The Spectrum of Learning and Teaching: The Impact of a Fourth-Year Anatomy Course on Medical Student Knowledge and Confidence

There is growing demand from accrediting agencies for improved basic science integration into fourth-year medical curricula and inculcation of medical students with teaching skills. The objective of this study was to determine the effectiveness of a fourth-year medical school elective course focused on teaching gross anatomy on anatomical knowledge and teaching confidence. Fourth-year medical student “teacher” participants' gross anatomy knowledge was assessed before and after the course. Students rated their overall perceived anatomy knowledge and teaching skills on a scale from 0 (worst) to 10 (best), and responded to specific knowledge and teaching confidence items using a similar scale. First-year students were surveyed to evaluate the effectiveness of the fourth-year student teaching on their learning. Thirty-two students completed the course. The mean anatomy knowledge pretest score and posttest scores were 43.2 (±22.1) and 74.1 (±18.4), respectively (P < 0.001). The mean perceived anatomy knowledge ratings before and after the course were 6.19 (±1.84) and 7.84 (±1.30), respectively (P < 0.0001) and mean perceived teaching skills ratings before and after the course were 7.94 (±1.24) and 8.53 (±0.95), respectively (P = 0.002). Student feedback highlighted five themes which impacted fourth-year teaching assistant effectiveness, including social/cognitive congruence and improved access to learning opportunities. Together these results suggest that integrating fourth-year medical students in anatomy teaching increases their anatomical knowledge and improves measures of perceived confidence in both teaching and anatomy knowledge. The thematic analysis revealed that this initiative has positive benefits for first-year students.     

Improving near‐peer teaching quality in anatomy by educating teaching assistants: An example from Sweden

Peer‐assisted learning has gained momentum in a variety of disciplines, including medical education. In Gothenburg, Sweden, medical students who have finished their compulsory anatomy courses have the option of working as teaching assistants (TAs). Teaching assistants provide small group teaching sessions as a complement to lectures given by faculty. Previously, TAs were left to handle the role as junior teachers by themselves, but since 2011, a continuation course in anatomy has been developed with the aim of providing the TAs better anatomy knowledge and guidance for teaching. The course was designed to comprise 7.5 ECTS credits (equivalent to 5 weeks of full‐time studies), and today all TAs are required to take this course before undertaking their own teaching responsibilities. This study aims to compare course evaluations of TA teaching before and after the introduction of the anatomy continuation course, in order to understand how students perceived teaching performed by self‐learned versus trained TAs. The results of this study demonstrate that there was a trend towards better teaching performed by trained TAs. The variability in rankings decreased significantly after the introduction of the continuation course. This was mainly due to an improvement among the TAs with the lowest levels of performance. In addition to comparing student rankings, TAs were interviewed regarding their experiences and perceptions within the continuation course. The course was generally positively regarded. The TAs described a sense of cohesion and appreciation since the institute invested in a course dedicated specifically for them. Anat Sci Educ 11: 403–409. © 2018 American Association of Anatomists.     

Bringing anatomy to life: Evaluating a novel ultrasound curriculum in the anatomy laboratory

As point-of-care ultrasound (POCUS) invades medical specialties, more students covet earlier ultrasound (US) training programs in medical school. Determining the optimal placement and format in the curriculum remains a challenge. This study uses student perceptions and confidence in interpreting and acquiring images to evaluate the effectiveness of an US curriculum and assesses their performance on US content. A unique US curriculum was incorporated into first-year clinical anatomy at Tufts University School of Medicine (TUSM). Students completed surveys evaluating changes in US confidence and perceptions. Mean ratings on pre- and post-surveys were compared using Mann–Whitney U tests. Performance on US examination questions was evaluated. Two independent evaluators coded narrative responses and NVivo software was used to identify common themes. Two hundred eleven students completed the US curriculum. Students reported higher post-curriculum mean confidence ratings on US comprehension, operation, image acquisition, artifact recognition, and normal image interpretation (P < 0.0001). US reinforced anatomy concepts and clinical correlates (9.56, ±0.97 SD; 9.60, ±1.05). Students disagreed with items stating learning US is too difficult (1.2, ±2.2) and that it interferes with learning anatomy (0.68, ±1.7). Students scored above passing on practical US knowledge questions, supporting survey data, and the relation to learning spatial relationships. Qualitative analysis identified seven major themes and additional subthemes. Limited integration of US breaks barriers in students' perceptions and confidence in performing POCUS. The TUSM US curriculum is a natural marriage of anatomy and POCUS applications, serving as a template for medical schools.     

