The place of cadaveric dissection in post-COVID-19 anatomy education

Efficacy of virtual reality and augmented reality in anatomy education: A systematic review and meta-analysis

Anatomy is the cornerstone of medical education. Virtual reality (VR) and augmented reality (AR) technologies are becoming increasingly popular in the development of anatomy education. Various studies have evaluated VR and AR in anatomy education. This meta-analysis aims to evaluate the effectiveness of VR and AR in anatomical education. The protocol was registered in Prospero. Scopus, PubMed, Web of Science, and Cochrane Library databases were searched. From the 4487 articles gathered, 24 randomized controlled trials were finally selected according to inclusion criteria. According to the results of the meta-analysis, VR had a moderate and significant effect on the improvement of knowledge scores in comparison with other methods (standardized mean difference = 0.58; 95% CI = 0.22, 0.95; p < 0.01). Due to the high degree of heterogeneity (I2 = 87.44%), subgroup analyses and meta-regression were performed on eight variables. In enhancing the "attitude," VR was found to be more "useful" than other methods (p = 0.01); however, no significant difference was found for "enjoyable" and "easy to use" statements. Compared with other methods, the effect of AR on knowledge scores was non-significant (SMD = -0.02; 95% CI = -0.39, 0.34; p = 0.90); also, in subgroup analyses and meta-regression, the results were non-significant. The results indicate that, unlike AR, VR could be used as an effective tool for teaching anatomy in medical education. Given the observed heterogeneity across the included studies, further research is warranted to identify those variables that may impact the efficacy of VR and AR in anatomy education.

Anatomy beyond the pandemic: A Q-methodology study exploring student perceptions toward a hybrid curriculum

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.

Leading the transition to ethical human body sourcing in Africa: The South African experience

BACKGROUND

The use of human bodies for anatomy education and research forms an integral part of the training of health professionals around the world. However, the ethical acquisition of human remains for this purpose has been a challenge in many countries, particularly for those on the African continent. South African institutions have however, been able to progressively transition to a more ethical approach to human body acquisition. The aim of the current study was to investigate the provenance of human bodies and the number used in South African health sciences institutions during the period 2017-2021.

METHODS

an online self-administered anonymised questionnaire was circulated to all health sciences institutions in South Africa. Questions were focused on establishing the provenance and the associated number of bodies and body donor programmes.

RESULTS

responses were received from thirteen of the fourteen South African institutions. All thirteen institutions use human bodies for teaching and research, with the majority of the institutions being reliant on bequests (77%) and family donations (62%), and less on unclaimed remains (46%). Most institutions have established body donor programmes. Four institutions were negatively affected by the effects of the pandemic. Memorial services, which continued during the pandemic, were conducted by eight of the thirteen institutions.

CONCLUSION

South Africa is leading the transition to the ethical acquisition of human remains on the African continent. It is hoped that South African institutions will soon transform to the exclusive sourcing of bodies through willed donation and provide guidance and support for the other countries on the continent.

Macro and micro ethics in fetal and embryological collections: Exploring the paradigms of informed consent among Australian education-focused stakeholders

The management of human fetal and embryological collections presents an ethical challenge that can be explored from different perspectives, particularly when considering informed consent. The "micro ethics" level focuses on parties engaged in giving and receiving human tissue while the "macro ethics" level focusses on the collective responsibility of the discipline and society. Additionally, adopting a framework, where ways of working are designed with relevant communities, requires understanding the perspectives of individuals, communities, and organizations. The aim of this study therefore was to assess the perceptions of education-focused Australian stakeholders. A survey collected the perspectives of 198 participants. The majority of participants (61.6%; n = 122/198) indicated that human fetal and embryological remains obtained prior to era of informed consent should be retained for use in education/research. It is likely that their perspective is based on the notion that if human fetal and embryological collections are used for good, then disposing of them would deny this benefit. Women (p < 0.001) indicated a preference for obtaining fetuses and embryos with informed consent for education and research (38.4%; n = 76/198). Majority were in favor of recording both maternal (MI) (59.6%; n = 118/198) and paternal information (PI) (58.1%; n = 115/198) with each donation. Majority (56.1%; n = 111/198) expressed that donations should be accepted from both parental sources. Consideration of stakeholder perspectives is important in developing guidelines regarding these collections. The results from this study demonstrate a level of discomfort with respect to collections without informed consent, which should be considered at the macro ethical and micro ethical level.

