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Mathew R, Ramakrishnan N, Boland F, Pawlikowska T, Holland JC. Learning cardiac embryology on YouTube-What videos are there to view? ANATOMICAL SCIENCES EDUCATION 2024; 17:1495-1508. [PMID: 39073248 DOI: 10.1002/ase.2467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 12/12/2023] [Accepted: 05/20/2024] [Indexed: 07/30/2024]
Abstract
In modern medical curricula, embryology is typically taught through lectures, with a few institutions providing tutorials. The use of 3-D videos or animations enables students to study these embryological structures and how they change with time. The aim of this study was to assess the quality of cardiac embryology videos available on YouTube. A systematic literature review regarding the use of YouTube in teaching or learning cardiac embryology identified no papers that examined this specific question, and next, a systematic search of YouTube was performed. A total of 1200 cardiac embryology videos were retrieved using 12 specific search terms, with 370 videos retrieved under two or more search terms and excluded. A further 511 videos were excluded under additional, specific criteria. The remaining 319 videos were evaluated with the YouTube Video Assessment Criteria (UTvAC), with 121 rated as "useful." Videos on YouTube are uploaded with a wide audience in mind, from children to cardiologists, and content control is imperfect. Multiple videos were identified as duplicates of videos from original channels, typically without attribution. While 49 videos showed operations or human material, none contained an ethical statement regarding consent, and only 10 of these included an age restriction or graphical advisory. While there are useful videos for medical students studying cardiac embryology on YouTube, intuitive search strategies will also identify many with irrelevant content and of variable quality. Digital competence and search strategies are not innate skills, so educators should teach students to assess information so as to avoid overload or "filter failure."
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Affiliation(s)
- Ruth Mathew
- Department of Obstetrics & Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Niveta Ramakrishnan
- Medical Graduate, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Teresa Pawlikowska
- Health Professions Education Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Jane C Holland
- Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Mbagwu SI, Edem EE, Adegbilero-Iwari OE, Akunna GG, Makanjuola VO, Ogbo FO, Enye LA. Medical school students' perspectives on virtual anatomy education in a developing country. ANATOMICAL SCIENCES EDUCATION 2024; 17:1345-1357. [PMID: 39056180 DOI: 10.1002/ase.2486] [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: 11/06/2021] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024]
Abstract
Understanding the fundamental role anatomy education plays in medical training and taking into consideration the nascence of online education in Nigeria, this study evaluated the perceptions of medical and allied-health students toward online anatomy education both during the COVID-19 lockdown in Nigeria and for the future. For this study, Google Form questionnaires were distributed via different social and academic platforms to medical and allied-health students in Nigeria between September 28 and December 17, 2020. A total of 954 students participated in the study and 947 valid responses were recorded. The results showed that 77.6% of the students had reported computer/IT skills and 12.1% admitted that they had never attended an online class. Interestingly, 60% of the respondents disapproved of online learning approaches as effective tools for instructions in the anatomical sciences. Majority of the students (84%) agreed that their performance in anatomy would have been better if the classes were face-to-face, while 55% found the online anatomy classes uninteresting. Furthermore, 91.5% agreed that anatomy educators needed advanced skills for online education, while 94.2% agreed that anatomy online teaching needs more advanced technology to be implemented in Nigeria. This study revealed an overall negative perception about the suitability and effectiveness of online anatomy education in Nigerian medical/health training. This study recommends further investigations into the challenges that were presented during online anatomy education at the peak of the pandemic. This will help direct the development and implementation of a workable and sustainable online education model for anatomical sciences in Nigeria.
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Affiliation(s)
- Smart I Mbagwu
- Department of Anatomy, Faculty of Basic Medical Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Edem E Edem
- Department of Human Anatomy, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
| | - Oluwaseun E Adegbilero-Iwari
- Department of Community Medicine, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
| | - Gabriel G Akunna
- Department of Anatomy, College of Health Sciences at, Benue State University, Makurdi, Benue State, Nigeria
| | - Victor O Makanjuola
- Department of Anatomy, College of Medicine and Health Sciences, Bingham University, Karu, Nigeria
| | - Felix O Ogbo
- Department of Anatomy, Faculty of Basic Medical Sciences, State University of Medical Sciences, Igbo Eno, Nigeria
| | - Linus A Enye
- Department of Human Anatomy, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
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3
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Pettersson A, Karlgren K, Hjelmqvist H, Meister B, Silén C. An exploration of students' use of digital resources for self-study in anatomy: a survey study. BMC MEDICAL EDUCATION 2024; 24:45. [PMID: 38195470 PMCID: PMC10777562 DOI: 10.1186/s12909-023-04987-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND The development of technology has provided new ways for active engagement and for visualizing structures in anatomy education including digital resources that may be used outside of the classroom. To support students' learning, there is a need to better understand students' experiences of using digital resources. This study aimed to identify which resources students use, their preferences, the purpose of using them, and barriers to adopting tools for self-study of anatomy. METHODS A mixed -methods approach combining qualitative and quantitative data was used to collect and analyse data. Two consecutive cohorts of first-semester medical students (n = 278) were invited to complete an anonymized survey. The survey consisted of itemized questions, free-text space for comments, and one open-ended question. Descriptive statistics were used for demographics and itemized answers. Comments and free-text answers were analysed qualitatively using abductive inference. RESULTS One hundred and twenty-seven students completed the survey (response rate 45%). Most students (46%) reported that they spend more than 30 h/per week on self-study. They used a variety of digital resources for different purposes. Most students used digital resources to prepare for examinations, when they encountered difficulties and after going through a section. Students reported that they would use digital resources to a greater extent if they were offered an introduction, if resources were more accessible, and if they could interact with a tutor. The free-text responses revealed that digital resources helped students understand anatomy, allowed them to make active choices, provided tools for repetition and memorization, accelerated and simplified the learning process, and complemented other learning resources. CONCLUSIONS Digital resources may support the understanding of anatomy by offering alternative modes of learning and providing a valuable complement to other learning resources. Educators should consider how digital resources are introduced and offer support and feedback.
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Affiliation(s)
- Anna Pettersson
- Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Solna, Sweden.
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Education, Development and Innovation, Södersjukhuset, Stockholm, Sweden
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Hans Hjelmqvist
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Björn Meister
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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4
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Bilella A, Eppler E, Link K, Filgueira L. Body painting, ultrasound, clinical examination, and peer-teaching: A student-centered approach to enhance musculoskeletal anatomy learning. ANATOMICAL SCIENCES EDUCATION 2024; 17:157-172. [PMID: 37670412 DOI: 10.1002/ase.2334] [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: 08/09/2022] [Revised: 07/12/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023]
Abstract
The presented course, established 2016 as a compulsory elective for 22nd-year bachelor medical students, aimed to enhance deep learning of upper and lower limb anatomy from a clinical perspective by a maximum of student-centered activities combining hands-on skills training with team-learning. Three cohorts (in total 60 students) participated in this study. Students rotated through body painting, ultrasound, and clinical investigation supervised by faculty or an experienced clinician. Teams of 3-4 students prepared presentations on clinical anatomy and pathological conditions, which by teacher- and peer assessments on average achieved >85% (mean 17.8/20 points ± 1.06). After each activity session, the students reported their learning experience through a reflective diary. Fifty students (83%) evaluated the course by a voluntary anonymous questionnaire combining Likert-type scale and free-text questions to assess, predominantly, perception of course activities and their perceived influence on learning anatomy. Journal reports and questionnaires revealed that the students highly valued the course, and 92% (29 females, 17 males) rated group work satisfying or well-perceived. The highest appreciation achieved ultrasound followed by clinical examination and body painting, which one third proposed to integrate into the regular dissection course. All students recommended the course to their younger peers. This course was feasible to integrate in the pre-existing curriculum. Limiting factors to offer this elective course to more students are availability of clinical teachers, technical equipment, and education rooms. Being student-directed tasks, body painting and reflective diary-writing would be feasible to implement without additional faculty, which we recommend to educators for student engagement activation.
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Affiliation(s)
- Alessandro Bilella
- Anatomy, University of Fribourg, Fribourg, Switzerland
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | | | - Karl Link
- Anatomy, University of Fribourg, Fribourg, Switzerland
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Khan J, Baatjes KJ, Layman-Lemphane JI, Correia J. Online anatomy education during the Covid-19 pandemic: Opinions of medical, speech therapy, and BSc Anatomy students. ANATOMICAL SCIENCES EDUCATION 2023; 16:892-906. [PMID: 36924347 DOI: 10.1002/ase.2271] [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: 03/08/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
With the emergence of the Covid-19 pandemic in 2020, it was difficult to predict if the "cadaveric-based (golden) standard" of teaching anatomy would be possible in the unforeseeable future. This forced traditional anatomical teaching and learning practices to be transitioned to remote online platforms. This study explored the opinions of anatomy students (n = 51), on their online learning experience of anatomy during the Covid-19 pandemic. A mixed methods approach using a descriptive, exploratory study design was conducted, by use of an online survey. The survey consisted of a six-point Likert scale and was assembled into four sub-categories. Likert scale options ranged from; strongly disagree, to strongly agree, and not applicable. Results obtained seem to tally with expectations, indicating an adequate theoretical course component with room to improve practical online teaching. Most participants had a positive perception of the theoretical course content, duration, and platforms of communication. Virtual classes were simple to navigate with few technical difficulties experienced by the participants. Students also noted having access to sufficient study material, videos, and additional online material. Overall, more than half of all participants reported adapting well to the remote learning environment, however, the greatest challenge experienced highlighted a sense of deprivation from the lack of cadaver exposure and hands-on instruction. This research highlighted the effects of the pandemic on the modality of anatomy education and how it affected students. Although anatomy is multi-modal, it can be concluded that it is possible to achieve academic success by using online learning methods.
