Outcomes and satisfaction of two optional cadaveric dissection courses: A 3-year prospective study

A comparison of 1- versus 3-month regional anatomy exposure on learning outcomes of undergraduate medical students

Regional anatomy teaching forms a cornerstone of undergraduate medical education. Owing to an increase in teaching and learning content throughout the medical curriculum in recent years, contact hours and overall course durations in anatomy are under review worldwide. This study aimed to assess whether shortening the course content duration impacts learning gain and the ability to identify anatomical structures correctly. Undergraduate medical students of the Johannes Kepler University Linz (JKU; n = 310) and at the Medical University of Graz (MUG; n = 156) participating in regional anatomy courses were included. Whole body regional anatomy courses, including hands-on dissection and accompanying lectures, were delivered over one or three months. Course content and examination mode were kept consistent, while the duration of knowledge delivery was one or three months, respectively. Objective structured practical examinations (OSPE) were then carried out on prosections for the neck, thorax, and abdomen. 3-month course exposure resulted in significantly higher OSPE scores for the neck (49 vs. 37%), thorax (65 vs. 54%), and abdomen (65 vs. 45%), respectively. Further evaluation of the utility of different embalming types yielded higher 3-month scores in the neck and thorax regions with Thiel-embalmed tissues and thorax and abdomen regions in ethanol-glycerin-embalmed tissues. Course exposure over a more extended period, like three months, appears to be highly beneficial.

Human anatomy curriculum reform for undergraduate nursing students: An exploratory study

This study aims to cultivate students' independent learning capacity, promote the interdisciplinary integration of "nursing + anatomy," and establish a curriculum system to enhance applied nursing abilities based on project-based teaching reform of everyday clinical nursing operations. A total of 151 second-year (class of 2021) undergraduate nursing students at a Chinese university were selected for this study. By adjusting the curriculum, reconstructing the teaching contents, employing the "hybrid + flip" teaching method based on BOPPPS (bridge-in, outcomes, preassessment, participatory learning, post-evaluation, summary), and implementing a teaching system based on the "three re-three linkage," a Human Anatomy curriculum with a focus on basic anatomical knowledge was developed and connected with nursing clinical operation practice. The restructuring of the course content received unanimous recognition from both the teaching staff and the students. Notably, students in the class of 2021 achieved significantly higher grades than did students in the class of 2020, who received traditional face-to-face instruction (p < 0.01). These results indicate enhanced clinical application skills among the former group of students. following the implementation of instructional reforms during one semester, students exhibited notable improvements in motivation, program implementation, self-management, and interpersonal communication. A statistically significant increase in overall scores for self-directed learning capacities over the preinstructional period was observed (p < 0.05). Furthermore, the findings of the student satisfaction surveys reflected highly favorable perceptions of the enriched instructional format, high levels of course engagement, frequent faculty-student interactions, and augmented overall competence. The practical implementation of the reform in the context of a Human Anatomy course for undergraduate nursing students led to significant positive outcomes, thereby enhancing the effectiveness of teaching and learning. Students' clinical application abilities and self-directed learning capacities notably improved, while overall satisfaction with the course remained high.

A comparison of pre- and post-clinical education learning preferences among medical students who elected to dissect compared to those who did not during the COVID-19 pandemic

Anatomy instructional methods varied widely during the COVID-19 pandemic and programs are assessing innovations for retention. Learning preferences were assessed among medical students dichotomized as elective dissectors (ED) or non-dissectors (ND) during the COVID-19 partial re-opening in 2020 (preclinical) and again in 2022 after clinical exposure (post-clinical) to assess the viability of elective dissection post-pandemic. A mixed-method approach was used for the assessment of test scores, learning preference surveys, learning activities rankings, and thematic analyses. No significant differences occurred in anatomy examination scores. Dissection was considered useful by both preclinical groups but significantly more so by ED, while the presence of an instructor was significantly preferred by ED although a majority of ND agreed. Elective dissection was significantly preferred by ND but also by a large minority of ED students. Pre- and post-clinical ND believed that elective dissection offered more academic flexibility, did not hinder clinical learning, and did not negatively impact medical education. The corresponding ED stated that confidence improved, clinical experiences were enhanced, and dissection was irreplaceable. Preclinical ND preferred self-learning, while ED students preferred online learning, but these differences largely disappeared post-clinically. Learning activity rankings were not significantly different among all groups (ND, ED, preclinical, and post-clinical). A hybrid laboratory with a virtual learning environment ranked highest across groups and preferences increased over time suggesting that students benefited from this instructional method during clinical exposure. The absence of laboratory experience ranked lowest, and preference decreased over time suggesting that anatomy dissection is valued.

A national survey to assess the state of anatomy teaching in France across various disciplines and professions

PURPOSE

To investigate the current practices in anatomy teaching at French universities in 2023.

METHODS

On January 10, 2023, a questionnaire was sent to all members of the official list of the French Medical College of Professors of Anatomy. Each Anatomy centre was asked to complete this online form only once. The questionnaire covered several key themes, including broad questions, dissections practices, "virtual" dissections, teaching methods and teaching staff.

RESULTS

The questionnaire was completed by 26/28 anatomy centres. Access to body donor dissection is reported to be mandatory in 15 of the 26 centers (58%), optional in 10 centers (38%), and "tolerated" in one center (4%). Fifteen of 26 centers (58%) reported having a virtual dissection table for teaching anatomy. Concerning the teaching of anatomy via live ultrasound, 10 out of 26 centers (38%) reported providing it. Regarding the teaching methods used for medical students, chalk and board lectures are the most common method, although the intensity of use varies. Most lectures are given with chalk and board in 42% (11/26) of the centers. In about 73% (19/26) of the centers, tablet lectures are used. Regarding anatomy teachers, it was reported that in 24/26 anatomy centres (92%), more than 50% of the courses for medical students are taught by professors holding the chair of anatomy (21/26 professors (81%), 3/26 associate professors (12%)).

