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Showing papers in "Anatomical Sciences Education in 2020"


Journal ArticleDOI
TL;DR: This study sought to identify the approaches taken in the United Kingdom and Republic of Ireland to deliver anatomical education through online means and compared adopting a thematic analysis approach.
Abstract: The Covid-19 pandemic has driven the fastest changes to higher education across the globe, necessitated by social distancing measures preventing face-to-face teaching. This has led to an almost immediate switch to distance learning by higher education institutions. Anatomy faces some unique challenges. Intrinsically, anatomy is a three-dimensional subject that requires a sound understanding of the relationships between structures, often achieved by the study of human cadaveric material, models, and virtual resources. This study sought to identify the approaches taken in the United Kingdom and Republic of Ireland to deliver anatomical education through online means. Data were collected from 14 different universities in the United Kingdom and Republic of Ireland and compared adopting a thematic analysis approach. Once themes were generated, they were collectively brought together using a strength, weakness, opportunity, threat (SWOT) analysis. Key themes included the opportunity to develop new online resources and the chance to engage in new academic collaborations. Academics frequently mentioned the challenge that time constrains could place on the quality and effectiveness of these resources; especially as in many cases the aim of these resources was to compensate for a lack of exposure to cadaveric exposure. Comparisons of the actions taken by multiple higher education institutions reveal the ways that academics have tried to balance this demand. Discussions will facilitate decisions being made by higher education institutions regarding adapting the curriculum and assessment methods in anatomy.

299 citations


Journal ArticleDOI
TL;DR: This study on anatomy education disruption at pandemic onset within Australia and New Zealand adopts a social constructivist lens and reveals loss of integrated “hands‐on” experiences, and impacts on workload, traditional roles, students, pedagogy, and anatomists' personal educational philosophies.
Abstract: Australian and New Zealand universities commenced a new academic year in February/March 2020 largely with "business as usual." The subsequent Covid-19 pandemic imposed unexpected disruptions to anatomical educational practice. Rapid change occurred due to government-imposed physical distancing regulations from March 2020 that increasingly restricted anatomy laboratory teaching practices. Anatomy educators in both these countries were mobilized to adjust their teaching approaches. This study on anatomy education disruption at pandemic onset within Australia and New Zealand adopts a social constructivist lens. The research question was "What are the perceived disruptions and changes made to anatomy education in Australia and New Zealand during the initial period of the Covid-19 pandemic, as reflected on by anatomy educators?." Thematic analysis to elucidate "the what and why" of anatomy education was applied to these reflections. About 18 anatomy academics from ten institutions participated in this exercise. The analysis revealed loss of integrated "hands-on" experiences, and impacts on workload, traditional roles, students, pedagogy, and anatomists' personal educational philosophies. The key opportunities recognized for anatomy education included: enabling synchronous teaching across remote sites, expanding offerings into the remote learning space, and embracing new pedagogies. In managing anatomy education's transition in response to the pandemic, six critical elements were identified: community care, clear communications, clarified expectations, constructive alignment, community of practice, ability to compromise, and adapt and continuity planning. There is no doubt that anatomy education has stepped into a yet unknown future in the island countries of Australia and New Zealand.

294 citations


Journal ArticleDOI
TL;DR: Despite the seriousness of the health situation, this new drive to move to online learning provides the necessary opportunity to assess the future approach to curriculum design and delivery for the anatomical sciences.
Abstract: \"All hands on deck, we need to move everything online as quickly as possible\". This is the message that has been ringing out across universities worldwide over the last couple of months as the Covid-19 pandemic has taken hold. Anatomists have responded to this call enthusiastically and creatively, ensuring that their students have resources available to continue and support their learning as they are forced to study remotely and exercise social distancing and where necessary self-isolation. Despite the seriousness of the health situation, this new drive to move to online learning provides the necessary opportunity to assess our future approach to curriculum design and delivery for the anatomical sciences. This pause to reevaluate is necessary as online learning, offers up refreshing and pedagogically innovative approaches to facilitate learning. For many courses and programs however, it is not the long-term silver bullet solution to all learning provision and has consequences that must be considered.

231 citations


Journal ArticleDOI
TL;DR: As both an anatomy student and anatomy demonstrator, Anatomical Sciences Education has become my go-to journal to further my knowledge of the latest developments in anatomy education, innovations in pedagogical practice, and indeed perspectives on current affairs in the field.
Abstract: As both an anatomy student and anatomy demonstrator, Anatomical Sciences Education has become my go-to journal to further my knowledge of the latest developments in anatomy education, innovations in pedagogical practice, and indeed perspectives on current affairs in the field.

