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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. [PMID: 39056180 DOI: 10.1002/ase.2486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [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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Yun YH, Kwon HY, Jeon SK, Jon YM, Park MJ, Shin DH, Choi HJ. Effectiveness and satisfaction with virtual and donor dissections: A randomized controlled trial. Sci Rep 2024; 14:16388. [PMID: 39014004 PMCID: PMC11252307 DOI: 10.1038/s41598-024-66292-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024] Open
Abstract
In recent years, human anatomy education has faced challenges with traditional donor dissection, leading to the emergence of virtual dissection as an alternative. This study aims to investigate the academic performance and satisfaction of medical students by comparing the virtual and donor dissections. An open-labeled crossover randomized controlled trial was conducted with 154 first-year medical students in Human Anatomy and Neuroanatomy laboratories, which were divided into three classes. Students were randomly assigned to either the virtual (virtual dissection followed by donor dissection) or donor (donor dissection followed by virtual dissection) groups in each class. A curriculum, incorporating head-mounted displays (HMDs), a life-sized touchscreen, and tablets, was developed. Data was evaluated through quizzes and surveys. In the Human Anatomy laboratory, each class of the donor group conducted heart extraction, dissection and observation. In observation class, the virtual group had a significantly higher mean quiz score than the donor group (p < 0.05). Compared to the donor, satisfaction was significantly higher for the HMD (understanding of concept and immersion), life-size touchscreen (esthetics, understanding of the concept, and spatial ability), and tablet (esthetics, understanding of the concept, spatial ability, and continuous use intention). In the Neuroanatomy laboratory, the virtual group showed significantly higher mean quiz scores than the donor group (p < 0.05), and tablet showed a significantly higher satisfaction than donor in terms of esthetics, understanding of the concept, and spatial ability. These results suggest that virtual dissection has the potential to supplement or replace donor dissection in anatomy education. This study is innovative in that it successfully delivered scenario-based virtual content and validated the efficacy in academic performance and satisfaction when using virtual devices compared to donor.Trial registration: This research has been registered in the Clinical Research Information Service (CRIS, https://cris.nih.go.kr/cris/search/detailSearch.do?search_lang=E&focus=reset_12&search_page=L&pageSize=10&page=undefined&seq=26002&status=5&seq_group=26002 ) with registration number "KCT0009075" and registration date "27/12/2023".
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Affiliation(s)
- Young Hyun Yun
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyeok Yi Kwon
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Su Kyoung Jeon
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Mi Jon
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min Jung Park
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Hoon Shin
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Hyung Jin Choi
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Metla SG, Akhtar-Danesh N, Saini J, Bayer I, Mezil Y, Brewer-Deluce D, Wainman BC. Anatomy beyond the pandemic: A Q-methodology study exploring student perceptions toward a hybrid curriculum. ANATOMICAL SCIENCES EDUCATION 2024; 17:831-843. [PMID: 38563458 DOI: 10.1002/ase.2415] [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: 08/18/2023] [Revised: 01/10/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
As a result of the COVID-19 pandemic, anatomy education was forced to adopt online modes of delivery. Previous research on student views revealed areas of strong preference (asynchronous lectures) and strong dislike (virtual specimens) in online anatomy courses. The current study seeks to compare the views of a single cohort of students experiencing both online and in-person undergraduate introductory anatomy and physiology courses. This comparison can highlight what students consider beneficial to their education and can inform future hybrid course offerings. Q-methodology was used to assess the opinions of students. Students sorted 41 statements on anatomy education in a quasi-normally distributed grid based on their degree of agreement with the statements. The rankings underwent a by-person factor analysis which categorized students with shared perceptions into groups. Data were collected from 246 students in the primarily online fall semester and 191 students in the primarily in-person winter semester. Analysis revealed three distinct factors (groups) in the cohort. Factor one (n = 113 (fall), n = 93 (winter)), was satisfied overall with the course materials and delivery. Factor two (n = 52 (fall), n = 18 (winter)) had a deep dislike of online learning, and factor three (n = 37 (fall), n = 49 (winter)) had a strong preference for online learning. While many students were comfortable in both online and in-person learning environments, this was not the case for all learners. The strengths and weaknesses of each teaching modality suggest the opportunity to explore hybrid learning as an option for future course offerings and specifically highlight valuable aspects to incorporate from each environment.
