An update on the status of anatomical sciences education in United States medical schools

Curricular changes continue at United States medical schools and directors of gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses continue to adjust and modify their offerings. Developing and supplying data related to current trends in anatomical sciences education is important if informed decisions are going to be made in a time of curricular and course revision. Thus, a survey was sent to course directors during the 2012–2013 academic years to gather information on total course hours, lecture and laboratory hours, the type of laboratory experiences, testing and competency evaluation, and the type of curricular approach used at their institution. The data gathered were compared to information obtained from previous surveys and conclusions reached were that only small or no change was observed in total course, lecture and laboratory hours in all four courses; more gross anatomy courses were part of an integrated curriculum since the previous survey; virtual microscopy with and without microscopes was the primary laboratory activity in microscopic anatomy courses; and neuroscience/neuroanatomy and embryology courses were unchanged. Anat Sci Educ 7: 321–325. © 2014 American Association of Anatomists.     

An approach toward the development of core syllabuses for the anatomical sciences

There is increasingly a call for clinical relevance in the teaching of the biomedical sciences within all health care programs. This presupposes that there is an understanding of what is “core” material within the curriculum. To date, the anatomical sciences have been poorly served by the development of core syllabuses, although there have been commendable attempts to define a core syllabus for gross anatomy in medicine and for some medical specialties. The International Federation of Associations of Anatomists and the European Federation for Experimental Morphology aim to formulate, on an international basis, core syllabuses for all branches of the anatomical sciences. This is being undertaken at the initial stage using Delphi Panels consisting of a team of anatomists, scientists, and clinicians who evaluate syllabus content and accord each element/topic “essential,” “important,” “acceptable,” or “not required” status. Their initial conjectures, published on the International Federation of Associations of Anatomists' website, provide merely a framework to enable anatomical (and other cognate learned) societies and individual anatomists, clinicians, and students to comment upon the syllabuses. This article presents the concepts and methodological approaches underlying the hybrid Delphi process employed. Preliminary findings relating to the development of a neuroanatomy core syllabus are provided to illustrate the methods initially employed by a Delphi Panel. The approach is novel in that it is international in scope, is conceptually democratic, and is developmentally fluid in terms of availability for amendment. The aim is to set internationally recognized standards and thus to provide guidelines concerning anatomical knowledge when engaged in course development. Anat Sci Educ 7: 302–311. © 2014 American Association of Anatomists.     

The perceived importance of anatomy and neuroanatomy in the practice of speech—Language pathology

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech‐language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case‐based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum. Anat Sci Educ. 7: 28–37. © 2013 American Association of Anatomists.     

E-Learning Three-Dimensional Anatomy of the Brainstem: Impact of Different Microscopy Techniques and Spatial Ability

Polarized light imaging (PLI) is a new method which quantifies and visualizes nerve fiber direction. In this study, the educational value of PLI sections of the human brainstem were compared to histological sections stained with Luxol fast blue (LFB) using e-learning modules. Mental Rotations Test (MRT) was used to assess the spatial ability. Pre-intervention, post-intervention, and long-term (1 week) anatomical tests were provided to assess the baseline knowledge and retention. One-on-one electronic interviews after the last test were carried out to understand the students’ perceptions of the intervention. Thirty-eight medical students, (19 female and 19 males, mean age 21.5 ± SD 2.4; median age: 21.0 years) participated with a mean MRT score of 13.2 ± 5.2 points and a mean pre-intervention knowledge test score of 49.9 ± 11.8%. A significant improvement in both, post-intervention and long-term test scores occurred after learning with either PLI or LFB e-learning module on brainstem anatomy (both P < 0.001). No difference was observed between groups in post-intervention test scores and long-term test scores (P = 0.913 and P = 0.403, respectively). A higher MRT-score was significantly correlated with a higher post-intervention test score (r_k = 0.321; P < 0.05, respectively), but there was not a significant association between the MRT- and the long-term scores (r_k = −0.078; P = 0.509). Interviews (n = 10) revealed three major topics: Learning (brainstem) anatomy by use of e-learning modules; The “need” of technological background information when studying brainstem sections; and Mnemonics when studying brainstem anatomy. Future studies should assess the cognitive burden of cross-sectional learning methods with PLI and/or LFB sections and their effects on knowledge retention.     

Evaluation of an Augmented Reality Application for Learning Neuroanatomy in Psychology

Neuroanatomy is difficult for psychology students because of spatial visualization and the relationship among brain structures. Some technologies have been implemented to facilitate the learning of anatomy using three-dimensional (3D) visualization of anatomy contents. Augmented reality (AR) is a promising technology in this field. A mobile AR application to provide the visualization of morphological and functional information of the brain was developed. A sample of 67 students of neuropsychology completed tests for visuospatial ability, anatomical knowledge, learning goals, and experience with technologies. Subsequently, they performed a learning activity using one of the visualization methods considered: a 3D method using the AR application and a two-dimensional (2D) method using a textbook to color, followed by questions concerning their satisfaction and knowledge. After using the alternative method, the students expressed their preference. The two methods improved knowledge equally, but the 3D method obtained higher satisfaction scores and was more preferred by students. The 3D method was also more preferred by the students who used this method during the activity. After controlling for the method used in the activity, associations were found between the preference of the 3D method because of its usability and experience with technologies. These results found that the AR application was highly valued by students to learn and was as effective as the textbook for this purpose.     

