Use of interactive live digital imaging to enhance histology learning in introductory level anatomy and physiology classes

Histology is one of the main subjects in introductory college-level Human Anatomy and Physiology classes. Institutions are moving toward the replacement of traditional microscope-based histology learning with virtual microscopy learning amid concerns of losing the valuable learning experience of traditional microscopy. This study used live digital imaging (LDI) of microscopic slides on a SMART board to enhance Histology laboratory teaching. The interactive LDI system consists of a digital camera-equipped microscope that projects live images on a wall-mounted SMART board via a computer. This set-up allows real-time illustration of microscopic slides with highlighted key structural components, as well as the ability to provide the students with relevant study and review material. The impact of interactive LDI on student learning of Histology was then measured based on performance in subsequent laboratory tests before and after its implementation. Student grades increased from a mean of 76% (70.3-82.0, 95% CI) before to 92% (88.8-95.3, 95% CI) after integration of LDI indicating highly significant (P < 0.001) enhancement in students' Histology laboratory performance. In addition, student ratings of the impact of the interactive LDI on their Histology learning were strongly positive, suggesting that a majority of students who valued this learning approach also improved learning and understanding of the material as a result. The interactive LDI technique is an innovative, highly efficient and affordable tool to enhance student Histology learning, which is likely to expand knowledge and student perception of the subject and in turn enrich future science careers.     

Assessing how students value learning communication skills in an undergraduate anatomy and physiology course

Students, particularly those in science, technology, engineering and mathematics (STEM) and healthcare-related programs, should develop proficient interpersonal skills, including communication. To help students develop effective communication skills, instructors need to consider the value students give to learning these skills. The Student Attitudes Toward Communication Skills Survey (SATCSS) was developed to measure how undergraduate students value learning communication skills based on Expectancy-Value Theory across three modes of communication (verbal, written, non-verbal). The survey was given to students interested in healthcare professions and enrolled in an undergraduate anatomy and physiology (A&P) course (n = 233) at a Midwest research active university. The survey showed evidence of validity, measuring two components: (1) “Value to Profession” (attainment and utility value) and (2) “Value to Self” (intrinsic value and cost). There was a significant difference in sub-scores among the four task values such that students thought that learning communication skills was important and relevant (high attainment and utility value) but not interesting (low intrinsic value) and costly. Students with high total scores valued communication skills across all four task values. As total value scores decreased, it was first due to students finding learning communication skills to be time prohibitive and then a lack of interest in learning communication skills. Based on these results, it is recommended that instructors incorporate communication skills training into content that is already part of their A&P course to reduce time concerns. Additional recommendations include using reflective activities and humor to increase student interest.     

The implementation of clay modeling and rat dissection into the human anatomy and physiology curriculum of a large urban community college

After a considerable amount of research and experimentation, cat dissection was replaced with rat dissection and clay modeling in the human anatomy and physiology laboratory curricula at La Guardia Community College (LAGCC), a large urban community college of the City University of New York (CUNY). This article describes the challenges faculty overcame and the techniques used to solve them. Methods involved were: developing a laboratory manual in conjunction with the publisher, holding training sessions for faculty and staff, the development of instructional outlines for students and lesson plans for faculty, the installation of storage facilities to hold mannequins instead of cat specimens, and designing mannequin clean‐up techniques that could be used by more than one thousand students each semester. The effectiveness of these curricular changes was assessed by examining student muscle practical examination grades and the responses of faculty and students to questionnaires. The results demonstrated that the majority of faculty felt prepared to teach using clay modeling and believed the activity was effective in presenting lesson content. Students undertaking clay modeling had significantly higher muscle practical examination grades than students undertaking cat dissection, and the majority of students believed that clay modeling was an effective technique to learn human skeletal, respiratory, and cardiovascular anatomy, which included the names and locations of blood vessels. Furthermore, the majority of students felt that rat dissection helped them learn nervous, digestive, urinary, and reproductive system anatomy. Faculty experience at LAGCC may serve as a resource to other academic institutions developing new curricula for large, on‐going courses. Anat Sci Educ. 7: 38–46. © 2013 American Association of Anatomists.     

