Anatomy: A must for teaching the next generation

The need to identify anatomy-related competencies in medical education

A profound grasp of anatomy is indispensable for shaping competent and safe medical practitioners. This knowledge acquisition is pivotal in the early stages of medical education and remains crucial throughout clinical training. However, the evolving landscape of medical education has ushered in changes to the anatomy curriculum, marked by a reduction in contact hours and a streamlined content structure to accommodate novel subjects and teaching methodologies. This transformation has precipitated a quandary in defining the essential scope and depth of anatomical knowledge to be imparted. Traditionally, surgeons assumed the role of anatomy instructors until Flexner's recommendations catalyzed the integration of trained anatomists. Nevertheless, the varied backgrounds of anatomists and the heterogeneity in anatomy curricula across institutions have introduced potential disparities in the quality of graduates. Addressing these challenges mandates the identification of key anatomy competencies tailored for undergraduate medical students. The imperative lies in ensuring that these competencies span cognitive, psychomotor, and affective domains, offering not only comprehensiveness but also direct applicability to clinical practice. Hence, this viewpoint highlights the necessity of adopting a systematic approach that includes gathering input from various stakeholders in developing and implementing a universal anatomy core competency framework, ensuring graduates are equipped for the multifaceted demands of clinical practice. Overall, the manuscript provides a comprehensive overview of the challenges and opportunities in anatomy education, with a clear call to action for a transformative approach to meet the evolving needs of medical practice.

Haptic experience to significantly motivate anatomy learning in medical students

BACKGROUND

Currently, multiple tools exist to teach and learn anatomy, but finding an adequate activity is challenging. However, it can be achieved through haptic experiences, where motivation is the means of a significant learning process. This study aimed to evaluate a haptic experience to determine if a tactile and painting with color marker interactive experience, established a better learning process in comparison to the traditional 2D workshop on printed paper with photographs.

METHODS

Plaster bone models of the scapulae, humerus and clavicle were elaborated from a computerized scan tomography. Second year undergraduate medical students were invited to participate, where subjects were randomly assigned to the traditional 2D method or the 3D plaster bone model. A third group decided not to join any workshop. Following, all three groups were evaluated on bone landmarks and view, laterality, muscle insertions and functions. 2D and 3D workshop students were asked their opinion in a focus group and answered a survey regarding the overall perception and learning experience. Evaluation grades are presented as mean ± standard deviation, and answers from the survey are presented as percentages.

RESULTS

The survey demonstrated the students in the 3D model graded the experience as outstanding, and in five out of the six questions, answers were very good or excellent. In contrast, for students participating in the 2D workshop the most common answers were fair or good. The exception was the answer regarding the quiz, where both groups considered it good, despite the average among all groups not being a passing grade.

CONCLUSIONS

To learn the anatomy of the shoulder, the conventional methodology was compared with a haptic experience, where plaster bone models were used, enabling students to touch and paint on them. Based on the focus group and survey this study revealed the 3D workshop was an interactive experience where, the sense of touch and painting greatly contributed to their learning process. Even though this activity was useful in terms of learning bone landmarks, view muscle insertions, and establish relations, further activities must be developed to increase their understanding regarding their function, and its relevance in a clinical setting.

A comparison of 1- versus 3-month regional anatomy exposure on learning outcomes of undergraduate medical students

Regional anatomy teaching forms a cornerstone of undergraduate medical education. Owing to an increase in teaching and learning content throughout the medical curriculum in recent years, contact hours and overall course durations in anatomy are under review worldwide. This study aimed to assess whether shortening the course content duration impacts learning gain and the ability to identify anatomical structures correctly. Undergraduate medical students of the Johannes Kepler University Linz (JKU; n = 310) and at the Medical University of Graz (MUG; n = 156) participating in regional anatomy courses were included. Whole body regional anatomy courses, including hands-on dissection and accompanying lectures, were delivered over one or three months. Course content and examination mode were kept consistent, while the duration of knowledge delivery was one or three months, respectively. Objective structured practical examinations (OSPE) were then carried out on prosections for the neck, thorax, and abdomen. 3-month course exposure resulted in significantly higher OSPE scores for the neck (49 vs. 37%), thorax (65 vs. 54%), and abdomen (65 vs. 45%), respectively. Further evaluation of the utility of different embalming types yielded higher 3-month scores in the neck and thorax regions with Thiel-embalmed tissues and thorax and abdomen regions in ethanol-glycerin-embalmed tissues. Course exposure over a more extended period, like three months, appears to be highly beneficial.

Self-Directed Learning Versus Traditional Teaching in Learning Gross Anatomy Among First-Year Medical Students: A Comparative Study

INTRODUCTION

Gross anatomy is the first subject to be grasped by budding medicos before learning a long series of skills and competencies required to bloom as a physician or surgeon. In recent years, the teaching time for anatomy has been reduced. The number of anatomy teachers is much less in comparison to the increasing number of students. There is also a paradigm shift in medical education; it has become competency-based, learner-centric, and technology-based. So, anatomical education is also shifting to adopt blended learning strategies. Now, the onus of learning lies more with the students, which can be promoted through self-directed learning (SDL). Many first-year medical students are unprepared for SDL and need assistance understanding SDL. Structured SDL can successfully instill the habit of SDL in young medical students, who are supposed to be lifelong learners in their professional careers. The concept of structured SDL under the supervision of teachers is comparatively new in India. Very few studies are there to compare the effectiveness of SDL with those of traditional teaching methods. The present study aimed to evaluate the effectiveness of SDL in learning the gross anatomy of an important viscus, viz., the liver, and to compare it with the effectiveness of the traditional method of teaching by demonstration/prosection.

METHODS

 This interventional comparative study was carried out at the department of anatomy of a government medical college in Kolkata, India. Sixty willing first-year undergraduate medical students were included in the study. The students were divided into two batches (Batch A and Batch B) of 30 each. Students of Batch A were taught the viscus (liver) by the traditional method of teaching by demonstration/prosection for one and a half hours. Validated pre-test and post-test questionnaires were administered to evaluate learning outcomes. Students of Batch B had a structured self-directed learning (SDL) session under the supervision of teachers on the same topic, viz., viscus (liver), for one and a half hours. The pre-test and post-test questionnaires were given before and after the SDL sessions to evaluate learning outcomes. The results were statistically analyzed.

RESULTS

It was observed that the mean post-test score after traditional teaching improved significantly compared to the mean pre-test score. Also, the mean post-test score after the SDL session improved significantly compared to the mean pre-test score. It was found that the mean post-test score after exposure to traditional teaching methods was slightly better than the mean post-test scores after exposure to SDL, but this difference was not statistically significant.

CONCLUSION

It can be inferred that structured SDL under the supervision of teachers was almost as good as the traditional teaching method by demonstration/prosection in learning the gross anatomy of an important viscus, viz., liver. In the context of the reduced number of anatomy teachers and an increasing number of students, this may open up an option of teaching some portion of gross anatomy, like a few viscera, by SDL. However, a more robust study with a larger sample size can be more conclusive.