The effect of face‐to‐face teaching on student knowledge and satisfaction in an undergraduate neuroanatomy course

The total number of anatomy teaching hours has declined in medical courses worldwide. Conversely, face‐to‐face teaching in undergraduate neuroanatomy at Macquarie University increased by 50% in 2011. Our aim was to investigate whether this influenced student performance and overall satisfaction with the course. One hundred eighty‐one students consented to participate in this study. A questionnaire was administered to rate the course, and final grades from the old and new unit cohorts were compared. The old and new unit cohorts did not differ in their final grades (P = 0.249). However, the new unit cohort rated their knowledge of the material higher compared to the old unit cohort (P = 0.013), and reported higher levels of satisfaction with the course (P < 0.001). In an era in which teaching time for anatomy has been reduced at tertiary institutions, and there is much lamenting of the effect this will have, there is a paucity of literature on whether the decrease really influences neuroanatomical knowledge. This is the first study, to the best of our knowledge, to show that an increase in total face‐to‐face teaching hours does not improve student grades, but does increase student satisfaction with the course. Anat Sci Educ 6: 239–245. © 2012 American Association of Anatomists.     

The value of neurosurgical and intraoperative magnetic resonance imaging and diffusion tensor imaging tractography in clinically integrated neuroanatomy modules: A cross‐sectional study

Neuroanatomy is considered to be one of the most difficult anatomical subjects for students. To provide motivation and improve learning outcomes in this area, clinical cases and neurosurgical images from diffusion tensor imaging (DTI) tractographies produced using an intraoperative magnetic resonance imaging apparatus (MRI/DTI) were presented and discussed during integrated second‐year neuroanatomy, neuroradiology, and neurosurgery lectures over the 2008–2011 period. Anonymous questionnaires, evaluated according to the Likert scale, demonstrated that students appreciated this teaching procedure. Academic performance (examination grades for neuroanatomy) of the students who attended all integrated lectures of neuroanatomy, was slightly though significantly higher compared to that of students who attended these lectures only occasionally or not at all (P=0.04). Significantly better results were obtained during the national progress test (focusing on morphology) by students who attended the MRI/DTI‐assisted lectures, compared to those who did so only in part or not at all, compared to the average student participating in the national test. These results were obtained by students attending the second, third and, in particular, the fourth year (P≤0.0001) courses during the three academic years mentioned earlier. This integrated neuroanatomy model can positively direct students in the direction of their future professional careers without any extra expense to the university. In conclusion, interactive learning tools, such as lectures integrated with intraoperative MRI/DTI images, motivate students to study and enhance their neuroanatomy education. Anat Sci Educ 6: 294–306. © 2013 American Association of Anatomists.     

Teaching neuroanatomy using computer‐aided learning: What makes for successful outcomes?

Computer‐aided learning (CAL) is an integral part of many medical courses. The neuroscience course at Oxford University for medical students includes CAL course of neuroanatomy. CAL is particularly suited to this since neuroanatomy requires much detailed three‐dimensional visualization, which can be presented on screen. The CAL course was evaluated using the concept of approach to learning. The aims of university teaching are congruent with the deep approach—seeking meaning and relating new information to previous knowledge—rather than to the surface approach of concentrating on rote learning of detail. Seven cohorts of medical students (N = 869) filled in approach to learning scale and a questionnaire investigating their engagement with the CAL course. The students' scores on CAL‐course‐based neuroanatomy assessment and later university examinations were obtained. Although the students reported less use of the deep approach for the neuroanatomy CAL course than for the rest of their neuroanatomy course (mean = 24.99 vs. 31.49, P < 0.001), deep approach for CAL was positively correlated with neuroanatomy assessment performance (r = 0.12, P < 0.001). Time spent on the CAL course, enjoyment of it, the amount of CAL videos watched and quizzes completed were each significantly positively related to deep approach. The relationship between deep approach and enjoyment was particularly notable (25.5% shared variance). Reported relationships between deep approach and academic performance support the desirability of deep approach in university students. It is proposed that enjoyment of the course and the deep approach could be increased by incorporation of more clinical material which is what the students liked most. Anat Sci Educ 10: 560–569. © 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.     

Exploring effectiveness in brain removal techniques: A comparison of approaches

Brain dissection is typically an important part of teaching neuroscience in health professional programs. This results in the need to effectively remove brains, which is often performed in a gross anatomy laboratory in the same curriculum. The aim of this study was to determine the most effective method of brain removal based on the time required for removal, difficulty of removal, and preservation of key brain structures for educational purposes. Six different dissectors performed each of the three calvaria removal approaches and three different spinal cord transection methods rating them for difficulty and tracking the time required. The combination of calvaria and brainstem approaches and the order of completion was randomized to control for fatigue and previous individual experience. After all brains were removed, each was evaluated by neuroscience faculty for utility in education contexts. The study found little difference between the individual approaches for both calvaria removal and spinal cord transection in regards to quality of outcome. The use of a circumferential cut only proved to be the most time-effective method for calvaria removal while a posterior cut between C1 and C2 was the most time-effective and least difficult method for brainstem release. There was no one technique that proved to be most beneficial across all three measures. However, different approaches resulted in a different combination of benefits across the time, difficulty, and outcome ratings that should be considered in light of the individual needs of any program or researcher.