腰椎椎骨骨性管道与腰椎管狭窄症的解剖学基础

目的:研究脊椎骨性管道为治疗椎管狭窄症提供解剖学基础。方法:用不同尸材19具,解剖出第四腰椎,观察测量其矢状径的大小。结果:19块椎骨管径在14.5mm-17.9mm之间,平均为(17.0±0.41)mm。结论:国人矢状径平均17.0mm,15mm为临界值,12mm以下为狭窄。     

自然科学视野中的鲁迅其人其文(之二)

鲁迅其人其文一直没有离开自然科学的理论支持，其既获利于科学方法又受益于科学精神。鲁迅终其一生的韧性战斗所创造的光辉业绩和文学瑰宝，都充溢着科学理性精神。从自然科学的视野来审视鲁迅其人其文，可以发现，自然科学不但深刻影响其人，同时也深刻地影响其文，至于由此所显现出来的规律性的东西，更值得我们认真地体味和解读。     

3D虚拟解剖模型在解剖学教学中的应用探析

在康复治疗技术专业解剖学教学中应用3D虚拟解剖模型和学生手机APP进行学习,能很好地解决标本短缺的问题,取得较好的教学效果。文章介绍3D虚拟解剖模型概况,探讨3D虚拟解剖模型的应用优势,并指出3D虚拟解剖模型的不足和改进办法,以激发学生的学习兴趣,使教师的教与学生的学都变得更加轻松。     

Longitudinal retention of anatomical knowledge in second‐year medical students

The Radboud University Medical Center has a problem‐based, learner‐oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students’ decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving. In a longitudinal cohort, the retention of anatomical knowledge gained during the first year of medical school among second‐year medical students was assessed. In May 2011, 346 medical students applied for the second‐year gastro‐intestinal (GI) tract course. The students were asked to participate in a reexamination of a selection of anatomical questions of an examination from October 2009. The examination consisted of a clinical anatomy case scenario and two computed tomography (CT) images of thorax and abdomen in an extended matching format. A total of 165 students were included for analysis. In 2011, students scored significantly lower for the anatomy examination compared to 2009 with a decline in overall examination score of 14.7% (±11.7%). Decrease in knowledge was higher in the radiological questions, compared to the clinical anatomy cases 17.5% (±13.6%) vs. 7.9% (±10.0%), respectively, d = 5.17. In both years, male students scored slightly better compared to female students, and decline of knowledge seems somewhat lower in male students (13.1% (±11.1%) vs. 15.5% (±12.0%), respectively), d = ?0.21. Anatomical knowledge in the problem‐oriented horizontal and vertical integrated medical curriculum, declined by approximately 15% 1.5 year after the initial anatomy course. The loss of knowledge in the present study is relative small compared to previous studies. Anat Sci Educ 10: 242–248. © 2016 American Association of Anatomists.     

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.     

Performance equivalency between computer‐based and traditional pen‐and‐paper assessment: A case study in clinical anatomy

The time, material, and staff‐consuming nature of anatomy's traditional pen‐and‐paper assessment system, the increase in the number of students enrolling in medical schools and the ever‐escalating workload of academic staff have made the use of computer‐based assessment (CBA) an attractive proposition. To understand the impact of such shift in the assessment method, an experimental study evaluating its effect on students’ performance was designed. Additionally, students’ opinions toward CBA were gathered. Second‐year medical students attending a Clinical Anatomy course were randomized by clusters in two groups. The pen‐and‐paper group attended two sessions, each consisting of a traditional sectional anatomy steeplechase followed by a theoretical examination, while the computer group was involved in two similar sessions conducted in a computerized environment. At the end of each of the computer sessions, students in this group filled an anonymous questionnaire. In the first session, pen‐and‐paper group students scored significantly better than computer‐group students in both the steeplechase (mean ± standard deviation: 66.00 ± 14.15% vs. 43.50 ± 19.10%; P < 0.001) and the theoretical examination (52.50 ± 12.70% vs. 39.00 ± 21.10%; P < 0.001). In the second session, no statistically significant differences were found for both the steeplechase (59.50 ± 17.30% vs. 54.50 ± 17.00%; P = 0.085) and the theoretical examination (57.50 ± 13.70% vs. 54.00 ± 14.30%; P = 0.161). Besides, an intersession improvement in students’ perceptions toward CBA was registered. These results suggest that, after a familiarization period, CBA might be a performance equivalent and student accepted alternative to clinical anatomy pen‐and‐paper theoretical and practical examinations. Anat Sci Educ 11: 124–136. © 2017 American Association of Anatomists.     

