Advance organizers in a gross anatomy dissection course and their effects on academic achievement

We presented two kinds of advance organizers (AOs), video clips and prosection, for a gross anatomy dissection course and compared their effects on academic achievement and student perception of the learning experience. In total, 141 students at Chonnam National University Medical School were randomly assigned to two groups: Group 1 (n = 70) was provided with video clips AO, whereas Group 2 (n = 71) was provided with prosection AO, the use of cadaveric specimens dissected by the course instructor. Student self‐assessment scores regarding the learning objectives of upper limb anatomy improved significantly in both groups. Academic achievement scores in Group 2 were significantly higher than those in Group 1, although the self‐assessment scores were not significantly different between the groups. Additionally, students in Group 2 responded significantly more positively to the statements about perception of the learning experience such as helping them understand the course content and concepts, decreasing anxiety about the dissection course, and participating actively in the dissection. It would seem that the application of prosection as an AO improved academic achievement and increased student engagement and satisfaction. This study will contribute to designing effective AOs and developing a teaching and learning strategy for a gross anatomy dissection course. Clin. Anat. 2013. © 2012 Wiley Periodicals, Inc.     

Utilizing Medical Students as Internal Assets to Enhance Gross Anatomy Laboratory Learning

Identification of cadaveric structures during anatomy summative practical examinations is a challenge for first-year medical students. To assist in cultivating this skill, we offered 12 formative laboratory activities (anatomy boot camps [ABCs]) that approximated the summative practical examination format using reciprocal and near-peer teaching. Students assisted in crafting the formative practical examination, then engaged in a self-review by scoring their individual answer sheets. Students performing below designated thresholds (≤60%) were offered laboratory review sessions led by medical student upperclassmen. Mann–Whitney U tests were used to compare the performance of participants who attended the ABC sessions leading up to each summative examination. Correlation analysis was utilized to examine the relationship between student participation in ABCs summative examinations. Voluntary surveys were administered to assess the perceived value of the experience. Mann–Whitney U tests indicated students who attended the ABC review preceding three of the four summative practical and two of the four written examinations scored consistently higher on these examinations than students who chose not to attend. Correlation analysis revealed that as the overall frequency of ABC attendance increased, students' performance on the summative practical and written examinations increased significantly (P < 0.001). These findings suggest that the provision of supplemental learning experiences, such as the ABCs, contributes to improved student learning outcomes. This sentiment was echoed in student surveys. This activity, which combines multiple peer teaching approaches, appears to be an effective strategy for guiding and enhancing student success in the anatomy practical examinations. Clin. Anat. 33:286–292, 2020. © 2019 Wiley Periodicals, Inc.     

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.     

Significance of the role of self‐study and group discussion

The study of anatomy is experiencing a reduction in course duration and content, lecture and dissection hours, and number of lectures and examinations. This necessitates that medical students develop skills for self‐study. Toward that end, a self‐study module in basic anatomy was tested. Fifty‐seven new entrants were given a pretest (Pretest A) containing a questionnaire on basic anatomy. Then, in three groups each of 11 and two groups each of 12, they learned basic anatomy from recommended books in the library by self‐study for 2 hours. They discussed what they had learned among their group members during a practical exercise, followed by a posttest (Posttest A). A control group of 57 new entrants during another year was given the same pretest (Pretest B) and a lecture on basic anatomy. Then, without opportunity for self‐study, they were given a posttest (Posttest B). The answers were scored out of 40. The students' mean mark in Pretest A was poor. All the groups performed well in the practical exercise. In Posttest A, the mean mark increased significantly (P < 0.001), by 9.4. It shows that self‐study and group discussions significantly helped the students in construction of core anatomical knowledge as well as the acquisition, assimilation, and application of anatomical concepts and content. The mean mark in Pretest B was also poor. In Posttest B, the mean mark increased significantly (P < 0.001), by 14.2. This indicates that the traditional teaching session is also useful and serves to advance student knowledge. Thus our innovative study module can create a positive learning environment and can become an alternative to traditional instruction in teaching anatomical terminology and basic anatomy. Clin. Anat. 12:277–280, 1999. © 1999 Wiley‐Liss, Inc.     