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Affiliation(s)
- Johara Khan
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karin J Baatjes
- Dean's Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jodie I Layman-Lemphane
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Janine Correia
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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6
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Gitto L, Middleton FA, Reynolds ES, Thangamani S, Jaeger DA, Mihaila DM. Quantification and persistence of COVID-19 virus in recently deceased individuals before and after embalming. ANATOMICAL SCIENCES EDUCATION 2023; 16:802-813. [PMID: 37332120 DOI: 10.1002/ase.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 04/07/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023]
Abstract
The COVID-19 pandemic severely affected the medical education worldwide. The infection risk for medical students and healthcare personnel who work with COVID-19 positive cadavers or tissues remains unclear. Moreover, COVID-19 positive cadavers have been rejected by medical schools, adversely impacting the continuum of medical education. Herein, the viral genome abundance in tissues from four COVID-19 positive donors before and after embalming were compared. Tissue samples were collected from the lungs, liver, spleen, and brain both pre- and postembalming. The possible presence of infectious COVID-19 was determined by inoculating human tissue homogenates onto a monolayer of human A549-hACE2 cells and observing for cytopathic effects up to 72 h postinoculation. A real- time quantitative reverse transcription polymerase chain reaction was performed to quantify COVID-19 present in culture supernatants. Fully intact viral genome sequence was possible to obtain in samples with higher levels of virus, even several days postmortem. The embalming procedure described above substantially reduces the abundance of viable COVID-19 genomes in all tissues, sometimes even to undetectable levels. However, in some cases, COVID-19 RNA can still be detected, and a cytopathic effect can be seen both pre- and postembalmed tissues. This study suggests that embalmed COVID-19 positive cadavers might be used safely with appropriate precautions followed in gross anatomy laboratories and in clinical and scientific research. Deep lung tissue is the best specimen to test for the virus. If the tests on the lung tissues are negative, there is a very low likelihood that other tissues will show positive results.
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Affiliation(s)
- Lorenzo Gitto
- Department of Pathology, Cook County Medical Examiner's Office, Chicago, Illinois, USA
| | - Frank A Middleton
- Department of Neuroscience and Physiology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Biochemistry and Molecular Biology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Erin S Reynolds
- Department of Microbiology and Immunology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- State University of New York Center for Vector-Borne Diseases, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Vector Biocontainment Laboratories, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Institute for Global Health and Translational Sciences, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Saravanan Thangamani
- Department of Microbiology and Immunology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- State University of New York Center for Vector-Borne Diseases, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Vector Biocontainment Laboratories, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Institute for Global Health and Translational Sciences, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Daniel A Jaeger
- Department of Cell and Developmental Biology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Dana M Mihaila
- Department of Cell and Developmental Biology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Neurology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Physical Therapy, College of Health Professions, The State University of New York Upstate Medical University, Syracuse, New York, USA
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7
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Vasil'ev YL, Dydykin SS, Kashtanov AD, Molotok EV, Lyakisheva AA, Kytko OV, Kapitonova M, Vorobyov AA, Litvina EV, Filimonov VI, Bezhin AI, Kolsanov AV. A comparative analysis of lecturers' satisfaction with Anatomage and Pirogov virtual dissection tables during clinical and topographic anatomy courses in Russian universities. ANATOMICAL SCIENCES EDUCATION 2023; 16:196-208. [PMID: 36571469 DOI: 10.1002/ase.2248] [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: 11/16/2021] [Revised: 09/19/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
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.
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Affiliation(s)
- Yuriy L Vasil'ev
- Department of Operative Surgery and Topographic Anatomy, Sechenov University, Moscow, Russian Federation
| | - Sergey S Dydykin
- Department of Operative Surgery and Topographic Anatomy, Sechenov University, Moscow, Russian Federation
| | - Artem D Kashtanov
- Department of Operative Surgery and Topographic Anatomy, Sechenov University, Moscow, Russian Federation
| | - Ekaterina V Molotok
- Department of Operative Surgery and Topographic Anatomy, Sechenov University, Moscow, Russian Federation
| | - Alexandra A Lyakisheva
- Department of Operative Surgery and Topographic Anatomy, Sechenov University, Moscow, Russian Federation
| | - Olesya V Kytko
- Department of Operative Surgery and Topographic Anatomy, Sechenov University, Moscow, Russian Federation
| | - Marina Kapitonova
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Alexandr A Vorobyov
- Department of Operative Surgery and Topographic Anatomy, Volgograd State Medical University, Volgograd, Russian Federation
| | - Ekaterina V Litvina
- Department of Operative Surgery and Topographic Anatomy, Volgograd State Medical University, Volgograd, Russian Federation
| | - Vladimir I Filimonov
- Department of Operative Surgery and Topographic Anatomy, Yaroslavl State Medical University, Yaroslavl, Russian Federation
| | - Alexandr I Bezhin
- Professor A.D. Myasnikov Department of Operative Surgery and Topographic Anatomy, Kursk State Medical University, Kursk, Russian Federation
| | - Alexandr V Kolsanov
- Department of Operative Surgery and Clinical Anatomy with a Course of Innovative Technologies, Samara State Medical University, Samara, Russian Federation
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8
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Hayes JA, Temple-Smith MJ. Teaching vulval anatomy in the twenty-first century: The Australian experience. ANATOMICAL SCIENCES EDUCATION 2023. [PMID: 36807881 DOI: 10.1002/ase.2264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/12/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Anatomy has often been regarded as an immutable discipline where everything that needs to be known is known. This article focuses on the teaching of vulval anatomy, the diversification of gender in contemporary society, and the increasing popularity of the Female Genital Cosmetic Surgery (FGCS) industry. The binary language and singular structural arrangements contained in lectures and chapters on "female genital anatomy" are nowadays rendered exclusive and incomplete. A series of 31 semi-structured interviews with Australian anatomy teachers identified barriers and facilitators for teaching vulval anatomy to contemporary student cohorts. Barriers included lack of connection to contemporary clinical practice, time and technical difficulty involved in regularly updating online presentations, the crowded curriculum, personal sensitivity to teaching vulval anatomy, and reluctance to introduce inclusive terminology. Facilitators included lived experience, regular use of social media, and institutional initiatives toward inclusivity including the support of queer colleagues.
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Affiliation(s)
- Jennifer A Hayes
- Department of General Practice, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
- Department of Anatomy and Physiology, School of Biomedical Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Meredith J Temple-Smith
- Department of General Practice, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
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9
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Hortsch M, Girão-Carmona VCC, de Melo Leite ACR, Nikas IP, Koney NKK, Yohannan DG, Oommen AM, Li Y, Meyer AJ, Chapman J. Teaching Cellular Architecture: The Global Status of Histology Education. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1431:177-212. [PMID: 37644293 DOI: 10.1007/978-3-031-36727-4_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Histology or microanatomy is the science of the structure and function of tissues and organs in metazoic organisms at the cellular level. By definition, histology is dependent on a variety of microscope techniques, usually light or more recently virtual, as well as electron microscopy. Since its inception more than two centuries ago, histology has been an integral component of biomedical education, specifically for medical, dental, and veterinary students. Traditionally, histology has been taught in two sequential phases, first a didactic transfer of information to learners and secondly a laboratory segment in which students develop the skill of analyzing micrographic images. In this chapter, the authors provide an overview of how histology is currently taught in different global regions. This overview also outlines which educational strategies and technologies are used, and how the local and cultural environment influences the histology education of medical and other students in different countries and continents. Also discussed are current trends that change the teaching of this basic science subject.