Evaluation of an innovative hands‐on anatomy‐centered ultrasound curriculum to supplement graduate gross anatomy education

Ultrasound (US) can enhance anatomy education, yet is incorporated into few non‐medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non‐medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy‐centered ultrasound (ACUS) curriculum were recruited. Mean Likert ratings on pre‐ and post‐course surveys (100% response rates) were compared to evaluate the effectiveness of the ACUS curriculum in developing US confidence, and gauge its impact on views of US. Post‐course, students reported significantly higher (P < 0.001) mean confidence ratings in five US skills (pre‐course versus post‐course mean): obtaining scans (3.13 ±1.04 versus 4.03 ±0.78), optimizing images (2.78 ±1.07 versus 3.75 ±0.92), recognizing artifacts (2.94 ±0.95 versus 3.97 ±0.69), distinguishing tissue types (2.88 ±0.98 versus 4.09 ±0.69), and identifying structures (2.97 ±0.86 versus 4.03 ±0.59), demonstrating the success of the ACUS curriculum in students with limited prior experience. Views on the value of US to anatomy education and to students' future careers remained positive after the course. End‐of‐semester quiz performance (91% response rate) provided data on educational outcomes. The average score was 79%, with a 90% average on questions about distinguishing tissues/artifacts, demonstrating positive learning outcomes and retention. The anatomy‐centered ultrasound curriculum significantly increased confidence with and knowledge of US among non‐medical anatomy students with limited prior training. Non‐medical students greatly value the contributions that US makes to anatomy education and to their future careers. It is feasible to enhance anatomy education outside of medical training by incorporating US. Anat Sci Educ 10: 348–362. © 2016 American Association of Anatomists.     

Perceptions of junior doctors and undergraduate medical students as anatomy teachers: Investigating distance along the near‐peer teaching spectrum

Near‐peer teaching involves more experienced students acting as tutors and has been widely used in anatomy education. This approach has many advantages for the learner due to the social and cognitive congruence they share with the teacher, however, the influence of distance between the teacher and learner on these congruences has yet to be explored. The aim of this study was to compare the attitudes and perceptions of the student learner towards neuroanatomy review sessions taught by either a senior medical student or a junior doctor. The students were randomly assigned to an allocated tutor. All tutors used standardized material and had access to identical resources. The type of allocated tutor was swapped between the two teaching sessions and 99 student feedback forms were collected in total. The rating for the overall quality of the teaching session was not significantly different between the junior doctors and senior medical students (P = 0.11). However, criteria closely relating to social and cognitive congruence such as “enjoyment of the session,” “delivery of the teaching,” and “was it a good use of time” were all rated significantly higher for the senior medical students (P < 0.05). The results of this study suggest that small increases in distance along the near‐peer teaching spectrum have an impact upon the student's perception of their learning experience. While all teachers were suitable role models it appears that junior doctors are too far removed from their own undergraduate experiences to share congruences with pre‐clinical medical students. Anat Sci Educ 7: 242–247. © 2013 American Association of Anatomists.     

Improvements in anatomy knowledge when utilizing a novel cyclical “Observe‐Reflect‐Draw‐Edit‐Repeat” learning process

Innovative educational strategies can provide variety and enhance student learning while addressing complex logistical and financial issues facing modern anatomy education. Observe‐Reflect‐Draw‐Edit‐Repeat (ORDER), a novel cyclical artistic process, has been designed based on cognitivist and constructivist learning theories, and on processes of critical observation, reflection and drawing in anatomy learning. ORDER was initially investigated in the context of a compulsory first year surface anatomy practical (ORDER‐SAP) at a United Kingdom medical school in which a cross‐over trial with pre‐post anatomy knowledge testing was utilized and student perceptions were identified. Despite positive perceptions of ORDER‐SAP, medical student (n = 154) pre‐post knowledge test scores were significantly greater (P < 0.001) with standard anatomy learning methods (3.26, SD = ±2.25) than with ORDER‐SAP (2.17, ±2.30). Based on these findings, ORDER was modified and evaluated in the context of an optional self‐directed gross anatomy online interactive tutorial (ORDER‐IT) for participating first year medical students (n = 55). Student performance was significantly greater (P < 0.001) with ORDER‐IT (2.71 ± 2.17) when compared to a control tutorial (1.31 ± 2.03). Performances of students with visual and artistic preferences when using ORDER were not significantly different (P > 0.05) to those students without these characteristics. These findings will be of value to anatomy instructors seeking to engage students from diverse learning backgrounds in a research‐led, innovative, time and cost‐effective learning method, in the context of contrasting learning environments. Anat Sci Educ 10: 7–22. © 2016 American Association of Anatomists.     

