An integrated teaching method of gross anatomy and computed tomography radiology

It is essential for medical students to learn and comprehend human anatomy in three dimensions (3D). With this in mind, a new system was designed in order to integrate anatomical dissections with diagnostic computed tomography (CT) radiology. Cadavers were scanned by CT scanners, and students then consulted the postmortem CT images during cadaver dissection to gain a better understanding of 3D human anatomy and diagnostic radiology. Students used handheld digital imaging and communications in medicine viewers at the bench‐side (OsiriX on iPod touch or iPad), which enabled “pixel‐to‐tissue” direct comparisons of CT images and cadavers. Students had lectures and workshops on diagnostic radiology, and they completed study assignments where they discussed findings in the anatomy laboratory compared with CT radiology findings. This teaching method for gross and radiological anatomy was used beginning in 2009, and it yielded strongly positive student perspectives and significant improvements in radiology skills in later clinical courses. Anat Sci Educ 7: 438–449. © 2014 American Association of Anatomists.     

陕西黄土高原34种豆科植物根瘤的比较形态解剖学研究

通过对生长在陕西黄土高原的豆科21属34种植物根瘤的形态结构观察研究表明，其根瘤生长在主根和侧根上或仅生在侧根上，外表白色、粉红色或浅棕色，呈圆形、长圆形或扇形，多不分又，少数分技。其根瘤结构都由4部分组成，由外向内依次为：保护层、皮层、鞘细胞层和中心组织(侵染组织)。据统计，不同种植物的根瘤中上述各部分细胞的层数不同，其中，中心组织内侵染细胞所占的百分比在种间也存在差异。研究结果为这些植物的分类和开发利用提供了一定的依据。     

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.     

Developing an audiovisual notebook as a self‐learning tool in histology: Perceptions of teachers and students

Videos can be used as didactic tools for self‐learning under several circumstances, including those cases in which students are responsible for the development of this resource as an audiovisual notebook. We compared students' and teachers' perceptions regarding the main features that an audiovisual notebook should include. Four questionnaires with items about information, images, text and music, and filmmaking were used to investigate students' (n = 115) and teachers' perceptions (n = 28) regarding the development of a video focused on a histological technique. The results show that both students and teachers significantly prioritize informative components, images and filmmaking more than text and music. The scores were significantly higher for teachers than for students for all four components analyzed. The highest scores were given to items related to practical and medically oriented elements, and the lowest values were given to theoretical and complementary elements. For most items, there were no differences between genders. A strong positive correlation was found between the scores given to each item by teachers and students. These results show that both students' and teachers' perceptions tend to coincide for most items, and suggest that audiovisual notebooks developed by students would emphasize the same items as those perceived by teachers to be the most relevant. Further, these findings suggest that the use of video as an audiovisual learning notebook would not only preserve the curricular objectives but would also offer the advantages of self‐learning processes. Anat Sci Educ 7: 209–218. © 2013 American Association of Anatomists.     

Exploring the validity of assessment in anatomy: Do images influence cognitive processes used in answering extended matching questions?

Assessment is an important aspect of medical education because it tests students' competence and motivates them to study. Various assessment methods, with and without images, are used in the study of anatomy. In this study, we investigated the use of extended matching questions (EMQs). To gain insight into the influence of images on the validity of test items, we focused on students' cognitive processes while they answered questions with and without images. Seventeen first‐year medical students answered EMQs about gross anatomy, combined with either labeled images or answer lists, while thinking aloud. The participants' verbal reports were transcribed verbatim and then coded. Initial codes were based on a task analysis and were adapted into final codes during the coding process. Results showed that students used more cues from EMQs with images and visualized more often in EMQs with answer lists. Ready knowledge and verbal reasoning were used equally often in both conditions. In conclusion, EMQs with and without images elicit different results in this think aloud experiment, indicating different cognitive processes. They seem to measure different skills, making them valid for different testing purposes. The take‐home message for anatomy teachers is that questions without images seem to test the quality of students' mental images while questions with images test their ability to interpret visual information. It makes sense to use both response formats in tests. Using images from clinical practice instead of anatomical drawings will help to improve test validity. Anat Sci Educ 7: 107–116. © 2013 American Association of Anatomists.     