A change in paradigm: Giving back identity to donors in the anatomy laboratory

This article describes a paradigm of teaching in the anatomy laboratory where students interact with the families of the deceased persons whom they are dissecting. This approach focuses learning anatomy and medicine on the patient via the implementation of five guiding principles: the First Patient; Knowledge; Reflection and Reflective Practice; Treating the Total Patient; and Professionalism. Physician training typically begins with cadaveric dissection (i.e., dissection of the first patient), and therefore the medical school gross anatomy course provides an ideal environment for multifaceted educational experiences where cadaveric dissection is used to teach structure and function as well as the skills and competencies critical to patient care. Here, these principles are described, and the impact on student doctors and outcomes discussed. The results suggest that mastery of basic science knowledge and competencies, including professionalism, compassion, and leadership skill is enhanced by this protocol. Clin. Anat. 2013. © 2012 Wiley Periodicals, Inc.     

Reciprocal peer teaching: students teaching students in the gross anatomy laboratory

Three common instructional strategies used to teach gross anatomy are lecture, discovery or inquiry-based learning, and cooperative learning. One form of cooperative learning, called reciprocal peer teaching (RPT), illustrates circumstances where students alternate roles as teacher and student. By assuming the responsibility of teaching their peers, students not only improve their understanding of course content, but also develop communication skills, teamwork, leadership, confidence and respect for peers that are vital to developing professionalism early in their medical careers. Traditionally in our Anatomy department, students dissect the entire body using a standard dissection manual. More non-traditionally, however, we have increased cooperative learning in the dissection laboratory by involving students in a series of supplementary RPT activities. During these exercises, 10% of the class practiced their demonstration with course instructors until the students felt prepared to demonstrate the exercise to their classmates. We designed one peer demonstration emphasizing three to six teaching objectives for most of the 40 dissection units. This resulted in a compendium of peer demonstrations for implementation throughout the course. The multitude of diverse exercises permitted each student many opportunities to teach their peers. A debriefing questionnaire was administered at the end of the course demonstrating that 100% of students agreed the RPT experience increased their understanding of the topics they taught and 97% agreed it increased their retention of information they taught to their peers. In addition, 92% agreed that RPT improved their communication skills, which can be applied beyond anatomy to their careers as future physicians.     

Do we need dissection in an integrated problem-based learning medical course? Perceptions of first- and second-year students

BACKGROUND: The introduction of a problem-based learning (PBL) curriculum at the School of Medicine of the University of Melbourne has necessitated a reduction in the number of lectures and limited the use of dissection in teaching anatomy. In the new curriculum, students learn the anatomy of different body systems using PBL tutorials, practical classes, pre-dissected specimens, computer-aided learning multimedia and a few dissection classes. The aims of this study are: (1) to assess the views of first- and second-year medical students on the importance of dissection in learning about the anatomy, (2) to assess if students' views have been affected by demographic variables such as gender, academic background and being a local or an international student, and (3) to assess which educational tools helped them most in learning the anatomy and whether dissection sessions have helped them in better understanding anatomy. METHODS: First- and second-year students enrolled in the medical course participated in this study. Students were asked to fill out a 5-point Likert scale questionnaire. Data was analysed using Mann-Whitney's U test, Wilcoxon's signed-ranks or the calculation of the Chi-square value. RESULTS: The response rates were 89% for both first- and second-year students. Compared to second-year students, first-year students perceived dissection to be important for deep understanding of anatomy (P < 0.001), making learning interesting (P < 0.001) and introducing them to emergency procedures (P < 0.001). Further, they preferred dissection over any other approach (P < 0.001). First-year students ranked dissection (44%), textbooks (23%), computer-aided learning (CAL), multimedia (10%), self-directed learning (6%) and lectures (5%) as the most valuable resources for learning anatomy, whereas second-year students found textbooks (38%), dissection (18%), pre-dissected specimens (11%), self-directed learning (9%), lectures (7%) and CAL programs (7%) as most useful. Neither of the groups showed a significant preference for pre-dissected specimens, CAL multimedia or lectures over dissection. CONCLUSIONS: Both first- and second-year students, regardless of their gender, academic background, or citizenship felt that the time devoted to dissection classes were not adequate. Students agreed that dissection deepened their understanding of anatomical structures, provided them with a three-dimensional perspective of structures and helped them recall what they learnt. Although their perception about the importance of dissection changed as they progressed in the course, good anatomy textbooks were perceived as an excellent resource for learning anatomy. Interestingly, innovations used in teaching anatomy, such as interactive multimedia resources, have not replaced students' perceptions about the importance of dissection.     