CONCLUSION

The present study endeavors to contribute to the existing body of knowledge on anatomy education by offering insights into the current practices in French universities.

Supplemental musculoskeletal anatomy education in a shortened medical school curriculum

To address anatomy knowledge gaps exacerbated by the education constraints of a new shortened medical school curriculum and the COVID-19 pandemic, the Orthopedic Surgery Interest Group (OSIG) created a novel hybrid anatomy curriculum for students interested in orthopedic surgery. The main objectives were to determine (1) Does this elective supplement to the curriculum improve students' perceived confidence with regard to orthopedic anatomy? (2) What are the students' preferred formats for receiving this elective supplement to the curriculum? To determine this, we used a prospective study design to determine the impact of the OSIG's student-led hybrid anatomy sessions. A survey with a five-point Likert scale (1) Strongly disagree; (2) Disagree; (3) Neither agree nor disagree; (4) Agree; (5) Strongly agree; was used to quantify responses. Chi-squared tests, Fisher's exact tests and T-tests were used when appropriate. Our results show that participants without prior anatomy experience rated the course higher on average when compared with those with prior anatomy experience (4.27 vs. 3.67, respectively; p = 0.168). Most students (88.2%) prefer for anatomy sessions to be held more frequently and 76.4% enjoyed having virtual components. 82.4% of participants reported that this course improved their self-confidence regarding orthopedic anatomy, and 100% would recommend it to other students. Most students enjoyed the course and reported improved self-perceived anatomy knowledge after participating. Medical schools that have a shortened anatomy curriculum can consider using the present study as a model for an optional musculoskeletal anatomy supplement at their institution.

Achievement of learning outcomes in non-traditional (online) versus traditional (face-to-face) anatomy teaching in medical schools: A mixed method systematic review

In recent years, the logistical challenges posed by the Covid-19 pandemic have prompted medical educators teaching gross anatomy to explore an expanded use of online instructional modalities. There is concern that this shift to online anatomy education in medical schools could affect long-term learning outcomes for future healthcare providers. In this systematic review, the educational effectiveness of online anatomy teaching is compared with traditional ("face-to-face") teaching methods, specifically in terms of students' academic performance and satisfaction. A search of four databases identified and screened 162 studies. Subsequently, 31 studies were analyzed, including both (a) teaching outcome measures (test scores) and (b) student satisfaction ratings. Authors chose studies, extracted data, assessed quality and examined risk of bias. Nineteen studies compared students' academic performances between online and face-to-face teaching methods. Twenty-six studies measured students' levels of satisfaction in both teaching methods. Both qualitative and quantitative analyses of the data revealed comparable academic performances with no statistical difference between the two teaching methods, but a higher level of satisfaction with face-to-face teaching. The findings confirm that students can learn from online teaching but are more satisfied with face-to-face teaching. The authors conclude that online teaching cannot replace traditional teaching and there is no preference for one type of modality over the other. Therefore, a multi-modal learning approach combining online with face-to-face educational modalities for medical students could be efficient and successful.

A randomized trial comparing cadaveric dissection and examination of prosections as applied surgical anatomy teaching pedagogies

Anatomy is an important component in the vertical integration of basic science and clinical practice. Two common pedagogies are cadaveric dissection and examination of prosected specimens. Comparative studies mostly evaluate their immediate effectiveness. A randomized controlled trial design was employed to compare both the immediate and long-term effectiveness of dissection and prosection. Eighty third-year medical students undergoing their surgical rotation from the Yong Loo Lin School of Medicine were randomized into two groups: dissection and prosection. Each participated in a one-day hands-on course following a similar outline that demonstrated surgical anatomy in the context of its clinical relevance. A pre-course test was conducted to establish baseline knowledge. A post-course test was conducted immediately after and at a one-year interval to evaluate learner outcome and knowledge retention. A post-course survey was conducted to assess participant perception. Thirty-nine and thirty-eight participants for the dissection and prosection groups, respectively, were included for analysis. There was no significant difference between mean pre-course test scores between the dissection and prosection groups [12.6 (3.47) vs. 12.7 (3.16), P > 0.05]. Both the mean immediate [27.9 (4.30) vs. 24.9 (4.25), P < 0.05] and 1 year [23.9 (4.15) vs. 19.9 (4.05), P < 0.05] post-course test scores were significantly higher in the dissection group. However, when adjusted for course duration [dissection group took longer than prosection group (mean 411 vs. 265 min)], these findings were negated. There is no conclusive evidence of either pedagogy being superior in teaching surgical anatomy. Based on learner surveys, dissection provides a greater learner experience.