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Affiliation(s)
- Sai Gayathri Metla
- Bachelor of Health Sciences Honours Program, McMaster University, Hamilton, Ontario, Canada
| | | | - Jessica Saini
- Bachelor of Health Sciences Honours Program, McMaster University, Hamilton, Ontario, Canada
| | - Ilana Bayer
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
| | - Yasmeen Mezil
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
| | - Danielle Brewer-Deluce
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
| | - Bruce C Wainman
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
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Mohanraj PS, Das A, Rajendran V, Gopal N, Saravanan K, Balan Y. Evaluating the Effectiveness of Online Assessments and Their Parameters as Predictors of Academic Performance in Undergraduate Medical Education. Cureus 2024; 16:e62129. [PMID: 38993421 PMCID: PMC11238035 DOI: 10.7759/cureus.62129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
Background and objectives Considering the increasing utilization of online educational tools in medical education, it is essential to evaluate the reliability and validity of online assessments to accurately assess student proficiency and predict academic success. This study investigated the predictive efficacy of different online assessment methods in comparison to standard offline methods within the medical educational setting. Methods This study utilized a mixed-methods crossover design, involving 125 first-year medical students who were randomly assigned to either online or traditional examinations. The students then crossed over to the other type of assessment. The assessments consisted of multiple-choice questions (MCQs), viva voce, objective structured clinical examinations, and written theory examinations. Quantitative data on results, finishing times, and academic metrics were analyzed, along with qualitative data from student interviews exploring perceptions of each format. Results The online MCQs had the highest average scores and a moderately positive correlation with performance on the theory examination (r=0.326). Regression models indicated that online and offline MCQs were moderate positive predictors of theoretical marks (R2=0.106 and 0.107, respectively). Qualitative responses emphasized advantages such as flexibility and accessibility for online examinations but also concerns regarding technological challenges, interaction, and integrity compared to traditional formats. Conclusions Online MCQ assessments showed promise as indicators of medical student academic performance. However, additional online forms require improvement to match conventional assessments reliably. As medical education involves digital technologies, cautious implementation of online evaluations substantiated by further research is needed to preserve educational quality standards.
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Affiliation(s)
| | - Arani Das
- Physiology, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Vinoth Rajendran
- Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Niranjan Gopal
- Biochemistry, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
- Biochemistry, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
| | - Kothandan Saravanan
- Biochemistry, Postgraduate Institute of Medical Education and Research Satellite Centre Sangrur, Sangrur, IND
| | - Yuvaraj Balan
- Biochemistry, All India Institute of Medical Sciences, Madurai, Madurai, IND
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Faydenko J, Grieve T, Madigan D, Pocius JD, Olsen C, Cramer GD. Comparison of online to face-to-face instruction for anatomy review in a third-year clinical course. THE JOURNAL OF CHIROPRACTIC EDUCATION 2024; 0:0. [PMID: 38329314 PMCID: PMC11097218 DOI: 10.7899/jce-23-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/18/2023] [Accepted: 11/22/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE This project compared student learning and satisfaction of an anatomy review delivered by a face-to-face lecture (F2FL) and an online learning module (OLM) for third-year doctor of chiropractic students. METHODS This cohort study compared student learning and satisfaction of a pediatric spinal anatomy review delivered via F2FL (cohort 1, n = 23) and OLM (cohort 2, n = 18) in 2 successive 2019 (pre-COVID) course offerings. Previously validated pre- and post-tests were given. Students completed a survey assessing delivery, comfort with online learning and online learning technology, and preference of F2FL vs OLM of review material. Pre- and post-test results were assessed using repeated-measures analysis of variance. RESULTS Testing results showed an improvement with both groups (F2FL 53.7%, p < .001 vs OLM 51.8%, p < .001), with no significant difference between the F2FL and OLM groups (p = .53; p = .82). The survey showed: 83.3% of OLM students felt the online method was effective, and 88.9% of the OLM students would prefer online reviews or have no preference between online or face-to-face; meanwhile, 80% of the F2FL group thought the lecture engaging/effective, whereas 60% of the F2FL group would have preferred to have the material presented online. CONCLUSION The OLM was found to be as effective as the F2FL for the content assessed. The majority of students would prefer the online method for future anatomy review content presented in the course. This strategy could be applied to provide review materials in other clinical courses, allowing material to be developed and given by content experts while freeing valuable in-class time.