A comparison of pre- and post-clinical education learning preferences among medical students who elected to dissect compared to those who did not during the COVID-19 pandemic

Anatomy instructional methods varied widely during the COVID-19 pandemic and programs are assessing innovations for retention. Learning preferences were assessed among medical students dichotomized as elective dissectors (ED) or non-dissectors (ND) during the COVID-19 partial re-opening in 2020 (preclinical) and again in 2022 after clinical exposure (post-clinical) to assess the viability of elective dissection post-pandemic. A mixed-method approach was used for the assessment of test scores, learning preference surveys, learning activities rankings, and thematic analyses. No significant differences occurred in anatomy examination scores. Dissection was considered useful by both preclinical groups but significantly more so by ED, while the presence of an instructor was significantly preferred by ED although a majority of ND agreed. Elective dissection was significantly preferred by ND but also by a large minority of ED students. Pre- and post-clinical ND believed that elective dissection offered more academic flexibility, did not hinder clinical learning, and did not negatively impact medical education. The corresponding ED stated that confidence improved, clinical experiences were enhanced, and dissection was irreplaceable. Preclinical ND preferred self-learning, while ED students preferred online learning, but these differences largely disappeared post-clinically. Learning activity rankings were not significantly different among all groups (ND, ED, preclinical, and post-clinical). A hybrid laboratory with a virtual learning environment ranked highest across groups and preferences increased over time suggesting that students benefited from this instructional method during clinical exposure. The absence of laboratory experience ranked lowest, and preference decreased over time suggesting that anatomy dissection is valued.

Virtual Dissection: an Educational Technology to Enrich Medical Students' Learning Environment in Gastrointestinal Anatomy Course

Background

Virtual dissection provides a digital experience of medical images to visualize anatomy on touchscreen tables. This study aimed to integrate the virtual dissection table (VDT) into the gastrointestinal anatomy course and assess medical students' intended learning outcomes and satisfaction with this educational technology.

Methods

This quasi-experimental study enrolled second-year undergraduate medical students who studied anatomical sciences in the autumn semester of 2021-2022 at a single medical school. In the intervention and control groups, the participants were randomized to study anatomy by VDT or topographical anatomy textbooks. The knowledge tests evaluated the students' learning outcomes of gastrointestinal anatomy, and following the course, students completed a satisfaction survey.

Results

The findings indicated that a significant gain occurred, and instructional intervention during which the learning environment was enriched with virtual dissection could enhance the students' learning (F = 13.33, df = 2, P < 0.01, partial η2 = 0.20) and satisfaction (T = 6.10, df = 54, P < 0.01, Cohen's d = 1.63, CI95% = 1.02-2.23).

Conclusions

This study demonstrates the potential for virtual dissection to augment anatomical science education. Further research is required to consider the contributing features and apply this educational technology to enhance students' anatomy learning.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01867-z.

The Anatomage Table: A Promising Alternative in Anatomy Education

Anatomy is one of medical and nursing education's most prominent and crucial keynotes. For ages, conventional lectures and the analysis of actual human corpses were employed as predominant teaching techniques. However, the sphere of healthcare pedagogy has been greatly altered by the developing passion for technology over the past few years. Anatomage offers a life-size digital representation of the human body, allowing the visualization, manipulation, and virtual dissection of complex anatomical structures, using detailed 3D (three-dimensional) models. Academic institutions utilize Anatomage as a means to enhance and contemporize the acquisition of anatomy knowledge. This systematic review aims to present the educational role of Anatomage in anatomy and whether it can replace the use of cadaveric material in medical education entirely in the future.  A detailed search on PubMed, SCOPUS, Wiley Online Library, and Google Scholar databases was performed. The criteria for the selection were the English language and the year of publication between 2018 and 2023. We rejected publications that were irrelevant to the topic. Before applying the filters, we found 198 publications, from which 24 were finally chosen for the purpose of this review.  The results of this systematic review indicate that most students agree on the beneficial role of Anatomage in the thorough comprehension of anatomical knowledge, and they prefer it over traditional learning methods, such as the use of cadaveric material. Anatomage not only offers a deeper insight into the relations between inner formations, since it is a particularly easy-to-use and pleasant teaching tool, but also contributes to the improvement of learning outcomes in the classroom, which is proved by higher grades in the anatomy course. However, it can be an effective teaching method if it is used in addition to the classic method of cadaver training, rather than being the only educational practice.  Integrating the Anatomage Table (AT) into undergraduate courses is paramount to the comprehensive learning and application of human anatomy in students' future health careers. Learners who have utilized the table note it to be a beneficial and effective tool in preparing them to enter into the healthcare profession.

