Immersive Anatomy Atlas: Learning Factual Medical Knowledge in a Virtual Reality Environment

In order to improve learning efficiency and memory retention in medical teaching, furthering active learning seems to be an effective alternative to classical teaching. One option to make active exploration of the subject matter possible is the use of virtual reality (VR) technology. The authors developed an immersive anatomy atlas which allows users to explore human anatomical structures interactively through virtual dissection. Thirty-two senior-class students from two German high schools with no prior formal medical training were separated into two groups and tasked with answering an anatomical questionnaire. One group used traditional anatomical textbooks and the other used the immersive virtual reality atlas. The time needed to answer the questions was measured. Several weeks later, the participants answered a similar questionnaire with different anatomical questions in order to test memory retention. The VR group took significantly less time to answer the questionnaire, and participants from the VR group had significantly better results over both tests. Based on the results of this study, VR learning seems to be more efficient and to have better long-term effects for the study of anatomy. The reason for that could lie in the VR environment's high immersion, and the possibility to freely and interactively explore a realistic representation of human anatomy. Immersive VR technology offers many possibilities for medical teaching and training, especially as a support for cadaver dissection courses.     

Measurement of maximal muscle cross-sectional area of the elbow extensors and flexors in children,teenagers and adults

Abstract

The aims of this study were to examine age and sex differences in elbow extensor and flexor anatomical muscle cross-sectional area (mCSA) measured by magnetic resonance imaging (MRI) and the location of maximal mCSA as a percentage of the distance from the distal to the proximal end of the humerus. Ninety-five individuals spread across the age groups 9 – 10 years, 16 – 17 years and 21 years participated in the study. Muscle cross-sectional area derived from the manual MRI tracing proved to be highly reliable in terms of limits of agreement (?2.5 to 1.5 cm²) and the intraclass correlation coefficient (ICC = 0.998). A sex-by-age group analysis of variance revealed significant effects (P < 0.01) of sex, group and a sex-by-group interaction, the latter reflecting a greater increase in males than females of upper arm mCSA from childhood to adulthood. Extensor mCSA was more proximal (55 ± 6%) than that of the flexors (28 ± 6%). A significant effect (P < 0.01) of group was found for location of maximal extensor mCSA, reflecting its more distal position with increasing age. Measurements of muscle size should be made at the individually determined position of maximal mCSA if interpreting data collected during growth and maturation, especially if the muscle group of interest is the elbow extensors and if different age groups are being monitored.     

Motion analysis of front crawl swimming applying CAST technique by means of automatic tracking

Abstract

Kinematic analysis of swimming is of interest to improve swimming performances. Although the video recordings of underwater swimmers are commonly used, the available methodologies are rarely precise enough to adequately estimate the three dimensional (3D) joint kinematics. This is mainly due to difficulties in obtaining the required kinematic parameters (anatomical landmarks, joint centres and reference frames) in the swimming environment. In this paper we propose a procedure to investigate the right upper limb’s 3D kinematics during front crawl swimming in terms of all elbow and shoulder degrees of freedom (three rotations of the shoulder, two of the elbow). The method is based upon the Calibrated Anatomical Systems Technique (CAST), a technique widely used in clinics, which allows estimation of anatomical landmarks of interest even when they are not directly visible. An automatic tracking technique was adopted. The intra-operator repeatability of the manual tracking was also assessed. The root mean squared difference of three anatomical landmarks, processed five times, is always lower than 8 mm. The mean of the root mean squared difference between trajectories obtained with the different methodologies was found to be lower than 20 mm. Results showed that complete 3D kinematics of at least twice as many frames than without CAST can be reconstructed faster and more precisely.     

Training tomorrow's anatomists today: A partnership approach

Anatomy is recognized to play a central role in the education and training of clinicians, healthcare professionals, and scientists. However, in recent years, the perceived decline in popularity of anatomy has led to a deficiency in the numbers of new anatomy educators. The tide is now turning with anatomy once again taking its rightful place in a wide of variety of disciplines, and therefore it is imperative that a new generation of anatomists is in place to meet this need. In response, the Anatomical Society of Great Britain and Ireland has made the training of the next set of anatomists, one of its strategic priorities, and in collaboration with the American Association of Anatomists has developed a dedicated Training Program. The overall aim of the Program is to provide trainees with the necessary knowledge, understanding, aptitudes, and attitudes in appropriate detail, sufficient to enable them to teach and examine Anatomy with full competence at the undergraduate and postgraduate level. The Program offers opportunities to consolidate knowledge and deepen understanding of anatomy, improve skills in teaching and communication with students, and be competent in preparing teaching materials and assessment modalities. The Program uses a distance‐learning approach with an incorporated Residential School and is particularly aimed at those undertaking a career in the biosciences. Early indications suggest that initiatives such as the development of this Training Program will help deliver the next generation of anatomists and ensure that anatomy continues to play a fundamental role in the education of clinicians, healthcare professionals, and scientists. Anat Sci Ed 2:119‐125, 2009 © 2009 American Association of Anatomists.     

