Anatomy Learning from Prosected Cadaveric Specimens Versus Plastic Models: A Comparative Study of Upper Limb Anatomy

"Spine to the future"-A narrative review of anatomy engagement

Anatomy has been integral to medical and health education for centuries, it has also had a significant role in wider public life, as an educational resource, a link to their health, and also as a darker deterrent. Historically, public engagement in anatomy is hallmarked by public dissections of convicted criminals across the globe. Artists, specifically non-medical men, such as Leonardo da Vinci, are reported to have participated in public dissection. Dissection would later rekindle public interest in anatomy as graverobbing led to the reform and regulation of anatomy in many countries. In recent years, there has been growing interest from the public in learning more about their bodies as health and well-being become of paramount importance, particularly following the COVID-19 pandemic. Anatomy sits in a prime position to direct and instigate conversations around health, well-being, and body image. Every human on earth possesses a perfect resource to look at and learn about. Models, art-based anatomical activities, and crafts provide active learning opportunities for the wider public around anatomy. Most recently, apps, games, and extended reality provide novel and insightful learning opportunities for the public relating to the body. Finally, training and resources must also be made available from institutions and professional bodies to anatomists to enable them to deliver engagement in an already congested and educationally heavy schedule. This resurgence of interest in anatomical public engagement sees anatomy re-enter the public spotlight, with more appropriate resources and educational settings to offer engagement with the aim of benefiting the public.

Strategies to Effectively Utilize Images in Anatomical Teaching and Assessment

Anatomical images are commonly used in the teaching process to help students understand the spatial orientation of anatomical structures. Previous research has shown that images effectively visualize the relationship between anatomical structures that are difficult to comprehend through verbal or written explanations alone. However, there is a lack of guidelines that specifically address the various methods of utilizing anatomical images and delivering them through multimedia and cognitive load principles. This article aims to provide a concise overview of the proper utilization and delivery of anatomical images and how these images can facilitate student interaction.

Pilot Study on the Development and Integration of Anthropomorphic Models within the Dental Technician Curriculum

The effectiveness of modern medical education largely depends on the integration and utilization of digital technologies in teaching various disciplines. In this pilot usability study, we introduced 3D printed anthropomorphic dental models, specifically designed for the elective discipline "Digital and Metal-Free Techniques in Dental Technology" from the curriculum of the Dental Technician specialty in the Medical University of Varna. The evaluation focused on dental technician students' perception of this novel learning environment, its influence on their performance, and the potential for future application of these models and related 3D technologies in their professional practice. A validated satisfaction questionnaire was distributed among 80 students, comprising the total cohort. The results indicated a high acceptance rate, with nearly 95% of participants finding the use of digitally created 3D-printed dental models beneficial. More than 90% believed that exploring digital technologies would enhance their skills. The well-trained instructor's competence in technology use convinced students of its value, with more than 98% expressing a willingness to incorporate these technologies into their future work for improved precision in dental models. However, due to the current high cost of needed equipment, only 10% of participants may practicably introduce this novel technology into their practical work. The use of anatomically accurate 3D printed models is a valuable addition to the current dental technician curriculum in medical colleges.

Investigation of factors that influence the relationship between mental rotation ability and anatomy learning

BACKGROUND

Mental rotation is a cognitive process that involves the rotation of a mental representation of an object. This ability is important for medical students in studying anatomy as this subject requires the understanding of positional relations between organs.

OBJECTIVES

To find the effect of video learning of anatomy, training, gender, and type of practical exam on mental rotation ability. Also, to find correlation between mental rotation and anatomy scores.

METHODS

Two groups were recruited: group A studied practical anatomy online using videos due to the COVID-19 pandemic lockdown; group B studied anatomy labs on-campus on plastic models. Both groups underwent a mental rotation test. Group A took labs on-campus during their second year and this was considered a training course for their mental rotation ability. Both groups, then, took a second mental rotation test. Group A was finally given a practical anatomy exam using plastic models.

RESULTS

Males scored higher than females, though not significantly. The intervention course produced no significant change in mental rotation score of group A. Mental rotation score was correlated more with the theoretical anatomy exams than the MCQ-based practical exam, for both groups. For group A, mental rotation was better correlated with the model-based than the MCQ-based practical exam, especially the post-training score.

