Anticipatory Feelings About Dissection: An Exercise for the First Day of a Gross Anatomy Course

Studies have demonstrated that students experience a variety of intense emotions in anticipation of human anatomical dissection, including enthusiasm, gratitude, responsibility, apprehension, detachment, anxiety, and spiritual or moral reflection. The exercise described here provides an opportunity to start a conversation about the complexity of students’ emotional reactions to the anatomy experience. The intention of this exercise is to normalize the variety of emotions that anatomy students experience, both to demonstrate to students that their emotions are normal and to encourage the empathy for others' reactions which may differ from their own. In the lecture hall setting before the first day of dissection, students are asked to draw how they feel about the dissection experience and are provided an opportunity to discuss their drawings with their peers. The course director then provides a slide show demonstration of drawings from previous years, and experienced anatomy faculty facilitate a large group discussion in which students react to the drawing exercise and slide show and ask questions which are addressed by the faculty. This exercise provides an opportunity for students to practice appropriately communicating about emotionally complex experiences in a professional setting. The exercise is straightforward to implement and is easily modifiable for different class sizes and curricular structures.     

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.     

An explorative learning approach to teaching clinical anatomy using student generated content

Translating basic sciences into a clinical framework has been approached through the implementation of various teaching techniques aimed at using a patient case scenario to facilitate learning. These techniques present students with a specific patient case and lead the students to discuss physiological processes through analysis of provided data supported by independent learning and research. However, no literature exists that describes a reverse teaching methodology in which students are given disease diagnosis and then asked to construct a patient case. This article discusses an explorative learning approach introduced in the gross anatomy course in which students were asked to use clinical skills and reasoning to create a patient case. The online knowledge‐sharing portal utilizing MediaWiki provided a necessary base for students in completing their task. Teams were given 4 weeks to complete their written online project with weekly feedback provided by 3rd year teaching assistants using the Wiki discussion page. A survey was performed to assess competence regarding a patient write up and oral presentation. Skills that the teams acquired through the completion of this project will benefit future patient interactions. This project also emphasized and reinforced the importance of effective communication, leadership, and teamwork. This study shows that a clinical anatomy project that incorporates explorative learning can be an effective way of introducing students to the skills needed for patient write ups and oral presentations. Furthermore this approach to learning allows students to excel during their clinical years and to correlate anatomy to clinical diagnoses. Anat Sci Ed 1:106–110, 2008. © 2008 American Association of Anatomists.     

Design and validation of a novel learning tool, the "Anato-Rug," for teaching equine topographical anatomy

Recognition of anatomical landmarks in live animals (and humans) is key for clinical practice, but students often find it difficult to translate knowledge from dissection‐based anatomy onto the live animal and struggle to acquire this vital skill. The purpose of this study was to create and evaluate the use of an equine anatomy rug (“Anato‐Rug”) depicting topographical anatomy and key areas of lung, heart, and gastrointestinal auscultation, which could be used together with a live horse to aid learning of “live animal” anatomy. Over the course of 2 weeks, 38 third year veterinary students were randomly allocated into an experimental group, revising topographical anatomy from the “Anato‐Rug,” or a control group, learning topographical anatomy from a textbook. Immediately post activity, both groups underwent a test on live anatomy knowledge and were retested 1 week later. Both groups then completed a questionnaire to ascertain their perceptions of their learning experiences. Results showed that the experimental groups scored significantly higher than the control group at the first testing session, experienced more enjoyment during the activity and gained more confidence in identifying anatomical landmarks than the control group. There was not a significant difference in scores between groups at the second testing session. The findings indicate that the anatomy rug is an effective learning tool that aids understanding, confidence, and enjoyment in learning equine thorax and abdominal anatomy; however it was not better than traditional methods with regards to longer term memory recall. Anat SciEduc. © 2012 American Association of Anatomists.     

Drawing in Veterinary Anatomy Education: What Do Students Use It For?

