Virtual cerebral ventricular system: an MR-based three-dimensional computer model

The inherent spatial complexity of the human cerebral ventricular system, coupled with its deep position within the brain, poses a problem for conceptualizing its anatomy. Cadaveric dissection, while considered the gold standard of anatomical learning, may be inadequate for learning the anatomy of the cerebral ventricular system; even with intricate dissection, ventricular structures remain difficult to observe. Three-dimensional (3D) computer reconstruction of the ventricular system offers a solution to this problem. This study aims to create an accurate 3D computer reconstruction of the ventricular system with surrounding structures, including the brain and cerebellum, using commercially available 3D rendering software. Magnetic resonance imaging (MRI) scans of a male cadaver were segmented using both semiautomatic and manual tools. Segmentation involves separating voxels of different grayscale values to highlight specific neural structures. User controls enable adding or removing of structures, altering their opacity, and making cross-sectional slices through the model to highlight inner structures. Complex physiologic concepts, such as the flow of cerebrospinal fluid, are also shown using the 3D model of the ventricular system through a video animation. The model can be projected stereoscopically, to increase depth perception and to emphasize spatial relationships between anatomical structures. This model is suited for both self-directed learning and classroom teaching of the 3D anatomical structure and spatial orientation of the ventricles, their connections, and their relation to adjacent neural and skeletal structures.     

A shortage of cadavers: The predicament of regional anatomy education in mainland China

Both in mainland China and around the world, regional anatomy stands as one of the most important basic science courses in medical school curricula. As such, dissection of human cadavers and use of prosected specimens remains the most essential teaching method in anatomy education. However, medical educators have raised increasing concerns about an ongoing shortage of cadavers for medical use in mainland China, a problem which may seriously limit the future development of human anatomy education. Based on a survey on cadaver usage in anatomy education in mainland China, this study found that the cadaver resources of most given medical schools in mainland China are associated with their geographic location, academic ranking, and local support for body donation policies. Effective measures to alleviate this shortage of cadavers may include future efforts to promote national‐level body donation legislation, broader acceptance of body donation among Chinese citizens, and an efficient and humane protocol for body donation. Anat Sci Educ 11: 397–402. © 2018 American Association of Anatomists.     

Modified use of team‐based learning for effective delivery of medical gross anatomy and embryology

Team‐based learning (TBL) is an instructional strategy that combines independent out‐of‐class preparation for in‐class discussion in small groups. This approach has been successfully adopted by a number of medical educators. This strategy allowed us to eliminate anatomy lectures and incorporate small‐group active learning. Although our strategy is a modified use of classical TBL, in the text, we use the standard terminology of TBL for simplicity. We have modified classical TBL to fit our curricular needs and approach. Anatomy lectures were replaced with TBL activities that required pre‐class reading of assigned materials, an individual self‐assessment quiz, discussion of learning issues derived from the reading assignments, and then the group retaking the same quiz for discussion and deeper learning. Students' performances and their educational experiences in the TBL format were compared with the traditional lecture approach. We offer several in‐house unit exams and a final comprehensive subject exam provided by the National Board of Medical Examiners. The students performed better in all exams following the TBL approach compared to traditional lecture‐based teaching. Students acknowledged that TBL encouraged them to study regularly, allowed them to actively teach and learn from peers, and this served to improve their own exam performances. We found that a TBL approach in teaching anatomy allowed us to create an active learning environment that helped to improve students' performances. Based on our experience, other preclinical courses are now piloting TBL. Anat Sci Ed 1:3–9, 2008. © 2007 American Association of Anatomists.     

Properties of publications on anatomy in medical education literature

Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to best evidence medical education (BEME) and second to evaluate the development of this literature toward more best evidence between 1985 and 2009. Four databases were searched for publications on anatomy in medical education published between 1985 and 2009, resulting in 525 references. Hundred publications were characterized by five variables (journal category, paper subject, paper category, author perspective, and paper perspective). Statements from these publications were characterized by two variables (category and foundation). The publications contained 797 statements that involved the words anatomy, anatomical, or anatomist. Forty-five percent of the publications contained no explicit research question. Forty percent of the statements made were about teaching methods and 17% about teaching content, 8% referred to practical value, and 10% to side effects of anatomy education. Ten percent of the statements were positional, five percent traditional, four percent self-evident, and two percent referred to quality of care. Fifty-six percent of the statements had no foundation, 17% were founded on empirical data, and 27% by references. These results substantiated the critical comments about the anecdotal nature of the literature. However, it is encouraging to see that between 1985 and 2009 the number of publications is rising that these publications increasingly focus on teaching methods and that an academic writing style is developing. This suggests a growing body of empirical literature about anatomy education.     

Anatomists debate the value of a teaching credential

Fewer and fewer programs are training graduate students and postdoctoral fellows in the classical anatomical disciplines. Nonetheless, there remains a need at all levels of clinical and basic science education for skilled instructors of anatomy, histology, and embryology. Two sessions at the 2006 annual meeting of the American Association of Anatomists (AAA) explored whether a system of accreditation would benefit students, institutions, and training programs. Although the value of accreditation was controversial, three challenges for the various anatomical societies emerged from these discussions: (1) To identify the skills and knowledge that should be shared among all anatomists, and the more specific skills and knowledge needed for the diverse settings in which anatomists work. (2) To address the historical inattention of institutions to the training of educators. (3) To develop strategies to lobby institutions and national organizations to support the training and work of educators in the anatomical sciences. One approach to meeting these challenges would be to develop guidelines for training programs. These guidelines would help graduate students seek the training they need, provide institutions with a benchmark to assess or develop training programs, and provide the basis for focusing lobbying efforts targeted at institutions or existing accreditation bodies. Anat Sci Ed 1:60–67, 2008. © 2008 American Association of Anatomists.     

