patient with a history was limited to student feedback from the donor- specific diagnostic imaging group.

CONCLUSION

Overall the integration of pre-mortem donor-specific diagnostic imaging into anatomical dissection provided students with practical skill development, an enhanced dissection experience, and reinforced personal qualities critical for future practice.

Effectiveness of blended learning in radiological anatomy for first year undergraduate medical students

PURPOSE

The aim of the study was to assess the effectiveness of blended learning modules for radiological anatomy among first-year medical students by estimating knowledge gain and evaluating student perceptions.

METHODS

A single-group, pre- and post-test study design was utilized. Five radiological anatomy modules consisting of online presentations and self-assessment quizzes were developed for the upper limb, lower limb, head and neck, thorax, and abdomen and pelvis. The content of the modules was uploaded on to a learning management system called TYRO. Each module focused on the normal anatomical features observed on plain and contrast radiographs. Other relevant imaging modalities and clinical contexts were also introduced. During the classroom session, the students were instructed to peruse the modules and answer the self-assessment quiz. The teacher in the classroom acted as a facilitator and was available to the students for any clarifications. A pre- and post-test was administered to the students before and after exposure to the modules, respectively. A paired t test was used to estimate differences in the pre- and post-test scores. Students' perceptions were assessed using a questionnaire.

RESULTS

One-hundred students attended both the tests. The mean and standard deviation of pre- and post-test scores were 17 ± 5.5 and 26 ± 7.6, respectively, and this difference was significant. Students' perceptions about the intervention were on the whole positive.

CONCLUSION

A significant improvement in the knowledge of radiological anatomy was noted after exposure to five blended learning modules of radiological anatomy. The modules were well received by the students.

The additional role of virtual to traditional dissection in teaching anatomy: a randomised controlled trial

Introduction

Anatomy has traditionally been taught via dissection and didactic lectures. The rising prevalence of informatics plays an increasingly important role in medical education. It is hypothesized that virtual dissection can express added value to the traditional one.

Methods

Second-year medical students were randomised to study anatomical structures by virtual dissection (intervention) or textbooks (controls), according to the CONSORT guidelines. Subsequently, they applied to the corresponding gross dissection, with a final test on their anatomical knowledge. Univariate analysis and multivariable binary logistic regression were performed.

Results

The rate of completed tests was 76.7%. Better overall test performance was detected for the group that applied to the virtual dissection (OR 3.75 with 95% CI 0.91–15.49; p = 0.06). A comparable performance between groups in basic anatomical knowledge (p 0.45 to 0.92) but not muscles and 2D-3D reporting of anatomical structures was found, for which the virtual dissection was of tendential benefit (p 0.08 to 0.13). Medical students who applied to the virtual dissection were over three times more likely to report a positive outcome at the post-dissection test than those who applied to textbooks of topographical anatomy. This would be of benefit with particular reference to the understanding of 2D–3D spatial relationships between anatomical structures.

Conclusion

The combination of virtual to traditional gross dissection resulted in a significant improvement of second-year medical students’ learning outcomes. It could be of help in maximizing the impact of practical dissection, overcoming the contraction of economic resources, and the shortage of available bodies.

Electronic supplementary material

The online version of this article (10.1007/s00276-020-02551-2) contains supplementary material, which is available to authorized users.

Reconstrução e impressão 3D do neurocrânio de cão com o uso de tomografia computadorizada como ferramenta para auxiliar no ensino da anatomia veterinária

RESUMO A impressão tridimensional (3D) vem contribuindo para o aprendizado da anatomia e para áreas aplicadas da medicina veterinária utilizando uma interface que pode valorizar o conhecimento da anatomia das espécies domésticas de maneira dinâmica. O presente trabalho objetivou utilizar imagens tridimensionais geradas por tomografias computadorizada (TC) para a obtenção de imagens digitalizadas e de modelos de ossos do crânio de cão por meio de uma impressora tridimensional. Foram gerados arquivos 3D de TC a partir de imagens que foram editadas pelo software Osirix Lite. Partes dos ossos e particularidades anatômicas do crânio foram impressas em escalas de 60% e 100%. Os resultados permitiram gerar imagens digitalizadas e impressões tridimensionais advindas das tomografias, e, assim, foi criado um acervo de imagens e modelos impressos para os estudos da anatomia do crânio da espécie canina. Além disso, a metodologia demonstrou claramente a importância para uso de planejamentos cirúrgicos nos casos de procedimentos que envolvam comprometimento de estruturas ósseas. Produziu-se um material interativo e impresso em 3D com maior durabilidade, o qual poderá ser disponibilizado para fins educacionais.