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Kitagawa N, Fukino K, Iwanaga J. Clinical dental anatomy active learning. J Dent Educ 2023; 87 Suppl 3:1797-1799. [PMID: 37249013 DOI: 10.1002/jdd.13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 05/31/2023]
Affiliation(s)
- Norio Kitagawa
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Fukino
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
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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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8
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Asad MR, Al Mutairi A, AlZahrani RE, Ahmed MM, Nazeer M, Taha M. Role of Living Anatomy in Medical Education: A Narrative Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S843-S845. [PMID: 37694003 PMCID: PMC10485445 DOI: 10.4103/jpbs.jpbs_235_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/19/2023] [Accepted: 03/26/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction There has been a significant change noticed in the way in how anatomy is taught and learned in last two decades. The use of teaching approaches such as body painting, peer physical examination, medical imaging, and virtual anatomy software in the teaching and learning of living anatomy was made possible by advancements in medical technology. This study focuses on a review of the historical context and contemporary developments in teaching and learning of live and surface anatomy with a special emphasis on its pedagogical elements, some opinions of medical educationists, and undergraduates. Conclusions It is suggested that living anatomy be included as a core subject in the curriculum. Learning about living anatomy will be improved in an integrated and pertinent framework with the inclusion and execution of teaching and learning modalities such as body painting, peer physical examination, medical imaging, and virtual anatomy software.
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Affiliation(s)
- Mohammad R. Asad
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia
| | - Ahmed Al Mutairi
- Department of Medicine, College of Medicine, Majmaah University, Saudi Arabia
| | - Raed E. AlZahrani
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia
| | - Mohammad M. Ahmed
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia
| | - Mohammed Nazeer
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia
| | - Mohamed Taha
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia
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Brusini A. The impact of Covid-19 pandemic on modification of medical teaching in Italy: A narrative review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:98. [PMID: 37288414 PMCID: PMC10243428 DOI: 10.4103/jehp.jehp_1393_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/20/2023] [Indexed: 06/09/2023]
Abstract
During the first wave of Covid-19 in Italy, there was a problem with University. Universities couldn't do face-to-face (FTF) lessons and started to do online lessons (OL). This study investigates the impressions of students, teachers, and institutions during the first wave situation. A search was conducted on the main international databases, and only studies conducted in Italy starting during the Covid-19 pandemic are considered. 9 studies tell about the impressions of students about OL lessons, and 10 studies speak about medical resident's situation and teacher's impressions. Studies about students give conflicting results, teachers are generally satisfied with the contents, but agree on the difficulty of not having relationships with students. Medical residents have reduced significantly the clinical and surgical practice, sometimes increasing the research. In the future, it is indispensable to create a system that guarantees the efficacy of FTF lessons for practice, it is still low in sanitary and medical courses in Italy during the pandemic period.
