1
|
Rees CE, Ottrey E. "Lives and times": The case for qualitative longitudinal research in anatomical sciences education. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 39354856 DOI: 10.1002/ase.2514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 08/05/2024] [Accepted: 08/12/2024] [Indexed: 10/03/2024]
Abstract
Qualitative longitudinal research (QLR) focuses on changes in perceptions, interpretations, or practices through time. Despite longstanding traditions in social science, QLR has only recently appeared in anatomical sciences education (ASE). While some existing methodology papers guide researchers, they take a narrow view of QLR and lack specificity for ASE. This discursive article aims to (1) describe what QLR is and its benefits, its philosophies, methodologies and methods, considerations, and quality indicators, and (2) critically discuss examples of QLR in ASE. Underpinned by relativist ontology and subjectivist epistemology, time can be understood as fluid/subjective or fixed/objective. QLR is a flexible, creative, and exploratory methodology, often associated with other methodologies. Sampling is typically purposive, with repeated and recursive data collection methods, and complex three-strand analyses (themes, cases, and time), enabling cross-sectional and longitudinal analyses. QLR involves ethical, relationship, analytical, dissemination, and funding considerations. Key quality indicators relate to qualitative research as well as temporal aspects. Most of the nine ASE papers reviewed explored changes in anatomy learners, but few labeled their methodology as QLR. Just under half described their sampling as purposive, most employed pre-planned and standardized repeated interviews, analyzed their data cross-sectionally, and utilized qualitative data analysis software. Most cited the confirmability and transferability of their studies, but few cited credibility and dependability elements. Study timeframes and tempos were generally clear, but details of longitudinal retention/attrition were often lacking, and longitudinal data analysis was not often conducted. We therefore provide recommendations for the conduct of QLR in ASE.
Collapse
Affiliation(s)
- Charlotte E Rees
- School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Ella Ottrey
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
2
|
Madgwick J, Anderson L, Cornwall J. Medical students' initial experiences of the dissection room and interaction with body donors: A qualitative study of professional identity formation, educational benefits, and the experience of Pasifika students. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 39223772 DOI: 10.1002/ase.2504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 08/01/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
The first experience of medical students in the dissecting room (DR) likely influences professional identity formation (PIF). Sparse data exist exploring how exposure to the DR and body donors without undertaking dissection influences PIF, or how culture may influence this experience. This qualitative study explored students' first, non-dissection DR experience to determine how this contributes to PIF, including the impact of culture through a Pasifika-student lens. It also explored student perspectives on what learning opportunities are unique to this experience. Medical students with no prior DR experience were recruited and then interviewed after initial engagement with the DR and body donors. Questions included participant experiences, cultural perspectives, and how the DR differed from other teaching experiences. Interviews were recorded, transcribed, and analyzed thematically. Twenty students were interviewed (mean age 22 years, 12 females; 8 Pasifika) resulting in 520 min of audio recording (mean 26 min). Four primary themes were identified: professional identity formation, educational elements, death and spirituality, and cultural perspectives. Three subthemes including student experiences, behaviors, and environment were developed within each theme. Findings indicate development of PIF likely occurs from a single engagement with body donors without undertaking dissection, including recognition of professional role. Culture can play an important role for students, with several Pasifika students viewing the DR as a "cultural purgatory". Unique learning experiences are identified, such as cultural awareness around behaviors with the dead. The experience is an educational "threshold concept" where students likely undergo substantial developments in PIF, and educational initiatives to support students are outlined.
Collapse
Affiliation(s)
- Jacob Madgwick
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | | | - Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
- Bioethics Centre, University of Otago, Dunedin, New Zealand
| |
Collapse
|
3
|
Cornwall J, Hildebrandt S, Champney TH, Goodman K. Ethical concerns surrounding artificial intelligence in anatomy education: Should AI human body simulations replace donors in the dissection room? ANATOMICAL SCIENCES EDUCATION 2024; 17:937-943. [PMID: 37750493 DOI: 10.1002/ase.2335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/09/2023] [Accepted: 08/27/2023] [Indexed: 09/27/2023]
Abstract
The potential effects of artificial intelligence (AI) on the teaching of anatomy are unclear. We explore the hypothetical situation of human body donors being replaced by AI human body simulations and reflect on two separate ethical concerns: first, whether it is permissible to replace donors with AI human body simulations in the dissection room when the consequences of doing so are unclear, and second, the overarching ethical significance of AI use in anatomy education. To do this, we highlight the key benefits of student exposure to the dissection room and body donors, including nontechnical, discipline-independent skills, awareness and interaction with applied bioethics, and professional identity formation. We suggest that the uniqueness of the dissection room experience and the importance of the key benefits accompanying this exposure outweigh the potential and so far unknown benefits of AI technology in this space. Further, the lack of engagement with bioethical principles that are intimately intertwined with the dissection room experience may have repercussions for future healthcare professional development. We argue that interaction with body donors must be protected and maintained and not replaced with AI human body donor simulations. Any move away from this foundation of anatomy education requires scrutiny. In light of the possible adoption of AI technologies into anatomy teaching, it is necessary that medical educators reflect on the dictum that the practice of healthcare, and anatomy, is a uniquely human endeavor.
Collapse
Affiliation(s)
- Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas H Champney
- Department of Cell Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Kenneth Goodman
- Institute of Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
4
|
Lazarus MD, Douglas P, Stephens GC. Personalization above anonymization? A role for considering the humanity and spirituality of the dead in anatomical education. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 38679804 DOI: 10.1002/ase.2431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/01/2024]
Abstract
Clinical anatomy education is meant to prepare students for caring for the living, often by working with the dead. By their nature many clinical anatomy education programs privilege topographical form over the donor's humanity. This inbalance between the living and the dead generates tensions between the tangible and the spiritual insofar as semblances of the humanity of donors endure even in depictions and derivatives. This article argues that considering the relevance of spirituality, and what endures of a donor's humanity after death, would enhance contemporary anatomy education and the ethical treatment of human body donors (and derivatives). In developing this argument, we (the authors) address the historical connection between spirituality and anatomy, including the anatomical locations of the soul. This serves as a basis for examining the role of the mimetic-or imitative-potential of deceased human donors as representations of the living. We deliberate on the ways in which the depersonalization and anonymization of those donating challenge the mimetic purpose of human body donors and the extent to which such practices are misaligned with the health care shift from a biomedical to a biopsychosocial model. Weighing up the risks and opportunities of anonymization versus personalization of human body donors, we propose curricula that could serve to enhance the personalization of human donors to support students learning topographical form. In doing so, we argue that the personalization of human donors and depictions could prevent the ill effects of digital representations going "viral," and enhance opportunities for donors to help the general public learn more about the human form.
Collapse
Affiliation(s)
- Michelle D Lazarus
- Centre for Human Anatomy Education, Monash University, Clayton, Victoria, Australia
- Monash Centre for Scholarship in Health Education, Monash University, Clayton, Victoria, Australia
| | - Peter Douglas
- Monash Bioethics Centre, Monash University, Clayton, Victoria, Australia
| | - Georgina C Stephens
- Centre for Human Anatomy Education, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
5
|
Leeper BJ, Grachan JJ, Robinson R, Doll J, Stevens K. Honoring human body donors: Five core themes to consider regarding ethical treatment and memorialization. ANATOMICAL SCIENCES EDUCATION 2024; 17:483-498. [PMID: 38197550 DOI: 10.1002/ase.2378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/11/2024]
Abstract
Dissection of human body donors is a common component of anatomy curricula, as it provides opportunities for tactile and intellectual engagement unmatched otherwise. Additionally, interaction with human body donors contributes to the "hidden curriculum" of allowing students to begin to ethically practice patient care with empathy, respect, and compassion. With this, there have been various proposed guidelines for the ethical treatment of human body donors, with most focusing on student reflections and a final ceremony for honoring the donors, but there are numerous other ways throughout the course to incorporate ethical values and to guide students to consider the humanity of the donor. This article proposes that institutions consider the incorporation of five easily implemented formalized ethical themes for working with human body donations into daily practices: (1) reflect the donor as possessing human dignity, (2) recognize the donor's role of the "First Patient" or "Silent Teacher," (3) honor the gift of human body donation, (4) recognize the decedent's family, and (5) consider inclusivity in memorialization practices. Multiple recommendations for integrating these five themes throughout the course are provided. The incorporation of these five core themes can assist in alleviating the psychological stress that some students struggle with in dissection courses, foster the feelings and attributes that comprise the hidden curriculum and are the desired characteristics of a caring medical provider, and discourage misuse and mistreatment of donors.