Integrating the iPod Touch in K–12 Education: Visions and Vices

Advocates of ubiquitous computing have long been documenting classroom benefits of one-to-one ratios of students to handheld or laptop computers. The recent sophisticated capabilities of the iPod Touch, iPhone, and iPad have encouraged further speculation on exactly how K–12 teaching and learning might be energized by such devices. This paper summarizes the research-to-date on mobile learning for K–12 students, and then delineates specific features and applications available on the iPod Touch that might impact student learning across the curricula. Finally, caveats are offered regarding the introduction and assimilation of these handheld computers into K–12 schools.     

An enriched multimedia eBook application to facilitate learning of anatomy

This pilot study compared the use of an enriched multimedia eBook with traditional methods for teaching the gross anatomy of the heart and great vessels. Seventy‐one first‐year students from an Australian medical school participated in the study. Students' abilities were examined by pretest, intervention, and post‐test measurements. Perceptions and attitudes toward eBook technology were examined by survey questions. Results indicated a strongly positive user experience coupled with increased marks; however, there were no statistically significant results for the eBook method of delivery alone outperforming the traditional anatomy practical session. Results did show a statistically significant difference in the final marks achieved based on the sequencing of the learning modalities. With initial interaction with the multimedia content followed by active experimentation in the anatomy lab, students' performance was improved in the final test. Obtained data support the role of eBook technology in modern anatomy curriculum being a useful adjunct to traditional methods. Further study is needed to investigate the importance of sequencing of teaching interventions. Anat Sci Educ. 7: 19–27. © 2013 American Association of Anatomists.     

Familiarity with Latin and Greek anatomical terms and course performance in undergraduates

Commonly used technical anatomy and physiology (A&P) terms are predominantly rooted in Latin and Greek vocabulary, so it is commonly inferred that a solid grounding in Latin and Greek roots of medical terminology will improve student learning in anatomy and related disciplines. This study examines the association of etymological knowledge of A&P terms and A&P course performance among 446 undergraduates in their first semester of the study of human gross anatomy and physiology, with a more detailed analysis of the characteristics of 52 students who filled out surveys about their prior knowledge and experiences related to medicine or anatomy. In both data sets, there was only a weak positive correlation between the performance on a quiz of Latin and Greek medical terms and the students' performance on regular assignments. The presumption that familiarity with Latin and Greek word roots has a strong influence on successful learning of anatomy is not supported by these data. Future research should address whether or not there are particular skills associated with using etymological knowledge in improving A&P course performance.     

The use of limericks to engage student interest and promote active learning in an undergraduate course in functional anatomy

The study of anatomy is a content-dense discipline with a challenging vocabulary. A mnemonic is a series of letters, a word, a phrase, or a rhyme that students can use when studying to facilitate recall. This project was designed to promote active learning in undergraduate students studying anatomy and physiology by asking them to create limericks based on course content and then to evaluate the limericks written by their peers for learning value, accuracy, style, and adherence to limerick characteristics. Students (278 and 288, respectively, in the 2009 and 2010 sections of ANP1107) worked in groups of three to create a total of 242 limericks. Peer evaluation was accomplished in two stages using a 20-point marking rubric. In Stage 1, students were randomly divided into 10 groups (n = 23 ± 2 students) with each group member evaluating the same 12 ± 1 limericks. In Stage 2, the top 19% of limericks were reevaluated by all students so that the best three could be chosen. In each of the two years, 60% of students completed all parts of the assignment. Higher percentages (75-80%) participated in limerick writing and one of the two assessment stages. A positive association was noted between level of student participation in the limerick assignment and final course marks. Limerick creation and evaluation can be used to promote active learning by encouraging students to review functional-anatomy-based content to create limericks with good learning value and to provide valid assessments of limericks written by their peers.     

Influence of study approaches and course design on academic success in the undergraduate anatomy laboratory

