National Survey on Canadian Undergraduate Medical Programs: The Decline of the Anatomical Sciences in Canadian Medical Education

The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.     

Anatomical Sciences in Chiropractic Education: A Survey of Chiropractic Programs in Australia

Human anatomy knowledge is a core requirement for all health care clinicians. There is a paucity of information relating to anatomy content and delivery in Australian chiropractic programs. The aim of this study was to describe anatomy teaching in Australian chiropractic programs, utilizing a survey which was distributed to all four programs, requesting information on: anatomy program structure, delivery methods, assessment, teaching resources, and academic staff profile at their institution. The survey was undertaken in 2016 and documented practices in that academic year. All four institutions responded. There was a reported difference in the teaching hours, content, delivery and assessment of anatomy utilized in Australian chiropractic programs. Anatomy was compulsory at all four institutions with the mean total of 214 (SD ± 100.2) teaching hours. Teaching was undertaken by permanent ongoing (30%) and sessional academic staff, and student to teacher ratio varied from 15:1 to 12:1. A variety of teaching resources were utilized, including human tissue access, either as prosected cadavers or plastinated body parts. The results of this survey confirm that anatomy has an established place in chiropractic education programs in Australia and while curricular variations exist, all programs had similar course design, delivery, and assessment methods. This study confirmed the provision of a strong foundation in topographical anatomy and neuroanatomy, while other anatomical sciences, such as histology and embryology were not consistently delivered. Formalization of a core anatomy curriculum together with competency standards is needed to assist program evaluation and development, and for accreditation purposes.     

Mexican Educators Survey on Anatomical Sciences Education and a Review of World Tendencies

Anatomical sciences curricula have been under constant reform over the years, with many countries having to reduce course hours while trying to preserve laboratory time. In Mexico, schools have historically been autonomous and unregulated, and data regarding structure and methods are still lacking. A national survey was sent by the Mexican Society of Anatomy to 110 anatomical sciences educators. The questionnaire consisted of 50 items (open and multiple choice) for gross anatomy, microscopic anatomy, neuroanatomy, and embryology courses in medical schools across Mexico. A clinical approach was the most common course approach in all disciplines. Contact course hours and laboratory hours were higher in Mexican anatomy education compared to other countries, with the highest reported contact hours for embryology (133.4 ± 44.1) and histology (125 ± 33.2). There were similar contact hours to other countries for gross anatomy (228.5 ± 60.5). Neuroanatomy course hours (43.9 ± 13.1) were less than reported by the United States and similar to Saudi Arabia and higher than the United Kingdom. Dissection and microscopy with histological slides predominate as the most common laboratory activities. Traditional methods prevail in most of the courses in Mexico and only a few educators have implemented innovative and technological tools. Implementation of new methods, approaches, and curricular changes are needed to enhance anatomical sciences education in Mexico.     

The Use of Anatomical Dissection Videos in Medical Education

Dissection videos are commonly utilized in gross anatomy courses; however, the actual usage of such videos, as well as the academic impact of student use of these videos, is largely unknown. Understanding how dissection videos impact learning is important in making curricular decisions. In this study, 22 dissection videos were created to review structures identified in laboratory sessions throughout the Organ Systems 1 (OS1), 2 (OS2), and 3 (OS3) courses. Dissection videos were provided to 201 first-year medical students, and viewing data were recorded. Demographic data for age and gender identity were also collected from students. Overall, there was a significant decrease in total views (P = 0.001), the number of students who pressed play (P < 0.001), and the number of students who viewed ≥ 90% of the total length of videos (P < 0.001) from OS1 to OS3. The total adjusted time spent viewing videos was not significantly different between individual OS courses. There were some instances where significant differences existed in examination performance between those who did and did not view videos, and by time spent viewing videos. There were no significant differences in time spent viewing videos by gender. Together these data suggest that students may utilize dissection videos more at the beginning of a dissection course, although they remain an important resource throughout the year for a subset of students.     

