Contrast in usage of FCAT‐approved anatomical terminology between members of two anatomy associations in North America

Almost 12 years since the publishing of Terminologia Anatomica (TA) by the Federative Committee on Anatomical Terminology (FCAT), there has yet to be a unified adoption of FCAT‐recommended anatomical terms by North American anatomists. A survey was sent to members of the Human Anatomy & Physiology Society (HAPS) to compare the frequency of FCAT term usage with a previous study involving the American Association of Anatomists (AAA). The HAPS differed from AAA in being composed mostly of biologists (56.5%) who teach anatomy with only 18.3% of respondents having terminal degrees in anatomy. The survey included the same 25 sets of synonymic names for selected gross anatomical structures or related terms used for the AAA survey. Overall results indicate that the FCAT preferred term had the highest frequency of usage in only 40.0% of the survey questions, demonstrating 4% lower compliance than AAA respondents. Compliance with FCAT preferred terms ranged from 92.2% to 1.7% usage. When compared with AAA anatomists, there were reversals in predominant usage between FCAT and non‐FCAT terms for six sets of anatomical structures: HAPS respondents predominantly used non‐FCAT terms for adrenal gland (88.7%), antecubital fossa (57.4%), patellar tendon (65.2%), ligamentum capitis femoris (36.5%), while preferring the FCAT anterior circumflex humeral artery (45.2%) and anterior/posterior preferred over ventral/dorsal (41.7%). Almost 54% of HAPS anatomists were not familiar with the FCAT, nearly 21% higher than the AAA. Anat Sci Educ 3:25–32, 2010. © 2009 American Association of Anatomists.     

Anatomists debate the value of a teaching credential

Fewer and fewer programs are training graduate students and postdoctoral fellows in the classical anatomical disciplines. Nonetheless, there remains a need at all levels of clinical and basic science education for skilled instructors of anatomy, histology, and embryology. Two sessions at the 2006 annual meeting of the American Association of Anatomists (AAA) explored whether a system of accreditation would benefit students, institutions, and training programs. Although the value of accreditation was controversial, three challenges for the various anatomical societies emerged from these discussions: (1) To identify the skills and knowledge that should be shared among all anatomists, and the more specific skills and knowledge needed for the diverse settings in which anatomists work. (2) To address the historical inattention of institutions to the training of educators. (3) To develop strategies to lobby institutions and national organizations to support the training and work of educators in the anatomical sciences. One approach to meeting these challenges would be to develop guidelines for training programs. These guidelines would help graduate students seek the training they need, provide institutions with a benchmark to assess or develop training programs, and provide the basis for focusing lobbying efforts targeted at institutions or existing accreditation bodies. Anat Sci Ed 1:60–67, 2008. © 2008 American Association of Anatomists.     

Training tomorrow's anatomists today: A partnership approach

Anatomy is recognized to play a central role in the education and training of clinicians, healthcare professionals, and scientists. However, in recent years, the perceived decline in popularity of anatomy has led to a deficiency in the numbers of new anatomy educators. The tide is now turning with anatomy once again taking its rightful place in a wide of variety of disciplines, and therefore it is imperative that a new generation of anatomists is in place to meet this need. In response, the Anatomical Society of Great Britain and Ireland has made the training of the next set of anatomists, one of its strategic priorities, and in collaboration with the American Association of Anatomists has developed a dedicated Training Program. The overall aim of the Program is to provide trainees with the necessary knowledge, understanding, aptitudes, and attitudes in appropriate detail, sufficient to enable them to teach and examine Anatomy with full competence at the undergraduate and postgraduate level. The Program offers opportunities to consolidate knowledge and deepen understanding of anatomy, improve skills in teaching and communication with students, and be competent in preparing teaching materials and assessment modalities. The Program uses a distance‐learning approach with an incorporated Residential School and is particularly aimed at those undertaking a career in the biosciences. Early indications suggest that initiatives such as the development of this Training Program will help deliver the next generation of anatomists and ensure that anatomy continues to play a fundamental role in the education of clinicians, healthcare professionals, and scientists. Anat Sci Ed 2:119‐125, 2009 © 2009 American Association of Anatomists.     