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Affiliation(s)
- Michael Hortsch
- Departments of Cell and Developmental Biology and of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA.
| | | | | | - Ilias P Nikas
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Nii Koney-Kwaku Koney
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Korle Bu, Ghana
| | - Doris George Yohannan
- Government Medical College, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Aswathy Maria Oommen
- Government Medical College, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Yan Li
- Department of Human Anatomy, Histology and Embryology, Fudan University, Shanghai, China
| | - Amanda J Meyer
- Department of Anatomy, Physiology, and Human Biology, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Jamie Chapman
- Tasmanian School of Medicine, University of Tasmania, Hobart, TAS, Australia
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Cullinane DP, Barry DS. Dyad pedagogy in practical anatomy: A description of the implementation and student perceptions of an adaptive approach to cadaveric teaching. ANATOMICAL SCIENCES EDUCATION 2023; 16:99-115. [PMID: 35502120 PMCID: PMC10084083 DOI: 10.1002/ase.2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 03/30/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
Prior to the challenges imposed by the Covid-19 pandemic, anatomy practical sessions at Trinity College Dublin involved eight to 10 students per donor station, rotating between digital learning, anatomical models/osteology, and dissection activities for three hours weekly. To maintain cadaveric participation in the anatomy laboratory while adhering to distancing guidelines, a transition to dyad pedagogy was implemented. This mode of delivery allowed two students per donor station to spend one hour per week in the anatomy laboratory with all digital learning elements transferred to the virtual learning platform Blackboard as pre- and post-practical session learning activities. Dyad pedagogy has been explored in clinical settings and simulation procedural-based training but is yet to be fully verified in anatomy education. To determine the effectiveness of hybrid practical sessions and reduced donor to student ratios, the opinions of first year medical students were examined using an online questionnaire with a 51% response rate. Although students recognized the merits of more time in the anatomy laboratory, including opportunities for self-directed study and exposure to anatomical variation, they felt that having two students per station enabled sufficient hands-on time with the donor body and fostered learning opportunities that would not be possible with larger groups. Strong preferences for quality time with the donor body supported by online resources suggests this modality should be a key consideration in course design for anatomy curricula and emphasizes the importance of gauging students' preferences to optimize satisfaction and learning output when pivoting to blended learning strategies in anatomy education.
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Affiliation(s)
| | - Denis S. Barry
- Discipline of AnatomyTrinity College DublinThe University of DublinIreland
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11
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Evans DJR. Has pedagogy, technology, and Covid-19 killed the face-to-face lecture? ANATOMICAL SCIENCES EDUCATION 2022; 15:1145-1151. [PMID: 36102494 PMCID: PMC9826245 DOI: 10.1002/ase.2224] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/11/2022] [Accepted: 09/11/2022] [Indexed: 05/05/2023]
Abstract
The lecture has been around for centuries and has featured as a popular and frequent component in higher education courses across many disciplines including anatomy. In more recent years, there has been a growing shift toward blended learning and related pedagogies that encourage active participation of students in both face-to-face and online learning environments. Unfortunately, in many cases, the lecture, which has typically focused on the transmission of information from educator to student has not been adapted to become a more learner-oriented approach with opportunities for students to actively interact and engage. As a result, the future of whether the lecture should continue has once again become a center of debate. The consequence of the Covid-19 pandemic and its aftermath have added to this with institutions now looking to stop all lectures or offer them in an online format only. This commentary argues that lecture-style components could still feature within face-to-face and online provision, but only if they are used sparingly within a blended curriculum, have a defined use that aligns well to learning outcomes, are assessed as the most effective method pedagogically, and importantly integrate approaches and activities that promote student engagement. Anatomy educators have demonstrated for years that they are able to be at the forefront of pedagogical change and evidenced during the pandemic their agile and innovative ability to adapt and do things differently. Therefore, the fate of the lecture, at least in anatomy, may well be in their hands.
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Affiliation(s)
- Darrell J. R. Evans
- School of Medicine and Public HealthThe University of NewcastleCallaghanNew South WalesAustralia
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
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12
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Ghosh SK. Evolving strategies in whirlwind mode: The changing face of anatomy education during Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:1103-1119. [PMID: 35924417 PMCID: PMC9537882 DOI: 10.1002/ase.2214] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 05/28/2023]
Abstract
The Covid-19 pandemic stipulated adoption of unfamiliar strategies for delivering anatomy education in online mode. The factors which determine education strategies are variable across geographical regions. It was perceived that an overview of education strategies around the globe would be useful for anatomists. Hence this narrative review was undertaken to collate observations from different geographical regions pertaining to education strategies adopted during the pandemic. Data relevant to the topic of study were extracted from 12 articles that were selected from an initial pool of 317 articles based on search criteria set for the review. Subtle differences in core education strategies implied that baseline response from anatomists was similar across regions. It was evident that online digital tools were key elements of education strategies adopted by educators for delivering online anatomy classes across the globe. Interestingly, a considerable gap in terms of number and variety of online tools used for anatomy education (those requiring commercial purchase) was noted between economically developed and developing regions. This may have an impact on learning outcome for students and may even lead to variations in anatomical knowledge by regions. It was observed that offline human dissection sessions were incorporated into online practical classes in one region as positive cases showed a declining trend. This positive development is worth emulating elsewhere based on cautious assessment of prevailing situation. From a broad perspective timely introduction of education strategies ensured delivery of anatomy education during the pandemic and gave an evolved outlook to the fabric of anatomy education.
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13
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Smith CF, Freeman SK, Heylings D, Finn GM, Davies DC. Anatomy education for medical students in the United Kingdom and Republic of Ireland in 2019: A 20-year follow-up. ANATOMICAL SCIENCES EDUCATION 2022; 15:993-1006. [PMID: 34314569 PMCID: PMC9786311 DOI: 10.1002/ase.2126] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 05/28/2021] [Accepted: 07/24/2021] [Indexed: 05/24/2023]
Abstract
Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's "Tomorrow's Doctors." The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full-time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part-time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system-based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub-disciplines.
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Affiliation(s)
- Claire F. Smith
- Department of Medical EducationBrighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | - Samuel K. Freeman
- Department of Medical EducationBrighton and Sussex Medical SchoolUniversity of SussexBrightonUK
- Department of PediatricsRoyal Alexandra Children's HospitalBrightonUK
| | - David Heylings
- Department of Medical EducationNorwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Gabrielle M. Finn
- School of Medical SciencesFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - D. Ceri Davies
- Human Anatomy UnitDepartment of Surgery and CancerImperial College LondonLondonUK
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14
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Gasmalla HEE, Mossa AH, Taha MH, Wadi MM, Shehzad K, Abdalla ME, Hadie SNH. Promoting more future-ready anatomy education after the Covid-19 pandemic: A scoping review. ANATOMICAL SCIENCES EDUCATION 2022; 15:1120-1137. [PMID: 36205041 DOI: 10.1002/ase.2227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 09/19/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
The coronavirus disease 2019 (Covid-19) pandemic caused an abrupt transition from face-to-face to online anatomy teaching, learning, and assessment. Although online education has ensured the continuity of anatomy education during the pandemic, its implementation has been challenging, and its effectiveness has been questioned. Therefore, literature pertinent to online anatomy education during the pandemic is crucial to explain Covid-19's disruptions to this field. Accordingly, this scoping review explored changes, disruptions, and gaps in anatomy teaching and assessment during Covid-19 using an enhanced version of Arksey and O'Malley's six-stage protocol. Five online databases were searched for articles that described changes and disruptions in anatomy education. Three independent researchers were involved in titles, abstracts, and full texts screening, while another four researchers were independently involved in data extraction, charting, and synthesis. This review revealed six themes: immediate strategic plans and actions, teaching and learning changes, online assessment practice, students' and educators' receptivity and adaptability, online learning and assessment effects, and future directions. It also revealed four gaps: non-future-ready curricula, learning obstacles, administrative and teaching challenges, and online education ethical issues. The results were reported in tabular and narrative forms, following the PRISMA Extension for Scoping Reviews (PRISMA-ScR guidelines). Understanding the evolution and gaps in anatomy education during the Covid-19 pandemic will help anatomists design future-ready, adaptable curricula.