In contrast to medical education, information on the use of arts as a learning approach is scarce in veterinary anatomy. The aim of this prospective, questionnaire-based study was to survey students' use of drawing in various aspects of veterinary anatomy learning (self-study, examinations, preparation for, and reflection on cadaver dissection). The quantitative data showed that first-year students with artistic preferences used drawing significantly more often in most aspects of anatomy learning than students with no such preferences, apart from the reported use of drawing in examinations and for reflection after cadaver dissection. The lack of significant correlations of the reported use of drawing in examinations with any other study variable provided support for the author's observation that student-generated drawings are not as commonly used in examinations as previously. In contrast to the study hypothesis, previous university studies did not correlate significantly with any aspect of the use of drawing in anatomy learning. None of the reported uses of drawing addressed the benefits of drawing in learning the comparative anatomy of animal species, a characteristic distinguishing veterinary anatomy from human anatomy. Qualitative student feedback indicated that encouragement and teacher-produced images would increase the use of drawing as a learning approach even if the implementation of drawing into the curriculum is not feasible. Conclusions from this study were implemented through self-directed learning in anatomy courses that replaced the canceled cadaveric dissections during the COVID-19 outbreak and also through the ongoing drawing workshops to further advance the use of drawing in veterinary anatomy learning.     

The use and effectiveness of interactive progressive drawing in anatomy education

Anatomical relationships are challenging concepts for first‐year medical students. The use of progressive drawing, where an image is created from a blank template, has long been utilized for outlining anatomical relationships and continuity from one region to another, and has shown positive outcomes for student learning. More recently, computerized progressive drawing has been introduced; however, challenges, including issues with visual clarity, have been described. In this study, 17 computerized screencasts of drawings covering neurovasculature of the limbs, abdomen, pelvis, head, and neck were created and provided to first‐year medical students at Morehouse School of Medicine. An animated method for drawing was utilized to increase visual clarity. Surveys were provided to 181 first‐year medical students to collect feedback about these screencasts. Sixty percent (n = 108) of students completed at least one survey. Respondents rated all 17 screencasts with a minimum of 4.7/5 for helpfulness in learning the material for course examinations. A majority of students (77.8%) reported viewing the screencasts more than once on at least one survey, and students reported varying methods for utilizing the screencasts. A majority of students provided positive feedback relating to technical quality. Some significant differences in course performance were seen based on screencast usage. The positive responses from students indicate that this is a useful method in medical education. Anat Sci Educ 11: 445–460. © 2018 American Association of Anatomists.     

Learning of cross‐sectional anatomy using clay models

We incorporated clay modeling into gross anatomy and neuro‐anatomy courses to help students understand cross‐sectional anatomy. By making clay models, cutting them and comparing cut surfaces to CT and MR images, students learned how cross‐sectional two‐dimensional images were created from three‐dimensional structure of human organs. Most students in a clay modeling group responded positively to this approach, and their average score on CT examination was higher than that of a group that did not use clay models. Clay modeling appears to be a useful supplement to conventional anatomy or radiologic anatomy education. It can be applied to any part of human body, and its effectiveness will be greater when a more complicated understanding of cross‐sectional anatomy is required. Anat Sci Educ 2:156–159, 2009. © 2009 American Association of Anatomists.     

Developing Student Metacognition through Reflective Writing in an Upper Level Undergraduate Anatomy Course

Incorporating metacognitive strategies in the classroom helps students monitor and adjust their learning strategies throughout the semester, and helps students progress from novice to expert learners in a subject. Journaling (i.e., reflective writing) is one metacognitive task that allows students to contemplate and articulate their skill development as they learn a new subject. The research reported here examines the use of ‘blogs’ (i.e., online journals) in an upper level undergraduate human anatomy course. The blogs both facilitated development of students' metacognitive skills and provided researchers insight into student metacognitive process. Data were examined from 92 students from three successive semesters (spring 2010, 2012 and 2014). Each student reviewed 10 radiology online cases throughout the semester and then reflected on their understanding of anatomy and radiology in an online blog for each case. A total of 927 blogs were examined for this research. The researchers used a grounded theory approach to analyze the blog narratives and develop a codebook based on common themes. The 927 blogs yielded 11,082 statements that were coded with the codebook. As the semester progressed, the blog entries showed that students demonstrated greater self-confidence in their abilities to understand the subject matter, expressed greater enthusiasm for anatomy in general, and they improved their metacognitive skills. This research illustrates that reflective writing in an undergraduate anatomy course not only facilitates improvement in student metacognitive skills, but also provides the instructor with evidence how a student progresses from novice to more experienced learner in anatomy.     

Assessing high-school students’ ability to direct their learning

Theory on student learning provides that students are able to direct their learning when they have metacognitive knowledge about their own learning processes. In this article, a preliminary attempt to assess untrained high-school students’ metacognitive knowledge of learning processes as an ability through multiple-choice questions is reported. In three studies, item selection was established for ninth graders at the end of their school year. Also, in the final study the results showed that the ninth-grade students’ self-reported use of learning and studying strategies, study techniques, school learning and tiresome academic subjects related significantly to their metacognitive knowledge regarding learning processes. In the discussion, the practical consequences for school assessment are explicated and future research questions are raised.     