Effects of 3D Scans on Veterinary Students' Learning Outcomes Compared to Traditional 2D Images in Anatomy Classes

Students often struggle with interpreting traditional textbook images and translating them to anatomical structures. This study aimed to compare the impact of 3D scans versus 2D images on students' learning outcomes when learning anatomical structures on skulls from horses and pigs. Furthermore, the correlation between spatial ability and learning outcomes using 3D scans or 2D images was examined. Second-year veterinary medicine students either used 3D scans or 2D images, annotated with arrows or numbers as learning material. Students' anatomical knowledge was tested before and after the learning session, and spatial ability was assessed using the mental rotation test. All groups improved significantly in the post-test. However, the differences between groups were not significant, suggesting that 3D scans do not necessarily lead to higher learning outcomes. The analysis of the correlation between spatial ability and learning outcomes did not prove that students with weaker spatial ability benefit from 3D scans. Students preferred 3D scans over 2D images despite similar outcomes, suggesting they are valuable for learning. However, results show that the introduction of novel learning materials likely amplified the impact of reduced learning time on the 3D group, as these materials necessitated additional time for effective comprehension and integration.

Anatomical variation is the norm: A novel curriculum framework

Anatomical variation is an inherent part of every health curriculum, due in large to the negative clinical consequences that can ensue if anatomical variation is not thoroughly understood. However, current literature fails to describe any structured whole-of-course pedagogy for the teaching of anatomical variation in higher education. This study therefore aimed to (i) propose a whole-of-course curriculum framework to guide academic development and implementation of anatomical variation resources and assessment; and (ii) assess the depth of anatomical variation knowledge in a multiyear undergraduate health-science cohort (n = 152) at the Queensland University of Technology. Current anatomical variation pedagogy, and subsequently the need for the curriculum framework, were explored using a scoping review protocol. As part of this study, anatomical variation was novelly defined as macroscopic differences in morphology (shape and size), topography (location), developmental timing, or frequency (number) of an anatomical structure between individuals that form during embryological or subadult development and result in no substantive, observable interruption to physiological function. The framework incorporated three themes of anatomical variation learning outcomes: description of anatomical variation, theories of the professional implications of variation, and investigation of variant formation. These themes were strongly aligned with the concepts recommended for teaching identified through the scoping review. Significant deficits in anatomical variation student knowledge were identified, with the third-year cohort recording a mean total score of only 54.6%. A strong recommendation to implement the anatomical variation curriculum framework in all medical and health-science curricula is made to intentionally develop student understanding of anatomical variation and improve future clinical practice.

A Bibliometric Analysis of Publications on Cadavers: A Study Based on Web of Science Data From 1978 to 2023

This study aimed to investigate the significance of publications examining the effectiveness of cadaver studies in the field of medicine with the method of bibliometric analysis, which emerged in the 1950s, offers the opportunity to conduct a detailed analysis of a specific subject, just like a systematic literature review or meta-analysis. Also, it aimed to enlighten the content of cadaver studies in the last half-century and to present a perspective for the future. In the study, an advanced search was conducted on the Web of Science Core Collection database on August 1, 2023, using the keywords "cadaver," "cadaver study," "cadaveric dissection." Review articles were excluded from the study. There were determined 34554 documents. The documents were transferred to the VOSviewer software program. In this way, the authors made detailed analyses of authors, keywords, journals, organizations, institutions, and countries and created scientific maps. The United States was one of the most important countries in terms of research. Generally, the use of cadaver terms in documents belongs to surgery, anatomy, and transplantation journals. Anatomy, cadaver, biomechanics, ultrasound, and computed tomography were the top 5 most frequently used keywords with cadaver term. The findings of our study showed that cadaver studies are used in many fields of medical science. However, clinical studies, including advanced imaging techniques, draw attention to the developing technology. Along with the powerful institutions of the United States, its great contributions to publications stand out.

Use of Clinically Oriented Laboratory Manuals in a Prosection Gross Anatomy Laboratory during COVID-19

Gross anatomy is a critical course for the development of a variety of skills such as anatomical knowledge and spatial, critical, and clinical reasoning. There have been few attempts to integrate clinical applications in gross anatomy, with the majority of these being in the lecture hall and not in the laboratory. Clinical cases and guided questions were added to a laboratory manual (Clinically Oriented Laboratory Manuals (COLMs)) in a first-year medical gross anatomy prosection course during COVID-19. The effectiveness of the COLMs was analyzed using in-laboratory assessments between treatment and control groups, as well as student perceptions. There was no significant difference between in-lab assessment scores between students with or without the COLMs in 2020 (t1304.735= 0.647, p ;= 0.518). Student perceptions demonstrated that 61.6% strongly agreed or agreed that the COLMs were a good way to learn anatomy and 32.0% desired more COLMs in the lab. Overall, COLMs did not increase student knowledge by the end of a session. Students thought the COLMs were a good tool to learn anatomy because they helped become more clinically aware; however, students desired better implementation of the COLMs. The addition of COLMs in the laboratory is a potential method to address the need for clinical applications within the gross anatomy laboratory.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01970-1.

Does regular attendance in supplemental virtual near-peer tutoring in anatomy laboratory content improve anatomy performance for medical students?

Near-peer tutoring (NPT) programs are popular vehicles to supplement traditional delivery of medical school curricula, including for anatomy laboratory (AL) content. While NPT programs can result in improved preclinical coursework performance for tutees, little to no data specifically show a benefit of NPT in AL course performance. In 2021, NYIT College of Osteopathic Medicine launched an NPT program where qualified second-year students led group tutoring sessions for first-year students. This study investigated whether participation and level of attendance in AL NPT sessions were associated with greater examination-to-examination improvement in AL performance. Student attendance at AL sessions in the NPT program was categorized as either regular (10 or more sessions), moderate (5-9 sessions), infrequent (1-4 sessions), or never during one semester. For the first 2 years of the NPT program, attendance frequency at AL tutoring sessions had a significant impact on average exam-to-exam improvement (p < 0.05). Overall, students who attended tutoring at any frequency had greater exam-to-exam improvement than students who never attended (p < 0.05). However, this trend was only significant in 1 of 2 years investigated. These data show that NPT programs can, though not uniformly, benefit student outcomes in AL coursework. With these data, this study provides additional details on the level of attendance necessary for expected improvements in AL coursework.

Objects drawn from haptic perception and vision-based spatial abilities

Haptic perception is used in the anatomy laboratory with the handling of three-dimensional (3D) prosections, dissections, and synthetic models of anatomical structures. Vision-based spatial ability has been found to correlate with performance on tests of 3D anatomy knowledge in previous studies. The objective was to explore whether haptic-based spatial ability was correlated with vision-based spatial ability. Vision-based spatial ability was measured in a study group of 49 medical graduates with three separate tests: a redrawn Vandenberg and Kuse Mental Rotations Tests in two (MRT A) and three (MRT C) dimensions and a Surface Development Test (SDT). Haptic-based spatial ability was measured using 18 different objects constructed from 10 cubes glued together. Participants were asked to draw these objects from blind haptic perception, and drawings were scored by two independent judges. The maximum score was 24 for each of MRT A and MRT C, 60 for SDT, and 18 for the drawings. The drawing score based on haptic perception [median = 17 (lower quartile = 16, upper quartile = 18)] correlated with MRT A [14 (9, 17)], MRT C [9 (7, 12)] and SDT [44 (36, 52)] scores with a Spearman's rank correlation coefficient of 0.395 (p = 0.0049), 0.507 (p = 0.0002) and 0.606 (p < 0.0001), respectively. Spatial abilities assessed by vision-based tests were correlated with a drawing score based on haptic perception of objects. Future research should investigate the contribution of haptic-based and vision-based spatial abilities on learning 3D anatomy from physical models.