195 citations


Journal ArticleDOI
TL;DR: E-learning platforms have become increasingly popular in teaching practices in tertiary institutions, in particular health professional education, and mainly ascribed to observed learning benefits through verbal, visual, and auditory stimulations.
Abstract: The Covid-19 crisis has caused devastation around the world, where face-to-face (F2F) teaching in universities has been abandoned and anatomy education courses shifted to the virtual mode (Evans et al., 2020; Ravi et al., 2020). In fact, e-learning platforms have become increasingly popular in teaching practices in tertiary institutions, in particular health professional education (Lewis et al., 2014), and mainly ascribed to observed learning benefits through verbal, visual, and auditory stimulations (Selim, 2007; Jelonek, 2015). E-learning is a way of teaching supported by digital technologies as underlined by the definition that e-learning is "the use of new multimedia technologies and the internet to improve the quality of learning by facilitating access to resources and services, as well as remote exchange and collaboration" (Alonso et al., 2005).

107 citations


Journal ArticleDOI
TL;DR: The majority perceived a positive learning experience following the shift to remote lectures, however, it was not the case for small group teaching including dissection sessions, and students reported concerns about their education, examinations, progression to next academic year and wellbeing.
Abstract: Covid-19 has spread globally, affecting all nations. Preventive measures were implemented by governments including the closure of universities. The aim of this study was to evaluate the student's perspectives and experiences on the shift to remote preclinical medical education while inquiring whether there has been any psychological impact on the students. A customized questionnaire utilizing Likert-scale-based questions and the Generalized Anxiety Disorder-7 assessment tool was distributed online to enrolled preclinical medical students at the Faculty of Medicine and Surgery at the University of Malta. Quantitative and qualitative analyses of the data gathered was carried out. Multivariate logistic regression analyses was performed to establish independent variables associated with anxiety symptoms. A total of 172 responded out of a cohort of 299 preclinical students (58%). The majority perceived a positive learning experience following the shift to remote lectures, however, it was not the case for small group teaching including dissection sessions. Nonetheless students reported concerns about their education, examinations, progression to next academic year and wellbeing. Less than half the students exhibited symptoms of anxiety. Students exhibiting "moderate" worry (OR:7.6; CI 95%:1.98-29.31; P < 0.01) and "severe" worry (OR: 2.0; CI 95%: 5.0-80.5; P < 0.01) on their mental, emotional, and wellbeing due to Covid-19 were associated with anxiety symptoms after adjusting for cofounders. Apart from the short-term effects, the Covid-19 pandemic may have a long-term impact on both the medical education and the students' future careers. It is important that the implemented changes in medical education are recorded and studied since such data will be essential on how to proceed post-Covid-19 pandemic.

72 citations


Journal ArticleDOI
TL;DR: It is instrumental to consider an aptitude–treatment interaction caused by visual‐spatial abilities when designing research into 3D learning, and further research is needed to identify contributing features and the most effective way of introducing this technology into current educational programs.
Abstract: Monoscopically projected three-dimensional (3D) visualization technology may have significant disadvantages for students with lower visual-spatial abilities despite its overall effectiveness in teaching anatomy. Previous research suggests that stereopsis may facilitate a better comprehension of anatomical knowledge. This study evaluated the educational effectiveness of stereoscopic augmented reality (AR) visualization and the modifying effect of visual-spatial abilities on learning. In a double-center randomized controlled trial, first- and second-year (bio)medical undergraduates studied lower limb anatomy with stereoscopic 3D AR model (n = 20), monoscopic 3D desktop model (n = 20), or two-dimensional (2D) anatomical atlas (n = 18). Visual-spatial abilities were tested with Mental Rotation Test (MRT), Paper Folding Test (PFT), and Mechanical Reasoning (MR) Test. Anatomical knowledge was assessed by the validated 30-item paper posttest. The overall posttest scores in the stereoscopic 3D AR group (47.8%) were similar to those in the monoscopic 3D desktop group (38.5%; P = 0.240) and the 2D anatomical atlas group (50.9%; P = 1.00). When stratified by visual-spatial abilities test scores, students with lower MRT scores achieved higher posttest scores in the stereoscopic 3D AR group (49.2%) as compared to the monoscopic 3D desktop group (33.4%; P = 0.015) and similar to the scores in the 2D group (46.4%; P = 0.99). Participants with higher MRT scores performed equally well in all conditions. It is instrumental to consider an aptitude-treatment interaction caused by visual-spatial abilities when designing research into 3D learning. Further research is needed to identify contributing features and the most effective way of introducing this technology into current educational programs.