Medical education in the anatomical sciences: The winds of change continue to blow

At most institutions, education in the anatomical sciences has undergone several changes over the last decade. To identify the changes that have occurred in gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses, directors of these courses were asked to respond to a survey with questions pertaining to total course hours, hours of lecture, and hours of laboratory, whether the course was part of an integrated program or existed as a stand‐alone course, and what type of laboratory experience occurred in the course. These data were compared to data obtained from a similar survey in 2002. Comparison between the data sets suggests several key points some of which include: decreased total hours in gross anatomy and neuroscience/neuroanatomy courses, increased use of virtual microscopy in microscopic anatomy courses, and decreased laboratory hours in embryology courses. Anat Sci Educ 2: 253–259, 2009. © 2009 American Association of Anatomists.     

Giving ourselves: The ethics of anatomical donation

In some European countries, such as Italy, medical education is threatened by a dearth of anatomical specimens. Such a shortage could spread to other nations, including the United States. This article addresses two ethical questions in body donation. Why might people choose to donate their bodies to education and science? What sorts of ethical appeals might anatomists, physicians, and other health professionals make to patients and family members for anatomical donation? Two models of giving, egoistic and liberal, merit close examination. Anat Sci Ed 1:217–219, 2008. © 2008 American Association of Anatomists.     

The utility of cadaver‐based approaches for the teaching of human anatomy: A survey of British and Irish anatomy teachers

Utilizing reality anatomy such as dissection and demonstrating using cadavers has been described as a superior way to create meaning. The chemicals used to embalm cadavers differentially alter the tissue of the human body, which has led to the usage of different processes along the hard to soft‐fixed spectrum of preserved cadavers. A questionnaire based approach was used to gain a better insight into the opinion of anatomists on the use of preserved cadavers for the teaching of human anatomy. This study focused on anatomy teachers in the United Kingdom and Ireland. From the 125 participating anatomists, 34.4% were medically qualified, 30.4% had a PhD in a non‐anatomical science and 22.4% had a PhD in an anatomical science, these figures include ten anatomists who had combinations of MD with the two other PhD qualifications. The main findings from the questionnaire were that 61.6% of participants agreed that hard‐fixed formalin cadavers accurately resemble features of a human body whereas 21.6% disagreed. Moreover, anatomists rated the teaching aids on how accurately they resemble features of the human body as follows: plastic models the least accurate followed by plastinated specimens, hard fixed cadavers; soft preserved cadavers were considered to be the most accurate when it comes to resembling features of the human body. Though anatomists considered soft preserved cadavers as the most accurate tool, further research is required in order to investigate which techniques or methods provide better teaching tool for a range of anatomical teaching levels and for surgical training. Anat Sci Educ 10: 137–143. © 2016 American Association of Anatomists.     

Ask an anatomist: Identifying global trends,topics and themes of academic anatomists using twitter

Social media (SoMe) is increasingly used in higher education (HE) to access knowledge and enable global communication. The SoMe platform Twitter^® is particularly beneficial in these contexts because it is readily accessible, easily searchable (via hashtags) and global. Given these advantages, the twitter platform @AskAnatomist was created to foster a global weekly tweet chat, where students and academics can ask and address anatomy‐related questions. The aim of this study was to identify themes arising in the early stages of the @AskAnatomy Twitter community to gain insights into current needs/key areas for academic anatomists, students, and other followers. A qualitative analysis of tweets including the hashtag #AnatQ, (the associated @AskAnatomist hashtag), was undertaken to achieve this aim. Thematic analysis revealed three core themes arising in the formative stages of the @AskAnatomist Twitter site: (1) anatomical education modalities, (2) specific anatomy content, and (3) research motivations. These themes reveal controversies within the field of anatomical sciences, areas for potential education resource improvement and research, as well as the humor of anatomists. Though the original intent of the @AskAnatomist site was to engage the general public in anatomy content and knowledge, tweet analysis suggests that academic anatomists were the primary active “tweeters”. Interestingly, this analysis reveals that the @AskAnatomist site progressed into a web‐based community of practice (CoP), suggesting an additional benefit of SoMe communities in the field of anatomy. Anat Sci Educ 11: 270–281. © 2017 American Association of Anatomists.     