Inclusion of cross-sectional and radiological images for better understanding of musculoskeletal anatomy and decreasing the risk of adverse events during dry needling in undergraduate physiotherapy students

Since there is an increasing rate of physiotherapists using invasive procedures during the clinical practice, understanding the cross-sectional anatomy and radiological images is essential for ensuring patients' safety during these interventions. Therefore, the aim of this study was to analyze the students' opinion of including cross-sectional and radiological images to traditional methodologies, to evaluate whether these additional resources improve their ability to identify musculoskeletal structures in radiological images and their understanding of neurovascular and visceral structures related with specific muscles to be avoided during invasive procedures. First-year undergraduate physiotherapy students were enrolled in the study. A brief online survey asking about their opinion about the use of cross-sectional and radiological images as complementary resources was built. In addition, two open-answer tests (before and after the inclusion of these resources) were conducted to evaluate their ability to identify correctly musculoskeletal structures in magnetic resonance and ultrasound images and to evaluate their awareness of high-risk structures related with specific muscles. One-hundred-thirty-two students returned the online survey and one-hundred-forty-eight completed all the tests. In general, students opined cross-sectional images to be of utility for learning anatomy (81.8%) and radiological images (93.9%) and felt they benefited from cross-sectional and ultrasound images (78.0%). All tests showed significant improvements after the inclusion of these complementary resources (all, p < 0.001) except for trunk structures in MRI (p = 0.777). The implementation of anatomical cross-sectional and radiological images resulted in better understanding of radiological images and better cognition of possible risk during invasive procedures.

A comparative analysis of lecturers' satisfaction with Anatomage and Pirogov virtual dissection tables during clinical and topographic anatomy courses in Russian universities

Anatomy is increasingly taught using computer-assisted learning tools, including electronic interactive anatomy dissection tables. Anatomage was he first virtual anatomy dissection table introduced in Russian medical universities and gained popularity among lecturers and students. The Pirogov interactive anatomy table was recently released, but the strengths and weakness of each platform is currently unknown. The objective of this article is to survey lecturers in anatomy to understand their perspectives on the Pirogov versus Anatomage virtual dissection tables' application to teaching in medical universities. A total of 80 anatomy educators from 12 Russian universities, using Anatomage (n = 40) and Pirogov (n = 40) tables were surveyed regarding their satisfaction with the application of the respective tables. Using a five-point Likert scale, both tables were assessed, and responses were statistically analyzed. In addition, qualitative analysis was performed on free response comments provided by survey respondents. There was no significant difference in overall satisfaction ratings between Pirogov (4.38 ± 0.53) and Anatomage (3.94 ± 0.60) interactive tables (p > 0.05). The Anatomage table ranked significantly higher on the accuracy of displayed anatomical details, resolution of the images, and its suitability for teaching senior medical and postgraduate students. Pirogov table performed significantly better on survey items measuring ergonomics, ability to assess students' performance, and teaching basic anatomy to junior first- and second-year medical students. Thus, in summary, anatomists' responses indicated that while both tables are suitable for teaching anatomy, the Pirogov table was superior in undergraduate medical education and the Anatomage table was more beneficial for teaching more senior trainees.

Do virtual dissection tables add benefit to cadaver-based anatomy education? An evaluation

PURPOSE

The anatomy education literature suggests blended-learning approaches as more effective. We performed a literature review to answer the question if virtual dissection tables can play a significant role as supplements to traditional cadaver-based anatomy education methods.

METHODS

PubMed, SCOPUS, ERIC and Cochrane databases were searched for articles with purpose to explore the outcomes of the use of virtual dissection tables in conjunction with cadaver-based anatomy education.