Collapse
Affiliation(s)
- Bobbie J Leeper
- Biology and Physician Assistant Programs, Seton Hill University, Greensburg, Pennsylvania, USA
| | - Jeremy J Grachan
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Rhiannon Robinson
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Julie Doll
- Department of Natural Sciences, University of St. Francis, Joliet, Illinois, USA
| | - Kelsey Stevens
- Department of Health Sciences, Briar Cliff University, Sioux City, Iowa, USA
| |
Collapse
|
6
|
Claveria A, Bachour D, Balta JY, Antonacci R, Ventura NM, Noel GPJC. A comparison of student perspectives on body donation across healthcare professional programs: From prosection- to dissection-based curricula. ANATOMICAL SCIENCES EDUCATION 2024; 17:558-570. [PMID: 38299426 DOI: 10.1002/ase.2383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 11/17/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
Donor-centered education offers students the opportunity to not only acquire visual and tactile experiences for applying anatomical knowledge but also a chance for students to reflect upon fundamental humanistic principles. The exploration of differences in students' viewpoints on body donation and the utilization of body donors in their education remains unexplored across various healthcare professional programs, which has an impact on student learning and experience. This study aimed to qualitatively examine the similarities and differences in student perspectives regarding body donation across three healthcare professional programs. One-page reflections from nursing (n = 37), physical and occupational therapy (n = 49), and medical students (n = 66) regarding their experiences in the anatomy laboratory at McGill University were collected and analyzed using a deductive approach based on themes and sub-themes outlined by Stephens et al. in 2019. Despite differences in their curricula, there were few discrepancies across the programs' reflections suggesting that donor-based learning had similar effects on each user group. Most students across the healthcare professional programs mentioned that their positive laboratory experiences motivated them to donate their bodies, extending the privilege they had to future generations. Nursing students did not reflect upon the notion that working with body donors provided unique learning experiences in the anatomy laboratory. Likewise, physical and occupational therapy (PT/OT) students did not address the importance of maintaining the privacy of body donors by covering certain body parts during lab. These findings show that prosection- and dissection-based exercises encourage reflective practices associated with these of medical ethics, highlighting an important advantage to including donor-based learning in anatomical education.
Collapse
Affiliation(s)
| | - Dona Bachour
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Québec, Canada
| | - Joy Y Balta
- Anatomy Learning Institute, Point Loma Nazarene University, San Diego, California, USA
- Division of Anatomy, Department of Surgery, University of California, San Diego, La Jolla, California, USA
| | - Rosetta Antonacci
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
| | - Nicole M Ventura
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Québec, Canada
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, McGill University, Montreal, Québec, Canada
| | - Geoffroy P J C Noel
- Division of Anatomy, Department of Surgery, University of California, San Diego, La Jolla, California, USA
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Québec, Canada
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, McGill University, Montreal, Québec, Canada
| |
Collapse
|
7
|
Okafor IA, Nnaka JA, Chia T. Cadaver Dissection Experience for First-Time Dissectors: a Hypothetical Three-Pronged Approach for Student Preparation. MEDICAL SCIENCE EDUCATOR 2024; 34:257-269. [PMID: 38510414 PMCID: PMC10948661 DOI: 10.1007/s40670-023-01950-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 03/22/2024]
Abstract
This systematic review synthesized evidence for the development of a preparatory process for first-time dissectors, geared toward improving cadaver dissection (CD) experiences. Eleven studies focused on pre-CD intervention were selected from a literature search in PubMed, the Education Resources Information Centre (ERIC), Google Scholar, PsycNET, and the Cochrane Library. A three-pronged preparatory process was formulated for first-time dissectors based on the evidence from the review. The process includes (1) background assessment; (2) pre-CD education; and (3) gradual exposure and desensitization. The preparatory process shows some hypothetical potential for decreasing negative CD-related experiences, but it still needs validation before implementation.
Collapse
Affiliation(s)
- Izuchukwu Azuka Okafor
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University, PMB 5001, Nnewi Campus Nnewi, Nigeria
| | - Jude Amechi Nnaka
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University, PMB 5001, Nnewi Campus Nnewi, Nigeria
| | - Terkuma Chia
- Institute of Health Sciences Education, McGill University, Montréal, QC Canada
| |
Collapse
|
8
|
Ghosh SK, Walocha JA. Responsible research in the practice of anatomy: Attributes relevant to body donors and human tissues sourced from them. Ann Anat 2024; 252:152184. [PMID: 37926402 DOI: 10.1016/j.aanat.2023.152184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
Responsible Research involves setting moral examples before fellow academicians and the society as a whole. The concept of Responsible Research applies appropriately to ethical sourcing and handling of human tissues. The present study was undertaken to analyze present situation regarding implementation of attributes of Relevant Research in relation to body donors in anatomical research. A literature search of relevant, peer-reviewed, published articles was undertaken from indexed databases (Medline & PubMed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar) for this study. The following attributes of Responsible Research were identified for possible intervention: the fact that research was conducted on human tissues from body donors and details regarding ethical handling thereof may be explicitly mentioned in method section; expression of gratitude towards body donors by authors may be included in acknowledgement section; editor's and publisher's note in support of adoption of attributes of Responsible Research may be included in published research. Adherence to best practices in terms of ethical guidelines requires anatomists to embrace a responsible approach in research from an inclusive perspective. Accordingly, practice of acknowledging the body donors may be nurtured and augmented to include the anonymised dead (human tissues from unclaimed bodies and unknown source) provided the research protocol received clearance from authorities concerned with ethical scrutiny. Moreover, adoption of the practice in review articles will enhance the boundaries of Responsible Research in anatomical science. Thus, few recommendations are proposed as epilogue for effectual implementation of the notion floated in present study.
Collapse
Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, Phulwarisharif, Patna 801507, India.
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kopernica 12, Krakow 31-034, Poland
| |
Collapse
|
9
|
Byram JN, Van Nuland SE, Harrell KM, Mussell JC, Cornwall J. Educator perspectives on non-technical, discipline-independent skill acquisition: An international, qualitative study. ANATOMICAL SCIENCES EDUCATION 2023; 16:1102-1117. [PMID: 37248341 DOI: 10.1002/ase.2302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 04/25/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
Gross anatomy education utilizing body donors and human specimens assists the acquisition of non-traditional, discipline-independent skills (NTDIS) such as teamwork, communication, and leadership. Alterations to anatomy curricula, such as those resulting from the COVID-19 pandemic, likely impact NTDIS acquisition, yet how this manifests is unclear. This study, therefore, explored anatomy educator perspectives on NTDIS acquisition as a response to changes in teaching delivery. Gross anatomy educators across different countries were recruited and took part in one-on-one, semi-structured interviews that were audio recorded and transcribed. Data were analyzed using the framework method. Basic statistical analyses were performed on demographic and categorical data. Fifteen educators from five continents were interviewed (average length 32.5 min, range 17-51 min). Educator experience ranged from 0-4 years (n = 3) to 20+ years (n = 7). Most taught using dissection (n = 14) with prosection use (n = 13) also common. Themes relating to NTDIS included expected content (respect for donors, teamwork, communication skills, humanistic values), assessable content, assessment challenges, and impact of curriculum changes; NTDIS unique to anatomy education included cultural, ethical, and social considerations around dead bodies, including boundaries, and social norms. Informed by curriculum alterations during the COVID-19 pandemic, this first empirical study of anatomy educator perspectives on NTDIS highlights the potentially adverse educational impacts of decreased interaction with body donors and human specimens on NTDIS acquisition and difficulties with NTDIS assessment. Findings support gross anatomy education as unique in providing NTDIS that cannot easily be replicated elsewhere. Recommendations around NTDIS-specific educator competencies and promoting NTDIS are provided.