Anatomy Teaching,a “Model” Answer? Evaluating “Geoff”, a Painted Anatomical Horse,as a Tool for Enhancing Topographical Anatomy Learning

Development of new methods for anatomy teaching is increasingly important as we look to modernize and supplement traditional teaching methods. In this study, a life-sized equine model, “Geoff,” was painted with surface and deep anatomical structures with the aim of improving students’ ability to convert theoretical knowledge into improved topographical anatomy knowledge on the live horse. Third and fourth year veterinary medicine students (n = 45) were randomly allocated into experimental (used “Geoff”) and control (used textbook) groups. The efficacy of the model was evaluated through a structured oral exam using a live horse. Questionnaires gathered information on student confidence and enjoyment of the task. There was no significant difference in the performance of experimental and control groups either immediately (44±20% vs. 40±21%; P = 0.504) or 9 weeks after the learning intervention (55±17% vs. 55±20%; P = 0.980). There were however specific questions on which the experimental group performed better than controls, and for which gender effects were apparent. The students using “Geoff” showed a transient gain in confidence following the session (Likert scale 2.7 to 3.6) however the initial increase was no longer present at the second test. There was a significant influence of gender on confidence with greater confidence gains in females in the Experimental group. The students found the model to be extremely useful and both groups found the sessions enjoyable. The model will be of benefit as a complementary learning tool for students.     

Cognitive load imposed by ultrasound‐facilitated teaching does not adversely affect gross anatomy learning outcomes

Ultrasonography is increasingly used in medical education, but its impact on learning outcomes is unclear. Adding ultrasound may facilitate learning, but may also potentially overwhelm novice learners. Based upon the framework of cognitive load theory, this study seeks to evaluate the relationship between cognitive load associated with using ultrasound and learning outcomes. The use of ultrasound was hypothesized to facilitate learning in anatomy for 161 novice first‐year medical students. Using linear regression analyses, the relationship between reported cognitive load on using ultrasound and learning outcomes as measured by anatomy laboratory examination scores four weeks after ultrasound‐guided anatomy training was evaluated in consenting students. Second anatomy examination scores of students who were taught anatomy with ultrasound were compared with historical controls (those not taught with ultrasound). Ultrasound's perceived utility for learning was measured on a five‐point scale. Cognitive load on using ultrasound was measured on a nine‐point scale. Primary outcome was the laboratory examination score (60 questions). Learners found ultrasound useful for learning. Weighted factor score on “image interpretation” was negatively, but insignificantly, associated with examination scores [F (1,135) = 0.28, beta = ?0.22; P = 0.61]. Weighted factor score on “basic knobology” was positively and insignificantly associated with scores; [F (1,138) = 0.27, beta = 0.42; P = 0.60]. Cohorts exposed to ultrasound had significantly higher scores than historical controls (82.4% ± SD 8.6% vs. 78.8% ± 8.5%, Cohen's d = 0.41, P < 0.001). Using ultrasound to teach anatomy does not negatively impact learning and may improve learning outcomes. Anat Sci Educ 10: 144–151. © 2016 American Association of Anatomists.     

The effect of face‐to‐face teaching on student knowledge and satisfaction in an undergraduate neuroanatomy course

The total number of anatomy teaching hours has declined in medical courses worldwide. Conversely, face‐to‐face teaching in undergraduate neuroanatomy at Macquarie University increased by 50% in 2011. Our aim was to investigate whether this influenced student performance and overall satisfaction with the course. One hundred eighty‐one students consented to participate in this study. A questionnaire was administered to rate the course, and final grades from the old and new unit cohorts were compared. The old and new unit cohorts did not differ in their final grades (P = 0.249). However, the new unit cohort rated their knowledge of the material higher compared to the old unit cohort (P = 0.013), and reported higher levels of satisfaction with the course (P < 0.001). In an era in which teaching time for anatomy has been reduced at tertiary institutions, and there is much lamenting of the effect this will have, there is a paucity of literature on whether the decrease really influences neuroanatomical knowledge. This is the first study, to the best of our knowledge, to show that an increase in total face‐to‐face teaching hours does not improve student grades, but does increase student satisfaction with the course. Anat Sci Educ 6: 239–245. © 2012 American Association of Anatomists.     

