Medical students' attitudes toward the anatomy dissection room in relation to personality

Assessment of the personalities of medical students could enable medical educators to formulate strategies for the best development of academic and clinical competencies. In this article, we focus on the experience of students in the anatomy dissecting room. While there have been many attempts to evaluate the emotional responses of medical students to human cadaveric dissection, there has been no investigation into how different personality traits affect the responses. The main hypothesis tested was that there is a relationship between personality traits and attitudes toward the dissection room. For the present study, a group of French medical students (n = 403; mean age 21.3 ± 1.6; 65.3% female) completed a "Big Five" personality inventory and a questionnaire to assess their attitudes in regard to human dissection. The findings are consistent with our hypothesis, in that we found a relationship between reporting anxiety and four of the "Big Five" dimensions (all except openness). The rated level of anxiety was positively correlated with negative affectivity, more strongly at the beginning than at the end of the course. There were significant gender differences in attitudes toward dissection. The findings are discussed in relation to the possibility of preparing students for the dissecting room experience and also in relation to the students' understanding of mortality issues.     

Effect of visual-spatial ability on medical students' performance in a gross anatomy course

The ability to mentally manipulate objects in three dimensions is essential to the practice of many clinical medical specialties. The relationship between this type of visual-spatial ability and performance in preclinical courses such as medical gross anatomy is poorly understood. This study determined if visual-spatial ability is associated with performance on practical examinations, and if students' visual-spatial ability improves during medical gross anatomy. Three hundred and fifty-two first-year medical students completed the Mental Rotations Test (MRT) before the gross anatomy course and 255 at its completion in 2008 and 2009. Hypotheses were tested using logistic regression analysis and Student's t-test. Compared with students in the lowest quartile of the MRT, students who scored in the highest quartile of the MRT were 2.2 [95% confidence interval (CI) 1.2 and 3.8] and 2.1 (95% CI 1.2 and 3.5) times more likely to score greater than 90% on practical examinations and on both practical and written examinations, respectively. MRT scores for males and females increased significantly (P < 0.0001). Measurement of students' pre-existing visual-spatial ability is predictive of performance in medical gross anatomy, and early intervention may be useful for students with low visual-spatial ability on entry to medical school. Participation in medical gross anatomy increases students' visual-spatial ability, although the mechanism for this phenomenon is unknown.     

Improved medical student perception of ultrasound using a paired anatomy teaching assistant and clinician teaching model

This study describes a new teaching model for ultrasound (US) training, and evaluates its effect on medical student attitudes toward US. First year medical students participated in hands‐on US during human gross anatomy (2014 N = 183; 2015 N = 182). The sessions were facilitated by clinicians alone in 2014, and by anatomy teaching assistant (TA)‐clinician pairs in 2015. Both cohorts completed course evaluations which included five US‐related items on a four‐point scale; cohort responses were compared using Mann‐Whitney U tests with significance threshold set at 0.05. The 2015 survey also evaluated the TAs (three items, five‐point scale). With the adoption of the TA‐clinician teaching model, student ratings increased significantly for four out of five US‐items: “US advanced my ability to learn anatomy” increased from 2.91 ± 0.77 to 3.35 ± 0.68 (P < 0.0001), “Incorporating US increased my interest in anatomy” from 3.05 ± 0.84 to 3.50 ± 0.71 (P < 0.0001), “US is relevant to my current educational needs” from 3.36 ± 0.63 to 3.54 ± 0.53 (P = 0.015), and “US training should start in Phase I” from 3.36 ± 0.71 to 3.56 ± 0.59 (P = 0.010). Moreover, more than 84% of students reported that TAs enhanced their understanding of anatomy (mean 4.18 ± 0.86), were a valuable part of US training (mean 4.23 ± 0.89), and deemed the TAs proficient in US (mean 4.24 ± 0.86). By using an anatomy TA‐clinician teaching team, this study demonstrated significant improvements in student perceptions of the impact of US on anatomy education and the relevancy of US training to the early stages of medical education. Anat Sci Educ 11: 175–184. © 2017 American Association of Anatomists.     

略论林纾的教书人生

翻译家和古文大家林纾,正式职业就是教师,但其长达50多年的教学生涯却极少有人关注.为了从新的一个角度对林纾有一个再认识,文章在广泛搜集材料基础上,阐述了林纾救国兴学的教育理念、不拘一格严谨务实的教学活动及平凡执著的教书生涯.林纾的教育思想、教学实践,对当时的京师大学堂(今北京大学)乃至全国的教育教学,都有积极而深刻的影响;即使对今天的教育教学改革,也将有很大的补益作用.     

