Medical student use of Facebook to support preparation for anatomy assessments

The use of Facebook to support students is an emerging area of educational research. This study explored how a Facebook Page could support Year 2 medical (MBChB) students in preparation for summative anatomy assessments and alleviate test anxiety. Overall, Facebook analytics revealed that in total 49 (19.8% of entire cohort) students posted a comment in preparation for either the first (33 students) or second (34) summative anatomy assessments. 18 students commented in preparation for both. In total, 155 comments were posted, with 83 for the first and 72 for the second. Of the 83 comments, 45 related to checking anatomical information, 30 were requiring assessment information and 8 wanted general course information. For the second assessment this was 52, 14 and 6, respectively. Student perceptions on usage, and impact on learning and assessment preparation were obtained via a five‐point Likert‐style questionnaire, with 119 students confirming they accessed the Page. Generally, students believed the Page was an effective way to support their learning, and provided information which supported their preparation with increases in perceived confidence and reductions in anxiety. There was no difference between gender, except for males who appeared to be significantly less likely to ask a question as they may be perceived to lack knowledge (P < 0.05). This study suggests that Facebook can play an important role in supporting students in preparation for anatomy assessments. Anat Sci Educ 10: 205–214. © 2016 American Association of Anatomists.     

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.     

Clay modeling versus written modules as effective interventions in understanding human anatomy

The effectiveness of clay modeling to written modules is examined to determine the degree of improvement in learning and retention of anatomical 3D relationships among students with different learning preferences. Thirty‐nine undergraduate students enrolled in a cadaver dissection course completed a pre‐assessment examination and the VARK questionnaire, classifying learning preference as visual, auditory, read/write, or kinesthetic. Students were divided into clay, module, and control groups with preference for learning style distributed among groups. The clay and module groups participated in weekly one‐hour classes using either clay models or answering written questions (modules) about anatomical relationships, respectively. The control group received no intervention. Post‐assessment and retention examinations were administered at the end of the semester, and three months later, respectively. Two variables (Δ1, Δ2) represented examination score differences between pre‐ and post‐assessment and between post‐assessment and retention examinations, respectively. The Δ1 for clay and module groups were each significantly higher than controls (21.46 ± 8.2 vs. 15.70 ± 7.5, P ≤ 0.05; and 21.31 ± 6.9 vs. 15.70 ± 7.5, P ≤0.05, respectively). The Δ2 for clay and module groups approached but did not achieve significance over controls (?6.09 ± 5.07 vs. ?8.80 ± 4.60, P = 0.16 and ?5.73 ± 4.47 vs. ?8.80 ± 4.60, P = 0.12, respectively). No significant differences were seen between interventions or learning preferences in any group. However, students of some learning styles tended to perform better when engaging in certain modalities. Multiple teaching modalities may accommodate learning preferences and improve understanding of anatomy. Anat Sci Educ. © 2013 American Association of Anatomists.     

Modified team‐based learning strategy to improve human anatomy learning: A pilot study at the Universidad del Norte in Barranquilla,Colombia

As part of an institutional program sponsored by the Centre for Teaching Excellence at the Universidad del Norte, Barranquilla, Colombia, we developed an educational research study on two sessions of human anatomy in which we combined team‐based learning (TBL) and the use of iPads. Study data included the TBL, assessments applied during the course, student's grades on mid‐term examinations and students' perceptions of their experiences. Students reported a positive attitude toward the use of the TBL sessions, and the results showed a significant improvement in their learning between the first and second sessions. Significantly positive correlations (P < 0.05) were obtained between (a) the individual students' readiness test performance 1 and mid‐term examination 1, (b) the individual readiness test performances from Session 1 to Session 2, and (c) the group readiness test performances from the first and second sessions. These results point to positive learning experiences for these students. Analyses of the students' reflections on their activities also pointed toward future challenges. Anat Sci Educ 7: 399–405. © 2014 American Association of Anatomists.     

