Learning anatomy through Thiel‐ vs. formalin‐embalmed cadavers: Student perceptions of embalming methods and effect on functional anatomy knowledge

Thiel‐embalmed cadavers, which have been adopted for use in anatomy teaching in relatively few universities, show greater flexibility and color retention compared to formalin‐embalmed cadavers, properties which might be considered advantageous for anatomy teaching. This study aimed to investigate student attitudes toward the dissection experience with Thiel‐ compared to formalin/ethanol‐embalmed cadavers. It also aimed to determine if one embalming method is more advantageous in terms of learning functional anatomy through the comparison of student anterior forearm functional anatomy knowledge. Student opinions and functional anatomy knowledge were obtained through use of a questionnaire from students at two medical schools, one using Thiel‐, and one using more traditional formalin/ethanol‐embalmed cadavers. Both the Thiel group and the formalin group of students were surveyed shortly after completing an anterior forearm dissection session. Significant differences (P‐values <0.01) in some attitudes were found toward the dissection experience between cohorts using Thiel‐ vs. formalin‐embalmed cadavers. The Thiel group of students felt more confident about recognizing anatomy in the living individual, found it easier to identify and dissect anatomical structures, and indicated more active exploration of functional anatomy due to the retained flexibility of the cadaver. However, on testing, no significant difference in functional anatomy knowledge was found between the two cohorts. Overall, although Thiel embalming may provide an advantageous learning experience in some investigated areas, more research needs to be carried out, especially to establish whether student perception is based on reality, at least in terms of structure identification. Anat Sci Educ 11: 166–174. © 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 diverse utility of wet prosections and plastinated specimens in teaching gross anatomy in New Zealand

Anatomical education has traditionally used cadaveric material to study the human body, with both wet prosections and plastinated (PP) material commonly utilized. However, the frequency of use of these different preparation modes in a tertiary institution has not been previously examined. An audit of PP use in the Department of Anatomy and Structural Biology at the University of Otago was performed for 2009, assessing the number of courses, variety, and number of PP used throughout 2009. Results indicate the unique and diverse nature of PP utilization and are discussed with reference to their relative strengths and weaknesses. Such information is useful to those wishing to initiate or maintain programs that involve the teaching of human anatomy with cadaveric material.     

A simple and efficient device for demonstrating cross‐sectional anatomy of the head

Described in this article is a novel device that facilitates study of the cross‐sectional anatomy of the human head. In designing our device, we aimed to protect sections of the head from the destructive action of handling during anatomy laboratory while also ensuring excellent visualization of the anatomic structures. We used an electric saw to create 15‐mm sections of three cadaver heads in the three traditional anatomic planes and inserted each section into a thin, perforated display box made of transparent acrylic material. The thin display boxes with head sections are kept in anatomical order in a larger transparent acrylic storage box containing formaldehyde solution, which preserves the specimens but also permits direct observation of the structures and their anatomic relationships to each other. This box‐within‐box design allows students to easily view sections of a head in its anatomical position as well as to examine internal structures by manipulating individual display boxes without altering the integrity of the preparations. This methodology for demonstrating cross‐section anatomy allows efficient use of cadaveric material and technician time while also giving learners the best possible handling and visualization of complex anatomic structures. Our approach to teaching cross‐sectional anatomy of the head can be applied to any part of human body, and the value of our device design will only increase as more complicated understandings of cross‐sectional anatomy are required by advances and proliferation of imaging technology. Anat Sci Educ 2010. © 2010 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.     

Building a low‐cost gross anatomy laboratory: A big step for a small university

This article illustrates details of the planning, building, and improvement phases of a cost‐efficient, full‐dissection gross anatomy laboratory on a campus of an historically design‐centric university. Special considerations were given throughout the project to the nature of hosting cadavers in a building shared amongst all undergraduate majors. The article addresses these needs along with discussion of relevant furnishings and infrastructure that went into the creation of a fully outfitted gross anatomy laboratory (ten cadavers) completed within a significantly constrained timeline and $210,000 budget. Anat Sci Educ. © 2010 American Association of Anatomists.     