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Sadeghinezhad J. Online veterinary anatomy education during Covid-19 pandemic in Iran: Challenges and opportunities. Vet Med Sci 2023. [PMID: 36943939 DOI: 10.1002/vms3.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/28/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The covid-19 pandemic changed veterinary anatomy in-person training to inexperienced virtual training rapidly. OBJECTIVES This survey was designed to assess the perceptions of first- and second-year Iranian veterinary students on learning outcomes during the online transition. METHODS The opinions of 684 students were examined using questionnaire. RESULTS The data showed that 23.8% of students were interested in learning anatomy online and 24.8% were satisfied with it. Only 13.5% of the students in the survey generally agree with replacing remote teaching with ordinary training. Less than 1% of students considered online education suitable for the practical part of anatomy. Most of the students' sources for theoretical part included professor's booklets, narrated PowerPoint lectures, in-class notes, and anatomy books. Professors' dissection videos, YouTube videos and also anatomy atlases were the most used sources for practical part. Many students (69.3%) were comfortable using technology. Few numbers of the students (36.1%) were satisfied with the result of the online anatomy exam. Students commented missing dissection, lack of interaction and technology challenges as main negative-points of E-learning. While time management and reviewing the recorded lessons was described as one of the most important benefits. CONCLUSIONS Online education cannot replace face-to-face education in anatomy and it can be used along ordinary training as an additional educational tool. However, group online learning activities, using dissection videos and 3-D software are suggested for online learning. The data of this study, collected for the first time in Iran, can be used for future decisions in veterinary anatomy.
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Affiliation(s)
- Javad Sadeghinezhad
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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11
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Kirkness KB, Bazira PJ, Finn GM, Nizza IE. "Preparing them for the profession": An interpretative phenomenological analysis of anatomy educators coping with complexity in the United Kingdom curriculum. ANATOMICAL SCIENCES EDUCATION 2023; 16:237-251. [PMID: 36120944 DOI: 10.1002/ase.2225] [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: 10/26/2021] [Revised: 07/26/2022] [Accepted: 09/15/2022] [Indexed: 06/15/2023]
Abstract
Efforts to integrate the basic sciences into the ever-changing curriculum are a trending area of research in health professions education. Low-stakes, high-frequency assessment methods such as the progress test are now widely implemented in the United Kingdom and Northern Ireland as a means of furthering curricular integration toward contemporary goals of competency and professional identity formation. The anatomy educator's experience vis-à-vis these curricular changes is not well understood. This study aimed to explore how anatomy educators make sense of the shifting demands of their role. The interviews were semi-structured, particularly concerned with the phenomenon of teachers adapting to the complexity of their learning environment. The study used interpretative phenomenological analysis (IPA) to focus on the lived experiences of participants coping with the phenomena in question: how do anatomy educators make sense of the learning environment in the United Kingdom? Interviews were transcribed verbatim and interpreted inductively, identifying four key themes: confidence through connectedness, variations in appraisals of curricular integration, managing expectations to perform in paradoxical situations, and the emergence of innovative teaching. Results point to the learning environment as a complex system and highlight the importance of feeling support from and connection to colleagues, enabling individual educators to develop confidence, meet the top-down demands of changing curricula, and experience personal identity development and uncertainty tolerance within their role. This IPA study offers insight into the lived experiences of anatomy educators whose experiential interpretations of a complex and changing curriculum can uniquely inform stakeholders in health professions education.