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.     

A longitudinal study in learning preferences and academic performance in first year medical school

This is a longitudinal study of first year medical students that investigates the relationship between the pattern change of the learning preferences and academic performance. Using the visual, auditory, reading‐writing, and kinesthetic inventory at the beginning of the first and second year for the same class, it was found that within the first year, 36% of the class remained unimodal (single) modality learners (SS), 14% changed from unimodal to multimodality learners (SM), 27% changed from multimodality to unimodal modality learners (MS) and 21% remained as multimodality learners (MM). Among the academic performance through subsequent didactic blocks from Clinical Anatomy, Cell and Subcellular Processes to Medical Neuroscience during first year, the SM group made more significant improvement compared to the SS group. Semi‐structured interview results from the SM group showed that students made this transition between the Clinical Anatomy course and the middle of the Medical Neuroscience course, in an effort to improve their performance. This study suggests that the transition from unimodal to multimodality learning among academically struggling students improved their academic performance in the first year of medical school. Therefore, this may be considered as part of academic advising tools for struggling students to improve their academic performances. Anat Sci Educ 11: 488–495. © 2017 American Association of Anatomists.     

An eight‐year study of online lecture use in a medical gross anatomy and embryology course

Online lectures have been used in lieu of live lectures in our gross anatomy and embryology course for the past eight years. We examined patterns of online lecture use by our students and related that use to academic entry measures, gender and examination performance. Detailed access records identified by student were available from server logs. Total views per page of lecture material increased over the first six years, then decreased markedly between years seven and eight, possibly due to the recent availability of alternate forms of lecture audio. Lecture use peaked in midafternoon and again in the evening, although some use was seen at all hours. Usage was highest at midweek and lowest on Fridays as might be expected. Individual student's use varied widely from rates equivalent to less than one viewing/page to more than three viewings per page. Overall use by male students was greater than that of females and gender‐specific differences in the daily pattern were seen. Lecture use was correlated to the Medical College Admission Test® (MCAT®) Verbal Reasoning and Physical Sciences scores but not to composite MCAT scores or undergraduate grade point average. Overall use appeared to be driven by scheduled team‐based learning (TBL) sessions and major examinations. Specific subsets of lecture material were most often viewed before related TBL sessions and again during review for examinations. A small but significant correlation between lecture use and examination and course performance was seen, specifically in the male student population. These findings, along with earlier observations, suggest that varied use of online lectures is attributable to multiple factors. Anat Sci Educ © 2012 American Association of Anatomists.     

Outcomes and satisfaction of two optional cadaveric dissection courses: A 3‐year prospective study

Teaching time dedicated to anatomy education has been reduced at many medical schools around the world, including Nova Medical School in Lisbon, Portugal. In order to minimize the effects of this reduction, the authors introduced two optional, semester‐long cadaveric dissection courses for the first two years of the medical school curriculum. These courses were named Regional Anatomy I (RAI) and Regional Anatomy II (RAII). In RAI, students focus on dissecting the thorax, abdomen, pelvis, and perineum. In RAII, the focus shifts to the head, neck, back, and upper and lower limbs. This study prospectively analyzes students' academic achievement and perceptions within the context of these two, newly‐introduced, cadaveric dissection courses. Students' satisfaction was assessed anonymously through a questionnaire that included items regarding students' perception of the usefulness of the courses for undergraduate teaching, as well as with regards to future professional activity. For each of the three academic years studied, the final score (1 to 20) in General Anatomy (GA), RAI, and RAII was on average 14.26 ± 1.89; 16.94 ± 1.02; 17.49 ± 1.01, respectively. The mean results were lower in GA than RAI or RAII (P < 0.001). Furthermore, students who undertook these courses ranked them highly with regards to consolidating their knowledge of anatomy, preparing for other undergraduate courses, and training for future clinical practice. These survey data, combined with data on participating students' academic achievement, lend strong support to the adoption of similar courses as complementary and compulsory disciplines in a modern medical curriculum. Anat Sci Educ 10: 127–136. © 2016 American Association of Anatomists.     

