Movement System Theory and Anatomical Competence: Threshold Concepts for Physical Therapist Anatomy Education

Medical students' initial experiences of the dissection room and interaction with body donors: A qualitative study of professional identity formation, educational benefits, and the experience of Pasifika students

The first experience of medical students in the dissecting room (DR) likely influences professional identity formation (PIF). Sparse data exist exploring how exposure to the DR and body donors without undertaking dissection influences PIF, or how culture may influence this experience. This qualitative study explored students' first, non-dissection DR experience to determine how this contributes to PIF, including the impact of culture through a Pasifika-student lens. It also explored student perspectives on what learning opportunities are unique to this experience. Medical students with no prior DR experience were recruited and then interviewed after initial engagement with the DR and body donors. Questions included participant experiences, cultural perspectives, and how the DR differed from other teaching experiences. Interviews were recorded, transcribed, and analyzed thematically. Twenty students were interviewed (mean age 22 years, 12 females; 8 Pasifika) resulting in 520 min of audio recording (mean 26 min). Four primary themes were identified: professional identity formation, educational elements, death and spirituality, and cultural perspectives. Three subthemes including student experiences, behaviors, and environment were developed within each theme. Findings indicate development of PIF likely occurs from a single engagement with body donors without undertaking dissection, including recognition of professional role. Culture can play an important role for students, with several Pasifika students viewing the DR as a "cultural purgatory". Unique learning experiences are identified, such as cultural awareness around behaviors with the dead. The experience is an educational "threshold concept" where students likely undergo substantial developments in PIF, and educational initiatives to support students are outlined.

Predicting performance in a doctor of physical therapy gross anatomy course based on an exploratory factor analysis of the anatomical self-efficacy instrument

Measuring self-efficacy can be a valuable means for instructors to predict student performance. However, it is crucial to measure self-efficacy within specific contexts to effectively gauge students' perceptions of their capabilities. This study evaluated the factors comprising the Anatomical Self-Efficacy Instrument (ASEI) and determined whether these factors could predict performance in gross anatomy. Three cohorts of Doctor Physical Therapy (DPT) students completed the ASEI at the start of gross anatomy. An exploratory factor analysis (EFA) analyzed the ASEI's dimensionality, and Cronbach's alpha evaluated the internal consistency of the extracted factors. Linear regression was used to determine whether ASEI's total or subdomain scores predicted final anatomy course performance scores. In total, 142 of 287 (49.5%) DPT students completed the ASEI. EFA revealed three distinct factors, including "cognitive," "psychomotor," and "clinical anatomy self-efficacy", and explained 44.9%, 13.7%, and 5.2% of the total variance, respectively. Only cognitive self-efficacy predicted final gross anatomy course performance (β = 0.34; R2 = 0.071; F(3,138) = 3.51; p < 0.05). Overall, the ASEI's 3-factor solution implies its multidimensionality, a finding that could inform the development of more comprehensive self-efficacy measures. Notably, "cognitive self-efficacy" was the only subdomain that predicted DPT student performance in anatomy, suggesting its potential as a tool for identifying students in need of additional learning support. The ASEI's practical usability should be further explored through additional psychometric testing.

A Comparative Analysis of Physical Therapy Anatomical Knowledge and Retention: Human Donor Dissection Versus Virtual Laboratory

INTRODUCTION

Despite a long history of using human donor dissection (HDD) for physical therapy (PT) anatomy education, there are no PT guidelines that require HDD. The purpose of this quantitative causal-comparative study was to determine if Doctor of Physical Therapy students who used HDD had different grades both within anatomy and within courses that require retention and application of anatomical knowledge (kinesiology and a foundational musculoskeletal course) compared with those who used virtual 3-dimensional anatomical software (VAS).

REVIEW OF LITERATURE

Numerous factors affect the decision to use HDD within PT anatomy, and few PT studies have compared the effectiveness of VAS to HDD.

SUBJECTS

All students who took anatomy in an entry-level PT program from 2018 to 2021 (232 total students, 115 who used HDD in 2018-2019 and 117 who used VAS in 2020-2021).

METHODS

Mann-Whitney tests were used to compare anatomy grades (course, written examination, and practical examination) and future grades in kinesiology and a foundational musculoskeletal course for students who used HDD or VAS.

RESULTS

Physical therapy students who used VAS had statistically significant higher anatomy course grades (VAS 93.81% ± 4.99% to HDD 92.20% ± 4.53%) and higher practical examination grades (VAS 97.43% ± 2.91% to HDD 93.55% ± 4.39%) compared with those who used HDD. However, there were no significant differences between groups on written anatomy examinations (VAS 89.42% ± 7.21% to HDD 90.40% ± 4.94%), kinesiology grades (VAS 91.86% ± 4.52% to HDD 92.80% ± 4.27%), or foundational musculoskeletal grades (VAS 89.50% ± 3.89% to HDD 89.77% ± 3.83%).

