Gross anatomy videos: Student satisfaction,usage, and effect on student performance in a condensed curriculum

Anatomy educators are being tasked with delivering the same quantity and quality of material in the face of fewer classroom and laboratory hours. As a result they have turned to computer‐aided instruction (CAI) to supplement and augment curriculum delivery. Research on the satisfaction and use of anatomy videos, a form of CAI, on examination performance continues to grow. The purpose of this study was to describe the usage and effect on examination scores of a series of locally produced anatomy videos after an 11% curriculum reduction. First‐year medical students (n = 40) were given access to the videos and the prior year's students (n = 40) were used as historical controls. There was no significant difference in demographics between the two groups. The survey response rate was 85% (n = 34) in the experimental group. The students found the videos to be highly satisfying (median = 5 on a five‐point Likert scale, interquartile range = 1) and used them on average 1.55 times/week (SD ± 0.77). Availability of the videos did have a statistically significant effect (4% improvement) on the final laboratory examination (p = 0.039). This suggests that the videos were a well‐received form of CAI that may be useful in bridging the gap created by a reduction in gross anatomy course contact hours. Anat Sci Educ 7: 273–279. © 2013 American Association of Anatomists.     

Online instructional anatomy videos: Student usage,self‐efficacy,and performance in upper limb regional anatomy assessment

Allied health professionals concur that a sound knowledge of practical gross anatomy is vital for the clinician, however, human anatomy courses in allied health programs have been identified as high‐risk for attrition and failure. While anatomists and clinicians agree that learning anatomy via human cadaveric instruction is the preferred method, students vary in their reaction to the cadaveric learning experience and have differing levels of anatomy self‐efficacy. This study investigated whether student self‐efficacy had an effect on student usage of supplemental instructional videos and whether the use of videos had an impact on student self‐efficacy and/or learning. Anatomy self‐efficacy differed based on gender and prior performance. Student usage of the videos varied widely and students with lower self‐efficacy were more inclined to use the resources. The provision of the videos did not improve overall cohort performance as compared to a historical cohort, however, those students that accessed all video sets experienced a greater normalized learning gain compared to students that used none or one of the four sets of videos. Student reports and usage patterns indicate that the videos were primarily used for practical class preparation and revision. Potentially, the videos represent a passive mode of teaching whereas active learning has been demonstrated to result in greater learning gains. Adapting the videos into interactive tutorials which will provide opportunity for feedback and the development of students' self‐evaluation may be more appropriate. Anat Sci Educ 11: 461–470. © 2017 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.     

Narrated Dissection Videos and Peer-Mentoring to Enhance Anatomy Performance of Underrepresented Minority Students in Physical Therapy Education

Three-dimensional virtual technology (3DVT) educational tools and peer-tutoring have proven to be effective teaching strategies in improving student learning outcomes. The purpose of this study was threefold: (1) compare the anatomy academic performance between underrepresented minority (URM) and non-minority (non-URM) students, (2) compare the voluntary use of 3DVT dissection videos and peer-mentoring between these two cohorts, and (3) estimate the association between the use of these teaching strategies on anatomy examinations and course grades at a school of physical therapy. Three-dimensional virtual technology narrated dissection videos and peer-mentoring were made available to all students. Time accessing the video and attending peer-mentoring sessions was measured throughout the course for all students. Three practical and four written examinations and the final course grade were calculated. Numerous one-way ANOVAs were used to compare examination/course grades between student cohorts (URM and non-URM) and usage of the two educational strategies (3DVT and peer-mentoring). Multiple linear regressions were performed with teaching strategies as predictors and grades as outcomes. Underrepresented minority students demonstrated significantly lower practical examination scores (P = 0.04), lower final course grades (P = 0.01), and a greater use of mentorship hours (P = 0.001) compared to non-URM. The regression models with both predictors (3DVT and peer-mentoring) combined demonstrated the greatest association with grades for both URM and non-URM. For both groups of students, the association between predictors and practical examination scores, although fair, was not statistically significant. Peer-mentoring seems to be the most effective teaching strategy in helping URM students succeed in anatomy.     

