The Role of History and Ethics of Anatomy in Medical Education

While time spent on anatomical education in medical school curricula has been diminishing over the last decades, the recognized role of anatomical dissection has expanded. It is perceived by many students and faculty not only as the means of learning the structure and function of the human body, but also as an opportunity for the acquisition of professional competencies such as team work, patient–doctor interaction, medical epistemology, self-awareness, and an understanding of medical ethics. This viewpoint article proposes that this learning process can be supported effectively through studying examples from the history of anatomy, as insights from this history can help illuminate contemporary ethical issues in anatomy and medicine. Anatomical education can thus provide not only the opportunity of gaining awareness of ethical questions, but also a chance to practice these new insights within the protected environment of the laboratories, in interaction with the dead and the living. Consequently, a new role has developed for anatomists, which includes the interweaving of the scholarly exploration of the history and ethics of anatomy with the practical application of research results into a reframed concept of anatomical education. Anatomy, as a foundational discipline in the medical curriculum, can thus provide a first step on the educational path of empathetic and humane medical caregivers.     

The Use of a Mobile Learning Tool by Medical Students in Undergraduate Anatomy and its Effects on Assessment Outcomes

Hand-held devices have revolutionized communication and education in the last decade. Consequently, mobile learning (m-learning) has become popular among medical students. Nevertheless, there are relatively few studies assessing students' learning outcomes using m-learning devices. This observational study presents an anatomy m-learning tool (eMed-App), an application developed to accompany an anatomy seminar and support medical students' self-directed learning of the skeletal system. Questionnaire data describe where, how frequently, and why students used the app. Multiple choice examination results were analyzed to evaluate whether usage of the app had an effect on test scores. The eMed-App application was used by 77.5% of the students, mainly accessed by Android smartphones, and at students' homes (62.2%) in order to prepare themselves for seminar sessions (60.8%), or to review learning content (67%). Most commonly, students logged on for less than 15 minutes each time (67.8%). Frequent app users showed better test results on items covering eMed-App learning content. In addition, users also achieved better results on items that were not related to the content of the app and, thus, gained better overall test results and lower failure rates. The top quartile of test performers used the eMed-App more frequently compared to students in lower quartiles. This study demonstrated that many students, especially the high-performing ones, made use of the eMed-App. However, the app itself did not result in better outcomes, suggesting that top students might have been more motivated to use the app than students who were generally weak in anatomy.     

Impact of Anatomy Boot Camp on Students in a Medical Gross Anatomy Course

Lincoln Memorial University‐DeBusk College of Osteopathic Medicine (LMU‐DCOM) offers an optional three‐week summer Anatomy Boot Camp course (ABC) to facilitate students' transition into medical school and promote retention of anatomy subject matter. The pre‐matriculation program is a supplemental instruction course that utilizes a small group learning format. Boot camp instruction is led by teaching assistants and two anatomy professors. Enrollees gain early exposure to Medical Gross Anatomy (MGA) course subject matter, which is taught in the fall semester, and learn study skills necessary to excel in medical school. No grade is assigned for the course, therefore participants can study without the fear of potentially affecting grades. This study evaluates the effectiveness of the LMU‐DCOM ABC course using data from four consecutive summers. Independent two‐sample t‐tests were used to compare ABC to non‐ABC students for the following variables: incoming grade point average (GPA) and Medical College Admission Test® (MCAT®) scores, MGA written and laboratory practical examination grades, and final MGA course grade. Additionally, a 26‐question survey was administered to 2012–2014 boot camp participants. There were no significant differences in incoming GPA and MCAT scores. However, boot campers scored significantly higher on the first two lecture and laboratory examinations (P < 0.05) for each year of the study. Thereafter scores varied less, suggesting a faster head start for boot camp participants. Mean MGA final grade was on average 3% higher for the boot camp cohort. The survey feedback supports that the ABC course assists with the academic and social transition into medical school. Anat Sci Educ 10: 215–223. © 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.     

The Use of Augmented Reality Technology in Medical Specimen Museum Tours

Human anatomical specimen museums are commonly used by medical, nursing, and paramedical students. Through dissection and prosection, the specimens housed in these museums allow students to appreciate the complex relationships of organs and structures in more detail than textbooks could provide. However, it may be difficult for students, particularly novices, to identify the various parts of these anatomical structures without additional explanations from a docent or supplemental illustrations. Recently, augmented reality (AR) has been used in many museum exhibits to display virtual objects in videos captured from the real world. This technology can significantly enhance the learning experience. In this study, three AR-based support systems for tours in medical specimen museums were developed, and their usability and effectiveness for learning were examined. The first system was constructed using an AR marker. This system could display virtual label information for specimens by capturing AR markers using a tablet camera. Individual AR markers were required for all specimens, but their presence in and on the prosected specimens could also be obtrusive. The second system was developed to set the specimen image itself as an image marker, as most specimens were displayed in cross section. Visitors could then obtain the label information presented by AR without any markers intruding on the display or anatomical specimens. The third system was comprised of a head-mounted display combined with a natural click interface. The system could provide visitors with an environment for the natural manipulation of virtual objects with future scalability.     