Coupled physical and digital cadaver dissection followed by a visual test protocol provides insights into the nature of anatomical knowledge and its evaluation

This research effort compared and contrasted two conceptually different methods for the exploration of human anatomy in the first‐year dissection laboratory by accomplished students: “physical” dissection using an embalmed cadaver and “digital” dissection using three‐dimensional volume modeling of whole‐body CT and MRI image sets acquired using the same cadaver. The goal was to understand the relative contributions each method makes toward student acquisition of intuitive sense of practical anatomical knowledge gained during “hands‐on” structural exploration tasks. The main instruments for measuring anatomical knowledge under this conceptual model were questions generated using a classification system designed to assess both visual presentation manner and the corresponding response information required. Students were randomly divided into groups based on exploration method (physical or digital dissection) and then anatomical region. The physical dissectors proceeded with their direct methods, whereas the digital dissectors generated and manipulated indirect 3D digital models. After 6 weeks, corresponding student anatomical assignment teams compared their results using photography and animated digital visualizations. Finally, to see whether each method provided unique advantages, a visual test protocol of new visualizations based on the classification schema was administered. Results indicated that all students, regardless of gender, dissection method, and anatomical region dissected performed significantly better on questions presented as rotating models requiring spatial ordering or viewpoint determination responses in contrast to requests for specific lexical feature identifications. Additional results provided evidence of trends showing significant differences in gender and dissection method scores. These trends will be explored with further trials with larger populations. Anat Sci Ed 1:27–40, 2008. © 2007 American Association of Anatomists.     

Transforming clinical imaging data for virtual reality learning objects

Advances in anatomical informatics, three‐dimensional (3D) modeling, and virtual reality (VR) methods have made computer‐based structural visualization a practical tool for education. In this article, the authors describe streamlined methods for producing VR “learning objects,” standardized interactive software modules for anatomical sciences education, from newer high‐resolution clinical imaging systems data. The key program is OsiriX, a free radiological image processing workstation software capable of directly reformatting and rendering volumetric 3D images. The transformed image arrays are then directly loaded into a commercial VR program to produce a variety of learning objects. Multiple types or “dimensions” of anatomical information can be embedded in these objects to provide different kinds of functions, including interactive atlases, examination questions, and complex, multistructure presentations. The use of clinical imaging data and workstation software speeds up the production of VR simulations, compared with reconstruction‐based modeling from segmented cadaver cross‐sections, while providing useful examples of normal structural variation and pathological anatomy. Anat Sci Ed 1:50–55, 2008. © 2008 American Association of Anatomists.     

The importance of exposure to human material in anatomical education: A philosophical perspective

Despite reductions in the importance, time committed to, and status of anatomical education in modern medical curricula, anatomical knowledge remains a cornerstone of medicine and related professions. Anatomists are therefore presented with the challenge of delivering required levels of core anatomical knowledge in a reduced time‐frame and with fewer resources. One common response to this problem is to reduce the time available for students to interact with human specimens (either via dissection or handling of prosected material). In some curricula, these sessions are replaced with didactic or problem‐based approaches focussed on transmitting core anatomical concepts. Here, I propose that the adoption of philosophical principles concerning the relationship and differences between “direct experience” and “concept” provides a strong case in support of requiring students to gain significant exposure to human material. These insights support the hypothesis that direct experience of human material is required for “deep,” rather than “superficial,” understanding of anatomy. Anat Sci Ed 1:264–266, 2008. © 2008 American Association of Anatomists.     