64 citations


Journal ArticleDOI
TL;DR: It is suggested that AR applications can play a role in future anatomy education as an add‐on educational tool, especially in learning three‐dimensional relations of anatomical structures.
Abstract: Neuroanatomy education is a challenging field which could benefit from modern innovations, such as augmented reality (AR) applications. This study investigates the differences on test scores, cognitive load and motivation after neuroanatomy learning by using AR applications or by using cross-sections of the brain. Prior to two practical assignments, a pre-test (extended matching questions, double-choice questions and a test on cross-sectional anatomy) and a mental rotation test (MRT) were completed. Sex and MRT scores were used to stratify students over the two groups. The two practical assignments were designed to study (1) general brain anatomy and (2) subcortical structures. Subsequently, participants completed a post-test similar to the pre-test and a motivational questionnaire. Finally, a focus group interview was conducted to appraise participants' perceptions. Medical and biomedical students (n = 31); 19 males (61.3%) and 12 females (38.7%), mean age 19.2 ±1.7 years participated in this experiment. Students who worked with cross-sections (n = 16) showed significantly more improvement on test scores than students who worked with GreyMapp-AR (P = 0.035) (n = 15). Further analysis showed that this difference was primarily caused by significant improvement on the cross-sectional questions. Students in the cross-section group, moreover, experienced a significantly higher germane (P = 0.009) and extraneous cognitive load (P = 0.016) than students in the GreyMapp-AR group. No significant differences were found in motivational scores. To conclude, this study suggests that AR applications can play a role in future anatomy education as an add-on educational tool, especially in learning three-dimensional relations of anatomical structures.

61 citations


Journal ArticleDOI
TL;DR: The data show that virtual and mixed reality technologies tested are inferior to physical models and that true stereopsis is critical in learning anatomy.
Abstract: Anatomy education has been revolutionized through digital media, resulting in major advances in realism, portability, scalability, and user satisfaction. However, while such approaches may well be more portable, realistic, or satisfying than traditional photographic presentations, it is less clear that they have any superiority in terms of student learning. In this study, it was hypothesized that virtual and mixed reality presentations of pelvic anatomy will have an advantage over two-dimensional (2D) presentations and perform approximately equal to physical models and that this advantage over 2D presentations will be reduced when stereopsis is decreased by covering the non-dominant eye. Groups of 20 undergraduate students learned pelvic anatomy under seven conditions: physical model with and without stereo vision, mixed reality with and without stereo vision, virtual reality with and without stereo vision, and key views on a computer monitor. All were tested with a cadaveric pelvis and a 15-item, short-answer recognition test. Compared to the key views, the physical model had a 70% increase in accuracy in structure identification; the virtual reality a 25% increase, and the mixed reality a non-significant 2.5% change. Blocking stereopsis reduced performance on the physical model by 15%, on virtual reality by 60%, but by only 2.5% on the mixed reality technology. The data show that virtual and mixed reality technologies tested are inferior to physical models and that true stereopsis is critical in learning anatomy.

50 citations


Journal ArticleDOI
TL;DR: As the current push for technology integration increases, it is likely that a large number of Indian academic scholars will begin seeing virtual dissections as beneficial to their classroom.
Abstract: Technology integration in teaching is an evolving concept in modern medical education like other study disciplines in India. The domain of medical science education is presently deficient of deploying technology-based practices. Currently, majority of medical schools and colleges continue to choose traditional wet laboratory dissections over new virtual dissections which are being followed in institutions such as All India Institute of Medical Sciences (AIIMS) and handful of other governmental as well as private medical schools of India like AIIMS Rishikesh, AIIMS Jodhpur, Government Medical College Vimsar, Burla, Odisha, GSL Medical College Rajahmundry, Andhra Pradesh, Yennapoya University Mangalore, Dutta Megha Medical College, GMC Chindwara Madhya Pradesh, Symbiosis Institute Pune and Apollo Medical College Chitoor. Not to mention, as the current push for technology integration increases, it is likely that a large number of Indian academic scholars will begin seeing virtual dissections as beneficial to their classroom.

50 citations


Journal ArticleDOI
TL;DR: In this study, anatomy training with a 3D immersive VR system was found to be beneficial and suggest that VR systems can be used as an alternative method to the conventional anatomy training approach for health students.
Abstract: The aim of this study was to investigate the effect of immersive three-dimensional (3D) interactive virtual reality (VR) on anatomy training in undergraduate physical therapy students. A total of 72 students were included in the study. The students were randomized into control (n = 36) and VR (n = 36) group according to the Kolb Learning Style Inventory, sex, and Purdue Spatial Visualization Test Rotations (PSVT-R). Each student completed a pre-intervention and post-intervention test, consisting of 15 multiple-choice questions. There was no significant difference between the two groups in terms of age, sex, Kolb Learning Style Inventory distribution, and the PSVT-R (P > 0.05). The post-test scores were significantly higher compared to pre-test scores in both the VR group (P < 0.001) and the control group (P < 0.001). The difference between the pre-test and post-test results was found to be significantly higher in favor of the VR group (P < 0.001). In this study, anatomy training with a 3D immersive VR system was found to be beneficial. These results suggest that VR systems can be used as an alternative method to the conventional anatomy training approach for health students.