RESULTS

Six articles were included. Three articles were comparative and comprised evaluation of participants' anatomy examinations results. Three articles were non-comparative and comprised only evaluation of participants' opinions about the educational intervention. In all studies, the participants expressed satisfaction about the educational value of this intervention, while the data about anatomy examinations' results suggest that virtual dissection tables may also enhance students' academic performance, when they are used in conjunction with cadavers.

CONCLUSION

Virtual dissection tables seem to do have a role in modern blended-learning anatomy curricula and could essentially supplement the educational power of cadaver-based methods. Our findings may stimulate further implementation of virtual dissection tables as supplementary tools to cadaver-based anatomy education.

Gestures-enhanced anatomy teaching: A literature review of an educational strategy with promising outcomes

PURPOSE

The educational use of gestures has resulted in positive outcomes in several fields. We performed a literature review to investigate the outcomes of the use of gestures to enhance the existing anatomy education methods.

METHODS

PubMed, SCOPUS, ERIC and Cochrane databases were searched for papers with purpose to investigate the outcomes of the use of gestures (either seeing or performing them or both) as adjuncts to existing anatomy education methods.

RESULTS

Six articles were included. Three studies comprised both seeing and performing gestures by the students, while the remaining three studies only comprised either seeing or performing gestures by the students. Most studies evaluated the acquisition of anatomical knowledge after the educational intervention and demonstrated that the addition of gestures resulted in significant benefit compared to control groups, while positive students' perceptions were recorded. It was not clarified whether seeing or performing gestures by the students leads to better educational outcomes.

CONCLUSION

Gestures-enhanced anatomy education seems to be a promising teaching strategy, given that it has led to significantly increased acquisition of anatomical knowledge compared to no gestures-enhanced modalities. The addition of gestures to existing anatomy education modalities seems able to increase their potential without increasing their cost. Further research is needed to determine if seeing or performing gestures by the students is more effective.

Transforming musculoskeletal anatomy learning with haptic surface painting

Anatomical body painting has traditionally been utilized to support learner engagement and understanding of surface anatomy. Learners apply two-dimensional representations of surface markings directly on to the skin, based on the identification of key landmarks. Esthetically satisfying representations of musculature and viscera can also be created. However, established body painting approaches do not typically address three-dimensional spatial anatomical concepts. Haptic Surface Painting (HSP) is a novel activity, distinct from traditional body painting, and aims to develop learner spatial awareness. The HSP process is underpinned by previous work describing how a Haptico-visual observation and drawing method can support spatial, holistic, and collaborative anatomy learning. In HSP, superficial and underlying musculoskeletal and vascular structures are located haptically by palpation. Transparent colors are then immediately applied to the skin using purposive and cross-contour drawing techniques to produce corresponding visual representations of learner observation and cognition. Undergraduate students at a United Kingdom medical school (n = 7) participated in remote HSP workshops and focus groups. A phenomenological study of learner perspectives identified four themes from semantic qualitative analysis of transcripts: Three-dimensional haptico-visual exploration relating to learner spatial awareness of their own anatomy; cognitive freedom and accessibility provided by a flexible and empowering learning process; altered perspectives of anatomical detail, relationships, and clinical relevance; and delivery and context, relating to curricular integration, session format, and educator guidance. This work expands the pedagogic repertoire of anatomical body painting and has implications for anatomy educators seeking to integrate innovative, engaging, and effective learning approaches for transforming student learning.

Achievement of learning outcomes in non-traditional (online) versus traditional (face-to-face) anatomy teaching in medical schools: A mixed method systematic review

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.

How Virtual Animal Anatomy facilitated a successful transition to online instruction and supported student learning during the coronavirus pandemic

Anatomy faculty with cadaver-based laboratory courses were presented with a significant challenge in March 2020 to create equivalent learning experiences without cadaveric access. The undergraduate domestic animal anatomy course at the Colorado State University was halfway into a 16-week semester when COVID-19 lockdown orders and the transition to remote instruction began. The new course curriculum was critically evaluated using student surveys and course outcome data. Most students (92.5%) agreed that the transition to online learning was a success; however, students who valued face-to-face lectures prior to March were less likely to perceive the transition as a success. Qualitative and quantitative analyses of survey results suggest that the resources perceived as most helpful for the transition to online learning were not the same as those that helped facilitate animal anatomy learning. Most students (92.5%) agreed that the Virtual Animal Anatomy (VAA) helped them learn anatomy, and 82.2% indicated that the VAA was a valuable resource following the transition to online learning. Additional resources associated with transition success included course instructors, weekly quizzes, written descriptions of anatomical structures and open laboratory sessions. In contrast, those resources associated with facilitating learning included guided quizzes and asynchronous lecture recordings. These findings suggest that the VAA can support online anatomy learning when used in conjunction with other best practices for online teaching.

