Development of a Novel Peer-sharing Application to Supplement Learning from Cadaveric Dissection

Gross anatomy dissection in contemporary medical education must balance the traditional value of learning from the cadaver with the possibilities created by the use of digital tools as supplemental resources that personalize and deepen the student learning experience. This study broadly examined the design, implementation, and use of AnatomyShare, a novel iPad application employing learner-generated content that allows students to securely share annotated images of their dissections with each other and take faculty-generated image-based quizzes during their first-year medical school gross anatomy course. Almost all students enrolled in the course used the application (N = 176; 91% use based on analytics). Seventy-five students responded to a survey asking how and when they used the application, along with their perceptions of its usefulness and contribution to learning. More students reported using the application outside of laboratory (97.3%) than during laboratory (85.3%), despite only in-laboratory use being required. Taking quizzes using the “Exam” feature was the highest rated use of AnatomyShare, and students cited that the application exposed them to anatomical variation and motivated them to correctly identify structures during dissection. While steps need to be taken to combat low-quality learner-generated content and to enhance meaningful student interaction and collaboration, AnatomyShare was a feasible and highly rated supplement to dissection that provided valuable assessment opportunities for students. Future research will examine the impact of use on course grades and engagement in gross anatomy dissection.     

No cuts,no buts: Satisfaction of first-year medical students with a hybrid prosection-based model for learning gross anatomy during the Covid-19 pandemic

Few realized the extent of disruption that the Covid-19 global pandemic would impose upon higher anatomical education. While many institutions were obliged to adopt a fully-remote online model, the New York Institute of Technology College of Osteopathic Medicine strove to develop a curriculum that would allow medical students to receive an in-person anatomy education. A hybrid model that emphasized learning from prosected cadavers and self-study stations was implemented, with the remainder of the students' time directed toward studying at home. Through an anonymous survey aimed at gleaning student satisfaction, this study demonstrates that this hybrid prosection-based anatomy course aligned with student preferences both assuming no health risk (64.6% agreed) and given the current risk of contracting Covid-19 (78.5% agreed). Generally, students felt that their education was equal to that of previous years (Likert scale = 3.24 ± 1.05), fostered an appreciation for anatomy (4.56 ± 0.59), promoted teamwork (4.13 ± 0.85), and prepared them for practical examinations (4.18 ± 0.74). Linear mixed-effect models demonstrated that specific differences in results could be attributed to students' preconceived preferences toward student-led dissections and to past medical training. Importantly, most students “disagree” (1.97 ± 1.00) that they were concerned about the risk of exposure to Covid-19 during in-person anatomy laboratory sessions. Areas requiring improvement were identified by the model, including the provision of access to the cadavers outside of the regularly scheduled laboratory times (3.89 ± 1.08). These findings should be utilized when designing future gross anatomy courses in response to the “new normal”.     

Use of electronic anatomy practical examinations for remediating “at risk” students

Restrictive laboratory scheduling, an increasing number of human cadaver‐based anatomy courses and a reduction in the curricular time allotted to anatomy courses have created problems with cadaver laboratory access at the University of New England. This article describes a combination of anatomy testing and grading strategies to allow “at risk” (borderline failing) students an opportunity to remediate their lowest set of examination scores and pass their anatomy course. An alternative electronic practical examination for these students provided flexibility in laboratory scheduling, thereby increasing laboratory access for other students taking concurrent courses. Specifically, the electronic examinations allowed for a reduction in the amount of time the cadaver laboratory is locked down for examination purposes. Masters‐level occupational therapy (MOT) students, physician assistant students (MPA), and doctoral level physical therapy (DPT) students participated in a prosection‐based human cadaver laboratory and take cadaver‐based practical examinations as part of their anatomy course. Students who were not performing at a passing level for their curriculum (69.5% for MOT and MPA, 79.5% for DPT) were given an opportunity to remediate their lowest set of multiple choice and practical examinations using the previous year's multiple choice examination and a new electronic practical examination. When the original cadaver‐based practical and multiple choice examination scores were replaced with the remedial electronic practical examination and remedial multiple choice examination scores, 75% (24/32) of these students were able to successfully remediate their academic deficiencies and pass their anatomy course. Anat Sci Educ 3:46–49, 2010. © 2009 American Association of Anatomists.     