Independent learning modules enhance student performance and understanding of anatomy

Didactic lessons are only one part of the multimodal teaching strategies used in gross anatomy courses today. Increased emphasis is placed on providing more opportunities for students to develop lifelong learning and critical thinking skills during medical training. In a pilot program designed to promote more engaged and independent learning in anatomy, self‐study modules were introduced to supplement human gross anatomy instruction at Joan C. Edwards School of Medicine at Marshall University. Modules use three‐dimensional constructs to help students understand complex anatomical regions. Resources are self‐contained in portable bins and are accessible at any time. Students use modules individually or in groups in a structured self‐study format that augments material presented in lecture and laboratory. Pilot outcome data, measured by feedback surveys and examination performance statistics, suggest that the activity may be improving learning in gross anatomy. Positive feedback on both pre‐ and post‐examination surveys showed that students felt the activity helped to increase their understanding of the topic. In concordance with student perception, average examination scores on module‐related laboratory and lecture questions were higher in the two years of the pilot program compared with the year before its initiation. Modules can be fabricated on a modest budget using minimal resources, making implementation practical for smaller institutions. Upper level medical students assist in module design and upkeep, enabling continuous opportunities for vertical integration across the curriculum. This resource offers a feasible mechanism for enhancing independent and lifelong learning competencies, which could be a valuable complement to any gross anatomy curriculum. Anat Sci Educ 7: 406–416. © 2014 American Association of Anatomists.     

Development of a didactical training concept for peer tutors in gross anatomy

Even though peer tutors are often used in gross anatomy courses, research in the field is rather a subject of the last two decades. This is especially true about the didactical challenges these types of peer tutors experience during their tutorials and about how they are prepared for the task. The aim of the presented study was to learn about the training needs of the tutors, and to subsequently design, implement, and evaluate a didactical training concept. A qualitative design was chosen to examine how tutors can best be prepared for tutorials of gross anatomy. To do so, focus group interviews were conducted. The data were analyzed and grouped into various concepts, using semi‐structured interview questions as guidance. It was found that peer tutors are in need of training in the following aspects: Dealing with students who are experiencing difficulties during or as a result of dissection, dealing with group dynamics, that is, at the dissection table, keeping students motivated, time management, and staying confident as a tutor. In order to be regarded as useful and relevant in the eyes of tutors, a preparatory training course should include all these aspects in addition to general didactical training elements. Training needs of peer tutors of gross anatomy go beyond the content of standardized didactical curricula; therefore, tutors should be prepared with a curriculum that is specifically geared toward the many challenges associated with teaching gross anatomy to first year medical students which are already so well documented in the research literature. Anat Sci Educ 10: 495–502. © 2017 American Association of Anatomists.     

The anatomy of self‐defense

The following study describes a creative application of anatomical principles in the instruction of self‐defense. Undergraduates at the University of Kentucky were invited to a special lecture that featured a series of self‐defense moves introduced by a local police officer. Following a demonstration of each self‐defense tactic, the students were briefed on the anatomy of both the victim and the assailant that contributed to the overall effectiveness of each move. This approach was unique in that students learned critical knowledge of self‐defense while reinforcing anatomical principles previously introduced in class. Moreover, this integration of topics prompted students to think about their response to potentially dangerous situations on campus. Anat Sci Ed 1:130–132, 2008. © 2008 American Association of Anatomists.     

The use of specially designed tasks to enhance student interest in the cadaver dissection laboratory

Cadaver dissection is a key component of anatomy education. Unfortunately, students sometimes regard the process of dissection as uninteresting or stressful. To make laboratory time more interesting and to encourage discussion and collaborative learning among medical students, specially designed tasks were assigned to students throughout dissection. Student response and the effects of the tasks on examination scores were analyzed. The subjects of this study were 154 medical students who attended the dissection laboratory in 2009. Four tasks were given to teams of seven to eight students over the course of 2 weeks of lower limb dissection. The tasks were designed such that the answers could not be obtained by referencing books or searching the Internet, but rather through careful observation of the cadavers and discussion among team members. Questionnaires were administered. The majority of students agreed that the tasks were interesting (68.0%), encouraged team discussion (76.8%), and facilitated their understanding of anatomy (72.8%). However, they did not prefer that additional tasks be assigned during the other laboratory sessions. When examination scores of those who responded positively were compared with those who responded neutrally or negatively, no statistically significant differences could be found. In conclusion, the specially designed tasks assigned to students in the cadaver dissection laboratory encouraged team discussion and collaborative learning, and thereby generated interest in laboratory work. However, knowledge acquisition was not improved.     