The Effectiveness of a Virtual Anatomy Curriculum Versus Traditional Cadaveric Dissection in UNC SOM's First-Year Class

Even prior to the COVID pandemic, the push for medical schools to adopt virtual anatomy curricula in lieu of human cadaveric dissection was growing. In this study, musculoskeletal and gastrointestinal anatomy examination scores of first-year medical students at the UNC School of Medicine were compared across three consecutive years. These classes experienced in-person, virtual, and hybridized anatomy curriculum, respectively. There was not a single instance noted where in-person curriculum produced higher examination scores than virtual or hybridized models. By incorporating virtual or hybridized models of anatomy, medical education programs can effectively reach and educate students far beyond the traditional cadaver laboratory.

Head-neck dissection course during COVID-19 pandemic: challenges, adaptations and how we did it

INTRODUCTION

Cadaveric dissection courses have come to a standstill since the onset of the COVID-19 pandemic. In addition to limited operative opportunities, cancellation of such courses has severely impacted surgical training, especially in a craft-based specialty such as head-neck surgery. The aim of this educational project was to: (1) study the feasibility of an in-person head-neck cadaveric dissection course during COVID-19 pandemic; and (2) validate the educational benefit of this teaching method to ear, nose and throat (ENT) trainees.

METHODS

We developed a 2-day head-neck cadaveric dissection course for ENT trainees. The course programme covered essential head-neck open surgical procedures. Content validity (subjective feedback) was assessed using a 5-point Likert scale. Construct validity (objective usefulness) was evaluated via two pre- and post-course questionnaires, estimating knowledge of head-neck surgical anatomy and self-assessment of levels of confidence with head-neck procedures, respectively.

RESULTS

A risk assessment was conducted and a protocol developed (risk was deemed to be low/tolerable). Content validity showed high satisfaction compared with a median Likert score of 3, 'average' (p=0.000002). For construct validity, the mean score per question improved significantly (p=0.001). Overall levels of confidence showed a trend towards improvement (p=0.08). There was significant improvement in laryngectomy (p=0.01) and level I dissection (p=0.01), with an indication of improvement in level II-V dissection (p=0.07).

CONCLUSIONS

We demonstrated that a cadaveric dissection course, using thorough risk assessment and protocol, could be safely conducted with high content and construct validation during these unprecedented times. This is an invaluable learning environment that needs to be encouraged despite infection control restrictions.

A Multicentre Analysis of Approaches to Learning and Student Experiences of Learning Anatomy Online

Introduction

The approaches to learning students adopt when learning anatomy online could yield important lessons for educators. Dissection room teaching can encourage students to adopt a deep approach to learning anatomy. It was therefore hypothesized that the proportion of students adopting a deep approach to learning would be lower in a population learning anatomy online. This research aims to investigate the experiences of students learning anatomy online during the COVID-19 pandemic and the approaches to learning they adopted.

Methods

A survey was distributed to medical students at 7 universities across the UK and Ireland. The survey included two previously validated questionnaires: Approaches and Study Skills Inventory for Students and Anatomy Learning Experience Questionnaire.

Results

The analysis included 224 unique student responses. Students' approach to learning mirrored reports from previous studies conducted during face-to-face tuition with 44.3% adopting deep, 40.7% strategic, 11.4% surface, and 3.6% combined learning approaches. The university (p = 0.019) and changes to formative (p = 0.016) and summative (p = 0.009) assessments significantly impacted approach to learning. Students reported that online resources were effective but highlighted the need for clearer guidance on how to find and use them successfully.

Conclusion

It is important to highlight that students value in-person opportunities to learn from human cadaveric material and hence dissection room sessions should remain at the forefront of anatomical education. It is recommended that future online and/or blended provisions of anatomy teaching include varied resources that maximize engagement with media featuring cadaveric specimens.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01633-7.