An initial preparation for human cadaveric dissection ameliorates the associated mental distress in students

It is universally recognized that cadaveric dissection is an essential part of anatomy training. However, it has been reported to induce mental distress in some students and impair their intrinsic motivation (IM) to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation of students for cadaveric dissection. Therefore, it is hypothesized that providing relevant information prior to cadaveric dissection will ameliorate the mental distress, enhance the IM of students, and improve their academic performance. A cohort of occupational therapy students enrolled in an anatomy course were psychologically prepared for cadaveric dissection. Students were provided with a curated list of YouTube videos and peer-reviewed journal articles related to cadaveric dissection prior to the commencement of the anatomy course. All students were also required to attend an oral presentation immediately before commencing dissection. The control group included students who had not been provided with any resources in preparation for cadaveric dissection. Compared to the control group, students who had been prepared demonstrated better quality of cadaveric dissection, improved academic performance, reported less mental distress and greater IM. Moreover, students reported the oral presentation to be most relevant and journal articles to be least useful in their preparation. Therefore, this is an effective approach in the amelioration of mental distress and improvement of performance in anatomy students. Consequently, this study represents a paradigm shift in the pedagogy of anatomy, and could represent a vital element in the evolution of a revitalized anatomy curriculum.

Dynamic three-dimensional virtual environment to improve learning of anatomical structures

Increasing number of medical students and limited availability of cadavers have led to a reduction in anatomy teaching through human cadaveric dissection. These changes triggered the emergence of innovative teaching and learning strategies in order to maximize students learning of anatomy. An alternative approach to traditional dissection was presented in an effort to improve content delivery and student satisfaction. The objective of this study is to acquire three-dimensional (3D) anatomical data using structured-light surface scanning to create a dynamic four-dimensional (4D) dissection tool of four regions: neck, male inguinal and femoral areas, female perineum, and brachial plexus. At each dissection step, identified anatomical structures were scanned using a 3D surface scanner (Artec Spider™). Resulting 3D color meshes were overlaid to create a 4D (3D+time) environment. An educational interface was created for neck dissection. Its implementation in the visualization platform allowed 4D virtual dissection by navigating from surface to deep layers and vice versa. A group of 28 second-year medical students and 17 first-year surgery residents completed a satisfaction survey. A majority of medical students (96.4%) and 100% of surgery residents said that they would recommend this tool to their colleagues. According to surgery residents, the main elements of this virtual tool were the realistic high-quality of 3D acquisitions and possibility to focus on each anatomical structure. As for medical students, major elements were the interactivity and entertainment aspect, precision, and accuracy of anatomical structures. This approach proves that innovative solutions to anatomy education can be found to help to maintain critical content and student satisfaction in anatomy curriculum.

An intensive anatomy by whole‐body dissection elective: a longitudinal study

Whole body dissection, once a long‐held method of learning and teaching in anatomy medical education, has largely been replaced by cost and time‐reduced methods of teaching. This paper reports on a longitudinal study of student knowledge acquisition and retention, following six annual intensive eight‐week elective anatomy by whole body dissection (AWBD) courses implemented between 2010 and 2015, utilizing a modified team‐based learning (TBL) pedagogy. A total of 160 students completed the intensive full‐time courses. During each course, students, in groups of five or six, completed the dissection of a whole cadaver. Students were assessed by a standardized practical test involving the accurate identification of 20 different tagged anatomical structures. All students (n = 160) completed pre‐course and end‐course individual assessments. Seventy students were assessed again 1 month after the course ended. A further 71 students were assessed 7 months later. A marked increase in topographical relational anatomical knowledge was demonstrated. The median pre‐course score was 9/20 (interquartile range 5). The median end‐course score was 19/20 (IQR 2), a statistically significant increase (p < 0.001). The assessments for the 70 students reassessed 1 month after the course ended showed no significant statistical change. The assessments for the further 71 students assessed 7 months later also showed no significant statistical change. The results of this study demonstrate that AWBD, provides significant acquisition and maintenance of three‐dimensional regional relational anatomical knowledge. As an elective, AWBD has a place in the medical curricula, particularly for students interested in a surgical or procedural based specialty career.

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.

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.

The influence of dissection on clinical anatomical knowledge for surgical needs

PURPOSE

Due to the ongoing discussion of the usefulness of dissection on human bodies in medical curricula, we investigated the influence of anatomical knowledge collected in the dissection course and requested for modules of visceral surgery.

METHODS

Students attending the dissection course of topographic anatomy had to answer a questionnaire of 22 questions with focus on anatomical knowledge required for visceral surgical modules. Failure was defined as 13 or fewer correct answers, success categorized as high, good or moderate. The same questionnaire was handed out to 245 students prior to the module on visceral surgery. Students provided information on which regions they had dissected during the course or prior to the module. The results were compared to the result of a written Multiple Choice Question (MCQ) exam of the module visceral surgery (n = 160 students) with an unannounced primary focus on anatomy.

RESULTS

Students who dissected the truncal regions of the human body succeeded in answering the questionnaire with high success. Students dissecting regions of the Head/Neck or Limbs had a high failure rate, and none of them reached the "high" success level. In the MCQ exam, students dissecting truncal regions had a high success rate, while those who had not dissected or who dissected the Head/Neck or Limbs had a high failure rate.

CONCLUSION

Dissections support and improve the required knowledge for surgical modules. For the visceral surgical module, students dissecting the region prior to the module greatly benefited. Therefore, entire human body dissection assumes to be preferable.

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.

The Importance of Optional Practical Anatomy Courses for Undergraduate Speech Therapy Students

An in-depth understanding of the anatomy discipline is essential for the work of healthcare professionals. In recent decades, the content and time of teaching anatomy have decreased in all health science degrees. The aim of this study was to look for alternatives for compensating the reduction of the teaching of anatomy by supplementing students with a practical training course and to know evaluations of the course given by students enrolled in the degree in Speech Therapy and its impact on their academic results. All students (100%) positively evaluated having acquired skills and attitudes for their future professional life. The majority of the students (95.8%) believed that their knowledge was acceptable; 97.2% of the students thought they would have the possibility to apply their acquired anatomical knowledge as professionals; 98.5% were satisfied with the voluntary course; and finally, the percentage of students that passed the "Anatomophysiology of language and voice organs" course increased from previous academic years. Optional (theoretical/practical) undergraduate courses can be used in parallel to overcome the devaluation of anatomical studies in new curricula. The optional undergraduate anatomy course in the Speech Therapy program has been positively evaluated because it stimulated students' motivation and appealed to their interest in anatomy. Students considered that these courses would help them in their training and they could put what they had learned into practice in their future professions. However, very little evidence for the impact of optional practical courses exists, yet it could be an efficient method to increase anatomical knowledge.