DISCUSSION AND CONCLUSION

The causal-comparative study design prevents concluding that PT student grade differences were due exclusively to either anatomy laboratory method. It does provide preliminary evidence that the PT anatomy laboratory method did not practically affect anatomy performance or long-term application of anatomy knowledge in future coursework.

Constructive alignment: Teaching introductory gross anatomy to sport science students

The purpose of this descriptive article was to illustrate the process of using constructive alignment in redesigning an introductory gross anatomy unit that is taught specifically to sports science and physical education students at Victoria University. The unit was redesigned as an intensive learning unit in 2017 as part of a broader university-wide process. The teaching team decided that the first stage of the constructive alignment process should be necessarily focused on an understanding of the career destinations of graduates from the courses. With this understanding, it became easier to work through the redesign of intended learning objectives, the shift from systemic to regional anatomy changes in content and learning support mechanisms, and alterations to assessment practices. A comparison of student pass rates for the unit from 2018 to 2023 with pass rates in the previous semester-long version of the unit, suggests optimism about the changes that were made through the constructive alignment process. However, there were a number of other factors that may have contributed to this result, and more research is needed on the specific effectiveness of the changes made during the constructive alignment process before a confident conclusion about the success of the process can be made.

Online anatomy education during the Covid-19 pandemic: Opinions of medical, speech therapy, and BSc Anatomy students

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.

A proposed anatomy syllabus for entry-level physiotherapists in the United Kingdom: A modified Delphi methodology by physiotherapists who teach anatomy

The ever-increasing scope of physiotherapy practice is raising questions on what anatomical knowledge and skills ought to be taught within qualifying physiotherapy degree programmes in the United Kingdom (UK). The aim of the study was to create core anatomical knowledge and skills learning objectives to inform knowledge and skills for entry-level physiotherapists in the UK. A two phased modified Delphi methodology created a consensual anatomy curriculum. A Research-Team-Expert-Panel of four physiotherapists who teach anatomy proposed Anatomy Learning Objectives (Anat-LOs) and accompanying clinical rationales relevant for newly qualified entry-level physiotherapists. A Teacher-Expert-Panel of nine physiotherapists who taught anatomy to physiotherapy students in the UK reviewed Anat-LOs in two consecutive Delphi Rounds, and rated and commented on each Anat-LO. After each Delphi Round, the Research-Team-Expert-Panel reviewed the ratings and comments from the Teacher-Expert-Panel and banked Anat-LOs that passed the 85% acceptance threshold. There were 182 banked Anat-LOs that spanned all eight areas: Introductory Concepts, Principles and Basic Histology; Head and Neck; Thorax; Abdomen, Pelvis and Perineum; Upper Limb; Lower Limb; Spine; and Neuroanatomy regions/systems. The Anat-LOs develop both anatomical knowledge and key anatomical skills, such as palpation and conducting manual tests on model patients. A first ever core anatomy curriculum for entry-level physiotherapists has been created for entry-level physiotherapists, typically Band-5 NHS physiotherapists, and takes an integrated learning approach. The anatomy curriculum brings clarity to students, teachers, clinical supervisors and future employers on the expected anatomical standards for entry-level physiotherapists.

A core musculoskeletal anatomy syllabus for undergraduate physical therapy student education

Knowledge of musculoskeletal anatomy is fundamental to physical therapy education. Although detailed anatomy syllabi have been developed for medical and other health professional students, none are available for training physical therapists. Therefore, the aim of this project was to produce a core musculoskeletal anatomy syllabus specific to physical therapy students, utilizing a modified Delphi approach. An international Delphi panel (n = 53) composed of anatomists and clinicians involved in physical therapy education considered a total of 2193 anatomical items arranged in four categories (musculoskeletal concepts; vertebral column; pectoral girdle and upper limb; pelvic girdle and lower limb). Using specific criteria, items were rated on the basis of whether they were considered essential knowledge for a competent physical therapy student, and were categorized as core, recommended, not recommended or not core. Of the 2193 items, 1700 (77.5%) were rated as core or recommended. For musculoskeletal concepts, 70% (233/332) of items were categorized as core/recommended. Approximately 80% of items in the other three categories were considered core/recommended-vertebral column (355/440), pectoral girdle and upper limb (513/657), and pelvic girdle and lower limb (599/764). This project presents a detailed musculoskeletal anatomy syllabus which may be used within a physical therapy curriculum. A key difference compared to published musculoskeletal anatomy syllabi for medical students is that a greater number of items are considered core/recommended (approximately 80% vs. 50%). These findings will now be considered and deliberated in accordance with the International Federation of Associations of Anatomists modified Delphi approach.