CONCLUSION

For students to take full advantage of their mental rotation ability, not only their practical anatomy sessions but their practical anatomy exams should be on anatomical specimens and not just videos or images.

Impact of gross anatomy laboratory on student written examination performance: A 3-year study of a large-enrollment undergraduate anatomy course

The efficacy of the various pedagogies that are used in human anatomy laboratories has been extensively debated. Nevertheless, an important question remains relatively unexamined-how the learning experience in the anatomy laboratory impacts students' mastery and application of anatomical knowledge beyond the laboratory setting. In this study, the effect of a prosection-based anatomy laboratory on overall comprehension and mastery of anatomical knowledge was evaluated in an upper division undergraduate anatomy curriculum that consists of a mandatory lecture course and an optional laboratory course. This flexible curricular structure permitted assessing the merit of laboratory learning on the written examination performance of the lecture course. In 2019 and 2022, the anatomy laboratory was taught in-person using prosections, while in 2021 due to the Covid-19 pandemic related regulations, it was taught remotely with live-streaming of prosections using document cameras. In both in-person and remote instructive formats, written examination scores of the lecture course were compared between two cohorts of students: Those enrolled in lecture only and those enrolled in both lecture and laboratory. Results showed that the cohort enrolled in both lecture and laboratory courses consistently outperformed the lecture-only cohort by one full letter grade. Furthermore, when the degrees of improvement on written examination scores were compared between the two instructive formats, in-person laboratory had a greater increase compared to remote laboratory. Altogether this study demonstrates that the prosection-based anatomy laboratory enhances students' mastery of anatomical knowledge beyond the laboratory setting by promoting comprehension of spatial relationships of anatomical structures.

A History of Musculoskeletal Medicine and Its Place and Progress in Undergraduate Medical Education

Musculoskeletal diseases are responsible for some of the most prevalent conditions affecting population health in the world. Despite the prevalence of these conditions, musculoskeletal medicine has a fraught history within the world of undergraduate medical education. We review the origins of musculoskeletal medicine, its evolution in undergraduate medical education, and progress that has been made over the last decade as a result of global initiatives such as the Bone and Joint Decade. Understanding the history of musculoskeletal medicine is essential to contextualizing the problems that exist today and creating comprehensive solutions to fill the gaps that persist in musculoskeletal curricula.

Creation of 21st century anatomy facilities: designing facilities for integrated preclinical education in the Middle East

BACKGROUND

The establishment of new anatomy facilities needs to accommodate a combination of modern teaching modalities that best align with evidence-based best teaching practices. This article describes the process in which our state-of-the-art anatomy laboratories were designed and implemented, and how these facilities support aspects of modern anatomy education.

METHODS

A list of best practices for anatomy education in a modern medical curriculum was summarized from the literature. To assess student satisfaction, a survey related to student perception of the anatomy facilities (5-point Likert scale) was conducted.

RESULTS

Our educational modalities include a broad range of teaching approaches. The Instructional Studio houses prosected and plastinated specimens, and cadaveric dissections are performed. Each of our three Dry Laboratories allow for active learning and interaction between small student groups. The Webinar Room acts as a conference room for departmental and online meetings, discussions with students, and dialogues with affiliated hospitals via the internet. The Imaging Center is equipped with a Sectra® medical educational platform, CAE Vimedix® Virtual Medical Imaging Ultrasound Training System, and Philipps Lumify® Ultrasound devices to train students to conduct and interpret sonographic images. Moreover, the Complete Anatomy® program is made available to all our students.

CONCLUSION

The layout of our newly created Anatomy Facilities allows for all aspects of modern medical education mentioned in the literature. These educational modalities and teaching approaches are highly appreciated by our faculty and students. Moreover, these technologies allowed for a smooth transition from on-site anatomy teaching to online education during the COVID pandemic.