The relative effectiveness of computer‐based and traditional resources for education in anatomy

There is increasing use of computer–based resources to teach anatomy, although no study has compared computer‐based learning to traditional. In this study, we examine the effectiveness of three formats of anatomy learning: (1) a virtual reality (VR) computer‐based module, (2) a static computer‐based module providing Key Views (KV), (3) a plastic model. We conducted a controlled trial in which 60 undergraduate students had ten minutes to study the names of 20 different pelvic structures. The outcome measure was a 25 item short answer test consisting of 15 nominal and 10 functional questions, based on a cadaveric pelvis. All subjects also took a brief mental rotations test (MRT) as a measure of spatial ability, used as a covariate in the analysis. Data were analyzed with repeated measures ANOVA. The group learning from the model performed significantly better than the other two groups on the nominal questions (Model 67%; KV 40%; VR 41%, Effect size 1.19 and 1.29, respectively). There was no difference between the KV and VR groups. There was no difference between the groups on the functional questions (Model 28%; KV, 23%, VR 25%). Computer‐based learning resources appear to have significant disadvantages compared to traditional specimens in learning nominal anatomy. Consistent with previous research, virtual reality shows no advantage over static presentation of key views. Anat Sci Educ 6: 211–215. © 2013 American Association of Anatomists.     

A survey of student perceptions of team‐based learning in anatomy curriculum: Favorable views unrelated to grades

Team‐based learning (TBL) combines independent out of class preparation with in class small group discussion. We adopted TBL in teaching first year medical gross anatomy. In this study, we evaluated student perceptions of TBL by using a survey that elicited perceptions of both pedagogy and mode of learning. Anatomy lectures were replaced with required preclass readings, self‐assessment quizzes, small group discussions of assignments, and groups retaking the same quizzes for deeper learning. At the course conclusion, students were surveyed to assess their preference for TBL, their perceptions of TBL effectiveness, and their perceptions of successful interpersonal relationships within groups. Respondents (n = 317; 89% response) were asked to rate the extent that they agreed (?2 = strongly disagree; ?1 = disagree; 0 = neutral; 1 = agree; and 2 = strongly agree). A principal components factor analysis with varimax rotation identified two 8‐item factors: “perceptions of TBL” and “perceptions of teamwork.” Internal consistency for each was high [Cronbach's alpha = 0.908 (preference for TBL); 0.884 (preference of teamwork)]. Results of one‐way analysis of variance between Honors/High Pass/Pass/Fail students indicated that Honors (n = 73) tended to rate perceptions of TBL higher than Pass (n = 54) [mean difference = 2.92; 95% CI (0.05, 5.79)], and also higher than Fail (n = 11) [mean difference = 6.30; 95% CI (1.13, 11.47)]. However, each had overallpositive ratings. No difference was noted between mean ratings of teamwork, which were also, overall, positive. We conclude that medical students view TBL favorably irrespective of their grades. Anat Sci Educ 2:150–155, 2009. © 2009 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.     

Dissecting the role of sessional anatomy teachers: A systematic literature review

Worldwide there is a growing reliance on sessional teachers in universities. This has impacted all disciplines in higher education including medical anatomy programs. The objective of this review was to define the role and support needs of sessional anatomy teachers by reporting on the (1) qualifications, (2) teaching role, (3) training, and (4) performance management of this group of educators. A systematic literature search was conducted on the 27 July 2017 in Scopus, Web of Science, and several databases on the Ovid, ProQuest and EBSCOhost platforms. The search retrieved 5,658 articles, with 39 deemed eligible for inclusion. The qualifications and educational distance between sessional anatomy teachers and their students varied widely. Reports of cross‐level, near‐peer and reciprocal‐peer teaching were identified, with most institutes utilizing recent medical graduates or medical students as sessional teachers. Sessional anatomy teachers were engaged in the full spectrum of teaching‐related duties from assisting students with cadaveric dissection, to marking student assessments and developing course materials. Fourteen institutes reported that training was provided to sessional anatomy teachers, but the specific content, objectives, methods and effectiveness of the training programs were rarely defined. Evaluations of sessional anatomy teacher performance primarily relied on subjective feedback measures such as student surveys (n = 18) or teacher self‐assessment (n = 3). The results of this systematic review highlight the need for rigorous explorations of the use of sessional anatomy teachers in medical education, and the development of evidence‐based policies and training programs that regulate and support the use of sessional teachers in higher education. Anat Sci Educ 11: 410–426. © 2017 American Association of Anatomists.     

