From the "what" to the "how": Teaching integrative medicine-related skills to medical students during COVID-19

ObjectiveTo examine the impact of an integrative medicine (IM) course on self-perceived IM-related communication and research skills.MethodsA 3-day mandatory "hybrid" (online and in-person) IM course was held within COVID-19 restrictions for 161 pre-clerkship medical students, with workshops facilitated by mentor healthcare professionals (IM and non-IM) and student-directed tasks. Self-perceived levels of 6 IM-related skills were scored (from 1 to 5) for history-taking; communicating with patients with "alternative" health-beliefs; referral to IM consultations; assessing risks/benefits; and working with non-medical IM practitioners.Results137 students (85.1%) completed pre-/post-course questionnaires, with overall scores improving from pre-course (1.98 ± 0.92) to post-course (3.31 ± 0.63; p < 0.0001), for the entire group and student subgroups (with vs. without prior IM experience). Multivariate analysis found no association between age, gender, primary language or prior experience with IM and improvement in skill scores.ConclusionsThe IM course increased self-perceived skill levels, reflecting the course curriculum and workshops. Further research needs to explore the application of these skills during clinical training.Practice implicationsTeaching medical students about IM in a course comprising communication and research skills was shown to be feasible and effective. The application of IM-related skills needs to be evaluated during the clinical clerkship.     

The quest for the deciphering stone—“How do I study for this course?”: Suggestions on how to approach medical gross anatomy

Faculty are frequently asked, “How do I study for this course?” Many have formulated responses, but often there is little sharing of this wisdom among faculty, and students may receive different and often conflicting suggestions from each faculty member they encounter. Although most students believe their study problems are unique, we have found students encounter typical pitfalls as they “learn how to learn” gross anatomy. This paper will describe a six-step Suggested Learning Plan for a dissection course in gross anatomy and its rationale, as well as other pertinent advice our students have found beneficial in making the transition from failing or “just getting by” to doing well and feeling confident about gross anatomy.     

A review of anatomy education during and after the COVID‐19 pandemic: Revisiting traditional and modern methods to achieve future innovation

The coronavirus disease 2019 (COVID‐19) pandemic has had enormous effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal way to learn anatomy since the 17th century. As it is difficult to predict future access to cadavers for students or in‐person classes, anatomy educators are encouraged to revisit all possible teaching methods in order to develop innovations. Here, we review anatomy education methods to apply to current and future education.     

Sharing personal information about anatomical body donors: What first‐year medical students want to know and how it affects emotional responses to dissection

Among educators who teach in the human anatomy laboratory, there has been lively debate about sharing information about anatomical donors. One consideration in this debate is concern about the emotional effect of personalizing donors on the students. The purpose of this study was to evaluate student responses to being exposed to donor information (DI). Three cohorts of first‐year medical students (n = 284) were surveyed at four time points throughout the year. Surveys queried students about positive and negative responses to working in the laboratory, wanting to know specific DI, and if knowing this DI would/did affect their responses to working with donors. Analyses examined the relationships between desire to know DI and indices of the following: positive response index (PRI), negative response index (NRI), avoid‐approach index (AAI), and compassion‐respect index. Across all surveys, a majority of respondents wanted to know some form of DI. At all time points, a majority of respondents felt that knowing all types of DI would increase their positive responses to working with donors. A greater PRI and AAI tended to be associated with wanting to know more personal DI (e.g., names and personal histories). A greater NRI tended to be associated with anticipating that learning personal DI would increase their negative responses before entering the laboratory, which did not persist after dissection began. These data suggest that for a majority of students, knowing personal DI increases their positive response and does not elicit negative responses to dissection or working with anatomical donors. Clin. Anat. 32:1019–1032, 2019. © 2019 Wiley Periodicals, Inc.     