A comparative analysis of lecturers' satisfaction with Anatomage and Pirogov virtual dissection tables during clinical and topographic anatomy courses in Russian universities

Anatomy is increasingly taught using computer-assisted learning tools, including electronic interactive anatomy dissection tables. Anatomage was he first virtual anatomy dissection table introduced in Russian medical universities and gained popularity among lecturers and students. The Pirogov interactive anatomy table was recently released, but the strengths and weakness of each platform is currently unknown. The objective of this article is to survey lecturers in anatomy to understand their perspectives on the Pirogov versus Anatomage virtual dissection tables' application to teaching in medical universities. A total of 80 anatomy educators from 12 Russian universities, using Anatomage (n = 40) and Pirogov (n = 40) tables were surveyed regarding their satisfaction with the application of the respective tables. Using a five-point Likert scale, both tables were assessed, and responses were statistically analyzed. In addition, qualitative analysis was performed on free response comments provided by survey respondents. There was no significant difference in overall satisfaction ratings between Pirogov (4.38 ± 0.53) and Anatomage (3.94 ± 0.60) interactive tables (p > 0.05). The Anatomage table ranked significantly higher on the accuracy of displayed anatomical details, resolution of the images, and its suitability for teaching senior medical and postgraduate students. Pirogov table performed significantly better on survey items measuring ergonomics, ability to assess students' performance, and teaching basic anatomy to junior first- and second-year medical students. Thus, in summary, anatomists' responses indicated that while both tables are suitable for teaching anatomy, the Pirogov table was superior in undergraduate medical education and the Anatomage table was more beneficial for teaching more senior trainees.

Musculoskeletal education in undergraduate medical curricula-A systematic review

Rheumatic and musculoskeletal diseases encompass a vast spectrum of up to 200 conditions that are increasingly prevalent, with significant associated disability and socioeconomic burden. Their impact is pervasive, with musculoskeletal conditions being the second leading cause of years lived with disability worldwide, in addition to the 9th most common cause of disability-adjusted life years. It is therefore imperative that all graduating medical physicians are competent in their management, and that the quality of undergraduate musculoskeletal education is commensurate with patient and societal needs. A systematic literature review was conducted between April 1, 2021 and June 1, 2021 assessing the quality of undergraduate musculoskeletal education in medical schools. Educational interventions in musculoskeletal medicine were also included. Quality assessment appraisal of the studies was done using a Mixed Methods Appraisal Tool. One thousand and thirty-three titles were screened, and 44 studies were included in the final analysis. Our analysis of these studies showed that the quality of undergraduate musculoskeletal education, as determined by the cognitive mastery and clinical confidence of undergraduate medical students remains inadequate. Multiple educational interventions were assessed with mixed results. Despite the prevalence, and burden associated with rheumatic and musculoskeletal diseases, the musculoskeletal education of undergraduate medical students remains inadequate. Urgent international collaboration is required to devise teaching strategies and curriculum initiatives that are globally and reproducibly applicable and effective. Further research into educational interventions and teaching strategies is also required.

Students' learning experiences of three-dimensional printed models and plastinated specimens: a qualitative analysis

BACKGROUND

Traditional cadaveric dissection is declining whilst plastinated and three-dimensional printed (3DP) models are increasingly popular as substitutes to the conventional anatomy teaching and learning methods. It is unclear about the pros and cons of these new tools and how they impact students' learning experiences of anatomy including humanistic values such as respect, care and empathy.  METHODS: Ninety-six students' views were sought immediately after a randomized cross-over study. Pragmatic design was used to investigate the learning experiences of using plastinated and 3DP models of cardiac (in Phase 1, n = 63) and neck (in Phase 2, n = 33) anatomy. Inductive thematic analysis was conducted based on 278 free text comments (related to strengths, weaknesses, things to improve), and focus group (n = 8) transcriptions in full verbatim about learning anatomy with these tools.

RESULTS

Four themes were found: perceived authenticity, basic understanding versus complexity, attitudes towards respect and care, and multimodality and guidance.

CONCLUSIONS

Overall, students perceived plastinated specimens as more real and authentic, thus perceived more respect and care than 3DP models; whereas 3DP models were easy to use and prefered for learning basic anatomy.