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Affiliation(s)
- Hosam Eldeen Elsadig Gasmalla
- Warwick Medical School, University of Warwick, Coventry, UK
- Department of Anatomy, Faculty of Medicine, Al Neelain University, Khartoum, Sudan
| | - Abubakr H Mossa
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed H Taha
- Medical Education Centre and College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Majed M Wadi
- Department of Medical Education, Qassim College of Medicine, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Khalid Shehzad
- Department of Anatomy and Histology, Qassim College of Medicine, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Mohamed Elhassan Abdalla
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Siti Nurma Hanim Hadie
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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15
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Abdellatif H, Al Mushaiqri M, Albalushi H, Al-Zaabi AA, Roychoudhury S, Das S. Teaching, Learning and Assessing Anatomy with Artificial Intelligence: The Road to a Better Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114209. [PMID: 36361089 PMCID: PMC9656803 DOI: 10.3390/ijerph192114209] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/01/2023]
Abstract
Anatomy is taught in the early years of an undergraduate medical curriculum. The subject is volatile and of voluminous content, given the complex nature of the human body. Students frequently face learning constraints in these fledgling years of medical education, often resulting in a spiraling dwindling academic performance. Hence, there have been continued efforts directed at developing new curricula and incorporating new methods of teaching, learning and assessment that are aimed at logical learning and long-term retention of anatomical knowledge, which is a mainstay of all medical practice. In recent years, artificial intelligence (AI) has gained in popularity. AI uses machine learning models to store, compute, analyze and even augment huge amounts of data to be retrieved when needed, while simultaneously the machine itself can be programmed for deep learning, improving its own efficiency through complex neural networks. There are numerous specific benefits to incorporating AI in education, which include in-depth learning, storage of large electronic data, teaching from remote locations, engagement of fewer personnel in teaching, quick feedback from responders, innovative assessment methods and user-friendly alternatives. AI has long been a part of medical diagnostics and treatment planning. Extensive literature is available on uses of AI in clinical settings, e.g., in Radiology, but to the best of our knowledge there is a paucity of published data on AI used for teaching, learning and assessment in anatomy. In the present review, we highlight recent novel and advanced AI techniques such as Artificial Neural Networks (ANN), or more complex Convoluted Neural Networks (CNN) and Bayesian U-Net, which are used for teaching anatomy. We also address the main advantages and limitations of the use of AI in medical education and lessons learnt from AI application during the COVID-19 pandemic. In the future, studies with AI in anatomy education could be advantageous for both students to develop professional expertise and for instructors to develop improved teaching methods for this vast and complex subject, especially with the increasing paucity of cadavers in many medical schools. We also suggest some novel examples of how AI could be incorporated to deliver augmented reality experiences, especially with reference to complex regions in the human body, such as neural pathways in the brain, complex developmental processes in the embryo or in complicated miniature regions such as the middle and inner ear. AI can change the face of assessment techniques and broaden their dimensions to suit individual learners.
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Affiliation(s)
| | | | | | | | | | - Srijit Das
- Correspondence: or ; Tel.: +968-24143546
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16
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Salman A, Qureshi AS, Umar Z, Riaz M, Usman M, Zulfiqar S, Ali U, Saeed H. Effects of COVID-19 pandemic on anatomy education of medical and dental students of Pakistan; a reality check. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:1495-1500. [PMID: 36260136 PMCID: PMC9580425 DOI: 10.1007/s00276-022-03034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 10/10/2022] [Indexed: 11/04/2022]
Abstract
Purpose Virtual anatomy education was the only way that supported the learning process of the students during the forced lockdown time of COVID-19 pandemic. The intention of the current study was to apprehend the expected challenges experienced by the medical and dental students during their cyber anatomy classes. Methods This study was carried on 300 1st and 2nd year medical and dental students who joined their respective college in January 2020, and consented to participate in the study. A multiple choice questionnaire regarding their stance about these online classes was formed and student’s feedback was taken. Results Most (80%) of the students longed for their traditional anatomy learning i.e., dissection courses, didactic lectures, interaction and motivation from their mentors and peer. The students blamed the learning without live dissections, models and microscopic slides for their lack of confidence. More than 80% students blamed inappropriate gadgets, absence of high-band internet connections, as possible barriers in their digital learning. Lack of self-motivation was considered by 66% students. Conclusions This situation of anatomy education while lockdown was not intentional and should not be taken as the silver bullet solution for a subject like anatomy. Although students had to face a lot of challenges but this shift to online mode went swiftly at the time of health crisis. This digital learning may extend for an indefinite period, the students’ feedback will be helpful in bringing appropriate and timely modifications in digital anatomy education.
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Affiliation(s)
- Amber Salman
- Department of Anatomy, The University of Faisalabad-Health Sciences Wings, Faisalabad, Pakistan
| | - Anas Sarwar Qureshi
- Department of Anatomy, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Zaima Umar
- Department of Anatomy, The University of Faisalabad-Health Sciences Wings, Faisalabad, Pakistan.
| | - Momna Riaz
- Department of Anatomy, The University of Faisalabad-Health Sciences Wings, Faisalabad, Pakistan
| | - Muhamad Usman
- Department of Anatomy, College of Veterinary and Animal Sciences, Narrowal, Pakistan
| | - Saba Zulfiqar
- Department of Anatomy, The University of Faisalabad-Health Sciences Wings, Faisalabad, Pakistan
| | - Uzma Ali
- Department of Anatomy, Faisalabad Medical University, Faisalabad, Pakistan
| | - Humaima Saeed
- Department of Physics, The University of Faisalabad-Health Sciences Wings, Faisalabad, Pakistan
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17
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Huang CY, Lai KC, Lai HL. Nurses' perspectives on the application of humanistic anatomical knowledge in clinical practice. ANATOMICAL SCIENCES EDUCATION 2022. [PMID: 36251364 DOI: 10.1002/ase.2228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/08/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Knowledge of human anatomy is vital for nurses. Medical educators use a variety of educational pedagogies, including the use of cadavers, to cultivate nursing students into competent and professional care providers and to help them gain authentic experience and knowledge before entering the workplace. Studies have provided numerous examples of students with positive learning experiences in human-centric (humanistic) anatomy courses; however, whether these positive experiences translate into effective clinical practice remains largely unknown. This study explored nurses' perspectives on the effects of a humanistic anatomy program on their nursing practice. Focus groups with semi-structured interview guidelines were conducted to collect data. Twenty-one nurses working in hospitals in Taiwan participated and divided themselves into four groups on the basis of willingness to participate and availability. The interviews were recorded using smartphones, and the recordings were transcribed using a computer. The transcriptions were then checked word by word artificially and analyzed by hand. Three main themes emerged during the analysis: adapting to the professional journey, managing time when providing humanistic care, and cultivating professionalism. The results demonstrate educators' expectations that humanistic anatomy education for nursing students expands students' professional knowledge and helps them develop humanistic competencies as professional nurses.
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Affiliation(s)
- Chiung-Yu Huang
- Department of Nursing, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Kuen-Cherng Lai
- Department of Anatomy, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hui-Ling Lai
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan
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18
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Stone D, Longhurst GJ, Dulohery K, Campbell T, Richards A, O’Brien D, Franchi T, Hall S, Border S. A Multicentre Analysis of Approaches to Learning and Student Experiences of Learning Anatomy Online. MEDICAL SCIENCE EDUCATOR 2022; 32:1117-1130. [PMID: 36160292 PMCID: PMC9483883 DOI: 10.1007/s40670-022-01633-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/01/2023]
Abstract
Introduction The approaches to learning students adopt when learning anatomy online could yield important lessons for educators. Dissection room teaching can encourage students to adopt a deep approach to learning anatomy. It was therefore hypothesized that the proportion of students adopting a deep approach to learning would be lower in a population learning anatomy online. This research aims to investigate the experiences of students learning anatomy online during the COVID-19 pandemic and the approaches to learning they adopted. Methods A survey was distributed to medical students at 7 universities across the UK and Ireland. The survey included two previously validated questionnaires: Approaches and Study Skills Inventory for Students and Anatomy Learning Experience Questionnaire. Results The analysis included 224 unique student responses. Students' approach to learning mirrored reports from previous studies conducted during face-to-face tuition with 44.3% adopting deep, 40.7% strategic, 11.4% surface, and 3.6% combined learning approaches. The university (p = 0.019) and changes to formative (p = 0.016) and summative (p = 0.009) assessments significantly impacted approach to learning. Students reported that online resources were effective but highlighted the need for clearer guidance on how to find and use them successfully. Conclusion It is important to highlight that students value in-person opportunities to learn from human cadaveric material and hence dissection room sessions should remain at the forefront of anatomical education. It is recommended that future online and/or blended provisions of anatomy teaching include varied resources that maximize engagement with media featuring cadaveric specimens. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-022-01633-7.
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Affiliation(s)
- Danya Stone
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, East Sussex, BN1 9PX UK
| | - Georga J. Longhurst
- Department of Anatomical Sciences, St George’s University of London, London, SW17 0RE UK
| | - Kate Dulohery
- School of Medicine, University of Sunderland, Sunderland, SR1 3SD UK
| | - Thomas Campbell
- School of Medicine, University College Dublin, Dublin, D04 V1W8 Ireland
| | | | - Dominic O’Brien
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, East Sussex, BN1 9PX UK
| | - Thomas Franchi
- School of Medicine, University of Sheffield, Sheffield, S10 2TN UK
| | - Samuel Hall
- Centre for Learning Anatomical Sciences, Southampton University, Southampton, SO17 1BJ UK
| | - Scott Border
- Department of Anatomy, University of Glasgow, Glasgow, G12 8QQ UK
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19
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Schurr AF, Burg BJ, Dickinson E, Granatosky MC. No cuts, no buts: Satisfaction of first-year medical students with a hybrid prosection-based model for learning gross anatomy during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:827-838. [PMID: 35726438 PMCID: PMC9350165 DOI: 10.1002/ase.2205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/31/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
Few realized the extent of disruption that the Covid-19 global pandemic would impose upon higher anatomical education. While many institutions were obliged to adopt a fully-remote online model, the New York Institute of Technology College of Osteopathic Medicine strove to develop a curriculum that would allow medical students to receive an in-person anatomy education. A hybrid model that emphasized learning from prosected cadavers and self-study stations was implemented, with the remainder of the students' time directed toward studying at home. Through an anonymous survey aimed at gleaning student satisfaction, this study demonstrates that this hybrid prosection-based anatomy course aligned with student preferences both assuming no health risk (64.6% agreed) and given the current risk of contracting Covid-19 (78.5% agreed). Generally, students felt that their education was equal to that of previous years (Likert scale = 3.24 ± 1.05), fostered an appreciation for anatomy (4.56 ± 0.59), promoted teamwork (4.13 ± 0.85), and prepared them for practical examinations (4.18 ± 0.74). Linear mixed-effect models demonstrated that specific differences in results could be attributed to students' preconceived preferences toward student-led dissections and to past medical training. Importantly, most students "disagree" (1.97 ± 1.00) that they were concerned about the risk of exposure to Covid-19 during in-person anatomy laboratory sessions. Areas requiring improvement were identified by the model, including the provision of access to the cadavers outside of the regularly scheduled laboratory times (3.89 ± 1.08). These findings should be utilized when designing future gross anatomy courses in response to the "new normal".