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

In recent years, the logistical challenges posed by the Covid-19 pandemic have prompted medical educators teaching gross anatomy to explore an expanded use of online instructional modalities. There is concern that this shift to online anatomy education in medical schools could affect long-term learning outcomes for future healthcare providers. In this systematic review, the educational effectiveness of online anatomy teaching is compared with traditional (“face-to-face”) teaching methods, specifically in terms of students' academic performance and satisfaction. A search of four databases identified and screened 162 studies. Subsequently, 31 studies were analyzed, including both (a) teaching outcome measures (test scores) and (b) student satisfaction ratings. Authors chose studies, extracted data, assessed quality and examined risk of bias. Nineteen studies compared students' academic performances between online and face-to-face teaching methods. Twenty-six studies measured students' levels of satisfaction in both teaching methods. Both qualitative and quantitative analyses of the data revealed comparable academic performances with no statistical difference between the two teaching methods, but a higher level of satisfaction with face-to-face teaching. The findings confirm that students can learn from online teaching but are more satisfied with face-to-face teaching. The authors conclude that online teaching cannot replace traditional teaching and there is no preference for one type of modality over the other. Therefore, a multi-modal learning approach combining online with face-to-face educational modalities for medical students could be efficient and successful.     

Cortex‐sparing fiber dissection: an improved method for the study of white matter anatomy in the human brain

Classical fiber dissection of post mortem human brains enables us to isolate a fiber tract by removing the cortex and overlying white matter. In the current work, a modification of the dissection methodology is presented that preserves the cortex and the relationships within the brain during all stages of dissection, i.e. ‘cortex‐sparing fiber dissection’. Thirty post mortem human hemispheres (15 right side and 15 left side) were dissected using cortex‐sparing fiber dissection. Magnetic resonance imaging study of a healthy brain was analyzed using diffusion tensor imaging (DTI)‐based tractography software. DTI fiber tract reconstructions were compared with cortex‐sparing fiber dissection results. The fibers of the superior longitudinal fasciculus (SLF), inferior fronto‐occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF) and uncinate fasciculus (UF) were isolated so as to enable identification of their cortical terminations. Two segments of the SLF were identified: first, an indirect and superficial component composed of a horizontal and vertical segment; and second, a direct and deep component or arcuate fasciculus. The IFOF runs within the insula, temporal stem and sagittal stratum, and connects the frontal operculum with the occipital, parietal and temporo‐basal cortex. The UF crosses the limen insulae and connects the orbito‐frontal gyri with the anterior temporal lobe. Finally, a portion of the ILF was isolated connecting the fusiform gyrus with the occipital gyri. These results indicate that cortex‐sparing fiber dissection facilitates study of the 3D anatomy of human brain tracts, enabling the tracing of fibers to their terminations in the cortex. Consequently, it is an important tool for neurosurgical training and neuroanatomical research.     

An evidence‐based approach to learning clinical anatomy: A guide for medical students,educators, and administrators

The amount of information that medical students learn is voluminous and those who do not use evidence‐based learning strategies may struggle. Research from cognitive and educational psychology provides a blueprint on how best to learn science subjects, including clinical anatomy. Students should aim for high‐cognitive learning levels as defined in the SOLO taxonomy. Using a real‐world example from a modern clinical anatomy textbook, we describe how to learn information using strategies that have been experimentally validated as effective. Students should avoid highlighting and rereading text because they do not result in robust learning as defined in the SOLO taxonomy. We recommend that students use (1) practice testing, (2) distributed practice, and (3) successive relearning. Practice testing refers to nonsummative assessments that contain questions used to facilitate retrieval (e.g., flashcards and practice questions). Practice questions can be fill‐in, short‐answer, and multiple‐choice types, and students should receive explanatory feedback. Distributed practice, the technique of distributing learning of the same content within a single study session or across sessions, has been found to facilitate long‐term retention. Finally, successive relearning combines both practice testing and distributed practice. For this strategy, students use practice questions to continue learning until they can answer all of the practice questions correctly. Students who continuously use practice testing, distributed practice, and successive relearning will become more efficient and effective learners. Our hope is that the real‐world clinical anatomy example presented in this article makes it easier for students to implement these evidence‐based strategies and ultimately improve their learning. Clin. Anat., 2018. © 2018 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.