Longitudinal retention of anatomical knowledge in second‐year medical students

The Radboud University Medical Center has a problem‐based, learner‐oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students’ decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving. In a longitudinal cohort, the retention of anatomical knowledge gained during the first year of medical school among second‐year medical students was assessed. In May 2011, 346 medical students applied for the second‐year gastro‐intestinal (GI) tract course. The students were asked to participate in a reexamination of a selection of anatomical questions of an examination from October 2009. The examination consisted of a clinical anatomy case scenario and two computed tomography (CT) images of thorax and abdomen in an extended matching format. A total of 165 students were included for analysis. In 2011, students scored significantly lower for the anatomy examination compared to 2009 with a decline in overall examination score of 14.7% (±11.7%). Decrease in knowledge was higher in the radiological questions, compared to the clinical anatomy cases 17.5% (±13.6%) vs. 7.9% (±10.0%), respectively, d = 5.17. In both years, male students scored slightly better compared to female students, and decline of knowledge seems somewhat lower in male students (13.1% (±11.1%) vs. 15.5% (±12.0%), respectively), d = ?0.21. Anatomical knowledge in the problem‐oriented horizontal and vertical integrated medical curriculum, declined by approximately 15% 1.5 year after the initial anatomy course. The loss of knowledge in the present study is relative small compared to previous studies. Anat Sci Educ 10: 242–248. © 2016 American Association of Anatomists.     

A need for logical and consistent anatomical nomenclature for cutaneous nerves of the limbs

The system of anatomical nomenclature needs to be logical and consistent. However, variations in translation to English of the Latin and Greek terminology used in Nomina Anatomica and Terminologia Anatomica have led to some inconsistency in the nomenclature of cutaneous nerves in the limbs. An historical review of cutaneous nerve nomenclature reveals that there are two general naming conventions: one primarily American and one primarily British. The American convention presents cutaneous nerves of the limbs in the format “medial brachial cutaneous nerve,” while the British convention presents the same nerve as “medial cutaneous nerve of the arm,” thereby translating “brachii” to “of the arm.” If logically and consistently applied throughout the body, the British convention would rename the sural nerve to the “nerve of the calf,” the brachial artery would become the “artery of the arm,” the femoral nerve would be “nerve of the thigh,” and femur would be “bone of the thigh” or “thigh bone.” The British convention leads to many other nomenclatural inconsistencies, which would seem to make learning anatomy more difficult for the beginning student. In this era of contracting anatomy curricula, every effort should be made to keep anatomical nomenclature simple, logical, and consistent. Anat Sci Ed 2:126–134, 2009. © 2009 American Association of Anatomists.     

Three‐dimensional printing of X‐ray computed tomography datasets with multiple materials using open‐source data processing

Advances in three‐dimensional (3D) printing allow for digital files to be turned into a “printed” physical product. For example, complex anatomical models derived from clinical or pre‐clinical X‐ray computed tomography (CT) data of patients or research specimens can be constructed using various printable materials. Although 3D printing has the potential to advance learning, many academic programs have been slow to adopt its use in the classroom despite increased availability of the equipment and digital databases already established for educational use. Herein, a protocol is reported for the production of enlarged bone core and accurate representation of human sinus passages in a 3D printed format using entirely consumer‐grade printers and a combination of free‐software platforms. The comparative resolutions of three surface rendering programs were also determined using the sinuses, a human body, and a human wrist data files to compare the abilities of different software available for surface map generation of biomedical data. Data shows that 3D Slicer provided highest compatibility and surface resolution for anatomical 3D printing. Generated surface maps were then 3D printed via fused deposition modeling (FDM printing). In conclusion, a methodological approach that explains the production of anatomical models using entirely consumer‐grade, fused deposition modeling machines, and a combination of free software platforms is presented in this report. The methods outlined will facilitate the incorporation of 3D printed anatomical models in the classroom. Anat Sci Educ 10: 383–391. © 2017 American Association of Anatomists.     

