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.     

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

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

Use of the one-minute preceptor as a teaching tool in the gross anatomy laboratory

The one-minute preceptor (OMP) is a time-efficient technique used for teaching in busy clinical settings. It consists of five microskills: (1) get a commitment from the student, (2) probe for supporting evidence, (3) reinforce what was done right, (4) correct errors and fill in omissions, and (5) teach a general rule. It can also be used to address structure-identification questions in gross anatomy laboratory small-group settings. The OMP is an active learner-centered teaching approach that prepares students for a style of learning that they need to master in clinical settings, provides novice anatomy teachers with an efficient and effective teaching strategy, and moves anatomy learning beyond mere name tagging to active knowledge construction.     

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.     

Browsing software of the Visible Korean data used for teaching sectional anatomy

The interpretation of computed tomographs (CTs) and magnetic resonance images (MRIs) to diagnose clinical conditions requires basic knowledge of sectional anatomy. Sectional anatomy has traditionally been taught using sectioned cadavers, atlases, and/or computer software. The computer software commonly used for this subject is practical and efficient for students but could be more advanced. The objective of this research was to present browsing software developed from the Visible Korean images that can be used for teaching sectional anatomy. One thousand seven hundred and two sets of MRIs, CTs, and sectioned images (intervals, one millimeter) of a whole male cadaver were prepared. Over 900 structures in the sectioned images were outlined and then filled with different colors to elaborate each structure. Software was developed where four corresponding images could be displayed simultaneously; in addition, the structures in the image data could be readily recognized with the aid of the color-filled outlines. The software, distributed free of charge, could be a valuable tool to teach medical students. For example, sectional anatomy could be taught by showing the sectioned images with real color and high resolution. Students could then review the lecture by using the sectioned and color-filled images on their own computers. Students could also be evaluated using the same software. Furthermore, other investigators would be able to replace the images for more comprehensive sectional anatomy.     

Perceptions among occupational and physical therapy students of a nontraditional methodology for teaching laboratory gross anatomy

This pilot study was designed to assess the perceptions of physical therapy (PT) and occupational therapy (OT) students regarding the use of computer-assisted pedagogy and prosection-oriented communications in the laboratory component of a human anatomy course at a comprehensive health sciences university in the southeastern United States. The goal was to determine whether student perceptions changed over the course of a summer session regarding verbal, visual, tactile, and web-based teaching methodologies. Pretest and post-test surveys were distributed online to students who volunteered to participate in the pilot study. Despite the relatively small sample size, statistically significant results indicated that PT and OT students who participated in this study perceived an improved ability to name major anatomical structures from memory, to draw major anatomical structures from memory, and to explain major anatomical relationships from memory. Students differed in their preferred learning styles. This study demonstrates that the combination of small group learning and digital web-based learning seems to increase PT and OT students' confidence in their anatomical knowledge. Further research is needed to determine which forms of integrated instruction lead to improved student performance in the human gross anatomy laboratory.     

Modernization of an anatomy class: From conceptualization to implementation. A case for integrated multimodal–multidisciplinary teaching

It has become increasingly apparent that no single method for teaching anatomy is able to provide supremacy over another. In an effort to consolidate and enhance learning, a modernized anatomy curriculum was devised by attempting to take advantage of and maximize the benefits from different teaching methods. Both the more traditional approaches to anatomy teaching, as well as modern, innovative educational programs were embraced in a multimodal system implemented over a decade. In this effort, traditional teaching with lectures and dissection was supplemented with models, imaging, computer‐assisted learning, problem‐based learning through clinical cases, surface anatomy, clinical correlation lectures, peer teaching and team‐based learning. Here, we review current thinking in medical education and present our transition from a passive, didactic, highly detailed anatomy course of the past, to a more interactive, as well as functionally and clinically relevant anatomy curriculum over the course of a decade. Anat Sci Educ. © 2012 American Association of Anatomists.     

The effectiveness of virtual and augmented reality in health sciences and medical anatomy

Although cadavers constitute the gold standard for teaching anatomy to medical and health science students, there are substantial financial, ethical, and supervisory constraints on their use. In addition, although anatomy remains one of the fundamental areas of medical education, universities have decreased the hours allocated to teaching gross anatomy in favor of applied clinical work. The release of virtual (VR) and augmented reality (AR) devices allows learning to occur through hands‐on immersive experiences. The aim of this research was to assess whether learning structural anatomy utilizing VR or AR is as effective as tablet‐based (TB) applications, and whether these modes allowed enhanced student learning, engagement and performance. Participants (n = 59) were randomly allocated to one of the three learning modes: VR, AR, or TB and completed a lesson on skull anatomy, after which they completed an anatomical knowledge assessment. Student perceptions of each learning mode and any adverse effects experienced were recorded. No significant differences were found between mean assessment scores in VR, AR, or TB. During the lessons however, VR participants were more likely to exhibit adverse effects such as headaches (25% in VR P < 0.05), dizziness (40% in VR, P < 0.001), or blurred vision (35% in VR, P < 0.01). Both VR and AR are as valuable for teaching anatomy as tablet devices, but also promote intrinsic benefits such as increased learner immersion and engagement. These outcomes show great promise for the effective use of virtual and augmented reality as means to supplement lesson content in anatomical education. Anat Sci Educ 10: 549–559. © 2017 American Association of Anatomists.     

