Student attitudes towards anatomy teaching and learning in a multiprofessional context

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.

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.

Identification-Based Multiple-Choice Assessments in Anatomy can be as Reliable and Challenging as Their Free-Response Equivalents

Multiple-choice (MC) anatomy "spot-tests" (identification-based assessments on tagged cadaveric specimens) offer a practical alternative to traditional free-response (FR) spot-tests. Conversion of the two spot-tests in an upper limb musculoskeletal anatomy unit of study from FR to a novel MC format, where one of five tagged structures on a specimen was the answer to each question, provided a unique opportunity to assess the comparative validity and reliability of FR- and MC-formatted spot-tests and the impact on student performance following the change of test format to MC. Three successive year cohorts of health science students (n = 1,442) were each assessed by spot-tests formatted as FR (first cohort) or MC (following two cohorts). Comparative question difficulty was assessed independently by three examiners. There were more higher-order cognitive skill questions and more of the course objectives tested in the MC-formatted tests. Spot-test reliability was maintained with Cronbach's alpha reliability coefficients ≥ 0.80 and 80% of the MC items of high quality (having point-biserial correlation coefficients > 0.25). These results also demonstrated guessing was not an issue. The mean final score for the MC-formatted cohorts increased by 4.9%, but did not change for the final theory examination that was common to all three cohorts. Subgroup analysis revealed that the greatest change in spot-test marks was for the lower-performing students. In conclusion, our results indicate spot-tests formatted as MC are suitable alternatives to FR tests. The increase in mean scores for the MC-formatted spot-tests was attributed to the lower demand of the MC format.

Interprofessional team-based learning in basic sciences: students' attitude and perception of communication and teamwork

OBJECTIVES

To explore whether a team-based learning strategy applied to an interprofessional course on basic science changes students' perception of communication and teamwork skills and attitudes as related to interprofessional learning.

METHODS

A mixed-methods approach was utilized. The participants were selected through an opportunity sample of 33 first-semester anatomy students from occupational therapy and orthoptics programs. Students completed an interprofessional questionnaire before and after the course. The data were analyzed descriptively. Fourteen students were selected randomly for group interviews. Qualitative data was interpreted using thematic analyses.

RESULTS

The pre-test scores for 'communication and teamwork skills' and 'interprofessional learning' were high with mean values of 26.58 and 34.24, respectively. The post-test scores were 27.30 and 34.27, respectively, indicating no relevant changes in students' perception and attitudes. Qualitative data suggested that team-based learning represents a valid strategy to encourage communication and teamwork skills but revealed a lack of interprofessional exchange during the course. Students reported that classroom activities must require the professional knowledge of all participating groups in order to prevent a negative attitudinal shift towards interprofessional education in the later years of their studies.

CONCLUSIONS

Implementing team-based learning in basic sciences can encourage communication and teamwork among students. Mixed classes can help socialize students of different professional groups, although they carry a risk of a negative attitudinal shift towards interprofessional education. Whether, and in what ways, effective interprofessional exchange during the teaching of basic sciences can be achieved needs further investigation.

Curricular and pedagogical aspects of gross anatomy education for undergraduate physiotherapy students: a scoping review

OBJECTIVE

The objective of this review was to collate and map gross anatomy curricular and pedagogical approaches for physiotherapy students.

INTRODUCTION

Knowledge of anatomy is essential for physiotherapy clinical diagnosis, treatment effectiveness and safe practice. The information on this topic is sparse, and what does exist is diverse. This scoping review describes anatomy educational approaches for physiotherapy students and provides needed insight into this topic.

INCLUSION CRITERIA

No limits were applied on the date of the database search or age of participants. Languages were limited to English, French, German and Spanish. Studies had to include information on gross anatomy curricula or pedagogy for physiotherapy students, or information from qualified physiotherapists or those teaching gross anatomy to physiotherapy students.

METHODS

Included studies were mainly sourced from EBSCOhost (CINAHL, ERIC and MEDLINE), PubMed and Scopus databases. Perusal of reference lists facilitated further retrievals. Studies published from inception up to 21 July 2019 were included. Studies were identified and screened, and the process was reported in a PRISMA flow diagram. JBI methodology for scoping reviews was followed. Selected studies were charted according to a template created and published in a JBI scoping review protocol.