Performance in a prematriculation gross anatomy course as a predictor of performance in medical school

The University of California at Davis School of Medicine offers a prematriculation program to nontraditional students. As part of the program, students take a 7‐day course on the gross anatomy of the upper limb that concludes with a written examination and a practical examination based on prosections. Here, the performance of students who took the course from 2002 to 2004 (n = 48) is compared with their performance in the medical gross anatomy course as well as their performance on Step 1 of the United States Medical Licensing Examination (USMLE). Both rank in the prematriculation program's anatomy course and the score on the examination were correlated (significant at the 0.01 level) with performance on the medical gross anatomy midterm and final examinations, the overall final grade, and class rank. Performance in the prematriculation anatomy course was also correlated with the score on Step 1 of the USMLE (rank significant at the 0.02 level; examination score, significant at the 0.05 level). Students who took the prematriculation course who eventually withdrew, were dismissed for academic reasons, or who failed the first attempt at the Step 1 of the licensing exam (n = 5) had a significantly lower score (77.6 ± 11.1; P < 0.05) on the prematriculation examination than did successful prematriculation students (86.2 ± 7.9). Thus, a gross anatomy examination following a short prematriculation course can be a predictor not only of medical student performance in anatomy, but also of performance on a standardized licensing examination. Anat Sci Ed 1:224–227, 2008. © 2008 American Association of Anatomists.     

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.     

Dissection videos do not improve anatomy examination scores

In this quasi-experimental study, we describe the effect of showing dissection videos on first-year medical students' performance in terms of test scores during a gross anatomy course. We also surveyed students' perception regarding the showing of dissection videos. Two hundred eighty-seven first-year medical students at Rawalpindi Medical College in Pakistan, divided into two groups, dissected one limb in first term and switched over to the other limb in the second term. During the second term, instruction was supplemented by dissection videos. Second-term anatomy examination marks were compared with first-term scores and with results from first-year medical students in previous years. Multiple linear regression analysis was performed, with term scores (continuous, 0-200) as the dependent variable. Students shown dissection videos scored 1.26 marks higher than those not shown. The relationship was not statistically significant (95% CI: -1.11, 3.70; P = 0.314). Ninety-three percent of students favored regular inclusion of dissection videos in curriculum, and 50% termed it the best source for learning gross anatomy. Seventy-six percent of students did not perform regular cadaver dissection. The most frequent reason cited for not performing regular dissection was high student-cadaver ratio. Dissection videos did not improve performance on final examination scores; however, students favored their use.     

Performance equivalency between computer‐based and traditional pen‐and‐paper assessment: A case study in clinical anatomy

The time, material, and staff‐consuming nature of anatomy's traditional pen‐and‐paper assessment system, the increase in the number of students enrolling in medical schools and the ever‐escalating workload of academic staff have made the use of computer‐based assessment (CBA) an attractive proposition. To understand the impact of such shift in the assessment method, an experimental study evaluating its effect on students’ performance was designed. Additionally, students’ opinions toward CBA were gathered. Second‐year medical students attending a Clinical Anatomy course were randomized by clusters in two groups. The pen‐and‐paper group attended two sessions, each consisting of a traditional sectional anatomy steeplechase followed by a theoretical examination, while the computer group was involved in two similar sessions conducted in a computerized environment. At the end of each of the computer sessions, students in this group filled an anonymous questionnaire. In the first session, pen‐and‐paper group students scored significantly better than computer‐group students in both the steeplechase (mean ± standard deviation: 66.00 ± 14.15% vs. 43.50 ± 19.10%; P < 0.001) and the theoretical examination (52.50 ± 12.70% vs. 39.00 ± 21.10%; P < 0.001). In the second session, no statistically significant differences were found for both the steeplechase (59.50 ± 17.30% vs. 54.50 ± 17.00%; P = 0.085) and the theoretical examination (57.50 ± 13.70% vs. 54.00 ± 14.30%; P = 0.161). Besides, an intersession improvement in students’ perceptions toward CBA was registered. These results suggest that, after a familiarization period, CBA might be a performance equivalent and student accepted alternative to clinical anatomy pen‐and‐paper theoretical and practical examinations. Anat Sci Educ 11: 124–136. © 2017 American Association of Anatomists.     