"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.

Lacunae regarding dearth of dissection-based teaching during COVID-19 pandemic: how to cope with it?

Introduction

In view of the ongoing COVID-19 pandemic, anatomy education programs were amended so as to shift to primarily online mode from physical classes. In the whole process, main concern area that has emerged is regarding dearth of physical human dissection sessions. There is enough evidence available in literature to suggest that dissection room is an ideal place to cultivate and inculcate discipline independent skills or humanistic skills among the students. These include attributes in relation to ethical practice, professionalism, communication skills, empathy and compassion. Imbibing these skills are an essential element of medical education curriculum as it is desirable that students exhibit these traits when they begin medical practice. Hence deficiency in terms of exposure to physical dissection sessions can adversely affect training of medical students on a long term.

Methods

A literature search of relevant, peer-reviewed, published articles was undertaken from indexed databases (Medline and PubMed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar) for this study.

Results

To counter the pertinent issue in online anatomy teaching program, a few measures have been suggested in this paper based on identification of actual deficit areas in terms of learning and analysis thereof. Live streaming of real time dissection, awareness sessions on human dissection, online interactive learning sessions and reflective thoughts-based exercise can contribute to building discipline independent skills in present scenario.

Conclusion

Incorporation and implementation of these interventions within the realm of online anatomy education programs during COVID-19 pandemic can possibly contribute towards desirable learning outcomes.

Efficacy of an intensive 2-week musculoskeletal anatomy course in a medical education setting

There is little consistency in student contact hours and teaching activities used in medical curriculums across North America, and controversy exists regarding the most efficient or effective way to teach musculoskeletal (MSK) anatomy in medical school. The purpose of this investigation was to retrospectively examine academic performance and levels of course satisfaction among first year medical students who had completed an intensive 2-week MSK anatomy course during the pre-clerkship portion of their Association of Faculties of Medicine in Canada accredited undergraduate medical program. Course data from formative and summative student evaluations, as well as end-of-course satisfaction surveys were analyzed for a homogenous group of 549 first-year medical students over a 5-year period. Data indicated that student's academic performance on both formative and summative evaluations for the 2-week MSK anatomy course were consistently high, and not significantly different from the results for other system-based 1^st year anatomy courses delivered over longer durations. Likert data from end-of-course surveys also suggested that student feedback regarding the course was overwhelmingly positive, and that the 2-week MSK anatomy course had the highest level of overall satisfaction when compared to all other first-year anatomy courses. These results can be used to help in the design and implementation of MSK anatomy courses within medical curriculums, and contribute to a growing body of literature which is focused on examining the effect of curricular design on MSK anatomy learning in a medical education setting.

The anatomy lesson of the SARS-CoV-2 pandemic: irreplaceable tradition (cadaver work) and new didactics of digital technology

Aim

To compare the efficacy of different components of online and contact anatomy classes as perceived by medical students.

Methods

An anonymous course evaluation survey was conducted at the end of the academic year 2019/2020. The organization of classes due to the SARS-CoV-2 pandemic provided our students with a unique opportunity to compare online and contact classes. Students’ responses were analyzed according to the type of obtained data (ratio, ordinal, and categorical).

Results

The response rate was 95.58%. Approximately 90% of students found anatomical dissection and practical work in general to be the most important aspect of teaching, which could not be replaced by online learning. During online classes, students missed the most the interaction with other students, followed by the interaction with student teaching assistants and teaching staff. Very few students found contact lectures useful, with most students reporting that they could be replaced with recorded video lectures. In contrast, recorded video lectures were perceived as extremely helpful for studying. Regular weekly quizzes were essential during online classes as they gave students adequate feedback and guided their learning process. Students greatly benefitted from additional course materials and interactive lessons, which were made easily available via e-learning platform.

Conclusions

Anatomical dissection and interaction during contact classes remain the most important aspects of teaching anatomy. However, online teaching increases learning efficiency by allowing alternative learning strategies and by substituting certain components of contact classes, thus freeing up more time for practical work.

Dissection versus Prosection: A Comparative Assessment of the Course Experiences, Approaches to Learning, and Academic Performance of Non-medical Undergraduate Students in Human Anatomy

Many institutions rely upon prosection-based laboratories as more resource-efficient and time-effective alternatives to traditional cadaver dissection for human anatomy education. To facilitate growing enrollment numbers despite resource limitations, the University of Guelph (a non-medical institution) introduced a modified "stepwise" prosection-based laboratory cohort to supplement a dissection-based course. In this design, all students attended the same lectures, but those in the dissection-based cohort learned by performing regional dissections and students in the prosection-based cohort studied from those dissections. Prosection students thereby witnessed a "slow reveal" of structures throughout the course. This study compared the perceived course experiences, student approaches to learning, and academic performance between the two groups. Multiple linear regression analyses were used to isolate the effect of the laboratory environment on student approaches to learning and academic performance from demographic and situational covariates. Both groups reported positive course experience ratings and high average final grades that were not statistically dissimilar (P > 0.05), increased reliance on deep approaches to learning (P = 0.002), and decreased reliance on surface approaches to learning (P = 0.023). When controlling for covariates, participation in dissection had small but statistically significant positive associations with deep approaches to learning (P = 0.043), performance on laboratory oral assessments (P < 0.001), and average final grades (P = 0.039). Ultimately, both designs promoted meaningful learning and desirable performance outcomes, indicating that both dissection and stepwise prosection have the potential to facilitate high quality human anatomy instruction.