Cadaver Dissection Experience for First-Time Dissectors: a Hypothetical Three-Pronged Approach for Student Preparation

This systematic review synthesized evidence for the development of a preparatory process for first-time dissectors, geared toward improving cadaver dissection (CD) experiences. Eleven studies focused on pre-CD intervention were selected from a literature search in PubMed, the Education Resources Information Centre (ERIC), Google Scholar, PsycNET, and the Cochrane Library. A three-pronged preparatory process was formulated for first-time dissectors based on the evidence from the review. The process includes (1) background assessment; (2) pre-CD education; and (3) gradual exposure and desensitization. The preparatory process shows some hypothetical potential for decreasing negative CD-related experiences, but it still needs validation before implementation.

The legal and ethical framework governing body donation in Europe - 2nd update on current practice

BACKGROUND

In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries.

METHODS

For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information.

RESULTS

Perspectives on the legal and ethical framework governing body donation in Europe.

CONCLUSIONS

We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies.

Enhancing Anatomy Education Throu€gh Flipped Classroom and Adaptive Learning A Pilot Project on Liver Anatomy

OBJECTIVES

Anatomy education plays a critical role in medical practice, and the level of anatomical knowledge among students and physicians significantly impacts patient care. This article presents a pilot project aimed at exploring the effectiveness of the Area9's Rhapsode platform, an intelligent tutoring system that uses artificial intelligence (AI) to personalize learning and collect data on mastery acquisition.

METHODS

The study focused on liver anatomy (microscopic and macroscopic anatomy, embryology, clinical anatomy) and employed a flipped classroom approach, incorporating adaptive learning modules and an interactive in-class session. A total of 123 first-year medicine students (55 M/68F) participated to the study. Content and resources of the module were adaptable to various digital devices. Statistics were compiled based, on the one hand, on the measurement of mastery for every single learning objective provided automatically by the platform via the student interactions with the system probes (questions); on the other hand, metacognition data were worked out by crossing mastery data with the self-awareness declared in every question and learning resource by each learner.

RESULTS AND CONCLUSIONS

At the outset of the study, students displayed a 18.11% level of conscious incompetence and a 19.43% level of unconscious incompetence. Additionally, 50.86% of students demonstrated conscious competence. By the conclusion of the learning module, the level of conscious incompetence had decreased to 1.87%, and 98.73% of students exhibited conscious mastery of the materials. The results demonstrated improved learning quality, positive repurposing of study time, enhanced metacognitive awareness among students, with most students demonstrating conscious mastery of the materials and a clear understanding of their level of competence. This approach, by providing valuable insights into the potential of AI-based adaptive learning systems in anatomy education, could address the challenges posed by limited teaching hours, shortage of anatomist, and the need for individualized instruction.

First patient project: Engaging pathology through the donor dissection experience and its role in professionalism

The peer-reviewed anatomical education literature thoroughly describes the benefits and drawbacks of donor dissection. Gross anatomy laboratory environments utilizing donor dissection are generally considered to be a premier environment where students foster non-traditional discipline-independent skills (NTDIS), including the acquisition of professionalism, empathy, resilience, emotional intelligence, and situational awareness. Therefore, this IRB-approved study explored the impact of a formal humanism and pathology thread, the first patient project (FPP), on the personal and professional development of pre-professional undergraduate students in a gross anatomy dissection-based course. Five reflections from each student were collected across four cohorts (n = 74 students, 370 reflections). A post-course questionnaire collected data on student perceptions of the project. The framework method was used to analyze reflection and free response data and descriptive statistics were performed on Likert-style items using Excel. Three themes were identified to encompass the impacts of the FPP on professional development and include: Socialization (through collective dissection experience and pathology), Humanistic Qualities (respect for the donor and their history, and introspection), and Content and Skills (technical and NTDIS, anatomical knowledge). The end of course FPP survey was completed by 29 students across three cohorts (65%) and their perspectives were generally favorable regarding the promotion of respect, empathy, and humanization of their donors. This study underscores the value of incorporating humanism, pathology, and reflection, facilitated through formal curriculum for pre-professional undergraduate students. It provides evidence of the positive impact on their personal and professional development, supporting the integration of NTDIS in curricula across various disciplines.

Israeli medical faculties' response to the COVID-19 crisis vis-à-vis anatomical education: The cultivation of future academic leadership-A national mixed-methods study

The COVID-19 crisis created unprecedented conditions for the medical academic system that enable it to showcase the real value of learning approaches in anatomical education. In parallel, the ongoing reassessment of the role of dissection in medical training, given the huge advances in imaging technology and science education, continued. The present study investigates the response of the six Israeli medical faculties to the pandemic vis-à-vis anatomical education. We reached out to medical students studying anatomy at the time of the crisis (N = 311), advanced medical students working as anatomy instructors (N = 55), and deans and heads of anatomy departments (N = 6). Applying a mixed-method approach, we used Likert scale questionnaires and held in-depth interviews with faculty members. Our results indicate that Israeli medical faculties were committed to a dissection-based anatomy curriculum and made substantial efforts to maintain it in the face of health restrictions. Students appreciated these efforts as this was their preferred learning method. Through a phenomenological analysis of interviews, we demonstrate how the crisis opened up a unique prism through which new insights into the debated role of dissection may be gleaned. Our analysis also reveals that anatomy instructors played a pivotal role in the crisis, not only because they carried out faculty policy, but especially because it gave them the opportunity to determine policy and show leadership. The crisis additionally enabled faculties to cultivate their leadership skills. Our research confirms donor body dissection as a mainstay of anatomical education and emphasizes its immeasurable value to the curriculum and future physicians.

The Practice of Teaching and Scientific Research on Cadaveric Material Remains Crucial for Medical Education

The practice of teaching and scientific research on cadaveric material remains crucial for medical education, especially in surgical disciplines. However, in Italy, this practice has been neglected due to legislative insufficiency and financial constraints. Although innovative methods and tools like simulators and e-learning have been adopted, direct hands-on experience with human cadavers remains irreplaceable for medical and surgical education. The absence of clear legislation governing cadaveric dissection has limited availability for teaching and research, resulting in economic burdens for universities and individuals seeking proper surgical training. To address this issue, Law No. 10/2020 and the recent implementing decree were introduced in Italy, providing detailed legislation on the donation of bodies for educational and research purposes. The law emphasizes the importance of respecting the donor's specific choices and aligns with constitutional principles promoting culture, research, and health protection. However, some critical issues related to consent procedures, duration of body availability, and preservation of anatomical parts remain. Additionally, the law's dissemination among the population needs improvement. Future optimization could include allowing donors to choose the timing of body donation and considering different timeframes for body availability. Furthermore, the implementation of consent procedures could be simplified to increase donations. The law should also address the need for appropriate reception centers and allocate resources for effective dissemination. Despite these challenges, Law No. 10/2020 represents a significant step forward in enhancing medical-surgical training, scientific research, and the overall quality of patient care in Italy.

