Teaching histology and anatomy online during the COVID-19 pandemic

Exploration and evaluation of reporting quality of randomised controlled trials on blended learning in medical education

Aims/Background Blended learning has been a commonly adopted teaching mode in the medical education community in recent years. Many studies have shown that the blended learning mode is superior to the traditional teaching mode. Nonetheless, pinpointing the specific advantages provided by blended teaching methods is challenging, since multiple elements influence their effectiveness. This study aimed to investigate the reliability of the conclusions of published randomised controlled trials (RCTs) on blended learning in medical education by assessing their quality, and to provide suggestions for future related studies. Methods Two investigators searched PUBMED and EMBASE, and assessed RCTs related to medical blended learning published from January 1, 2010 to December 31, 2021. The analysis of the overall quality of each report was based on the 2010 consolidated standard of reporting trials (CONSORT) Statement applying a 28-point overall quality score. We also conducted a multivariate assessment including year of publication, region of the trial, journal, impact factor, sample size, and the primary outcome. Results A total of 22 RCTs closely relevant to medical blended learning were eventually selected for study. The results demonstrated that half of the studies failed to explicitly describe at least 34% of the items in the 2010 CONSORT Statement. Medical blended learning is an emerging new teaching mode, with 95.45% of RCTs published since 2010. However, many issues that we consider crucial were not satisfactorily addressed in the selected RCTs. Conclusion Although the 2010 CONSORT Statement was published more than a decade ago, the quality of RCTs remains unsatisfactory. Some important items were inadequately reported in many RCTs such as sample size, blinding, and concealment. We encourage researchers who focus on the effects of blended learning in medical education to incorporate the guidelines in the 2010 CONSORT Statement when designing and conducting relevant research. Researchers, reviewers, and editors also need to work together to improve the quality of relevant RCTs in accordance with the requirements of the 2010 CONSORT Statement.

Designing a Massive Open Online Course (MOOC) in face-to-face sessions. A blended design to teach practical histology

Teaching histology, through virtual microscopy in educational strategies, undeniably moved towards the digitization and distancing of teaching. The setting up of the Massive Open Online Course (MOOC) entitled "Introduction to Histology: exploring the tissues of the human body" made it possible to exploit the potential to share digital resources with a wider audience while being integrated into the teaching on-campus students. This article described the pedagogical choices prevailing during the design of the MOOC and its combination with face-to-face sessions to achieve specific learning outcomes. The pedagogical alignment of learning outcomes described according to their cognitive levels, with online and face-to-face learning activities and evaluation methods has been demonstrated. The impact of such a blended design into an academic program has been ascertained using perception and performance data. Student satisfaction and engagement as well as motivational cues were identified. The level of performance was maintained in the educational strategy implemented and made it possible to achieve the objectives expected by the teachers. The benefits of integrating a MOOC with classroom-based teaching were highlighted, as well as barriers that could hinder the successful implementation.

Impact of modified teaching strategies used in a gross anatomy course on the academic performance of dental students during the COVID-19 pandemic

INTRODUCTION

Modified teaching strategies (MTS), asynchronous online teaching and smaller dissection groups, were applied to a gross anatomy course for dental students in the National Taiwan University in April 2020 in response to the COVID-19 pandemic. This study aimed to investigate the effects and perceptions of MTS on dental students.

MATERIALS AND METHODS

Scores for anatomy examinations for 2018-2019 (without MTS) and 2019-2020 (with MTS) cohorts were compared to explore the effect on academic performance. Moreover, questionnaire from the 2019-2020 cohort was analysed to determine dental students' perceptions about MTS.

RESULTS

The lecture performance in the final examination of the second semester for the 2019-2020 cohort was significantly higher than that of the first semester (pre-COVID-19) and that for the 2018-2019 cohort. However, the laboratory performance in the midterm examination of the second semester for the 2019-2020 cohort was significantly lower than that for the 2018-2019 cohort and showed no difference in the final examination of the first semester. The questionnaires revealed that the majority of students displayed positive attitudes towards MTS and agreed with the importance of peer discussion during laboratory dissection.

CONCLUSIONS

Asynchronous online learning for anatomy lecture may be beneficial for dental students; however, a smaller dissection group accompanied by reduced peer discussion may temporarily exert negative effects on their laboratory performance at the beginning of the application. Furthermore, more dental students exhibited positive perceptions towards smaller dissection groups. These findings could illuminate the learning condition of dental students in anatomy education.

Perceptions and Attitudes of Jordanian Medical Students on Using 3D Interactive Anatomy Dissection in Teaching and Learning Anatomy

BACKGROUND AND AIMS

This study evaluates the use of virtual anatomy dissection (Anatomage Table) in teaching anatomy for Jordanian medical students. The study also highlights any gender differences in students' perception on this method of teaching anatomy.