The Benefits of an Augmented Reality Magic Mirror System for Integrated Radiology Teaching in Gross Anatomy

Early exposure to radiological cross-section images during introductory anatomy and dissection courses increases students' understanding of both anatomy and radiology. Novel technologies such as augmented reality (AR) offer unique advantages for an interactive and hands-on integration with the student at the center of the learning experience. In this article, the benefits of a previously proposed AR Magic Mirror system are compared to the Anatomage, a virtual dissection table as a system for combined anatomy and radiology teaching during a two-semester gross anatomy course with 749 first-year medical students, as well as a follow-up elective course with 72 students. During the former, students worked with both systems in dedicated tutorial sessions which accompanied the anatomy lectures and provided survey-based feedback. In the elective course, participants were assigned to three groups and underwent a self-directed learning session using either Anatomage, Magic Mirror, or traditional radiology atlases. A pre- and posttest design with multiple choice questions revealed significant improvements in test scores between the two tests for both the Magic Mirror and the group using radiology atlases, while no significant differences in test scores were recorded for the Anatomage group. Furthermore, especially students with low mental rotation test (MRT) scores benefited from the Magic Mirror and Anatomage and achieved significantly higher posttest scores compared to students with a low MRT score in the theory group. Overall, the results provide supporting evidence that the Magic Mirror system achieves comparable results in terms of learning outcome to established anatomy learning tools such as Anatomage and radiology atlases.

The impacts of three-dimensional anatomical atlas on learning anatomy

Gross anatomy has traditionally been the foundation of medical education. Medical students have learned the structure of the human body through dissection, lecture, and textbooks. As tablets and three-dimensional (3D) applications are developed, 3D atlas applications are utilized in learning anatomy by medical students. The purpose of this research is to investigate the impacts of 3D atlas applications on students' understanding of gross anatomy. This research was targeted at medical students taking the Anatomy and Embryology class in 2017 and 2018, at Ewha Womans University. The correlation between use of 3D atlas and student's results on the Anatomy and Embryology test was analyzed. An open-book anatomy quiz was also carried out to analyze the correlation between the type of atlas each student refers to and the results of the quiz. Independent t test between groups did not show statistically significant difference in the results of the Anatomy and Embryology test. However, the group referring to 3D atlas showed significantly higher results on the simple questions of the open-book anatomy quiz (P<0.05). In conclusion, 3D atlas is not very helpful in acquiring deep anatomical knowledge or memorizing the location of anatomical structures, but it can simply aid in the rapid identification of anatomical structures. Additionally, the 3D atlas will show good synergy with the two-dimensional atlas if used properly in anatomy education, because most students think it is useful to use the 3D atlas.

Use of dynamic images in radiology education: Movies of CT and MRI in the anatomy classroom

Radiology education is a key component in many preclinical anatomy courses. However, the reported effectiveness of radiology education within such anatomy classrooms has varied. This study was conducted to determine if a novel educational method using dynamic images of movies of computed tomography (CT) and magnetic resonance imaging (MRI) was effective in radiology education during a preclinical anatomy course, aided by clay modeling, specific hand gestures (digit anatomy), and reports from dissection findings uploaded to the anatomy course website (digital reports). Feedback surveys using a five-point Likert scale were administered to better clarify students' opinions regarding their understanding of CT and MRI of anatomical structures, as well as to determine if such preclinical radiology education was helpful in their clinical studies. After completion of the anatomy course taught with dynamic images of CT and MRI, most students demonstrated an adequate understanding of basic CT and MR images. Additionally, students in later clinical years generally believed that their study of radiologic images during the preclinical anatomy course was helpful for their clinical studies and clerkship rotations. Moreover, student scores on imaging anatomy examinations demonstrated meaningful improvements in performance after using dynamic images from movies of CT and MRI.

Microanatomy Around the Facial Nerve Pathway for Microvascular Decompression Surgery Investigated with Correlative Light Microscopy and Block-Face Imaging

BACKGROUND

Microvascular decompression for hemifacial spasm is performed at the root exit zone. More proximal segments of the facial nerve, defined as the root emerging zone (REmZ), may also be susceptible to neurovascular compression. Consequently, detailed knowledge of the microanatomy around facial nerve fibers at the pontomedullary junction is essential for consistent success of microvascular decompression.