Incorporation of team-based learning in the cadaveric anatomy laboratory: An overview

PURPOSE

Team-based learning is a strategy which has resulted in positive outcomes concerning health professions education. We aimed to shed light on the role of this strategy when it is incorporated in the cadaveric anatomy laboratory.

METHODS

We explored PubMed, SCOPUS, ERIC and Cochrane databases for articles with purpose to investigate the educational outcomes of the integration of team-based learning in the cadaveric anatomy laboratory.

RESULTS

Six articles were eligible for inclusion. One of them assessed only participants' opinions about the educational intervention and five papers evaluated students' knowledge. Overall, the research showed significant improvement in students' examinations performance and significant superiority to control groups, as well as positive perceptions. There are limited data regarding the factors which may contribute to this success, but it seems that particularly the degree of teacher's involvement and competency needs to be further investigated.

CONCLUSION

Anatomy educators may consider further adopting team-based learning to facilitate the achievement of the learning objectives of the cadaveric anatomy laboratory and increase the teaching potential of cadavers.

Medical students' perceptions and performance in an online regional anatomy course during the Covid-19 pandemic

The present study evaluated the students' psychological well-being, experiences, performance, and perception of learning regional anatomy remotely. A regional anatomy remote learning curriculum was designed and learning materials were delivered virtually to 120 undergraduate medical students at Jinan University, China. All the students consented and voluntarily participated in this study by completing self-administered online questionnaires including the Zung's Self-Rating Anxiety and Depression Scales at the beginning and end of the learning session. A subset participated in focus group discussions. Most of the students (90.0%) positively evaluated the current distance learning model. More than 80% were satisfied with the content arrangement and coverage. Many students preferred virtual lectures (68.2%) and videos showing dissections (70.6%) during the distance learning sessions. However, writing laboratory reports and case-based learning were the least preferred modes of learning as they were only preferred by 23.2% and 14.1% of the students, respectively. There was no significant lockdown-related anxiety or depression reported by students using depression and anxiety scales as well as feedback from focus group discussions. The surveyed students' confidence scores in distance learning were significantly higher after 5 weeks than at the beginning of the session (3.05 ± 0.83 vs. 3.70 ± 0.71, P < 0.05). Furthermore, the present results showed no significant differences between the current group's academic performance in the unit tests as well as the final overall evaluation for different parts of the course compared to that of the previous year's cohort. The findings above were congruent with focus group discussion data that the use of the online teaching platform for regional anatomy significantly improved the students' confidence in virtual and self-directed learning and did not negatively affect their academic performance.

The value of in-person undergraduate dissection in anatomical education in the time of Covid-19

While several innovative pedagogical practices have been developed and implemented in anatomy education since the onset of the coronavirus disease 2019 (Covid-19) pandemic, considering the value of in-person undergraduate dissection remains crucial. In this commentary, a human dissection course at the University of Toronto is used as an example to highlight the value of dissection for undergraduate learners in non-professional programs. In-person dissection allows for real life, anatomical variation, and supports the advancement of students' conceptual knowledge of the human body and visual-spatial abilities. Direct involvement with dissection during undergraduate training also provides students with an opportunity to practice and refine non-technical skills, such as communication and collaboration, while simultaneously promoting the development of students' professional identity formation. Further, dissection is a practical, hands-on experience that can provide students with insight into potential career aspirations related to anatomy and the health professions. It is suggested that as institutions veer from traditional pedagogical practices and evaluate how to best move forward post-pandemic, it is imperative that the value of undergraduate dissection is considered among new innovations in the field of anatomy.

Anatomy: An Opportunity for South African Health Science Students to Discuss Their Emotional Responses to Human Remains in the Laboratory

Human dissection remains a cornerstone of the anatomy learning experience. However, the emotional response of students to the use of human remains for learning is influenced by a number of factors and is not always positive. Therefore, this study explored the students’ emotional response to and factors affecting their perceptions of the use of human remains for learning anatomy in a South African context. Four hundred and eighty of the 1538 health sciences students enrolled in human anatomy courses at the University of the Witwatersrand, South Africa during 2016 and 2017, completed a voluntary survey. The survey included closed and open-ended questions on students’ emotional responses, coping mechanisms and the factors that affected their perceptions of the use of human remains and dissection. Overall, the students had a positive emotional response. Their perceptions of dissection were affected in positive and negative ways by their religious and cultural beliefs. Feelings of gratitude and respect toward the cadaver were informed by belief systems. However, anxiety was caused by the delay of accepted sociocultural burial practices. Peer discussions were the preferred coping method, which may provide an approach for students to discuss how their beliefs influence their dissection experience.