No cuts,no buts: Satisfaction of first-year medical students with a hybrid prosection-based model for learning gross anatomy during the Covid-19 pandemic

Few realized the extent of disruption that the Covid-19 global pandemic would impose upon higher anatomical education. While many institutions were obliged to adopt a fully-remote online model, the New York Institute of Technology College of Osteopathic Medicine strove to develop a curriculum that would allow medical students to receive an in-person anatomy education. A hybrid model that emphasized learning from prosected cadavers and self-study stations was implemented, with the remainder of the students' time directed toward studying at home. Through an anonymous survey aimed at gleaning student satisfaction, this study demonstrates that this hybrid prosection-based anatomy course aligned with student preferences both assuming no health risk (64.6% agreed) and given the current risk of contracting Covid-19 (78.5% agreed). Generally, students felt that their education was equal to that of previous years (Likert scale = 3.24 ± 1.05), fostered an appreciation for anatomy (4.56 ± 0.59), promoted teamwork (4.13 ± 0.85), and prepared them for practical examinations (4.18 ± 0.74). Linear mixed-effect models demonstrated that specific differences in results could be attributed to students' preconceived preferences toward student-led dissections and to past medical training. Importantly, most students “disagree” (1.97 ± 1.00) that they were concerned about the risk of exposure to Covid-19 during in-person anatomy laboratory sessions. Areas requiring improvement were identified by the model, including the provision of access to the cadavers outside of the regularly scheduled laboratory times (3.89 ± 1.08). These findings should be utilized when designing future gross anatomy courses in response to the “new normal”.     

Student and recent graduate perspectives on radiological imaging instruction during basic anatomy courses

Recently, faculty at Pritzker School of Medicine, The University of Chicago, have made efforts to improve the depth of radiological anatomy knowledge that students have, but no insights exist as to student and resident opinions of how clinically helpful deep anatomical understanding is. A single‐institution survey of second‐ and fourth‐year medical students and postgraduate year 1–4 residents from 11 specialties, composed of five‐point Likert questions, sample examination questions, and narrative response questions, was distributed in 2015. One hundred seventy‐seven of the 466 potential respondents replied (71 residents and 106 students), response rate 38.0%. No nonresponse bias was present in two separate analyses. Respondents generally favored a superficial “identification” question as more relevant to clinical practice, which was positively associated with increasing clinical experience ρ = 0.357, P < 0.001 by point‐biserial correlation. Students and residents most commonly used self‐directed methods to learn medical imaging during their medical anatomy courses (72.6 and 57.7%, respectively). Small group education was least commonly used by students and residents (45.3 and 39.4%, respectively), but most commonly recommended (62.3 and 69%, respectively). A total of 56.6 and 64.8% of students and residents, respectively, reported that having multiple learning methods was “quite” or “extremely” important. Respondents with more clinical experience were more likely to report that a superficial identification question was more clinically relevant than a question testing deeper radiological anatomy knowledge. Small group learning was preferred among students and residents but was the least commonly employed method of instruction. Both findings contrast starkly with current radiological anatomy instructional understanding and practices. Anat Sci Educ 11: 25–31. © 2017 American Association of Anatomists.     

The place of surface anatomy in the medical literature and undergraduate anatomy textbooks

