Relevance and attitudes toward histology and embryology course through the eyes of freshmen and senior medical students: Experience from Serbia

Perceptions of medical students towards the role of histology and embryology during curricular review

BACKGROUND

The continuous changes in the medical education to prepare medical doctors for the future requires updates in medical curriculum. However, the perspectives of the medical students are not frequently considered during the revision of the medical curriculum. In parallel with the process of defining and adjusting the medical curriculum, a large survey was performed to inquire the perspectives of the medical students at the Faculty of Medicine of the University of Porto (FMUP), Portugal, about the role of Histology and of Embryology.

METHODS

Medical students at FMUP (Portugal) completed a structured and anonymous online questionnaire about the subjects Histology and Embryology. The questionnaire was prepared using questions of previous surveys performed in Europe, including another Portuguese medical school, and additional questions that were specifically prepared to this study. The questions referred to teaching methods, clinical relevance, use of virtual (digital) microscopes and association of Histology and Embryology with other subjects of the medical curriculum.

RESULTS

Four hundred and sixty-two students participated in the study. The students in clinical years were more likely to recognise the clinical relevance of Histology (p = 0.016) and Embryology (p < 0.001). Students agree that teaching of these subjects would benefit from a clinical orientation (89% for Histology; 90% for Embryology). Students highlighted that Histology is crucial to understand Biopathology and agree (75%) that an integration of Histology with Biopathology could be considered in the medical curriculum. Most students (55%) agree that slide microscopes are more useful than virtual microscopes.

CONCLUSIONS

Our study contributes to the debate about the evolution of medical curriculum. Gathering the medical students' perceptions using large surveys such as that performed in the present study may be useful to adapt the methods of teaching which may increase the motivation of the students. In the case of Histology and Embryology at the FMUP (Portugal) providing more clinically oriented teaching may be useful to motivate the students. Students of clinical years have strong clinical perspectives of Histology and Embryology and their enrolment in teaching of Histology and Embryology can also contribute to increase motivation of younger students. Consulting and involving medical students in the development of the medical curriculum can be positive and students should be more responsible and engaged in building their own 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.

Medical Students' Attitude and Perception Towards Embryology Course at Debre Markos University, Ethiopia

INTRODUCTION

Medical students' attitudes and perceptions are crucial for designing an anatomy curriculum that meets the standards for safe medical practice.

OBJECTIVE

To assess the attitude and perception of medical students towards the clinical relevance of embryology at Debre Markos University.

METHODS

A cross-sectional study was conducted at Debre Markos University from March 10 to April 20, 2022. Data were collected using a self-administered questionnaire. The questionnaire includes students' attitudes, career choices, and perceptions of integration of embryology and teratology courses. All viewpoints were rated using a positive Likert scale ranging from "strongly disagree" to "strongly agree". Data were entered using EpiData version 3.1 and exported to SPSS version 25 for analysis.

RESULTS

A total of 246 medical students participated in the study. About 159 (64.63%) medical students perceived that embryology requires understanding in the clinics. More than half of the respondents, 169 (68.70%) perceived that embryology is most clinically relevant for all basic sciences. About two-thirds of medical students, 189 (76.83%) agreed that integration of embryology and teratology courses in the first and second years was better than teaching each discipline alone. More than half of medical students, 145 (58.94%) also preferred problem-based learning that combines embryology and teratology. About 201 (81.71%) medical students perceived that virtual reality is more effective than images in the textbook for teaching embryology.

CONCLUSION

In this study, most of the medical students have a positive attitude toward the embryology course. The first-year curricular integration of embryology and teratology must be maintained, and great effort is required to improve students' passion for developmental anatomy/embryology. These findings might be utilized as an additional motivation for the improvement of the embryology course, with a focus on the practical application of knowledge in a clinical context.

Evaluation of a prerequisite course of histology implementation for Chinese students of eight-year medical programme: a mixed quantitative survey

BACKGROUND

Due to insufficient basic medical knowledge and inappropriate learning strategies, students of 8-year medical programme encountered many obstacles in the initial stage of basic medicine learning. This study was to determine whether a prerequisite course can improve basic medicine learning performance and adjust learning strategies to adapt to basic medicine learning.

METHODS

A prerequisite course of histology was constructed by a two-round modified Delphi study. Seventy-four students of 8-year medical programme were subjected to two groups: the prerequisite course group (PC group) and non-prerequisite course group (NPC group). The PC group take part in the prerequisite course by student-centred blended learning approach but NPC group not. The PC and NPC group underwent requisite histology teaching activities after prerequisite course. Examination of the prerequisite course and requisite histology course were carried out. Effect of the prerequisite course was evaluated by an empirical method using a questionnaire-based approach.