大学生宗教信仰的调查与思考——以芜湖市高校为例

对芜湖市几所高校391名大学生的问卷调查和与部分辅导员的访谈显示,大学生显性信教人数不多,潜在信教人数不少。信教的程度不深,对宗教认识模糊。应正视大学生信教问题,要做到疏而不堵,积极引导。在尊重大学生信仰自由的同时,引导他们在法律和政策的范围内活动,帮助大学生认清宗教的本质,增强其明辨是非的能力。     

Evaluation of small‐group teaching in human gross anatomy in a Caribbean medical school

Although there are a number of medical schools in the Caribbean islands, very few reports have come out so far in the literature regarding the efficacy of small‐group teaching in them. The introduction of small‐group teaching in the gross anatomy laboratory one and a half years ago at St. Matthew's University (SMU) on Grand Cayman appears to have had a significant positive impact on the academic achievement of students in anatomy. This study surveyed the responses of the students to the small‐group learning method in gross anatomy at SMU using a structured questionnaire. The results show that our students prefer this small‐group learning method over a completely self‐directed method in the gross anatomy lab because the study materials were carefully chosen and the study objectives were demonstrated by the resource person. However, teacher‐centered teaching was deliberately avoided by fostering problem‐solving skills in the anatomy lab sessions. Another aim of the small‐group teaching at SMU was to develop the interpersonal and communication skills of the students, which are important in their later education and career. Anat Sci Ed 1:19–22, 2008. © 2007 American Association of Anatomists.     

The Impact of No-Loan Policies on Student Economic Diversity at Public Colleges and Universities

To improve college access for low-income students, an increasing number of public colleges and universities have implemented no-loan policies, where student loans are replaced with institutional grant aid that does not require repayment. Using detailed income measures provided by Mobility Report Card data, this study examines the effect of no-loan policies on student economic diversity at public 4-year institutions. Using a difference-in-differences design and the synthetic control method, we found that the adoption of no-loan policies at public institutions increased enrollment shares of low-income students (bottom two family income quintiles). However, the increase was minimal for students from the lowest income quintile, particularly at the most selective institutions. Our findings suggest that although no-loan policies may help improve affordability at public colleges and universities, further efforts are needed to address underrepresentation of students from the lowest part of the income distribution.

     

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.     

Anatomical Sciences Education vol.2, issue 5, 2009 cover image

A near‐peer (NP) teacher discussing structures of the head and neck region with first‐ and second‐year students in the anatomy laboratory at Brighton and Sussex Medical School. NP teachers are fourth‐year medical students who elect to teach in gross anatomy practical classes delivered to first‐ and second‐year medical students. Evans and Cuffe discuss design, implementation and outcomes of the NP teaching program in the current issue of ASE.     

Loosely‐guided,self‐directed learning versus strictly‐guided,station‐based learning in gross anatomy laboratory sessions

Anatomy students studying dissected anatomical specimens were subjected to either a loosely‐guided, self‐directed learning environment or a strictly‐guided, preformatted gross anatomy laboratory session. The current study's guiding questions were: (1) do strictly‐guided gross anatomy laboratory sessions lead to higher learning gains than loosely‐guided experiences? and (2) are there differences in the recall of anatomical knowledge between students who undergo the two types of laboratory sessions after weeks and months? The design was a randomized controlled trial. The participants were 360 second‐year medical students attending a gross anatomy laboratory course on the anatomy of the hand. Half of the students, the experimental group, were subjected without prior warning to station‐based laboratory sessions; the other half, the control group, to loosely‐guided laboratory sessions, which was the course's prevailing educational method at the time. The recall of anatomical knowledge was measured by written reproduction of 12 anatomical names at four points in time: immediately after the laboratory experience, then one week, five weeks, and eight months later. The strictly‐guided group scored higher than the loosely‐guided group at all time‐points. Repeated ANOVA showed no interaction between the results of the two types of laboratory sessions (P = 0.121) and a significant between‐subject effect (P ≤ 0.001). Therefore, levels of anatomical knowledge retrieved were significantly higher for the strictly‐guided group than for the loosely‐guided group at all times. It was concluded that gross anatomy laboratory sessions with strict instructions resulted in the recall of a larger amount of anatomical knowledge, even after eight months. Anat Sci Educ. © 2012 American Association of Anatomists.     