Collapse
Affiliation(s)
- Jessica N Byram
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sonya E Van Nuland
- Department of Cell Biology & Anatomy, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Kelly M Harrell
- Department of Anatomy and Neurobiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jason C Mussell
- Department of Cell Biology & Anatomy, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| |
Collapse
|
10
|
N Boulos A. Tutorials in anatomy education of medical students during the COVID-19 pandemic - An evaluation of its effectiveness. Clin Anat 2023. [PMID: 37092773 DOI: 10.1002/ca.24047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 03/12/2023] [Accepted: 04/10/2023] [Indexed: 04/25/2023]
Abstract
Anatomy has traditionally been taught through prosected specimens and the use of models and other techniques. During the COVID-19 period, this was replaced by tutorials, where students came to college to continue taking practical sessions. The study comprised four components. The first component consisted of demographic data. The second component consisted of questions concerning students' satisfaction with the tutorials. The third component included questions for Year 2 medical students only because they had tried both the new and old systems. The fourth component included the results for the Year 2 medical students. The study included 102 medical students. The number of tutorials each week and the duration of each tutorial were considered successful, since 47 (46.1%) and 44 (43.1%) students approved, respectively. The students were comfortable with understanding the information from PowerPoint presentations; 41 (40.2%) agreed with this statement. Moreover, 44 students (43.1%) agreed about the ability to recall material after the tutorial and the interaction it allowed them with the doctors. Overall, all the questions proved that the tutorials were of great value to the students during the COVID-19 period. Although COVID-19 limited anatomy teaching, tutorials were seen as a light at the end of the tunnel pending the end of the COVID-19 period.
Collapse
Affiliation(s)
- Atef N Boulos
- Faculty of Medicine, Department of Anatomy and Embryology, University of Alexandria, Egypt
| |
Collapse
|
11
|
Wu A, McWatt SC, Utomo R, Talis A, Xiao QY, Saraci K, Brassett C, Sagoo MG, Wingate R, Chien CL, Traxler H, Waschke J, Vielmuth F, Sigmund A, Yamada Y, Sakurai T, Zeroual M, Olsen J, El-Batti S, Viranta-Kovanen S, Keay K, Stewart W, Mao Y, Lang A, Kunzel C, Bernd P, Kielstein H, Noël GPJC. A thematic analysis of students' discussions on death and body donation in international online focus groups. ANATOMICAL SCIENCES EDUCATION 2023. [PMID: 36883007 DOI: 10.1002/ase.2265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Historically, Anatomy education is an in-person discipline involving exposure to human body donors that facilitates personal and professional growth through, in part, the initiation of reflection on the topic of death. However, during the COVID-19 pandemic the decreased exposure to cadaveric anatomy for many health professions students may have influenced the depth of their individual reflections on this topic. Accordingly, this study aimed to investigate the effect of an alternate approach-focus group discussions between peers with varying degrees of exposure to cadaveric material-that may offer one strategy to stimulate deep reflection on the topic of death. A programmatic intervention was introduced, wherein students (n = 221) from 13 international universities discussed differences in their anatomy courses during small focus group sessions as part of an online exchange program. An inductive semantic thematic analysis was conducted on responses to an open-ended text-response question on how the activity influenced students' reflections about death. Resulting themes were organized into categories that described the content and topics of the students' discussions as they grappled with this sensitive topic. The students reportedly engaged in deep reflection and expressed an increased sense of connectedness with their peers, despite their disparate exposure levels to cadaveric anatomy and being physically distanced. This demonstrates that focus groups with students experiencing different laboratory contexts can be used to help all students reflect on the topic of death and that interchanges between dissecting and non-dissecting students can initiate thoughts about death and body donation among non-dissecting students.
Collapse
Affiliation(s)
- Anette Wu
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons Columbia University, New York, New York, USA
| | - Sean C McWatt
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rachel Utomo
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Austin Talis
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Que Yun Xiao
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Kerstin Saraci
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Cecilia Brassett
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Mandeep Gill Sagoo
- Department of Anatomy and Neurobiology, School of Centre for Education, King's College London, London, UK
| | - Richard Wingate
- Department of Anatomy and Neurobiology, School of Centre for Education, King's College London, London, UK
| | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hannes Traxler
- Center for Anatomy and Cell Biology, Medical University Vienna, Vienna, Austria
| | - Jens Waschke
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Fransziska Vielmuth
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Anna Sigmund
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Yukari Yamada
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Sakurai
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mina Zeroual
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Jorgen Olsen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Salma El-Batti
- Department of Cardiovascular Surgery, University of Paris, Paris, France
| | | | - Kevin Keay
- Discipline of Anatomy and Histology, The University of Sydney, Sydney, New South Wales, Australia
| | - William Stewart
- Anatomy Section, Department of Surgery, Yale University, New Haven, Connecticut, USA
| | - Yinghui Mao
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons Columbia University, New York, New York, USA
| | - Ariella Lang
- Columbia College, Columbia University, New York, New York, USA
| | - Carol Kunzel
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Paulette Bernd
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons Columbia University, New York, New York, USA
| | - Heike Kielstein
- Institute of Anatomy and Cell Biology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany
| | - Geoffroy P J C Noël
- Anatomy Division, Department of Surgery, University of California San Diego, San Diego, California, USA
| |
Collapse
|
12
|
Ruth AA, Nesbitt A, Johnson LE. Flexible, short-duration outreach sessions in the human anatomy laboratory provide authentic, humanistic experiences. ANATOMICAL SCIENCES EDUCATION 2023; 16:280-290. [PMID: 35776633 DOI: 10.1002/ase.2209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 05/04/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
Anatomy laboratories can provide rich opportunities for outreach to K-12 and college students interested in pursuing careers in health, medicine, or science. At the University of Missouri, the Department of Pathology and Anatomical Sciences has designed flexible, one-hour interactive sessions that typically cover basic anatomical concepts using whole-body donors. In order to evaluate whether short-duration programs were impactful in increasing enthusiasm for anatomy and the health professions sciences, we used mixed methods to study participant experience covering three topics: (1) enthusiasm for anatomy, (2) interest in pursuing a career in healthcare professions, and (3) perception of the importance of whole-body donation. The same questions were asked pre- and post-session, and the post-session survey had additional questions related to student satisfaction. Quantitative analyses showed an increased interest in anatomy and appreciation for whole-body donation following the session. Students also perceived that they had a better understanding of the body and what it would be like to attend a health professions school. Thematic analysis revealed an appreciation for contextualizing the size, position, and hands-on feel of anatomical structures, and emphasized that students felt that they understood the body better after having seen a donor's anatomy. This work shows that short-duration, flexible outreach sessions involving whole-body donors can provide students with a rare opportunity to confirm their contextual understanding of anatomy, and provide students with an authentic, and humanistic experience.
Collapse
Affiliation(s)
- Aidan A Ruth
- Center for Anatomical Science and Education, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Allison Nesbitt
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Laura E Johnson
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, Missouri, USA
| |
Collapse
|
13
|
Smith CF, Munro R, Davies DC, Wilkinson T, Shaw H, Claridge K, Llewellyn S, Mc Ateer P, Ward S, Farsides T. Understanding beliefs, preferences and actions amongst potential body donors. ANATOMICAL SCIENCES EDUCATION 2023; 16:224-236. [PMID: 35726397 DOI: 10.1002/ase.2204] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/26/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
Body donation is a prosocial act providing a unique learning experience to students, ultimately impacting on patient care and science. With an increasing number of training professionals, there is an increasing need for body donors, yet little is understood about donors' beliefs and preferences. A four-center study aimed to understand donors' perceptions, 843 responses highlighted a significant relationship between completing a body donor consent form and being both an organ donor and having ever donated blood (p < 0.01). In exploring donor intentions, 69% had been considering donation for fewer than five years, 40% knew another body donor, and 27% had a family member or friend currently registered. Of those who had requested donor information packs, 97% had completed body donation consent forms. Of these, 92% had not selected any time restriction for their donation and 96% had consented to images being taken. Almost all (98%) were aware that their donation might not be accepted. Donors' motives highlighted a wish to: improve education, improve health care, advance science, and contribute to the greater good. A bimodal response was observed with body donation being used to save relatives money and inconvenience. Donors felt comfortable with their bodies being used by medical, dental, and allied health professionals; however, donors were less comfortable with their bodies being used by other groups. Only 57% were comfortable with artists, beauticians and yoga teachers using their remains. Understanding donors' motivations and decision-making process is vital to ensure resources for future and to meet any changing requirements of both donors and those studying them.