Measuring change in professionalism attitudes during the gross anatomy course

By design or default, anatomy educators are often responsible for introducing students to medical professionalism. Although much has been said about the role of anatomical education, there are no published reports suggesting how to measure change. This study investigated what professionalism attitudes, if any, change during a gross anatomy course. Additionally, the influence of four dichotomous variables related to student identity and preparation for medical school were analyzed for their effect on professionalism attitudes. A cross‐sectional time‐one (T1; beginning of the course), time‐two (T2; end of the course) study using the Penn State College of Medicine Survey of Professionalism was conducted. A multivariate analysis of variance identified the main effects and interaction effects of categorical variables. A Mann Whitney U test verified significant differences. This study found a reprioritization of professionalism attitudes in favor of altruism (P = 0.04 with a Cohen's d = 0.26) at T2. Female students (P = 0.03, Cohen's d = 0.38) and students from a science background (P = 0.04, Cohen's d = 0.36) changed the most in favor of altruism. Interestingly, though several factors correlated with dissimilarities in professionalism values at T1, gender was the only factor to show a significant difference in professionalism attitudes at T2. This cohort of students reported a statistically significant increase in altruism and no significant decreases in other professionalism attitudes concurrent with the gross anatomy course. Anat Sci Educ 3:12–16, 2010. © 2009 American Association of Anatomists     

Game-Based Learning in Virtual Worlds: A Multiuser Online Game for Medical Undergraduate Radiology Education within Second Life

Game-based learning can have a positive impact on medical education, and virtual worlds have great potential for supporting immersive online games. It is necessary to reinforce current medical students' knowledge about radiological anatomy and radiological signs. To meet this need, the objectives of this study were: to design a competition-based game in the virtual world, Second Life and to analyze the students' perceptions of Second Life and the game, as well as to analyze the medium-term retention of knowledge and the potential impact on the final grades. Ninety out of 197 (45.6%) third-year medical students voluntarily participated in an online game based on self-guided presentations and multiple-choice tests over six 6-day stages. Participants and non-participants were invited to perform an evaluation questionnaire about the experience and a post-exposure knowledge test. Participants rated the experience with mean scores equal to or higher than 8.1 on a 10-point scale, highlighting the professor (9.5 ± 1.1; mean ± SD) and the virtual environment (8.9 ± 1.1). Participants had better results in the post-exposure test than non-participants (59.0 ± 13.5 versus 45.3 ± 11.5; P < 0.001) and a lower percentage of answers left blank (6.7 ± 8.4 versus 13.1 ± 12.9; P = 0.014). Competitive game-based learning within Second Life is an effective and well-accepted means of teaching core radiological anatomy and radiological signs content to medical students. The higher medium-term outcomes obtained by participants may indicate effective learning with the game. Additionally, valuable positive perceptions about the game, the educational contents, and the potential benefit for their education were discovered among non-participants.     

A Web-Based Virtual Microscopy Platform for Improving Academic Performance in Histology and Pathology Laboratory Courses: A Pilot Study

Virtual microscopy (VM) has been utilized to improve students' learning experience in microscope laboratory sessions, but minimal attention has been given to determining how to use VM more effectively. The study examined the influence of VM on academic performance and teacher and student perceptions and compared laboratory test scores before and after VM incorporation. A total of 662 third-year students studying histology and 651 fourth-year students studying pathology were divided into two groups. The light microscopy (LM) group used a light microscope in 2014 and 2015, while the LM + VM group used the VM platform and a light microscope in 2016 and 2017. Four factors positively predict laboratory scores (R square, 0.323; P < 0.001): (i) the pathology course and test-enhanced learning, (ii) the VM platform and experience, (iii) medical students and lecture scores, and (iv) female students. The LM + VM group exhibited less score variability on laboratory examinations relative to their mean than the LM group. The LM + VM group was also associated with fewer failing grades (F grade; odds ratio, 0.336; P < 0.001) and higher scores (A grade; odds ratio, 2.084; P < 0.001) after controlling for sex, school, course, and lecture grades. The positive effect of the VM platform on laboratory test grades was associated with prior experience using the VM platform and was synergistic with more interim tests. Both teachers and students agreed that the VM platform enhanced laboratory learning. The incorporation of the VM platform in the context of test-enhanced learning may help more students to master microscopic laboratory content.     

Quantitative and qualitative changes in teaching histology by means of virtual microscopy in an introductory course in human anatomy

This study compares overall laboratory averages and individual test scores along with a student survey to determine the effects of using virtual microscopy in place of optical microscopes in a large undergraduate human anatomy course. T‐tests revealed that the first two laboratory examinations (of four) and the overall laboratory averages were significantly increased compared with the previous year. We hypothesize that this is due to students' ability to use and understand the technology quickly as opposed to learning how to maneuver an optical microscope. Students also responded positively in a survey about the virtual microscope, indicating that increased accessibility, ease of use, and the ability to understand the material were important components of the virtual microscope. In addition, an increase in student collaboration was noted because multiple students were able to view the image at a time. This level of acceptance of virtual microscopy has been reported in previous studies, though this level of increased examination scores is rare. We attribute this to differences between the medical students, with whom this technology has been researched in the past, and undergraduate introductory students. Anat Sci Educ 2:218–226, 2009. © 2009 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.