RESULTS

Fifty-four studies satisfied the inclusion criteria. Various studies gave calculable length of intervention in weeks (n=14, 26%), hours (n = 7, 13%) or both (n = 21, 39%). The majority of studies (n = 50, 93%) were cross-sectional studies; three were randomized controlled trials (6%). Mean sample sizes varied from 55.3 ± 30.4 (professional behaviors, ethical and humanistic aspects) to 323.2 ± 219.7 participants (multi-modal and blended learning). Overall, 29 studies (54%) included physiotherapy students or personnel in physiotherapy anatomy programs exclusively in the sample. Other disciplines with physiotherapy students included medical students (n = 12, 22%), and occupational therapy students (n = 10, 19%). The interprofessional education category (n = 8) determined that interdisciplinary teamwork led to increased anatomical learning and awareness of future clinical roles. Computer-assisted learning (n = 9) was effective as a stand-alone or adjunct pedagogy, useful for self-study and helped anatomical knowledge retention. Team-based learning (n = 2), peer teaching (n = 6) and clinical input incorporating case-based learning and horizontal and vertical integration (n = 4) resulted in anatomical knowledge retention and were associated with mastery of anatomical understanding, an increase in examination confidence and higher examination grades. Contradictory learning outcomes resulted from the use of online videos in blended and multi-model learning studies (n = 7). Increased student participation in asynchronous online discussion forums benefitted academic learning outcomes. The category of curriculum, pedagogy and materials (n = 15) identified and compared different survey results pertaining to the curricular aspect of the objectives of this review. One study investigated the flipped classroom concept. The use of anatomy content to encourage professional, ethical and humanistic aspects (n = 3) of physiotherapy students' behavior resulted in positive outcomes.

CONCLUSIONS

This scoping review revealed a multi-faceted topic with many types of interventions and outcomes recorded. It identified variations in pedagogies, curricular content and learning approaches integral to the subject and their impact on gross anatomy education for this population. Beneficial behavioral, anatomical learning, knowledge retention and academic outcomes were identified.

Nursing and medical students near-peer activity in the anatomy laboratory: format for success

BACKGROUND/AIMS

An anatomy interprofessional near-peer learning activity (AIP-NPLA) between nursing and medical students was piloted to assess its implementability. This study aimed to: (1) identify key factors of feasibility and (2) describe student-group perceptions of their experience of the interprofessional education (IPE) activity.

METHODS

A total of 59 medical and 179 nursing students participated in the AIP-NPLA whereby medical students were asked to facilitate and lead group discussions with their nursing students colleagues on an anatomical topic using a donor cadaver. Each AIP-NPLA session lasted a total of two hours. A mixed methods approach was employed using both quantitative and qualitative means of assessment. Variables such as Readiness for Interprofessional Learning, Professional Self-Identity, Clinical Teaching Preference, and Near-Peer Teaching and Learning Experience were assessed quantitatively using validated surveys. Qualitative measures included thematic content analysis of focus group interviews conducted following the AIP-NPLA to capture the perceptions of the student groups' experience in the IPE activity.

RESULTS

The results of this investigation demonstrated that there are key factors to consider when designing successful and sustainable IPE activities; the level of clinical exposure and therefore student-group pairing based on professional self-identify scores, optimal tutor-to-tutee group ratios and an activity format that maintained an informal, flexible and free forum for discussion on a topic of common knowledge. Focus group interviews also revealed reflections on professional stereotypes.

CONCLUSION

These findings suggest that early implementation of IPE activities outside of a clinical setting are beneficial and can foster both learning from one another and positive perceptions of interprofessional roles when carefully designed.

Construction of the Equine Digestive System: A Tool for Teaching Topographical Anatomy

Anatomy is traditionally regarded as a difficult, non-motivating course involving a large body of theoretical and practical content, and it is often associated with high levels of dropout and failure. Given the relevance of the topic, we propose an alternative active multisensory teaching tool consisting of the construction of a low-fidelity anatomical model assembled into an articulated equine skeleton. Model construction and assembly assists students in the recognition of the topography and anatomical boundaries of the equine abdominal digestive system. Digestive system organs (liver, pancreas, stomach, small and large intestines) were constructed using common, easily available materials, such as newspaper, balloons, laminated rubber sheets, and polyethylene cylinders. The method described in this study is a low-cost, user-friendly teaching tool that is potentially applicable across different academic disciplines and that can also be used to construct models of other systems and species. However, it should be combined with other anatomy teaching methods because it does not provide detailed representation of specific digestive system organ features.