Digital science platform: an interactive web application and database of osteological material for anatomy education

BACKGROUND

To meet the remote-learning constraints imposed due to the COVID-19 pandemic, the Digital Science Platform was developed. Human anatomy courses require practical classes that involve working on prepared specimens, although access to such specimens has been restricted. Therefore, the aim was to prepare appropriate-quality, scanned 3D model databases of human bone specimens and an interactive web application for universal access to educational materials.

MAIN BODY

The database is located on the pcn.cnt.edu.pl website and contains 412 three-dimensional osteological models created via a structured light scanner, tomography and microtomography. The webservice contains a search engine and enables interactive visualization of the models. The database can be accessed, without restrictions, by any student or researcher wishing to use the models for noncommercial purposes. The stored models can be visualized with the open-source VisNow platform, which is also available to download from the webservice. The MariaDB backend database was deployed, and an Apache server with a personal home page (PHP) frontend was used.

CONCLUSION

The models in the database are unique due to the specific digitalization process and skeleton specimen origin. Further development of the Digital Science Platform is foreseen in the near future to digitize other valuable materials.

Influence of Supervisors’ Fairness on Work Climate, Job Satisfaction, Task Performance, and Helping Behavior of Health Workers During COVID-19 Outbreak

The need for supervisors to exhibit fairness was a key motivating tool for effective health service delivery during the initial stages of the COVID-19 outbreak. Nonetheless, the number of deaths and hospitalization was alarming health workers were actively working throughout the time. This study explores the role of supervisors’ fairness in creating a work climate and job satisfaction that promote workers’ task performance and helping behaviors. The researchers adopted a quantitative method with a questionnaire used for data collection. SPSS and AMOS were used for data analysis, and statistical models of correlation and hierarchical regression were used to examine relationships among the variables. The study established that supervisors’ fairness has a positive effect on work climate, job satisfaction, task performance, and helping behavior of health workers. Work climate has positive effects of task performance and helping behaviors, whereas job satisfaction also has positive effects on employees’ task performance and helping behavior. The researchers recommended the need for supervisors to exhibit fairness to workers at all times and create room for the workers to appeal their decision to avoid the feeling of supervisors’ biasness.

Full color 3D printing of anatomical models

INTRODUCTION

We propose an effective method for manufacturing human anatomical specimens in response to the shortage of cadaver specimens and the poor simulation results of anatomical specimen substitutes.

METHODS

Digital human data with high precision were used to create digital models and corresponding mapped textures. Different materials were chosen to print the digital models with full-color and multimaterial 3D-printing technology on the basis of the histological characteristics of the anatomical structures. Anatomy experts and surgeons were then invited to compare the 3D printed models with authentic anatomical specimens in terms of morphological appearance, anatomical detail, and textural properties.

RESULTS

The skull, brain, hand muscles, blood vessels and nerves of the hand, and the deep structure of the head and face were printed. The skull model used hard material, and the brain and hand muscles models used flexible and hard materials combined. The blood vessels, nerves of the hand, and the superficial and deep structure of the head and face used transparent materials, revealing the small vessels and nerves in the interior. In all the models there were no significant differences from anatomical specimens in morphological appearance and anatomical detail. They also affected vision and touch in the same way as authentic specimens in the textural properties of color, roughness, smoothness, and fineness.

CONCLUSION

Full-color and multi-material 3D printed anatomical models have the same visual and tactile properties as anatomical specimens and could serve to complement or supplement them in anatomy teaching to compensate for the shortage of cadavers. This article is protected by copyright. All rights reserved.