METHODS

Five human brainstems obtained from cadavers were investigated using correlative light microscopy and block-face imaging, which obtains arbitrary two-dimensional light microscopic and three-dimensional volume data from a single specimen. The entire facial nerve pathway, including the myelin transition, was evaluated inside and outside the brainstem.

RESULTS

Correlative light microscopy and block-face imaging showed the intra-brainstem facial nerve fibers emerging at the brainstem surface deep at the pontomedullary sulcus (REmZ) and coursing along the pontine surface before detaching from the pons (root exit zone). An acute emerging angle significantly increased the surface area with central myelin. The facial nerve bundle formed 1 fasciculus in the portion covered by central myelin but divided into 2 fasciculi in the myelin transitional portion and then into multiple fasciculi more distally. Arteries around the REmZ were often anchored by perforating branches entangled with lower cranial nerves.

CONCLUSIONS

Facial nerve fibers are susceptible to vascular compression on emerging onto the deep brainstem surface at the pontomedullary sulcus. The key procedure in microvascular decompression is full dissection of the lower cranial nerves down to the brainstem origin to explore both the root exit zone and the REmZ.

Different Digitalization Techniques for 3D Printing of Anatomical Pieces

The use of different technological devices that allow the creation of three-dimensional models is in constant evolution, allowing a greater application of these technologies in different fields of health sciences and medical training. The equipment for digitalization is becoming increasingly sophisticated allowing obtaining three-dimensional which are more defined and similar to real image and original object. In this work, different modalities of designing 3D anatomical models of bone pieces are presented, for use by students of different disciplines in Health Sciences. To do this we digitalized bone pieces, with different models of scanners, producing images that can be transformed for 3D printing, with a Colido X 3045 printer by digital treatment with different software.

Student and recent graduate perspectives on radiological imaging instruction during basic anatomy courses

Recently, faculty at Pritzker School of Medicine, The University of Chicago, have made efforts to improve the depth of radiological anatomy knowledge that students have, but no insights exist as to student and resident opinions of how clinically helpful deep anatomical understanding is. A single-institution survey of second- and fourth-year medical students and postgraduate year 1-4 residents from 11 specialties, composed of five-point Likert questions, sample examination questions, and narrative response questions, was distributed in 2015. One hundred seventy-seven of the 466 potential respondents replied (71 residents and 106 students), response rate 38.0%. No nonresponse bias was present in two separate analyses. Respondents generally favored a superficial "identification" question as more relevant to clinical practice, which was positively associated with increasing clinical experience ρ = 0.357, P < 0.001 by point-biserial correlation. Students and residents most commonly used self-directed methods to learn medical imaging during their medical anatomy courses (72.6 and 57.7%, respectively). Small group education was least commonly used by students and residents (45.3 and 39.4%, respectively), but most commonly recommended (62.3 and 69%, respectively). A total of 56.6 and 64.8% of students and residents, respectively, reported that having multiple learning methods was "quite" or "extremely" important. Respondents with more clinical experience were more likely to report that a superficial identification question was more clinically relevant than a question testing deeper radiological anatomy knowledge. Small group learning was preferred among students and residents but was the least commonly employed method of instruction. Both findings contrast starkly with current radiological anatomy instructional understanding and practices. Anat Sci Educ 11: 25-31. © 2017 American Association of Anatomists.

Cadaver Dissection Is Obsolete in Medical Training! A Misinterpreted Notion

Cadaver dissection (CD) is considered a tool for studying the structural details of the human body. Lately, conflicting opinions regarding the utility of this modality in medical training have been published in medical literature. This review of the literature examines the status of anatomy teaching with CD in traditional, modern, and postgraduate medical training across the world. Literature published in the En-glish language on topics related to CD in the past 3 decades was scrutinized using different search engines. About 200 full texts were reviewed. We describe how medical schools have continued to include CD in anatomy teaching in the traditional or modified form. Medical schools that stopped or decreased CD have learnt from their experiences, and have restarted it in modified forms by integrating it vertically with medical training. In addition, CD activities have increased in postgraduate anatomy courses, surgery training, and voluntary/optional CD programs. CD, when integrated vertically, still has a part to play in medical training in modified ways. This overview may help curriculum designers to place CD in medical curricula and training programs in a justified manner.