The skeletons in our closet: E‐learning tools and what happens when one side does not fit all

In the anatomical sciences, e‐learning tools have become a critical component of teaching anatomy when physical space and cadaveric resources are limited. However, studies that use empirical evidence to compare their efficacy to visual‐kinesthetic learning modalities are scarce. The study examined how a visual‐kinesthetic experience, involving a physical skeleton, impacts learning when compared with virtual manipulation of a simple two‐dimensional (2D) e‐learning tool, A.D.A.M. Interactive Anatomy. Students from The University of Western Ontario, Canada (n = 77) participated in a dual‐task study to: (1) investigate if a dual‐task paradigm is an effective tool for measuring cognitive load across these different learning modalities; and (2) to assess the impact of knowledge recall and spatial ability when using them. Students were assessed using knowledge scores, Stroop task reaction times, and mental rotation test scores. Results demonstrated that the dual‐task paradigm was not an effective tool for measuring cognitive load across different learning modalities with respect to kinesthetic learning. However, our study highlighted that handing physical specimens yielded major, positive impacts on performance that a simple commercial e‐learning tool failed to deliver (P < 0.001). Furthermore, students with low spatial ability were significantly disadvantaged when they studied the bony joint and were tested on contralateral images (P = 0.046, R = 0.326). This suggests that, despite limbs being mirror images, students should be taught the anatomy of, as well as procedures on, both sides of the human body, enhancing the ability of all students, regardless of spatial ability, to take anatomical knowledge into the clinic and perform successfully. Anat Sci Educ 10: 570–588. © 2017 American Association of Anatomists.     

The effect of image quality,repeated study,and assessment method on anatomy learning

The use of two‐dimensional (2D) images is consistently used to prepare anatomy students for handling real specimen. This study examined whether the quality of 2D images is a critical component in anatomy learning. The visual clarity and consistency of 2D anatomical images was systematically manipulated to produce low‐quality and high‐quality images of the human hand and human eye. On day 0, participants learned about each anatomical specimen from paper booklets using either low‐quality or high‐quality images, and then completed a comprehension test using either 2D images or three‐dimensional (3D) cadaveric specimens. On day 1, participants relearned each booklet, and on day 2 participants completed a final comprehension test using either 2D images or 3D cadaveric specimens. The effect of image quality on learning varied according to anatomical content, with high‐quality images having a greater effect on improving learning of hand anatomy than eye anatomy (high‐quality vs. low‐quality for hand anatomy P = 0.018; high‐quality vs. low‐quality for eye anatomy P = 0.247). Also, the benefit of high‐quality images on hand anatomy learning was restricted to performance on short‐answer (SA) questions immediately after learning (high‐quality vs. low‐quality on SA questions P = 0.018), but did not apply to performance on multiple‐choice (MC) questions (high‐quality vs. low‐quality on MC questions P = 0.109) or after participants had an additional learning opportunity (24 hours later) with anatomy content (high vs. low on SA questions P = 0.643). This study underscores the limited impact of image quality on anatomy learning, and questions whether investment in enhancing image quality of learning aids significantly promotes knowledge development. Anat Sci Educ 10: 249–261. © 2016 American Association of Anatomists.     

An evaluation of outcomes following the replacement of traditional histology laboratories with self‐study modules

Changes in medical school curricula often require educators to develop teaching strategies that decrease contact hours while maintaining effective pedagogical methods. When faced with this challenge, faculty at the University of Cincinnati College of Medicine converted the majority of in‐person histology laboratory sessions to self‐study modules that utilize multiple audiovisual modalities and a virtual microscope platform. Outcomes related to this shift were investigated through performance on in‐house examinations, results of the United States Medical Licensing Examination^® (USMLE^®) Step 1 Examination, and student feedback. Medical School College Admissions Test^® (MCAT^®) scores were used as a covariate when comparing in‐house examinations. Results revealed no significant change in performance on in‐house examinations when the content being assessed was controlled (F(2, 506) = 0.676, P = 0.51). A significant improvement in overall practical examination grade averages was associated with the self‐study modules (F(6, 1164) = 10.213, P < 0.01), but gradual changes in examination content may explain this finding. The histology and cell biology portion of USMLE Step 1 Examination remained consistent throughout the time period that was investigated. Student feedback regarding the self‐study modules was positive and suggested that features such as instructor narrated videos were an important component of the self‐study modules because they helped recreate the experience of in‐person laboratory sessions. Positive outcomes from the student perspective and no drop in examination performance suggests that utilizing self‐study modules for histology laboratory content may be an option for educators faced with the challenge of reducing contact hours without eliminating content. Anat Sci Educ 10: 276–285. © 2016 American Association of Anatomists.