"Anatomizing" reversed: Use of examination questions that foster use of higher order learning skills by students

"Anatomizing" is a new verb some use to describe the breaking apart of a complex entity such as the human body, into isolated tidbits of information for study, which can never equal the complex, integrated whole. Although popular with first-year medical students, this practice of "tidbitting" anatomical information into easy to memorize facts or tables of facts does not prepare medical students for the inevitable task of dealing with the integrated structure-function of the human body, both normal and diseased, as patient managers. Examination questions drive the cognitive methods students will use to learn content. Asking students on examinations for recall of previously memorized tidbits fosters the cognitive learning behavior of only memorization. Examination questions, however, can be constructed that assess student understanding and integration of the content, that is, student use of cognitive and metacognitive methods of higher order learning that will foster high-quality learning producing better practitioners and lifelong learners. This kind of efficient student learning needs to begin in the first year of medical school.Learning more efficiently and at deeper levels of understanding is especially pertinent as the contact hours in anatomy courses continue to decrease.     

Evaluation of the effectiveness of 3D vascular stereoscopic models in anatomy instruction for first year medical students

The head and neck region is one of the most complex areas featured in the medical gross anatomy curriculum. The effectiveness of using three‐dimensional (3D) models to teach anatomy is a topic of much discussion in medical education research. However, the use of 3D stereoscopic models of the head and neck circulation in anatomy education has not been previously studied in detail. This study investigated whether 3D stereoscopic models created from computed tomographic angiography (CTA) data were efficacious teaching tools for the head and neck vascular anatomy. The test subjects were first year medical students at the University of Mississippi Medical Center. The assessment tools included: anatomy knowledge tests (prelearning session knowledge test and postlearning session knowledge test), mental rotation tests (spatial ability; presession MRT and postsession MRT), and a satisfaction survey. Results were analyzed using a Wilcoxon rank‐sum test and linear regression analysis. A total of 39 first year medical students participated in the study. The results indicated that all students who were exposed to the stereoscopic 3D vascular models in 3D learning sessions increased their ability to correctly identify the head and neck vascular anatomy. Most importantly, for students with low‐spatial ability, 3D learning sessions improved postsession knowledge scores to a level comparable to that demonstrated by students with high‐spatial ability indicating that the use of 3D stereoscopic models may be particularly valuable to these students with low‐spatial ability. Anat Sci Educ 10: 34–45. © 2016 American Association of Anatomists.     

Analyzing the temporal evolution of students’ behaviors in open-ended learning environments

Metacognition and self-regulation are important for developing effective learning in the classroom and beyond, but novice learners often lack effective metacognitive and self-regulatory skills. However, researchers have demonstrated that metacognitive processes can be developed through practice and appropriate scaffolding. Betty’s Brain, an open-ended computer-based learning environment, helps students practice their cognitive skills and develop related metacognitive strategies as they learn science topics. In this paper, we analyze students’ activity sequences in a study that compared different categories of adaptive scaffolding in Betty’s Brain. The analysis techniques for measuring students’ cognitive and metacognitive processes extend our previous work on using sequence mining methods to discover students’ frequently-used behavior patterns by (i) developing a systematic approach for interpreting derived behavior patterns using a cognitive/metacognitive task model and (ii) analyzing the evolution of students’ frequent behavior patterns over time. Our results show that it is possible to identify students’ learning behaviors and analyze their evolution as they work in the Betty’s Brain environment. Further, the results illustrate that changes in student behavior were generally consistent with the scaffolding provided, suggesting that these metacognitive strategies can be taught to middle school students in computer-based learning environments.     

Surgical Clinical Correlates in Anatomy: Design and implementation of a first‐year medical school program