Assessing the integration of audience response system technology in teaching of anatomical sciences

The goals of our study were to determine the predictive value and usability of an audience response system (ARS) as a knowledge assessment tool in an undergraduate medical curriculum. Over a three year period (2006–2008), data were collected from first year didactic blocks in Genetics/Histology and Anatomy/Radiology (n = 42–50 per class). During each block, students answered clinically oriented multiple choice questions using the ARS. Students' performances were recorded and cumulative ARS scores were compared with final examination performances. Correlation coefficients between these variables were calculated to assess the existence and direction of an association between ARS and final examination score. If associations existed, univariate models were then constructed using ARS as a predictor of final examination score. Student and faculty perception of ARS difficulty, usefulness, effect on performance, and preferred use were evaluated using a questionnaire. There was a statistically significant positive correlation between ARS and final examination scores in all didactic blocks and predictive univariate models were constructed for each relationship (all P < 0.0001). Students and faculty agreed that ARS was easy to use and a reliable tool for providing real‐time feedback that improved their performance and participation. In conclusion, we found ARS to be an effective assessment tool benefiting the faculty and the students in a curriculum focused on interaction and self‐directed learning. Anat Sci Educ 2:160–166. © 2009 American Association of Anatomists.     

Objective and subjective assessment of reciprocal peer teaching in medical gross anatomy laboratory

Reciprocal peer teaching (RPT), wherein students alternate roles as teacher and learner, has been applied in several educational arenas with varying success. Here, we describe the implementation of a reciprocal peer teaching protocol in a human gross anatomy laboratory curriculum. We compared the outcomes of the RPT class with those of previous classes in which RPT was not employed. Objective data (i.e., course grades) show no significant differences in gross anatomy laboratory grades between students in the RPT and non‐RPT classes. To subjectively evaluate the relative success of RPT in the laboratory, we analyzed student opinions obtained through anonymous surveys. These data show that a powerful majority of student respondents felt that RPT was beneficial and should be used in future classes. The greatest disadvantage was unreliable quality of teaching from peers; however, most students still felt that RPT should be continued. Students who felt that they had insufficient hands‐on experience (by virtue of dissecting only half the time) were significantly more likely to recommend abandoning RPT. These results underscore the importance of active student dissection, and suggest that a modified version of the described RPT protocol may satisfy more of the needs of large, diverse student populations. Several hidden benefits of RPT exist for faculty, administration, and students, including reduced need for large numbers of cadavers, attendant reduction in operating costs, and smaller student‐to‐teacher ratios. Anat Sci Educ 2:143–149, 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.     

Anatomy education in a changing medical curriculum in India: Medical student feedback on duration and emphasis of gross anatomy teaching

Authors report here a survey of medical student feedback on the effectiveness of two different anatomy curricula at Christian Medical College, Vellore, India. Undergraduate medical students seeking the Bachelor in Medicine and Bachelor in Surgery (M.B.B.S.) degrees were divided into two groups by the duration of their respective anatomy curriculum. Group 1 students had completed a longer, 18‐month curriculum whereas Group 2 counterparts followed a shorter, 12‐month curriculum. Students' responses to a questionnaire were studied. Analysis of feedback from Groups 1 and 2 contrasted the effectiveness of the two anatomy curricula. The coverage of gross anatomy was rated adequate or more than adequate by 98% of Group 1 and 91% of Group 2. A desire for greater emphasis on gross anatomy teaching was expressed by 24% of Group 1 and 50% of Group 2 (P = 0.000). Two‐thirds of all students felt that the one‐year program was not adequate, and 90% of Group 1 and 74% of Group 2 felt that clinically oriented anatomy teaching required more emphasis. Dissection was helpful or very helpful for 94% of Group 1 and 88% of Group 2. This study suggests that a better understanding of gross anatomy was gained from a course of longer duration (18 months with 915 contact hr vs. 12 months with 671 contact hr). Students who completed the longer anatomy course had greater appreciation of the need for clinically oriented anatomy teaching and dissection. Anat Sci Educ 2:179–183, 2009. © 2009 American Association of Anatomists.     