The aims of this review were to examine the place of surface anatomy in the medical literature, particularly the methods and approaches used in teaching surface and living anatomy and assess commonly used anatomy textbooks in regard to their surface anatomy contents. PubMed and MEDLINE databases were searched using the following keywords “surface anatomy,” “living anatomy,” “teaching surface anatomy,” “bony landmarks,” “peer examination” and “dermatomes”. The percentage of pages covering surface anatomy in each textbook was calculated as well as the number of images covering surface anatomy. Clarity, quality and adequacy of surface anatomy contents was also examined. The search identified 22 research papers addressing methods used in teaching surface anatomy, 31 papers that can help in the improvement of surface anatomy curriculum, and 12 anatomy textbooks . These teaching methods included: body painting, peer volunteer surface anatomy, use of a living anatomy model, real time ultrasound, virtual (visible) human dissector (VHD), full body digital x‐ray of cadavers (Lodox^® Statscan^® images) combined with palpating landmarks on peers and the cadaver, as well as the use of collaborative, contextual and self‐directed learning. Nineteen of these studies were published in the period from 2006 to 2013. The 31 papers covered evidence‐based and clinically‐applied surface anatomy. The percentage of surface anatomy in textbooks' contents ranged from 0 to 6.2 with an average of 3.4%. The number of medical illustrations on surface anatomy varied from 0 to 135. In conclusion, although there has been a progressive increase in publications addressing methods used in teaching surface anatomy over the last six to seven years, most anatomy textbooks do not provide students with adequate information about surface anatomy. Only three textbooks provided a solid explanation and foundation of understanding surface anatomy. Anat Sci Educ 6: 415–432. © 2013 American Association of Anatomists.     

Dissecting the role of sessional anatomy teachers: A systematic literature review

Worldwide there is a growing reliance on sessional teachers in universities. This has impacted all disciplines in higher education including medical anatomy programs. The objective of this review was to define the role and support needs of sessional anatomy teachers by reporting on the (1) qualifications, (2) teaching role, (3) training, and (4) performance management of this group of educators. A systematic literature search was conducted on the 27 July 2017 in Scopus, Web of Science, and several databases on the Ovid, ProQuest and EBSCOhost platforms. The search retrieved 5,658 articles, with 39 deemed eligible for inclusion. The qualifications and educational distance between sessional anatomy teachers and their students varied widely. Reports of cross‐level, near‐peer and reciprocal‐peer teaching were identified, with most institutes utilizing recent medical graduates or medical students as sessional teachers. Sessional anatomy teachers were engaged in the full spectrum of teaching‐related duties from assisting students with cadaveric dissection, to marking student assessments and developing course materials. Fourteen institutes reported that training was provided to sessional anatomy teachers, but the specific content, objectives, methods and effectiveness of the training programs were rarely defined. Evaluations of sessional anatomy teacher performance primarily relied on subjective feedback measures such as student surveys (n = 18) or teacher self‐assessment (n = 3). The results of this systematic review highlight the need for rigorous explorations of the use of sessional anatomy teachers in medical education, and the development of evidence‐based policies and training programs that regulate and support the use of sessional teachers in higher education. Anat Sci Educ 11: 410–426. © 2017 American Association of Anatomists.     

Is remote near-peer anatomy teaching an effective teaching strategy? Lessons learned from the transition to online learning during the Covid-19 pandemic

In response to the Covid-19 pandemic, medical educators have transformed pre-clerkship anatomy curricula into online formats. The purpose of this study was to evaluate the effectiveness and student perceptions of an online near-peer anatomy curriculum. The classes of 2022 and 2023 completed identical foundational anatomy curricula in-person, whereas the class of 2024 completed an adapted curriculum for remote online learning. Quantitative and qualitative responses were used to compare attitudes between instructional methods. Assessment scores and evaluation survey responses were collected from the classes of 2022 (n = 185), 2023 (n = 184), and 2024 (n = 183). Mean assessment scores (±SD) for the classes of 2022, 2023, and 2024 were 93.64% (±5.86), 93.75% (±4.09), and 92.04% (±4.83), respectively. Post hoc group comparisons showed the class of 2024 scored significantly lower than the two previous classes [2022: (H(1) = 18.58, P < 0.001), 2023: (H(1) = 18.65, P < 0.001)]. Mean survey results concerning curriculum quality were 4.06/5.00 for the class of 2023 and 3.57/5.0 for the class of 2024 (t(365) = 2.67, P = 0.008). Considering a small effect size (η² = 0.034), there was no meaningful difference in student assessment scores. A potential drawback of online near-peer anatomy teaching remains in student perceptions of course quality; qualitative feedback suggested technological limitations and perceptions of online course instructors were partly responsible for lower student satisfaction. Following the Covid-19 pandemic, medical educators should incorporate the lessons learned from this unique educational inflection point to improve curricula moving forward.     