RESULTS

The results of examinations showed students' scores of the PC group were significantly higher than those of students of NPC group in both prerequisite course and requisite histology examinations (P < 0.05). The results of questionnaires showed that students were satisfied with the prerequisite course, which was beneficial for uptake in medical knowledge, cultivation of clinical thinking and scientific research ability and adaptation in learning strategies (P < 0.01). Furthermore, our prerequisite course is conducive to subsequent courses learning, especially for pathology (P < 0.01).

CONCLUSION

Our prerequisite course could effectively supplement knowledge of basic medicine, improve clinical thinking and scientific research ability and adapt their learning strategies. These findings suggest that the prerequisite course is useful and should be introduced in medical curriculum reform at the early stages of basic medical training.

Attitude and Perception of Medical Students Towards Histology Subject at Wollo University, Ethiopia

INTRODUCTION

Students' perceptions and feedback have a significant impact on academic progress.

OBJECTIVE

To assess the attitude and perception of medical students towards histology subject at Wollo University, Northern Ethiopia.

METHODS

An institution-based cross-sectional study design was carried out in Wollo University from January, 2021 to February, 2021. A pre-tested and structured self-administered questionnaire was used for data collection. All opinions were rated using a positive-point Likert scale, which ranges from "strongly disagree" to "strongly agree." The data were entered and analyzed using SPSS version 20.

RESULTS

A total of 184 students participated in this study, with a 100% response rate. Of the respondents, 84.24% of them were very much interested in histology subject. However, only 31 (16.85%) thought of histology as a career choice. The two major reason for not joining histology was less chance of promotion (65, 35.33%) and financial growth (41, 22.28%) followed by difficulty of the subject (23, 12.5%). Most of the respondents (155, 84.24%) agreed or strongly agreed that histology knowledge will help them a lot in their future clinical practice. Regarding different methods of teaching histology, our study reveals that there were 82.61% of participants who agreed with the proposed integration of histology and pathology. Moreover, system approach in teaching pathology with other disciplines was preferred by 70.1% and was comparable to several studies.

CONCLUSION

Overall, the study findings indicate that medical students have a favorable attitude toward histology courses. But, they are unable to join the field due to the lower chance of promotion and financial growth. The curricular integration of histology and pathology in the first year needs to be continued, and much effort is needed to increase students' affinity for microscopic anatomy. This evidence serves as an additional motive for the development of histology courses focusing on practical application of knowledge in a clinically oriented setting.

Exploring Visualisation for Embryology Education: A Twenty-First-Century Perspective

Embryology and congenital malformations play a key role in multiple medical specialties including obstetrics and paediatrics. The process of learning clinical embryology involves two basic principles; firstly, understanding time-sensitive morphological changes that happen in the developing embryo and, secondly, appreciating the clinical implications of congenital conditions when development varies from the norm. Visualising the sequence of dynamic events in embryonic development is likely to be challenging for students, as these processes occur not only in three dimensions but also in the fourth dimensions of time. Consequently, features identified at any one timepoint can subsequently undergo morphological transitions into distinct structures or may degenerate and disappear. When studying embryology, learners face significant challenges in understanding complex, multiple and simultaneous events which are likely to increase student cognitive load. Moreover, the embryology content is very nonlinear. This nonlinear content presentation makes embryology teaching challenging for educators. Embryology is typically taught in large groups, via didactic lecture presentations that incorporate two-dimensional diagrams or foetal ultrasound images. This approach is limited by incomplete or insufficient visualisation and lack of interactivity.It is recommended that the focus of embryology teaching should instill an understanding of embryological processes and emphasise conceptualising the potential congenital conditions that can occur, linking pre-clinical and clinical disciplines together. A variety of teaching methods within case-based and problem-based curricula are commonly used to teach embryology. Additional and supplementary resources including animations and videos are also typically utilised to demonstrate complex embryological processes such as septation, rotation and folding.We propose that there is a need for embryology teaching in the twenty-first century to evolve. This is particularly required in terms of appropriate visualisation resources and teaching methodologies which can ensure embryology learning is relevant to real-world scenarios. Here we explore embryology teaching resources and methodologies and review existing evidence-based studies on their implementation and impact on student learning. In doing so, we aim to inform and support the practice of embryology educators and the learning of their students.