Can CanMEDS competencies be developed in medical school anatomy laboratories? A literature review

OBJECTIVES

The purpose of this literature review was to identify potential ways in which undergraduate medical anatomy education may be relevant to the CanMEDS Roles, a competency-based framework used throughout Canadian medical training.

METHODS

A scoping review of medical education literature was conducted in March 2017 for English language publications that included key words related to anatomy education and to key competencies formally described for each of the Roles in the CanMEDS 2015 framework. Indicated benefits were then collated, characterized, and synthesized for each CanMEDS Role.

RESULTS

There were 71 studies identified describing original findings. Perceived benefits of anatomy education were most often identified for competencies related to the Medical Expert Role. Multiple studies also cited benefits related to the Scholar, Professional and Collaborator Roles. There was a lack of literature related to the Health Advocate, Communicator, and Leader Roles. The majority of benefits defined in the literature were limited to student perceptions rather than objectively measured outcomes.

CONCLUSIONS

There is some evidence to suggest that anatomy education can facilitate the development of core competencies related to several CanMEDS Roles, outside of simply developing medical knowledge in the Medical Expert Role. Future studies need to develop methods to objectively assess outcomes related to these competencies.

Use of a Garment as an Alternative to Body Painting in Equine Musculoskeletal Anatomy Teaching

Living anatomy is gaining increasing popularity as an alternative to the use of preserved cadaver specimens in musculoskeletal anatomy teaching. This article describes the development of a garment painted with musculoskeletal structures as an alternative to body painting. Garments offer some advantages over traditional body painting in anatomy teaching. The technique can be used across different disciplines, enhances students' ability to identify anatomic structures in living bodies, and provides insights into the topography of one or more body systems at the same time. The fact that garments are amenable to palpation by large groups of students with no damage to the painting favors repeated use in hands-on wet labs. Garments such as the one described in this article introduce a novel approach to interdisciplinary teaching and learning, which can be combined with traditional anatomy teaching methods. The first garment produced depicts part of the equine musculoskeletal system. Steps in garment construction are highlighted and indications, advantages, and limitations of the method discussed.

An interactive, multi-modal Anatomy workshop improves academic performance in the health sciences: a cohort study

BACKGROUND

Students often strategically adopt surface approaches to learning anatomy in order to pass this necessarily content-heavy subject. The consequence of this approach, without understanding and contextualisation, limits transfer of anatomical knowledge to clinical applications. Encouraging deep approaches to learning is challenging in the current environment of lectures and laboratory-based practica. A novel interactive anatomy workshop was proposed in an attempt to address this issue.

METHODS

This workshop comprised of body painting, clay modelling, white-boarding and quizzes, and was undertaken by 66 health science students utilising their preferred learning styles. Performance was measured prior to the workshop at the mid-semester examination and after the workshop at the end-semester examination. Differences between mid- and end-semester performances were calculated and compared between workshop attendees and non-attendees. Baseline, post-workshop and follow-up surveys were administered to identify learning styles, goals for attendance, useful aspects of the workshop and self-confidence ratings.

RESULTS

Workshop attendees significantly improved their performance compared to non-attendees (p = 0.001) despite a difference at baseline (p = 0.05). Increased self-confidence was reported by the attendees (p < 0.001). To optimise their learning, 97% of attendees reported utilising multi-modal learning styles. Five main goals for participating in the workshop included: understanding, strategic engagement, examination preparation, memorisation and increasing self-confidence. All attendees reported achieving these goals. The most useful components of the workshop were body painting and clay modelling.

CONCLUSIONS

This interactive workshop improved attendees' examination performance and promoted engaged-enquiry and deeper learning. This tool accommodates varied learning styles and improves self-confidence, which may be a valuable supplement to traditional anatomy teaching.