The interrupted learner: How distractions during live and video lectures influence learning outcomes

New instructional technologies have been increasingly incorporated into the medical school learning environment, including lecture video recordings as a substitute for live lecture attendance. The literature presents varying conclusions regarding how this alternative experience impacts students' academic success. Previously, a multi‐year study of the first‐year medical histology component at the University of Michigan found that live lecture attendance was positively correlated with learning success, while lecture video use was negatively correlated. Here, three cohorts of first‐year medical students (N = 439 respondents, 86.6% response rate) were surveyed in greater detail regarding lecture attendance and video usage, focusing on study behaviors that may influence histology learning outcomes. Students who reported always attending lectures or viewing lecture videos had higher average histology scores than students who employed an inconsistent strategy (i.e., mixing live attendance and video lectures). Several behaviors were negatively associated with histology performance. Students who engaged in “non‐lecture activities” (e.g., social media use), students who reported being interrupted while watching the lecture video, or feeling sleepy/losing focus had lower scores than their counterparts not engaging in these behaviors. This study suggests that interruptions and distractions during medical learning activities—whether live or recorded—can have an important impact on learning outcomes. Anat Sci Educ 11: 366–376. © 2017 American Association of Anatomists.     

YouTube-based course orientation videos delivered prior to matriculation fail to alleviate medical student anxiety about anatomy

Gross anatomy is a source of anxiety for matriculating medical students due to the large volume of information presented in a truncated timeline, and because it may be their first exposure to human cadavers. This study aimed to assess if video-based resources would affect matriculating medical students' anatomy state anxiety levels. Videos were designed to be short, YouTube-based units that served to provide orientation information about the anatomy course, dissection facilities, and available study resources to dispel anxiety around beginning their anatomy studies. To evaluate the impact of the videos, students in two consecutive matriculating years (2018 and 2019) completed the validated State-Trait Anxiety Inventory and a demographic questionnaire. The 2019 cohort (n = 118) served as the experimental group with access to the videos; while the 2018 cohort (n = 120) without video access served as a historical control. Analyses revealed that the groups were equivalent in terms of trait anxiety (P = 0.854) and anatomy state anxiety even when student video exposure was controlled (P = 0.495). Anatomy state anxiety was only significantly lower in students with prior formal anatomy exposure (P = 0.006). Further inquiry into students' prior anatomy experience identified that individuals with post-secondary dissection experience were significantly less anxious than those without formal anatomical experience (P = 0.023). These results may serve as a cautionary tale to educators; while preference for video-based instructional materials is prevalent in the literature, videos delivered on public social media platforms fail to prepare students for the psychological impact of studying human anatomy.     

Computer‐assisted learning in anatomy at the International Medical School in Debrecen,Hungary: A preliminary report

The University of Debrecen's Faculty of Medicine has an international, multilingual student population with anatomy courses taught in English to all but Hungarian students. An elective computer‐assisted gross anatomy course, the Computer Human Anatomy (CHA), has been taught in English at the Anatomy Department since 2008. This course focuses on an introduction to anatomical digital images along with clinical cases. This low‐budget course has a large visual component using images from magnetic resonance imaging and computer axial tomogram scans, ultrasound clinical studies, and readily available anatomy software that presents topics which run in parallel to the university's core anatomy curriculum. From the combined computer images and CHA lecture information, students are asked to solve computer‐based clinical anatomy problems in the CHA computer laboratory. A statistical comparison was undertaken of core anatomy oral examination performances of English program first‐year medical students who took the elective CHA course and those who did not in the three academic years 2007–2008, 2008–2009, and 2009–2010. The results of this study indicate that the CHA‐enrolled students improved their performance on required anatomy core curriculum oral examinations (P < 0.001), suggesting that computer‐assisted learning may play an active role in anatomy curriculum improvement. These preliminary results have prompted ongoing evaluation of what specific aspects of CHA are valuable and which students benefit from computer‐assisted learning in a multilingual and diverse cultural environment. Anat Sci Educ. © 2012 American Association of Anatomists.     