Medical students state the need for a clinically oriented anatomy class so to maximize their learning experience. We hypothesize that the first‐year medical students, who take the Surgical Clinical Correlates in Anatomy program, will perform better than their peers in their anatomy course, their surgical clerkships and ultimately choose surgical residencies. We designed and recently implemented this program for first‐year medical students. It consisted of General Surgical Knowledge, Orthopedic Surgery, Plastic Surgery, Urology, Cardiothoracic Surgery, General Surgery, Vascular Surgery, and Ear, Nose, and Throat (ENT) sessions. Each session had defined learning objectives and interactive cadaveric operations performed by faculty members and students. The program was elective and had 25 participants randomly chosen. An evaluative questionnaire was completed before and after the program. Comparative analysis of the questionnaires, first‐year anatomy examination results, clinical surgical rotation scores, and residency match results will be completed. The positive opinions of surgeons increased for all medical students from the pre‐evaluation to the post‐evaluation, and there was a greater increase in positive opinions for our participants. Our participants also had the highest average overall for all combined anatomy examinations. A need exists among medical students to develop a clinically correlated anatomy program that will maximize their learning experience, improve their performance and allow them to make moreinformed career choices. The recent implementation of this Surgical Clinical Correlates in Anatomy program fulfills this need. Anat Sci Educ 2: 265?272, 2009. © 2009 American Association of Anatomists.     

Eliciting Metacognitive Experiences and Reflection in a Year 11 Chemistry Classroom: An Activity Theory Perspective

Concerns regarding students’ learning and reasoning in chemistry classrooms are well documented. Students’ reasoning in chemistry should be characterized by conscious consideration of chemical phenomenon from laboratory work at macroscopic, molecular/sub-micro and symbolic levels. Further, students should develop metacognition in relation to such ways of reasoning about chemistry phenomena. Classroom change eliciting metacognitive experiences and metacognitive reflection is necessary to shift entrenched views of teaching and learning in students. In this study, Activity Theory is used as the framework for interpreting changes to the rules/customs and tools of the activity systems of two different classes of students taught by the same teacher, Frances, who was teaching chemical equilibrium to those classes in consecutive years. An interpretive methodology involving multiple data sources was employed. Frances explicitly changed her pedagogy in the second year to direct students attention to increasingly consider chemical phenomena at the molecular/sub-micro level. Additionally, she asked students not to use the textbook until toward the end of the equilibrium unit and sought to engage them in using their prior knowledge of chemistry to understand their observations from experiments. Frances’ changed pedagogy elicited metacognitive experiences and reflection in students and challenged them to reconsider their metacognitive beliefs about learning chemistry and how it might be achieved. While teacher change is essential for science education reform, students are not passive players in change efforts and they need to be convinced of the viability of teacher pedagogical change in the context of their goals, intentions, and beliefs.     

Does learning in clinical context in anatomical sciences improve examination results,learning motivation,or learning orientation?

The preclinical compulsory elective course “Ready for the Operating Room (OR)!?” [in German]: “Fit für den OP (FOP)”] was implemented for students in their second year, who were simultaneously enrolled in the gross anatomy course. The objective of the study was to determine whether the direct practical application of anatomical knowledge within the surgical context of the course led to any improvement in learning motivation, learning orientation, and ultimately examination results in the gross anatomy course, as compared with a control group. Within the scope of five teaching sessions, the students learned surgical hand disinfection, suturing techniques, and the identification of commonly used surgical instruments. In addition, the students attended five surgical demonstrations performed by surgical colleagues on cadavers. Successful learning of these basic skills was then assessed based on an Objectively Structured Practical Examination. Learning motivation and learning orientation in both subgroups was determined using the SELLMO‐ST motivation test and the Approaches and Study Skills Inventory test. While a significant increase in work avoidance was identified in the control group, this was not the case for FOP participants. Similarly, an increase in the “deep approach” to learning, as well as a decrease in the “surface approach,” was able to be documented among the FOP participants following completion of the course. The results suggest that students enrolled in the gross anatomy course, who were simultaneously provided with the opportunity to learn in clinical context, were more likely to be successful at maintaining learning motivation and learning orientation required for the learning process, than students who attended the gross anatomy course alone. Anat Sci Educ. 7: 3–11. © 2013 American Association of Anatomists.     

Near‐peer teaching in anatomy: An approach for deeper learning

Peer teaching has been recognized as a valuable and effective approach for learning and has been incorporated into medical, dental, and healthcare courses using a variety of approaches. The success of peer teaching is thought to be related to the ability of peer tutors and tutees to communicate more effectively, thereby improving the learning environment. Near‐peer teaching involves more experienced students acting as tutors who are ideally placed to pass on their knowledge and experience. The advantage of using near‐peer teachers is the opportunity for the teacher to reinforce and expand their own learning and develop essential teaching skills. This study describes the design and implementation of a program for fourth year medical students to teach anatomy to first‐ and second‐year medical students and evaluates the perceptions of the near‐peer teachers on the usefulness of the program, particularly in relation to their own learning. Feedback from participants suggests that the program fulfills its aims of providing an effective environment for developing deeper learning in anatomy through teaching. Participants recognize that the program also equips them with more advanced teaching skills that will be required as they move nearer toward taking on supervisory and teaching duties. The program has also provided the school with an additional valuable and appropriate resource for teaching anatomy to first‐ and second‐year students, who themselves view the inclusion of near‐peer teachers as a positive element in their learning. Anat Sci Educ 2:227–233, 2009. © 2009 American Association of Anatomists.     