Collapse
Affiliation(s)
- Claire F Smith
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Ross Munro
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - D Ceri Davies
- Human Anatomy Unit, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Tracey Wilkinson
- Centre for Human Anatomy and Identification, School of Science and Engineering, Dundee University, Dundee, UK
| | - Hannah Shaw
- School of Biosciences, Cardiff University, Cardiff, UK
| | - Kim Claridge
- London Anatomy Office, King's College London, London, UK
| | | | | | - Siobhan Ward
- Discipline of Anatomy, Trinity College Dublin, Dublin, Ireland
| | - Tom Farsides
- School of Psychology, University of Sussex, Brighton, UK
| |
Collapse
|
14
|
Nawras M, Aoun J, Yazdi V, Hecht M, Khuder S, Frank P. Assessing the Ethical Concerns of Medical Students in the Gross Anatomy Lab. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231168505. [PMID: 37051224 PMCID: PMC10084544 DOI: 10.1177/23821205231168505] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES Cadaver dissection has become the gold-standard for anatomical education in US medical schools. Ethical issues regarding cadavers may not be as obvious as in living patients, which can lead to their potential neglect in medical school curricula. In this study, we assessed the different ethical concerns (ECs) of medical students regarding cadavers in the gross anatomy lab (GAL), gathered student information, including self-reported academic performance (AP) in the GAL, and determined the best predictors for a student's EC. METHODS All second-year medical students at the University of Toledo were invited to complete an anonymous, online-survey. Participants were presented with 10 hypothetical but realistic lab scenarios and asked to rate their EC for each on a 5-point Likert scale. Gender, age, and scores received in the GAL course were also collected. A multiple linear regression model was used to find the best predictors of the total EC score. RESULTS A total of 112 (63%) responses to the online-survey were recorded. The highest EC was for Q7: Taking pictures of the cadaver. The lowest EC was for Q10: The dissection of cadavers itself is an EC. Gender was the best predictor of total EC, followed by age. Female total EC was significantly higher than that for males (35.8 ± 5.5 vs 33.1 ± 7.9). Female scores for Q1 and Q2 were significantly higher than those for males. Total EC for students in the age group 25 to 34 was significantly higher than those in the age group 18 to 24 (35.9 ± 6.1 vs 33.9 ± 7.2). No significant difference was found for individual scenarios. AP was not significantly related to the total score or the scores of the individual scenarios. CONCLUSION The significant differences in ECs of medical students found in our study indicate that not all students have the same outlook towards the GAL specifically and ECs generally.
Collapse
Affiliation(s)
- Mohamad Nawras
- Mohamad Nawras, University of Toledo, College of Medicine and Life Sciences, Toledo, OH 43614, USA.
| | | | | | | | | | | |
Collapse
|
15
|
Wu A, Xiao QY, McWatt S, Utomo R, Talis A, Saraci K, Brassett C, Sagoo MG, Wingate R, Chien CL, Traxler H, Waschke J, Vielmuth F, Yamada Y, Sakurai T, Zeroual M, Olsen J, El-Batti S, Viranta-Kovanen S, Keay K, Stewart W, Kunzel C, Bernd P, Kielstein H, Noël GPJC. The Anatomy Course During COVID-19: The Impact of Cadaver-Based Learning on the Initiation of Reflection on Death. MEDICAL SCIENCE EDUCATOR 2022; 32:1033-1044. [PMID: 36097588 PMCID: PMC9453724 DOI: 10.1007/s40670-022-01609-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, in-person cadaveric dissection laboratories for teaching anatomy were omitted by many schools around the world. While knowledge domains can be easily evaluated via remote exams, non-traditional discipline-independent skills such as those encouraged through reflection on the topic of death are often overlooked. This study investigated how different anatomy course formats played a role in initiating students' reflections on death during the COVID-19 pandemic. METHOD In fall 2020, 217 medical, dental, premedical, and health sciences students from 13 international universities discussed differences in their anatomy courses online. Formats of anatomy courses ranged from dissection-based, prosection-based, hybrid (combination of dissection and prosection) to no laboratory exposure at all. Students' responses to the question, "Did/does your anatomy course initiate your thinking about life's passing?" were collected, and they self-reported themes that were present in their reflections on death using a multiple-choice prompt. Statistical analyses to detect differences between students with and without exposure to cadavers were performed using the chi-squared test. RESULTS When comparing students who had exposure to human anatomical specimens to those who had no exposure, the majority of students with exposure thought that the course did initiate thoughts about life's passing, compared to students without exposure (P < 0.05). Reflection themes were consistent across groups. DISCUSSION These findings indicate that anatomy dissection courses are important for the initiation of students' feelings about the topic of death. Omission of cadaveric dissection- or prosection-based laboratories will decrease the likelihood that students initiate reflection on this topic and gain important transferable skills.
Collapse
Affiliation(s)
- Anette Wu
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Que Yun Xiao
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Sean McWatt
- Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | - Rachel Utomo
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Austin Talis
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Kerstin Saraci
- Institute of Anatomy, Faculty of Medicine, Vegetative Anatomy, Ludwig Maximilian University, Munich, Germany
| | - Cecilia Brassett
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Mandeep Gill Sagoo
- Department of Anatomy and Neurobiology, School of Centre for Education, King’s College London, London, UK
| | - Richard Wingate
- Department of Anatomy and Neurobiology, School of Centre for Education, King’s College London, London, UK
| | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hannes Traxler
- Center for Anatomy and Cell Biology, Medical University Vienna, Vienna, Austria
| | - Jens Waschke
- Institute of Anatomy, Faculty of Medicine, Vegetative Anatomy, Ludwig Maximilian University, Munich, Germany
| | - Franziska Vielmuth
- Institute of Anatomy, Faculty of Medicine, Vegetative Anatomy, Ludwig Maximilian University, Munich, Germany
| | - Yukari Yamada
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Sakurai
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mina Zeroual
- Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | - Jorgen Olsen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Salma El-Batti
- Department of Cardiovascular Surgery, University of Paris, Paris, France
| | | | - Kevin Keay
- Discipline of Anatomy and Histology, The University of Sydney, Sydney, Australia
| | - William Stewart
- Anatomy Section, Department of Surgery, Yale University, New Haven, CT USA
| | - Carol Kunzel
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Paulette Bernd
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Heike Kielstein
- Institute for Anatomy and Cell Biology, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
| | - Geoffroy P. J. C. Noël
- Anatomy Division, Department of Surgery, University of California San Diego, San Diego, CA USA
| |
Collapse
|
16
|
Hatcher AR, Pearson AS, Platt KM. A quality improvement apprenticeship: Gross anatomy in the time of Covid-19. ANATOMICAL SCIENCES EDUCATION 2022; 15:970-979. [PMID: 35892188 PMCID: PMC9353286 DOI: 10.1002/ase.2212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 07/05/2022] [Accepted: 07/23/2022] [Indexed: 06/15/2023]
Abstract
The study of anatomy is a team-driven field in which anatomy instruction occurs in small groups in the laboratory with one faculty member guiding students through each anatomical region. One laboratory experience may include several small group instructors in one simultaneous learning session. In comparison, the education of future gross anatomists often happens in an apprenticeship model, where the optimal learning outcomes are met through training with an experienced mentor. It was the vision of the authors to further their education through initiating an inter-institutional exchange to apprentice with innovative mentors in order to bring new ideas back to their own gross anatomy courses. The Southeastern Conference, a consortium of the Universities in the Southern region of the United States often associated with intercollegiate sports, has a host of academic initiatives in addition to the athletic emphasis. The Southeastern Conference Faculty Travel Program is one mechanism by which the organization promotes scholarly excellence. In this case, the Faculty Travel Program provided a way for authors from the University of Kentucky to visit a nearby institution, Vanderbilt University, and learn from like-minded anatomy educators, with the goal of incorporating changes in their courses geared toward quality improvement. After this implementation, positive themes emerged in the student feedback on course evaluations. However, the collaboration was interrupted by the onset of the Covid-19 pandemic. This article examines the strengths of interinstitutional apprenticeship and the benefits of such practices in a time of accelerated change in anatomical instruction.