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Affiliation(s)
- Alissa F. Schurr
- New York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
| | - Brandon J. Burg
- New York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
| | - Edwin Dickinson
- Department of AnatomyNew York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
| | - Michael C. Granatosky
- Department of AnatomyNew York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
- Center for Biomedical InnovationNew York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
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20
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Zhang JF, Zilundu PLM, Fu R, Zheng XF, Zhou LH, Guo GQ. Medical students' perceptions and performance in an online regional anatomy course during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:928-942. [PMID: 35766990 DOI: 10.1002/ase.2208] [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: 09/08/2021] [Revised: 04/09/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
The present study evaluated the students' psychological well-being, experiences, performance, and perception of learning regional anatomy remotely. A regional anatomy remote learning curriculum was designed and learning materials were delivered virtually to 120 undergraduate medical students at Jinan University, China. All the students consented and voluntarily participated in this study by completing self-administered online questionnaires including the Zung's Self-Rating Anxiety and Depression Scales at the beginning and end of the learning session. A subset participated in focus group discussions. Most of the students (90.0%) positively evaluated the current distance learning model. More than 80% were satisfied with the content arrangement and coverage. Many students preferred virtual lectures (68.2%) and videos showing dissections (70.6%) during the distance learning sessions. However, writing laboratory reports and case-based learning were the least preferred modes of learning as they were only preferred by 23.2% and 14.1% of the students, respectively. There was no significant lockdown-related anxiety or depression reported by students using depression and anxiety scales as well as feedback from focus group discussions. The surveyed students' confidence scores in distance learning were significantly higher after 5 weeks than at the beginning of the session (3.05 ± 0.83 vs. 3.70 ± 0.71, P < 0.05). Furthermore, the present results showed no significant differences between the current group's academic performance in the unit tests as well as the final overall evaluation for different parts of the course compared to that of the previous year's cohort. The findings above were congruent with focus group discussion data that the use of the online teaching platform for regional anatomy significantly improved the students' confidence in virtual and self-directed learning and did not negatively affect their academic performance.
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Affiliation(s)
- Ji-Feng Zhang
- Department of Anatomy, Basic Medical College, Jinan University, Guangzhou, People's Republic of China
| | - Prince Last Mudenda Zilundu
- College of Dentistry, Ajman University, Ajman Emirate, United Arab Emirates
- Department of Anatomy, Sun Yat-sen School of Medicine, Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Rao Fu
- Department of Anatomy, Sun Yat-sen School of Medicine, Sun Yat-sen University, Shenzhen, People's Republic of China
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xue-Feng Zheng
- Department of Anatomy, Basic Medical College, Jinan University, Guangzhou, People's Republic of China
| | - Li-Hua Zhou
- Department of Anatomy, Sun Yat-sen School of Medicine, Sun Yat-sen University, Shenzhen, People's Republic of China
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Guo-Qing Guo
- Department of Anatomy, Basic Medical College, Jinan University, Guangzhou, People's Republic of China
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21
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Evans DJR, Pawlina W. The future of anatomy education: Learning from Covid-19 disruption. ANATOMICAL SCIENCES EDUCATION 2022; 15:643-649. [PMID: 35656637 DOI: 10.1002/ase.2203] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Darrell J R Evans
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Wojciech Pawlina
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
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22
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Cullinane DP, Barry DS. Breaking the norm: Anatomical variation and its key role in medical education. ANATOMICAL SCIENCES EDUCATION 2022; 15:803-805. [PMID: 34657381 DOI: 10.1002/ase.2141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Dearbhla P Cullinane
- Department of Anatomy, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin, Dublin 2, Republic of Ireland
| | - Denis S Barry
- Department of Anatomy, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin, Dublin 2, Republic of Ireland
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23
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Ishak A, AlRawashdeh MM, Meletiou-Mavrotheris M, Nikas IP. Virtual Pathology Education in Medical Schools Worldwide during the COVID-19 Pandemic: Advantages, Challenges Faced, and Perspectives. Diagnostics (Basel) 2022; 12:diagnostics12071578. [PMID: 35885484 PMCID: PMC9321717 DOI: 10.3390/diagnostics12071578] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
The COVID-19 pandemic shifted pathology education in medical schools worldwide towards online delivery. To achieve this goal, various innovative platforms were used by pathology educators and medical students, facilitating both synchronous and asynchronous learning. The aim of this study was to review the published evidence regarding remote pathology teaching at the medical school level during this period, present our own experience, and provide some perspectives regarding the best mode of pathology teaching post-pandemic. Among its advantages, virtual pathology education was considered among students and educators as convenient, flexible, and engaging, while learning outcomes were met and students’ academic performance was in general satisfactory. However, several challenges were faced. For instance, suboptimal internet connection compromised the flow of classes and was even associated with a lower academic performance. The lack of hands-on laboratory activities, such as operating the light microscope and tissue grossing, and the reduced student interactions among themselves and their instructors, were also pointed out as significant drawbacks of remote pathology education. Whereas online education has multiple advantages, experiencing the physical university environment, in-person interactions and teamwork, exposure to the “hidden curriculum”, and hands-on activities are vital for medical school education and future student development. In conclusion, the implementation of a blended approach in pathology education—where online and face-to-face sessions are jointly used to promote students’ engagement, interaction with their instructors and peers, and learning—could be the most optimal approach to pathology teaching in medical schools post-pandemic.
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Affiliation(s)
- Angela Ishak
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (M.M.A.)
| | - Mousa M. AlRawashdeh
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (M.M.A.)
| | | | - Ilias P. Nikas
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (M.M.A.)
- Correspondence:
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24
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Lachman N, Pawlina W. Reconsidering laboratory-based anatomy within the backdrop of digital transformation: Bringing an old practice into a new world. ANATOMICAL SCIENCES EDUCATION 2022; 15:439-446. [PMID: 35429369 DOI: 10.1002/ase.2182] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Nirusha Lachman
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Wojciech Pawlina
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
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25
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Santos VA, Barreira MP, Saad KR. Technological resources for teaching and learning about human anatomy in the medical course: Systematic review of literature. ANATOMICAL SCIENCES EDUCATION 2022; 15:403-419. [PMID: 34664384 DOI: 10.1002/ase.2142] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
The consolidation of technology as an alternative strategy to cadaveric dissection for teaching anatomy in medical courses was accelerated by the recent Covid-19 pandemic, which caused the need for social distance policies and the closure of laboratories and classrooms. Consequently, new technologies were created, and those already been developed started to be better explored. However, information about many of these instruments and resources is not available to anatomy teachers. This systematic review presents the technological means for teaching and learning about human anatomy developed and applied in medical courses in the last ten years, besides the infrastructure necessary to use them. Studies in English, Portuguese, and Spanish were searched in MEDLINE, Scopus, ERIC, LILACS, and SciELO databases, initially resulting in a total of 875 identified articles, from which 102 were included in the analysis. They were classified according to the type of technology used: three-dimensional (3D) printing (n = 22), extended reality (n = 49), digital tools (n = 23), and other technological resources (n = 8). It was made a detailed description of technologies, including the stage of the medical curriculum in which it was applied, the infrastructure utilized, and which contents were covered. The analysis shows that between all technologies, those related to the internet and 3D printing are the most applicable, both in student learning and the financial cost necessary for its structural implementation.
