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

Habituation for professional learning: a qualitative study of physiotherapy students' experiences working with anatomy cadavers

INTRODUCTION

Cadaveric dissection shapes the ways in which healthcare students understand the human body and the attitudes, identities and behaviors they exhibit as health professionals. There is however a paucity of related research with physiotherapy (PT) students.

PURPOSE

The purpose of this interpretivist study was to investigate PT students' conceptions of the human body in relation to experiences with human cadavers in anatomy education.

METHODS

Ten semi-structured interviews were conducted with PT students along with four optional written reflections completed. Data was thematically analyzed.

RESULTS

Students engaged in a continuous process of habituation involving oscillation between "humanization" and "dehumanization" of cadavers in the anatomy lab. We describe the contextual mediators that shaped the process, the multi-sensory and emotional experience of the students, and the "interruptions" that contributed to the variability in their conceptions over time and contexts. Students ultimately habituated toward dehumanization which had multiple effects on learning and professionalization.

CONCLUSION

Study findings highlight the complexity of PT students' experiences and learning within the cadaver lab outside of the formal goals of anatomy education. We discuss the implications for anatomy curricula, including the potential advantages of incorporating a biopsychosocial approach.

Collaborative Assessment in the Gross Anatomy Lab

Purpose

In 2018, the Michigan State University College of Human Medicine incorporated two-stage examinations into the gross anatomy curriculum. Multiple studies have investigated two-stage examinations and have largely reported positive findings. Here, we used a mixed-methods approach to further investigate the feasibility and student perceptions of the two-stage examination in the context of a medical school curriculum that emphasizes longitudinal group-based learning and formative assessments.

Methods

Three student cohorts were assessed with a formative two-stage examination at the end of their first-year anatomy experience. Data for the quantitative analysis included examination scores from the individual and group portions of the two-stage examination. For the qualitative stage of this project, we utilized a constructivist grounded theory methodology in which data, including both post-examination survey results and one-on-one semi-structured student interviews, were transcribed (interviews), coded, inductively and iteratively reviewed, and thematically interpreted.

Results

Survey and interview results revealed an overwhelmingly positive perception of the collaborative assessment experience. Student comments demonstrated educational value in the immediate feedback provided by this examination format and suggested that collaboration during the examination transformed the assessment into a learning experience.

Conclusions

While two-stage examinations have the potential to positively transform an assessment into a learning experience, we also identified complex relationships between content knowledge and anxiety that may affect student perceptions. In addition, examination logistics (e.g., curricular timing) have the potential to negatively affect student perceptions, indicating that faculty should consider these factors when implementing collaborative assessments into their curriculum.

Learning Outcomes of Nursing Students' Experience With Cadaveric Dissection: A Scoping Review

Introduction

Cadaver dissection in anatomy, a cornerstone of medical school education, has been replaced by digital technologies. This study aimed to determine the learning outcomes nursing students could achieve through cadaveric dissection practice (CDP).

Methods

This scoping review was carried out using the checklist outlined in the Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews through August 2023. Articles from PubMed, ERIC, and CINAL were included. This scoping review included studies that focused on the learning effects of nursing students' experiences with cadaver dissection, written in English, and covered all study types.

Results

The cadaveric dissection exercise resulted in a strong interest in the human body and a thorough understanding of anatomy and physiology. It also allows for creating an image of care for the patient before death, the meaning of existence after death, acceptance that death is not frightening, and an understanding of the afterlife. Furthermore, the cadaveric dissection exercise has been reported to improve confidence in patient care, lead to a better understanding of what other professions practice, and involve the development of professional identity.

Conclusions

Studies on the learning effects of CDP have differed in subject matter and educational methodologies. In the future, while determining how the experience of CDP is related to nursing practice of nursing students and graduates, we must explore effective CDP and develop educational methodologies that can achieve similar learning effects.

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.