The Spectrum of Learning and Teaching: The Impact of a Fourth-Year Anatomy Course on Medical Student Knowledge and Confidence

There is growing demand from accrediting agencies for improved basic science integration into fourth-year medical curricula and inculcation of medical students with teaching skills. The objective of this study was to determine the effectiveness of a fourth-year medical school elective course focused on teaching gross anatomy on anatomical knowledge and teaching confidence. Fourth-year medical student “teacher” participants' gross anatomy knowledge was assessed before and after the course. Students rated their overall perceived anatomy knowledge and teaching skills on a scale from 0 (worst) to 10 (best), and responded to specific knowledge and teaching confidence items using a similar scale. First-year students were surveyed to evaluate the effectiveness of the fourth-year student teaching on their learning. Thirty-two students completed the course. The mean anatomy knowledge pretest score and posttest scores were 43.2 (±22.1) and 74.1 (±18.4), respectively (P < 0.001). The mean perceived anatomy knowledge ratings before and after the course were 6.19 (±1.84) and 7.84 (±1.30), respectively (P < 0.0001) and mean perceived teaching skills ratings before and after the course were 7.94 (±1.24) and 8.53 (±0.95), respectively (P = 0.002). Student feedback highlighted five themes which impacted fourth-year teaching assistant effectiveness, including social/cognitive congruence and improved access to learning opportunities. Together these results suggest that integrating fourth-year medical students in anatomy teaching increases their anatomical knowledge and improves measures of perceived confidence in both teaching and anatomy knowledge. The thematic analysis revealed that this initiative has positive benefits for first-year students.     

The Quality and Readability of English Wikipedia Anatomy Articles

Forty anatomy articles were sampled from English Wikipedia and assessed quantitatively and qualitatively. Quantitatively, each article’s edit history was analyzed by Wikipedia X-tools, references and media were counted manually, and two readability indices were used to evaluate article readability. This analysis revealed that each article was updated 8.3 ± 6.8 times per month, and referenced with 33.5 ± 24.3 sources, such as journal articles and textbooks. Each article contained on average 14.0 ± 7.6 media items. The readability indices including: (1) Flesch–Kincaid Grade Level Readability Test and (2) Flesch Reading Ease Readability Formula demonstrated that the articles had low readability and were more appropriate for college students and above. Qualitatively, the sampled articles were evaluated by experts using a modified DISCERN survey. According to the modified DISCERN, 13 articles (32.5%), 24 articles (60%), 3 articles (7.5%), were rated as “good,” “moderate,” and “poor,” respectively. There were positive correlations between the DISCERN score and the number of edits (r = 0.537), number of editors (r = 0.560), and article length (r = 0.536). Strengths reported by the panel included completeness and coverage in 11 articles (27.5%), anatomical details in 10 articles (25%), and clinical details in 5 articles (12.5%). The panel also noted areas which could be improved, such as providing missing information in 28 articles (70%), inaccuracies in 10 articles (25%), and lack or poor use of images in 17 articles (42.5%). In conclusion, this study revealed that many Wikipedia anatomy articles were difficult to read. Each article’s quality was dependent on edit frequency and article length. Learners and students should be cautious when using Wikipedia articles for anatomy education due to these limitations.     

高强度的环境规制能够促进国内大气科技创新吗？——以〖SO〗_2排放控制技术为例

从理论上来说,波特弱假说涉及双重外部性问题,即大气污染的负外部性和技术创新的正外部性,环境规制和知识产权保护合力才能予以切实彻底解决,而后者并没有得到普遍重视。本文认为,波特弱假说需要考虑知识产权保护强度。以SO_2排放控制技术为例,本文运采用2000-2013年省际省份面板数据,结合固定效应模型进行实证研究检验了知识产权保护对于波特弱假说的作用。结果发现,当知识产权保护较弱时,环境规制对大气科技创新具有呈现负向影响;。只有当知识产权保护较强时力度超过一定阈值时,环境规制才会对大气科技创新产生正向影响,波特弱假说成立。此外,环境规制和知识产权保护影响大气科技创新的交叉效应主要出现在企业,而非科研院所和个人,创新主体存在明显的差异性。     

FDI和环境规制对技术创新的影响——基于中国省际面板数据分析

采用我国2000—2014年30个省份的面板数据构建面板门槛回归模型,从FDI及其与环境规制相结合的角度实证分析FDI对技术创新的影响。研究结果表明,FDI对技术创新存在显著的门槛效应,当经济发展水平和环境规制强度跨越相应门槛时,其能有效促进技术创新;环境规制会抑制FDI技术溢出效应,对技术创新产生间接影响;FDI技术溢出效应存在明显的地区性差异。政府应结合不同地区的现状,有针对性地提高地区经济发展水平,合理制定地区环境规制强度,以此显著提升地区技术创新能力。     

规划调控下的农村居民点整治潜力测算研究

农村居民点整治潜力测算是土地整治的重要内容,也是土地整治规划的核心环节。在乡镇土地利用总体规划调控下,将农村居民点划分为城镇化型及非城镇化型两大类;针对非城镇化型,构建农村居民点综合影响力评价指标体系,评价其综合影响力,并结合乡镇土地利用总体规划相关规定,将其划分为内部改造型、原地优化型及迁村并点型;根据不同整治类型,采用模式法构建相应的整治潜力测算模型。并以宜城市小河镇为例进行实证研究,预计到2020年小河镇通过整治可释放潜力117.83hm²。本研究将为农村居民点整治潜力测算提供新的思路。