A simple dissection method for the conduction system of the human heart

A simple dissection guide for the conduction system of the human heart is shown. The atrioventricular (AV) node, AV bundle, and right bundle branch were identified in a formaldehyde‐fixed human heart. The sinu‐atrial (SA) node could not be found, but the region in which SA node was contained was identified using the SA nodal artery. Gross anatomical observation of the conduction system is useful for understanding the structure and function of the heart. Anat Sci Ed 2:78–80, 2009. © 2009 American Association of Anatomists.     

The Case Anatomical Knowledge Index (CAKI): A novel method used to assess anatomy content in clinical cases

There are concerns in the literature that the use of case‐based teaching of anatomy could be compromising the depth and scope of anatomy learned by students in a problem‐based learning curriculum. Poor selection of clinical cases that are used as vehicles for teaching/learning anatomy may be the root problem because some clinical cases do not provide enough opportunities to learn anatomy and are, therefore, inappropriate for case‐based teaching. Although anatomy educators are expected to respond to the identified deficiencies of case‐based anatomy teaching, making sure that students acquire sufficient anatomical knowledge to practice safely and successfully, there are no tools available that can help improve the selection of clinical cases for case‐based teaching. The author proposes a composite index, which incorporates considerations of anatomical knowledge for evaluating clinical cases/conditions for suitability in case‐based anatomy teaching. The development of the case anatomical knowledge index (CAKI) using a modified Guttman procedure is described. The scalability of the index was measured using the coefficient of reproducibility. A total of 47 clinicians participated in the validation activities that measured interrater and intraclass reliability. The CAKI was able to consistently discriminate between clinical cases/conditions with higher demand for anatomical knowledge than those with lower demand for anatomical knowledge. A review of the literature suggests that such an index has not been previously reported. Given the concerns about the depth and scope of anatomy learning in case‐based teaching, these findings have international relevance. Anat Sci Ed 2:9–18, 2009. © 2009 American Association of Anatomists.     

Can anatomists teach living anatomy using ultrasound as a teaching tool?

The utilization of bedside ultrasound by an increasing number of medical specialties has created the need for more ultrasound exposure and teaching in medical school. Although there is a widespread support for more vertical integration of ultrasound teaching throughout the undergraduate curriculum, little is known about whether the quality of ultrasound teaching differs if performed by anatomists or clinicians. The purpose of this study is to compare medical students' evaluation of ultrasound anatomy teaching by clinicians and anatomists. Hands‐on interactive ultrasound sessions were scheduled as part of the gross anatomy course following principles of adult learning and instructional design. Seven teachers (three anatomists and four clinicians) taught in each session. Before each session, anatomists were trained in ultrasound by clinicians. Students were divided into groups, rotated teachers between sessions, and completed evaluations. Results indicated students perceived the two groups as comparable for all factors except for knowledge organization and the helpfulness of ultrasound for understanding anatomy (P < 0.001). However, results from unpaired samples t‐tests demonstrated a nonstatistically significant difference between the groups within each session for both questions. Moreover, students' test performance for both groups was similar. This study demonstrated that anatomists can teach living anatomy using ultrasound with minimal training as well as clinicians, and encourage the teaching of living anatomy by anatomists in human anatomy courses using ultrasound. Repeating this study at a multicenter level is currently being considered to further validate our conclusion. Anat Sci Educ 7: 340–349. © 2013 American Association of Anatomists.     