Strength,Weakness, Opportunity,Threat (SWOT) Analysis of the Adaptations to Anatomical Education in the United Kingdom and Republic of Ireland in Response to the Covid-19 Pandemic

The Covid-19 pandemic has driven the fastest changes to higher education across the globe, necessitated by social distancing measures preventing face-to-face teaching. This has led to an almost immediate switch to distance learning by higher education institutions. Anatomy faces some unique challenges. Intrinsically, anatomy is a three-dimensional subject that requires a sound understanding of the relationships between structures, often achieved by the study of human cadaveric material, models, and virtual resources. This study sought to identify the approaches taken in the United Kingdom and Republic of Ireland to deliver anatomical education through online means. Data were collected from 14 different universities in the United Kingdom and Republic of Ireland and compared adopting a thematic analysis approach. Once themes were generated, they were collectively brought together using a strength, weakness, opportunity, threat (SWOT) analysis. Key themes included the opportunity to develop new online resources and the chance to engage in new academic collaborations. Academics frequently mentioned the challenge that time constrains could place on the quality and effectiveness of these resources; especially as in many cases the aim of these resources was to compensate for a lack of exposure to cadaveric exposure. Comparisons of the actions taken by multiple higher education institutions reveal the ways that academics have tried to balance this demand. Discussions will facilitate decisions being made by higher education institutions regarding adapting the curriculum and assessment methods in anatomy.     

价值工程在成本法估价中的运用

分析了目前房地产成本法估价中存在的问题,对价值工程原理进行介绍,把价值工程的分析方法运用到房屋价值的评估中,对房屋的功能进行评价,进行房屋价值分析,并通过案例进行说明。     

Beyond the Sex Binary: Toward the Inclusive Anatomical Sciences Education

Developments in biology and genetics in recent decades have caused significant shifts in the understanding and conceptualization of human biological variation. Humans vary biologically in different ways, including individually, due to age, ancestry, and sex. An understanding of the complexities of all levels of biological variation is necessary for efficient health care delivery. Important steps in teaching medical students about human variation could be carried out in anatomy classes, and thus, it is important that anatomical education absorbs new developments in how biological variation is comprehended. Since the early 1990s biological sex in humans has been vigorously investigated by scientists, social scientists, and interest groups. Consequently, the binary division in male and female sex has been called into question and a more fluid understanding of sex has been proposed. Some of the major textbooks teach anatomy, particularly of the urogenital system, as a male-female binary. Anatomical sciences curricula need to adopt a more current approach to sex including the introduction of the category of “intersex”/“differences in sexual development” and present sex as a continuum rather than two sharply divided sets of characteristics. This approach offers a better understanding of the complexity of sex differences and, at the same time, provides students with an improved theoretical framework for understanding human variation in general, transcending the limitations of biological typology. When well delivered, the non-binary approach could play a significant contribution to the formation of competent and responsible medical practitioners and avoidance of problematic practices such as non-consensual “normalizing” surgeries.     

我国高等教育成本分担特点及发展趋势预测

我国高等教育成本分担体制从新中国成立到现在经历了国家财政负担和国家负担为主,个人、社会分担为辅的两个发展阶段。文章通过对两个发展阶段的特点分析,寻找高等教育成本分担体制形成、发展和变化的轨迹,找出影响高等教育成本分担的主要因素,根据我国国情和主要因素的变化,对未来我国高等教育成本分担发展趋势进行了分析预测。     

Assessing the impact of the Graduate Certificate in Anatomical Sciences Instruction: A post‐degree survey

There are few graduate programs available for pursuing a doctorate in anatomy where students gain specific training in gross anatomy dissection and the responsibilities of a medical educator. In light of this fact, the University of Kentucky created a Graduate Certificate in Anatomical Sciences Instruction in 2006. This 12‐credit hour curriculum includes detailed training in gross anatomy and/or neuroscience courses, practicum experiences, a seminar class in pedagogical literature, and a course in educational strategies for the anatomical sciences. The award of certificate completion affirms that the candidate has demonstrated faculty‐supervised proficiency in anatomy dissection, instruction in anatomy topics, and teaching strategies for anatomy. Seventeen graduate students have earned the certificate since its inception; nine students accepted teaching positions in anatomy following their graduate training and currently nine certificate graduates have assistant (six) or associate (three) professor positions in academia. In 2016, an anonymous survey including Likert‐style and open‐ended questions was emailed to all certificate graduates. Graduates favorably responded (each question averaged 4.4 or greater out of 5) that the certificate increased their awareness of teaching‐faculty responsibilities, adequately prepared them for teaching‐related duties, and positively contributed toward their first employment. Graduates indicated that the lecturing and dissection experience, awareness of faculty responsibilities, and job preparation (e.g., teaching philosophy development) were the most helpful aspects of the certificate. These results indicate that the Graduate Certificate in Anatomical Sciences Instruction is viewed by its graduates and their employers as a valuable teaching credential that can be attained alongside a basic science degree. Anat Sci Educ 11: 516–524. © 2018 American Association of Anatomists.     