To Touch or Not to Touch: Evaluating Student Laboratory Outcomes of Hands-On versus Visual Examination of Prosected Cadavers

We utilized the physical manipulation of cadaveric donors by students to evaluate learning outcomes in two undergraduate anatomy courses. Students (n = 176) were assigned as those whom ‘manipulated’ (n = 100) or ‘did not manipulate’ (n = 76) donors, and data were compared to performance on laboratory assessments. A Fisher’s exact test was conducted within individual and combined course populations to assess if the relationship between physical touch and receiving a passing grade is more than expected by chance. BIO 201 ‘manipulating’ students received a ‘C’ or better (n = 58) vs. 6 D, F, or Withdraw grades (DFW) on lab practicals as compared to those who did not manipulate (n = 33 DFW vs. 18 C or better) (p < 0.0001). BIO 221 ‘manipulating’ students (n = 34) received a ‘C’ or better vs. DFW grades (n = 2), while ‘non-manipulating’ students were able to earn outcomes of ‘C’ or better (n = 13 vs. 12 DFW). However, students involved in donor manipulation were more likely to receive a ‘C or better’ (p = 0.0002). Analysis of the data as a single cohort indicates non-manipulating students are 7.24 times more likely to earn a ‘DFW’ on lab practicals, demonstrating that students are better prepared for laboratory assessments when encouraged to manipulate anatomical structures.

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

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

SETTINGS

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

PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

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

Wet Specimens, Plastinated Specimens, or Plastic Models in Learning Anatomy: Perception of Undergraduate Medical Students

BACKGROUND

Methods of teaching anatomy have shown major change as the medical undergraduate curriculum became more challenging. Traditional teaching methods like dissection and wet specimens are nowadays widely replaced by anatomical models, plastination, and technology-enhanced applications.

AIM

To explore the perception of undergraduate students of three methods of learning anatomy, which are wet specimens, plastinated specimens, and plastic models.

METHODS

This is a descriptive, cross-sectional, questionnaire-based study that included a sample of 268 male and female undergraduate medical students of the third and fourth study years at Ibn Sina National College for Medical Studies in Saudi Arabia.

RESULTS

Students in this study preferred wet specimens in regard to motivation to gaining anatomical knowledge in clinical context and usefulness for surgical career. On the other hand, they preferred plastinated specimens when it comes to feasibility of use, ability to differentiate between structures, and understanding complex structures.

CONCLUSION

Although the findings in general refer to preferring the use of wet specimens, no one modality seems to be enough for effectively learning anatomy. A combination of various modalities can provide the best benefit for medical students in this regard.

The practical examination types (spot test and slide test) of gross anatomy course in faculty of medicine: a simultaneous evaluation of the aspect of student success

PURPOSE

This study aimed to compare the students' scores of the spot (spotter/classical/traditional/tag/ring/bell-ringer) test (3D environment) performed in the laboratory with the slide test (gross anatomy images) (2D environment) in the class. The observation of our department regarding both types for practical examination was reported, in terms of exam marks of the students. Both are preferred as the practical examination types for gross anatomy course our in medical faculty.

METHODS

The 29 blocks' scores in 5 years (2013/2014-2017/2018) belonging to first- and second-year medical students' spot tests and slide tests are evaluated retrospectively and statistically compared. Correlations of the spot tests and the slide tests, besides the correlations between theoretical examinations and the practical examination types, are calculated.

RESULTS

Spot test scores were significantly higher (p < 0.05) in nine blocks, while slide test scores were higher significantly (p < 0.05) in fourteen. There was no statistically significant difference between the practical examination types (spot/slide) in six blocks. There were correlations between the spot test and the slide test in all blocks (p < 0.001).

CONCLUSION

It is considered that the spot test reflects the success/ability in a 3D environment, while the slide test reflects it in the 2D environment. In conclusion, neither of these two types of examinations stands out absolutely. Both types of examinations have their own features in areas, such as assessment power, applicability, and effect on success.

Evaluation of a 3D-MC examination format in anatomy

INTRODUCTION

The quality of education in medical anatomy is a fundamental pillar of good clinical practice. Current reforms of the medical curriculum have resulted in major methodological changes in the teaching and testing of anatomy. A number of recent studies have however described a decrease in positive metrics of anatomical knowledge among students so taught. It has been suggested that the reduced anatomical knowledge measured in these studies may endanger patient safety. As proxy measures of exam quality, evaluation of the levels of students 'achievement in the examinations, assessment of the subjectively perceived level of question difficulty and analysis of exam satisfaction are each suitable parameters of investigation of medical education.