Integrating ultrasound into modern medical curricula

Ultrasonography is widely practiced in many disciplines. It is becoming increasingly important to design well‐structured curricula to introduce imaging to students during medical school. This review aims to analyze the literature for evidence of how ultrasonography has been incorporated into anatomy education in medical school curricula worldwide. A literature search was conducted using multiple databases with the keywords: “Ultrasound OR Ultrasonographic examination*” and “Medical student* OR Undergraduate teaching* OR Medical education*” and “Anatomy* OR Living anatomy* OR Real‐time anatomy.*” This review found that ultrasound curricula vary in stage of implementation, course length, number of sessions offered to students as well as staffing and additional course components. Most courses consisted of didactic lectures supplemented with demonstration sessions and/or hands‐on ultrasound scanning sessions. The stage of course implementation tended to depend on the aim of the course; introductory courses were offered earlier in a student's career. Most courses improved student confidence and exam performance, and more junior students tended to benefit more from learning anatomy with ultrasound guidance rather than learning clinical examination skills. Students tended to prefer smaller groups when learning ultrasound to get more access to using the machines themselves. Ultrasonography is an important skill, which should be taught to medical students early in their careers as it facilitates anatomical education and is clinically relevant, though further objective research required to support the use of ultrasound education as a tool to improve clinical examination skills in medical students. Clin. Anat. 30:452–460, 2017. © 2017 Wiley Periodicals, Inc.     

Impact of the clinical ultrasound elective course on retention of anatomical knowledge by second‐year medical students in preparation for board exams

Ultrasound has been integrated into a gross anatomy course taught during the first year at an osteopathic medical school. A clinical ultrasound elective course was developed to continue ultrasound training during the second year of medical school. The purpose of this study was to evaluate the impact of this elective course on the understanding of normal anatomy by second‐year students. An anatomy exam was administered to students enrolled in the clinical ultrasound elective course before the start of the course and after its conclusion. Wilcoxon signed ranks tests were used to determine whether exam scores changed from the pre‐test to the post‐test. Scores from two classes of second‐year students were analyzed. Students who took the elective course showed significant improvement in the overall anatomy exam score between the pre‐test and post‐test (P < 0.001). Scores for exam questions pertaining to the heart, abdomen, upper extremity, and lower extremity also significantly improved from the pretest to post‐test (P < 0.001), but scores for the neck and eye showed no significant improvement. The clinical ultrasound elective course offered during the second year of medical school provided students with an important review of key anatomical concepts while preparing them for board exams. Our results suggested that more emphasis should be placed on head and neck ultrasound to improve student performance in those areas. Musculoskeletal, abdominal, and heart ultrasound labs were more successful for retaining relevant anatomical information. Clin. Anat. 28:156–163, 2015. © 2014 Wiley Periodicals, Inc.     