A “Do‐It‐Yourself” interactive bone structure module: Development and evaluation of an online teaching resource

A stand‐alone online teaching module was developed to cover an area of musculoskeletal anatomy (structure of bone) found to be difficult by students. The material presented in the module was not formally presented in any other way, thus providing additional time for other curriculum components, but it was assessed in the final examination. The module was developed using “in‐house” software designed for academics with minimal computer experience. The efficacy and effectiveness of the module was gauged via student surveys, testing student knowledge before and after module introduction, and analysis of final examination results. At least 74% of the class used the module and student responses were positive regarding module usability (navigation, interaction) and utility (learning support). Learning effectiveness was demonstrated by large significant improvements in the post‐presentation test scores for “users” compared with “non‐users” and by the percentage of correct responses to relevant multiple choice questions in the final examination. Performance on relevant short answer questions in the final examination was, on average, comparable to that for other components. Though limited by study structure, it was concluded that the module produced learning outcomes equivalent to those generated by more traditional teaching methods. This “Do‐It‐Yourself” e‐learning approach may be particularly useful for meeting specific course needs not catered for by commercial applications or where there are cost limitations for generation of online learning material. The specific approaches used in the study can assist in development of effective online resources in anatomy. Anat Sci Educ 6: 107–113. © 2012 American Association of Anatomists.     

The relationship between student engagement with online content and achievement in a blended learning anatomy course

Blended learning has become increasingly common in higher education. Recent findings suggest that blended learning achieves better student outcomes than traditional face‐to‐face teaching in gross anatomy courses. While face‐to‐face content is perceived as important to learning there is less evidence for the significance of online content in improving student outcomes. Students enrolled in a second‐year anatomy course from the physiotherapy (PT), exercise physiology (EP), and exercise science (ES) programs across two campuses were included (n = 500). A structural equation model was used to evaluate the relationship of prior student ability (represented by grade in prerequisite anatomy course) and final course grade and whether the relationship was mediated by program, campus or engagement with the online elements of the learning management system (LMS; proportion of documents and video segments viewed and number of interactions with discussion forums). PT students obtained higher grades and were more likely to engage with online course materials than EP and ES students. Prerequisite grade made a direct contribution to course final grade (P < 0.001) but was also mediated by engagement with LMS videos and discussion forums (P < 0.001). Student learning outcomes in a blended anatomy course can be predicted the by level of engagement with online content. Anat Sci Educ 11: 471–477. © 2017 American Association of Anatomists.     

Interactive anatomical and surgical live stream lectures improve students' academic performance in applied clinical anatomy

Tuebingen's Sectio Chirurgica (TSC) is an innovative, interactive, multimedia, and transdisciplinary teaching method designed to complement dissection courses. The Tuebingen's Sectio Chirurgica (TSC) allows clinical anatomy to be taught via interactive live stream surgeries moderated by an anatomist. This method aims to provide an application‐oriented approach to teaching anatomy that offers students a deeper learning experience. A cohort study was devised to determine whether students who participated in the TSC were better able to solve clinical application questions than students who did not participate. A total of 365 students participated in the dissection course during the winter term of the 2012/2013 academic year. The final examination contained 40 standard multiple‐choice (S‐MC) and 20 clinically‐applied multiple‐choice (CA‐MC) items. The CA‐MC items referred to clinical cases but could be answered solely using anatomical knowledge. Students who regularly participated in the TSC answered the CA‐MC questions significantly better than the control group (75% and 65%, respectively; P < 0.05, Mann‐Whitney U test). The groups exhibited no differences on the S‐MC questions (85% and 82.5%, respectively; P > 0.05). The CA‐MC questions had a slightly higher level of difficulty than the S‐MC questions (0.725 and 0.801, respectively; P = 0.083). The discriminatory power of the items was comparable (S‐MC median Pearson correlations: 0.321; CA‐MC: 0.283). The TSC successfully teaches the clinical application of anatomical knowledge. Students who attended the TSC in addition to the dissection course were able to answer CA‐MC questions significantly better than students who did not attend the TSC. Thus, attending the TSC in addition to the dissection course supported students' clinical learning goals. Anat Sci Educ 10: 46–52. © 2016 American Association of Anatomists.     