Interprofessional anatomy education in the United Kingdom and Ireland: Perspectives from students and teachers

There is increasing recognition of multiprofessional learning in anatomy and its role in medical and healthcare professions. This study utilized two components to investigate anatomy interprofessional education (AIPE) in the United Kingdom and Ireland. First, a survey involving qualitative and quantitative components asked Heads of Anatomy to report on their institutions' uptake of AIPE. Second, a series of case studies explored the experiences of students by using evaluation forms and an in-depth analysis of thematic concepts to understand the learners' perspectives on designing and delivering AIPE. Out of the 13 institutions that took part in the survey, eight did not offer an AIPE program. Between the remaining five institutions that deliver AIPE programs, 10 different modules are offered with the majority involving healthcare professions. The AIPE component is rated highly by students. The themes from the case studies highlight how valuable AIPE is from the student perspective both in terms of engaging them in anatomy as well as in the broader skills of teamwork and communication. The case studies also revealed how AIPE can be engaging for groups of students who might not have previously had access to cadaveric anatomy, for example, engineers and archeologists. The results of this study have implications for curriculum design in medicine and healthcare but also for further engagement of professional groups from non-healthcare backgrounds.

Frank Netter's legacy: Interprofessional anatomy instruction

Several medical schools have recently described new innovations in interprofessional interactions in gross anatomy courses. The Frank H. Netter MD School of Medicine at Quinnipiac University in Hamden, CT has developed and implemented two contrasting interprofessional experiences in first-year medical student gross anatomy dissection laboratories: long-term, informal visits by pathologists' assistant students who work with the medical students to identify potential donor pathologies, and a short-term, formal visit by fourth-year dental students who teach craniofacial anatomy during the oral cavity dissection laboratory. A survey of attitudes of participants was analyzed and suggest the interprofessional experiences were mutually beneficial for all involved, and indicate that implementing multiple, contrasting interprofessional interactions with different goals within a single course is feasible. Two multiple regression analyses were conducted to analyze the data. The first analysis examined attitudes of medical students towards a pathologists' assistant role in a health care team. The question addressing a pathologists' assistant involvement in the anatomy laboratory was most significant. The second analysis examined attitudes of medical students towards the importance of a good foundation in craniofacial anatomy for clinical practice. This perceived importance is influenced by the presence of dental students in the anatomy laboratory. In both instances, the peer interprofessional interactions in the anatomy laboratory resulted in an overall positive attitude of medical students towards pathologists' assistant and dental students. The consequences of these interactions led to better understanding, appreciation and respect of the different professionals that contribute to a health care team.

Interprofessional education: The magical mystery tour now less of a mystery

Interprofessional education (IPE) is on today's agenda in medical education as a response to advances in medicine, the changes that have taken place in healthcare delivery, and pressures from the public and the profession. Although attention has focused on IPE in the later stages of the education program, there are benefits to be gained from the introduction of IPE in the early years. Curriculum developments supporting this include the adoption of outcome-based education and vertical integration. There is also a recognition that students' attitudes and biases are formed early in their education and the appropriate learning environment in the early years is important. Interprofessional education in the early years can also be seen as a part of a more general trend to greater collaboration in the delivery of an education program in the healthcare professions. Anatomy by incorporating IPE can help shape the future of medical education as well as being shaped by it. The possibility of success or failure with IPE can be captured with the equation IPE = (V × I)/N, where V = the IPE vision, I = the implementation strategy and N = negative perceptions of the approach. Success is more likely where there is a well thought out and shared vision for what is to be achieved, an appropriate implementation strategy and a plan to counteract a negative mind-set.

Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students

Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions.

Factors influencing student performance on the carpal bone test as a preliminary evaluation of anatomical knowledge retention

It has been demonstrated that a positive correlation exists between clinical knowledge and retained concepts in basic sciences. Studies have demonstrated a modest attrition of anatomy knowledge over time, which may be influenced by students' perceived importance of the basic sciences and the learning styles adopted. The aims of this study were to: (1) conduct a cross-sectional evaluation of the retention of anatomical knowledge in preclinical (second-year) and clinical (fifth-year) chiropractic students at Murdoch University; and (2) examine students' perceptions of factors that may influence their anatomy knowledge retention. Second- and fifth-year chiropractic students at Murdoch University were invited to participate in the study. Ninety-one students voluntarily participated. The Carpal Bone Test, previously utilized to determine the retention of anatomical knowledge, was utilized to determine the extent to which participants retained gross anatomy knowledge. Participants also completed a questionnaire specifically designed to identify the factors that may have influenced their retention of gross anatomy knowledge. A two-sided Pearson chi-square test of association was used to ascertain statistically significant differences in carpal bone retention and students' responses between the two cohorts. Seventy percent of the fifth-year (clinical) chiropractic students correctly identified all eight carpal bones compared to only six percent of second-year chiropractic students. The majority of participants in both cohorts believed that gross anatomy knowledge is of clinical importance. The use of mnemonics and the clinical application of anatomy knowledge were identified as factors that significantly influenced participants' gross anatomy knowledge retention within this study.