Anatomy by Whole Body Dissection as an Elective: Student Outcomes

BACKGROUND

Anatomy education has long been considered fundamental to the medical profession. Recently, Australasian medical schools have favored prosected human material, models and medical imaging in their anatomy curriculum with only 3 medical schools offering whole-body dissection. The aim of this study was to explore the knowledge acquisition and perceptions of an elective anatomy by whole body dissection (AWBD) course for senior medical students.

METHODS

In the 2017 AWBD course, 53 self-selected senior medical students carried out dissections over an 8-week period. Students were assessed via true/false questions and practical tests involving the identification of structures on anatomical images at precourse, mid-course and end-course. In addition, at completion of the course, students completed a questionnaire using a 5-point Likert scale and 2 open-ended questions. Quantitative data analysis was conducted on test scores and questionnaire data using a paired-sample t-test and descriptive statistics. Qualitative data were coded and categorised into themes.

RESULTS

There was a significant improvement (p < 0.0001) in student test scores from pre-course (mean 34.1 ± 12.9%) to mid-course (mean 74.8 ± 9.4%) and end-course (mean 75.4 ± 9.8%). Analysis of the questionnaire data showed strongly favorable perceptions of the course, highlighting dissection, complemented by Structure, Clinical, Objective-Referenced, Problem-Based, Integrated and Organized (SCORPIO) teaching, frequent testing and senior surgeon supervision as beneficial teaching methods.

CONCLUSIONS

Dissecting in small groups has been shown to be an effective part of anatomy learning. Our study suggests complementary teaching methods as possible augmenters to a well-structed, small group AWBD course. We have presented a framework suitable for an intensive AWBD course within medical curricula, that was valued by participants, and improved students' knowledge of anatomy.

Matriculating Students' Opinions on Cadaveric Dissection: Maintaining Tradition in Changing Times

As medical education advances, cadaveric dissection is no longer the sole modality to teach anatomy. In light of this, there is limited data regarding how incoming medical students perceive the importance of cadaveric dissection and whether they continue to desire the experience as they consider matriculating to medical school. Surveys were sent to incoming first-year medical students concerning their views of death and dissection. Our data show a strong and temporally reproducible opinion that cadaveric dissection is important among incoming medical students. This survey also reviews the predominant emotional reactions generated in anticipation of the cadaveric dissection experience.

Creating a Human Gross Anatomy Laboratory: The Experience at a Primarily Undergraduate Institution

This paper details the creation of a human gross anatomy laboratory from a defunct chemistry laboratory at West Liberty University, a small primarily undergraduate institution in West Virginia. The article highlights important considerations with regard to the development of a human gross anatomy laboratory including access to human gifts; assessment of the space for size, security, and privacy; assessment of the utilities; acquisition of a dissection table; ventilation; aesthetics in functional design; expenses; and sustainability. The report also identifies favorable conditions and potential pitfalls regarding the creation of a human gross anatomy laboratory. This paper demonstrates that a human gross anatomy laboratory can be created quickly and at little expense.

A Novel Approach to Gross Dissection of the Human Pelvis and Perineum

Progressive curricular changes in medical education over the past two decades have resulted in the diaspora of gross anatomy content into integrated curricula while significantly reducing total contact hours. Despite the development of a wide range of alternative teaching modalities, gross dissection remains a critical component of medical education. The challenge posed to modern anatomists is how to maximize and integrate the time spent dissecting under the current curricular changes. In this study, an alternative approach to the dissection of the pelvis and perineum is presented in an effort to improve content delivery and student satisfaction. The approach involves removal of the perineum en bloc from the cadaver followed by excision of the pubic symphysis, removal and examination of the bladder and associated structures, examination and bisection of the midline pelvic organs in situ, and midsagittal hemisection of the pelvis for identification of the neurovasculature. Results indicate that this novel dissecting approach increases the number of structures identified by 46% ± 14% over current dissecting methods. Survey results indicate that students were better able to integrate lecture and laboratory concepts, understand the concepts, and successfully identify more structures using the new approach (P < 0.05). The concept of anatomic efficiency is introduced and proposed as a standard quantitative measure of gross dissection proficiency across programs and institutions. These findings provide evidence that innovative solutions to anatomy education can be found that help to maintain critical content and student satisfaction in a modern medical curriculum.

Time Spent in Practicing Dissection Correlated with Improvement in Anatomical Knowledge of Students: Experimental Study in an Integrated Learning Program

Introduction and aim

Cadaveric dissection has long been used as the main domain for teaching anatomy in medical schools. However, recently with a limited number of cadavers and time for practicing dissection, prosections and anatomical models are widely used and may replace traditional dissection. We aimed to explore the possible association between practicing dissection and test results among medical students and to determine whether there are differences in achievements between students who studied anatomy by cadaveric dissection and those who used prosections and anatomical models.

Methods

The study was conducted at the University of Bisha, College of Medicine, Saudi Arabia, during the period from March to August 2017. Students were randomly assigned to one of two groups (50 in each). The first group studied anatomy (upper limb course) by practicing dissection while the other studied it by using prosections and anatomical models. Both groups were subjected to the same final assessments. Scores of both groups were compared by using the Student’s t-test. Correlation analysis between time spent in practicing dissection (carefully registered using a predesigned portfolio and an attendance logbook) and assessment grades was implemented using the rank-based Pearson correlation coefficient.