Using collaborative two‐stage examinations to address test anxiety in a large enrollment gateway course

Large enrollment foundational courses are perceived as “high stakes” because of their potential to act as barriers for progression to the next course or admittance to a program. The nature of gateway courses makes them ideal settings to explore the relationship between anxiety, pedagogical interventions, and student performance. Here, two‐stage collaborative examinations were implemented to improve test‐taking skills and address widespread test anxiety in an introductory human anatomy course. Test anxiety data were collected (using the Motivated Strategies for Learning Questionnaire) before the first examination and last examination. Most students experienced decreased test anxiety over the course of the semester; however, some students may have experienced performance limiting conditions due to test anxiety at the end of the semester based on academic ability in the course (in “C” students when compared to “A” students: P < 0.00006 and “B” students: P < 0.05), overall academic ability (in academically weaker students: P < 0.025), and demographic factors (in women: P < 0.025). The strongest performances on examinations were primarily observed in already academically strong students (mean individual performance: P < 0.000, mean group performance: P < 0.000). Furthermore, changes in test anxiety were not significantly associated with the group portion of the examinations. Patterns of changes in test anxiety over the course of the semester underscore a complex interaction between test anxiety, student background, and student performance. Results suggest that pathways for test anxiety in “high stakes” courses may be separate from the mechanisms responsible for the benefits of collaborative testing. Anat Sci Educ 10: 409–422. © 2017 American Association of Anatomists.     

An Analysis of Anatomy Education Before and During Covid-19: May–August 2020

Coronavirus disease 2019 (Covid-19) created unparalleled challenges to anatomy education. Gross anatomy education has been particularly impacted given the traditional in-person format of didactic instruction and/or laboratory component(s). To assess the changes in gross anatomy lecture and laboratory instruction, assessment, and teaching resources utilized as a result of Covid-19, a survey was distributed to gross anatomy educators through professional associations and listservs. Of the 67 survey responses received for the May–August 2020 academic period, 84% were from United States (US) institutions, while 16% were internationally based. Respondents indicated that in-person lecture decreased during Covid-19 (before: 76%, during: 8%, P < 0.001) and use of cadaver materials declined (before: 76 ± 33%, during: 34 ± 43%, P < 0.001). The use of cadaver materials in laboratories decreased during Covid-19 across academic programs, stand-alone and integrated anatomy courses, and private and public institutions (P ≤ 0.004). Before Covid-19, cadaveric materials used in laboratories were greater among professional health programs relative to medical and undergraduate programs (P ≤ 0.03) and among stand-alone relative to integrated anatomy courses (P ≤ 0.03). Furthermore, computer-based assessment increased (P < 0.001) and assessment materials changed from cadaveric material to images (P < 0.03) during Covid-19, even though assessment structure was not different (P > 0.05). The use of digital teaching resources increased during Covid-19 (P < 0.001), with reports of increased use of in-house created content, BlueLink, and Complete Anatomy software (P < 0.05). While primarily representing US institutions, this study provided evidence of how anatomy educators adapted their courses, largely through virtual mediums, and modified laboratory protocols during the initial emergence of the Covid-19 pandemic.     

Improving Academic Performance of Sport and Exercise Science Undergraduate Students in Gross Anatomy Using a Near-Peer Teaching Program

Peer and near-peer teaching programs are common in medical undergraduate courses. However, there are no studies that have investigated the effectiveness of a near-peer teaching program on the academic performance of undergraduate students pursuing sport and exercise science coursework. This study was conducted to analyze the effectiveness of such a program for students who participated in a course on the functional anatomy of the locomotor apparatus. A total of 39 student participants were divided into two groups: students in one group voluntarily attended at least one session of a near-peer teaching program, and students in the other group attended no sessions. The final grade (range 0–100%) was recorded and used as an indicator of academic performance. The final grade of students who attended the near-peer teaching program (69.5 ± 16.0%) was 38.7% higher (P = 0.002, d = 1.06) than those who did not (50.1 ± 20.4%). When the academic performance of the same students was evaluated in another course (exercise physiology) that did not offer a near-peer teaching program, there were no significant differences between the groups (students who attended or did not attend the near-peer teaching program). A significant positive association was found between near-peer teaching program frequency and the number of students approved and not approved in the course (P = 0.041). A significant difference (P = 0.001) was found in the attendance at regular classes between the group who participated in the near-peer teaching program (median: 62 hours; IQR [interquartile ranges]: 4.0 hours) and those who did not (median: 58 hours; IQR: 4.0 hours). Gender was not a moderating factor on academic performance or near-peer teaching program attendance. These results highlight the effectiveness of a near-peer teaching program on the academic performance of students from a sport and exercise science degree program while enrolled in an anatomy course. Anat Sci Educ. © 2018 American Association of Anatomists.