Clinicians' opinions on the clinical relevance of anatomy education at Stellenbosch University

A consolidated summary of South African human skeletal repositories

AIM

Human skeletal repositories are crucial resources for research and education in human biology, variation, anatomy, biocultural frameworks, forensic/medico-legal casework, heritage and understanding the past. In this review paper, we assess the composition of human skeletal repositories in South Africa, along with the ethical and legal frameworks that safeguard their curation.

METHODS

The data and information pertaining to local human skeletal repositories were gathered through a combination of literature review and direct contact with local curators for information. Data pertaining to source origins, sample demographics, and temporal distribution (where applicable) were extracted and reporting trends across publications were assessed.

RESULTS

South Africa has 12 main human skeletal repositories, six affiliated with universities and six with museums. There are over 12 300 human skeletal remains housed across these repositories, mainly of cadaveric, archaeological, forensic (medico-legal), and unknown origin. Universities are primarily stewards of large cadaveric collections (n = ± 6 200); however, a few manage archaeological (n = ± 1 300) and forensic repositories (n = ± 1 000). Museums exclusively curate repositories of archaeological origin and approximately ± 3 700 archaeological individuals can be found countrywide.

CONCLUSIONS

The ethical challenges faced by South African repositories are deeply connected to the country's colonial and apartheid history. Concerns related to consent, autonomy, cultural sensitivity, data availability and the respectful treatment of the deceased, require constant attention and consideration. We highlight several initiatives undertaken to address these issues, including the implementation of new management approaches by repositories, a shift away from using unclaimed bodies, efforts in deaccessioning and repatriation and an increased focus on community engagement.

Relationship between the relative timing of prosection and dissection experiences and laboratory examination performance in a gross anatomy course

Reduced hours of instruction are reported within the gross anatomy education literature. Anatomy instruction continues to be challenged with motivating and inspiring learners to value the contribution of gross anatomy knowledge to their career development alongside increased organizational demands for efficiency and effectiveness. To address these demands, this retrospective study sought to understand how the relative timing and amount of gross anatomy instruction were related to examination performance. Undergraduate and graduate students between 2018 and 2022 were assigned to three cohorts determined by enrollment in prosection-based anatomy only (n = 334), concurrent enrollment in prosection- and dissection-based anatomy in the same semester (n = 67), or consecutive enrollment in the courses one year apart (n = 43). Concurrent students had higher prosection-based anatomy examination scores than prosection-only and consecutive students. Consecutively, enrolled students outperformed concurrently enrolled students on the first two dissection examinations but showed no performance differences on the third and fourth dissection examinations. While the results on the timing and presentation of anatomical instruction were inconclusive, the results do support increased instructional time using both prosection and dissection modalities concurrently to improve performance on identification-based gross anatomy examinations.

On the added benefit of virtual anatomy for dissection-based skills

Technological approaches deploying three-dimensional visualization to integrate virtual anatomy are increasingly used to provide medical students with state-of-the-art teaching. It is unclear to date to which extent virtual anatomy may help replace the dissection course. Medical students of Johannes Kepler University attend both a dissection and a virtual anatomy course. This virtual anatomy course is based on Cinematic Rendering and radiological imaging and teaches anatomy and pathology. This study aims to substantiate student benefits achieved from this merged teaching approach. Following their dissection course, 120 second-year students took part in objective structured practical examinations (OSPE) conducted on human specimens prior to and following a course on Cinematic Rendering virtual anatomy. Likert-based and open-ended surveys were conducted to evaluate student perceptions of both courses and their utility. Virtual anatomy teaching was found to be unrelated to improvements in student's ability to identify anatomical structures in anatomical prosections, yielding only a 1.5% increase in the OSPE score. While the students rated the dissection course as being more important and impactful, the virtual anatomy course helped them display the learning content in a more comprehensible and clinically applicable way. It is likely that Cinematic Rendering-based virtual anatomy affects knowledge gain in domains other than the recognition of anatomical structures in anatomical prosections. These findings underline students' preference for the pedagogic strategy of the dissection course and for blending this classical approach with novel developments like Cinematic Rendering, thus preparing future doctors for their clinical work.

Clinicians' and Students' Perceptions and Attitudes Regarding the Anatomical Knowledge of Medical Students

BACKGROUND

In both the preclinical and clinical sciences, anatomy is considered as the foundation of medical education. Anatomy education serves as a foundation for clinical application and future practice of medicine. Health practitioners and students are interested in the adequacy of anatomical knowledge in clinical years since it has a direct impact on medical education and professional clinical practice.

OBJECTIVE

To examine the opinions and attitudes of medical students and clinicians regarding the preclinical and clinical years' teaching of anatomy and anatomical knowledge to medical students.

METHODS

Participants in the study, including clinicians and medical students, were required to answer an 8-question, 5-point Likert scale questionnaire to assess their attitudes regarding anatomical knowledge. The maximum score was 40, and the higher the score, the more the positive attitude towards anatomical knowledge. The difference in the mean attitude score between males and females was investigated using the Independent sample t-test.

RESULTS

A total of 327 clinicians and 423 students participated in the study. Clinicians and students showed moderately high positive attitude towards anatomical knowledge. The mean statements score for clinicians' attitudes was 31.4(±3.4). There was no significant difference between total attitude score means for clinicians and students, p=0.83. Attitude statements attained a significantly higher percentages and were in favor to clinicians in comparison to students, particularly for clinical significance of anatomical knowledge to students in the clinical years, the importance of anatomical knowledge to surgical and non-surgical specialties, and re-teaching special anatomy for students in the clinical years would improve their clinical background. Both clinicians and students expressed low agreement regarding anatomical educational style and quality of study materials.

CONCLUSION

Teaching anatomy to medical students is a continuous process. Therefore, we recommend reforming the anatomy curriculum by vertical integration of anatomy into the clinical rotations, clerkship, and specialist training.