Comparisons between the attitudes of medical and dental students toward the clinical importance of gross anatomy and physiology

Marked changes are occurring within both the medical and dental curricula and new ways of teaching the basic sciences have been devised and traditional methods (e.g., dissection for gross anatomy and of bench‐based animal preparations for physiology) are increasingly no longer the norm. Although there is much anecdotal evidence that students are not in favor of such changes, there is little evidence for this based on quantitative analyses of students' attitudes. Using Thurstone and Chave attitude analyses, we assessed the attitudes of first year medical and dental students at Cardiff University toward gross anatomy and physiology in terms of their perceived clinical importance. In addition, we investigated the appropriateness (“fitness for purpose”) of teaching methodologies used for anatomy and physiology. The hypotheses tested recognized the possibility that medical and dental students differed in their opinions, but that they had a preference to being taught gross anatomy through the use of dissection and had no preference for physiology teaching. It was found that both medical and dental students displayed positive attitudes toward the clinical relevance of gross anatomy and that they preferred to be taught by means of dissection. Although both medical and dental students displayed positives attitudes toward the clinical relevance of physiology, this was greater for the medical students. Both medical and dental students showed a preference for being taught physiology through didactic teaching in small groups but the medical students also appreciated being taught by means of practicals. Overall, this study highlights the expectations that students have for the basic science foundation teaching within their professional training and signals a preference for being taught experientially/practically. Differences were discerned between medical and dental students that might reflect the direct association between systems physiology and pathophysiology and the application of this knowledge within the medical field in comparison to the dental field, which is heavily skill‐based. Clin. Anat. 27:976–987, 2014. © 2014 Wiley Periodicals, Inc.     

The attitudes of medical students toward the importance of understanding classical Greek and Latin in the development of an anatomical and medical vocabulary

Students on entering medical school are faced with acquiring new, and voluminous, anatomical and medical terminologies. A reason why acquiring these terminologies may be problematic relates to the fact that many terms are derived from classical Greek and Latin; languages nowadays that are rarely taught at school. It might also be supposed that the often reported reduction in exposure to anatomy, and time spent in the dissection room, impairs the students' knowledge and understanding of anatomical relationships, and thus further complicates the acquisition of the terminologies. To date, there have been no studies that have quantified the attitudes of medical students toward the importance of understanding classical Greek and Latin during their medical training. In order to assess these attitudes, this study was undertaken for the newly‐recruited (First Year) medical students and for the Final Year medical students at Cardiff University. They were provided with a brief questionnaire that was devised in accordance with Thurstone and Chave (1951) principles and with ethical approval. One hundred and eighty First Year students and one hundred and nineteen Final Year students responded. Our initial hypothesis was that students throughout the medical curriculum have an unfavorable attitude toward the importance of classical Greek and Latin. This hypothesis was supported by the attitudes of the Final Year students but not by the First Year medical students. While we would still advocate that First Year medical students should acquire some understanding of and have some formal or informal instruction in, classical Greek and Latin as they pertain to medical terminologies, we acknowledge that Final Year students are likely to have become reasonably well‐versed in the origins of medical terminologies without formal instruction. Clin. Anat. 29:696–701, 2016. © 2016 Wiley Periodicals, Inc.     

Perception of medical students towards the clinical relevance of anatomy

Recent developments worldwide in medical curricula have often led to major cuts in the teaching of human anatomy. Indeed, it is perceived by some that gross (topographical) anatomy has an exaggerated importance in the initial training of doctors. The value of anatomy consequently has frequently been considerably diminished within medical curricula that have reduced factual content. To date, however, there have been no objective studies into the perceived relevance of anatomy to clinical medicine that have aimed to quantify the attitudes of medical students. On the basis of responses to an attitude analysis questionnaire devised according to the precepts of Thurstone and Chave (The Measurement of Attitude: A Psychophysical Method and Some Experiments with a Scale for Measuring Attitude Toward the Church. Chicago, IL: University of Chicago Press, 1951), we investigated the perception of medical students at Cardiff and Paris towards the importance of gross anatomy to clinical medicine. This was undertaken during the early stages of their studies (when they were newly-admitted to university and were about to commence anatomy courses), immediately after finishing their anatomy courses, and later in the final year of medical studies. The results suggest that, even where there might be geopolitical and cultural backgrounds, students at all stages of their medical course share with professional anatomists the view that anatomy is a very important subject for their clinical studies. Thus, contrary to the unquantified beliefs of those who are sceptical about the purpose and value of anatomy in an undergraduate medical curriculum, the students themselves do not appear to share such beliefs.     