Journal ArticleDOI
TL;DR: Competitive game‐based learning within Second Life is an effective and well‐accepted means of teaching core radiological anatomy and radiological signs content to medical students and the higher medium‐term outcomes obtained by participants may indicate effective learning with the game.
Abstract: Game-based learning can have a positive impact on medical education, and virtual worlds have great potential for supporting immersive online games. It is necessary to reinforce current medical students' knowledge about radiological anatomy and radiological signs. To meet this need, the objectives of this study were: to design a competition-based game in the virtual world, Second Life and to analyze the students' perceptions of Second Life and the game, as well as to analyze the medium-term retention of knowledge and the potential impact on the final grades. Ninety out of 197 (45.6%) third-year medical students voluntarily participated in an online game based on self-guided presentations and multiple-choice tests over six 6-day stages. Participants and non-participants were invited to perform an evaluation questionnaire about the experience and a post-exposure knowledge test. Participants rated the experience with mean scores equal to or higher than 8.1 on a 10-point scale, highlighting the professor (9.5 ± 1.1; mean ± SD) and the virtual environment (8.9 ± 1.1). Participants had better results in the post-exposure test than non-participants (59.0 ± 13.5 versus 45.3 ± 11.5; P < 0.001) and a lower percentage of answers left blank (6.7 ± 8.4 versus 13.1 ± 12.9; P = 0.014). Competitive game-based learning within Second Life is an effective and well-accepted means of teaching core radiological anatomy and radiological signs content to medical students. The higher medium-term outcomes obtained by participants may indicate effective learning with the game. Additionally, valuable positive perceptions about the game, the educational contents, and the potential benefit for their education were discovered among non-participants.

Journal ArticleDOI
TL;DR: Data from this study suggest that a combination of multiple pedagogical resources seems to be the more advantageous for teaching neuroanatomy.
Abstract: Neuroanatomy has been deemed crucial for clinical neurosciences. It has been one of the most challenging parts of the anatomical curriculum and is one of the causes of "neurophobia," whose main implication is a negative influence on the choice of neurology in the near future. In the last decades, several educational strategies have been identified to improve the skills of students and to promote a deep learning. The aim of this study was to systematically review the literature to identify the most effective method/s to teach human neuroanatomy. The search was restricted to publications written in English language and to articles describing teaching tools in undergraduate medical courses from January 2006 through December 2017. The primary outcome was the observation of improvement of anatomical knowledge in undergraduate medical students. Secondary outcomes were the amelioration of long-term retention knowledge and the grade of satisfaction of students. Among 18 selected studies, 44.4% have used three-dimensional (3D) teaching tools, 16.6% near peer teaching tool, 5.55% flipped classroom tool, 5.55% applied neuroanatomy elective course, 5.55% equivalence-based instruction-rote learning, 5.55% mobile augmented reality, 5.55% inquiry-based clinical case, 5.55% cadaver dissection, and 5.55% Twitter. The high in-between study heterogeneity was the main issue to identify the most helpful teaching tool to improve neuroanatomical knowledge among medical students. Data from this study suggest that a combination of multiple pedagogical resources seems to be the more advantageous for teaching neuroanatomy.

Journal ArticleDOI
TL;DR: From the perspective of a medical student, how the lack of practical teaching with cadavers can adversely impact training and lead to losses for students is described.
Abstract: In the context of the Covid-19 pandemic and the various subsequent changes and behavioral adjustments necessary in the educational field, two important articles were recently published in Anatomical Sciences Education (Franchi, 2020; Srinivasan, 2020). The first study (Franchi, 2020) reported the impact of the pandemic on human anatomy education in the United Kingdom. This article described from the perspective of a medical student how the lack of practical teaching with cadavers can adversely impact training and lead to losses for students.

Journal ArticleDOI
TL;DR: Evidence was found for improvement of spatial abilities in anatomy education using instruction in anatomy and mental rotations training using instruction to improve spatial abilities.
Abstract: Spatial abilities have been correlated to anatomy knowledge assessment and spatial training has been found to improve spatial abilities in previous systematic reviews. The objective of this systematic review was to evaluate spatial abilities training in anatomy education. A literature search was done from inception to 3 August 2017 in Scopus® and several databases on the EBSCOhost platform. Citations were reviewed and those involving anatomy education, an intervention, and a spatial abilities test were retained and the corresponding full-text articles were reviewed for inclusion. Before and after training studies, as well as comparative training programs, relating a spatial training intervention to spatial abilities were eligible. Of the 2,405 citations obtained, 52 articles were identified and reviewed, yielding eight eligible articles. Instruction in anatomy and mental rotations training were found to improve spatial abilities. For the seven studies retained for the meta-analysis that included the effect of interventions on spatial abilities test scores, the pooled treatment effect difference was 0.49 (95% CI [0.17; 0.82]; n = 11) improvement. For the two studies that included the practice effect on spatial abilities test scores in a control group, the pooled treatment effect difference was 0.47 (95% CI [-0.03; 0.97]; n = 2) improvement. In these two studies, the impact of the intervention on spatial abilities test scores was found despite the practice effect. Evidence was found for improvement of spatial abilities in anatomy education using instruction in anatomy and mental rotations training.