Results

Students practicing dissection achieved higher grades (169 ± 1.99) than those who studied anatomy by only using prosections and anatomical models (142 ± 1.78, p<0.001). There was an association between the time spent in practicing dissections and overall anatomy summative assessments (r²=0.841, p<0.001). Students expressed positive responses towards the effectiveness and value of practicing dissection.

Conclusions

We concluded that practicing dissection helps students to achieve higher results than learning using only models and prosections. Time spent in practicing dissection correlated with final assessment results. Further research is required to measure not only the statistical significance of results but also their educational effectiveness and long term learning outcomes.

Challenges and implementation of the German maternity protection act for female medical students in macroscopic anatomical education

Background: Recent decades have seen controversial discussions on the validity of dissection courses in medical education, with alternative programs tested for various reasons. On April 1, 2015 the classification of formaldehyde as a hazardous substance was upgraded by the EU, leding to some universities precluding the participation of pregnant and breastfeeding students in dissection course. However, the revision to the Maternity Protection Act, implemented in Germany on January 1, 2018, now protects student mothers from being disadvantaged in their studies as a consequence of their pregnancy or breastfeeding. Therefore, universities must offer alternatives to dissection courses using formaldehyde to these female students. Project description: As an alternative to regular dissection courses, which use the abovementioned chemical, the Centre for Anatomy at Charité has opted for developing dedicated courses for student mothers. These new courses use plastinated prosection material instead of formalin-treated cadavers of body donors. As the core of the anatomical education takes place during the third and fourth semester in the current curriculum of human medicine at Charité the alternative courses are limited to those two semesters. Additionally, alternative exams at the end of both semesters had to be developed. The alternative courses were designed to offer pregnant and breastfeeding students a study program as close as possible to the one in which their peers learn human anatomy. Results: For the new courses, plastinates had to be produced and further specimens are still needed. Additionally required sets of bones, models and radiological images were readily available at the Centre for Anatomy. The planning and conceptualization of the courses took half a year of intense preparation. The courses for the third and fourth semester were first running during summer semester 2017. There is a clear demand for courses among pregnant and breastfeeding students. At least 5 student participants per course were registered, corresponding to every fortieth female student in their semester cohorts. The highest number of student participants was 13 in one course so far. The performances of the participants in the anatomical examinations were matching that of students attending the regular courses. Discussion: The alternative macroscopic anatomy courses enable the implementation of the revised Maternity Protection Act. The targeted student group is highly satisfied with the offered alternative courses. Considering the number of participants and their examination performance so far, the Centre for Anatomy regards the efforts involved in planning and implementing the courses as justified. The courses allow pregnant and breastfeeding students to address the same anatomical themes at the same time as their fellow students. However, due to restricted flexibility of plastinates and because students cannot prepare specific anatomical structures independently the scope of topographic learning is limited. That being said, well-produced plastinates can display anatomical structures which often cannot be dissected in regular courses. The alternative macroscopic anatomy courses using plastinates constitute suitable alternatives to the regular dissection courses with formalin-treated cadavers for pregnant and breastfeeding students.

Participation in Dissection Affects Student Performance on Gross Anatomy Practical and Written Examinations: Results of a Four-Year Comparative Study

The role of human dissection in modern medical curricula has been a topic of intense debate. In part, this is because dissection can be time-consuming and curricular hours are being monitored more carefully. This has led some to question the efficacy and importance of dissection as a teaching method. While this topic has received considerable attention in the literature, the question of how dissection impacts learning has been difficult to evaluate in a real-world, high-stakes setting since participation in dissection is often one of many variables. In this study, this challenge was overcome due to a change in the curriculum of a Special Master Program (SMP) that permitted a comparison between two years of students that learned anatomy using prosection only and two years of students that participated in dissection laboratories. Since each class of SMP students took courses in the medical school, and the medical school anatomy curriculum was constant, medical student performance served as a control throughout the study period. Results demonstrate that SMP students who learned through prosection had lower performance on anatomy practical and written examinations compared to medical students. When the SMP program changed and students started participating in dissection, there were measurable improvements in both practical and written examinations. These findings provide evidence of dissection's role in learning and applying anatomy knowledge both within and outside the gross anatomy laboratory.

Neuroanatomy, the Achille's Heel of Medical Students. A Systematic Analysis of Educational Strategies for the Teaching of Neuroanatomy

Neuroanatomy has been deemed crucial for clinical neurosciences. It has been one of the most challenging parts of the anatomical curriculum and is one of the causes of "neurophobia," whose main implication is a negative influence on the choice of neurology in the near future. In the last decades, several educational strategies have been identified to improve the skills of students and to promote a deep learning. The aim of this study was to systematically review the literature to identify the most effective method/s to teach human neuroanatomy. The search was restricted to publications written in English language and to articles describing teaching tools in undergraduate medical courses from January 2006 through December 2017. The primary outcome was the observation of improvement of anatomical knowledge in undergraduate medical students. Secondary outcomes were the amelioration of long-term retention knowledge and the grade of satisfaction of students. Among 18 selected studies, 44.4% have used three-dimensional (3D) teaching tools, 16.6% near peer teaching tool, 5.55% flipped classroom tool, 5.55% applied neuroanatomy elective course, 5.55% equivalence-based instruction-rote learning, 5.55% mobile augmented reality, 5.55% inquiry-based clinical case, 5.55% cadaver dissection, and 5.55% Twitter. The high in-between study heterogeneity was the main issue to identify the most helpful teaching tool to improve neuroanatomical knowledge among medical students. Data from this study suggest that a combination of multiple pedagogical resources seems to be the more advantageous for teaching neuroanatomy.