A thematic analysis of students' discussions on death and body donation in international online focus groups

Historically, Anatomy education is an in-person discipline involving exposure to human body donors that facilitates personal and professional growth through, in part, the initiation of reflection on the topic of death. However, during the COVID-19 pandemic the decreased exposure to cadaveric anatomy for many health professions students may have influenced the depth of their individual reflections on this topic. Accordingly, this study aimed to investigate the effect of an alternate approach-focus group discussions between peers with varying degrees of exposure to cadaveric material-that may offer one strategy to stimulate deep reflection on the topic of death. A programmatic intervention was introduced, wherein students (n = 221) from 13 international universities discussed differences in their anatomy courses during small focus group sessions as part of an online exchange program. An inductive semantic thematic analysis was conducted on responses to an open-ended text-response question on how the activity influenced students' reflections about death. Resulting themes were organized into categories that described the content and topics of the students' discussions as they grappled with this sensitive topic. The students reportedly engaged in deep reflection and expressed an increased sense of connectedness with their peers, despite their disparate exposure levels to cadaveric anatomy and being physically distanced. This demonstrates that focus groups with students experiencing different laboratory contexts can be used to help all students reflect on the topic of death and that interchanges between dissecting and non-dissecting students can initiate thoughts about death and body donation among non-dissecting students.

Effect of interprofessional education on cadaver dissection seminar

In 2010, WHO published a "Framework for action on interprofessional education and collaborative practice." Interprofessional education (IPE) is now being conducted in various ways. We have been holding cadaver dissection seminars to provide opportunities for medical students, nursing students, and nurse practitioner (NP) students to learn together. In this study, we investigated the effect of learning about IPE in cadaver dissection seminars. The seminars were held for 5 days each in 2021 and 2022 (the number of days of participation was arbitrary). In the seminars, teams of 3-5 participants with the same theme collaborated to dissect a single donated cadaver. Teams were made up of participants with different departments: 29 medical students, 12 NP students, and 20 nursing students participated in the seminar, and participants were surveyed before and after the seminars. The Readiness for Interprofessional Learning Scale (RIPLS) scores before and after the dissection seminar increased significantly overall. The scores of medical and nursing students increased significantly, but those of NP students did not significantly change. In terms of the number of days of participation, a significant increase in scores was found for participants who participated for ≥ 2 days. Overall, a significant positive correlation was found between intrinsic motivation to learn and RIPLS scores. For medical students, a significant negative correlation was noted between extrinsic motivation and RIPLS scores. Cadaver dissection seminars conducted by medical, nursing, and NP students demonstrated IPE learning effect on medical students and undergraduate nursing students.

Nursing students' experiences and perceptions of an anatomy laboratory session: Mixed methods study

Many nursing curricula do not offer anatomy laboratories and exposure to cadaveric material. In this mixed methods study, nursing students' perceptions and experiences from an anatomy laboratory session were examined. Students from two academic nursing programs (a four-year general baccalaureate nursing program and a two-year accelerated nursing program for non-nursing baccalaureate graduates) took part in an anatomy laboratory session (N = 223). Participants' learning experiences, emotional experiences, and satisfaction with the anatomy laboratory session were assessed by their responses to closed-ended questionnaires. Participants' reasons for participation and suggestions for improvement were examined by open-ended questions. A mixed methods analysis of the data revealed a high level of satisfaction with the anatomy laboratory experience. Positive attitudes and learning experiences correlated with a sense of identification with the nursing profession. Satisfaction was positively associated with a perceived quality of learning and negatively associated with a negative emotional experience. Curiosity and self-challenge, as well as the quest for tangible, in-depth learning, were major motivators involved in the students' desire to participate in the session. Both qualitative and quantitative analyses indicated that the educational experience was significant. Therefore, it is recommended to integrate anatomy laboratory sessions into anatomy courses for nursing students. This will help to illustrate and assimilate classroom material and strengthen nursing students' sense of identification with their profession.