Use of interactive sessions and e‐learning in teaching anatomy to first‐year optometry students

Students enrolled in the Optometry program at the University of Manchester are required to take a functional anatomy course during the first year of their studies. Low mean scores in the written examination of this unit for the past two academic years energized staff to rethink the teaching format. Interactive sessions lasting 20 minutes each were introduced during the two hour lecture sessions. In these sessions students reinforced their anatomical knowledge learned in lectures, through playing games such as anatomy bingo and solving anatomical anagrams. In addition, five e‐learning modules were also introduced for students to complete in their own time. A pre‐ and postcourse questionnaire were distributed to obtain student views on their expectations of the course and interactive sessions. Comparisons were made between written examination results from 2008 to 2009 to written examination results from the previous five academic years to see if the interactive sessions and e‐learning modules had any impact on student knowledge. In addition, comparisons were made between student performances on the functional anatomy course with their performance in all of the other assessments taken by the students during their first year of study. Analysis of the questionnaires showed that student's expectations of the course were fulfilled and the interactive sessions were well received by the majority. There was a significant increase (P ≤ 0.01) in the mean examination score in 2008–2009 after introduction of the interactive sessions and e‐learning modules compared with scores in previous years. The introduction of interactive sessions has increased student enjoyment of the module and along with the e‐learning modules have had a positive impact on student examination results. Anat Sci Educ 3:39–45, 2010. © 2009 American Association of Anatomists.     

Anatomy integration blueprint: A fourth‐year musculoskeletal anatomy elective model

Current undergraduate medical school curricular trends focus on both vertical integration of clinical knowledge into the traditionally basic science‐dedicated curricula and increasing basic science education in the clinical years. This latter type of integration is more difficult and less reported on than the former. Here, we present an outline of a course wherein the primary learning and teaching objective is to integrate basic science anatomy knowledge with clinical education. The course was developed through collaboration by a multi‐specialist course development team (composed of both basic scientists and physicians) and was founded in current adult learning theories. The course was designed to be widely applicable to multiple future specialties, using current published reports regarding the topics and clinical care areas relying heavily on anatomical knowledge regardless of specialist focus. To this end, the course focuses on the role of anatomy in the diagnosis and treatment of frequently encountered musculoskeletal conditions. Our iterative implementation and action research approach to this course development has yielded a curricular template for anatomy integration into clinical years. Key components for successful implementation of these types of courses, including content topic sequence, the faculty development team, learning approaches, and hidden curricula, were developed. We also report preliminary feedback from course stakeholders and lessons learned through the process. The purpose of this report is to enhance the current literature regarding basic science integration in the clinical years of medical school. Anat Sci Educ 7: 379–388. © 2014 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.     

An exploration of anatomists’ views toward the use of body painting in anatomical and medical education: An international study

Previous research has explored the experiences of medical students using body painting as a learning tool. However, to date, faculty experiences and views have not been explored. This international qualitative study utilized a grounded theory approach with data collection through interviews with academics and clinicians who utilized body painting as part of their anatomical teaching. Twenty‐six anatomists participated in the study from 14 centers worldwide. Three themes emerged from the data: (1) the efficacy of body painting, (2) the promotion of knowledge retention and recall, (3) considerations and practicalities regarding the use of body painting as a teaching tool. Subthemes show that body painting is used as an adjunct to the curriculum for teaching surface anatomy and peer examination. Benefits included diffusing the formal curricula, high student engagement and learning for future clinical practice. Body painting was advocated for promoting knowledge retention and recall, particularly learning through the process of cognitive load due to combining the use of color and kinesthetic learning with anatomical theory. Critical discussions surfaced on the topic of undressing in the classroom due to cultural and personal considerations possibly leading to unequal involvement and different learning experiences. Overall results support previous research showing that anatomists appreciate body painting as an effective, enjoyable, engaging and cost efficient adjunct to the multimodal anatomy curriculum. The role of cognitive load theory in learning anatomy through body painting emerged from the data as a possible theoretical framework supporting learning benefits from body painting and is suggested for further investigation. Anat Sci Educ 11: 146–154. © 2017 American Association of Anatomists.     

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.     

A cross‐cultural comparison of anatomy learning: Learning styles and strategies

Cultural influences on anatomy teaching and learning have been investigated by application of a questionnaire to medical students in British and Chinese Medical Schools. Results from the responses from students of the two countries were analyzed. Both groups found it easier to understand anatomy in a clinical context, and in both countries, student learning was driven by assessment. Curriculum design differences may have contributed to the British view wherein students were less likely to feel time pressure and enjoyed studying anatomy more than their Chinese counterparts. Different teaching approaches resulted in British students being more likely to recite definitions to learn, and the Chinese students found learning from cross‐sectional images easy. Cultural differences may account for the observation that British students were more inclined to ask questions in class, and the preference of Chinese students to study in small groups. The findings give evidence to show how ‘cultures of learning’ influence students' approaches and indicate the importance of cultural influences as factors amongst international and home learner groups. Anat Sci Ed 2:49–60, 2009. © 2009 American Association of Anatomists.     