Many pre‐health professional programs require completion of an undergraduate anatomy course with a laboratory component, yet grades in these courses are often low. Many students perceive anatomy as a more challenging subject than other coursework, and the resulting anxiety surrounding this perception may be a significant contributor to poor performance. Well‐planned and deliberate guidance from instructors, as well as thoughtful course design, may be necessary to assist students in finding the best approach to studying for anatomy. This article assesses which study habits are associated with course success and whether course design influences study habits. Surveys (n = 1,274) were administered to students enrolled in three undergraduate human anatomy laboratory courses with varying levels of cooperative learning and structured guidance. The surveys collected information on potential predictors of performance, including student demographics, educational background, self‐assessment ability, and study methods (e.g., flashcards, textbooks, diagrams). Compared to low performers, high performers perceive studying in laboratory, asking the instructor questions, quizzing alone, and quizzing others as more effective for learning. Additionally, students co‐enrolled in a flipped, active lecture anatomy course achieve higher grades and find active learning activities (e.g., quizzing alone and in groups) more helpful for their learning in the laboratory. These results strengthen previous research suggesting that student performance is more greatly enhanced by an active classroom environment that practices successful study strategies rather than one that simply encourages students to employ such strategies inside and outside the classroom. Anat Sci Educ 11: 496–509. © 2018 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.     

Reflections as near‐peer facilitators of an inquiry project for undergraduate anatomy: Successes and challenges from a term of trial‐and‐error

Near‐peer facilitators (senior students serving as facilitators to their more junior peers) bring a unique student‐based perspective to teaching. With fewer years of teaching experience however, students who become involved in a facilitator role typically develop related skills quickly through a process of trial‐and‐error within the classroom. The aim of this paper is to report on the authors' own experiences and reflections as student near‐peer facilitators for an inquiry‐based project in an undergraduate anatomy course. Three areas of the facilitator experience are explored: (1) offering adequate guidance as facilitators of inquiry, (2) motivating students to engage in the inquiry process, and (3) fostering creativity in learning. A practical framework for providing guidance to students is discussed which offers facilitators a scaffold for asking questions and assisting students through the inquiry process. Considerations for stimulating intrinsic motivations toward inquiry learning are made, paying attention to ways in which facilitators might influence feelings of motivation towards learning. Also, the role of creativity in inquiry learning is explored by highlighting the actions facilitators can take to foster a creative learning environment. Finally, recommendations are made for the development of formalized training programs that aid near‐peer facilitators in the acquisition of facilitation skills before entering into a process of trial‐and‐error within the classroom. Anat Sci Educ. 7: 64–70. © 2013 American Association of Anatomists.     

Dyad pedagogy in practical anatomy: A description of the implementation and student perceptions of an adaptive approach to cadaveric teaching

Prior to the challenges imposed by the Covid-19 pandemic, anatomy practical sessions at Trinity College Dublin involved eight to 10 students per donor station, rotating between digital learning, anatomical models/osteology, and dissection activities for three hours weekly. To maintain cadaveric participation in the anatomy laboratory while adhering to distancing guidelines, a transition to dyad pedagogy was implemented. This mode of delivery allowed two students per donor station to spend one hour per week in the anatomy laboratory with all digital learning elements transferred to the virtual learning platform Blackboard as pre- and post-practical session learning activities. Dyad pedagogy has been explored in clinical settings and simulation procedural-based training but is yet to be fully verified in anatomy education. To determine the effectiveness of hybrid practical sessions and reduced donor to student ratios, the opinions of first year medical students were examined using an online questionnaire with a 51% response rate. Although students recognized the merits of more time in the anatomy laboratory, including opportunities for self-directed study and exposure to anatomical variation, they felt that having two students per station enabled sufficient hands-on time with the donor body and fostered learning opportunities that would not be possible with larger groups. Strong preferences for quality time with the donor body supported by online resources suggests this modality should be a key consideration in course design for anatomy curricula and emphasizes the importance of gauging students' preferences to optimize satisfaction and learning output when pivoting to blended learning strategies in anatomy education.     

A psychometric evaluation of the anatomy learning experiences questionnaire and correlations with learning outcomes