Anxiety in first year medical students taking gross anatomy

To study anxiety levels in first‐year medical students taking gross anatomy. Thirty medical students per year, for 2 years, completed the Beck Anxiety Inventory (BAI) 10 times during a 13‐week gross anatomy course. In addition, behavioral observations were made by a psychiatrist during gross anatomy for demonstrations of assertive, destructive, neutral, or passive behavior. Additional qualitative outcome measures were group exit interviews with the faculty and students. The mean BAI for all 60 students per year, for 2 years, was 2.19 ± 3.76, 93% of the scores indicated minimal anxiety, and 89% of BAI values were less than five which confirmed a minimal level of anxiety. The low level of reported BAI contrasted sharply with verbal reports by the same students and face‐to‐face exit interviews with the psychiatrist. Symptoms of stress and anxiety emerged as a result of these conversations. The high levels of subjective stress and anxiety revealed by the interviews were unknown to the gross anatomy faculty. The low scores of students on the BAI's stand in sharp contrast to the BAI's reported for medical students in other published reports. Although it is possible that our students were truthfully devoid of anxiety, it is more likely that our students were denying even minimal anxiety levels. There have been reports that medical students feel that admitting stress, depression, or anxiety put their competitiveness for a residency at risk. We conclude that students may be in frank denial of experiencing anxiety and, if so, this behavior is not conducive to good mental health. Clin. Anat. 27:835–838, 2014. © 2014 Wiley Periodicals, Inc.     

Survey of clinicians' attitudes to the anatomical teaching and knowledge of medical students

There is considerable and ongoing debate surrounding the teaching of anatomy to medical students, and the anatomical knowledge of those medical students once they graduate. Few attempts have been made to gather the opinions of clinicians on this subject. A questionnaire was sent to 362 senior clinicians in hospitals affiliated to the University of Aberdeen. A total of 162 replies were received, with this sample being representative of the population of hospital consultants. Our results indicate that the majority of clinicians feel that the current anatomical education of medical students is inadequate, and below the minimum necessary for safe medical practice. There is widespread support among clinicians for more vertical integration of anatomy teaching throughout the undergraduate curriculum.     

Teaching histology and anatomy online during the COVID-19 pandemic

The aim of this study is to analyze differences in participation, and in the results obtained in the anatomy and histology exams, over two academic years of the Sport Sciences degree course. During the first semester of the academic year 2019/2020 both the lectures and the exam took place face-to-face, while during the academic year 2020/2021 everything was done online. Statistical analysis revealed that the online modality was especially advantageous for the anatomy exam. Students' opinions were also assessed through a short questionnaire. The results showed that teachers involved themselves in both groups. Students needed to interact socially with teachers and colleagues and to ask them questions. Even if the differences were not significant, the difference was greater for face-to-face students in most comparisons. Finally, the most common methods of peer communication were by social media.     

Sexism and anatomy,as discerned in textbooks and as perceived by medical students at Cardiff University and University of Paris Descartes

Contemporary textbooks of anatomy and surface anatomy were evaluated to ascertain whether they were gender-neutral. The evidence of this, and previous studies, suggests that, both in terms of imagery and text, many textbooks lack neutrality. To further investigate such matters, we provided second-year medical students studying at Cardiff University (n = 293) and at the Paris Descartes University (n = 142) during the 2011–2012 academic year with a questionnaire inviting them to address the possibility that social/gender factors hinder the dispassionate representation of anatomy. Ethical approval was obtained from both Cardiff and Paris universities. Eighty-six percent of the students at Cardiff and 39% at Paris Descartes responded and provided data for analysis. The hypothesis tested is that medical students perceive a gender bias that is reflected in the books they read and the tuition they receive. Our findings suggest that, while students recognise the importance of gender issues and do not wish to associate with sexism, most are unaware of the possible negative aspects of sexism within anatomy. In this respect, the findings do not support our hypothesis. Nevertheless, we recommended that teachers of anatomy and authors of anatomy textbooks should be aware of the possibility of adverse effects on professional matters relating to equality and diversity issues.     