The anatomy room: a positive learning experience for nursing students

BACKGROUND

Management of death and dying is an important aspect of nursing practice. Many nursing students have not been exposed to death prior to their commencement in nurse education and typically do not encounter dying and death until their clinical experience begins.

OBJECTIVES

To examine the effects and impact of exposure of nursing students to an anatomy room for anatomy teaching compared with students taught anatomy in a laboratory using plastic anatomical specimens.

METHODS

Two groups of first year nursing students were surveyed; one group received tuition in anatomy using plastic specimens and the second group used dissected cadavers. Questionnaires were administered before and immediately after the first teaching experience and again 9 weeks later.

RESULTS

Students studying anatomy using cadaveric specimens were more apprehensive of subsequent visits to the anatomy room. However, after 9 weeks there was no significant difference when compared to students using plastic specimens. The students using cadavers felt significantly more stressed and reported significantly more symptoms than those using plastic specimens after their first lesson. There was no significant difference in stress levels and symptom reporting between the groups after 9 weeks. While a large proportion of the students using both cadavers (97%) and plastic specimens (88%) found their learning experiences positive, 43% of the respondents using cadavers stated that as a result of this experience they felt more prepared to deal with death in a hospital and that they were happy to see death in a stress free environment. The responses from the group using plastic specimens were positive as essentially they had found the theory easier to learn.

CONCLUSIONS

The results suggest that learning anatomy using cadavers is a beneficial learning experience and could be a valuable way to encounter death for the first time in a protected environment rather than in the clinical setting.

The perceived importance of anatomy and neuroanatomy in the practice of speech-language pathology

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case-based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum.

Meeting the family: promoting humanism in gross anatomy

BACKGROUND

Human dissection commonly occurs early in the undergraduate medical school curriculum, thus presenting an immediate opportunity for educators to teach and encourage humanistic qualities of respect, empathy, and compassion.

PURPOSE

The purpose of this study was to measure the impact of the Donor Luncheon, a unique program in which medical students meet the families of the anatomical donor prior to dissection in the anatomy course at the University of Oklahoma College of Medicine.

METHODS

Students were randomized into groups of 8 to attend the luncheon and either met with family of the donor or attended the luncheon with no donor family present. A questionnaire measured students' attitudes at 2 weeks, 6 weeks, and at the conclusion of the anatomy course.

RESULTS

Factor analysis revealed 5 scales. Analysis revealed statistically significant differences across time for Donor as Person, Dissection Process, and Donor as Patient and statistically significant differences between groups for Donor as Person and Donor as Patient.

CONCLUSIONS

These results suggest that this program can provide students with the opportunity to maintain more humanistic attitudes at the beginning of their medical education career.

Student perception of a new integrated anatomy practical program: does students' prior learning make a difference?

While there is evidence that science and non-science background students display small differences in performance in basic and clinical sciences, early in a 4-year, graduate entry medical program, this lessens with time. With respect to anatomy knowledge, there are no comparable data as to the impact previous anatomy experience has on the student perception of the anatomy practical learning environment. A study survey was designed to evaluate student perception of the anatomy practical program and its impact on student learning, for the initial cohort of a new medical school. The survey comprised 19 statements requiring a response using a 5-point Likert scale, in addition to a free text opportunity to provide opinion of the perceived educational value of the anatomy practical program. The response rate for a total cohort of 82 students was 89%. The anatomy practical program was highly valued by the students in aiding their learning of anatomy, as indicated by the high mean scores for all statements (range: 4.04-4.7). There was a significant difference between the students who had and had not studied a science course prior to entering medicine, with respect to statements that addressed aspects of the course related to its structure, organization, variety of resources, linkage to problem-based learning cases, and fairness of assessment. Nonscience students were more positive compared to those who had studied science before (P levels ranging from 0.004 to 0.035). Students less experienced in anatomy were more challenged in prioritizing core curricular knowledge. Clin. Anat. 24:664-670, 2011. © 2011 Wiley-Liss, Inc.