METHODS

This is a cross-sectional questionnaire-based study that was carried out on medical students enrolled in Al-Balqa Applied University, a Jordanian public university. A group of expert anatomists designed a questionnaire that investigates the students' perceptions and attitudes toward using virtual anatomy dissection. The questionnaire also investigated student's opinions and expectations on the impact of using this method on the academic achievement of students.

RESULTS

The findings of the study showed that most students agreed that Anatomage Table helped them better understand (64.3%) and memorize (64%) anatomy lectures. In addition, most students were interested in using this learning method in lab groups (72.3%). However, the didactic approach that combined anatomical models and the Anatomage Table was preferred over the unilateral approach that included only the Anatomage Table (80.5% vs 30.2%, p<0.001, r=0.9). Of note, there was a statistically significant difference between males and females in their preference for Anatomage Table (p<0.001), and in their perceptions on the impact of Anatomage Table on understanding of lectures (p<0.001) and memorization of anatomical structures (p=0.004).

CONCLUSION

The Anatomage Table is a powerful teaching and learning method in undergraduate medical education. Its application to Al-Balqa Applied University has proven to be effective so far. It can be used to overcome the problems facing anatomical education in the college of medicine in Al-Balqa Applied University and perhaps other universities in Jordan, but this needs better cooperation between universities and stakeholders to provide adequate funding for this method.

The Michigan Histology website as an example of a free anatomical resource serving learners and educators worldwide

With anatomical education becoming a global endeavor, free online resources offered via the Internet or other electronic venues are of increasing importance for teaching and learning communities worldwide. Students and instructors from developing countries, often limited in access to modern instructional resources by infrastructural and financial constraints, are frequent users of such online learning tools. During the recent Covid-19 pandemic when all academic institutions were forced to quickly switch to a non-contact mode of teaching, free online instructional resources were often essential for continuing the educational mission. However, there are a number of obstacles and issues that need to be considered when creating and offering such learning resources. These include the type, quality, and completeness of the content, their educational purpose, access to technical and financial resources, copyright and ethical issues, and more. Educators, who plan to generate and maintain free online resources, should also be aware that such projects usually require a considerable long-term time commitment. In this article, these issues are discussed using the Michigan Histology website as an example. The discussion also addresses how e-learning resources like the Michigan Histology website supported online learning during the recent Covid-19 pandemic.

The impact of Covid-19 pandemic on modification of medical teaching in Italy: A narrative review

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.

Online veterinary anatomy education during Covid-19 pandemic in Iran: Challenges and opportunities

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.

The challenges of histology education

Generations of students have struggled to learn histology. They have found the subject extremely dry and the nomenclature very challenging. Insidiously, histology is fading from the minds of stakeholders. Unless this is rectified, it is not inconceivable that the subject will be further diluted in the medical curriculum. What contributing factors could there be? Via a survey and focus group discussions, international faculty (n = 111) were asked what the challenges in teaching histology were. Both qualitative and quantitative data were collected and stratified by the number of teaching years. A collaborative teaching session with a pathologist was also delivered to the YLLSoMM1 students (n = 280), who gave opinions about it. Of the international faculty, 85 (±1)% responded. Among those, 60 (±1)% felt that the pedagogy should be reformed (e.g., by gamification). Interestingly, 30 (±1)% opined that organ system histology should be moved into the clinical years. Notably, 70 (±1)% of teachers preferred to teach face to face (FTF) using either microscopes or virtual microscopy. Among the students, 71 (±1)% reported self-teaching from online resources. Significantly, 88 (±1)% of M1 students agreed that having the pathologist co-teach histology was beneficial. Some teachers, and most students, struggle with histology. There is a generational divide in opinions concerning how histology should be taught. The traditionalists wish to maintain the status quo while the reformists want changes. Learners want to be engaged with hybrid approaches aided by the pathologist. They also welcome more clinical context during histology lessons.

Comparison of classical and distance histology education taken by daytime and evening education students of health services at a vocational high school

Background/Aim: Distance education applications can improve histology education. This study aimed to compare the classical and distance histology education given to the daytime and evening education students of the Health Services Vocational High School Medical Laboratory Techniques course. The students’ academic achievement, motivation, and mood were compared. Methods: The students (n=134) that participated in the study were divided into four groups. The daytime and evening education students to whom the classical education model was applied were identified as the control group (Groups 1 and 3). The daytime and evening education students who received distance education were identified as the experimental group (Groups 2 and 4). Before and after the study, a pretest and posttest, the State-Trait Anxiety Inventory, and the Academic Motivation Scale were applied to the students who received nervous system histology education. Results: The state-trait anxiety scores did not differ significantly according to the groups (P>0.05). The state anxiety scores obtained after the posttest were significantly lower than the state anxiety scores obtained before the pretest. According to the Academic Motivation Scale scores, the extrinsic motivation - external regulation subscale was significantly lower in Group 3 compared to the other groups (P<0.05). For the knowledge test results, there was a significant difference between the pretest and posttest scores in all groups, and the mean posttest scores were higher than the mean pretest scores. The posttest score of the daytime education face-to-face group (Classical education, Group 1) was significantly higher than the other groups (P=0.011). Conclusion: In our study, the daytime education face-to-face group was the most effective among the different teaching styles and training methods in nervous system histology education. Our finding that the efficiency of distance education applications was not as high as face-to-face education suggests that such digital applications require further optimization. The lower success rates observed in the evening education groups can be increased by integrating face-to-face and distance education.