Humanities in Gross Anatomy Project: A novel humanistic learning tool at Des Moines University

Gross anatomy affords physical therapy students an opportunity to discover human morphology by intimately studying the dead. Moreover, it also exposes future physical therapists to the humanistic aspects of the profession. In 2007, anatomy faculty decided to socialize students to the humanities with a new course requirement: Humanities in Gross Anatomy Project (HuGA) Project. At the end of the course, students, either individually or as a group, submitted a project that described how they had been personally touched by the donor's gift and how the gift contributed to their professional growth and education. The submission could be in the form of a narrative, poem, song, video, etc. All students met the three grading criteria that were established; thus taking the first step in socializing themselves to the humanistic domain of their professional education. In summary, the HuGA project is a novel educational tool that formally provided physical therapy students with humanistic learning opportunities in a gross anatomy course and appeared to facilitate reflective learning. The utilization of reflection as it relates to clinical decision making and patient interaction is critical for physical therapy practice. Anat Sci Educ 3: 94–96, 2010. © 2010 American Association of Anatomists.     

Effects of training experienced teachers in the use of the one‐minute preceptor technique in the gross anatomy laboratory

The one‐minute preceptor (OMP) is a time‐efficient, learner‐centered teaching method used in a busy ambulatory care setting. This project evaluated the effects of training experienced anatomy teachers in the use of the OMP in the gross anatomy laboratory on students' perceived learning. Second‐year medical students from a five‐year, undergraduate‐entry, system‐ and problem‐based medical program were divided randomly into two groups of 76 students each. The groups took part in the same gross anatomy laboratory session on different dates, supervised by the same two teachers (both with over 25 years of teaching experience). The teachers attended a workshop on the use of the OMP between the two sessions. Students were given a questionnaire at the end of the two sessions to indicate their agreements to statements regarding their learning experiences. Semistructured interviews were conducted with the two teachers after the second session. Results showed that training experienced anatomy teachers in the use of the OMP did not result in improvement of student learning perception in the gross anatomy laboratory. The experienced teachers have developed their own approaches with elements similar to those in the OMP: being learner centered and adaptable to individual student's needs, providing feedback, and enhancing teacher immediacy. They do not have an explicit structure such as the OMP, and are thus flexible and adaptive. Confining the teachers' teaching behaviors to the OMP structure could limit their performance. Although there are theoretical advantages for novice teachers in adopting the OMP technique, these advantages still need to be supported by further studies. Anat Sci Educ 7: 124–129. © 2013 American Association of Anatomists.     

Peer teaching among physical therapy students during human gross anatomy: Perceptions of peer teachers and students

Despite nearly 200 accredited entry‐level physical therapist education programs in the United States that culminate in a doctoral degree, only a paucity of reports have been published regarding the efficacy of peer teaching in gross anatomy. No one has described the usefulness of peer teaching from the viewpoint of the peer teacher. An organized peer teaching method provided by four second‐year doctors of physical therapy (DPT) students in a semester course in gross anatomy had a positive impact on the academic performance in gross anatomy of first‐year DPT students. The unique feature of the weekly peer teaching sessions was a packet assembled by the second‐year peer teachers, which contained diagrams, fill‐in‐the blank questions, and helpful mnemonic devices. This study surveyed perceptions of first‐year DPT students in response to a peer teaching method, using a structured 10‐item questionnaire and a five‐point Likert scale. Second‐year DPT peer teachers provided written reflections about the benefits and challenges of serving as a peer teacher. Results revealed that 13 planned peer‐teaching experiences provided by four second‐year DPT students were valuable and promoted a firm understanding of anatomical relationships important for the clinical competence of physical therapist students. Moreover, peer teachers acknowledged acquiring clinically desirable teaching, academic, organizational, and time management skills from the experience. As a result, physical therapist educators may wish to consider this model of peer teaching to augment their teaching strategies for a class in gross human anatomy. Anat Sci Ed 1:199–206, 2008. © 2008 American Association of Anatomists.