The Anatomy Learning Experiences Questionnaire (ALEQ) was designed by Smith and Mathias to explore students' perceptions and experiences of learning anatomy. In this study, the psychometric properties of a slightly altered 34‐item ALEQ (ALEQ‐34) were evaluated, and correlations with learning outcomes investigated, by surveying first‐ and second‐year undergraduate medical students; 181 usable responses were obtained (75% response rate). Psychometric analysis demonstrated overall good reliability (Cronbach's alpha of 0.85). Exploratory factor analysis yielded a 27‐item, three‐factor solution (ALEQ‐27, Cronbach's alpha of 0.86), described as: (Factor 1) (Reversed) challenges in learning anatomy, (Factor 2) Applications and importance of anatomy, and (Factor 3) Learning in the dissection laboratory. Second‐year students had somewhat greater challenges and less positive attitudes in learning anatomy than first‐year students. Females reported slightly greater challenges and less confidence in learning anatomy than males. Total scores on summative gross anatomy examination questions correlated with ALEQ‐27, Pearson's r = 0.222 and 0.271, in years 1 and 2, respectively, and with Factor 1, r = 0.479 and 0.317 (all statistically significant). Factor 1 also had similar correlations across different question types (multiple choice; short answer or essay; cadaveric; and anatomical models, bones, or radiological images). In a retrospective analysis, Factor 1 predicted poor end‐of‐semester anatomy examination results in year 1 with a sensitivity of 88% and positive predictive value of 33%. Further development of ALEQ‐27 may enable deeper understanding of students' learning of anatomy, and its ten‐item Factor 1 may be a useful screening tool to identify at‐risk students. Anat Sci Educ 10: 514–527. © 2017 American Association of Anatomists.     

The LINDSAY Virtual Human Project: An immersive approach to anatomy and physiology

The increasing number of digital anatomy teaching software packages challenges anatomy educators on how to best integrate these tools for teaching and learning. Realistically, there exists a complex interplay of design, implementation, politics, and learning needs in the development and integration of software for education, each of which may be further amplified by the somewhat siloed roles of programmers, faculty, and students. LINDSAY Presenter is newly designed software that permits faculty and students to model and manipulate three‐dimensional anatomy presentations and images, while including embedded quizzes, links, and text‐based content. A validated tool measuring impact across pedagogy, resources, interactivity, freedom, granularity, and factors outside the immediate learning event was used in conjunction with observation, field notes, and focus groups to critically examine the impact of attitudes and perceptions of all stakeholders in the early implementation of LINDSAY Presenter before and after a three‐week trial period with the software. Results demonstrate that external, personal media usage, along with students' awareness of the need to apply anatomy to clinical professional situations drove expectations of LINDSAY Presenter. A focus on the software over learning, which can be expected during initial orientation, surprisingly remained after three weeks of use. The time‐intensive investment required to create learning content is a detractor from user‐generated content and may reflect the consumption nature of other forms of digital learning. Early excitement over new technologies needs to be tempered with clear understanding of what learning is afforded, and how these constructively support future application and integration into professional practice. Anat Sci Educ. © 2012 American Association of Anatomists.     

Development of a supported self-directed learning approach for anatomy education

The ability to deliver sufficient core anatomical knowledge and understanding to medical students with limited time and resources remains a major challenge for anatomy educators. Here, we report the results of switching from a primarily didactic method of teaching to supported self-directed learning for students studying anatomy as part of undergraduate medicine at the University of Edinburgh. The supported self-directed approach we have developed makes use of an integrated range of resources, including formal lectures and practical sessions (incorporating gross anatomy specimens, medical imaging technologies, anatomical models, clinical scenarios, and surface anatomy workstations). In practical sessions, students are provided with a custom-made workbook that guides them through each session, with academic staff, postgraduate tutors, and near-peer teaching assistants present to deal with misunderstandings and explain more complicated topics. This approach retains many of the best attributes of didactic teaching but blends them with the advantages associated with self-directed learning approaches. The switch to supported self-directed learning-initially introduced in 2005-resulted in a significant improvement in anatomy examination scores over the subsequent period of five years, manifesting as an increase in the average anatomy practical spot examination mark, less students failing to obtain the pass mark and more students passing with distinction. We conclude that the introduction of supported self-directed learning improved students' engagement, leading to deeper learning and better understanding and knowledge of anatomy.     

A survey of anatomy and physiology pedagogy and lifestyle factors in undergraduate medical students in Zimbabwe

Abstract

Studies on health pedagogy in medical students in African universities are lacking. The aim of the current investigation was to assess the following pedagogy influences on second year Zimbabwean medical students’ well-being. A group of 100 students studying Physiology and Anatomy in MBChB. II program at the University of Zimbabwe College of Health Sciences were asked to voluntarily complete a structured questionnaire. As Physiology was examinable, students desired to practice MCQ questions. Dissection was regarded as excellent for medical knowledge. The stress of study probably necessitated the drinking of alcohol. Most of the respondents did not actively smoke. Although students knew about calories, they were unaware of the daily requirements. Their diets were mostly balanced. Music helped alleviate stress. Stress levels were high although no overwhelming effects on general health were observed. IT use was rated well although the slow internet was problematic. We encourage more studies on medical students in central and southern Africa.     