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.     

A tool for teaching three‐dimensional dermatomes combined with distribution of cutaneous nerves on the limbs

A teaching tool that facilitates student understanding of a three‐dimensional (3D) integration of dermatomes with peripheral cutaneous nerve field distributions is described. This model is inspired by the confusion in novice learners between dermatome maps and nerve field distribution maps. This confusion leads to the misconception that these two distribution maps fully overlap, and may stem from three sources: (1) the differences in dermatome maps in anatomical textbooks, (2) the limited views in the figures of dermatome maps and cutaneous nerve field maps, hampering the acquisition of a 3D picture, and (3) the lack of figures showing both maps together. To clarify this concept, the learning process can be facilitated by transforming the 2D drawings in textbooks to a 3D hands‐on model and by merging the information from the separate maps. Commercially available models were covered with white cotton pantyhose, and borders between dermatomes were marked using the drawings from the students' required study material. Distribution maps of selected peripheral nerves were cut out from color transparencies. Both the model and the cut‐out nerve fields were then at the students' disposal during a laboratory exercise. The students were instructed to affix the transparencies in the right place according to the textbook's figures. This model facilitates integrating the spatial relationships of the two types of nerve distributions. By highlighting the spatial relationship and aiming to provoke student enthusiasm, this model follows the advantages of other low‐fidelity models. Anat Sci Educ 6: 277–280. © 2013 American Association of Anatomists.     

Perceptions of junior doctors and undergraduate medical students as anatomy teachers: Investigating distance along the near‐peer teaching spectrum

Near‐peer teaching involves more experienced students acting as tutors and has been widely used in anatomy education. This approach has many advantages for the learner due to the social and cognitive congruence they share with the teacher, however, the influence of distance between the teacher and learner on these congruences has yet to be explored. The aim of this study was to compare the attitudes and perceptions of the student learner towards neuroanatomy review sessions taught by either a senior medical student or a junior doctor. The students were randomly assigned to an allocated tutor. All tutors used standardized material and had access to identical resources. The type of allocated tutor was swapped between the two teaching sessions and 99 student feedback forms were collected in total. The rating for the overall quality of the teaching session was not significantly different between the junior doctors and senior medical students (P = 0.11). However, criteria closely relating to social and cognitive congruence such as “enjoyment of the session,” “delivery of the teaching,” and “was it a good use of time” were all rated significantly higher for the senior medical students (P < 0.05). The results of this study suggest that small increases in distance along the near‐peer teaching spectrum have an impact upon the student's perception of their learning experience. While all teachers were suitable role models it appears that junior doctors are too far removed from their own undergraduate experiences to share congruences with pre‐clinical medical students. Anat Sci Educ 7: 242–247. © 2013 American Association of Anatomists.     

A novel phased‐concept course for the delivery of anatomy and orthopedics training in medical education

Integration of anatomy and clinical teaching is a theoretical ideal, yet there is a worldwide paucity of such amalgamation. These teaching models provide support for medical trainees, an important element in Germany where orthopedic intern numbers have declined and anecdotal evidence suggests disinterest in orthopedics. The aim of the study was to develop an integrated anatomy‐surgical course for undergraduate medical training, assess the model developed, and explore how medical students perceive orthopedics as a career. The course was to deliver medical anatomy and clinical orthopedic training, focusing on interdisciplinary teaching and learning, vertical integration of clinical knowledge and skills, and professional interaction. Survey evaluation of the course and students' perceptions of orthopedic careers was performed, including Likert‐type responses rating variables of interest. A phased‐concept program of five courses, each optional and under one‐week in duration, was developed parallel to the undergraduate medical program. Delivered by anatomists and surgeons, courses included biomechanics, advanced dissection, surgical approaches, casts and implants, and sports medicine. Course data indicate positive support for course format, stimulation of interest, and high clinical relevance. Students are generally interested in surgery, and identify hierarchy, lawsuits, bureaucracy and physical stress as barriers to orthopedic careers. This novel phased‐concept successfully delivers combined anatomy and surgery training in a vertically‐integrated format while addressing students' clinical and professional skills. The format facilitates an appreciation of potential career options in orthopedics, while fostering professional skills during medical training. Barriers to careers in orthopedics can now be addressed in future courses. Anat Sci Educ 10: 372–382. © 2016 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.