Near-peer teaching in an anatomy course with a low faculty-to-student ratio

Near-peer teaching is an educational format which utilizes tutors who are more advanced in a curriculum's content to supervise students' activities and to act as instructors in laboratory settings. This format is often used in anatomy laboratory courses. The goal of the present study is to describe the design and implementation of near-peer teaching in an anatomy course and to evaluate students' perceptions of the program. A total of 700 students were registered for this anatomy course which employed near-peer instructors. Of enrolled students, 558 (79.7%) agreed to participate in this study. In general, the practical section (e.g., the clinical hour, image-based anatomy session, and gross anatomy laboratory) of the course was viewed more favorably compared to the theory section (54.8%, n = 306), with dissection and prosection in the laboratory rated as the most valued experiences (34.9%, n = 195). Near-peer teaching is a viable option that satisfies the demands of modern curricula using small groups. This format stimulates learning within courses that have large numbers of students and low faculty-to-student ratios.     

The use of electronic media to develop transferable skills in science students studying anatomy

Transferable skills such as team working, communication, information gathering, critical thinking, and peer assessment are essential for graduates seeking employment in the competitive jobs market. Use of online discussion boards have grown to allow students to communicate with each other at a time and location of their choosing. This study aimed to develop transferable skills using specially developed online components supported by discussion boards and chat rooms. Students enrolled in the Human Anatomy and Histology module at the University of Manchester were put into groups of six or seven students (26 groups in total). Two e-learning components were constructed to develop transferable skills. Each group had a discussion board and chat room available to assist communication in completion of the components. Peer marking was also done on this media. Data collected showed the discussion boards were heavily utilized (average number of posts per group was 48). Eighty-three percent of students found the discussion boards useful to complete the tasks. Students felt their team building and critical analysis skills had improved. Peer assessment was well received by students. Using online discussion boards proved an excellent way to develop transferable skills in a large group of science students.     

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.     

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.     

Application of flipped classroom pedagogy to the human gross anatomy laboratory: Student preferences and learning outcomes

To improve student preparedness for anatomy laboratory dissection, the dental gross anatomy laboratory was transformed using flipped classroom pedagogy. Instead of spending class time explaining the procedures and anatomical structures for each laboratory, students were provided online materials to prepare for laboratory on their own. Eliminating in‐class preparation provided the opportunity to end each period with integrative group activities that connected laboratory and lecture material and explored clinical correlations. Materials provided for prelaboratory preparation included: custom‐made, three‐dimensional (3D) anatomy videos, abbreviated dissection instructions, key atlas figures, and dissection videos. Data from three years of the course (n = 241 students) allowed for analysis of students' preferences for these materials and detailed tracking of usage of 3D anatomy videos. Students reported spending an average of 27:22 (±17:56) minutes preparing for laboratory, similar to the 30 minutes previously allocated for in‐class dissection preparation. The 3D anatomy videos and key atlas figures were rated the most helpful resources. Scores on laboratory examinations were compared for the three years before the curriculum change (2011–2013; n = 242) and three years after (2014–2016; n = 241). There was no change in average grades on the first and second laboratory examinations. However, on the final semi‐cumulative laboratory examination, scores were significantly higher in the post‐flip classes (P = 0.04). These results demonstrate an effective model for applying flipped classroom pedagogy to the gross anatomy laboratory and illustrate a meaningful role for 3D anatomy visualizations in a dissection‐based course. Anat Sci Educ 11: 385–396. © 2017 American Association of Anatomists.     