Cadaveric Dissection in Relation to Problem-Based Learning Case Sequencing: A Report of Medical Student Musculoskeletal Examination Performances and Self-Confidence

Mercer University School of Medicine utilizes a problem-based learning (PBL) curriculum for educating medical students in the basic clinical sciences. In 2014, an adjustment was piloted that enabled PBL cases to align with their corresponding cadaver dissection that reviewed the content of anatomy contained in the PBL cases. Faculty had the option of giving PBL cases in sequence with the cadaveric dissection schedule (sequential group) or maintaining PBL cases out of sequence with dissections (traditional group). During this adjustment, students' academic performances were compared. Students' perception of their own preparedness for cadaveric dissection, their perceived utility of the cadaver dissections, and free-response comments were solicited via an online survey. There were no statistically significant differences when comparing student mean examination score values between the sequential and traditional groups on both multidisciplinary examinations (79.39 ± 7.63 vs. 79.88 ± 7.31, P = 0.738) and gross anatomy questions alone (78.15 ± 10.31 vs. 79.98 ± 9.31, P = 0.314). A statistically significant difference was found between the sequential group's and traditional group's (63% vs. 29%; P = 0.005) self-perceived preparedness for cadaveric dissections in the 2017 class. Analysis of free-response comments found that students in the traditional group believed their performance in PBL group, participation in PBL group and examination performance was adversely affected when compared to students with the sequential schedule. This study provides evidence that cadaveric dissections scheduled in sequence with PBL cases can lead to increased student self-confidence with learning anatomy but may not lead to improved examination scores.

The Role of Anatomy Computer-Assisted Learning on Spatial Abilities of Medical Students

Currently, medical education context poses different challenges to anatomy, contributing to the introduction of new pedagogical approaches, such as computer-assisted learning (CAL). This approach provides insight into students' learning profiles and skills that enhance anatomy knowledge acquisition. To understand the influence of anatomy CAL on spatial abilities, a study was conducted. A total of 671 medical students attending Musculoskeletal (MA) and Cardiovascular Anatomy (CA) courses, were allocated to one of three groups (MA Group, CA Group, MA + CA Group). Students' pre-training and post-training spatial abilities were assessed through Mental Rotations Test (MRT), with scores ranging between 0-24. After CAL training sessions, students' spatial abilities performance improved (9.72 ± 4.79 vs. 17.05 ± 4.57, P < 0.001). Although male students in both MA Group and CA Group show better baseline spatial abilities, no sex differences were found after CAL training. The improvement in spatial abilities score between sessions (Delta MRT) was correlated with Musculoskeletal Anatomy training sessions in MA Group (r = 0.333, P < 0.001) and MA + CA Group (r = 0.342, P < 0.001), and with Cardiovascular Anatomy training sessions in CA Group (r = 0.461, P = 0.001) and MA + CA Group (r = 0.324, P = 0.001). Multiple linear regression models were used, considering the Delta MRT as dependent variable. An association of Delta MRT to the amount of CAL training and the baseline spatial abilities was observed. The results suggest that CAL training in anatomy has positive dose-dependent effect on spatial abilities.

Improving Academic Performance of Sport and Exercise Science Undergraduate Students in Gross Anatomy Using a Near-Peer Teaching Program

Peer and near-peer teaching programs are common in medical undergraduate courses. However, there are no studies that have investigated the effectiveness of a near-peer teaching program on the academic performance of undergraduate students pursuing sport and exercise science coursework. This study was conducted to analyze the effectiveness of such a program for students who participated in a course on the functional anatomy of the locomotor apparatus. A total of 39 student participants were divided into two groups: students in one group voluntarily attended at least one session of a near-peer teaching program, and students in the other group attended no sessions. The final grade (range 0-100%) was recorded and used as an indicator of academic performance. The final grade of students who attended the near-peer teaching program (69.5 ± 16.0%) was 38.7% higher (P = 0.002, d = 1.06) than those who did not (50.1 ± 20.4%). When the academic performance of the same students was evaluated in another course (exercise physiology) that did not offer a near-peer teaching program, there were no significant differences between the groups (students who attended or did not attend the near-peer teaching program). A significant positive association was found between near-peer teaching program frequency and the number of students approved and not approved in the course (P = 0.041). A significant difference (P = 0.001) was found in the attendance at regular classes between the group who participated in the near-peer teaching program (median: 62 hours; IQR [interquartile ranges]: 4.0 hours) and those who did not (median: 58 hours; IQR: 4.0 hours). Gender was not a moderating factor on academic performance or near-peer teaching program attendance. These results highlight the effectiveness of a near-peer teaching program on the academic performance of students from a sport and exercise science degree program while enrolled in an anatomy course. Anat Sci Educ. © 2018 American Association of Anatomists.