Dissections or prosections: Which method has a better impact on sustainable gross anatomy knowledge?

Background Assessing the level of knowledge of anatomy of undergraduate students four years after their primary anatomy training will give a better indication as to which system of teaching is more effective. We aimed to ascertain which method was more effective at establishing a core of anatomy knowledge that could be recalled after a considerable amount of time. Methods We tested two groups of medical students in their final year on the key concepts of gross anatomy using a question paper that included true-false type questions and identification of anatomical line diagrams. These two batches of students followed a dissection-based curriculum and a newly introduced prosections-based curriculum at the beginning of their medical education. The prosections- based curriculum brought with it a reduction in the in-class teaching and learning activities when compared to the old curriculum. This would in turn reflect how much anatomy knowledge one would possess when they start to practise medicine as a newly qualified doctor and also embark on a postgraduate training programme. The two groups were subjected without prior warning to a question paper that had six questions, each with five true-false statements and four questions on identification and labelling of anatomical line diagrams. Results There was no statistically significant difference in the marks obtained for the true-false type questions between the two groups (p=0.08), but the prosections group obtained higher marks for the diagram identification questions (p=0.02). Conclusion A prosection-based curriculum when compared to a dissection-based curriculum was equally effective at establishing a core of gross anatomy knowledge.

Exploring the Application of Peer-Assisted Learning in Practical Neuroanatomy Classes: A Cohort Comparison Within a Medical Curriculum

Despite well-documented benefits, the effectiveness of some aspects of near-peer (NP) teaching in medical education within anatomy curricula remains unclear. Here, we explored the impact of various permutations of staff/student laboratory-based co-teaching in neuroanatomy by determining the optimal staff and student teaching combination. We assessed student perceptions and knowledge acquisition using three different co-teaching strategies. Second-year medical students at the University of Southampton were co-taught neuroanatomy by faculty staff and third-year medical students (NP teachers). Three cohorts, 2016/2017, 2017/2018, and 2018/2019, were included in the study. Subsequent cohorts experienced increasingly structured NP teaching with more NP teachers. Students completed evaluations for anatomy sessions, which were statistically compared. The 2017/2018 and 2018/2019 cohorts completed lunchtime quizzes matched to the learning outcomes of each practical session, which were analysed. A focus group involving six students was transcribed and thematically analysed. Anatomy practical ratings were significantly higher when both session structure and NP teacher numbers increased from 3 to 5-6 (p = 0.0010) and from 3 to 7-8 (p = 0.0020). There were no significant differences in anatomy practical ratings using 5-6 and 7-8 NP teachers (p > 0.9999). There were no significant differences between the knowledge scores of students who experienced 5-6 and 7-8 NP teachers. Themes detailing the benefits of NP teaching and the importance of faculty involvement were identified, demonstrating that students appreciated NP teaching within a co-teaching environment. Therefore, increased NP teaching may augment students' perceptions and knowledge acquisition. In this context, the optimal number of NP teachers may sit between 5 and 8.

The anatomist’s perspective today towards human body donation for procurement of cadavers for study of human anatomy

Anatomy is the study of structure of human body. Dissection of human cadavers has always been an integral part of study of anatomy as well as research in it. Till now the only source for cadavers for dissection purposes were unclaimed bodies. Today the need for bodies for medical education has increased and most medical schools are experiencing difficulties in procuring the requisite number of cadavers.<b> </b>Body donation programs may help fulfil this need of the medical schools. The present study was an attempt to analyze the attitude of the anatomists towards different aspects of body donation. 24.7% of the participants stated that they have insufficient cadavers, 12.3% claimed surplus cadavers while 62.8% claimed sufficient cadavers. 26% of the anatomists were unaware of the necessity for a death certificate and 35% were unaware of the necessity for a unique identification document for carrying out body donation.

Anatomy in the daily practice of the gynecologist, essential or just window dressing?

Traditionally, anatomy was one of the basic pillars of medical training. However, due to the expansion of medical science and medical knowledge in general, anatomy teaching has steadily declined and the way anatomy is taught has changed. These changes go hand in hand with growing literature about a perceived and proven lack of anatomical knowledge. While anatomy is important for all doctors, these developments seem to be more worrying for surgical residents. At the same time, little is known about how clinicians use anatomy in daily practice. The primary aim of this study was to increase understanding of the role of anatomy in the daily practice of gynecologists. An explorative qualitative study was performed to answer the question "What is the tangible utility of solid anatomical knowledge in the daily practice of the gynecologist"? Semi-structured interviews with gynecologists and obstetrics and gynecology (ObGyn) residents from Belgium and the Netherlands were held and the responses were analyzed using a phenomenographic inductive coding approach. Anatomical knowledge was important and used for technical skills and non-technical achievements in the daily practice of gynecologists, and three themes were distinguished. Specifically, anatomical knowledge was important and used (1) for daily activities, (2) for the feeling of self-efficacy, and (3) to gain a respected name as a doctor. These findings are discussed in light of (perceived) insufficient anatomical knowledge, and recommendations are made for the postgraduate education of ObGyn doctors.

Payment with knowledge: A method for a training of anatomy near-peer teachers and formation of future anatomists

Near-peer teaching has been widely implemented in medical schools and the benefits for the near-peer teachers (NPTs), the students, and the institution have been well documented. However, NPT training methods and perceptions of such have been limited. A four-year clinical anatomy and surgical training program was established (est. 2019) as part of the continuous training timeline for NPTs (n > 60 total) formation at the Universidad Autónoma de Nuevo León, in Mexico. The program provides various training courses for the NPTs according to their hierarchy, including teaching skills, professional development, psychosocial aspects, and career objectives. A "Clinical Anatomy and Surgical Training Diploma" was planned with 12 modules to aid in developing these abilities, along with a higher understanding of clinical anatomy shared by expert clinical specialists, and diverse clinical and surgical skills such as suturing, catheterization, and basic surgical procedures. The program has a completion rate of approximately 15 NPTs/year. All, while creating an environment with a sense of belonging, and facilitating mentorship between fellow NPTs and educators. Near-peer teachers develop leadership, communication, and teaching skills. The program has provided a constant source of anatomy educators, avoiding any shortage.

Knowledge levels and attitudes of medical faculty students related to whole body donation in Türkiye

BACKGROUND

Cadaver is a very important educational material for medical faculty students, students of health sciences, residents of any specialty in medicine and specialists. In developed countries, cadavers are mainly obtained by individual donations. However, like in other developing or underdeveloped countries, whole-body donations for cadaveric use in Türkiye are extremely scarce. This study sought to investigate the knowledge and awareness levels of medical faculty students about body donation and the factors that might influence their attitudes to body donation. The aim of the study is, with the results of the questionnaire, to raise public awareness for whole-body donation by creating public spots and by giving place in the official website of the Ministry of Health and make medical faculties to put lectures about body donation and its importance into their anatomy curriculum.