Musculoskeletal anatomy knowledge in Australian chiropractors

Anatomy is a key knowledge area in chiropractic and is formally offered in the undergraduate component of chiropractic education. There is the potential for loss of anatomy knowledge before the opportunity to apply it in a clinical setting. This study aimed to determine whether chiropractic clinicians retain a level of anatomy knowledge comparable to that of chiropractic students and to compare chiropractors' self-rating of their anatomical knowledge against an objective knowledge assessment tool. A previously validated multiple-choice test was utilized to measure retention of limb musculoskeletal (MSK) knowledge in Australian chiropractors. One hundred and one registered chiropractors completed the questionnaire and responses were scored, analyzed, and compared to scores attained by undergraduate and postgraduate chiropractic students who had previously completed the same questionnaire. The results indicated that practitioners retained their anatomy knowledge, with a significantly higher total mean score than the undergraduate group [total mean score = 36.5% (±SD 13.6%); P < 0.01] but not significantly different to the postgraduate group [total mean score = 52.2% (±SD 14.1%); P = 0.74]. There was a weak positive correlation between chiropractors' self-rated knowledge and test performance scores indicating the effectiveness of this Australian chiropractic group in self-assessing their anatomy knowledge. This study found that Australian chiropractors' knowledge of MSK anatomy was retained during the transition from university to clinical practice and they accurately evaluated their own test performance.     

Participation in asynchronous online discussion forums does improve student learning of gross anatomy

Asynchronous online discussion forums are common in blended learning models and are popular with students. A previous report has suggested that participation in these forums may assist student learning in a gross anatomy subject but it was unclear as to whether more academically able students post more often or whether participation led to improved learning outcomes. This study used a path model to analyze the contribution of forum participation, previous academic ability, and student campus of enrolment to final marks in a multicampus gross anatomy course for physiotherapy students. The course has a substantial online learning management system (LMS) that incorporates asynchronous forums as a learning tool, particularly to answer learning objectives. Students were encouraged to post new threads and answer queries in threads started by others. The forums were moderated weekly by staff. Discussion forums were the most used feature of the LMS site with 31,920 hits. Forty‐eight percent of the students posted at least once with 186 threads initiated by students and a total of 608 posts. The total number of posts made a significant direct contribution to final mark (P = 0.008) as did previous academic ability (P = 0.002). Although campus did not contribute to final mark, there was a trend for students at the campus where the course coordinator was situated to post more often than those at the other campus (P = 0.073). These results indicate that asynchronous online discussion forums can be an effective tool for improving student learning outcomes as evidenced by final marks in gross anatomy teaching. Anat Sci Educ. 7: 71–76. © 2013 American Association of Anatomists.     

Equivalence of students' scores on timed and untimed anatomy practical examinations

Untimed examinations are popular with students because there is a perception that first impressions may be incorrect, and that difficult questions require more time for reflection. In this report, we tested the hypothesis that timed anatomy practical examinations are inherently more difficult than untimed examinations. Students in the Doctor of Physical Therapy program at Thomas Jefferson University were assessed on their understanding of anatomic relationships using multiple‐choice questions. For the class of 2012 (n = 46), students were allowed to circulate freely among 40 testing stations during the 40‐minute testing session. For the class of 2013 (n = 46), students were required to move sequentially through the 40 testing stations (one minute per item). Students in both years were given three practical examinations covering the back/upper limb, lower limb, and trunk. An identical set of questions was used for both groups of students (untimed and timed examinations). Our results indicate that there is no significant difference between student performance on untimed and timed examinations (final percent scores of 87.3 and 88.9, respectively). This result also held true for students in the top and bottom 20th percentiles of the class. Moreover, time limits did not lead to errors on even the most difficult, higher‐order questions (i.e., items with P‐values < 0.70). Thus, limiting time at testing stations during an anatomy practical examination does not adversely affect student performance. Anat Sci Educ 6: 281–285. © 2013 American Association of Anatomists.     