Classic versus millennial medical lab anatomy

This study investigated the integration, implementation, and use of cadaver dissection, hospital radiology modalities, surgical tools, and AV technology during a 12‐week contemporary anatomy course suggesting a millennial laboratory. The teaching of anatomy has undergone the greatest fluctuation of any of the basic sciences during the past 100 years in order to make room for the meteoric rise in molecular sciences. Classically, anatomy consisted of a 2‐year methodical, horizontal, anatomy course; anatomy has now morphed into a 12‐week accelerated course in a vertical curriculum, at most institutions. Surface and radiological anatomy is the language for all clinicians regardless of specialty. The objective of this study was to investigate whether integration of full‐body dissection anatomy and modern hospital technology, during the anatomy laboratory, could be accomplished in a 12‐week anatomy course. Literature search was conducted on anatomy text, journals, and websites regarding contemporary hospital technology integrating multiple image mediums of 37 embalmed cadavers, surgical suite tools and technology, and audio/visual technology. Surgical and radiology professionals were contracted to teach during the anatomy laboratory. Literature search revealed no contemporary studies integrating full‐body dissection with hospital technology and behavior. About 37 cadavers were successfully imaged with roentograms, CT, and MRI scans. Students were in favor of the dynamic laboratory consisting of multiple activity sessions occurring simultaneously. Objectively, examination scores proved to be a positive outcome and, subjectively, feedback from students was overwhelmingly positive. Despite the surging molecular based sciences consuming much of the curricula, full‐body dissection anatomy is irreplaceable regarding both surface and architectural, radiological anatomy. Radiology should not be a small adjunct to understand full‐body dissection, but rather, full‐body dissection aids the understanding of radiology mediums. The millennial anatomy dissection laboratory should consist of, at least, 50% radiology integration during full‐body dissection. This pilot study is an example of the most comprehensive integration of full‐body dissection, radiology, and hospital technology. Clin. Anat. 27:988–993, 2014. © 2014 Wiley Periodicals, Inc.     

The relationships between learning outcomes and methods of teaching anatomy as perceived by professional anatomists

Changes in the teaching of gross anatomy have often involved decreasing student contact time alongside the use of new methods for teaching. However, there remains controversy over teaching methods and about whether cadaveric dissection by students should remain the preferred method. Furthermore, decisions concerning changes to curricula are more likely to be taken by choosing a method of teaching rather than by proper evaluation of what are the desired learning outcomes for a course in anatomy. The purpose of this study was to ascertain the attitudes of anatomists in Europe towards the methods of teaching best fitting a series of learning outcomes for anatomy and secondarily to test the hypothesis that, from evaluation of learning outcomes, anatomy is best taught by cadaveric dissection by the students. About 113 completed questionnaires were received from anatomists who are employed at higher education institutions that use various teaching methods. Most anatomists (69%) favored the use of cadaveric dissection above other teaching methods when considering the whole series of learning comes, this method seeming to achieve a range of different course aims/objectives, P < 0.001; Kruskal-Wallis). Consequently, these findings are consistent with our initial hypothesis. However, when individual learning outcomes were considered, the relationship was not so clear cut and, for example, little difference was discernible between teaching methods when considering learning outcomes related to the acquisition of anatomical knowledge. The use of human cadaveric dissection gained more approval when the skills-base was considered rather than just the content(knowledge)-base of an anatomical course.     

Motivation to Learn Neuroanatomy by Cadaveric Dissection is Correlated with Academic Performance

Implementing educational activities, such as a wet lab with cadaveric brain dissection, is known to have a direct impact on medical students' motivation. These activities demonstrate the clinical relevance of concepts taught in the classroom setting. The correlation between motivation and academic performance is not clear. First year medical students participated in wet lab activities. The wet lab included cadaveric dissection of the surface and internal anatomy of the brain, as well as discussions facilitated by the neuroscience faculty and clinicians. Discussions were centered around the clinical relevance of the neuroanatomical features dissected during the wet laboratory activities. Following completion of the laboratory activities, students completed a survey, which was used to assess the students' motivation for learning neuroanatomy based on the Attention, Relevance, Confidence, Satisfaction (ARCS) model of motivation. These results were then correlated with performance on a laboratory examination that tested three-dimensional and cross-sectional knowledge of neuroanatomy and practical skills including the use of imaging techniques. The total mean score of motivation was generally high for all categories of ARCS model of motivation (4.26/5) and was highest for Relevance (4.46/5). When these results were correlated with students' performance on the lab examination, a positive correlation between students' motivation and lab examination scores was found (R² = 0.877). Implementation of the neuroanatomy cadaveric dissection lab led to increased student motivation, which was positively correlated with students' academic performance. Clin. Anat. 32:128–135, 2019. © 2019 Wiley Periodicals, Inc.     