Student Perceptions of Sectional CT/MRI Use in Teaching Veterinary Anatomy and the Correlation with Visual Spatial Ability: A Student Survey and Mental Rotations Test

Diagnostic imaging technology is becoming more advanced and widely available to veterinary patients with the growing popularity of veterinary-specific computed tomography (CT) and magnetic resonance imaging (MRI). Veterinary students must, therefore, be familiar with these technologies and understand the importance of sound anatomic knowledge for interpretation of the resultant images. Anatomy teaching relies heavily on visual perception of structures and their function. In addition, visual spatial ability (VSA) positively correlates with anatomy test scores. We sought to assess the impact of including more diagnostic imaging, particularly CT/MRI, in the teaching of veterinary anatomy on the students' perceived level of usefulness and ease of understanding content. Finally, we investigated survey answers' relationship to the students' inherent baseline VSA, measured by a standard Mental Rotations Test. Students viewed diagnostic imaging as a useful inclusion that provided clear links to clinical relevance, thus improving the students' perceived benefits in its use. Use of CT and MRI images was not viewed as more beneficial, more relevant, or more useful than the use of radiographs. Furthermore, students felt that the usefulness of CT/MRI inclusion was mitigated by the lack of prior formal instruction on the basics of CT/MRI image generation and interpretation. To be of significantly greater use, addition of learning resources labeling relevant anatomy in tomographical images would improve utility of this novel teaching resource. The present study failed to find any correlation between student perceptions of diagnostic imaging in anatomy teaching and their VSA.

A novel imaging method for correlating 2D light microscopic data and 3D volume data based on block-face imaging

We have developed an imaging method designated as correlative light microscopy and block-face imaging (CoMBI), which contributes to improve the reliability of morphological analyses. This method can collect both the frozen sections and serial block-face images in a single specimen. The frozen section can be used for conventional light microscopic analysis to obtain 2-dimensional (2D) anatomical and molecular information, while serial block-face images can be used as 3-dimensional (3D) volume data for anatomical analysis. Thus, the sections maintain positional information in the specimen, and allows the correlation of 2D microscopic data and 3D volume data in a single specimen. The subjects can vary in size and type, and can cover most specimens encountered in biology. In addition, the required system for our method is characterized by cost-effectiveness. Here, we demonstrated the utility of CoMBI using specimens ranging in size from several millimeters to several centimeters, i.e., mouse embryos, human brainstem samples, and stag beetle larvae, and present successful correlation between the 2D light microscopic images and 3D volume data in a single specimen.

New Generation of Three-Dimensional Tools to Learn Anatomy

We present a new generation tool based of interactive 3D models. This models are based on the radiological two-dimensional images by computed tomography imaging. Our article focuses on the anatomical region of the skull base. These new three-dimensional models offer a wide field of application in the learning, as they offer multiple visualization tools (rotation, scrolling, zoom…). In this way, understanding of the anatomical region is facilitated. A feature to be dismissed is that a professional workstation is not required to work with three-dimensional models, since a personal computer can be viewed and interacted with the models. Educational and clinical applications are also discussed.

A practical description and student perspective of the integration of radiology into lower limb musculoskeletal anatomy

BACKGROUND

Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need.

AIMS

We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions.

MATERIALS AND METHODS

The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions.

RESULTS

Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool.

CONCLUSIONS

The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.

Post mortem CT scans as a supplementary teaching method in gross anatomy

Despite increasing the integration of radiologic imaging teaching in anatomy dissection courses, studies on learning outcome of these interventions are rare or have certain shortcomings in study design. In this study, students were randomly allocated to an intervention group (n=53) receiving five weekly CT-courses of 30min duration during a 6-week gross anatomy course. Students in the control group (n=329) received no additional teaching. Total teaching time did not differ among groups. All students were asked to participate in a pre- and post-course self-assessment (comparative self-assessment; CSA) of learning objectives related to anatomical spatial relationships and a post-course formative assessment on radiologic anatomy. Items of both assessments were matched. Moreover, students of the intervention group were asked to evaluate the CT-courses. Most participants of the intervention group classified the CT-courses as "good" or "very good". Nevertheless, results of the CSA and formative assessment did not differ among study and control groups. These findings indicate that the teaching intervention (CT-courses) did not have an impact on recognition of anatomical structures in radiological images beyond the knowledge acquired in the anatomical dissection course. As a consequence, interventions integrating radiology imaging into dissection courses should be based on psychological considerations of how to best foster student learning. Learning outcome has to be monitored, as results of evaluation surveys can be misleading. Further research on curricular concepts is needed considering both short- and long-term effects.