The Role of History and Ethics of Anatomy in Medical Education

While time spent on anatomical education in medical school curricula has been diminishing over the last decades, the recognized role of anatomical dissection has expanded. It is perceived by many students and faculty not only as the means of learning the structure and function of the human body, but also as an opportunity for the acquisition of professional competencies such as team work, patient–doctor interaction, medical epistemology, self-awareness, and an understanding of medical ethics. This viewpoint article proposes that this learning process can be supported effectively through studying examples from the history of anatomy, as insights from this history can help illuminate contemporary ethical issues in anatomy and medicine. Anatomical education can thus provide not only the opportunity of gaining awareness of ethical questions, but also a chance to practice these new insights within the protected environment of the laboratories, in interaction with the dead and the living. Consequently, a new role has developed for anatomists, which includes the interweaving of the scholarly exploration of the history and ethics of anatomy with the practical application of research results into a reframed concept of anatomical education. Anatomy, as a foundational discipline in the medical curriculum, can thus provide a first step on the educational path of empathetic and humane medical caregivers.     

The Effect of Passive and Active Education Methods Applied in Repetition Activities on the Retention of Anatomical Knowledge

This study examines the long-term retention of anatomical knowledge from 180 students after various repetition activities. The retention of anatomical knowledge was assessed by multiple-choice tests at five different points in time: before and after a course in Functional Anatomy, before and after repetition activities that occurred 14 weeks after this course, and 28 weeks after this course to establish long-term retention. Students were divided into five groups: one without any repetition activity, one with a restricted repetition activity (the multiple-choice test), and three groups that were offered repetition activities (traditional lecture, e-learning module, and small group work in the dissection room). During all three repetition activities the same information was conveyed, and this content was not revisited in other courses for the duration of the study. The results showed that students who did not engage in a repetition activity scored significantly lower on the long-term retention test compared to all other groups (ANCOVA: P = 0.0001). Pair-wise comparison with estimated means showed that the other four groups, regardless of the type of repeating activity, did not differ in the amount of knowledge they retained during any of the five assessments (P = 0.008, P = 0.0001, P = 0.001, and P = 0.0001, respectively). This study suggests that the type of repetition activity has no effect on knowledge retention both immediately following the activity and in the long term. It is concluded that the repetition of anatomical knowledge in any form is beneficial for students and will likely improve student outcomes in a curriculum that builds on prior knowledge.     

教育研究改进:教育发展方式转变的理论保障

目前,我们的教育研究难以为教育发展方式的转变提供有效的智力支持与技术保证。本文从研究主体、研究目的、研究内容、研究方法、研究评价等维度,分析理论人的研究、实践人的研究、大学中小学合作研究的缺陷与不足,提出从教育研究的价值取向、组织管理、技术方法等多方面入手,全系统、多角度地进行教育研究改进,以提高教育发展的理性化水平。     

Strengths and Weaknesses of Non-enhanced and Contrast-enhanced Cadaver Computed Tomography Scans in the Teaching of Gross Anatomy in an Integrated Curriculum

Cadaver-specific postmortem computed tomography (PMCT) has become an integral part in anatomy teaching at several universities. Recently, the feasibility of contrast-enhanced (CE)-PMCT has been demonstrated. The purpose of this study was to identify particular strengths and weaknesses of both non-enhanced and contrast-enhanced PMCT compared to conventional cadaver dissection. First, the students’ perception of the learning effectiveness of the three different modalities have been assessed using a 34-item survey (five-point Likert scale) covering all anatomy course modules. Results were compared using the nonparametric Friedman Test. Second, the most frequent artifacts in cadaver CT scans, were systematically analyzed in 122 PMCT and 31 CE-PMCT data sets to quantify method-related limitations and characteristics. Perfusion quality was assessed in 57 vascular segments (38 arterial and 19 venous). The survey was answered by n = 257/320 (80.3%) students. Increased learning benefits of PMCT/ CE-PMCT compared to cadaver dissection were found in osteology (2/3 categories, P < 0.001), head and neck (2/5 categories, P < 0.01), and brain anatomy (3/3 categories, P < 0.01). Contrast-enhanced-PMCT was perceived particularly useful in learning vascular anatomy (10/10 categories, P < 0.01). Cadaver dissection received significantly higher scores compared to PMCT and CE-PMCT in all categories of the abdomen and thorax (7/7 categories, P < 0.001), as well as the majority of muscular anatomy (5/6 categories, P < 0.001). Frequent postmortem artifacts (total n = 28, native-phase n = 21, contrast injection-related n = 7) were identified and assessed. The results of this work contribute to the understanding of the value of integrating cadaver-specific PMCT in anatomy teaching.     