An Insight into Professional Identity Formation: Qualitative Analyses of Two Reflection Interventions During the Dissection Course

The professional behavior of future doctors is increasingly important in medical education. One of the first subjects in the curriculum to address this issue is gross anatomy. The Tuebingen Medical Faculty implemented a learning portfolio and a seminar on medical professionalism during the dissection course. The aims of this research project are to get an overview of how students form a professional identity in the dissection course and to compare the content of both their oral and written reflections on the course. A qualitative analysis was conducted of the oral and written reflections on the dissection laboratory experience. This study was conducted during winter term 2013/2014 with a cohort of 163 participants in the regular dissection course. Written reflection texts (from n = 96 students) and audio recordings from four oral reflection seminar discussions (with n = 11 students) were transcribed and deductively categorized with Mayring’s qualitative content analysis method. Both qualitative analyses show that students reflected on many topics relevant to professional development, including empathy, respect, altruism, compassion, teamwork, and self-regulation. Quantitative analysis reveals that students who attended the oral reflection wrote significantly more in their written reflection than students who did not. There is, however, no difference in the reflection categories. Reflection content from students corresponds with categories derived from existing competency frameworks. Both the seminar (oral reflections) and the learning portfolio (written reflections) present excellent opportunities to foster professional development during anatomy education; the key is using them in conjunction with the dissection course.     

Anatomical Sciences Education Vol. 4, Issue 6, 2011 Cover Image

Physical Therapy students at the College of Medicine, Mayo Clinic in Rochester, Minnesota receive instruction at the cadaver during a second year musculoskeletal course. In this issue of ASE Dr. Krause and his colleagues from the Doctoral Program in Physical Therapy share their experience developing a clinical skills course in a human gross anatomy laboratory.     

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

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

Anatomical Sciences Education Vol. 4, Issue 3, 2011 Cover Image

Medical Gross Anatomy lecture at the University of Padova, Italy. Gross Anatomy at the University of Padova is taught utilizing both traditional and technological resources, which are integrated with practical laboratory exercises (mainly on plastic models and plastinated specimens) as well as radiological anatomy. In this issue of ASE, Dr. Veronica Macchi and her colleagues from the Department of Human Anatomy and Physiology at the University of Padova discuss an innovative pilot project with their University Hospital in which they obtain body parts removed from patients during surgical procedures and utilize them for gross anatomy education. The cover photograph shows one of the co‐authors of this paper, Professor Raffaele De Caro and his students, performing dissection of the distal forearm and hand in the anatomy lecture theater at the University of Padova.     

What type of learner are your students? Preferred learning styles of undergraduate gross anatomy students according to the index of learning styles questionnaire

Students learn and process information in many different ways. Learning styles are useful as they allow instructors to learn more about students, as well as aid in the development and application of useful teaching approaches and techniques. At the undergraduate level there is a noticeable lack of research on learning style preferences of students enrolled in gross anatomy courses. The Index of Learning Styles (ILS) questionnaire was administered to students enrolled in a large enrollment undergraduate gross anatomy course with laboratory to determine their preferred learning styles. The predominant preferred learning styles of the students (n = 505) enrolled in the gross anatomy course were active (54.9%), sensing (85.1%), visual (81.2%), and sequential (74.4%). Preferred learning styles profiles of particular majors enrolled in the course were also constructed; analyses showed minor variation in the active/reflective dimension. An understanding of students' preferred learning styles can guide course design but it should not be implemented in isolation. It can be strengthened (or weakened) by concurrent use of other tools (e.g., flipped classroom course design). Based on the preferred learning styles of the majority of undergraduate students in this particular gross anatomy course, course activities can be hands on (i.e., active), grounded in concrete information (i.e., sensing), utilize visual representation such as images, figures, models, etc. (i.e., visual), and move in small incremental steps that build on each topic (i.e., sequential). Anat Sci Educ 11: 358–365. © 2017 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.     

The histopathologic reliability of tissue taken from cadavers within the gross anatomy laboratory

The purpose of this study was to examine the histopathologic reliability of embalmed cadaveric tissue taken from the gross anatomy laboratory. Tissue samples from hearts, livers, lungs, and kidneys were collected after the medical students’ dissection course was completed. All of the cadavers were embalmed in a formalin‐based fixative solution. The tissue was processed, embedded in paraffin, sectioned at six micrometers, and stained with H&E. The microscope slides were evaluated by a board certified pathologist to determine whether the cellular components of the tissues were preserved at a high enough quality to allow for histopathologic diagnosis. There was a statistically significant relationship between ratings and organ groups. Across all organs, there was a smaller proportion of “poor” ratings. The lung group had the highest percentage of “poor” ratings (23.1%). The heart group had the least “poor” ratings (0.0%). The largest percentage of “satisfactory” ratings were in the lung group (52.8%), and the heart group contained the highest percentage of “good” ratings (58.5%) The lung group had the lowest percentage of “good” ratings (24.2%). These results indicate that heart tissue is more reliable than lung, kidney, or liver tissue when utilizing tissue from the gross anatomy laboratory for research and/or educational purposes. This information advises educators and researchers about the quality and histopathologic reliability of tissue samples obtained from the gross anatomy laboratory. Anat Sci Educ 11: 207–214. © 2017 American Association of Anatomists.     