Journal ArticleDOI
TL;DR: It is demonstrated that many students, especially the high‐performing ones, made use of the eMed‐App, however, the app itself did not result in better outcomes, suggesting that top students might have been more motivated to use the app than students who were generally weak in anatomy.
Abstract: Hand-held devices have revolutionized communication and education in the last decade. Consequently, mobile learning (m-learning) has become popular among medical students. Nevertheless, there are relatively few studies assessing students' learning outcomes using m-learning devices. This observational study presents an anatomy m-learning tool (eMed-App), an application developed to accompany an anatomy seminar and support medical students' self-directed learning of the skeletal system. Questionnaire data describe where, how frequently, and why students used the app. Multiple choice examination results were analyzed to evaluate whether usage of the app had an effect on test scores. The eMed-App application was used by 77.5% of the students, mainly accessed by Android smartphones, and at students' homes (62.2%) in order to prepare themselves for seminar sessions (60.8%), or to review learning content (67%). Most commonly, students logged on for less than 15 minutes each time (67.8%). Frequent app users showed better test results on items covering eMed-App learning content. In addition, users also achieved better results on items that were not related to the content of the app and, thus, gained better overall test results and lower failure rates. The top quartile of test performers used the eMed-App more frequently compared to students in lower quartiles. This study demonstrated that many students, especially the high-performing ones, made use of the eMed-App. However, the app itself did not result in better outcomes, suggesting that top students might have been more motivated to use the app than students who were generally weak in anatomy.

Journal ArticleDOI
TL;DR: Phenoxyethanol‐based embalming forms an effective alternative to standard embalmer techniques for human cadavers, allowing fixation procedures to be carried out in less sophisticated facilities with non‐anatomy staff.
Abstract: Embalming fixatives such as formaldehyde and phenol have been associated with occupational health hazards. While anatomists aim at replacing these chemicals, this seems presently unfeasible in particular for formaldehyde. Furthermore, fixation protocols usually require well-equipped facilities with highly experienced staff to achieve good fixation results in spite of only a minimal use of formaldehyde. Combining these aspects, a technique robust enough to be carried out by morticians is presented, resulting in durable tissues with minimal formaldehyde use. An embalming protocol involving phenoxyethanol was established, using concentrations of 7 and 1.5 Vol% of phenoxyethanol in the fixative and the conservation fluid, respectively. Visual, haptic, histological, and biomechanical properties and their perceived potential to positively influence student learning outcomes were compared to standard embalming techniques. The phenoxyethanol technique provides esthetic, durable, and odorless tissues. Bleaching is less pronounced compared to ethanol- or formaldehyde-based protocols. The tissues remain pliable following the phenoxyethanol-based embalming and can be used for biomechanical experiments to some extent. Phenoxyethanol-fixed tissues are well suited for undergraduate teaching with perceived positive learning outcomes and partly for postgraduate training. Phenoxyethanol tissues provide the option to obtain well-preserved histology samples, similar to those derived from formaldehyde. The provided protocol helps replace the use of phenol and formaldehyde for conservation purposes and minimizes the use of formaldehyde for the initial injection fixation. Phenoxyethanol-based embalming forms an effective alternative to standard embalming techniques for human cadavers. It is simple to use, allowing fixation procedures to be carried out in less sophisticated facilities with non-anatomy staff.

Journal ArticleDOI
TL;DR: Students found that the procedural dissection components enhanced the knowledge of applied anatomy and is beneficial for the development of clinical skills, and welcomed the idea of implementing more procedure‐based dissections alongside lectures and prosections‐based practical sessions.
Abstract: For centuries cadaveric dissection has been a cornerstone of medical anatomy education However, time and financial limitations in modern, compressed medical curricula, coupled with the abundance of alternate modalities, have raised questions about the role of dissection This study was designed to explore student perceptions of the efficacy of a dissection program for learning musculoskeletal anatomy, and possible adaptations for appropriate inclusion of dissection in the modern medical curricula A paper-based questionnaire was used to collect data from 174 medical students after completion of cadaveric dissections Data were analyzed using both quantitative and qualitative methods Students strongly believed that cadaver-based learning is essential to anatomy education and modern teaching modalities only complement this Moreover, most students reported that dissection provided an additional, immersive learning experience that facilitated active learning and helped in developing manual competencies Students with previous dissection experience or an interest in anatomy-related specialties were significantly more likely to attend dissection sessions Students found that the procedural dissection components enhanced the knowledge of applied anatomy and is beneficial for the development of clinical skills They welcomed the idea of implementing more procedure-based dissections alongside lectures and prosections-based practical (PBP) sessions Cadaveric dissection plays an integral role in medical anatomy education Time restraints and an increased focus on clinical significance, however, demand carefully considered adaptations of existing dissection protocols The introduction of procedure-based dissection offers an innovative, highly engaging and clinically relevant package that would amalgamate skills essential to medical practice while retaining the benefits that have allowed dissection to stand the test of time