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Affiliation(s)
- Vinícius A Santos
- School of Medicine, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | - Matheus P Barreira
- School of Medicine, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | - Karen R Saad
- Department of Morphology, School of Medicine, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
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Bauler LD, Lesciotto KM, Lackey-Cornelison W. Factors impacting the rapid transition of anatomy curricula to an online environment in response to Covid-19. ANATOMICAL SCIENCES EDUCATION 2022; 15:221-232. [PMID: 34898018 DOI: 10.1002/ase.2163] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Due to the Covid-19 pandemic, many academic institutions had to rapidly transition education to a remote online environment. While a hurdle for most educators, this transition posed an even greater challenge for anatomy educators, many of whom were forced to depart from the traditional cadaver-based laboratory to a virtual format. Recent publications have discussed the rapid transition to online formats necessitated by Covid-19 and the accompanying difficulties, but none have identified specific factors that influenced the difficulty of this transition. Anatomy educators were surveyed to examine how this transition was accomplished and perceived. Of the 165 educators who responded, the majority utilized cadaver-based laboratory instruction. Educators felt that transitioning the laboratory portion of their courses was significantly more difficult and required more time than converting lecture materials. Factors that impacted the difficulty of the transition included a number of pedagogical aspects of the pre-Covid-19 curricula, including the delivery format of prior content, availability of pre-existing electronic materials, and the laboratory technique previously used. Additionally, the length of time an educator had been teaching prior to Covid-19 impacted their perception of difficulty, with newer and more senior educators finding this much more challenging than mid-tenure educators. Ease of transition may be related to previous exposure to curricular reform, experience with multiple anatomy pedagogies, and educator adaptability. While not surprising that converting a cadaver-based laboratory to an online format was challenging, knowledge of the alignment of this difficulty with prior educator pedagogy can help guide future innovations to anatomy education.
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Affiliation(s)
- Laura D Bauler
- Department of Biomedical Sciences, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Kate M Lesciotto
- Department of Clinical Anatomy, College of Osteopathic Medicine, Sam Houston State University, Conroe, Texas, USA
| | - Wendy Lackey-Cornelison
- Department of Biomedical Sciences, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
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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.
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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
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28
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Basavanna PN, Ravishankar MV, Arora D. Anatomy lives in the dissection hall: Post-Covid-19 perception of students. ANATOMICAL SCIENCES EDUCATION 2022; 15:83-85. [PMID: 34826205 PMCID: PMC9011431 DOI: 10.1002/ase.2156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 05/21/2023]
Affiliation(s)
| | | | - Dyuksha Arora
- JSS Medical CollegeJSS Academy of Higher Education and ResearchMysoreIndia
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Nikas IP, Lamnisos D, Meletiou‐Mavrotheris M, Themistocleous S, Pieridi C, Mytilinaios DG, Michaelides C, Johnson EO. Shift to emergency remote preclinical medical education amidst the Covid-19 pandemic: A single-institution study. ANATOMICAL SCIENCES EDUCATION 2022; 15:27-41. [PMID: 34854255 PMCID: PMC9011537 DOI: 10.1002/ase.2159] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 08/09/2021] [Accepted: 11/29/2021] [Indexed: 05/22/2023]
Abstract
The Covid-19 pandemic disrupted medical education, shifting it towards emergency remote delivery. This cross-sectional study aimed to assess the impact of the pandemic on preclinical medical education and identify predictors of the virtual learning experience and perceived stress. An anonymous survey was delivered electronically to the students of the authors' medical school that attended either histology or pathology. This survey contained two scales, the virtual learning experience (VLE) and the perceived stress scale-10 (PSS-10). A total of 173/255 (68%) responded, showing a positive perception towards the remote delivery of both courses. An exploratory factor analysis was performed on the VLE scale items and four new dimensions were formed: "course quality and learning outcomes", "student motivation", virtual against F2F learning", and "virtual laboratory sessions". The following significant predictors of enhanced VLE, in at least one dimension, were identified: female gender, pathology course, final examination grade >80%, lower perceived stress levels, studying in home country, and holding of another degree before medical school. In addition, the following predictors were significantly associated with higher levels of student perceived stress: female gender, pathology course, studying away from home, and suboptimal internet connection. Notably, the quality of internet connection was significantly associated with the students' final examination performance. Concerning the best mode for future delivery of both courses, most students proposed a blended, rather than an entirely on-campus or online approach. In conclusion, despite its problems, a high-quality remote preclinical medical education was possible in the authors' school and offered tremendous opportunities for future improvement.
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Affiliation(s)
- Ilias P. Nikas
- School of MedicineEuropean University CyprusNicosiaCyprus
| | - Demetris Lamnisos
- Department of Health SciencesEuropean University CyprusNicosiaCyprus
| | | | | | - Chryso Pieridi
- School of MedicineEuropean University CyprusNicosiaCyprus
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30
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Kurtulmus‐Yilmaz S, Önöral Ö. Effectiveness of screen-to-screen and face-to-face learning modalities in dental anatomy module during Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:57-66. [PMID: 34719111 PMCID: PMC8653335 DOI: 10.1002/ase.2150] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 05/21/2023]
Abstract
The Covid-19 pandemic has forced all dentistry faculties to quickly shift to the online supplementation or replacement of traditional modules to pursue education. However, there is limited research evaluating the effectiveness of this education modality on student performance in dental anatomy and manipulation module. Accordingly, it was aimed to compare the influence of different education modalities on the performances of the students enrolled in this module. The students were requested to perform 11 practical assignments throughout the fall term. A total of 220 face-to-face-educated (F2F) and 138 screen-to-screen-educated (S2S) students were included. To evaluate the influence of education modality on the performances of the students, cumulative success scores were calculated and compared using an independent t-test. The grades of the first (maxillary central), sixth (maxillary premolar), and eleventh assignments (mandibular first molar) were also analyzed to understand the manipulation-skill progress of each student within the same year. The grades of above-mentioned three assignments were converted into nominal data (excellent, very good, good, acceptable, and fail) based on certain thresholds, and a chi-square test was conducted. The cumulative success scores in F2F group were significantly lower than those in S2S group (P = 0.02). Differences between the first and eleventh tasks in both education modalities were significant (P < 0.05). The S2S-educated students achieved significantly higher achievement points in the sixth and eleventh assignments (P < 0.001). The S2S education can be suggested as an applicable modality for teaching dental anatomy and manipulation module. However, further work is needed to ascertain whether this result is replicable throughout dental anatomy education.
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Affiliation(s)
| | - Özay Önöral
- Department of ProsthodonticsFaculty of DentistryNear East UniversityNicosia, Mersin10Turkey
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31
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Mahdy MAA, Sayed RKA. Evaluation of the online learning of veterinary anatomy education during the Covid-19 pandemic lockdown in Egypt: Students' perceptions. ANATOMICAL SCIENCES EDUCATION 2022; 15:67-82. [PMID: 34714602 PMCID: PMC8653125 DOI: 10.1002/ase.2149] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/11/2021] [Accepted: 10/26/2021] [Indexed: 05/21/2023]
Abstract
The sudden shift of veterinary anatomy teaching from traditional to online mode during the coronavirus disease 2019 (Covid-19) pandemic lockdown was a major challenge used for the first time in Egyptian veterinary medical schools. This study aimed to evaluate the students' perspectives regarding the shift of veterinary anatomy teaching to online mode during the lockdown in Egypt. A total of 502 students from all veterinary medical schools in Egypt (n = 17) answered the questionnaire. The results revealed that nearly two-thirds of students felt enthusiastic about studying anatomy online during the pandemic. Moreover, approximately 63% of students were satisfied with the provided learning materials, 66% were able to understand anatomy using the online learning system during the lockdown period, 67% were comfortable with technological skills during their online study, and 47% believed that online learning of anatomy could replace face-to-face teaching. Therefore, despite the problems associated with the emergency switch to remote teaching, it appears to be a suitable alternative in teaching veterinary anatomy in Egyptian universities during this pandemic crisis in Egyptian universities. Moreover, the study provided several measurements to overcome the common problems associated with this challenging method for future application, such as providing three-dimensional virtual tools and electronic devices with either free or low-priced Internet packages, and measuring students' understanding before and after each lecture. This is the first study to solicit the early students' feedback regarding the emergency shift to online veterinary anatomy teaching which might help decision-makers in Egypt for future implementation of online learning of veterinary anatomy.