METHODS

A 31-item questionnaire with close-ended statements was administered to 291 students at Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty.

RESULTS

Only two of the participants (0.7%) stated that they had already donated their bodies to be used as a cadaver. Of note, those who reported considering whole body donation had higher maternal education levels (p = 0.002). The presence or absence of religious belief and the degree of religiosity were also significant factors, for significantly higher rates of non-believers and those who defined themselves as having a low degree of religiosity were in favor of body donation (p < 0.0001).

CONCLUSIONS

According to the religion of Islam, we should inform the relevant media that there is no harm in donating a body. In addition, considering the effect of mother's education level on the decisions of young people on this issue, we can state that we see once again how important women's education is in order to make progress in every field.

Understanding beliefs, preferences and actions amongst potential body donors

Body donation is a prosocial act providing a unique learning experience to students, ultimately impacting on patient care and science. With an increasing number of training professionals, there is an increasing need for body donors, yet little is understood about donors' beliefs and preferences. A four-center study aimed to understand donors' perceptions, 843 responses highlighted a significant relationship between completing a body donor consent form and being both an organ donor and having ever donated blood (p < 0.01). In exploring donor intentions, 69% had been considering donation for fewer than five years, 40% knew another body donor, and 27% had a family member or friend currently registered. Of those who had requested donor information packs, 97% had completed body donation consent forms. Of these, 92% had not selected any time restriction for their donation and 96% had consented to images being taken. Almost all (98%) were aware that their donation might not be accepted. Donors' motives highlighted a wish to: improve education, improve health care, advance science, and contribute to the greater good. A bimodal response was observed with body donation being used to save relatives money and inconvenience. Donors felt comfortable with their bodies being used by medical, dental, and allied health professionals; however, donors were less comfortable with their bodies being used by other groups. Only 57% were comfortable with artists, beauticians and yoga teachers using their remains. Understanding donors' motivations and decision-making process is vital to ensure resources for future and to meet any changing requirements of both donors and those studying them.

Fostering uncertainty tolerance in anatomy education: Lessons learned from how humanities, arts and social science (HASS) educators develop learners' uncertainty tolerance

Uncertainty tolerance, individuals' perceptions/responses to uncertain stimuli, is increasingly recognized as critical to effective healthcare practice. While the Covid-19 pandemic generated collective uncertainty, healthcare-related uncertainty is omnipresent. Correspondingly, there is increasing focus on uncertainty tolerance as a health professional graduate "competency," and a concomitant interest in identifying pedagogy fostering learners' uncertainty tolerance. Despite these calls, practical guidelines for educators are lacking. There is some initial evidence that anatomy education can foster medical students' uncertainty tolerance (e.g., anatomical variation and dissection novelty), however, there remains a knowledge gap regarding robust curriculum-wide uncertainty tolerance teaching strategies. Drawing upon humanities, arts and social sciences (HASS) educators' established uncertainty tolerance pedagogies, this study sought to learn from HASS academics' experiences with, and teaching practices related to, uncertainty pedagogy using a qualitative, exploratory study design. Framework analysis was undertaken using an abductive approach, wherein researchers oscillate between inductive and deductive coding (comparing to the uncertainty tolerance conceptual model). During this analysis, the authors analyzed ~386 min of data from purposively sampled HASS academics' (n = 14) discussions to address the following research questions: (1) What teaching practices do HASS academics' perceive as impacting learners' uncertainty tolerance, and (2) How do HASS academics execute these teaching practices? The results extend current understanding of the moderating effects of education on uncertainty tolerance and supports prior findings that the anatomy learning environment is ripe for supporting learner uncertainty tolerance development. This study adds to growing literature on the powerful moderating effect education has on uncertainty tolerance and proposes translation of HASS uncertainty tolerance teaching practices to enhance anatomy education.

Evaluating the knowledge acquisition of lower limb anatomy among medical students during the post-acute COVID-19 era

Anatomy is the foundation of many medical and surgical specialties yet knowledge acquisition and retention among medical students is questionable. Over the years the anatomy teaching environment and teaching modalities have changed, even more so with the onset of the COVID-19 pandemic and the shift to a virtual environment. The aim of this study was to evaluate the knowledge acquisition of applied musculoskeletal lower limb clinical anatomy among first year medical students in Malta following the transition back to face-to-face lectures. The Kahoot online game-based quiz platform was used through a best out of four multiple-choice setting across four sessions. Scores generated by the platform along with frequencies of correctly answered questions were utilized to measure knowledge acquisition. The average scores for each question across sessions were statistically analyzed using ANOVA and student's t-test accordingly. Across the four sessions, the positive percentage response for clinical based questions remained higher than for pure anatomy questions. Anatomy knowledge acquisition appears to be subjective to clinical based knowledge rather than pure anatomy. There may be a plethora of reasons as to this outcome including the misconception that anatomy is not essential for clinical practice as well as the potential aftermath of the COVID-induced virtual learning environment. Further research is merit to ensure that students are provided with the best tools to enhance their knowledge acquisition, both as students and as future doctors.

Anatomy education for medical students in the United Kingdom and Republic of Ireland in 2019: A 20-year follow-up

Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's "Tomorrow's Doctors." The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full-time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part-time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system-based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub-disciplines.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Cadaver dissection for oculoplastic procedures: A beginner's guide

The purpose of this article is to form a basic guide for beginning the cadaver dissection training programs focused on oculoplastic surgical procedures. Ours was a collaborative study between the departments of Ophthalmology and Anatomy in a tertiary care teaching institute. We formed a step-wise approach to begin the cadaver dissection focused on the oculoplastic surgical procedures. The basics of cadaver procurement, processing, and preparation for dissections were described. The operative requirements of trainees, surgical handling of cadavers, and basic oculoplastic surgical steps were discussed. The types of embalming (cadaver preservation process) and steps have been described in detail. We have emphasized the preoperative discussion about the proposed dissections using standard teachings and skull models for easier understanding. Additional helping tools like soft embalming and injectable substances for better intra-dissection understanding (intra-arterial, intravenous and orbital injections) have been described. Post-dissection cadaver handing and soft-tissue disposal protocols have also been described. Overall, the cadaver dissections provide holistic surgical learning for the residents, specialty trainees, and practitioners. This article may act as a basic step-wise guide for starting the cadaver-based oculoplastics lab dissection in various institutes and workshops.