临床医学专业强化人文教育的可行性分析

为适应医学科学和医学教育的发展,在中国协和医科大学的八年制临床医学专业的预科阶段适当增加和强化了人文科学的教育。本文对1997年至2001年共五届学生所选修的人文学科课程门类,选修学分对预科总成绩的影响等作了分析。分析结果表明,医学生对选修此类课程有兴趣,而且并未因此增加整个预科阶段的学习负担。     

医学生临床沟通技能课程设置及效果自评

目的 有效提高医学生的医患沟通技能.方法 北京协和医学院2009年3月至2011年10月期间对165名八年制高年级医学生教授临床沟通课程,使用学生自评问卷的方式对教学效果进行评估.结果 医学生在课后大部分临床沟通技能高于课前,大部分医患沟通能力评分高于课前,以患者为中心的理念得到强化.课程整体满意度为96.2％.结论 临床沟通技能课程达到了提高沟通技能的目的,沟通技能的客观考核方式需要进一步探索.     

Introduction to histology through the use of familiar objects: Innovative teaching module

To introduce first-year medical students to fundamental concepts in histology and facilitate interpretation of two-dimensional images in the context of the three-dimensional nature of the object, a simple teaching module consisting of active exercises plus group discussions, using familiar objects from everyday use, was planned. In the process of mentally reconstructing sections through familiar objects, and representing in diagrams the appearance of these sections, students learned the use of common histology terms; the value of studying sections in series and at different planes; and spatial relationships of a) a nucleus within a cell, and b) tissue components within solid and hollow organs. Their understanding of these concepts was found to be good when evaluated by a multiple-choice-questions test, suggesting that this is an effective method for introducing beginners to fundamentals of histology. Clin. Anat. 10:333–336, 1997. © 1997 Wiley-Liss, Inc.     

Evaluating the knowledge acquisition of lower limb anatomy among medical students during the post-acute COVID-19 era

Anatomy is the foundation of many medical and surgical specialties yet knowledge acquisition and retention among medical students is questionable. Over the years the anatomy teaching environment and teaching modalities have changed, even more so with the onset of the COVID-19 pandemic and the shift to a virtual environment. The aim of this study was to evaluate the knowledge acquisition of applied musculoskeletal lower limb clinical anatomy among first year medical students in Malta following the transition back to face-to-face lectures. The Kahoot online game-based quiz platform was used through a best out of four multiple-choice setting across four sessions. Scores generated by the platform along with frequencies of correctly answered questions were utilized to measure knowledge acquisition. The average scores for each question across sessions were statistically analyzed using ANOVA and student's t-test accordingly. Across the four sessions, the positive percentage response for clinical based questions remained higher than for pure anatomy questions. Anatomy knowledge acquisition appears to be subjective to clinical based knowledge rather than pure anatomy. There may be a plethora of reasons as to this outcome including the misconception that anatomy is not essential for clinical practice as well as the potential aftermath of the COVID-induced virtual learning environment. Further research is merit to ensure that students are provided with the best tools to enhance their knowledge acquisition, both as students and as future doctors.     