One year of anatomy teaching and learning in the outbreak: Has the Covid-19 pandemic marked the end of a century-old practice? A systematic review

At the end of 2019, the Covid-19 pandemic spread caused restrictions in business and social spheres. Higher education was also severely affected: universities and medical schools moved online to distance learning and laboratory facilities closed. Questions arise about the long-term effects of this pandemic on anatomical education. In this systematic review, the authors investigated whether or not anatomical educators were able to deliver anatomical knowledge during this pandemic. They also discuss the challenges that anatomical education has faced over the last year. The search strategy was conducted between July 2020 and July 2021. Two hundred and one records were identified, and a total of 79 studies were finally included. How best to deliver anatomy to students remains a moot point. In the last years, the advent of new technologies has raised the question of the possible overcoming of dissection as the main instrument in anatomical education. The Covid-19 pandemic further sharpened the debate. Remote learning enhanced the use of technologies other than cadaveric dissection to teach anatomy. Moreover, from the analyzed records it appears that both from students' perspective as well as teachers' there is a clear tear between those who endorse dissection and those who believe it could be easily overcome or at least integrated by virtual reality and online learning. The authors strongly believe that the best anatomy teaching practice requires the careful adaptation of resources and methods. Nevertheless, they support cadaveric dissection and hope that it will not be replaced entirely as a result of this pandemic.

An analysis of anatomy education before and during Covid-19: August-December 2020

Coronavirus disease-2019 (Covid-19) disrupted the in-person teaching format of anatomy. To study changes in gross anatomy education that occurred during August-December, 2020 compared to before the pandemic, an online survey was distributed to anatomy educators. The 191 responses received were analyzed in total and by academic program, geographic region, and institution type. Cadaver use decreased overall (before: 74.1 ± 34.1%, during: 50.3 ± 43.0%, P < 0.0001), as well as across allopathic and osteopathic medicine, therapy, undergraduate, and veterinary programs (P < 0.05), but remained unchanged for other programs (P > 0.05). Cadaver use decreased internationally and in the US (P < 0.0001), at public and private (P < 0.0001) institutions, and among allopathic medical programs in Northeastern, Central, and Southern (P < 0.05), but not Western, US geographical regions. Laboratories during Covid-19 were delivered through synchronous (59%), asynchronous (4%), or mixed (37%) formats (P < 0.0001) and utilized digital resources (47%), dissection (32%), and/or prosection (21%) (P < 0.0001). The practical laboratory examination persisted during Covid-19 (P = 0.419); however, the setting and materials shifted to computer-based (P < 0.0001) and image-based (P < 0.0001), respectively. In-person lecture decreased during Covid-19 (before: 88%, during: 24%, P = 0.003). When anatomy digital resources were categorized, dissection media, interactive software, and open-access content increased (P ≤ 0.008), with specific increases in BlueLink, Acland's Videos, and Complete Anatomy (P < 0.05). This study provided evidence of how gross anatomy educators continued to adapt their courses past the early stages of the pandemic.

Body Donation, Teaching, and Research in Dissection Rooms in Spain in Times of Covid-19

The state of alarm due to Covid-19 pandemic in Spain stopped all educational and most university research activities. The Spanish Anatomical Society (SAE) Consensus Expert Group on Body Donations piloted a study based on a questionnaire to know the status of body donations and dissection activities during the lockdown, as well as the future implications of Covid-19 pandemic for body donation programs and anatomy teaching. The questionnaire results show that Spanish Universities refused body donations and stopped all dissection research and teaching. The Covid-19 expected influence on anatomy teaching was referred to the increase in teaching workforce and resources required to apply the new safety measures to future practical activities, as well as to prepare and adapt teaching material for online-only programs. The application of reinforced safety measures was expected to be perceived by the respondent's students as a gain in teaching quality, while the transformation of the anatomy courses in online-only programs will be perceived as a quality decrease. The respondent's concerns about future institutional implications of the pandemic were related to increased costs of the adaptation of the facilities and the reinforced preventive measures, as well as the eventual decrease in donations. The complete lockdown applied to dissection rooms was not justified by scientific evidence and represented a break of the confidence deposed in the institutions by the donors. A consensus is required for the adoption of a renewed, comprehensive protocol for present and future body donations including the evidence Covid-19 pandemic has contributed to create.

Bilateral absence: A rare anomaly of the gemelli muscles

The superior and inferior gemelli are deep muscles of the gluteal region, that facilitate the maintenance of a dynamic stability of the hip joint. Their absence could increase the chances of failure in the management of total hip anthroplasty and column acetabular ring fractures. We present a case of an adult female cadaver, with bilateral absence of the superior and inferior gemelli muscles.