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Affiliation(s)
- Karen B Kirkness
- Health Professions Education Unit (HPEU), Hull York Medical School, University of Hull, Hull, UK
| | - Peter J Bazira
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Hull, UK
| | - Gabrielle M Finn
- School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Isabella E Nizza
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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12
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Zhang Q, Yuan QZ, Ma PQ, Li Y, Zhao MH, Chen RX, Tang ZG, Zhang B, Liu B, Liu X, Li FF. Perceptions towards online learning among medical students during the COVID-19 pandemic. Heliyon 2023; 9:e13119. [PMID: 36712914 PMCID: PMC9859645 DOI: 10.1016/j.heliyon.2023.e13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Social distancing has been essential during the COVID-19 pandemic to slow the spread of the disease. Online learning ensures students can participate in learning activities while also maintaining a physical distance from other students. Although online learning was used to prevent the spread of COVID-19, the development of online learning has also been promoted. Here, we sought to explore the perceptions and responses of students to online learning during the pandemic using a cross-sectional study. Electronic questionnaire was used for data collection. Statistical analyses were performed for 1614 valid questionnaires and P < 0.05 was considered statistically significant. Overall, COVID-19 had more effect on female students, such as fear of COVID-19 (2.4 times higher than the number of male students) and length of time spent learning (H = 42.449, P < 0.05). However, the higher the students' grades were, the less the impact of COVID-19. For the style of lessons, all students would prefer shorter lessons (P < 0.05). Female and fifth-grade students were more prefer combined online and face-to-face learning, and male and freshmen students were more likely to prefer face-to-face learning after the pandemic. More than 50% of students thought the main advantage of online learning was convenience, with low efficiency being a disadvantage. The main factors negatively influencing online learning were eyestrain, poor network connections, and poor learning environments at home. In conclusion, synchronous online and face-to-face learning may become more common in future curricula, however the efficiency of online learning and the female students more attentions.
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Affiliation(s)
- Qiong Zhang
- Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China,Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China,Department of Pharmaceutical Engineering, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, China
| | - Qing-zhi Yuan
- Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China
| | - Peng-qiang Ma
- Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China,Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China
| | - Yue Li
- Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China,Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China
| | - Meng-hui Zhao
- Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China,Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China
| | - Rong-xia Chen
- Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China,Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China
| | - Zhen-gang Tang
- Institute of Neurological Diseases, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Bei Zhang
- Health Management Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Bing Liu
- Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China,Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China,Corresponding author. Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China.
| | - Xiang Liu
- Health Management Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, China,Corresponding author. Health Management Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, China.
| | - Fei-feng Li
- Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China,Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, China,Department of Pharmaceutical Engineering, School of Pharmaceutical Sciences, Hubei University of Medicine, Shiyan, China,Health Management Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, China,Corresponding author. Hubei Biomedical Detection Sharing Platform in Water Source Area of South to North Water Diversion Project, Hubei University of Medicine, Shiyan, China.
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13
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Stevenson SE, Anbu D, Wijeyendram P, Laurayne H, Border S. Can Synchronous Online Near-Peer Teaching Offer the Same Benefits as the Face-to-Face Version When Used in Clinical Neuroanatomy Education? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1397:151-172. [DOI: 10.1007/978-3-031-17135-2_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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14
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McNamara JP, Nolan MF. COVID-19 modifications to a first year medical human anatomy course: Effects on student performance on summative examinations. Clin Anat 2023; 36:83-91. [PMID: 36216782 PMCID: PMC9874716 DOI: 10.1002/ca.23965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 01/27/2023]
Abstract
The COVID-19 (COVID) pandemic forced changes in how medical curricula are organized and delivered. In addition to disease mitigation strategies, other curricular modifications were required to maintain educational effectiveness and student and faculty safety. While these changes appear to be successful in their primary goal, their effect on learning and other important educational outcomes is less well understood. We describe changes to our anatomy course and describe their effects on summative examination scores. We compared anatomy examination scores from 4 years prior to COVID with scores from the 2 years following COVID mandated changes in an effort to determine the effectiveness of our course modifications. Examination scores for the first of four successive Blocks of instruction following the implementation of curricular changes demonstrated a lower mean score and greater range of scores than for the four pre-COVID years. Pre-COVID and post-COVID scores for Blocks II, III, and IV were comparable. Our results indicate that our changes to the anatomy curriculum did not prevent a performance decline during the first Block of instruction only. However, students were able to successfully adapt to these changes during the remainder of the course. We discuss factors that may have accounted for the Block I performance decline and call attention to changes within the larger curriculum that may have affected student performance.