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Affiliation(s)
- Mohamed A. A. Mahdy
- Department of Anatomy and EmbryologyFaculty of Veterinary MedicineSouth Valley UniversityQenaEgypt
| | - Ramy K. A. Sayed
- Department of Anatomy and EmbryologyFaculty of Veterinary MedicineSohag UniversitySohagEgypt
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32
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Saverino D, Zarcone D. Keeping histology students under the microscope during Covid-19 lockdown: Lessons learned from the University of Genoa. ANATOMICAL SCIENCES EDUCATION 2022; 15:86-88. [PMID: 34758199 PMCID: PMC8652816 DOI: 10.1002/ase.2153] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/28/2021] [Accepted: 11/06/2021] [Indexed: 05/06/2023]
Affiliation(s)
- Daniele Saverino
- Department of Experimental MedicineSchool of Medical and Pharmaceutical SciencesUniversity of GenovaGenovaItaly
- Department of AutoimmunologyPoliclinic hospital San Martino di GenoaGenovaItaly
| | - Daniela Zarcone
- Department of Experimental MedicineSchool of Medical and Pharmaceutical SciencesUniversity of GenovaGenovaItaly
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33
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Attardi SM, Harmon DJ, Barremkala M, Bentley D, Brown KM, Dennis JF, Goldman H, Harrell KM, Klein BA, Ramnanan C, Farkas GJ. An analysis of anatomy education before and during Covid-19: August-December 2020. ANATOMICAL SCIENCES EDUCATION 2022; 15:5-26. [PMID: 34758206 PMCID: PMC8653345 DOI: 10.1002/ase.2152] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/26/2021] [Accepted: 11/06/2021] [Indexed: 05/21/2023]
Abstract
Coronavirus disease-2019 (Covid-19) disrupted the in-person teaching format of anatomy. To study changes in gross anatomy education that occurred during August-December, 2020 compared to before the pandemic, an online survey was distributed to anatomy educators. The 191 responses received were analyzed in total and by academic program, geographic region, and institution type. Cadaver use decreased overall (before: 74.1 ± 34.1%, during: 50.3 ± 43.0%, P < 0.0001), as well as across allopathic and osteopathic medicine, therapy, undergraduate, and veterinary programs (P < 0.05), but remained unchanged for other programs (P > 0.05). Cadaver use decreased internationally and in the US (P < 0.0001), at public and private (P < 0.0001) institutions, and among allopathic medical programs in Northeastern, Central, and Southern (P < 0.05), but not Western, US geographical regions. Laboratories during Covid-19 were delivered through synchronous (59%), asynchronous (4%), or mixed (37%) formats (P < 0.0001) and utilized digital resources (47%), dissection (32%), and/or prosection (21%) (P < 0.0001). The practical laboratory examination persisted during Covid-19 (P = 0.419); however, the setting and materials shifted to computer-based (P < 0.0001) and image-based (P < 0.0001), respectively. In-person lecture decreased during Covid-19 (before: 88%, during: 24%, P = 0.003). When anatomy digital resources were categorized, dissection media, interactive software, and open-access content increased (P ≤ 0.008), with specific increases in BlueLink, Acland's Videos, and Complete Anatomy (P < 0.05). This study provided evidence of how gross anatomy educators continued to adapt their courses past the early stages of the pandemic.
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Affiliation(s)
- Stefanie M. Attardi
- Department of Foundational Medical StudiesOakland University William Beaumont School of MedicineRochesterMichiganUSA
| | - Derek J. Harmon
- Department of AnatomyUniversity of California, San Francisco, School of MedicineSan FranciscoCaliforniaUSA
| | - Malli Barremkala
- Department of Foundational Medical StudiesOakland University William Beaumont School of MedicineRochesterMichiganUSA
| | - Danielle C. Bentley
- Division of Anatomy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Kirsten M. Brown
- Department of Anatomy and Cell BiologyGeorge Washington University School of Medicine and Health SciencesWashingtonDCUSA
| | - Jennifer F. Dennis
- Department of AnatomyKansas City University College of MedicineJoplinMissouriUSA
| | - Haviva M. Goldman
- Department of Neurobiology and AnatomyDrexel University College of MedicinePhiladelphiaPennsylvaniaUSA
| | - Kelly M. Harrell
- Department of Anatomy and NeurobiologyVirginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | - Barbie A. Klein
- Department of AnatomyUniversity of California, San Francisco, School of MedicineSan FranciscoCaliforniaUSA
| | | | - Gary J. Farkas
- Department of Physical Medicine and RehabilitationUniversity of Miami Miller School of MedicineMiamiFloridaUSA
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34
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Patera E. Is There a Correlation Between How Medical Students Study and Prepare for Anatomy and the Reasons Why They Find Anatomy Difficult? ANATOMICAL SCIENCES EDUCATION 2021; 14:853-855. [PMID: 33876582 DOI: 10.1002/ase.2091] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/14/2021] [Accepted: 04/14/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Eleni Patera
- Department of Anatomy, School of Biomedical Sciences, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
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35
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Cheung CC, Yang J, Tipoe GL. Multifactorial learning challenges in anatomy: What is the niche in current research? ANATOMICAL SCIENCES EDUCATION 2021; 14:856-858. [PMID: 34313012 DOI: 10.1002/ase.2125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Chun Chung Cheung
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Jian Yang
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - George L Tipoe
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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36
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McWatt SC. Responding to Covid-19: A thematic analysis of students' perspectives on modified learning activities during an emergency transition to remote human anatomy education. ANATOMICAL SCIENCES EDUCATION 2021; 14:721-738. [PMID: 34523241 PMCID: PMC8652611 DOI: 10.1002/ase.2136] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/23/2021] [Accepted: 09/11/2021] [Indexed: 05/21/2023]
Abstract
In March 2020, the coronavirus disease 2019 (Covid-19) global pandemic forced many post-secondary institutions to move their teaching online, which had a substantial impact on students enrolled in laboratory-based courses in fields like human anatomy. This descriptive study collected students' perspectives on the transition to remote education, with specific attention to the teaching activities, resources, and assessments used in an undergraduate Clinical Human Visceral Anatomy course at McGill University. Through inductive semantic thematic analysis, student-held values for effective remote education were identified and grouped into the following themes: (1) preferences for communication, (2) values for remote learning activities and resources, (3) values for remote assessment, and (4) perceived positive and negative impacts of remote education on learning. Students generally valued having clear communication, opportunities for both synchronous and asynchronous learning activities, and flexible assessment formats that maintained alignment with the course outcomes and activities. Many felt that remote education had a net-negative impact on their learning, course satisfaction, and sense of community. However, there were no significant differences in grades on laboratory quizzes administered before and after the shutdown (P = 0.443), and grades on the remote final examination were significantly higher than those on the in-person midterm examination (P < 0.001). These findings are discussed in the context of modern educational theories and practices related to remote teaching. Strategies for facilitating a student-centered environment online are also proposed. Future longitudinal research into skill development, learning outcome attainment, and the evolving perspectives of students and instructors operating in remote education contexts is warranted.
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Affiliation(s)
- Sean C. McWatt
- Department of Anatomy and Cell BiologyFaculty of Medicine and Health SciencesMcGill UniversityMontréalQuébecCanada
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Longhurst GJ. Teaching a blind student anatomy during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2021; 14:586-589. [PMID: 34236766 PMCID: PMC8426809 DOI: 10.1002/ase.2120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/03/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
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de Carvalho Filho MA, Hafferty FW, Pawlina W. Anatomy 3.0: Rediscovering Theatrum Anatomicum in the wake of Covid-19. ANATOMICAL SCIENCES EDUCATION 2021; 14:528-535. [PMID: 34363339 PMCID: PMC9135058 DOI: 10.1002/ase.2130] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/07/2021] [Indexed: 05/07/2023]
Abstract
The Covid-19 pandemic has challenged medical educators internationally to confront the challenges of adapting their present educational activities to a rapidly evolving digital world. In this article, the authors use anatomy education as proxy to reflect on and remap the past, present, and future of medical education in the face of these disruptions. Inspired by the historical Theatrum Anatomicum (Anatomy 1.0), the authors argue replacing current anatomy dissection laboratory (Anatomy 2.0) with a prototype anatomy studio (Anatomy 3.0). In this studio, anatomists are web-performers who not only collaborate with other foundational science educators to devise meaningful and interactive content but who also partner with actors, directors, web-designers, computer engineers, information technologists, and visual artists to master online interactions and processes in order to optimize students' engagement and learning. This anatomy studio also offers students opportunities to create their own online content and thus reposition themselves digitally, a step into developing a new competency of stage presence within medical education. So restructured, Anatomy 3.0 will prepare students with the skills to navigate an emergent era of tele and digital medicine as well as help to foreshadow forthcoming changes in medical education.
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Affiliation(s)
- Marco Antonio de Carvalho Filho
- Life and Health Sciences Research InstituteSchool of MedicineUniversity of MinhoBragaPortugal
- Center for Education Development and Research in Health Professions (CEDAR)Lifelong Learning, Education and Assessment Research Network (LEARN)University Medical Centre GroningenGroningenThe Netherlands
| | - Frederic W. Hafferty
- Division of General Internal MedicineDepartment of MedicineMayo Clinic College of Medicine and ScienceMayo ClinicRochesterMinnesotaUSA
- Program in Professionalism and ValuesMayo ClinicRochesterMinnesotaUSA
| | - Wojciech Pawlina
- Department of Clinical AnatomyMayo Clinic College of Medicine and ScienceMayo ClinicRochesterMinnesotaUSA
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Thom ML, Kimble BA, Qua K, Wish‐Baratz S. Is remote near-peer anatomy teaching an effective teaching strategy? Lessons learned from the transition to online learning during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2021; 14:552-561. [PMID: 34268899 PMCID: PMC8426839 DOI: 10.1002/ase.2122] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/23/2021] [Accepted: 07/13/2021] [Indexed: 05/11/2023]
Abstract
In response to the Covid-19 pandemic, medical educators have transformed pre-clerkship anatomy curricula into online formats. The purpose of this study was to evaluate the effectiveness and student perceptions of an online near-peer anatomy curriculum. The classes of 2022 and 2023 completed identical foundational anatomy curricula in-person, whereas the class of 2024 completed an adapted curriculum for remote online learning. Quantitative and qualitative responses were used to compare attitudes between instructional methods. Assessment scores and evaluation survey responses were collected from the classes of 2022 (n = 185), 2023 (n = 184), and 2024 (n = 183). Mean assessment scores (±SD) for the classes of 2022, 2023, and 2024 were 93.64% (±5.86), 93.75% (±4.09), and 92.04% (±4.83), respectively. Post hoc group comparisons showed the class of 2024 scored significantly lower than the two previous classes [2022: (H(1) = 18.58, P < 0.001), 2023: (H(1) = 18.65, P < 0.001)]. Mean survey results concerning curriculum quality were 4.06/5.00 for the class of 2023 and 3.57/5.0 for the class of 2024 (t(365) = 2.67, P = 0.008). Considering a small effect size (η2 = 0.034), there was no meaningful difference in student assessment scores. A potential drawback of online near-peer anatomy teaching remains in student perceptions of course quality; qualitative feedback suggested technological limitations and perceptions of online course instructors were partly responsible for lower student satisfaction. Following the Covid-19 pandemic, medical educators should incorporate the lessons learned from this unique educational inflection point to improve curricula moving forward.