Collapse
Affiliation(s)
- April R. Hatcher
- Department of Neuroscience, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - A. Scott Pearson
- Department of SurgeryVanderbilt University School of Medicine, Vanderbilt UniversityNashvilleTennesseeUSA
| | - Kristen M. Platt
- Department of Neuroscience, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| |
Collapse
|
17
|
Stephens GC, Sarkar M, Lazarus MD. 'A whole lot of uncertainty': A qualitative study exploring clinical medical students' experiences of uncertainty stimuli. MEDICAL EDUCATION 2022; 56:736-746. [PMID: 35130579 PMCID: PMC9306844 DOI: 10.1111/medu.14743] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/17/2022] [Accepted: 01/31/2022] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Uncertainty tolerance (UT) describes how individuals respond to stimuli of uncertainty, with low UT among medical doctors and students linked to negative outcomes such as burnout. UT research in medical education has focused on measuring the construct, with little research seeking to understand how medical students experience uncertainty. Hence, knowledge on how education may shape students' UT development is lacking. As a first step to understanding students' UT, we asked 'How do medical students, in their clinical years, experience uncertainty stimuli?' METHODS Utilising a social constructionist approach, we undertook a qualitative study with 41 clinical years medical students. Data were collected during the 2020 academic year employing in-semester reflective diary entries (n = 230 entries), and semi-structured interviews at the end of semesters (n = 40 interviews). Data were analysed by framework analysis. RESULTS Students described three major themes of uncertainty stimuli: (i) educational uncertainty, (ii) professional uncertainty and (iii) clinical uncertainty. Educational uncertainty was the dominant stimulus described by students and represents unknowns related to what students needed to learn and how to learn within the context of clinical placements. Professional uncertainty encompassed questions about who students are as developing professionals and who they would be as doctors. Clinical uncertainty was the least represented stimulus and concerned aspects of patient care where the body of medical knowledge is unable to provide clear answers. CONCLUSIONS Our findings indicate that clinical learners experience wide reaching uncertainties and suggest that students' stimuli may differ from those of clinicians with more established knowledge and careers. This work now paves the way forward in developing educational interventions to foster UT, such as modifying uncertainties not integral to learning, and purposefully introducing clinical uncertainties relevant to students' learning stage.
Collapse
Affiliation(s)
| | - Mahbub Sarkar
- Monash Centre for Scholarship in Health EducationMonash UniversityClaytonVictoriaAustralia
| | - Michelle D. Lazarus
- Centre for Human Anatomy Education Director and Monash Centre for Scholarship in Health EducationMonash UniversityClaytonVictoriaAustralia
| |
Collapse
|
18
|
Chu SY, Tseng TC, Ho YC, Tseng GF. The Impact of a Gross Anatomy Curriculum With Donor Family Interaction: Thematic Analysis of Student Letters to Silent Mentors. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1065-1070. [PMID: 35320128 PMCID: PMC9232274 DOI: 10.1097/acm.0000000000004678] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Tzu Chi University's anatomy curriculum incorporates interaction with donors' families and regards body donors as silent teachers and altruistic role models. In this silent mentor program (SMP), students learn about their donor's life before dissection to better appreciate the selfless donation. This study explores the influence of the program on students' humanistic literacy based on student letters to silent mentors, which students wrote near the end of the program and laid by the silent mentor during the coffining ceremony. METHOD The study included 125 letters from third-year medical students who took the gross anatomy curriculum in academic years 2015, 2016, and 2017. With student consent, the program collated and published the letters in the open-access SMP yearbook. Using thematic analysis, the authors manually analyzed the letters in their original Mandarin, with the names of students made anonymous to ensure the authors were blind to students' identity throughout the study. RESULTS The analysis identified 3 themes and 11 subthemes. Theme 1, my silent mentor, included 3 subthemes: life characteristics, altruistic attitude, and expectation of offering body. Theme 2, connection to silent mentor and family, included 4 subthemes: intersubjective bonding, emotive first encounter, spiritual communication, and encouragement from silent mentor. Theme 3, reflection and transformation, included 4 subthemes: reflection on life and death, professional self-expectation, inner transformation, and feedback action. CONCLUSIONS The findings suggest that interactions with donors' families increased students' appreciation of the donation and enhanced students' humanistic literacy. Further, the letters seem to indicate that the SMP inspired students to develop a grateful, respectful, and empathic attitude toward life and their career. Thus, by implementing similar programs, gross anatomy curricula could go beyond the acquisition of structural knowledge to the cultivation of medical students' humanistic literacy.
Collapse
Affiliation(s)
- Shao-Yin Chu
- S.-Y. Chu is associate professor, School of Medicine, Tzu Chi University, and Department of Medical Education and Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Ting-Chun Tseng
- T.-C. Tseng is a medical student, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yun-Chi Ho
- Y.-C. Ho is professor, Institute of Education, Tzu Chi University, Hualien, Taiwan
| | - Guo-Fang Tseng
- G.-F. Tseng is professor, Department of Anatomy, School of Medicine, and director, Medical Simulation Center, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
19
|
Papa V, Varotto E, Galli M, Vaccarezza M, Galassi FM. One year of anatomy teaching and learning in the outbreak: Has the Covid-19 pandemic marked the end of a century-old practice? A systematic review. ANATOMICAL SCIENCES EDUCATION 2022; 15:261-280. [PMID: 34890477 PMCID: PMC9011560 DOI: 10.1002/ase.2162] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 05/21/2023]
Abstract
At the end of 2019, the Covid-19 pandemic spread caused restrictions in business and social spheres. Higher education was also severely affected: universities and medical schools moved online to distance learning and laboratory facilities closed. Questions arise about the long-term effects of this pandemic on anatomical education. In this systematic review, the authors investigated whether or not anatomical educators were able to deliver anatomical knowledge during this pandemic. They also discuss the challenges that anatomical education has faced over the last year. The search strategy was conducted between July 2020 and July 2021. Two hundred and one records were identified, and a total of 79 studies were finally included. How best to deliver anatomy to students remains a moot point. In the last years, the advent of new technologies has raised the question of the possible overcoming of dissection as the main instrument in anatomical education. The Covid-19 pandemic further sharpened the debate. Remote learning enhanced the use of technologies other than cadaveric dissection to teach anatomy. Moreover, from the analyzed records it appears that both from students' perspective as well as teachers' there is a clear tear between those who endorse dissection and those who believe it could be easily overcome or at least integrated by virtual reality and online learning. The authors strongly believe that the best anatomy teaching practice requires the careful adaptation of resources and methods. Nevertheless, they support cadaveric dissection and hope that it will not be replaced entirely as a result of this pandemic.
Collapse
Affiliation(s)
- Veronica Papa
- Department of Motor Sciences and WellnessSchool of Sciences, Engineering and HealthUniversity of Naples “Parthenope”NaplesItaly
- Forensic Anthropology, Paleopathology and Bioarchaeology (FAPAB) Research CenterAvolaItaly
| | - Elena Varotto
- Forensic Anthropology, Paleopathology and Bioarchaeology (FAPAB) Research CenterAvolaItaly
- Department of Humanities (DISUM)University of CataniaCataniaItaly
- Archaeology, College of Humanities, Arts and Social SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences “Luigi Sacco”University of MilanMilanItaly
- III Division of Infectious DiseasesASST Fatebenefratelli SaccoMilanoItaly
| | - Mauro Vaccarezza
- Curtin Medical SchoolFaculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | - Francesco M. Galassi
- Forensic Anthropology, Paleopathology and Bioarchaeology (FAPAB) Research CenterAvolaItaly
- Archaeology, College of Humanities, Arts and Social SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| |
Collapse
|
20
|
Wong MK, Hong DZH, Wu J, Ting JJQ, Goh JL, Ong ZY, Toh RQE, Chiang CLL, Ng CWH, Ng JCK, Cheong CWS, Tay KT, Tan LHS, Ong YT, Chiam M, Chin AMC, Mason S, Radha Krishna LK. A systematic scoping review of undergraduate medical ethics education programs from 1990 to 2020. MEDICAL TEACHER 2022; 44:167-186. [PMID: 34534043 DOI: 10.1080/0142159x.2021.1970729] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Ensuring medical students are equipped with essential knowledge and portable skills to face complex ethical issues underlines the need for ethics education in medical school. Yet such training remains variable amidst evolving contextual, sociocultural, legal and financial considerations that inform training across different healthcare systems. This review aims to map how undergraduate medical schools teach and assess ethics. METHODS Guided by the Systematic Evidence-Based Approach (SEBA), two concurrent systematic scoping reviews were carried out, one on ethics teaching and another on their assessment. Searches were conducted on PubMed, Embase, PsycINFO and ERIC between 1 January 1990 and 31 December 2020. Data was independently analysed using thematic and content analysis. RESULTS Upon scrutinising the two sets of full-text articles, we identified 141 articles on ethics teaching and 102 articles on their assessments. 83 overlapped resulting in 160 distinct articles. Similar themes and categories were identified, these include teaching modalities, curriculum content, enablers and barriers to teaching, assessment methods, and their pros and cons. CONCLUSION This review reveals the importance of adopting an interactive, multimodal and interdisciplinary team-teaching approach to ethics education, involving community resource partners and faculty trained in ethics, law, communication, professionalism, and other intertwining healthcare professions. Conscientious effort should also be put into vertically and horizontally integrating ethics into formal medical curricula to ensure contextualisation and application of ethics knowledge, skills and attitudes, as well as protected time and adequate resources. A stage-based multimodal assessment approach should be used to appropriately evaluate knowledge acquisition, application and reflection across various practice settings. To scaffold personalised development plans and remediation efforts, multisource evaluations may be stored in a centralised portfolio. Whilst standardisation of curricula content ensures cross-speciality ethical proficiency, deliberative curriculum inquiry performed by faculty members using a Delphi approach may help to facilitate the narrowing of relevant topics.