中国四省市学生ICT胜任力的表现及影响因素——基于PISA 2015 ICT精熟度问卷数据的分析

信息素养是学生生存和发展的基本素养,对信息通信技术(ICT)的胜任力是反映学生信息素养的重要指标。基于PISA 2015中的ICT精熟度问卷数据,对中国四省市学生的ICT胜任力表现进行分析,考查中国学生的ICT资源、ICT使用情况以及ICT兴趣对其ICT胜任力的影响。结果发现:中国四省市学生的ICT胜任力在参测的48个国家和地区中排名靠后;不同性别、不同年级学生的ICT胜任力存在显著差异;家庭ICT资源对学生ICT胜任力有显著的正向预测作用;学生在学校使用ICT越多、在家使用ICT做作业越多,学生的ICT胜任力越高;学生的ICT兴趣越高,他们的ICT胜任力越高,学生的ICT兴趣对他们的ICT胜任力影响最大。为了提高我国学生的ICT胜任力,教育行政部门、学校、教师应充分重视ICT教育,完善ICT素养测评体系;扩大对ICT资源的投入,为学生更多地接触电子设备提供条件;加大ICT和电子设备的使用频率,在教育实践中逐步融入信息素养教育;着力培养学生对信息技术的兴趣,提高他们的ICT胜任力。     

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.     

We are what we do: Examining learner‐generated content in the anatomy laboratory through the lens of activity theory

Video and photography are often used for delivering content within the anatomical sciences. However, instructors typically produce these resources to provide instructional or procedural information. Although the benefits of learner‐generated content have been explored within educational research, virtually no studies have investigated the use of learner‐generated video and photograph content within anatomy dissection laboratories. This study outlines an activity involving learner‐generated video diaries and learner‐generated photograph assignments produced during anatomy laboratory sessions. The learner‐generated photographs and videos provided instructors with a means of formative assessment and allowed instructors to identify evidence of collaborative behavior in the laboratory. Student questionnaires (n = 21) and interviews (n = 5), as well as in‐class observations, were conducted to examine student perspectives on the laboratory activities. The quantitative and qualitative data were examined using the framework of activity theory to identify contradictions between student expectations of, and engagement with, the activity and the actual experiences of the students. Results indicate that learner‐generated photograph and video content can act as a rich source of data on student learning processes and can be used for formative assessment, for observing collaborative behavior, and as a starting point for class discussions. This study stresses the idea that technology choice for activities must align with instructional goals. This research also highlights the utility of activity theory as a framework for assessing classroom and laboratory activities, demonstrating that this approach can guide the development of laboratory activities. Anat Sci Educ 7: 361–369. © 2014 American Association of Anatomists.     

Cognitive load imposed by ultrasound‐facilitated teaching does not adversely affect gross anatomy learning outcomes