Anatomy teaching: students’ perceptions

The goal of this study was to analyse students’ perceptions of anatomy teaching. A questionnaire was distributed to two classes of first year dental students taught anatomy in both problem-based learning (PBL) and traditional formats. The questionnaire explored the students’ most preferred techniques for learning anatomy, their examination preferences and their perceived level of mastery of anatomy. Fifty-seven (95%) students completed the survey. The most commonly used study aids were atlases, dissection and lecture notes (in descending order). Students expressed the desire for the final examination to include both written and oral components. Six months after the final examination, the students reported their perceived level of mastery of anatomy as either “very good” or “OK”. Even in the PBL curriculum 39% of both classes felt it is necessary to have quizzes during the course to motivate and guide them in studying anatomy.     

Medical students' approaches to learning anatomy: Students' experiences and relations to the learning environment

To examine students' perceptions and experiences of learning anatomy, an on‐line Likert‐style questionnaire was administered during 2006 to students reading a Bachelor of Medicine 4‐ and 5‐year program (n = 256, 23.8%). Statistical analysis found that students predominantly felt that understanding anatomy and working with human cadaveric material were very important in becoming a doctor. Students reported that working on cadaveric specimens was an effective way of learning anatomy, and also found the amount of anatomy they needed to learn to be daunting. Student responses were correlated with their approaches to learning [Approaches to Studying Inventory for Students (ASSIST)] scores using a Kruskal Wallis test. Significant relationships between the approach to learning anatomy adopted and students' perception and experience of anatomy were found. A deep approach to learning anatomy correlated with students who reported that the most effective way of learning anatomy in the dissecting room was to get their hands in and feel for structures, who used anatomical terms and language at clinical opportunities, and who frequently used their anatomy‐radiology knowledge in clinical situations. A surface approach to learning anatomy was associated with elements, such as students finding anatomy learning daunting and not seeing the point to it. The outcomes provide clear associations between students' perception of the anatomy learning environment, the approach to learning adopted, and the anatomy activities in which students engage. The findings highlight that understanding and applying anatomical knowledge are best accomplished by the adoption of a deep approach to learning. Clin. Anat. 23:101–103, 2010. © 2009 Wiley‐Liss, Inc.     

Online lessons of human anatomy: Experiences during the COVID-19 pandemic

The social distancing measures necessitated by the COVID-19 pandemic have resulted in the migration of human anatomy lessons to virtual platforms. Even student communities have had to relocate online. The virtual replacement of visual–spatial and social elements, essential for studying anatomy, has posed particular challenges for educators. Our department used Microsoft Teams, an online communication platform, in conjunction with Visible Body, a 3D anatomical modeling program, EdiErmes online resources, and Leica Acquire for teaching microscopic anatomy. We delivered about 160 h of both synchronous and asynchronous lessons for students on the medical degree program per academic year. In this study, we compare face-to-face and distance teaching in order to define these different approaches better and to evaluate the final student scores. The aim is to debate the relevance of distance learning pedagogy to the design of new online anatomy teaching courses and the development of online learning. Analysis of the final scores showed that anatomy examinations after the online course had a statistically significantly higher average value than those obtained at the end of the face-to-face course. The experience at the University of Genoa shows that distance learning in the teaching of human anatomy was perceived by most students as useful and positive. Distance learning can be an effective support for anatomy teaching, facilitating a different mode of learning in which lessons and study are more sensitive to the individual's schedule and needs. Of course, we should not and cannot exclude face-to-face teaching.     