Stereotyping at the undergraduate level revealed during interprofessional learning between future doctors and biomedical scientists

Interprofessional education (IPE) involving undergraduate health professionals is expected to promote collaboration in their later careers. The role of IPE between doctors and biomedical scientists has not been explored at the undergraduate level. Our aim was to introduce IPE sessions for medical and biomedical students in order to identify the benefits and barriers to these groups learning together. Medical and biomedical students together discussed laboratory results, relevant literature, and ideas for developing new diagnostic tools. The programme was evaluated with questionnaires and interviews. While there was general support for the idea of IPE, medical and biomedical students responded differently. Biomedical students were more critical, wanted more explicit learning objectives and felt that their professional role was often misunderstood. The medical students were more enthusiastic but regarded the way the biomedical students communicated concerns about their perceived role as a barrier to effective interprofessional learning. We conclude that stereotyping, which can impede effective collaborations between doctors and biomedical scientists, is already present at the undergraduate level and may be a barrier to IPE. Effective learning opportunities should be supported at the curriculum level and be designed to specifically enable a broad appreciation of each other's future professional roles.

The anatomy of anatomy: a review for its modernization

Anatomy has historically been a cornerstone in medical education regardless of nation or specialty. Until recently, dissection and didactic lectures were its sole pedagogy. Teaching methodology has been revolutionized with more reliance on models, imaging, simulation, and the Internet to further consolidate and enhance the learning experience. Moreover, modern medical curricula are giving less importance to anatomy education and to the acknowledged value of dissection. Universities have even abandoned dissection completely in favor of user-friendly multimedia, alternative teaching approaches, and newly defined priorities in clinical practice. Anatomy curriculum is undergoing international reformation but the current framework lacks uniformity among institutions. Optimal learning content can be categorized into the following modalities: (1) dissection/prosection, (2) interactive multimedia, (3) procedural anatomy, (4) surface and clinical anatomy, and (5) imaging. The importance of multimodal teaching, with examples suggested in this article, has been widely recognized and assessed. Nevertheless, there are still ongoing limitations in anatomy teaching. Substantial problems consist of diminished allotted dissection time and the number of qualified anatomy instructors, which will eventually deteriorate the quality of education. Alternative resources and strategies are discussed in an attempt to tackle these genuine concerns. The challenges are to reinstate more effective teaching and learning tools while maintaining the beneficial values of orthodox dissection. The UK has a reputable medical education but its quality could be improved by observing international frameworks. The heavy penalty of not concentrating on sufficient anatomy education will inevitably lead to incompetent anatomists and healthcare professionals, leaving patients to face dire repercussions.

The Practice-based Small Group Learning programme: experiences of learners in multi-professional groups

This study describes the experiences of General Practitioners (GPs) and Practice Nurses (PNs) as they came together and engaged in the Practice-based Small Group Learning (PBSGL) programme. Based on principles of adult and small group learning, PBSGL, which was developed in Canada, was used for the first time for the Continuing Professional Development (CPD) of multi-professional groups in the UK. The findings detail the main reasons GPs and PNs participated in PBSGL, the nature of interaction and development of cohesion in the groups, factors influencing contribution to discussions, the learning process, and outcomes for learners. Respect shown for different roles and perspectives enabled participants to be open about gaps in their knowledge and to ask questions. A mutual keenness to understand the perspectives of and learn from the other profession emerges as a key ingredient for learners to feel that their learning needs were met. The learning process in the groups came close to transformative learning--there were changes in perspectives, acquisition of new knowledge and increased self-esteem. The appropriateness of the PBSGL approach for the CPD of mixed groups of GPs and PNs is discussed.