Experimental evidence for improved neuroimaging interpretation using three-dimensional graphic models

Three-dimensional (3D) or volumetric visualization is a useful resource for learning about the anatomy of the human brain. However, the effectiveness of 3D spatial visualization has not yet been assessed systematically. This report analyzes whether 3D volumetric visualization helps learners to identify and locate subcortical structures more precisely than classical cross-sectional images based on a two dimensional (2D) approach. Eighty participants were assigned to each experimental condition: 2D cross-sectional visualization vs. 3D volumetric visualization. Both groups were matched for age, gender, visual-spatial ability, and previous knowledge of neuroanatomy. Accuracy in identifying brain structures, execution time, and level of confidence in the response were taken as outcome measures. Moreover, interactive effects between the experimental conditions (2D vs. 3D) and factors such as level of competence (novice vs. expert), image modality (morphological and functional), and difficulty of the structures were analyzed. The percentage of correct answers (hit rate) and level of confidence in responses were significantly higher in the 3D visualization condition than in the 2D. In addition, the response time was significantly lower for the 3D visualization condition in comparison with the 2D. The interaction between the experimental condition (2D vs. 3D) and difficulty was significant, and the 3D condition facilitated the location of difficult images more than the 2D condition. 3D volumetric visualization helps to identify brain structures such as the hippocampus and amygdala, more accurately and rapidly than conventional 2D visualization. This paper discusses the implications of these results with regards to the learning process involved in neuroimaging interpretation.     

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.     

Collaborative development of anatomy workshops for medical and dental students in Cambodia

After Phnom Penh was liberated from the Khmer Rouge in 1979, health science education in Cambodia had to be completely rebuilt. In this article, the authors report the results of a teaching collaboration between the University of Melbourne (Australia), the International University (Cambodia), and the University of Health Sciences (Cambodia). The main objectives in this collaboration were to provide the opportunity for dental and medical students in Cambodia to attend resourced anatomy workshops and to provide an opportunity for anatomy teachers in Cambodia to gain experience in implementing anatomy workshops of the style that are routinely used in the medical and dental curricula at the University of Melbourne. Experienced anatomy educators from the Department of Anatomy and Cell Biology, University of Melbourne, designed and resourced a series of workshops and then delivered these in collaboration with Cambodian teaching staff in Phnom Penh. The Cambodian students who participated in the workshops were incredibly engaged and enthusiastic. The students' evaluations (by questionnaire) indicated a very positive response to the workshops. All of the workshop resources were donated to the two universities so that the staff could continue to implement similar workshops, and plans were developed to continue our collaboration by developing more resourced workshops for this purpose in the future. Two staff members from Cambodia will travel to Melbourne to participate in anatomy workshops and dissection classes at the University of Melbourne. We hope that this extension of the collaboration provides further support and impetus for the development of anatomy education in Cambodia in the future.     

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.     

National survey on anatomical sciences in medical education

The drivers for curricular change in medical education such as the addition of innovative approaches to teaching, inclusion of technology and adoption of different assessment methods are gaining momentum. In an effort to understand how these changes are impacting and being implemented in gross anatomy, microscopic anatomy, neuroanatomy/neuroscience, and embryology courses, surveys were sent out to course directors/discipline leaders at allopathic Medical Schools in the United States during the 2016‐2017 academic year. Participants in the study were asked to comment on course hours, student experiences in the classroom and laboratory, amount of faculty participation, the use of peers as teachers in both the classroom and laboratory, methods used for student assessment and identification of best practices. Compared to data published from a similar survey in 2014, a number of changes were identified: (1) classroom hours in gross anatomy increased by 24% and by 29% in neuroanatomy/neuroscience; (2) laboratory hours in gross anatomy decreased by 16%, by 33% in microscopic anatomy, and by 38% in neuroanatomy/neuroscience; (3) use of virtual microscopy in microscopic anatomy teaching increased by 129%; and (4) the number of respondents reporting their discipline as part of a partially or fully integrated curriculum increased by greater than 100% for all four disciplines. Anat Sci Educ 11: 7–14. © 2017 American Association of Anatomists.     

Understanding neurophobia: Reasons behind impaired understanding and learning of neuroanatomy in cross‐disciplinary healthcare students

Recent studies have highlighted a fear or difficulty with the study and understanding of neuroanatomy among medical and healthcare students. This has been linked with a diminished confidence of clinical practitioners and students to manage patients with neurological conditions. The underlying reasons for this difficulty have been queried among a broad cohort of medical, dental, occupational therapy, and speech and language sciences students. Direct evidence of the students’ perception regarding specific difficulties associated with learning neuroanatomy has been provided and some of the measures required to address these issues have been identified. Neuroanatomy is perceived as a more difficult subject compared to other anatomy topics (e.g., reproductive/pelvic anatomy) and not all components of the neuroanatomy curriculum are viewed as equally challenging. The difficulty in understanding neuroanatomical concepts is linked to intrinsic factors such as the inherent complex nature of the topic rather than outside influences (e.g., lecture duration). Participants reporting high levels of interest in the subject reported higher levels of knowledge, suggesting that teaching tools aimed at increasing interest, such as case‐based scenarios, could facilitate acquisition of knowledge. Newer pedagogies, including web‐resources and computer assisted learning (CAL) are considered important tools to improve neuroanatomy learning, whereas traditional tools such as lecture slides and notes were considered less important. In conclusion, it is suggested that understanding of neuroanatomy could be enhanced and neurophobia be decreased by purposefully designed CAL resources. This data could help curricular designers to refocus attention and guide educators to develop improved neuroanatomy web‐resources in future. Anat Sci Educ 11: 81–93. © 2017 American Association of Anatomists.