Teaching gross anatomy during the Covid-19 pandemic: Effects on medical students' gain of knowledge, confidence levels and pandemic-related concerns

For medical students the dissection course is the preferred method to learn gross anatomy. However, the added value of active cadaver dissection on knowledge gain in multimodal curricula offering a diversity of e-learning resources is unknown. The Covid-19-related lockdown forced educators to replace the dissection course by e-learning resources. At the end of the summer term 2020 loosening of pandemic-related regulations allowed offering a compact, voluntary active dissection course of the head-neck region to first-year medical students at Hannover Medical School. A study was conducted comparing a dissection group (G1, n = 115) and a non-dissection group (G2, n = 23). Knowledge gain and confidence level were measured with a multiple-choice (MC-)test. The use of e-learning resources was recorded. A questionnaire measured motivation, interest and level of concern regarding Covid-19 and anatomy teaching. No differences between groups were found regarding motivation and interest in anatomy of the head-neck region. G2, however, had significantly higher concerns regarding the Covid-19 pandemic than G1. Neither before nor after the educational intervention, differences in the scores of the MC-test were found. However, after the course G1 answered more MC-questions with highest confidence level than G2 (6.7 ± 6.0 vs. 3.6 ± 4.6, p < 0.05) and demonstrated by trend an increased improvement in the scores of image-based questions (30.8 ± 18.2 % vs. 17.1 ± 14.8 %, p = 0.06). In general, frequent users of online quizzes, a part of the e-learning resources, scored significantly better in the knowledge test. Active dissection improves self-assurance to identify anatomical structures and should be re-implemented in multimodal, blended-learning-based anatomical curricula in the post-pandemic era.

Curriculum of gross anatomy education in Korean dental hygiene programs: Perceptions of clinical dental hygienists

It is essential for dental hygienists to have basic knowledge of gross anatomy to provide efficient treatment. However, gross anatomy course is relatively neglected due to their disparity from actual clinical dental practice. This study aimed to propose an effective dental hygiene gross anatomy curriculum that reflects the opinions of professional clinical dental hygienists. The study had an online-based cross-sectional design and the survey was distributed to clinical dental hygienists via social networks (n = 200). The questionnaire consisted of questions on the utilization of anatomical knowledge in clinical practice, opinions on the contents and methods of gross anatomy education, and general characteristics. The present study found that 186 (93%) used anatomical knowledge at an above-average level. Qualitative analysis indicated that dental implant surgery, radiography, and extraction were the clinical procedures that required the most anatomical knowledge. The clinical dental hygienists answered that the most-necessary knowledge is that of the mandibular nerve, followed by that on the temporomandibular joint, mandible, maxilla, maxillary nerve, and masticatory muscle. The methods proposed to improve gross anatomy education were (in decreasing order of importance) using videos or photographs (X-rays, CT, MRI, etc.), integrating education with clinical subjects, and using a three-dimensional visualization program. Higher education levels of respondents have increased their tendency to believe that the contents and methods of the presented education were necessary. Dental hygienists who utilized anatomical knowledge more often tended to be had a greater appreciation of the necessity of all educational contents and methods.

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.

Pre-Clinical Medical Students' Use of Motivational and Cognitive Study Strategies During Anatomy Learning: A Three-Year Cross-Sectional Survey

Medical students' motivation and study strategies are crucial in determining academic performance. This study aimed to assess the motivation and learning strategies of medical students as well as their association with performance in anatomy examinations. The Motivated Strategies for Learning Questionnaire, two focus group discussions, and students' current anatomy cumulative grade point average (cGPA) were used. Generally, the medical students strongly felt that anatomy is fundamental to the practice of medicine and surgery. This result was consistent with high task value scores of 5.99 ± 1.25. They were also driven by extrinsic goal orientation (5.59 ± 1.42) and intrinsic goal orientation (5.08 ± 1.26). Most medical students typically relied on elaboration (5.35 ± 1.25) ahead of other cognitive strategies namely rehearsal (5.30 ± 1.11), organization (5.15 ± 1.34), and lowest-rated critical thinking (4.77 ± 1.19). The students also relied on resource management strategies, effort regulation (5.15 ± 1.20) and time and study environment regulation (5.03 ± 1.03) more than the moderately scored peer learning (4.95 ± 1.50) and help-seeking (4.95 ± 1.09). In the focus group discussions, students reported that they often narrate or explain to each other what they would have read and understood from anatomy lectures, tutorials, and textbooks. They also bemoaned the lack of institutional support for stress burdens. The motivation and learning strategies subscales were not correlated with anatomy cGPA. Males were driven by extrinsic goals and experienced significantly higher levels of test anxiety than females (P < 0.05). Knowing the motivation and learning strategies students employ early in the medical curriculum can be leveraged to promote self-directed learning and academic achievement.

Effectiveness of Pedagogical Tools for Teaching Medical Gross Anatomy During the COVID-19 Pandemic

Medical institutions have been forced to modify gross anatomy pedagogy to comply with the health restrictions imposed by the novel coronavirus (COVID-19). Boston University School of Medicine (BUSM) is one such institution that temporarily restructured its course. We replaced cadaveric dissection activities with prosections and placed a greater emphasis on a flipped classroom model. This study investigates the effectiveness of new course materials developed to aid these curriculum changes. Course materials were developed for three purposes: (1) preparation before laboratory sessions (orientation videos and Complete Anatomy (3D4Medical, Elsevier) screens); (2) guidance during laboratory sessions (laboratory guides); and (3) review after laboratory sessions (Zoom recitation sessions). We performed a grounded theory thematic analysis of students' responses (80/160, 50% response) to qualitative survey questions and to focus group questions (16 students who self-selected between 4 different sessions). Data from both the survey and focus groups demonstrated that the vast majority of students agreed that the materials helped them navigate through learning gross anatomy. However, laboratory guides were used mostly for post-lab review as opposed to the intended direction during laboratory sessions. Students within all focus groups overwhelmingly touted the value of Zoom recitation sessions, with many stating that they were imperative to course success. When comparing performance data between 2019 (pre-COVID) and 2020 students, we found that the students who took the anatomy course during the onset of COVID had a slightly higher overall average score in all three modules of the course than compared to the 2019 students. We propose that the utilization of course materials that students perceived as time saving and pertinent to their exam performance, when combined with cadaveric prosection, emphasized the benefits of flipped-classroom learning to help students learn gross anatomy effectively and efficiently during the pandemic and beyond.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01524-x.

The Level of Anatomical Knowledge, Hard to Establish: a Systematic Narrative Review

OBJECTIVE

This literature review aimed to gain more insight into the level of anatomical knowledge based on published measurements among medical students, residents, fellows, and specialists.

METHODS

We performed an extensive literature search in three online databases: Medline (using PubMed), Web of Science, and Education Resources Information Centre (ERIC).

RESULTS

A total of 30 relevant studies were found. In these studies, participants took different anatomy tests, and their mean/median scaled scores range from 22.5 to 82.4% on a 0 to 100% scale.

CONCLUSION

This review provides an overview of what is known about measured anatomical knowledge. After critically reviewing the literature, we have to conclude that the existing literature confirms that anatomical knowledge is hard to establish, mainly due to the lack of standardisation.Further research should focus on ways to define and assess 'desired anatomical knowledge' in different contexts. In a next phase, we can discuss if anatomical knowledge is lacking and if interventions are needed.