Self-guided clinical cases for medical students based on postmortem CT scans of cadavers

In the summer of 2009, we began full body computed tomography (CT) scanning of the pre-embalmed cadavers in the University of Michigan Medical School (UMMS) dissection lab. We theorized that implementing web-based, self-guided clinical cases based on postmortem CT (PMCT) scans would result in increased student appreciation for the clinical relevance of anatomy, increased knowledge of cross-sectional anatomy, and increased ability to identify common pathologies on CT scans. The PMCT scan of each cadaver was produced as a DICOM dataset, and then converted into a Quicktime movie file using Osirix software. Clinical cases were researched and written by the authors, and consist of at least one Quicktime movie of a PMCT scan surrounded by a novel navigation interface. To assess the value of these clinical cases we surveyed medical students at UMMS who are currently using the clinical cases in their coursework. Students felt the clinical cases increased the clinical relevance of anatomy (mean response 7.77/10), increased their confidence finding anatomical structures on CT (7.00/10), and increased their confidence recognizing common pathologies on CT (6.17/10). Students also felt these clinical cases helped them synthesize material from numerous courses into an overall picture of a given disease process (7.01/10). These results support the conclusion that our clinical cases help to show students why the anatomy they are learning is foundational to their other coursework. We would recommend the use of similar clinical cases to any medical school utilizing cadaver dissection as a primary teaching method in anatomy education.     

临床医学生视角下的医学人文素养现状调查

目的了解临床医学生对医疗实践中医学人文素养现状的认知并提出改进建议。方法对已参与临床实践的临床医学本科生、研究生和博士生采用问卷调查的方法收集信息(共回收184份问卷)。结果 1)医患沟通以及医际沟通过程中医务人员存在人文素养不足;2)目前医学院校对临床医学生人文教育投入不足;3)大多数医学生愿意并且希望通过多途径进一步提高自身人文素质。结论医学生对临床医学人文素养的诸多问题有相当清楚的认识,增设人文相关课程、定期举办讲座、提高薪资待遇、增大考核力度具有必要性和可行性。     

Medical students' attitudes towards science and gross anatomy,and the relationship to personality

Assessment of the personalities of medical students can enable medical educators to formulate strategies for the best development of academic and clinical competencies. Previous research has shown that medical students do not share a common personality profile, there being gender differences. We have also shown that, for French medical students, students with personality traits associated with strong competitiveness are selected for admission to medical school. In this study, we further show that the medical students have different personality profiles compared with other student groups (psychology and business studies). The main purpose of the present investigation was to assess attitudes to science and gross anatomy, and to relate these to the students'' personalities. Questionnaires (including Thurstone and Chave analyses) were employed to measure attitudes, and personality was assessed using the Big Five Inventory (BFI). Data for attitudes were obtained for students at medical schools in Cardiff (UK), Paris, Descartes/Sorbonne (France), St George''s University (Grenada) and Ankara (Turkey). Data obtained from personality tests were available for analysis from the Parisian cohort of students. Although the medical students were found to have strongly supportive views concerning the importance of science in medicine, their knowledge of the scientific method/philosophy of science was poor. Following analyses of the BFI in the French students, ‘openness’ and ‘conscientiousness’ were linked statistically with a positive attitude towards science. For anatomy, again strongly supportive views concerning the subject''s importance in medicine were discerned. Analyses of the BFI in the French students did not show links statistically between personality profiles and attitudes towards gross anatomy, except male students with ‘negative affectivity’ showed less appreciation of the importance of anatomy. This contrasts with our earlier studies that showed that there is a relationship between the BF dimensions of personality traits and anxiety towards the dissection room experience (at the start of the course, ‘negative emotionality’ was related to an increased level of anxiety). We conclude that medical students agree on the importance to their studies of both science in general and gross anatomy in particular, and that some personality traits relate to their attitudes that could affect clinical competence.     

Computer knowledge amongst clinical year medical students in a resource poor setting

Objective

To study the computer knowledge and desires of clinical year medical students at one of the oldest and largest medical schools in Nigeria.

Design

A survey using validated structured questionnaires.

Setting

Medical school of Ahmadu Bello University, Zaria, Nigeria.

Subjects

Two hundred and thirty seven clinical year (4^th, 5^th and 6^th years) medical students.

Outcome measures

Computer knowledge, mode of acquiring computer knowledge, regular access to computer, desire for inclusion of computer training in curriculum.