Journal ArticleDOI
TL;DR: It is suggested that desktop VLR delivery may minimize the risk of discomfort and disorientation associated with more immersive modalities while still providing a valuable learning experience.
Abstract: Technologies such as virtual reality are used in higher education to develop virtual learning resources (VLRs). These VLRs can be delivered in multiple modalities, from truly immersive involving wearable devices to less immersive modalities such as desktop. However, research investigating perceptions of VLRs in anatomy has mainly focused on a single delivery modality and a limited-demographic participant cohort, warranting a comparison of different modalities and a consideration of different cohorts. This pilot study aimed to compare perceptions of highly immersive and less immersive VLR deliveries among anatomy students and tutors and evaluate the impact of prior university experience on students' perceptions of VLRs. A skull anatomy VLR was developed using the Unity® gaming platform and participants were voluntarily recruited to assess highly immersive stereoscopic and less immersive desktop deliveries of the VLR. A validated survey tool was used to gather perceptions of both deliveries. Most participants agreed that both VLR deliveries were interesting and engaging and provided an immersive experience. Anatomy students perceived the stereoscopic delivery to be significantly more useful for understanding (P = 0.013), while anatomy tutors perceived the desktop delivery as more useful. A degree of physical discomfort and disorientation was reported by some participants for both deliveries, although to a greater extent for the stereoscopic delivery. The stereoscopic delivery was also found to be more mentally taxing than desktop delivery. These results suggest that desktop VLR delivery may minimize the risk of discomfort and disorientation associated with more immersive modalities while still providing a valuable learning experience.

Journal ArticleDOI
TL;DR: Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper‐year courses and further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.
Abstract: The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.

Journal ArticleDOI
TL;DR: In this article, the authors explored trends in the number, type, and fill rate of anatomy educator job openings by analyzing job posting in the United States over the past two years and found that most departmental leaders who responded (65% or more) from United States/Canada and the European Union (n = 52) anticipate they will have “moderate to great difficulty hiring anatomy educators in gross anatomy, histology, and embryology over the next five years.
Abstract: In 2002, a widely publicized report projected an anatomy educator shortage based on department chairpersons' perceptions. Now, 17 years later, the question lingers: “Does an anatomy educator shortage persist and, if so, how severe is the shortage?” Trends in the number, type, and fill rate of anatomy educator job openings were explored by analyzing job posting in the United States over the past two years. A survey was distributed to leaders of anatomy‐related departments in the United States, Canada, and European Union. Most departmental leaders who responded (65% or more) from the United States/Canada (n = 81) and the European Union (n = 52) anticipate they will have “moderate” to “great” difficulty hiring anatomy educators in gross anatomy, histology, and embryology over the next five years. Within the United States, the number of anatomy educator job postings at medical schools more than doubled from at least 21 postings in 2017 to 52 postings in 2018. Twenty‐one percent of postings between 2017 and 2018 were never filled. While the number of anatomy educator openings within the United States/Canada is perceived to remain in a steady state for the next five years, the European Union estimates a five‐fold increase in the number of openings. Departmental leaders prioritize anatomy educator applicants who have teaching experience (mean ± SD = 4.64 ± 0.84 on five‐point Likert scale), versatility in teaching multiple anatomy disciplines (3.93 ± 1.07), and flexibility in implementing various teaching pedagogies (3.69 ± 1.17). Collectively, these data suggest the shortage of anatomy educators continues in the United States/Canada and the European Union.

Journal ArticleDOI
TL;DR: Plastic models may be a valuable supplementary modality in learning upper limb musculoskeletal anatomy, despite their limitations, easy to use and with no need for maintaining facilities, they are highly appreciated by students and can be useful when preparing for the use of cadaveric specimens.
Abstract: Human cadaveric prosections are a traditional, effective, and highly appreciated modality of anatomy learning. Plastic models are an alternative teaching modality, though few studies examine their effectiveness in learning of upper limb musculoskeletal anatomy. The purpose of this study is to investigate which modality is associated with a better outcome, as assessed by students' performance on examinations. Overall, 60 undergraduate medical students without previous knowledge of anatomy participated in the study. Students were assigned into two groups. Group 1 attended lectures and studied from cadaveric prosections (n = 30) and Group 2 attended lectures and used plastic models in the laboratory (n = 30). A knowledge assessment, including examination with tag questions (spot test) and written multiple-choice questions, was held after the end of the study. Students' perceptions were also investigated via an anonymous questionnaire. No significant difference in students' performance was observed between the group using prosections and the group using plastic models (32.2 ± 14.7 vs 35.0 ± 14.8, respectively; P = 0.477). Similarly, no statistically significant difference was found regarding students' satisfaction from using each learning modality (P = 0.441). Plastic models may be a valuable supplementary modality in learning upper limb musculoskeletal anatomy, despite their limitations. Easy to use and with no need for maintaining facilities, they are highly appreciated by students and can be useful when preparing for the use of cadaveric specimens.