Teaching Cellular Architecture: The Global Status of Histology Education

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.

Past and Current Learning and Teaching Resources and Platforms

For over two centuries, the educational landscape both nationally and globally has changed tremendously. The more traditional teaching and learning resources and platforms, such as traditional textbooks, chalkboards and whiteboards, overhead transparency and carousel projectors, and traditional classroom settings, have been either replaced or supplemented in the anatomical sciences by integrated and virtual eBooks, online learning management (OLM) platforms, and virtual learning and meeting apps. Virtual teaching and learning, especially proliferated with the advent and aftermath of the COVID-19 pandemic, and institutions worldwide that had already been utilizing virtual class and lab sessions in their anatomy curricula expanded virtual course offerings. Many institutions have retained virtual course offerings even after the pandemic, given the distance learning benefits. The future of anatomy education holds many promising possibilities given the voracious speed with which technology is advancing. One such promising advancement is the full, seamless incorporation of virtual three-dimensional (3D) immersive and semi-immersive learning into anatomy laboratories and classroom settings globally as well as into students' laptops and handheld devices for easy use at home or anywhere.

The gross anatomy course: SARS-CoV-2 pandemic-related effects on students' learning, interest in peer-teaching, and students' perception of its importance

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.

Anatomy education beyond the Covid-19 pandemic: A changing pedagogy

The coronavirus disease 2019 (Covid-19) pandemic has induced multifaceted changes in anatomical education. There has been a significant increase in the employment of digital technologies coupled with the upskilling of educators' capacity and altered attitudes toward the digitalization process. While challenges remain, learners have demonstrated capabilities to adapt to digital delivery, engagement and assessment. With alternative and innovative teaching and learning strategies having been trialed and implemented for almost two years, the key question now is what the pedagogy will be for anatomy education beyond the pandemic. Here we discuss some of the changes in anatomy education that have taken place as a result of the Covid-19 pandemic and importantly present some outlooks for evidence-based anatomy pedagogy as the world enters the post-pandemic phase and beyond. The authors conclude that the anatomy discipline is ready to further modernize and has the opportunity to use digital technologies to evolve and enhance anatomy education to ensure students are provided with the learning experience which will prepare them best for the future.

Study satisfaction among university students during the COVID-19 pandemic: Longitudinal development and personal-contextual predictors

The COVID-19 pandemic challenges the well-being and academic success of many students. Yet, little is known about students' study satisfaction during the COVID-19 pandemic, a multilayered construct which accounts for students' subjective cognitive well-being and academic success. Besides, previous studies on study satisfaction are mostly cross-sectional and hardly consider the distinct subdimensions of this construct. Therefore, our main goal in this study was to shed light on the understudied development of the subdimensions of study satisfaction (i.e., satisfaction with study content, conditions of studying, and coping with study-related stress) in two semesters amid the COVID-19 pandemic. Additionally, we examined how particular personal (i.e., gender, age, GPA, intrinsic motivation, motivational cost, and academic procrastination) and contextual (i.e., loneliness) factors are related to these subdimensions. We conducted two panel studies with convenience and purposeful samples of university students in Germany (N study1 = 837; N study2 = 719). Participants responded online to questions on each of the subdimensions of study satisfaction at the beginning, middle, and end of each semester but responded to measures of personal and contextual factors only at the beginning of each semester. In both studies, manifest growth curve models indicated a decrease in all subdimensions of study satisfaction as the semester progressed. Generally, gender (male) and intrinsic motivation were positive predictors but age (younger students), motivational cost, and loneliness were negative predictors of different subdimensions of study satisfaction - particularly satisfaction with study content. Overall, motivational costs and loneliness were the most consistent predictors of all subdimensions of study satisfaction across both studies. Our findings provide support for the understanding that study satisfaction could diminish in the face of challenging situations such as in this pandemic. The present study also highlights certain personal and contextual factors that relate to study satisfaction and calls for intensive research into the multidimensional construct of study satisfaction.

Teaching histology and anatomy online during the COVID-19 pandemic

The aim of this study is to analyze differences in participation, and in the results obtained in the anatomy and histology exams, over two academic years of the Sport Sciences degree course. During the first semester of the academic year 2019/2020 both the lectures and the exam took place face-to-face, while during the academic year 2020/2021 everything was done online. Statistical analysis revealed that the online modality was especially advantageous for the anatomy exam. Students' opinions were also assessed through a short questionnaire. The results showed that teachers involved themselves in both groups. Students needed to interact socially with teachers and colleagues and to ask them questions. Even if the differences were not significant, the difference was greater for face-to-face students in most comparisons. Finally, the most common methods of peer communication were by social media.