Results

One hundred twenty (50.6%) students had knowledge of computer technology and it use. Of these, 108 (90%) had no regular access to a computer and none owned a computer; only 32 (26.7%) were sufficiently familiar with computer tools to perform advanced tasks, but 72 (60%) were comfortable with word processing. Seventy two of the 120 students acquired their computer knowledge through self-learning efforts while 45 (37.5%) attended short periods of formal training. Overall, 45.7% of males and 64.5% of females had computer knowledge. The main reason for lack of computer knowledge was lack of time and lack of access to a computer. Eighty percent of all students would like computer education to be included in medical school curriculum.

Conclusion

Knowledge and use of computers amongst clinical year medical students in this setting is low. It is important that computer education be taught to the students to enhance their ability to use electronic information and communicate more effectively using computer resources.     

Psychosocial predictors of attitudes toward physician empathy in clinical encounters among 4732 1st year medical students: A report from the CHANGES study

Objective

Medical school curricula intended to promote empathy varies widely. Even the most effective curricula leave a significant group of students untouched. Pre-existing student factors influence their response to learning experiences. We examined the individual predictors of first semester medical students’ attitudes toward the value of physician empathy in clinical encounters.

Methods

First year students (n = 4732) attending a stratified random sample of 49 US medical schools completed an online questionnaire that included measures of dispositional characteristics, attitudes and beliefs, self-concept and well-being.

Results

Discomfort with uncertainty, close-mindedness, dispositional empathy, elitism, medical authoritarianism, egalitarianism, self-concept and well-being all independently predicted first year medical students’ attitudes toward the benefit of physician empathy in clinical encounters.

Conclusion

Students vary on their attitude toward the value of physician empathy when they start medical school. The individual factors that predict their attitudes toward empathy may also influence their response to curricula promoting empathic care.

Practice implications

Curricula in medical school promoting empathic care may be more universally effective if students’ preexisting attitudes are taken into account. Messages about the importance of physician empathy may need to be framed in ways that are consistent with the beliefs and prior world-views of medical students.     

Student responses to the gross anatomy laboratory in a medical curriculum

Working with cadavers, whether through active dissection or by examination of prosected specimens, constitutes a potential stressor in medical education although there is no consensus on its effect. Some reports have suggested that it creates such a strongly negative experience that it warrants special curricular attention. To assess the issue for ourselves, we administered surveys to the freshman medical students taking the Anatomical Sciences course in the problem-based Alternative Curriculum (A.C.) at Rush Medical College for four consecutive years. We found that although a vast majority of students expressed a positive attitude toward the experience, both before and after taking the course, there remains a small percentage of students for whom human dissection may initially be a traumatic experience. We offer explanations for our findings, comments on disparate results from other studies and suggestions for appropriate responses by anatomy faculty, who must address these student needs.     

微信公众平台对促进医学生自主学习的作用探究

微信公众平台是一种新的信息传播和交互方式,由于其传播内容及时、丰富,传播渠道便捷、通常,传播效果个性、智能,可帮助医学生自主学习。协和八微信公众号对微信公众平台如何促进医学生的自主学习,进行了研究,探索了兴趣导向的自主学习模式、协作导向的自主学习模式和反思导向的自主学习模式,取得了良好的效果。     

The dimensional structure of medical students' perceptions of diseases

First- and second-year medical students rated 35 diseases (e.g., cancer, heart attack, herpes, schizophrenia, alcoholism) on nine different rating scales (e.g., prognosis, ease of management). In order to uncover the underlying dimensional structure, mean ratings were subjected to multidimensional scaling analyses in which both diseases and rating scales were placed in the same configuration. The results indicated that a two-dimensional solution, accounting for 97% of the variance, was most appropriate. The first dimension distinguishes between diseases that appear to be more physiological in nature and those that have some psychological involvement as well. The second dimension seems most related to fear, seriousness, prognosis, patient desirability, and ease of management.The research reported in this paper was supported in part by Grant CA 18002-08 from the National Cancer Institute.