Attitudes and Responses of Medical Students and Professional Anatomists to Dissecting Different Regions of the Body

Although there have been many studies assessing emotional responses of medical students to the dissecting room experience, little is known about whether dissecting particular regions of the human body cause more concern than others. Furthermore, no studies have been conducted on the concerns of professional anatomists. In this study, we assessed the hypothesis that medical students are more concerned about the dissection of the face, the perineum and the extremities of the limbs. We also hypothesized that there are gender differences. For the reactions of a group of professional anatomists from the United States and Europe we hypothesized that they were less concerned than the medical students and showed no differences across the regions of the body. The hypotheses were tested by means of questionnaires distributed to medical students at Cardiff University and at the Descartes Paris University who had recently completed their anatomy courses and to anatomists working at universities in Europe and the USA. Ethical approval for the study was obtained from the ethical committees at the Cardiff School of Biosciences and at Paris and all data was obtained by consent of the respondents and remained confidential. The findings were complex, although the level of concern was low overall. Some regional differences were discerned, particularly concerning the face, the perineum, the hand and the female chest. Anatomists were less concerned than the students and female students and female anatomists showed more concern than their male counterparts. Few differences were discerned however between student respondents who had positive and neutral attitudes to gender "politics" and those who espoused negative views. We recommend that, at the start of an anatomy dissection course, time is spent dealing with sensitive issues (including equality and diversity issues), emotional responses, and matters pertaining to mortality. However, we argue that this should not involve hiding regions of the body, nor overreacting to the natural anxiety of students, since doing either of these things could enhance negative reactions and stifle the progress of the student from being a layperson to a competent healthcare professional. Clin. Anat. 32:253-267, 2019. © 2018 Wiley Periodicals, Inc.

Benefits of extracurricular participation in dissection in a prosection-based medical anatomy program

The purpose of this study was to evaluate the extracurricular cadaveric dissection program available to medical students at an institution with a modern (time-compressed, student-centered, and prosection-based) approach to medical anatomy education. Quantitative (Likert-style questions) and qualitative data (thematic analysis of open-ended commentary) were collated from a survey of three medical student cohorts who had completed preclerkship. Perceived benefits of dissection included the hands-on learning style and the development of anatomy expertise, while the main barrier that limited participation was the time-intensive nature of dissection. Despite perceived benefits, students preferred that dissection remain optional. Analysis of assessments for the MD2016 cohort revealed that dissection participation was associated with enhanced performance on anatomy items in each systems-based unit examination, with the largest benefits observed on discriminating items that assessed knowledge application. In conclusion, this study revealed that there are academic and perceived benefits of extracurricular participation in dissection. While millennial medical students recognized these benefits, these students also indicated strong preference for having flexibility and choice in their anatomy education, including the choice to participate in cadaveric dissection. Anat Sci Educ 11: 294-302. © 2017 American Association of Anatomists.

Performance equivalency between computer-based and traditional pen-and-paper assessment: A case study in clinical anatomy

The time, material, and staff-consuming nature of anatomy's traditional pen-and-paper assessment system, the increase in the number of students enrolling in medical schools and the ever-escalating workload of academic staff have made the use of computer-based assessment (CBA) an attractive proposition. To understand the impact of such shift in the assessment method, an experimental study evaluating its effect on students' performance was designed. Additionally, students' opinions toward CBA were gathered. Second-year medical students attending a Clinical Anatomy course were randomized by clusters in two groups. The pen-and-paper group attended two sessions, each consisting of a traditional sectional anatomy steeplechase followed by a theoretical examination, while the computer group was involved in two similar sessions conducted in a computerized environment. At the end of each of the computer sessions, students in this group filled an anonymous questionnaire. In the first session, pen-and-paper group students scored significantly better than computer-group students in both the steeplechase (mean ± standard deviation: 66.00 ± 14.15% vs. 43.50 ± 19.10%; P < 0.001) and the theoretical examination (52.50 ± 12.70% vs. 39.00 ± 21.10%; P < 0.001). In the second session, no statistically significant differences were found for both the steeplechase (59.50 ± 17.30% vs. 54.50 ± 17.00%; P = 0.085) and the theoretical examination (57.50 ± 13.70% vs. 54.00 ± 14.30%; P = 0.161). Besides, an intersession improvement in students' perceptions toward CBA was registered. These results suggest that, after a familiarization period, CBA might be a performance equivalent and student accepted alternative to clinical anatomy pen-and-paper theoretical and practical examinations. Anat Sci Educ 11: 124-136. © 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.

Experience from an optional dissection course in a clinically-orientated concept to complement system-based anatomy in a reformed curriculum

Profound anatomical knowledge is the basis for modern demands in medicine and surgery, but many countries worldwide including Australia and New Zealand have discontinued offering dissection courses to medical and dental students during the past decades. This educational project done in Australia aimed at enhancing basic and advanced anatomy teaching by engaging a sub-group of second-year undergraduate students of a compulsory prosection- and model-based anatomy course (n = 54/170) in an optional multimodal course, which should easily articulate with a vertical curriculum. With topographical cadaver dissections as core, peer student-teams prepared and peer-assessed anatomy lectures based on clinical topics, which were rated highly by the peers and teachers. Anatomical knowledge was tested by quizzes and a multiple-choice examination. Individual dissection skills were self- and teacher-assessed. A final course grade was assigned based on these assessments. The grades in the system-based compulsory course achieved by the attendees of the paralleling dissection course were compared with their peers attending other optional courses. After beginning of the semester, the students in the dissection course performed similar, significantly (P < 0.005) improved during the semester (78.5% vs. 69.9%, 70.1% vs. 64.1%), but in the integrated (including anatomy, biochemistry, physiology) final examination at the end of the year only tended to higher scores. As assessed through interviews and a voluntary questionnaire, all students of the optional dissection course liked these activities, which enhanced their learning experience. Thus, this concept elegantly integrates anatomical dissection with modern teaching demands and is feasible for implementation in modernized curricula. Anat Sci Educ 11: 32-43. © 2017 American Association of Anatomists.