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Affiliation(s)
- John Patrick McNamara
- Department of Basic Science EducationVirginia Tech Carilion School of MedicineRoanokeVirginiaUSA
| | - Michael F. Nolan
- Department of Basic Science EducationVirginia Tech Carilion School of MedicineRoanokeVirginiaUSA
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15
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Dempsey AMK, Hunt E, Lone M, Nolan YM. Awareness of Universal Design for Learning among anatomy educators in higher level institutions in the Republic of Ireland and United Kingdom. Clin Anat 2023; 36:137-150. [PMID: 36069043 PMCID: PMC10087201 DOI: 10.1002/ca.23947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 12/14/2022]
Abstract
There is an increasing need to facilitate enhanced student engagement in anatomy education. Higher education students differ in academic preferences and abilities and so, not all teaching strategies suit all students. Therefore, it is suggested that curricula design and delivery adapt to sustain learner engagement. Enhanced learner engagement is a fundamental feature of Universal Design for Learning (UDL). The aim of this study is to determine if anatomy educators in the Republic of Ireland (ROI) and United Kingdom (UK) are aware of UDL and to assess if, and to what extent, it has been implemented in the design and delivery of anatomy curricula for healthcare students. An anonymous online questionnaire was administered to anatomy educators in higher level institutions in the ROI and UK. Inductive content analysis was used to identify the impact of UDL on student learning, engagement, and motivation, as perceived by the participants. The response rate was 23% (n = 61). Nineteen participants stated they knew of UDL. Of these, 15 had utilized UDL in their teaching of anatomy. Analysis indicated that the perception of UDL was mixed. However, the majority of responses relating to UDL were positive. The majority of the respondents were unaware of UDL but identified the frameworks' checkpoints within their curriculum, suggesting they have unknowingly incorporated elements of UDL in their curriculum design and delivery. There is a lack of information on the benefits of explicit utilization of UDL for engagement and motivation to learn anatomy in healthcare programs in the ROI and UK.
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Affiliation(s)
- Audrey M K Dempsey
- Department of Anatomy and Neuroscience, School of Medicine, University College Cork, Cork, Ireland
| | - Eithne Hunt
- Department of Occupational Science and Occupational Therapy, School of Clinical Therapies, University College Cork, Cork, Ireland
| | - Mutahira Lone
- Department of Anatomy and Neuroscience, School of Medicine, University College Cork, Cork, Ireland
| | - Yvonne M Nolan
- Department of Anatomy and Neuroscience, School of Medicine, University College Cork, Cork, Ireland
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16
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Abualadas HM, Xu L. Achievement of learning outcomes in non-traditional (online) versus traditional (face-to-face) anatomy teaching in medical schools: A mixed method systematic review. Clin Anat 2023; 36:50-76. [PMID: 35969356 PMCID: PMC10087909 DOI: 10.1002/ca.23942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 12/14/2022]
Abstract
In recent years, the logistical challenges posed by the Covid-19 pandemic have prompted medical educators teaching gross anatomy to explore an expanded use of online instructional modalities. There is concern that this shift to online anatomy education in medical schools could affect long-term learning outcomes for future healthcare providers. In this systematic review, the educational effectiveness of online anatomy teaching is compared with traditional ("face-to-face") teaching methods, specifically in terms of students' academic performance and satisfaction. A search of four databases identified and screened 162 studies. Subsequently, 31 studies were analyzed, including both (a) teaching outcome measures (test scores) and (b) student satisfaction ratings. Authors chose studies, extracted data, assessed quality and examined risk of bias. Nineteen studies compared students' academic performances between online and face-to-face teaching methods. Twenty-six studies measured students' levels of satisfaction in both teaching methods. Both qualitative and quantitative analyses of the data revealed comparable academic performances with no statistical difference between the two teaching methods, but a higher level of satisfaction with face-to-face teaching. The findings confirm that students can learn from online teaching but are more satisfied with face-to-face teaching. The authors conclude that online teaching cannot replace traditional teaching and there is no preference for one type of modality over the other. Therefore, a multi-modal learning approach combining online with face-to-face educational modalities for medical students could be efficient and successful.