MATERIAL AND METHODS

To address these issues with regard to medical education at the Charité-Universitätsmedizin Berlin, we have analyzed students' levels of achievement in the anatomical Three Dimensional Multiple Choice (hereafter, 3D-MC)-examination of 2,015 students matriculated in medical studies from Summer Semester of 2014 through Summer Semester of 2017. We either compared students' achievement levels of identical 3D-MC questions using models or prepared anatomical specimen. Furthermore, we have analyzed the type and frequency of cognitive levels used in the anatomical questions in relation to the students' level of achievement. Finally, we conducted an anonymous survey to measure students' (n = 207) and instructors' (n = 16) satisfaction with the 3D-MC-examination in comparison to other employed anatomical testing strategies.

RESULTS

Students' achievement is significantly enhanced with anatomical questions using models relative to those utilizing anatomical specimen. Over 80% of the anatomical questions in the 3D-MC-examinations assessed the lowest cognitive levels and higher cognitive question levels were accompanied by a significant decrease of the levels of students' performance. Our survey further revealed that both, students and instructors preferred the practical examinations in anatomy and that the difficulty levels of the 3D-MC-examination was perceived as being the lowest in comparison to the other anatomical testing strategies.

DISCUSSION

Testing levels of anatomical understanding using anatomical models is not comparable to human specimen, and thus using specimen before models should be preferred to learn and test close to an authentic medical situation. The application of anatomical models and low cognitive question levels in the examination reduces the subjectively perceived level of difficulty, encourages superficial learning, and therefore decreases the retention of anatomical knowledge.

CONCLUSION

Although students and instructors prefer practical examinations in anatomy, the current development does not reflect these results. Therefore, it would be recommendable to rethink the development of anatomical testing strategies based on the existing evidence.

Examining the Short-, Medium-, and Long-Term Success of an Embodied Learning Activity in the Study of Hand Anatomy for Clinical Application

A student's own body provides an often disregarded site of knowledge production and corporeal wisdom. Learning via cognitive processes anchored in physical movement and body awareness, known as embodied learning, may aid students to visualize structures and understand their functions and clinical relevance. Working from an embodied learning perspective, the current article evaluates the use of an offline physical learning tool (Anatomical Glove Learning System; AGLS) for teaching hand anatomy for clinical application in medical students. Two student samples (N₁  = 105; N₂  = 94) used the AGLS in two different ways. In the first sample, the AGLS was compared to a traditional approach using hand bones, models and prosected specimens. Secondly, the AGLS and traditional approach were combined. The evaluation consisted of three outcomes: short-term learning (post-test), medium-term applications (mock-objective structured clinical examination, MOSCE), and longer-term assessment (objective structured clinical examination, OSCE). Findings from the first sample indicated no significant differences between the AGLS and traditional laboratory groups on short- (F_(1,78) = 0.036, P = 0.849), medium- (F_(1,50) = 0.743, P = 0.393), or longer-term (F_(1,82) = 0.997, P = 0.321) outcomes. In the second sample using the AGLS in combination with a traditional approach was associated with significantly better short-term post-test scores (F_(2,174) = 5.98, P = 0.003) than using the AGLS alone, but demonstrated no effect for long-term OSCE scores. These results suggest an embodied learning experience alone does not appear to be advantageous to student learning, but when combined with other methods for studying anatomy there are learning gains.

Musculoskeletal anatomy: evaluation and comparison of common teaching and learning modalities

Anatomy teaching has traditionally been based on dissection. However, alternative teaching modalities constantly emerge, the use of which along with a decrease in teaching hours has brought the anatomy knowledge of students and young doctors into question. In this way, the goal of the present study is to a. compare the efficacy of the most common teaching modalities and b. investigate students' perceptions on each modality. In total, 313 medical students were taught gross anatomy of the upper limb, using four different learning modalities: dissection (n = 80), prosections (n = 77), plastic models (n = 84) and 3D anatomy software (n = 72). Students' knowledge was examined by 100 multiple-choice and tag questions followed by an evaluation questionnaire. Regarding performance, the dissection and the 3D group outperformed the prosection and the plastic models group in total and multiple-choice questions. The performance of the 3D group in tag questions was also statistically significantly higher compared to the other three groups. In the evaluation questionnaire, dissection outperformed the rest three modalities in questions assessing students' satisfaction, but also fear or stress before the laboratory. Moreover, dissection and 3D software were considered more useful when preparing for clinical activities. In conclusion, dissection remains first in students' preferences and achieves higher knowledge acquisition. Contemporary, 3D anatomy software are considered equally important when preparing for clinical activities and mainly favor spatial knowledge acquisition. Prosections could be a valuable alternative when dissection is unavailable due to limited time or shortage of cadavers. Plastic models are less effective in knowledge acquisition but could be valuable when preparing for cadaveric laboratories. In conclusion, the targeted use of each learning modality is essential for a modern medical curriculum.