Journal ArticleDOI
TL;DR: It is proposed that as standard practice, anatomists obtain informed consent from donors before sharing images of cadaveric material on social media and ensure posts include a statement stating the same.
Abstract: Social Media has changed the way that individuals interact with each other - it has brought considerable benefits, yet also some challenges. Social media in anatomy has enabled anatomists all over the world to engage, interact and form new collaborations that otherwise would not have been possible. In a relatively small discipline where individuals may be working as the only anatomist in an institution, having such a virtual community can be important. Social media is also being used as a means for anatomists to communicate with the current generation of students as well as members of the public. Posting appropriate content is one of the challenges raised by social media use in anatomy. Human cadaveric material is frequently shared on social media and there is divided opinion among anatomists on whether or not such content is appropriate. This article explores the uses and challenges of social media use in the field of anatomy and outlines guidelines on how social media can be used by anatomists globally, while maintaining professional and ethical standards. Creating global guidelines has shown to be difficult due to the differences in international law for the use of human tissue and also the irregularities in acquiring informed consent for capturing and sharing cadaveric images. These nuances may explain why cadaveric images are frequently shared on social media. This article proposes that as standard practice, anatomists obtain informed consent from donors before sharing images of cadaveric material on social media and ensure posts include a statement stating the same.

Journal ArticleDOI
TL;DR: 3D printed models of the pterygopalatine fossa were developed as a visual and kinesthetic learning tool for completely visualizing the fossa, its boundaries, its communicating channels, and its neurovascular structures and satisfaction surveys indicated that the intervention group found the 3D printed model to be significantly more useful as compared to the half skull used by the control group.
Abstract: The pterygopalatine fossa (PPF) is a bilateral space deep within the skull that serves as a major neurovascular junction. However, its small volume and poor accessibility make it a difficult space to comprehend using two-dimensional illustrations and cadaveric dissections. A three-dimensional (3D) printed model of the PPF was developed as a visual and kinesthetic learning tool for completely visualizing the fossa, its boundaries, its communicating channels, and its neurovascular structures. The model was evaluated by analyzing student performance on pre- and post-quizzes and a student satisfaction survey based on the five-point Likert scale. The first cohort comprised of 88 students who had never before studied the PPF. The second cohort consisted of 30 students who were previously taught the PPF. Each cohort was randomly divided into a control group who were provided with a half skull and an intervention group that were provided with the 3D printed model. The intervention group performed significantly better on the post-quiz as compared to the control group in cohort I (P = 0.001); while not significant, it also improved learning in cohort II students (P = 0.124). Satisfaction surveys indicated that the intervention group found the 3D printed model to be significantly more useful (P < 0.05) as compared to the half skull used by the control group. Importantly, the effect sizes for cohorts I and II (0.504 and 0.581, respectively) validated the statistical results. Together, this study highlights the importance of 3D printed models as teaching tools in anatomy education.

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TL;DR: A substantial improvement was observed in individuals with initially lower scores on the visual‐spatial abilities test indicating a different trajectory of improvement, and students' preferences for attending extracurricular anatomy dissection course was not driven by visual‐ Spatial abilities.
Abstract: Visual-spatial abilities are considered a successful predictor in anatomy learning Previous research suggest that visual-spatial abilities can be trained, and the magnitude of improvement can be affected by initial levels of spatial skills This case-control study aimed to evaluate (1) the impact of an extra-curricular anatomy dissection course on visual-spatial abilities of medical undergraduates and (2) the magnitude of improvement in students with initially lower levels of visual-spatial abilities, and (3) whether the choice for the course was related to visual-spatial abilities Course participants (n = 45) and controls (n = 65) were first and second-year medical undergraduates who performed a Mental Rotations Test (MRT) before and 10 weeks after the course At baseline, there was no significant difference in MRT scores between course participants and controls At the end of the course, participants achieved a greater improvement than controls (first-year: ∆60 ± 41 vs ∆49 ± 32; ANCOVA, P = 0019, Cohen's d = 041; second-year: ∆65 ± 33 vs ∆61 ± 40; P = 003, Cohen's d = 011) Individuals with initially lower scores on the MRT pretest showed the largest improvement (∆84 ± 23 vs ∆68 ± 28; P = 0011, Cohen's d = 061) In summary, (1) an anatomy dissection course improved visual-spatial abilities of medical undergraduates; (2) a substantial improvement was observed in individuals with initially lower scores on the visual-spatial abilities test indicating a different trajectory of improvement; (3) students' preferences for attending extracurricular anatomy dissection course was not driven by visual-spatial abilities