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

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

Developing medical students as teachers: An anatomy‐based student‐as‐teacher program with emphasis on core teaching competencies

Teaching is an increasingly recognized responsibility of the resident physician. Residents, however, often assume teaching responsibilities without adequate preparation. Consequently, many medical schools have implemented student‐as‐teacher (SAT) programs that provide near‐peer teaching opportunities to senior medical students. Near‐peer teaching is widely regarded as an effective teaching modality; however, whether near‐peer teaching experiences in medical school prepare students for the teaching demands of residency is less understood. We explored whether the anatomy‐based SAT program through the Human Structure didactic block at Mayo Medical School addressed the core teaching competencies of a medical educator and prepared its participants for further teaching roles in their medical careers. A web‐based survey was sent to all teaching assistants in the anatomy‐based SAT program over the past five years (2007–2011). Survey questions were constructed based on previously published competencies in seven teaching domains – course development, course organization, teaching execution, student coaching, student assessment, teacher evaluation, and scholarship. Results of the survey indicate that participants in the anatomy‐based SAT program achieved core competencies of a medical educator and felt prepared for the teaching demands of residency. Anat Sci Educ 6: 385–392. © 2013 American Association of Anatomists.     

Evaluation of computer‐aided instruction in a gross anatomy course: A six‐year study

Web‐based computer‐aided instruction (CAI) has become increasingly important to medical curricula. This multi‐year study investigated the effectiveness of CAI and the factors affecting level of individual use. Three CAI were tested that differed in specificity of applicability to the curriculum and in the level of student interaction with the CAI. Student personality preferences and learning styles were measured using the Meyers Briggs Type Indicator (MBTI) and Kolb's Learning Style Inventory (LSI). Information on “computer literacy” and use of CAI was collected from student surveys. Server logs were used to quantify individual use of respective CAI. There was considerable variability in the level of utilization of each CAI by individual students. Individual use of each CAI differed and was associated with gender, MBTI preferences and learning style, but not with “computer literacy.” The majority of students found the CAI useful for learning and used the CAI by themselves. Students who accessed the CAI resources most frequently scored significantly higher on exams compared with students who never accessed the resources. Our results show that medical students do not uniformly use CAI developed for their curriculum and this variability is associated with various attributes of individual students. Our data also provide evidence of the importance of understanding student preferences and learning styles when implementing CAI into the curriculum. Anat Sci Ed 2:2–8, 2009. © 2009 American Association of Anatomists.     

Improving near‐peer teaching quality in anatomy by educating teaching assistants: An example from Sweden

Peer‐assisted learning has gained momentum in a variety of disciplines, including medical education. In Gothenburg, Sweden, medical students who have finished their compulsory anatomy courses have the option of working as teaching assistants (TAs). Teaching assistants provide small group teaching sessions as a complement to lectures given by faculty. Previously, TAs were left to handle the role as junior teachers by themselves, but since 2011, a continuation course in anatomy has been developed with the aim of providing the TAs better anatomy knowledge and guidance for teaching. The course was designed to comprise 7.5 ECTS credits (equivalent to 5 weeks of full‐time studies), and today all TAs are required to take this course before undertaking their own teaching responsibilities. This study aims to compare course evaluations of TA teaching before and after the introduction of the anatomy continuation course, in order to understand how students perceived teaching performed by self‐learned versus trained TAs. The results of this study demonstrate that there was a trend towards better teaching performed by trained TAs. The variability in rankings decreased significantly after the introduction of the continuation course. This was mainly due to an improvement among the TAs with the lowest levels of performance. In addition to comparing student rankings, TAs were interviewed regarding their experiences and perceptions within the continuation course. The course was generally positively regarded. The TAs described a sense of cohesion and appreciation since the institute invested in a course dedicated specifically for them. Anat Sci Educ 11: 403–409. © 2018 American Association of Anatomists.     

Effects of image‐based and text‐based active learning exercises on student examination performance in a musculoskeletal anatomy course

Research on the benefits of visual learning has relied primarily on lecture‐based pedagogy, but the potential benefits of combining active learning strategies with visual and verbal materials on learning anatomy has not yet been explored. In this study, the differential effects of text‐based and image‐based active learning exercises on examination performance were investigated in a functional anatomy course. Each class session was punctuated with an average of 12 text‐based and image‐based active learning exercises. Participation data from 231 students were compared with their examination performance on 262 questions associated with the in‐class exercises. Students also rated the helpfulness and difficulty of the in‐class exercises on a survey. Participation in the active learning exercises was positively correlated with examination performance (r = 0.63, P < 0.001). When controlling for other key demographics (gender, underrepresented minority status) and prior grade point average, participation in the image‐based exercises was significantly correlated with performance on examination questions associated with image‐based exercises (P < 0.001) and text‐based exercises (P < 0.01), while participation in text‐based exercises was not. Additionally, students reported that the active learning exercises were helpful for seeing images of key ideas (94%) and clarifying key course concepts (80%), and that the image‐based exercises were significantly less demanding, less hard and required less effort than text‐based exercises (P < 0.05). The findings confirm the positive effect of using images and active learning strategies on student learning, and suggest that integrating them may be especially beneficial for learning anatomy. Anat Sci Educ 10: 444–455. © 2017 American Association of Anatomists.     