Ultrasonography is increasingly used in medical education, but its impact on learning outcomes is unclear. Adding ultrasound may facilitate learning, but may also potentially overwhelm novice learners. Based upon the framework of cognitive load theory, this study seeks to evaluate the relationship between cognitive load associated with using ultrasound and learning outcomes. The use of ultrasound was hypothesized to facilitate learning in anatomy for 161 novice first‐year medical students. Using linear regression analyses, the relationship between reported cognitive load on using ultrasound and learning outcomes as measured by anatomy laboratory examination scores four weeks after ultrasound‐guided anatomy training was evaluated in consenting students. Second anatomy examination scores of students who were taught anatomy with ultrasound were compared with historical controls (those not taught with ultrasound). Ultrasound's perceived utility for learning was measured on a five‐point scale. Cognitive load on using ultrasound was measured on a nine‐point scale. Primary outcome was the laboratory examination score (60 questions). Learners found ultrasound useful for learning. Weighted factor score on “image interpretation” was negatively, but insignificantly, associated with examination scores [F (1,135) = 0.28, beta = ?0.22; P = 0.61]. Weighted factor score on “basic knobology” was positively and insignificantly associated with scores; [F (1,138) = 0.27, beta = 0.42; P = 0.60]. Cohorts exposed to ultrasound had significantly higher scores than historical controls (82.4% ± SD 8.6% vs. 78.8% ± 8.5%, Cohen's d = 0.41, P < 0.001). Using ultrasound to teach anatomy does not negatively impact learning and may improve learning outcomes. Anat Sci Educ 10: 144–151. © 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.     

YouTube: An emerging tool in anatomy education

The use of online social networks in medical education can remodel and enhance anatomy teaching and learning; one such network is the video-sharing site YouTube. Limited research in the literature exists on the use of YouTube as a platform for anatomy education. The aim of this study is to assess student's perceptions and patterns of usage of this resource, as well as the effectiveness of YouTube videos within a problem-based learning (PBL) curriculum. The study was conducted on 91 second-year medical students for whom video links were suggested throughout the academic year. In addition, the Human Anatomy Education (HAE) Channel was launched on YouTube to support classroom teaching with videos that emphasized applied aspects of anatomy. The results demonstrated that 98% of the students used YouTube as an online information resource, albeit in different frequencies. Out of the 86% who have been to the HAE Channel, 92% agreed/strongly agreed that the channel helped them learn anatomy. The study also reports the popularity of and awareness about using YouTube as a social network as well as in learning. Based on these findings, YouTube can be considered as an effective tool to enhance anatomy instruction if the videos are scrutinized, diversified, and aimed toward course objectives. Faculty of average computer literacy should be enabled to produce videos on their own YouTube channels to support independent learning and integration in a PBL curriculum. The methods described for capturing and editing the videos can be used as a prototype.     

Learning anatomy enhances spatial ability

Spatial ability is an important factor in learning anatomy. Students with high scores on a mental rotation test (MRT) systematically score higher on anatomy examinations. This study aims to investigate if learning anatomy also oppositely improves the MRT‐score. Five hundred first year students of medicine (n = 242, intervention) and educational sciences (n = 258, control) participated in a pretest and posttest MRT, 1 month apart. During this month, the intervention group studied anatomy and the control group studied research methods for the social sciences. In the pretest, the intervention group scored 14.40 (SD: ± 3.37) and the control group 13.17 (SD: ± 3.36) on a scale of 20, which is a significant difference (t‐test, t = 4.07, df = 498, P < 0.001). Both groups show an improvement on the posttest compared to the pretest (paired samples t‐test, t = 12.21/14.71, df = 257/241, P < 0.001). The improvement in the intervention group is significantly higher (ANCOVA, F = 16.59, df = 1;497, P < 0.001). It is concluded that (1) medical students studying anatomy show greater improvement between two consecutive MRTs than educational science students; (2) medical students have a higher spatial ability than educational sciences students; and (3) if a MRT is repeated there seems to be a test effect. It is concluded that spatial ability may be trained by studying anatomy. The overarching message for anatomy teachers is that a good spatial ability is beneficial for learning anatomy and learning anatomy may be beneficial for students' spatial ability. This reciprocal advantage implies that challenging students on spatial aspects of anatomical knowledge could have a twofold effect on their learning. Anat Sci Educ 6: 257–262. © 2013 American Association of Anatomists.