PUBLIC TWO‐YEAR COLLEGE FUNDING AND PROGRAM PATTERNS

Several sets of data were employed in efforts to address the major concerns of this study. The first was a national survey of state directors of two‐year colleges. From them basic data regarding the distribution of funding for public two‐year college institutions on a state‐by‐state basis was obtained. It was found that 57% of funding nationally was derived from state legislatures, 17% from local or regional governments, 14% from tuition, and 10% from other sources. Also computed from the survey data was the distribution of full‐time enrollments by generic program. It was found that about half of the full‐time students were enrolled in occupational programs.

Using selected national data, the cost per credit‐hour for 1979‐1980 full‐time students was computed to be $115 if 24 credit‐hours are considered a full‐time load, and $92 using 30 credit‐hours as a full‐time load.

Also determined were the correlations between selected population data and certain public two‐year college demographics. Strong positive relationships were found between state populations, number of colleges in the state, and the magnitude of the states’ gross weights (fraction of total national full‐time enrollments found in that state).     

Resident perceptions of anatomy education: a survey of medical school alumni from two different anatomy curricula and multiple medical specialties

In 2004, the University of Michigan Medical School reduced its gross anatomy curriculum. To determine the effect of this reduction on resident perceptions of their clinical preparedness, we surveyed alumni that included residents from the original and new shortened curricula. A Likert-scale survey was sent to four classes of alumni. Respondents were compared in old curriculum (OC) and new curriculum (NC) groups, surgical specialty (SS) and nonsurgical specialty (NS) groups, and subgroups of SS and NS were compared for differences between OC and NC. Mean response scores were compared using independent samples T-tests. As a single population (n = 110), respondents felt their anatomy education prepared them well for residency, that a more robust anatomy curriculum would be helpful, that dissection was important to their residency preparation, and that a 4th year anatomy elective was effective in expanding their anatomy education and preparing them for residency. No significant difference existed between OC and NC groups, neither as a whole nor as SS and NS subgroups. The SS group felt dissection was more important to their residency preparation than the NS group (P = 0.001) and that a more robust anatomy curriculum would have better prepared them for residency (P = 0.001). Thirty percent of SS respondents who did not take a 4th year elective commented that they wish they had. Fourth year anatomy electives were highly valued by residents, and respondents felt that they should be offered to students as a way of revisiting anatomy following the 1st year of clinical training.     

The gross anatomy course: An analysis of its importance

The gross anatomy dissection course is a cost‐intensive piece of undergraduate medical education that students and professionals alike describe as very important within the overall medical curriculum. We sought to understand more explicitly students' valuation of gross anatomy as an “important” course and so developed a quantitative longitudinal questionnaire. Medical students (n = 124) enrolled in the winter term 2006/2007 gross anatomy course at the Ulm University Faculty of Medicine were surveyed anonymously prior to, in the middle of, and at the end of the dissection course. Subgroups of students expressing rising or falling opinions of course value were identified and correlated with student opinions about the course's ability to convey professional competencies. Five‐point Likert scales were used for each survey item, which included such standardized instruments as the NeoFFI, BSI, and FBM. The study confirmed that medical students believe dissection to be valuable. Students indicated that participation in the course facilitated acquisition of anatomy knowledge as well as skills related to teamwork, coping with stress, and, to a lesser extent, time management. Students also noted that they developed less empathy than expected beforehand. Significant subgroup differences were observed relative to the competencies of teamwork, stress coping strategies, and empathy, as well as in students' stress levels associated with having to take a dissection course. Our study builds on previous work that has shown dissection courses help students develop professional competencies. The increase in professionalism might be a reason for the generally high value students place on the gross anatomy dissection course, Anat Sci Educ 3:3–11, 2010. © 2010 American Association of Anatomists.