Curriculum Reform and New Technology to Fill the Void of Musculoskeletal Education in Medical School Curriculum

Musculoskeletal (MSK) disease comprises over 20% of all visits to healthcare providers each year, yet a disproportionately small percentage of medical school education focuses on MSK disease. Even among students applying into orthopaedic surgery, less than 50% demonstrate prerequisite anatomic knowledge before beginning their residency. Medical school curriculum reform is needed, given that only 15% have a required MSK curriculum. Inadequate education ultimately leads to poor patient care and forces clinicians to learn MSK medicine later in practice. Although this inadequacy in medical school MSK education has been recognized for decades, little has changed to address this critical deficiency. A successful curriculum development requires defining critical MSK topics, evaluative methods to assess knowledge acquisition, and ultimately assessment of applying that knowledge to the care of patients. Newer strategies for MSK education include "near-peer" learning from senior classmates and residents, clinical immersion within MSK care teams, peer interest groups, and standardize learning platforms and assessment tools. Technologies such as virtual reality simulation, adaptive video learning, and other technologies will inform the development of affordable, succinct, evidence-informed curriculums that can enhance medical student MSK education with universal implementation. As clinical practice evolves to optimize patient care, so should the education of physicians who deliver that care.

Learning anatomy by virtual reality and augmented reality. A scope review

During the last century, there were no significant changes in the teaching methods of anatomy in universities, predominating expositive lectures, and anatomy laboratory activities. With the advent of new technologies, simulators, augmented reality, and virtual reality, new teaching possibilities have emerged that may provide assistance and, in some situations, replace traditional methods of teaching. In this narrative scope review we evaluate articles that compare traditional methods with virtual reality or augmented reality through a search on Cochrane library, MEDLINE, EMBASE, and LILACS databases, using the MeSH terms "Anatomy", "Virtual Reality", "Augmented Reality", "Video Games", "Education Medical, Undergraduate", "Teaching" and "Simulation Training". We concluded that virtual reality and augmented reality have a promising value for teaching anatomy in addition to a positive economic impact on universities.

The Effect of Stereoscopic Augmented Reality Visualization on Learning Anatomy and the Modifying Effect of Visual-Spatial Abilities: A Double-Center Randomized Controlled Trial

Monoscopically projected three-dimensional (3D) visualization technology may have significant disadvantages for students with lower visual-spatial abilities despite its overall effectiveness in teaching anatomy. Previous research suggests that stereopsis may facilitate a better comprehension of anatomical knowledge. This study evaluated the educational effectiveness of stereoscopic augmented reality (AR) visualization and the modifying effect of visual-spatial abilities on learning. In a double-center randomized controlled trial, first- and second-year (bio)medical undergraduates studied lower limb anatomy with stereoscopic 3D AR model (n = 20), monoscopic 3D desktop model (n = 20), or two-dimensional (2D) anatomical atlas (n = 18). Visual-spatial abilities were tested with Mental Rotation Test (MRT), Paper Folding Test (PFT), and Mechanical Reasoning (MR) Test. Anatomical knowledge was assessed by the validated 30-item paper posttest. The overall posttest scores in the stereoscopic 3D AR group (47.8%) were similar to those in the monoscopic 3D desktop group (38.5%; P = 0.240) and the 2D anatomical atlas group (50.9%; P = 1.00). When stratified by visual-spatial abilities test scores, students with lower MRT scores achieved higher posttest scores in the stereoscopic 3D AR group (49.2%) as compared to the monoscopic 3D desktop group (33.4%; P = 0.015) and similar to the scores in the 2D group (46.4%; P = 0.99). Participants with higher MRT scores performed equally well in all conditions. It is instrumental to consider an aptitude-treatment interaction caused by visual-spatial abilities when designing research into 3D learning. Further research is needed to identify contributing features and the most effective way of introducing this technology into current educational programs.