高等教育腐败的代价

本文以高等教育领域的腐败问题为考察对象,揭示了该现象在中亚和东欧国家的普遍存在.文中的腐败既包括高校管理人员在认证、采购、录取和评分环节发生的行贿受贿行为,也包括学生和老师在评分、考试以及教科书购买环节发生的行贿受贿行为.腐败现象日益严重的原因在于,转型时期决策权的下放和高等院校相关经验的缺乏.本文运用中亚和东欧六国学生调查的数据,阐明了这些国家教育领域的腐败问题较之北美和西欧的严重程度.文章还对遏制腐败的措施、调查中的统计数据以及腐败给国家带来的损失进行了探讨.     

现代性:语文教育的百年价值诉求

在百年语文教育变革中,现代性的核心价值从不同向度建构了语文教育现代性的历史谱系。一方面,现代性的核心价值并非均衡地参与,因而造成语文教育现代性的生成及变革呈现出不平衡及单一性等特点;另一方面,在不同历史阶段,现代性的核心价值又被反复确认,并被不断重写。在现代性的核心价值之间,又存在着既矛盾、冲突又暧昧的关系。在时代的精神状况之下,重建语文教育既要重估经典教育的价值,又不能拒绝生活关怀;既要深刻反思科学在语文教育中的价值与作用,又要从语文学科人文性及汉语语言本身的特性出发。     

The body donation program at the Federal University of Health Sciences of Porto Alegre: A successful experience in Brazil

The use of dissection to study human anatomy is the foundation for educational excellence among future health professionals, as it offers an ideal opportunity to learn the body's morphology in three dimensions while also providing students with a more humanistic education. The shortage of bodies for dissection, combined with the Brazilian population's lack of knowledge concerning the possibility of voluntarily donating their own bodies, led to the creation of the Body Donation Programs for Education and Research in Anatomy at the Federal University of Health Sciences of Porto Alegre (UFCSPA). The program is based on three pillars: Informing the general public about the program, donor registration, and donation itself. Since the creation of the donor program in 2008, there has been an increase in both the number of donations made during donor's lifetime and the number of bodies received by the university. There has also been a shift in relation to the origin of these bodies, as before the creation of the program most bodies were unclaimed cadavers, while today most of the bodies are sourced from voluntary donations. The initial results regarding the public's acceptance of the possibility of making body donations have been encouraging, as shown by the annual growth in donor registrations. Consequently, the quality and quantity of the material available for educational purposes have greatly improved. Anat Sci Educ. © 2013 American Association of Anatomists.     

美国高等教育经济学研究:几个主要研究问题

近几十年来,高等教育经济学的研究取得了蓬勃发展.本文在对该领域的研究成果进行系统梳理的基础上,归纳出美国高等教育经济学研究的五大主题并逐一进行述评,这五大主题分别是:高等教育的回报、高等教育的需求、大学的运作及成本、高等教育市场的竞争和学术劳动力市场.这些研究主题大多与美国高等教育领域的重大政策议题密切相关.     

我国高等教育评估的成本与效益研究

研究高等教育评估的成本和效益对于考察评估的质量与成效,提高评估资源的利用效率有着重要的作用与意义。本文对高等教育评估成本和效益的概念、类别及其构成进行探讨,并从管理效益原理出发,对高等教育评估成本——效益分析的原则和高等教育评估活动中的成本、效益体现进行了总结,对我国高等教育评估的成效作了现实分析。     

在经济学中使用数学方法的收益与成本分析

经济学的发展表明,数学方法是经济学中最重要的方法之一,是经济理论取得突破的重要工具.但是目前经济学也存在着数学形式主义的倾向,引起了一些经济学家的批评.本文力图在简要回顾在西方经济学中使用数学方法的历史后,对经济学中使用数学方法带来的收益与成本作具体分析,并对其运用的利弊权衡和应持的态度进行探讨.