An initial preparation for human cadaveric dissection ameliorates the associated mental distress in students

It is universally recognized that cadaveric dissection is an essential part of anatomy training. However, it has been reported to induce mental distress in some students and impair their intrinsic motivation (IM) to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation of students for cadaveric dissection. Therefore, it is hypothesized that providing relevant information prior to cadaveric dissection will ameliorate the mental distress, enhance the IM of students, and improve their academic performance. A cohort of occupational therapy students enrolled in an anatomy course were psychologically prepared for cadaveric dissection. Students were provided with a curated list of YouTube videos and peer-reviewed journal articles related to cadaveric dissection prior to the commencement of the anatomy course. All students were also required to attend an oral presentation immediately before commencing dissection. The control group included students who had not been provided with any resources in preparation for cadaveric dissection. Compared to the control group, students who had been prepared demonstrated better quality of cadaveric dissection, improved academic performance, reported less mental distress and greater IM. Moreover, students reported the oral presentation to be most relevant and journal articles to be least useful in their preparation. Therefore, this is an effective approach in the amelioration of mental distress and improvement of performance in anatomy students. Consequently, this study represents a paradigm shift in the pedagogy of anatomy, and could represent a vital element in the evolution of a revitalized anatomy curriculum.

Professional Attitudes in Health Professions' Education: The Effects of an Anatomy Near-Peer Learning Activity

Interprofessional attitudes existing between healthcare disciplines can negatively impact communication and collaboration in the clinical setting. While human anatomy is a topic central to healthcare trainees, the potential of the anatomy laboratory to minimize negative interprofessional attitudes has yet to be characterized. This study aimed to assess the effects of an anatomy interprofessional near-peer learning activity (AIP-NPLA) on medical and nursing students' interprofessional attitudes at McGill University. The authors employed a convergent parallel mixed methods study to explore participants' AIP-NPLA experiences. The Attitudes to Health Professionals Questionnaire (AHPQ) was used pre- and post-AIP-NPLA to assess participants' attitudes toward their own and their counterpart profession. In addition, a focus group was held immediately following the AIP-NPLA to explore participants' experiences and interprofessional perceptions. Quantitative results using a principal components analysis demonstrated significant changes in nursing students' responses between pre- and post-AIP-NPLA scoring, rating the medical profession as being more caring overall. Medical students' responses pre- and post-AIP-NPLA demonstrated no significant differences. Qualitative results also suggested a breakdown of negative attitudes, an increased understanding of inter- and intra-professional roles, and the importance of interprofessional collaboration and mutual learning for their careers. These findings revealed that attitudes among healthcare trainees may be positively restructured in the anatomy laboratory, allowing for collaborative care to predominate in current and future clinical practices.

Integration of Gross Anatomy Laboratory Sessions into Medical Physics Curriculum

BACKGROUND

Gross anatomy laboratory sessions with hands-on activities using specimens are essential for teaching anatomy in the medical field. However, they are not seen in medical physics programs. The objective of this pilot study at McGill University was to explore the educational potential of integrated gross anatomy laboratory sessions tailored to the medical physics curriculum.

METHODS

The study included 21 medical physics and 11 radiation oncology participants. It was conducted over four 2-h laboratory sessions on pelvic, thoracic, and head and neck anatomy. A radiotherapy applicator device and augmented reality tools were brought in to focus on radiological anatomy and radiation therapy. Students' lab experiences were evaluated through post-laboratory surveys using a mixed methodology. Qualitative data from short-answer questions were analyzed using an inductive coding approach. Quantitative data from Likert scale questions were analyzed with descriptive statistics.

RESULTS

All participants reported gross anatomy laboratory sessions as a superior method of learning anatomy compared with a single didactic course (mean Likert: 4.38; median = 5; SD = 0.74). Participants also expressed greater comfort with radiological anatomy and the lab environment with gradual exposure from pelvic prosections to full-body cadavers. Lastly, all participants showed enthusiasm for multidisciplinary activities.

CONCLUSION

Carefully designed gross anatomy laboratory sessions were very well received by medical physics students as they transition into a clinical role in healthcare. This pilot study serves as a foundation for future studies exploring anatomical education in medical physics. These sessions will continue to be offered at our school and could be adopted also by other medical physics departments in their courses.