Computer visualizations: factors that influence spatial anatomy comprehension

Computer visualizations are increasingly common in education across a range of subject disciplines, including anatomy. Despite optimism about their educational potential, students sometime have difficulty learning from these visualizations. The purpose of this study was to explore a range of factors that influence spatial anatomy comprehension before and after instruction with different computer visualizations. Three major factors were considered: (1) visualization ability (VZ) of learners, (2) dynamism of the visual display, and (3) interactivity of the system. Participants (N = 60) of differing VZs (high, low) studied a group of anatomical structures in one of three visual conditions (control, static, dynamic) and one of two interactive conditions (interactive, non-interactive). Before and after the study phase, participants' comprehension of spatial anatomical information was assessed using a multiple-choice spatial anatomy task (SAT) involving the mental rotation of the anatomical structures, identification of the structures in 2D cross-sections, and localization of planes corresponding to given cross-sections. Results indicate that VZ had a positive influence on SAT performance but instruction with different computer visualizations could modulate the effect of VZ on task performance.     

An audience response system may influence student performance on anatomy examination questions

This study integrated an in-house audience response system (ARS) in the human anatomy course over two years to determine whether students performed better on high-stakes examinations following exposure to similar interactive questions in a large lecture format. Questions in an interactive ARS format were presented in lectures via PowerPoint presentations. Students who chose to participate in the anonymous ARS sessions submitted answers via their personal wireless devices (e.g., laptops, smartphones, PDAs, etc). Students were surveyed for feedback. Student participation in ARS activities was greatest (65-80%) in the first lecture. The number of students who actively participated in ARS activities decreased over the next four sessions, and then slightly increased in the last two sessions. This trend was the same for both years. Use of the ARS did not dramatically enhance overall student performance on examination questions that dealt with content similar to content presented in the ARS sessions. However, students who scored in the lower quartile of the examination performed better on the examination questions after the ARS was implemented. Accordingly, our findings suggest that the effect of ARS to improve student performance on examinations was not uniform. The overall benefit of an ARS to enhance the lecture experience was confirmed by student surveys.     

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.     

The virtual anatomy laboratory: usability testing to improve an online learning resource for anatomy education

An increasing number of instructors are seeking to provide students with online anatomy resources. Many researchers have attempted to identify associations between resource use and student learning but few studies discuss the importance of usability testing in resource design and modification. Usability testing provides information about ease of use and resource flexibility and indicates navigational issues that contribute to extraneous cognitive load for the user. An example of usability testing for modification of an online anatomy resource called the "Virtual Lab" is presented. Usability testing was used to determine whether increased content would impair navigation through the interface. Subjects with varying levels of experience with anatomy content were recruited to assess efficiency and effectiveness (defined by usability standards) of the original resource and of the redesigned resource. Comparisons between usability evaluation of the original "Virtual Lab" (OVL) and of the redesigned "Virtual Lab" (RVL) revealed that subjects were better able to successfully complete tasks using the RVL than they were with the OVL. Results also demonstrated that subjects did not take significantly more time to successfully complete tasks with the RVL. Additionally, usability testing revealed that subjects were able to successfully complete tasks using the RVL regardless of whether they possessed prior experience with anatomy content or not. Results of this study suggest that the modified resource is more effective for users. The example presented here underscores the need for usability testing prior to resource implementation and whenever significant changes are made to a resource interface.     

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.     

Pregnant students in the gross anatomy laboratory: policies and practices at chiropractic colleges

Chiropractic and medical colleges have experienced a significant increase in the number of female applicants in recent years, a percentage of whom are pregnant or become pregnant following admission. It is therefore important to ask the question: How do institutions that educate future health care providers address the issue of pregnancy and the gross anatomy laboratory? A survey instrument was developed and pretested. IRB approval was obtained. The administrators charged with overseeing the policies and practices for the gross anatomy laboratory at each of the 16 chiropractic colleges in the USA were identified and contacted. An email containing a link to the Web based survey was sent to each, using SurveyMonkey. The survey response rate was 100%. A majority of colleges (69%) have a written policy regarding pregnancy and the gross laboratory. Of these, 36% allow pregnant students to take the laboratory if a waiver is signed, 18% do not allow them to take the laboratory, 18% allow them to take it without a waiver, and 27% have other policies. In cases where students do not take the gross laboratory while pregnant, 64% of colleges require them to take the laboratory after completion of their pregnancy, 27% require them to complete an alternative (dry) laboratory, and 9% have other policies. Considerable diversity exists in the way colleges address this issue. It is at present unknown whether pregnant students or their fetuses are at any risk from laboratory chemicals. Risk assessment research is needed before consistent policies can be developed. Anat Sci Educ. © 2011 American Association of Anatomists.     

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.