Collapse
Affiliation(s)
- Mun Kit Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Daniel Zhi Hao Hong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jiaxuan Wu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jacquelin Jia Qi Ting
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jia Ling Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Zhi Yang Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Rachelle Qi En Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Christine Li Ling Chiang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Caleb Wei Hao Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jared Chuan Kai Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Clarissa Wei Shuen Cheong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Laura Hui Shuen Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, United Kingdom
- Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, United Kingdom
- Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom
- Duke-NUS Medical School, Singapore, Singapore
- Centre of Biomedical Ethics, National University of Singapore, Singapore, Singapore
- PalC, The Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore
| |
Collapse
|
21
|
Balmer DF, Varpio L, Bennett D, Teunissen PW. Longitudinal qualitative research in medical education: Time to conceptualise time. MEDICAL EDUCATION 2021; 55:1253-1260. [PMID: 33847408 PMCID: PMC8596518 DOI: 10.1111/medu.14542] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/26/2021] [Accepted: 04/09/2021] [Indexed: 05/14/2023]
Abstract
CONTEXT Longitudinal qualitative research is an approach to research that entails generating qualitative data with the same participants over extended periods of time to understand their lived experiences as those experiences unfold. Knowing about dynamic lived experiences in medical education, that is, learning journeys with stops and starts, detours, transitions and reversals, enriches understanding of events and accomplishments along the way. The purpose of this paper is to create access points to longitudinal qualitative research in support of increasing its use in medical education. METHODS The authors explore and argue for different conceptualisations of time: analysing lived experiences through time versus analysing lived experiences cross-sectional or via 2-point follow-up studies and considering time as subjective and fluid as well as objective and fixed. They introduce applications of longitudinal qualitative research from several academic domains: investigating development and formal education; building longitudinal research relationship; and exploring interconnections between individual journeys and social structures. They provide an illustrative overview of longitudinal qualitative research in medical education, and end with practical advice, or pearls, for medical education investigators interested in using this research approach: collecting data recursively; analysing longitudinal data in three strands; addressing mutual reflexivity; using theory to illuminate time; and making a long-term commitment to longitudinal qualitative research. CONCLUSIONS Longitudinal qualitative research stretches investigators to think differently about time and undertake more complex analyses to understand dynamic lived experiences. Research in medical education will likely be impoverished if the focus remains on time as fixed. Seeing things qualitatively through time, where time is fluid and the past, present and future interpenetrate, produces a rich understanding that can move the field forward.
Collapse
Affiliation(s)
- Dorene F. Balmer
- Department of PediatricsPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Lara Varpio
- Department of MedicineCenter for Health Professions EducationUniformed Services University of the Health SciencesBethesdaMDUSA
| | - Deirdre Bennett
- Medical Education UnitSchool of MedicineUniversity College CorkCorkIreland
| | - Pim W. Teunissen
- Faculty of Health, Medicine and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
- Department of Obstetrics and GynecologyMaastricht University Medical CenterMaastrichtThe Netherlands
| |
Collapse
|
22
|
Pirri C, Stecco C, Porzionato A, Boscolo-Berto R, Fortelny RH, Macchi V, Konschake M, Merigliano S, De Caro R. Forensic Implications of Anatomical Education and Surgical Training With Cadavers. Front Surg 2021; 8:641581. [PMID: 34250002 PMCID: PMC8260677 DOI: 10.3389/fsurg.2021.641581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
Anatomical education and surgical training with cadavers are usually considered an appropriate method of teaching, above all for all surgeons at various levels. Indeed, in such a way they put into practice and exercise a procedure before performing it live, reducing the learning curve in a safe environment and the risks for the patients. Really, up to now it is not clear if the nonuse of the cadavers for anatomical education and surgical training can have also forensic implications. A substantial literature research was used for this review, based on PubMed and Web of Science database. From this review, it is clear that the cadaveric training could be considered mandatory, both for surgeons and for medical students, leading to a series of questions with forensic implications. Indeed, there are many evidences that a cadaver lab can improve the learning curve of a surgeon, above all in the first part of the curve, in which frequent and severe complications are possible. Consequently, a medical responsibility for residents and surgeons which perform a procedure without adequate training could be advised, but also for hospital, that has to guarantee a sufficient training for its surgeons and other specialists through cadaver labs. Surely, this type of training could help to improve the practical skills of surgeons working in small hospitals, where some procedures are rare. Cadaver studies can permit a better evaluation of safety and efficacy of new surgical devices by surgeons, avoiding using patients as ≪guinea pigs≫. Indeed, a legal responsibility for a surgeon and other specialists could exist in the use of a new device without an apparent regulatory oversight. For a good medical practice, the surgeons should communicate to the patient the unsure procedural risks, making sure the patients' full understanding about the novelty of the procedure and that they have used this technique on few, if any, patients before. Cadaver training could represent a shortcut in the standard training process, increasing both the surgeon learning curve and patient confidence. Forensic clinical anatomy can supervise and support all these aspects of the formation and of the use of cadaver training.
Collapse
Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Rafael Boscolo-Berto
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - René H Fortelny
- Medical Faculty, Sigmund Freud Private University, Vienna, Austria
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Marko Konschake
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefano Merigliano
- Department of Surgery, Center for Esophageal Disease, Oncology and Gastroenterology, University Hospital of Padova, Padua, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| |
Collapse
|
23
|
Banovac I, Katavić V, Blažević A, Bičanić I, Hladnik A, Kovačić N, Petanjek Z. The anatomy lesson of the SARS-CoV-2 pandemic: irreplaceable tradition (cadaver work) and new didactics of digital technology. Croat Med J 2021. [PMID: 33938657 PMCID: PMC8107989 DOI: 10.3325/cmj.2021.62.173] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
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.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Zdravko Petanjek
- Zdravko Petanjek, Department of Anatomy and Clinical Anatomy and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Šalata 11, 10 000 Zagreb, Croatia,
| |
Collapse
|
24
|
Initiating Students' Reflections on Life's Passing in the Anatomy Course - an International Observation at 14 Universities. Ann Anat 2021; 237:151741. [PMID: 33892095 DOI: 10.1016/j.aanat.2021.151741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Medical and dental students' feelings and thoughts about the topic of death and life's passing are often associated with learning in the gross anatomy course, when students begin working with a deceased body donor in order to study human anatomy. Little is known of whether the format of anatomy teaching has an impact on these experiences. An observational study was performed to capture the initiation of students' sentiments on the topic of life's passing during the anatomy course at 14 international universities, identify common themes regarding these thoughts, and to study the connection to variations in anatomy course formats and included elements. METHOD Preclinical anatomy students reflected on one question (i.e., "How did your experience in the anatomy laboratory bring about your reflections on the meaning of life and human existence as well as the sanctity of one's passing?"). Written assignments were collected and anonymously coded. Information on anatomy courses was obtained via faculty questionnaires. RESULT A variety of themes were identified at the different schools, correlated with different anatomy formats and elements. Results indicate that the courses that offer hands-on cadaveric dissections may play an important role in triggering these sentiments. DISCUSSION The initiation of students' sentiments about the topic of death varies and includes several themes. There can be a connection to the way anatomy is taught, particularly if hands-on comprehensive cadaveric dissection or prosections are included. CONCLUSION In summary, anatomy courses can initiate students' thinking about life's passing - particularly in schools that offer hands-on cadaveric dissections or prosections.