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TL;DR: Spatial awareness training did not improve SA or anatomy scores; however, SA may identify students who may benefit from additional academic support.
Abstract: Spatial ability (SA) is the cognitive capacity to understand and mentally manipulate concepts of objects, remembering relationships among their parts and those of their surroundings. Spatial ability provides a learning advantage in science and may be useful in anatomy and technical skills in health care. This study aimed to assess the relationship between SA and anatomy scores in first- and second-year medical students. The training sessions focused on the analysis of the spatial component of objects' structure and their interaction as applied to medicine; SA was tested using the Visualization of Rotation (ROT) test. The intervention group (n = 29) received training and their pre- and post-training scores for the SA tests were compared to a control group (n = 75). Both groups improved their mean scores in the follow-up SA test (P < 0.010). There was no significant difference in SA scores between the groups for either SA test (P = 0.31, P = 0.90). The SA scores for female students were significantly lower than for male students, both at baseline and follow-up (P < 0.010). Anatomy training and assessment were administered by the anatomy department of the medical school, and examination scores were not significantly different between the two groups post-intervention (P = 0.33). However, participants with scores in the bottom quartile for SA performed worse in the anatomy questions (P < 0.001). Spatial awareness training did not improve SA or anatomy scores; however, SA may identify students who may benefit from additional academic support.

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TL;DR: This research illustrates that reflective writing in an undergraduate anatomy course not only facilitates improvement in student metacognitive skills, but also provides the instructor with evidence how a student progresses from novice to more experienced learner in anatomy.
Abstract: Incorporating metacognitive strategies in the classroom helps students monitor and adjust their learning strategies throughout the semester, and helps students progress from novice to expert learners in a subject. Journaling (i.e., reflective writing) is one metacognitive task that allows students to contemplate and articulate their skill development as they learn a new subject. The research reported here examines the use of 'blogs' (i.e., online journals) in an upper level undergraduate human anatomy course. The blogs both facilitated development of students' metacognitive skills and provided researchers insight into student metacognitive process. Data were examined from 92 students from three successive semesters (spring 2010, 2012 and 2014). Each student reviewed 10 radiology online cases throughout the semester and then reflected on their understanding of anatomy and radiology in an online blog for each case. A total of 927 blogs were examined for this research. The researchers used a grounded theory approach to analyze the blog narratives and develop a codebook based on common themes. The 927 blogs yielded 11,082 statements that were coded with the codebook. As the semester progressed, the blog entries showed that students demonstrated greater self-confidence in their abilities to understand the subject matter, expressed greater enthusiasm for anatomy in general, and they improved their metacognitive skills. This research illustrates that reflective writing in an undergraduate anatomy course not only facilitates improvement in student metacognitive skills, but also provides the instructor with evidence how a student progresses from novice to more experienced learner in anatomy.

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TL;DR: This narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.
Abstract: There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.

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TL;DR: The total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools.
Abstract: Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990-1999, 2000-2009, and 2010-2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000-2009 to 36.10 ± 47.26 in 2010-2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990-1999 to 14.22 ± 5.0 in 2010-2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000-2009 to 1:33.2 in 2010-2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.

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TL;DR: The incorporation of the VM platform in the context of test‐enhanced learning may help more students to master microscopic laboratory content and improve students' learning experience in microscope laboratory sessions.
Abstract: Virtual microscopy (VM) has been utilized to improve students' learning experience in microscope laboratory sessions, but minimal attention has been given to determining how to use VM more effectively. The study examined the influence of VM on academic performance and teacher and student perceptions and compared laboratory test scores before and after VM incorporation. A total of 662 third-year students studying histology and 651 fourth-year students studying pathology were divided into two groups. The light microscopy (LM) group used a light microscope in 2014 and 2015, while the LM + VM group used the VM platform and a light microscope in 2016 and 2017. Four factors positively predict laboratory scores (R square, 0.323; P < 0.001): (i) the pathology course and test-enhanced learning, (ii) the VM platform and experience, (iii) medical students and lecture scores, and (iv) female students. The LM + VM group exhibited less score variability on laboratory examinations relative to their mean than the LM group. The LM + VM group was also associated with fewer failing grades (F grade; odds ratio, 0.336; P < 0.001) and higher scores (A grade; odds ratio, 2.084; P < 0.001) after controlling for sex, school, course, and lecture grades. The positive effect of the VM platform on laboratory test grades was associated with prior experience using the VM platform and was synergistic with more interim tests. Both teachers and students agreed that the VM platform enhanced laboratory learning. The incorporation of the VM platform in the context of test-enhanced learning may help more students to master microscopic laboratory content.