Evolution of the anatomical theatre in Padova

The anatomical theatre played a pivotal role in the evolution of medical education, allowing students to directly observe and participate in the process of dissection. Due to the increase of training programs in clinical anatomy, the Institute of Human Anatomy at the University of Padova has renovated its dissecting room. The main guidelines in planning a new anatomical theatre included: (1), the placement of the teacher and students on the same level in a horizontal anatomical theatre where it is possible to see (theatre) and to perform (dissecting room); (2), in the past, dissection activities were concentrated at the center of the theatre, while in the new anatomical theatre, such activities have been moved to the periphery through projection on surrounding screens—thus, students occupy the center of the theatre between the demonstration table, where the dissection can be seen in real time, and the wall screens, where particular aspects are magnified; (3), three groups of tables are placed with one in front with two lateral flanking tables in regards to the demonstration table, in a semicircular arrangement, and not attached to the floor, which makes the room multifunctional for surgical education, medical students and physician's continued professional development courses; (4), a learning station to introduce the students to the subject of the laboratory; (5), cooperation between anatomists and architects in order to combine the practical needs of a dissection laboratory with new technologies; (6), involvement of the students, representing the clients' needs; and (7), creation of a dissecting room of wide measurements with large windows, since a well‐illuminated space could reduce the potentially negative psychological impact of the dissection laboratory on student morale. Anat Sci Educ 7: 487–493. © 2014 American Association of Anatomists.     

Dissecting the dissectors: Knowledge,attitude, and practice of body bequests by Nigerian anatomists

Anatomy education in most African countries is limited by an insufficient number of cadavers for students to undertake dissection. This already significant shortage is exacerbated by an increasing number of medical schools and students. Virtual dissections are impractical in alleviating such a shortfall in African anatomy education, and further cadaver supply is challenged by unethical and dubious sources. This study was designed to assess the knowledge, attitudes, and practice of whole body and organ donation by Nigerian anatomists with the aim of finding solutions to the problems associated with the availability of cadavers in Nigerian medical schools. Out of 46 anatomists that participated in the survey, only 23.9% would consider donating their whole bodies and 60.9% their organs. More than 95% of respondents did not believe that body bequests could become the sole source of cadavers for anatomic dissection in Nigeria. Age and gender were not statistically significant in the choice of being a body or organ donor. The unacceptability to one's family members regarding body donation was the major reason for respondents' unwillingness to make a whole body donation. None of the 14 medical schools sampled in this study have yet instituted a body registration and donation program. The anatomists showed a high level of knowledge and awareness of body bequest programs, which were not reflected by their attitudes and practice. The authors recommend proactive measures aimed at improving the perception and attitudes of Nigerian anatomists. Anat Sci Educ. © 2012 American Association of Anatomists.     

The benefits and limitations of using ultrasonography to supplement anatomical understanding

Anatomical understanding is critical to medical education. With reduced teaching time and limited cadaver availability, it is important to investigate how best to utilize in vivo imaging to supplement anatomical understanding and better prepare medical graduates for the proliferation of point‐of‐care imaging in the future. To investigate whether using short sessions of in vivo imaging using ultrasonography could benefit students' anatomical knowledge and clinical application, we conducted a 2‐hour session on abdominal anatomy using ultrasonography in small groups of five to six students, for both first‐ and second‐year student cohorts. Individual feedback was collected to assess student perceptions. To measure retention and understanding, a short examination containing ultrasound images and questions and performance of a clinical skill (gastrointestinal' tract examination) were assessed. Ultrasonography sessions were highly valued by the students, with 90% of the students reporting their understanding was improved, and over 70% reporting increased confidence in their anatomical knowledge. However, the assessments showed no appreciable impact on skills or understanding related to abdominal anatomy and examination. We conclude that the risk associated with limited exposure increasing confidence without increasing skills remains real and that in vivo imaging is not effective when used as a short adjunct teaching tool. The widespread use of ultrasonography means finding the best way to incorporate ultrasound into medical education remains important. To this end, we are currently implementing an extended program including echocardiography and multiple anatomical sessions that will determine if frequency and repetition of use can positively impact on student performance and understanding. Anat Sci Educ. © 2013 American Association of Anatomists.