Student outcomes associated with use of asynchronous online discussion forums in gross anatomy teaching

Asynchronous online discussion forums are increasingly common in blended learning environments but the relationship to student learning outcomes has not been reported for anatomy teaching. Forums were monitored in two multicampus anatomy courses; an introductory first year course and a second year physiotherapy‐specific course. The forums are structured with a separate site for each course module and moderated weekly by staff. Students are encouraged to post to new threads (initial post) and answer queries in threads started by others (reply post). Analysis of forums was conducted separately for each course and included overall activity (posts and views) for a full semester and a detailed analysis for one week in the middle of semester. Students were classified as zero, moderate, or high contributors to the forums based on the number of posts. Final mark for the course was related to level of forum contribution using nonparametric tests. Forum threads were characterized as task‐focused, administrative, or other. A higher proportion of second year (36%) than first‐year (17%) students posted on the forums and the postings were more likely to be task‐focused and student initiated. Second‐year students that posted frequently to the forum gained a higher final mark for the course than those that did not post or only posted a moderate number of times (P < 0.01). This relationship was not evident for first‐year students who had a much higher proportion of administrative threads. Forums in anatomy courses can be powerful learning tools encouraging deeper learning and improved learning outcomes. Anat Sci Educ 6: 101–106. © 2012 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.     

Peer assessment among first year medical students in anatomy

Peer assessment has been shown to be an effective tool to promote professionalism in medical students. Peer assessment may be particularly useful in anatomy dissection laboratory as the required close collaboration and long hours of anatomy laboratory provide students insights into their peers' work habits and interpersonal skills. The objective of this study was to quantitatively and qualitatively analyze the use of a validated peer assessment tool in Gross Anatomy. Students in a first year medical school class evaluated three members of their dissection group using an online survey tool. The mid‐course and end‐of‐course evaluation included open‐ended comments, as well as a five‐point scale that measured three work habits, two interpersonal attributes and one overall score. All 267 students completed the assignment. The overall score and four of the five other assessed categories showed significant improvement from the mid‐ to end‐of‐course evaluations. Quantitative and qualitative data also revealed significant improvement among the students who received the lowest mid‐course assessments. Seventy‐six percent of the class agreed with the statement: “Based on the feedback I received, I made a change in how I worked with or taught my peers.” The use of this peer assessment tool used by students in anatomy was associated with improvements in work habits and interpersonal attributes, particularly by the cohort of students who received the lowest mid‐course feedback. Peer assessment offers students an opportunity to improve their interpersonal skills and work habits. Anat Sci Educ 7: 144–152. © 2013 American Association of Anatomists.     

Lecture recording system in anatomy

The literature reports that using Learning Recording Systems (LRS) is usually well received by students but that the pedagogical value of LRS in academic settings remains somewhat unclear. The primary aim of the current study is to document students' perceptions, actual pattern of usage, and impact of use of LRS on students' grade in a dental gross and neuroanatomy course. Other aims are to determine if students' learning preference correlated with final grades and to see if other factors like gender, age, overall academic score on the Dental Aptitude Test (DAT), lecture levels of difficulty, type of lecture, category of lecture, or teaching faculty could explain the impact, if any, of the use of LRS on the course final grade. No significant correlation was detected between the final grades and the variables studied except for a significant but modest correlation between final grades and the number of times the students accessed the lecture recordings (r=0.33 with P=0.01). Also, after adjusting for gender, age, learning style, and academic DAT, a significant interaction between auditory and average usage time was found for final grade (P=0.03). Students who classified themselves as auditory and who used the LRS on average for fewer than 10 minutes per access, scored an average final grade of 16.43 % higher than the nonauditory students using the LRS for the same amount of time per access. Based on these findings, implications for teaching are discussed and recommendations for use of LRS are proposed. Anat Sci Educ 6: 376–384. © 2013 American Association of Anatomists.