Spatial abilities of expert clinical anatomists: comparison of abilities between novices, intermediates, and experts in anatomy

Spatial ability has been found to be a good predictor of success in learning anatomy. However, little research has explored whether spatial ability can be improved through anatomy education and experience. This study had two aims: (1) to determine if spatial ability is a learned or inherent facet in learning anatomy and (2) to ascertain if there is any difference in spatial ability between experts and novices in anatomy. Fifty participants were identified: 10 controls, 10 novices, 10 intermediates, and 20 experts. Participants completed four computerized spatial ability tasks, a visual mental rotation task, categorical spatial judgment task, metric spatial task, and an image-scanning task. The findings revealed that experts (P = 0.007) and intermediates (P = 0.016) were better in the metric spatial task than novices in terms of making more correct spatial judgments. Experts (P = 0.033), intermediates (P = 0.003), and novices (P = 0.004) were better in the categorical spatial task than controls in terms of speed of responses. These results suggest that certain spatial cognitive abilities are especially important and characteristic of work needed in clinical anatomy, and that education and experience contribute to further development of these abilities.     

Formal body bequest program in Nigerian medical schools: When do we start?

Human body dissection is a prerequisite for the training of health professionals and the conduct of medical research. However, most Nigerian medical schools experience difficulty obtaining an adequate and regular supply of human tissue. Presently, the major source of anatomical material comes from unclaimed bodies collected from hospital mortuaries. However, one sure way to ensure a regular supply of bodies for anatomical dissection is to establish a whole body bequest program among the departments of anatomy in Nigerian medical schools. If such a program were to be supported by an appropriate legislative act of parliament, the supply of acceptable cadavers for anatomical teaching and research would be substantially increased. The author advocates for establishing a whole body bequest program among Nigerian medical schools.     

Medical students' perceptions of the body donor as a "first patient" or "teacher": a pilot study

University of Michigan Medical School (UMMS) students attending a seminar on the history and ethics of anatomical dissection were fascinated by a report on the dissection room experience in Thailand that relates the body donor's status as a teacher. The students felt that they had naturally adopted the "body as teacher" approach in their dissection course, rather than the "body as first patient" approach that is encouraged by faculty. It was decided to explore the question whether other medical students shared these perceptions. A questionnaire was sent out to all UMMS students who had finished the anatomical dissection course. One hundred twenty-eight responses from a population of 500 students were received. Results indicate that students believe the "body as teacher" approach is more effective in engendering respect and empathy towards the body and towards future patients, and in facilitating students' emotional development. Students also reported wanting a more personal relationship with their donors. Eighty four percent of students preferred the "body as teacher" approach to the currently taught "body as first patient" approach. The results support the hypothesis that students' desired closer personal relationship with donors might be better facilitated by the "body as teacher" approach, and that this closer relationship engenders empathy and respect towards the donor and future patients. A new model for anatomy programs could introduce the donor first as a teacher and later transition into viewing the donor as a patient.     

Supporting collaborative dissection through the development of an online wiki positively impacts the learning of veterinary anatomy

An innovative series of dissections of the canine abdomen was created to facilitate social distancing in the dissection room following COVID-19 restrictions imposed in the UK. In groups of six, first-year veterinary students took turns dissecting selected parts of the canine abdomen while maintaining social distancing and documenting their work with video and photographs. Here, students learned about the canine abdominal anatomy by dissecting, recording the dissections of others in their group, and compiling the recorded material into a collaborative electronic media portfolio (Wiki). An online formative multiple-choice test was created to test students' knowledge of the canine abdominal anatomy. The result analysis showed that although students achieved the learning outcomes only by studying the Wiki, they had better performance in the anatomical areas where they learned through the dissection (p < 0.05). Student performance was very similar in the areas in which they were present in the dissection room and participated in recording the dissection compared with the areas that they effectively dissected (p > 0.05). A qualitative thematic analysis was developed to understand students' opinions via their feedback on this dissection approach. Our results showed that student collaboration and the development of practical skills were the most valued aspects of this dissection teaching initiative. Moreover, these results show that developing a group Wiki has a positive impact on student achievement of learning objectives, with a practical hands-on dissection being fundamental for the optimal learning of the canine abdominal anatomy.     

Clinical Anatomy and Unexpected Careers: Is There Curriculum for That?

Reduction in faculty positions in higher education and increased graduate matriculation rates represent a higher education conundrum. Planned happenstance theory (PHT) is a career development model focusing on positive outcomes resulting from unpredictable precareer events. This mixed methods study explores how PHT applies to the career paths of a clinical anatomy (CA) postgraduate cohort. It provides insight into educational practices designed to equip students for labor markets inside and outside academia. Alumni of CA (n = 12; 2014-2018) were interviewed about career-related events transpiring from graduate studies to present, allowing exploration on how PHT contextualizes their shared experiences. Planned happenstance career inventory (PHCI) enumerated planned happenstance skill (PHS) scores. Total PHS was referenced 527 times across 12 interviews. Of the PHS references, curiosity established highest incidence (154 references, 29%), optimism (132 references, 25%), flexibility (101 references, 19%), risk-taking (85 references, 16%), and persistence (55 references, 10%) and 43 distinct happenstance events were documented. In addition, social networking (52 references) arose as an emergent code and was divided into internal networking (28 references, 54%) and external networking (24 references, 46%). Application of the five-point PHCI scale revealed: curiosity (4.4 ± 0.3; mean ± SD), flexibility (3.6 ± 0.7), persistence (4.4 ± 0.3), optimism (4.3 ± 0.4), and risk-taking (4.1 ± 0.5). Curiosity had the strongest association with happenstance event incidence. Social networking was a key substituent of PHT not yet described in the literature. Educational practices incorporating PHT concepts, with emphasis on curiosity, may provide graduates novel metacognitive skills needed to develop novel career paths.