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Affiliation(s)
- Hana M Abualadas
- Department of Structural and Cellular Biology, School of Medicine, Tulane University, New Orleans, Louisiana, USA.,Department of Neurological Sciences, Robert Larner M.D. College of Medicine, University of Vermont, South Burlington, Vermont, USA
| | - Lu Xu
- Department of Structural and Cellular Biology, School of Medicine, Tulane University, New Orleans, Louisiana, USA
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17
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From Lecture Halls to Zoom Links: How Can Educational Theory Help Us to Deliver Effective and Engaging Teaching in an Online Environment? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1397:79-94. [DOI: 10.1007/978-3-031-17135-2_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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18
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Messerer DAC, Behr JL, Kraft SF, Schön M, Horneffer A, Kühl SJ, Benedikt Seifert L, Huber-Lang M, Böckers TM, Böckers A. The gross anatomy course: SARS-CoV-2 pandemic-related effects on students' learning, interest in peer-teaching, and students' perception of its importance. ANATOMICAL SCIENCES EDUCATION 2022. [PMID: 36564994 DOI: 10.1002/ase.2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic required adjustments and limitations in university teaching, thereby challenging teaching concepts in anatomy requiring in-person contact, including the gross anatomy course. Therefore, the present study investigates the impact of COVID-19-associated adjustments on students' perception of the gross anatomy course's importance and quality, students' preferred learning setting and outcome, and their motivation to involve themselves in academic activities, including becoming a future peer-teacher of the course. Using paper-based questionnaires in Ulm, Germany, 397 (response rate: 82.3%) students of the winter term of 2020/2021 were surveyed using quantitative and qualitative items, which were compared with cohorts prior to the pandemic. Students reported a higher global rating on course quality during COVID-19 (pre-COVID-19: 5.3 ± 0.9, during-COVID-19: 5.6 ± 0.7, p < 0.001; 1 = very bad, 6 = very good). Students' perceived importance of the gross anatomy course showed a small but significant increase (pre-COVID-19: 4.2 ± 0.6, during-COVID-19: 4.3 ± 0.6, p < 0.001; 1 = strongly disagree, 6 = strongly agree). Students' motivation to apply as a peer-teacher remained stable, nevertheless, they reported less interest in transferring their knowledge to junior students. Finally, students reported that they spent significantly more learning time alone and their examination grades remained unchanged during the pandemic. Astonishingly, despite radical changes of the teaching environment due to COVID-19, students appreciate the offered teaching and highly valued the gross anatomy course.
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Affiliation(s)
- David Alexander Christian Messerer
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital Ulm, Ulm, Germany
- Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jonathan Lukas Behr
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
| | - Sophie Felice Kraft
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
| | - Michael Schön
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
| | - Astrid Horneffer
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - Susanne Julia Kühl
- Institute of Biochemistry and Molecular Biology, Ulm University, Ulm, Germany
| | - Lukas Benedikt Seifert
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital Ulm, Ulm, Germany
| | - Tobias Maria Böckers
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - Anja Böckers
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
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19
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Moya-Salazar J, Jaime-Quispe A, Milachay YS, Cañari B, Lozano-Zanely G, Chicoma-Flores K, Moya-Salazar MM, Contreras-Pulache H. What is the perception of medical students about eLearning during the COVID-19 pandemic? A multicenter study in Peru. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/12289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Chang M, Liao M, Lue J, Yeh C. The impact of asynchronous online anatomy teaching and smaller learning groups in the anatomy laboratory on medical students' performance during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:476-492. [PMID: 35291048 PMCID: PMC9082485 DOI: 10.1002/ase.2179] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 03/05/2022] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
Due to the Covid-19 pandemic, National Taiwan University anatomy teachers adopted asynchronous online video teaching and reduced the size of anatomy laboratory groups in April 2020. The aim of this study was to investigate the impact of these changes on medical students' learning. Before Covid-19, the performance of the 2019-2020 cohort was significantly better than that of the 2018-2019 cohort. However, the implementation of modified teaching strategies significantly lowered the laboratory midterm score of the 2019-2020 cohort in the second semester. Conversely, the final laboratory examination score of the 2019-2020 cohort was significantly higher than that of the 2018-2019 cohort. Through correlation analysis, lecture and laboratory examination scores were highly correlated. Additionally, the difference in lecture and laboratory z-scores between two cohorts, the Likert scale survey and free-text feedback of the 2019-2020 cohort, were conducted to show the impact of modified teaching strategies. There were several important findings in this study. First, the change in teaching strategies may temporarily negatively influence medical students to learn anatomy. Besides, analyzing the performance of laboratory assessments could be a complementary strategy to evaluate online assessments. Applying lecture examination scores to predict laboratory performance was a feasible way to identify students who may have difficulty in learning practical dissection. Finally, reducing group size together with reduced peer discussion may have a negative effect on learning cadaver dissection for students with low academic performance. These findings should be taken into consideration when anatomy teachers apply new teaching strategies in anatomy courses.