Using computer-based interactive imagery strategies for designing instructional anatomy programs

In an effort to design and implement effective anatomy educational programs, this study was conducted to evaluate students' perceptions toward using two computer-based self-directed instructional modules (e.g., digestive system and canine skull) that were designed utilizing interactive imagery strategy for teaching and learning veterinary anatomy. Sixty-eight freshmen veterinary students and one graduate student participated in this study. Open-ended and close-ended questionnaires were administered to evaluate the utilization of computer-based interactive imagery strategy in developing anatomy instructional programs, and to collect data about the students' perceptions toward the use of interactive images in teaching and learning of anatomy. Means and standard deviations were calculated and analyzed for close-ended items. The open-ended questionnaire items were analyzed to identify shared patterns or themes in the students' experience after using the two instructional anatomy modules. Students reported positive attitudes toward the interactive imagery strategy used in the development of computer-based anatomy modules. Based on our findings, this study outlines the characteristics of effective instructional images that will serve as guidelines for the preparation and selection of anatomical images, as well as, how to utilize these images to develop computer-based instructional anatomy programs. Students perceived interactive imagery as an effective design strategy that helped them learn anatomical concepts.     

Are medical students being taught anatomy in a way that best prepares them to be a physician?

Reasoning in a clinical context is an attribute of medical expertise. Clinical reasoning in medical school can be encouraged by teaching basic science with a clinical emphasis. The aim of this study was to investigate whether anatomy is being taught in a way that facilitates the development of clinical reasoning. Two multiple‐choice tests on thoracic anatomy were developed using a modified Delphi approach with groups of four clinical consultants and four teachers, respectively, expressing their opinions about knowledge relevant to thoracic anatomy. Validity was assessed by administering the tests to clinical consultants, anatomy teachers, and pre‐course medical students. Post‐course medical students took both tests to explore the focus of the course, i.e., whether it facilitated clinical reasoning. The pre‐course students scored significantly lower than the teachers and post‐course students on both tests and lower than the consultants on the consultants’ test (P < 0.001 for all comparisons). The teachers significantly outperformed the consultants (P = 0.03 on the consultants’ test, P < 0.001 on the teachers’ test) and the medical students (P < 0.001 on both tests). The post‐course students scored significantly lower on the consultants’ test (P = 0.001) and significantly higher on the teachers’ test (P = 0.02) than the consultants. This study demonstrates poor performances by medical students on a test containing clinically relevant anatomy, implying that the teaching they have received has not encouraged clinical reasoning. Clin. Anat. 28:568–575, 2015. © 2015 Wiley Periodicals, Inc.     

Anatomy in medical education: Perceptions of undergraduate medical students

AimThe best method to teach anatomy is widely debated. A shift away from cadaveric dissection in UK medical schools towards newer approaches has taken place without adequate evaluation of their suitability. The impact of this on future anatomical and surgical competencies is unclear. We assessed student perceptions to different methods of anatomy teaching.MethodsAll 2nd year students at Leeds School of Medicine were invited to complete a matrix-grid questionnaire. Participants were asked to score six methods of anatomy teaching (dissection; prosection; lectures; models; PC software packages; living & radiological anatomy) using a 5-point Likert-type scale on the ability to achieve nine learning objectives. Kruskal–Wallis and Mann–Whitney analyses suitable for non-parametric data were used to evaluate differences in scores between teaching methods.Results170 students (71%) responded to the survey. Overall, dissection was the single highest scored method, followed by prosection. Newer approaches such as models, computer software packages and living & radiological anatomy scored comparatively worse. The most suitable method for achieving individual learning objectives was variable with dissection perceived as most suitable for four out of nine objectives.ConclusionsCadaveric dissection is a favourable approach for achieving important learning objectives in the field of anatomy. Further evaluation of teaching methods is required prior to changes being made in the curricula of UK medical schools.