Breaking barriers: The landscape of human and veterinary medical anatomy education and the potential for collaboration

Despite human (HUM) and veterinary (VET) medical institutions sharing the goal of educating future clinicians, there is little collaboration between them regarding curricular and pedagogical practices during the preclinical/basic science training years. This may be, at least in part, due to a lack of understanding of each type of curriculum. This study presents data about curricula, student populations, pedagogical methodologies applied, and anatomy educators' training at both HUM and VET institutions. Preclinical curricula, admissions criteria, and student demographics were analyzed for 21 institutions in the United States having both HUM and VET schools. This dataset was augmented by a questionnaire sent to anatomists internationally, detailing anatomy curricula, pedagogies applied, and anatomy educators' training. Many curricular similarities between both training programs were identified, including anatomy education experiences. However, VET programs were found to include more preclinical coursework than HUM programs. Students who matriculate to VET or HUM schools have similar academic records, including prerequisite coursework and grade point average. Median HUM class size was significantly larger, and the percentage of women enrolled in VET institutions was significantly higher. Training of anatomy educators was identical with one exception: VET educators are far more likely to hold a clinical degree. This study elucidates the substantial similarities between VET and HUM programs, particularly in anatomy education, underscoring the potential for collaboration between both types of programs in areas such as interprofessional education, bioethics, zoonotic disease management, and postgraduate training.     

Cost‐effective teaching of radiology with preclinical anatomy

Graduating physicians in all subspecialties have an increased need for competency in radiology, particularly since the use of diagnostic imaging continues to grow. To integrate the teaching of radiology with anatomy during the first year of medical school at Howard University, a novel approach was developed to overcome the limitations of resources including funding, faculty, and curricular time. The resulting program relies on self‐study and peer‐to‐peer interactions to develop proficiency at manipulating free versions of medical image viewer software (using the DICOM standard), identifying normal anatomy in medical images, and applying critical thinking skills to understand common clinical conditions. An effective collaborative relationship between a radiologist and anatomist was necessary to develop and implement the program of anatomic–radiographic instruction which consists of five tiers: (1) initial exposure to anatomy through dissection which provides a foundation of knowledge; (2) study of annotated radiographs from atlases; (3) a radiology quiz open to group discussions; (4) small group study of clinical cases with diagnostic images; and (5) radiographic tests. Students took all quizzes and tests by working from image datasets preloaded on their personal computers, mimicking the approach by which radiologists analyze medical images. In addition to stimulating student support of a new teaching initiative, the strengths of Howard's program are that it can be introduced into an existing preclinical curriculum in almost any medical school with minimal disruption, it requires few additional resources to implement and run, and its design is consistent with the principles of modern education theory. Anat Sci Educ 11: 196–206. © 2017 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.     

Measuring learning gain: Comparing anatomy drawing screencasts and paper‐based resources

The use of technology‐enhanced learning (TEL) resources is now a common tool across a variety of healthcare programs. Despite this popular approach to curriculum delivery there remains a paucity in empirical evidence that quantifies the change in learning gain. The aim of the study was to measure the changes in learning gain observed with anatomy drawing screencasts in comparison to a traditional paper‐based resource. Learning gain is a widely used term to describe the tangible changes in learning outcomes that have been achieved after a specific intervention. In regard to this study, a cohort of Year 2 medical students voluntarily participated and were randomly assigned to either a screencast or textbook group to compare changes in learning gain across resource type. Using a pre‐test/post‐test protocol, and a range of statistical analyses, the learning gain was calculated at three test points: immediate post‐test, 1‐week post‐test and 4‐week post‐test. Results at all test points revealed a significant increase in learning gain and large effect sizes for the screencast group compared to the textbook group. Possible reasons behind the difference in learning gain are explored by comparing the instructional design of both resources. Strengths and weaknesses of the study design are also considered. This work adds to the growing area of research that supports the effective design of TEL resources which are complimentary to the cognitive theory of multimedia learning to achieve both an effective and efficient learning resource for anatomical education. Anat Sci Educ 10: 307–316. © 2016 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.