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Affiliation(s)
- Mitchell L. Thom
- Case Western Reserve University School of MedicineClevelandOhioUSA
| | - Blair A. Kimble
- Case Western Reserve University School of MedicineClevelandOhioUSA
| | - Kelli Qua
- Office of Curricular Affairs and AssessmentCase Western Reserve University School of MedicineClevelandOhioUSA
- Clinical and Translational Science CollaborativeCase Western Reserve University School of MedicineClevelandOhioUSA
| | - Susanne Wish‐Baratz
- Department of AnatomyCase Western Reserve University School of MedicineClevelandOhioUSA
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40
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Das S, Al Mushaiqri M. Anatomy Online Teaching During Covid-19 Pandemic: The Need for Responsive Anatomy Learning Ecosystem. ANATOMICAL SCIENCES EDUCATION 2021; 14:428-429. [PMID: 33818915 PMCID: PMC8251033 DOI: 10.1002/ase.2082] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 05/25/2023]
Affiliation(s)
- Srijit Das
- Department of Human and Clinical AnatomyCollege of Medicine and Health SciencesSultan Qaboos UniversityMuscatSultanate of Oman
| | - Mohamed Al Mushaiqri
- Department of Human and Clinical AnatomyCollege of Medicine and Health SciencesSultan Qaboos UniversityMuscatSultanate of Oman
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Baptiste YM. Digital Feast and Physical Famine: The Altered Ecosystem of Anatomy Education due to the Covid-19 Pandemic. ANATOMICAL SCIENCES EDUCATION 2021; 14:399-407. [PMID: 33961346 PMCID: PMC8239895 DOI: 10.1002/ase.2098] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 05/21/2023]
Abstract
This article explores the effects of the coronavirus disease 2019 (Covid-19) pandemic on the evolution of both physical and digital cadavers within the unique ecosystem of the anatomy laboratory. A physical cadaver is a traditional and established learning tool in anatomy education, whereas a digital cadaver is a relatively recent phenomenon. The Covid-19 pandemic presented a major disturbance and disruption to all levels and types of education, including anatomy education. This article constructs a conceptual metaphor between a typical anatomy laboratory and an ecosystem, and considers the affordances, constraints, and changing roles of physical and digital cadavers within anatomy education through an ecological lens. Adaptation of physical and digital cadavers during the disturbance is analyzed, and the resiliency of digital cadaver technology is recognized. The evolving role of the digital cadaver is considered in terms of increasing accessibility and inclusivity within the anatomy laboratory ecosystem of the future.
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Affiliation(s)
- Yvonne M. Baptiste
- Division of Science, Health, and MathematicsNiagara County Community CollegeSanbornNew York
- Curriculum, Instruction, and the Science of Learning PhD ProgramState University of New York at BuffaloBuffaloNew York
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Cortese K, Frascio M. New Settings in Anatomy and Surgery Teaching During the Covid-19 Pandemic. ANATOMICAL SCIENCES EDUCATION 2021; 14:430-431. [PMID: 33773083 PMCID: PMC8251397 DOI: 10.1002/ase.2077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 05/05/2023]
Affiliation(s)
- Katia Cortese
- Department of Experimental MedicineSchool of Medical and Pharmaceutical SciencesUniversity of GenoaGenoaItaly
| | - Marco Frascio
- Department of Surgical Sciences and Integrated DiagnosticsSchool of Medical and Pharmaceutical SciencesUniversity of GenoaGenoaItaly
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Barash A, Dickman N, Karasik D. Educating Future Doctors in Covid-19 Times: Anatomists Lead the Way! ANATOMICAL SCIENCES EDUCATION 2021; 14:426-427. [PMID: 33837676 PMCID: PMC8251054 DOI: 10.1002/ase.2086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 05/07/2023]
Affiliation(s)
- Alon Barash
- Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
- Research Institute, Ziv Medical CenterSafedIsrael
| | - Nomy Dickman
- Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
| | - David Karasik
- Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
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Roxburgh M, Evans DJR. Assessing Anatomy Education: A Perspective from Design. ANATOMICAL SCIENCES EDUCATION 2021; 14:277-286. [PMID: 33544967 DOI: 10.1002/ase.2060] [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: 08/07/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
Medical and healthcare practice is likely to see fundamental changes in the future that will require a different approach to the way in which we educate, train, and assess the next generation of healthcare professionals. The anatomical sciences will need to be part of that challenge so they continue to play a full role in preparing students with the knowledge and ever increasingly the skills and competencies that will contribute to the fundamentals of their future capacity to practice effectively. Although there have been significant advances in anatomical science pedagogy, by reviewing learning and assessment in an apparently unrelated field, provides an opportunity to bring a different perspective and enable appropriate challenge of the current approaches in anatomy. Design learning has had to continually reimagine itself in response to the shifting landscape in design practice and the threats associated with technology and societal change. Design learning has also long used a student-centric active pedagogy and allied authentic assessment methods and, therefore, provides an ideal case study to help inform future changes required in anatomical learning and assessment.
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Affiliation(s)
- Mark Roxburgh
- School of Creative Industries, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Darrell J R Evans
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Jones DG. Anatomy in a Post-Covid-19 World: Tracing a New Trajectory. ANATOMICAL SCIENCES EDUCATION 2021; 14:148-153. [PMID: 33463041 PMCID: PMC8014461 DOI: 10.1002/ase.2054] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/31/2020] [Accepted: 01/13/2021] [Indexed: 05/21/2023]
Abstract
In responding to Covid-19 anatomists have succeeded in adapting their teaching to online delivery. However, long-term reliance on this mode of teaching raises the prospect that transferring the whole of the learning environment to an impersonal digital world will lead to loss of anatomy's humanistic side. In looking to a future increasingly dependent upon digital input to teaching, a number of roadblocks are identified. These are: the peril of abandoning the ethos of anatomy; for the workload of staff and especially for female academic staff; by a lack of adequate resources; to the research nature of departments, including the quality of research; to the position of anatomy in the biomedical sciences; and from pressures to retreat from a dissection-based education. In tracing a future trajectory for anatomy, issues outlined are the inevitability of change, the need for anatomy to market itself to the world, and the opportunities presented for anatomy to view itself increasingly as a contributor to broad scholastic endeavors. Suggestions include exploring the possibilities presented by virtual anatomy museums, the use of online learning to reach those not normally in touch with anatomy teaching, and exploring the integrated courses with humanities disciplines. It is concluded that anatomy will flourish if there is a willingness to expand the traditional horizons and be prepared to integrate all that is best in the person-to-person and digital worlds.
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Affiliation(s)
- David Gareth Jones
- Department of AnatomyDivision of Health SciencesUniversity of OtagoDunedinNew Zealand
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Patra A, Chaudhary P, Ravi KS. Adverse Impact of Covid-19 on Anatomical Sciences Teachers of India and Proposed Ways to Handle This Predicament. ANATOMICAL SCIENCES EDUCATION 2021; 14:163-165. [PMID: 33404199 DOI: 10.1002/ase.2052] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/03/2021] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Apurba Patra
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Bathinda, India
| | - Priti Chaudhary
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Bathinda, India
| | - Kumar Satish Ravi
- National Journal of Clinical Anatomy, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
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Evans DJR, Pawlina W. Effects of Covid-19: The Need to Assess the Real Value of Anatomy Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:129-131. [PMID: 33547880 PMCID: PMC8013589 DOI: 10.1002/ase.2061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Darrell J. R. Evans
- School of Medicine and Public HealthThe University of NewcastleCallaghanNew South WalesAustralia
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
| | - Wojciech Pawlina
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and ScienceMayo ClinicRochesterMinnesota
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