The effect of simulation-based education before a cadaver dissection course

Although the methods for medical education continue to evolve due to the development of medicines, the cadaver dissection course still plays a fundamental role. The cadaver dissection course allows students to learn to handle instruments correctly while actively exploring three-dimensional anatomy. However, dissection comes with the risk of accidental injury. In recent years, the number of classes offered for the cadaver dissection course has decreased while the amount of knowledge required in clinical medicine has increased. Simulation-based education (SBE) has been proven to be an effective educational method that enhances the development of practical skills by integrating learners' knowledge and skills. This study aimed to investigate the effect of SBE as a preparatory education course when taken prior to a medical student's enrollment in the cadaver dissection course. In the present study, an SBE assuming practical cadaver dissection course was performed in the Clinical Simulation Center. The frequency of injury rates per 1000 h of cadaver dissection course was significantly less in 2017 and 2018 compared to that in 2016. Two years after the implementation of the SBE, average student self-efficacy scores and written examination scores significantly increased, whereas self-contentment scores were relatively unchanged. The results showed that the implementation of SBE decreased the incidence of injuries and improved students' overall self-efficacy scores and increased acquisition of knowledge evident on written examination score. Therefore, SBE as a preparatory education course may effectively promote the combined development of dissection skills and anatomical knowledge in the subsequent fundamental cadaver dissection course.

Twelve tips for optimising medical student retention of anatomy

Concern that many graduate medical students do not know sufficient anatomy to safely and effectively assess and treat patients is a frequent complaint by clinicians. Although downgrading of anatomy relative to newer basic sciences is often blamed, there is evidence students rapidly forget anatomy. However, there are a number of ways instructors can foster long-term retention of anatomy, the most powerful involving intertwining clinical and anatomical information and assessing in-depth processing. Assisting this process is 'triaging' the curriculum so it contains only clinically engaged anatomy. Students are far more likely to remember information which they consider to be relevant to their future vocation. Therefore, teaching only anatomy which is likely to be useful in a clinical context tends to improve long-term retention of anatomy by medical students. Other helpful techniques include incorporating surface and radiological anatomy in a vertically integrated curriculum, reciprocal peer teaching and employing clinically qualified instructors.

Is inadequate anatomical knowledge on the part of physicians hazardous for successful clinical practice?

Purpose

The physicians say that the least anatomy is required for clinical practice. But the disease causes anatomical distortions or variations in structures impairing functions of organs and systems. So, the diagnosis and analysis of treatment of disease depend on interwoven inter-relationship among Anatomy, Physiology, Pathology, Radiology and clinical sciences. Consequently, the upcoming doctors are to be cultivated sufficient anatomy. Therefore, the objective of this study is to analyze viewpoints of medical students, faculties and practitioners regarding degree of need of Anatomy in clinical practice.

Methods

A feedback survey has been carried out among students and faculties to seek their views on the need of Anatomy in clinical practice using two hypotheses. Hypothesis 1 defines the degree of need of Anatomy (‘most essential’, ‘essential’ and ‘least essential’) in clinical practice based on answers of questionnaire by medical students and faculties, whereas hypothesis 2 assigns weights depending on knowledge and experience of the feedback providers. The means/weighted means of views have been statistically analyzed. Additionally, the literature survey was carried out on the demand, necessity, importance, usefulness and applicability of Anatomy in clinical practice.

Results

Our statistical analysis revealed that Anatomy is ‘most essential’ for clinical practice. In literature survey too, the inadequate knowledge of anatomy among medical students leads to poor comprehension of clinical practice. So, anatomy is most essential for clinical practice.

Conclusion

Sound knowledge of Human Anatomy is most essential during medical practice for Physicians.

The influence of dissection on clinical anatomical knowledge for surgical needs

PURPOSE

Due to the ongoing discussion of the usefulness of dissection on human bodies in medical curricula, we investigated the influence of anatomical knowledge collected in the dissection course and requested for modules of visceral surgery.

METHODS

Students attending the dissection course of topographic anatomy had to answer a questionnaire of 22 questions with focus on anatomical knowledge required for visceral surgical modules. Failure was defined as 13 or fewer correct answers, success categorized as high, good or moderate. The same questionnaire was handed out to 245 students prior to the module on visceral surgery. Students provided information on which regions they had dissected during the course or prior to the module. The results were compared to the result of a written Multiple Choice Question (MCQ) exam of the module visceral surgery (n = 160 students) with an unannounced primary focus on anatomy.

RESULTS

Students who dissected the truncal regions of the human body succeeded in answering the questionnaire with high success. Students dissecting regions of the Head/Neck or Limbs had a high failure rate, and none of them reached the "high" success level. In the MCQ exam, students dissecting truncal regions had a high success rate, while those who had not dissected or who dissected the Head/Neck or Limbs had a high failure rate.

CONCLUSION

Dissections support and improve the required knowledge for surgical modules. For the visceral surgical module, students dissecting the region prior to the module greatly benefited. Therefore, entire human body dissection assumes to be preferable.

From Tutoring Gross Anatomy to Pancreatic Surgery Innovation

The training for pancreatic surgery still is not conducted according to standardized protocols, and academic programs differ between countries and hospitals. Moreover, due to recent technological innovations such as minimally invasive and robotic surgery, and the broader indications for complex pancreatic procedures due to the use of neoadjuvant chemotherapy, training is continuously redefining itself. The historical paradigm of "see one, do one, teach one" has been challenged and might have become obsolete. Finally, the rising number of surgical residents along with the limited time required practicing during residency might represent a major limitation to becoming an independent surgeon. Gross anatomy is a solid practice for the active learning of human anatomy during medical school. With regards to the pancreas, it offers a unique opportunity to both actively study the pancreatic gland anatomy during dissection and simulate actual surgical procedures. A critical review of the literature was conducted, aiming to assess the role of gross anatomy in surgical training and possible future perspectives.

Teaching Musculoskeletal Module using dissection videos: feedback from medical students

BACKGROUND AND AIMS

Over the last two decades many medical schools have been exploring alternatives to hands-on cadaver dissection in teaching anatomy. This study aimed at reporting medical students' feedback on using dissection videos in teaching anatomy of the musculoskeletal system.

METHODS

Dissection videos were used to teach the anatomy of the musculoskeletal system for third year medical students. At the end of the module, feedbacks from medical students were reported using a questionnaire designed for this purpose. Statistically valid responses were considered for 284 students.

RESULTS

Around 60% of the students enjoyed learning anatomy by watching dissection videos but the majority - mostly non-Jordanian - thought that the duration of the videos should be shorter. 83% (236/284)of the students enjoyed the presence of an instructor to guide them through the video and 85% (241/284) wanted to discuss the content with the instructor after watching. Most of the students liked to have access to the videos at any time in an open lab policy. Only 23% (66/284) of the students - mostly Jordanian - were willing to completely replace cadaveric prosections with dissection videos. Most of the students found that dissection videos helped them to understand anatomy lectures in a better way and in memorizing anatomical details. A significantly higher percentage of Jordanian students preferred watching dissection videos at home and preferred dissection videos to replace traditional anatomy lab sessions.

CONCLUSIONS

In the light of our present findings, using dissection videos as a teaching method of anatomy was well received by students. However, it seemed that the students wanted dissection videos to be integrated with using cadaveric prosections rather than replacing them.

Case-based radiological anatomy instruction using cadaveric MRI imaging and delivered with extended reality web technology

PURPOSE

Extended reality (XR) technology enhances learning in medical education. The purpose of this study was to develop and apply a case-based approach for teaching radiological anatomy utilizing XR technology for improved student exploration and engagement.

