A Scoping Review of Effective Teaching Strategies in Surface Anatomy

The combined effects of an anatomy program integrating drawing and gamification on basic psychological needs satisfaction among sport sciences students: Results of a natural experiment

According to self-determination theory, the need for competence, autonomy, and relatedness has been associated with intrinsic motivation. Fulfilling basic psychological needs can lead to better learning, academic performance, and well-being. In this study, an anatomy program integrated gamification and drawing methods to explore their influence on basic psychological needs satisfaction and potential learning implications. Basic psychological needs outcomes of sport sciences students were compared to test the effects of the Observe-Reflect-Draw-Edit-Repeat (ORDER) method and gamification (experimental condition) versus a non-ORDER and non-gamified program (control condition). These two different 30-h (7-week) anatomy education programs were implemented at two Spanish public universities with 116 first-year sport sciences students. Pre and post-treatment measurements were collected using the Basic Psychological Needs Satisfaction Scale. Statistical analyses included independent samples t-tests, ANCOVAs, and factorial repeated measures ANOVAs 2 × 2 (time × treatment). The gamified ORDER program achieved higher satisfaction scores in basic psychological needs compared to the control group (t = 2.98, p = 0.004, d = 0.54). Additionally, an interaction effect between time and treatment was observed (p = 0.042,η p 2  = 0.038). Treatment and interaction effects were observed for 'autonomy' (p = 0.003,η p 2  = 0.074) and 'competence' satisfaction (p = 0.048,η p 2  = 0.035). A time effect was found for 'relatedness' in the control group, but no significant treatment or interaction effects were identified. The causes of these effects are debated in the study, as well as the limitations. These findings support the notion that students' basic psychological needs are better satisfied in anatomy education with the implementation of this multimethod educational intervention based on ORDER and gamification.

The influence of collaborative learning and self-organisation on medical students' academic performance in anatomy

BACKGROUND

In 2021, university teaching at the Faculty of Medicine Tuebingen was transferred to a digital setting. Due to the discontinuation of face-to-face teaching, students lacked the temporal and spatial framework of the curriculum and the possibility to socialise with fellow students was extremely limited. Increased demands were placed on the students' self-organisation, and the possibility of collaborative learning was drastically limited. The present study investigated the extent to which these study conditions affected the academic performance of medical students in the oral exam after the 60-hour introductory anatomy lecture. Specifically, collaborative, and organisational learning strategies were considered.

METHODS

Learning strategies of 146 students were assessed by means of a questionnaire. The anatomy exam was used to assess the academic performance. In addition, students were asked to rate their own oral exam performance.

RESULTS

Students used strategies of collaborative learning (M = 3.30, SD = 0.88) and self-organisation (M = 3.28, SD = 0.72) about equally as often. A significant correlation was found between the use of collaborative learning strategies and the ability for realistic self-assessment (ρ = -0.22, P =.02). Collaborative behaviour could be divided into Initiative Collaborative Learning and Subordinate Collaborative Learning. Only the former had an influence on the ability for realistic self-assessment. Neither organisational learning strategies nor collaborative learning strategies had an influence on academic performance.

DISCUSSION AND CONCLUSION

Initiative collaborative learners showed a higher degree of realistic self-assessment. This could be explained through a more distinct social referencing, as fellow students' knowledge levels can be related early on to their own academic performance. There was no correlation between the learning strategies used and the exam result.

Using represented bodies in Renaissance artworks to teach musculoskeletal and surface anatomy

Surface anatomy is an important skill for students in preparation for patient care, and peer examination is often used to teach musculoskeletal and surface anatomy. An alternative pedagogical approach is to use bodies represented in artworks. Represented bodies display fictive anatomy, providing students with the opportunity to apply their musculoskeletal knowledge and to think critically when evaluating the anatomical fidelity of a represented body. An elective course at the University of Michigan enabled undergraduate students to analyze the musculoskeletal and surface anatomy depicted in Renaissance artworks. Students traveled to Italy in 2018 (n = 14) and 2022 (n = 15) to analyze the fictive anatomy portrayed in artistic sculptures and musculoskeletal structures depicted in wax anatomy models and sculpted skeletons. In assignments, students were asked to identify musculoskeletal structures as portrayed in the context of represented anatomy created by Italian Renaissance artists and to assess the fidelity of the depicted anatomy. The students also applied their knowledge of musculoskeletal anatomy to describe body position and evaluate muscle function in their assessments of the accuracy or inaccuracy of the fictive anatomy. The students reported that evaluating the anatomical fidelity of represented bodies in artworks supported their learning of musculoskeletal and surface anatomy, and that their critical thinking skills improved in the course. Evaluation of the anatomical fidelity of represented bodies in artworks is an effective pedagogical approach that can be implemented in art museums as an adjunctive learning experience to deepen students' musculoskeletal and surface anatomy knowledge and further develop their critical thinking skills.