Improved medical student perception of ultrasound using a paired anatomy teaching assistant and clinician teaching model

This study describes a new teaching model for ultrasound (US) training, and evaluates its effect on medical student attitudes toward US. First year medical students participated in hands‐on US during human gross anatomy (2014 N = 183; 2015 N = 182). The sessions were facilitated by clinicians alone in 2014, and by anatomy teaching assistant (TA)‐clinician pairs in 2015. Both cohorts completed course evaluations which included five US‐related items on a four‐point scale; cohort responses were compared using Mann‐Whitney U tests with significance threshold set at 0.05. The 2015 survey also evaluated the TAs (three items, five‐point scale). With the adoption of the TA‐clinician teaching model, student ratings increased significantly for four out of five US‐items: “US advanced my ability to learn anatomy” increased from 2.91 ± 0.77 to 3.35 ± 0.68 (P < 0.0001), “Incorporating US increased my interest in anatomy” from 3.05 ± 0.84 to 3.50 ± 0.71 (P < 0.0001), “US is relevant to my current educational needs” from 3.36 ± 0.63 to 3.54 ± 0.53 (P = 0.015), and “US training should start in Phase I” from 3.36 ± 0.71 to 3.56 ± 0.59 (P = 0.010). Moreover, more than 84% of students reported that TAs enhanced their understanding of anatomy (mean 4.18 ± 0.86), were a valuable part of US training (mean 4.23 ± 0.89), and deemed the TAs proficient in US (mean 4.24 ± 0.86). By using an anatomy TA‐clinician teaching team, this study demonstrated significant improvements in student perceptions of the impact of US on anatomy education and the relevancy of US training to the early stages of medical education. Anat Sci Educ 11: 175–184. © 2017 American Association of Anatomists.     

Student perceptions of an upper-level, undergraduate human anatomy laboratory course without cadavers

Several programs in health professional education require or are considering requiring upper-level human anatomy as prerequisite for their applicants. Undergraduate students are confronted with few institutions offering such a course, in part because of the expense and logistical issues associated with a cadaver-based human anatomy course. This study describes the development of and student reactions to an upper-level human anatomy laboratory course for undergraduate students that used a regional approach and contemporary, alternative teaching methods to a cadaver-based course. The alternative pedagogy to deliver the curriculum included use of commercially available, three-dimensional anatomical virtual dissection software, anatomical models coupled with a learning management system to offer Web-based learning, and a new laboratory manual with collaborative exercises designed to develop the student's anatomical skills and collaborative team skills. A Likert-scale survey with open-ended questions was used to ascertain student perceptions of the course and its various aspects. Students perceived that the noncadaver-based, upper-level human anatomy course with an engaging, regional approach is highly valuable in their learning of anatomy. anatomy.     

The effects of passive and active learning on student preference and performance in an undergraduate basic science course

Active learning is based on self-directed and autonomous teaching methods, whereas passive learning is grounded in instructor taught lectures. An animal physiology course was studied over a two-year period (Year 1, n = 42 students; Year 2, n = 30 students) to determine the effects of student-led seminar (andragogical) and lecture (pedagogical) teaching methods on students' retention of information and performance. For each year of the study, the course was divided into two time periods. The first half was dedicated to instructor-led lectures, followed by a control survey in which the students rated the efficiency of pedagogical learning on a five-point Likert scale from one (strongly disagree) to five (strongly agree). During the second period, students engaged in andragogical learning via peer-led seminars. An experimental survey was then administered to students using the same scale as above to determine students' preferred teaching method. Raw examination scores and survey results from both halves of the course were statistically analyzed by ANOVA with Newman-Keuls multiple comparison test. By the end of the study, student preference for peer-led seminars increased [mean ± SD: (2.47 ± 0.94)/(4.03 ± 1.36), P < 0.04], and examination scores significantly increased [mean ± SD: (73.91% ± 13.18)/(85.77 ± 5.22), P < 0.001]. A majority of students (68.8%) preferred a method that contained peer-led seminars and instructor-led lectures. These results may indicate that integration of active and passive learning into undergraduate courses may have greater benefit in terms of student preference and performance than either method alone.