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Affiliation(s)
- Ming‐Fong Chang
- Department of Anatomy and Cell BiologyNational Taiwan University College of MedicineTaipeiTaiwan
| | - Meng‐Lin Liao
- Department of Anatomy and Cell BiologyNational Taiwan University College of MedicineTaipeiTaiwan
| | - June‐Horng Lue
- Department of Anatomy and Cell BiologyNational Taiwan University College of MedicineTaipeiTaiwan
| | - Chi‐Chuan Yeh
- Department of SurgeryNational Taiwan University HospitalNational Taiwan University College of MedicineTaipeiTaiwan
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21
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Yun YH, Jo DH, Jeon SK, Kwon HY, Jeon YM, Shin DH, Choi HJ. The impact of the modified schedules of anatomy education on students' performance and satisfaction: Responding to COVID-19 pandemic in South Korea. PLoS One 2022; 17:e0266426. [PMID: 35404971 PMCID: PMC9000102 DOI: 10.1371/journal.pone.0266426] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/18/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic substantially undermined medical education and healthcare systems. Owing to the pandemic in South Korea, most medical schools needed to be flexible when conducting online and offline classes, but the guidelines did not reflect the specificity of medical schools. This study described the impact of modified anatomy education schedules at the Seoul National University College of Medicine (SNUCM) on students' academic performance and satisfaction. METHODS Anatomy education in SNUCM is divided into three regional units (the upper and lower limbs, trunk, and head and neck). Owing to the COVID-19 pandemic, the schedule was mixed with simultaneous and rotating schedules. The authors conducted exceptions for online lectures, cadaver dissections, and written and practical examinations in three classes of approximately 50 students each. Furthermore, the authors assessed students' performance using three sets of written and practical examinations, and students completed a questionnaire regarding modified anatomy laboratory schedules. RESULTS Despite the pandemic events in Seoul and South Korea during the laboratory sessions, all sessions were completed without any confirmed COVID-19 cases among the students, faculty, and staff. Most of the scores on the written and practical examinations significantly decreased in 2020 compared to those in 2019. However, in the trunk session that used the virtual anatomy application, the score on the practical examination in 2020 was significantly higher than that in 2019. Over 70% (79 and 77 out of 105 respondents on the upper and lower limbs and trunk, respectively) and 53% (55/105) students reported that there were no significant difficulties in studying anatomy in a face-to-face laboratory. CONCLUSIONS In conclusion, an adequate education program for cadaver dissection should be developed and provided to overcome the pandemic restrictions. The study findings could serve as a reference for anatomy education during the COVID-19 pandemic.
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Affiliation(s)
- Young Hyun Yun
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Hyun Jo
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Su Kyoung Jeon
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyeok Yi Kwon
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Yu Mi Jeon
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Hoon Shin
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyung Jin Choi
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
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