Secondary school science predictors of academic performance in university bioscience subjects

In 2009 the Faculty of Health Sciences at La Trobe University in Melbourne, Australia is introducing a common first year for 11 different undergraduate courses in the faculty. Current prerequisite science entry requirements vary with course and range from none to at least two science or mathematics subjects and from approximately 50 to 99 in Equivalent National Tertiary Entrance Rank (ENTER) scores. Under the previous structure, students in different courses completed a variety of different subjects at first year. Concern about the ability of such disparate groups to complete a common first year led to the current investigation of the relationships between year 12 (final year of secondary school) science subjects and performance in first year university bioscience subjects. Year 12 results for all science-related units and ENTER scores were obtained for all Victorian students enrolling in a first year course in the Faculty of Health Sciences in 2005 and 2006. Regression and other analyses were conducted for five first year bioscience subjects. The ENTER score was the best predictor of academic performance in all units except regional anatomy. Performance in many secondary school science subjects was highly predictive of performance in physiology, combined systematic physiology and anatomy and biomechanics units, but again not for regional anatomy units. It appears that year 12 performance in science subjects and ENTER scores may be important predictors of success in physiology, but not regional anatomy subjects at university. It is possible that regional anatomy is an entirely new subject area that requires new types of learning unrelated to year 12 science subjects.

A cross-cultural comparison of anatomy learning: learning styles and strategies

Cultural influences on anatomy teaching and learning have been investigated by application of a questionnaire to medical students in British and Chinese Medical Schools. Results from the responses from students of the two countries were analyzed. Both groups found it easier to understand anatomy in a clinical context, and in both countries, student learning was driven by assessment. Curriculum design differences may have contributed to the British view wherein students were less likely to feel time pressure and enjoyed studying anatomy more than their Chinese counterparts. Different teaching approaches resulted in British students being more likely to recite definitions to learn, and the Chinese students found learning from cross-sectional images easy. Cultural differences may account for the observation that British students were more inclined to ask questions in class, and the preference of Chinese students to study in small groups. The findings give evidence to show how 'cultures of learning' influence students' approaches and indicate the importance of cultural influences as factors amongst international and home learner groups.

How useful is plastination in learning anatomy?

In recent years plastination has begun to revolutionize the way in which human and veterinary gross anatomy can be presented to students. The study reported here assessed the efficacy of plastinated organs as teaching resources in an innovative anatomy teaching/learning system. The main objective was to evaluate whether the use of plastinated organs improves the quality of teaching and learning of anatomy. For this purpose, we used an interdepartmental approach involving the departments of Veterinary Anatomy, Human Anatomy, Veterinary Surgery, and Education Development and Research Methods. The knowledge base of control and experimental student groups was examined before and after use of the fixed or plastinated resources, respectively, to gather information evaluating the effectiveness of these teaching resources. Significant differences (p < 0.001) between control and experimental groups of Human and Veterinary Anatomy were observed in the post-test results. The Veterinary Surgery students had the most positive opinion of the use of plastinated specimens. Using these data, we were able to quantitatively characterize the use of plastinated specimens as anatomy teaching resources. This analysis showed that all the plastinated resources available were heavily used and deemed useful by students. Although the properties of plastinated specimens accommodate student needs at various levels, traditional material should be used in conjunction with plastinated resources.

Provision of anatomical teaching in a new British medical school: Getting the right mix

In response to a government report, which recommended a substantial increase in the number of medical students in the United Kingdom by 2005, several new medical schools have been set up throughout the country. One such school, the Brighton and Sussex Medical School (BSMS), recently opened its doors to new students. BSMS offers a 5-year medical curriculum that uses an integrated systems-based approach to cultivate academic knowledge and clinical experience. Anatomy is one of the core elements of the program and, as such, features strongly within the modular curriculum. The challenge for the anatomy faculty has been to decide how best to integrate anatomy into the new curriculum and what teaching modalities should be used. A multidisciplinary approach has been taken using both traditional and contemporary teaching methods. Unlike most of the other new medical schools, BSMS uses cadaveric dissection as the cornerstone of its teaching, as the faculty believes that dissection still provides the most powerful technique for demonstrating anatomy as well as enhancing communication and teamwork skills. The dissection experience is handled using an understanding and professional way. However, to ensure that our students do not become detached from the process of patient-focused care, emphasis in the dissecting room environment is also placed on respect and compassion. To enhance conceptual understanding of structure and function and provide further clinical relevance, we are using imaging technology to demonstrate living anatomy. Unique to the BSMS curriculum is the teaching of the anatomy in the later years of the program. During specialist rotations, students will return to the dissecting room to study the anatomy relevant to that area. Such vertical integration ensures that core anatomical knowledge is gained at the most appropriate level relative to a student's clinical experience.