METHODS

The workflow consisted of MRI scanning cadavers followed by radiological, pathological, and anatomical assessment, and finally case presentation based on XR visualizations and student interaction. Case information (Subject, History, and Physical Exam) was presented to student groups who generated and recorded hypotheses using Google Forms.

RESULTS

Use of all components of the system was voluntary and a total of 74 students responded to the survey request (response rate = 95%). Assessment of the experience was conducted through a qualitative survey comprising four Likert scale questions (1-5, 1 lowest), three binary questions, and open-ended comments. Mean, standard deviation, and overall agreement (mean ± SD, OA) showed that students found MRI scans of cadavers to be helpful for dissections (4.14 ± 1.1, 74.3%) and provided an understanding of relevant anatomy (4.32 ± 0.9, 79.7%), while 78.4% of students used the DICOM viewer to visualize scans of cadavers. The difficulty of use was found to be average (2.90 ± 1.0, 23%). zSpace visualizations were used by 40.5% of students, generally agreeing that an understanding of spatial relationships improved as a result (3.60 ± 1.0, 43.2%). More case-based sessions were favored by 97.3% of students.

CONCLUSIONS

Results suggest that cadaveric MRI radiological visualization and XR technology enhance understanding of case-based anatomical dissections and encourage student exploration and engagement.

Evaluation of Information on Body Donation Promotion at Official Websites of Turkish Anatomy Departments

Raising public awareness of body donation is crucial for countries like Turkey that have struggling donation programs. The official websites of anatomy departments may contribute to achieving this goal. Nevertheless, previous studies reported institutional or individual reluctance of departments or anatomists, respectively, due to an expectation of adverse publicity. This study aimed to investigate whether the official websites of Turkish anatomy departments provided information on body donation and analyzed the content of these websites. Websites of anatomy departments at 100 medical faculties were evaluated. Only 12 departments (12%) provided information on body donation with varying content. A thematic analysis of the information provided revealed five main themes. These were (1) legal aspects, (2) significance, (3) acceptance/rejection criteria, (4) availability, and (5) redirection. All departments (n = 12, 100%) outlined the legal aspects of body donation, seven departments (58%) highlighted the significance of body donation, seven departments (58%) provided contact information for potential donors, five departments (41%) covered acceptance/rejection criteria, and three departments (25%) provided a link to the official website of the Turkish Society of Anatomy and Clinical Anatomy. Thus, Turkish anatomy departments were reluctant to provide information on body donation, and the content of provided information varied greatly among departments. This lack of information, coordination, and participation in existing awareness activities for body donation in anatomy department websites may be contributing to the low numbers of body donations and donor registrations seen nationally.

Anatomy Terminology Performance is Improved by Combining Jigsaws, Retrieval Practice, and Cumulative Quizzing

Science courses containing English-language terminology are a common implement in "English as a foreign language" (EFL) countries across the globe. In many of these countries, licensing examinations place added significance on terminology competence by requiring health science graduates to demonstrate mastery of English-language anatomy terms. In recent years, a wealth of research has shown active learning can offer many benefits over lecture-based, didactic approaches. Despite this work, very little has been done to test the potential of active learning in improving medical terminology performance. The present study explores this potential in two human gross anatomy lecture courses in South Korea, collecting performance and survey data from 399 undergraduates over a period of four years. Jigsaws, retrieval practice, and regular cumulative quizzing were used to mitigate three learning challenges specific to the study context: high vocabulary volume, low feelings of control over learning, and difficulties with exam preparation. The results show the reforms significantly improved both performance and learning attitudes, with students overwhelmingly favoring the use of new methods over lecture when taught using a mixture of both. Given that science learning often resembles the process of learning a foreign language, this study offers broad potential for improving terminology competence across disciplines, even for non-EFL students.

Anatomy (knowledge) in postgraduate obstetrics and gynaecology training: Is it sufficient enough?

BACKGROUND

Due to the importance, anatomy training is worldwide recognizable in virtually all undergraduate curricula and many postgraduate surgical curricula (Estai and Bunt, 2016; Older, 2004). The postgraduate curriculum of Obstetrics and Gynaecology (O&G) is such a surgical curriculum. It is a diverse branch of medicine and the role of anatomy in O&G is versatile. In the Netherlands nor in Europe the expectations of knowledge on anatomy are specified in the current training program, making trainees insecure about their performance in anatomy knowledge ("Better Education for Obsetrics and Gynaecology,"). Therefore, we recently performed a Delphi study to determine which anatomical structures should be taught to ensure safe and competent practice among general gynaecologists (Koppes et al., 2020). The aim of this study is the determination of the anatomical knowledge level in postgraduate training for O&G. Our hypothesis is that the trainees possess a good knowledge of anatomy and on average at least 80% of correct answers on core knowledge is shown.

METHODS

A longitudinal knowledge analysis was performed under Dutch Trainees Obstetrics and Gynaecology. The anatomy questions of the annual progress tests from 2010 to 2019 were analysed. Anatomy questions were selected and assessed on relevance based on the previous performed Delphi study which identified 86 structures which are essential to perform safe and competent practice as a general gynaecologist. Scores on relevant anatomy questions were calculated.

RESULTS

In 10-year 3136 trainees performed the annual progress test. 54 Anatomy related questions were asked on a total of 1637 questions (3.3%). Of these 54 questions, 38 (70%) were concerned as relevant questions. Overall 10-year score was 64.5%.

CONCLUSIONS

The anatomy knowledge of trainees' Obstetrics and Gynaecology is insufficient. Our results are a step in the awareness of testing and improving anatomy knowledge of postgraduate O&G training.

Clinical Anatomy and Unexpected Careers: Is There Curriculum for That?

Reduction in faculty positions in higher education and increased graduate matriculation rates represent a higher education conundrum. Planned happenstance theory (PHT) is a career development model focusing on positive outcomes resulting from unpredictable precareer events. This mixed methods study explores how PHT applies to the career paths of a clinical anatomy (CA) postgraduate cohort. It provides insight into educational practices designed to equip students for labor markets inside and outside academia. Alumni of CA (n = 12; 2014-2018) were interviewed about career-related events transpiring from graduate studies to present, allowing exploration on how PHT contextualizes their shared experiences. Planned happenstance career inventory (PHCI) enumerated planned happenstance skill (PHS) scores. Total PHS was referenced 527 times across 12 interviews. Of the PHS references, curiosity established highest incidence (154 references, 29%), optimism (132 references, 25%), flexibility (101 references, 19%), risk-taking (85 references, 16%), and persistence (55 references, 10%) and 43 distinct happenstance events were documented. In addition, social networking (52 references) arose as an emergent code and was divided into internal networking (28 references, 54%) and external networking (24 references, 46%). Application of the five-point PHCI scale revealed: curiosity (4.4 ± 0.3; mean ± SD), flexibility (3.6 ± 0.7), persistence (4.4 ± 0.3), optimism (4.3 ± 0.4), and risk-taking (4.1 ± 0.5). Curiosity had the strongest association with happenstance event incidence. Social networking was a key substituent of PHT not yet described in the literature. Educational practices incorporating PHT concepts, with emphasis on curiosity, may provide graduates novel metacognitive skills needed to develop novel career paths.