Needs assessment of essential anatomy: The perspective of adult primary care resident physicians

Curricular development and modification involve first identifying a problem and then performing a needs assessment, which can guide the design of curricular components. Pedagogical changes, coupled with reductions in curricular time for gross anatomy, pose challenges and impose restrictions within medical school curricula. In order to make anatomy education effective and efficient, it is important to determine the anatomy considered essential for medical education through a targeted needs assessment. In this study, 50 adult primary care resident physicians in family medicine (FM) and internal medicine (IM) were surveyed to assess the importance of 907 anatomical structures, or groups of structures, across all anatomical regions from a curated list based on the boldface terms in four primary anatomy texts. There were no statistically significant differences in the ratings of structures between the two groups for any anatomical region. In total, 17.0% of structures, or groups of structures, were classified as essential, 58.0% as more important, 24.4% as less important, and 0.7% as not important. FM residents rated tissues classified as skeleton, nerves, fasciae, anatomical spaces, blood vessels, lymphatics, and surface anatomy (p < 0.0001) significantly higher than IM residents, but there were no differences in the rating of muscles or organs (p > 0.0056). It was notable that 100.0% of cranial nerves were classified as essential, and 94.5% of surface anatomy structures were classified as essential or more important. It is proposed that results of this study can serve to inform curricular development and revision.

Transforming musculoskeletal anatomy learning with haptic surface painting

Anatomical body painting has traditionally been utilized to support learner engagement and understanding of surface anatomy. Learners apply two-dimensional representations of surface markings directly on to the skin, based on the identification of key landmarks. Esthetically satisfying representations of musculature and viscera can also be created. However, established body painting approaches do not typically address three-dimensional spatial anatomical concepts. Haptic Surface Painting (HSP) is a novel activity, distinct from traditional body painting, and aims to develop learner spatial awareness. The HSP process is underpinned by previous work describing how a Haptico-visual observation and drawing method can support spatial, holistic, and collaborative anatomy learning. In HSP, superficial and underlying musculoskeletal and vascular structures are located haptically by palpation. Transparent colors are then immediately applied to the skin using purposive and cross-contour drawing techniques to produce corresponding visual representations of learner observation and cognition. Undergraduate students at a United Kingdom medical school (n = 7) participated in remote HSP workshops and focus groups. A phenomenological study of learner perspectives identified four themes from semantic qualitative analysis of transcripts: Three-dimensional haptico-visual exploration relating to learner spatial awareness of their own anatomy; cognitive freedom and accessibility provided by a flexible and empowering learning process; altered perspectives of anatomical detail, relationships, and clinical relevance; and delivery and context, relating to curricular integration, session format, and educator guidance. This work expands the pedagogic repertoire of anatomical body painting and has implications for anatomy educators seeking to integrate innovative, engaging, and effective learning approaches for transforming student learning.

Promoting more future-ready anatomy education after the Covid-19 pandemic: A scoping review

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.

Digital health for quality healthcare: A systematic mapping of review studies

Objective

To systematically catalogue review studies on digital health to establish extent of evidence on quality healthcare and illuminate gaps for new understanding, perspectives and insights for evidence-informed policies and practices.

Methods

We systematically searched PubMed database using sensitive search strings. Two reviewers independently conducted two-phase selection via title and abstract, followed by full-text appraisal. Consensuses were derived for any discrepancies. A standardized data extraction tool was used for reliable data mining.

Results

A total of 54 reviews from year 2014 to 2021 were included with notable increase in trend of publications. Systematic reviews constituted the majority (61.1%, (37.0% with meta-analyses)) followed by scoping reviews (38.9%). Domains of quality being reviewed include effectiveness (75.9%), accessibility (33.3%), patient safety (31.5%), efficiency (25.9%), patient-centred care (20.4%) and equity (16.7%). Mobile apps and computer-based were the commonest (79.6%) modalities. Strategies for effective intervention via digital health included engineering improved health behaviour (50.0%), better clinical assessment (35.1%), treatment compliance (33.3%) and enhanced coordination of care (24.1%). Psychiatry was the discipline with the most topics being reviewed for digital health (20.3%).

Conclusion

Digital health reviews reported findings that were skewed towards improving the effectiveness of intervention via mHealth applications, and predominantly related to mental health and behavioural therapies. There were considerable gaps on review of evidence on digital health for cost efficiency, equitable healthcare and patient-centred care. Future empirical and review studies may investigate the association between fields of practice and tendency to adopt and research the use of digital health to improve care.