Collapse
|
25
|
Maloney S, Pather N, Foo J, Lazarus MD. Spending Wisely: The Role of Cost and Value Research in the Pursuit of Advancing Anatomical Sciences Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:263-269. [PMID: 33068329 DOI: 10.1002/ase.2027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Studies of "cost and value" in anatomical sciences education examine not only what works, but at what cost, thus evaluating the inputs and outputs of education. This research provides insights into how to use available resources (e.g., academic time, budgets, infrastructure) as a mechanism to obtaining the maximum outcomes available. The purpose of this viewpoint article is to expand on the application of cost and value concepts to anatomical sciences education, contextualizing these concepts through a deeper dive into the more costly educational approaches of human donor dissection. In doing so, both questions and opportunities are raised for the discipline of anatomical sciences going forward. Educational decisions, inclusive of cost and value appraisals, consider the range of outcomes for which the activity is designed to achieve, and the activity's integration with the philosophy of the educational program it is contributing to; these decisions, thus, evaluate more than just cost alone. Healthcare students' engagement with human donor dissection pedagogy offers an array of reported non-economic benefits, including non-traditional discipline-independent skill (NDIS) development (e.g., professionalism, teamwork skills). These skills are often harder to measure, but are no less important to the final pedagogical decision-making process. The goal of cost and value research is to create an evidence-base toward education that delivers maximum value for a given spend. Anatomy educators, researchers, and decision makers who embrace cost and value dialogue, and interpret and apply findings from studies of educational costs, are best positioned to improve the educational value for their learners and provide effective outputs for all stakeholders.
Collapse
Affiliation(s)
- Stephen Maloney
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Nalini Pather
- Department of Anatomy, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Jonathan Foo
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Centre for Scholarship in Health Education, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
26
|
McDaniel KG, Brown T, Radford CC, McDermott CH, van Houten T, Katz ME, Stearns DA, Hildebrandt S. Anatomy as a Model Environment for Acquiring Professional Competencies in Medicine: Experiences at Harvard Medical School. ANATOMICAL SCIENCES EDUCATION 2021; 14:241-251. [PMID: 32657538 DOI: 10.1002/ase.2000] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 06/03/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
Anatomy education provides students with opportunities to learn structure and function of the human body, to acquire professional competencies such as teamwork, interpersonal skills, self-awareness, and to reflect on and practice medical ethics. The fulfillment of this wide potential can present challenges in courses that are part of an integrated curriculum and shorter than traditional courses. This new reality, together with students' increasing concern about the stresses within medical education, led to efforts at Harvard Medical School to implement practical steps toward an optimal learning environment in anatomy. These were based on core elements of ethical anatomy education and principles of trauma-informed care. Anatomy is conceptualized here as the "first clinical discipline," with relational interactions between anatomical educators, medical students, and body donors/patients. Essential prerequisites for the implementation of this work were support by the medical school leadership, open partnership between engaged students and faculty, faculty coordination, and peer-teaching. Specific interventions included pre-course faculty development on course philosophy and invitations to students to share their thoughts on anatomy. Student responses were integrated in course introductions, combined with a pre-dissection laboratory visit, an introductory guide, and a module on the history and ethics of anatomy. During the course, team-building activities were scheduled, and self-reflection encouraged, for example, through written exercises, and elective life-body drawing. Students' responses to the interventions were overall positive, but need further evaluation. This first attempt of a systematic implementation of an optimal learning environment in anatomy led to the identification of areas in need of adjustment.
Collapse
Affiliation(s)
| | - Taylor Brown
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | | | - Cynthia H McDermott
- Department of Cell Biology, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Trudy van Houten
- Program in Medical Education at Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Brigham's and Women's Hospital, Boston, Massachusetts
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Martha E Katz
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dana A Stearns
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
27
|
Rajasekhar SSSN, Dinesh Kumar V. The Cadaver Conundrum: Sourcing and Anatomical Embalming of Human Dead Bodies by Medical Schools during and after COVID-19 Pandemic: Review and Recommendations. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:924-936. [PMID: 33681708 PMCID: PMC7917023 DOI: 10.1007/s42399-021-00778-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 10/28/2022]
Abstract
COVID-19 pandemic has posed a new challenge for medical schools across the world regarding the acceptance of donated and unclaimed dead bodies for academic purpose. Uncertainty of the COVID-19 status among the donated bodies poses a health risk for embalming personnel and medical students who handle the embalmed cadavers. There is a paucity of literature delineating the criteria for accepting or rejecting the bodies during COVID-19 pandemic. Similarly, there is no recommended standard operating procedure for anatomical embalming during COVID-19. We propose certain criteria for accepting and rejecting the human dead bodies for anatomical embalming. And we propose some technical modifications to the conventional procedure of formalin-based anatomical embalming. A guarded approach and diligent screening of donated bodies is the way forward during the COVID-19 pandemic.
Collapse
Affiliation(s)
- S. S. S. N. Rajasekhar
- Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education, JIPMER, Puducherry, 605006 India
| | - V. Dinesh Kumar
- Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education, JIPMER, Puducherry, 605006 India
| |
Collapse
|
28
|
Stephens GC, Rees CE, Lazarus MD. Exploring the impact of education on preclinical medical students' tolerance of uncertainty: a qualitative longitudinal study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:53-77. [PMID: 32378150 DOI: 10.1007/s10459-020-09971-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 04/27/2020] [Indexed: 05/27/2023]
Abstract
Tolerance of uncertainty, a construct describing individuals' responses to perceived uncertainty, has relevancy across healthcare systems, yet little work explores the impact of education on medical students' tolerance of uncertainty. While debate remains as to whether tolerance of uncertainty is changeable or static, the prevailing conceptual healthcare tolerance of uncertainty model (Hillen et al. in Soc Sci Med 180:62-75, 2017) suggests that individuals' tolerance of uncertainty is influenced by so-called moderators. Evidence regarding education's role as a moderator of tolerance of uncertainty is, however, lacking. Preliminary work exploring medical students' professional identity formation within anatomy learning identified tolerance of uncertainty as a theme warranting further exploration. Extending from this work, our research question was: How does the anatomy education learning environment impact medical students' tolerance of uncertainty? To address this question, qualitative data were collected longitudinally across two successive cohorts through online discussion forums during semester and end of semester interviews. Framework analysis identified five stimuli of uncertainty, four moderators of uncertainty, and cognitive, emotional and behavioral responses to uncertainty with variable valency (positive and/or negative). Longitudinal data analyses indicated changes in stimuli, moderators and responses to uncertainty over time, suggesting that tolerance of uncertainty is changeable rather than static. While our findings support the Hillen et al. (Soc Sci Med 180:62-75, 2017) model in parts, our data extend this model and the previous literature. Although further research is needed about students' development of tolerance of uncertainty in the clinical learning environment, we encourage medical educators to incorporate aspects of tolerance of uncertainty into curricular and learning environments.
Collapse
Affiliation(s)
- Georgina C Stephens
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Room 168, 10 Chancellors Walk, Clayton, VIC, 3800, Australia
| | - Charlotte E Rees
- College of Science, Health, Engineering and Education (SHEE), Murdoch University, Murdoch, WA, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Room 168, 10 Chancellors Walk, Clayton, VIC, 3800, Australia.
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
| |
Collapse
|
29
|
Iwanaga J, Loukas M, Dumont AS, Tubbs RS. A review of anatomy education during and after the COVID-19 pandemic: Revisiting traditional and modern methods to achieve future innovation. Clin Anat 2021; 34:108-114. [PMID: 32681805 PMCID: PMC7404762 DOI: 10.1002/ca.23655] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/15/2020] [Indexed: 12/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had enormous effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal way to learn anatomy since the 17th century. As it is difficult to predict future access to cadavers for students or in-person classes, anatomy educators are encouraged to revisit all possible teaching methods in order to develop innovations. Here, we review anatomy education methods to apply to current and future education.