Blended learning model via small private online course improves active learning and academic performance of embryology

While blended learning has been growing in popularity in recent years, the effectiveness of this procedure remains controversial. In this report, we assess the effectiveness of blended learning of embryology within international medical students. The participants were international medical students taking embryology in the Bachelor of Medicine and Bachelor of Surgery program. The blended learning group (BLG) consisted of students (n = 43) in the 2018-2019 academic year, taught with blended learning model via a customized small private online course (SPOC). The control traditional teaching group (TTG) consisted students (n = 48) in the 2017-2018 academic year, taught with traditional teaching model. Academic performance, including mean scores and passing ratios on the final exam of two groups were compared and analyzed with a t-test. In addition, a questionnaire directed toward evaluating student's perceptions with the blended learning was administered to students in BLG. The majority of students in BLG actively participated in online self-study activities and discussion in face-to-face class sessions. The mean score and passing ratio were significantly greater than those of students in TTG (p < 0.01). Results from the questionnaire revealed that the majority of BLG students felt that this method was beneficial for their learning of human embryology. The blended learning model, that integrates SPOC with face-to-face class lectures proved a more effective means for the teaching of embryology than the traditional lecture-based teaching model. This blended learning method may serve as a feasible model that can be readily applied for use in other medical courses.

Learning Cardiac Embryology-Which Resources Do Students Use, and Why?

With increasing class sizes, small group activities for learning embryology are present in few institutions. How then do students supplement their lectures in order to ask and answer questions, or delve into concepts in detail? Arguably, animations and videos are ideal for visualizing four-dimensional anatomy, but how do students find and filter these? First-year medical students were surveyed with respect to the cardiac embryology component of their course and asked their opinions regarding the clinical relevance of this content and the resources they used to enhance learning. Students indicated that they considered cardiac embryology to be of relevance to clinical practice and that videos are a useful resource in helping them to learn this material. However, when seeking videos or resources, it emerged that students tended to Google information in preference to accessing online resources (or textbooks) specifically recommended by their instructor, despite students' recognition that "accuracy of information" was paramount when choosing what resource to use. While all students seemed reluctant to contact a staff member with questions, those with less proficiency in English were less likely to approach faculty for assistance. While acknowledging students as adult learners, self-regulated learning skills do not develop automatically and the development of these skills should be viewed as a "shared responsibility" between students and staff. Likewise, students also need to be taught critical appraisal of learning resources, especially in the complex online environment, with design of their bespoke institutional virtual learning environment facilitating easy identification and access of recommended resources.

Ethical Rationales and Guidelines for the Continued Use of Archival Collections of Embryonic and Fetal Specimens

Benefits from the use of cadavers in anatomical education are well described. Historically, human embryos and fetal cadavers were used in anatomy education to understand development and congenital malformations. Recently, three-dimensional printed models produced from archival fetal specimens, and online repositories of images from archival collections of embryos and fetuses, have been used as an educational tool in human development courses. Given that the archival specimens were likely obtained prior to the era of informed consent, this raises questions about their appropriate and ethical use. Because some institutions in the United States retain archival collections of embryonic and fetal specimens that were once used as educational tools, their existence and utility require frequent reexamination against contemporary ethical frameworks to guide appropriate use or utilization. Four ethical rationales for uses of these collections are examined, including destruction, indefinite storage, use in research, and use in health professions education. Guidelines for the use of archival collections of human embryos and fetuses are presented. Indefinite storage and use in health professions education are supported, while use in research is also permitted, however, such use is limited and dependent on circumstance and purpose. The development of current digital repositories and three-dimensionally printed models based on archival collections that were collected without informed consent, or those promoting commercial opportunity, are not supported. New embryonic and fetal donations obtained with informed consent should include reference to potential uses with new technology and virtual, genetic, or imaging applications.

The influence of learning style in understanding analogies and 2D animations in embryology course

Undergraduate students struggle to comprehend embryology because of its dynamic nature. Studies have recommended using a combination of teaching methods to match the student's learning style. But there has been no study to describe the effect of such teaching strategy over the different types of learners. In the present study, an attempt has been made to teach embryology using the combination of analogies and simple 2D animations made with Microsoft powerpoint software. The objective of the study is to estimate the difference in academic improvement and perception scale between the different types of learners after introducing analogies and 2D animation in a lecture environment. Based on Visual, Aural, Read/Write, and Kinesthetic (VARK) scoring system the learners were grouped into unimodal and multimodal learners. There was significant improvement in post-test score among the unimodal (P<0.001) and multimodal learners (P<0.001). When the post-test score was compared between the two groups, the multimodal learners performed better the unimodal learners (P=0.018). But there was no difference in the perception of animations and analogies and long-term assessment between the groups. The multimodal learners performed better than unimodal learners in short term recollection, but in long term retention of knowledge the varied learning style didn't influence its outcome.