Collapse
Affiliation(s)
- Joe Iwanaga
- Department of NeurosurgeryTulane University School of MedicineNew OrleansLouisianaUSA
- Department of NeurologyTulane University School of MedicineNew OrleansLouisianaUSA
- Dental and Oral Medical CenterKurume University School of MedicineFukuokaJapan
- Department of AnatomyKurume University School of MedicineFukuokaJapan
| | - Marios Loukas
- Department of AnatomyUniversity of Warmia and MazuryOlsztynPoland
- Department of Anatomical SciencesSt. George's UniversitySt. George'sGrenada
| | - Aaron S. Dumont
- Department of NeurosurgeryTulane University School of MedicineNew OrleansLouisianaUSA
| | - R. Shane Tubbs
- Department of NeurosurgeryTulane University School of MedicineNew OrleansLouisianaUSA
- Department of Structural & Cellular BiologyTulane University School of MedicineNew OrleansLouisianaUSA
- Department of Neurosurgery and Ochsner Neuroscience InstituteOchsner Health SystemNew OrleansLouisianaUSA
- Department of Anatomical SciencesSt. George's UniversitySt. George'sGrenada
| |
Collapse
|
30
|
The practice of ethics in the context of human dissection: Setting standards for future physicians. Ann Anat 2020; 232:151577. [PMID: 32688021 PMCID: PMC7366954 DOI: 10.1016/j.aanat.2020.151577] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/18/2020] [Accepted: 06/24/2020] [Indexed: 02/07/2023]
Abstract
It is a much desirable skill among physicians that clinical practice should be guided by ethical norms. The dissection room experience provides an opportunity for nurturing the principles of ethical practice among medical students early in the curriculum. When the exercise of human dissection is followed within the boundaries of ethics it effectively props an ideal example for the young minds to emulate in the future. Hence in every stage of dissection room activity precious human body needs to be handled in an ethical manner so as to set a standard for the students. The present review is an attempt to collate the recommendations documented by researchers as per ethical guidelines in the context of human dissection. The review highlights on the ethical norms which needs to be adhered to while receiving the human body of a donor and during preservation of the same. It reflects on ideal ethical behaviour in the dissection room during the act of dissection and finally emphasize on the respectful disposal of the human remains in an ethical manner. The intended purpose of this article is to support uniform adoption of the recommendations for ethical handling of human bodies used in anatomical dissection.
Collapse
|
31
|
Wolf JJ, McVeigh J, Vallières F, Hyland P, MacLachlan M. Death anxiety, self-worth, and exposure to human donor remains: A longitudinal study of Irish medical students. DEATH STUDIES 2020; 46:875-884. [PMID: 32628572 DOI: 10.1080/07481187.2020.1783030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study aimed to investigate the relationship between death anxiety levels at pre-exposure to human donor remains, post-exposure self-worth, and post-exposure death anxiety levels, among a sample of Irish medical students. A multi-wave prospective study was conducted, using questionnaires administered at six time-points. Path analysis was used to investigate the effect of pre-exposure death anxiety levels and post-exposure self-worth on post-exposure death anxiety levels. Baseline death anxiety was found to predict post-exposure death anxiety. Furthermore, self-worth at one month of exposure was found to mediate the relationship between pre-exposure death anxiety levels and death anxiety levels at six months.
Collapse
Affiliation(s)
- Jonathan J Wolf
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Joanne McVeigh
- School of Applied Psychology, University College Cork, Cork, Ireland
- Assisting Living and Learning (ALL) Institute, Maynooth University, Maynooth, Ireland
| | - Frédérique Vallières
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Philip Hyland
- Assisting Living and Learning (ALL) Institute, Maynooth University, Maynooth, Ireland
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Malcolm MacLachlan
- Assisting Living and Learning (ALL) Institute, Maynooth University, Maynooth, Ireland
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Maynooth University, Maynooth, Ireland
- Centre for Rehabilitation Studies, Stellenbosch University, Cape Town, South Africa
- Olomouc University Social Health Institute, Palacký University, Olomouc, Czech Republic
| |
Collapse
|
32
|
Pather N, Blyth P, Chapman JA, Dayal MR, Flack NA, Fogg QA, Green RA, Hulme AK, Johnson IP, Meyer AJ, Morley JW, Shortland PJ, Štrkalj G, Štrkalj M, Valter K, Webb AL, Woodley SJ, Lazarus MD. Forced Disruption of Anatomy Education in Australia and New Zealand: An Acute Response to the Covid-19 Pandemic. ANATOMICAL SCIENCES EDUCATION 2020; 13:284-300. [PMID: 32306555 PMCID: PMC7264523 DOI: 10.1002/ase.1968] [Citation(s) in RCA: 219] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 05/03/2023]
Abstract
Australian and New Zealand universities commenced a new academic year in February/March 2020 largely with "business as usual." The subsequent Covid-19 pandemic imposed unexpected disruptions to anatomical educational practice. Rapid change occurred due to government-imposed physical distancing regulations from March 2020 that increasingly restricted anatomy laboratory teaching practices. Anatomy educators in both these countries were mobilized to adjust their teaching approaches. This study on anatomy education disruption at pandemic onset within Australia and New Zealand adopts a social constructivist lens. The research question was "What are the perceived disruptions and changes made to anatomy education in Australia and New Zealand during the initial period of the Covid-19 pandemic, as reflected on by anatomy educators?." Thematic analysis to elucidate "the what and why" of anatomy education was applied to these reflections. About 18 anatomy academics from ten institutions participated in this exercise. The analysis revealed loss of integrated "hands-on" experiences, and impacts on workload, traditional roles, students, pedagogy, and anatomists' personal educational philosophies. The key opportunities recognized for anatomy education included: enabling synchronous teaching across remote sites, expanding offerings into the remote learning space, and embracing new pedagogies. In managing anatomy education's transition in response to the pandemic, six critical elements were identified: community care, clear communications, clarified expectations, constructive alignment, community of practice, ability to compromise, and adapt and continuity planning. There is no doubt that anatomy education has stepped into a yet unknown future in the island countries of Australia and New Zealand.
Collapse
Affiliation(s)
- Nalini Pather
- Department of Anatomy EducationSchool of Medical SciencesFaculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Phil Blyth
- Department of AnatomySchool of Biomedical SciencesUniversity of OtagoDunedinNew Zealand
| | - Jamie A. Chapman
- Tasmanian School of MedicineCollege of Health and MedicineUniversity of TasmaniaHobartTasmaniaAustralia
| | - Manisha R. Dayal
- School of ScienceWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Natasha A.M.S. Flack
- Department of AnatomySchool of Biomedical SciencesUniversity of OtagoDunedinNew Zealand
| | - Quentin A. Fogg
- Department of Anatomy and NeuroscienceSchool of Biomedical SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Rodney A. Green
- Department of Pharmacy and Biomedical Sciences, College of Science, Health and EngineeringLa Trobe UniversityBendigoVictoriaAustralia
| | - Anneliese K. Hulme
- Department of Anatomy EducationSchool of Medical SciencesFaculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Ian P. Johnson
- Department of Biomedical SciencesFaculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Amanda J. Meyer
- School of Human SciencesFaculty of ScienceThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - John W. Morley
- School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Peter J. Shortland
- School of ScienceWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Goran Štrkalj
- Department of Anatomy EducationSchool of Medical SciencesFaculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Mirjana Štrkalj
- Department of Biomedical SciencesFaculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Krisztina Valter
- Medical Education UnitMedical SchoolCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Alexandra L. Webb
- Medical Education UnitMedical SchoolCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Stephanie J. Woodley
- Department of AnatomySchool of Biomedical SciencesUniversity of OtagoDunedinNew Zealand
| | - Michelle D. Lazarus
- Centre for Human Anatomy EducationDepartment of Anatomy and Developmental BiologyFaculty of Medicine Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
- Monash Centre for Scholarship in Health Education, Faculty of Medicine Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
| |
Collapse
|
33
|
Cornwall J, Hildebrandt S. Anatomy, Education, and Ethics in a Changing World. ANATOMICAL SCIENCES EDUCATION 2019; 12:329-331. [PMID: 31125503 DOI: 10.1002/ase.1898] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/09/2019] [Accepted: 05/21/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|