Dissecting through Barriers: A Follow-up Study on the Long-Term Effects of Interprofessional Education in a Dissection Course with Healthcare Professional Students

Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists.     

Guiding Low Spatial Ability Individuals through Visual Cueing: The Dual Importance of Where and When to Look

Research suggests that spatial ability may predict success in complex disciplines including anatomy, where mastery requires a firm understanding of the intricate relationships occurring along the course of veins, arteries, and nerves, as they traverse through and around bones, muscles, and organs. Debate exists on the malleability of spatial ability, and some suggest that spatial ability can be enhanced through training. It is hypothesized that spatial ability can be trained in low-performing individuals through visual guidance. To address this, training was completed through a visual guidance protocol. This protocol was based on eye-movement patterns of high-performing individuals, collected via eye-tracking as they completed an Electronic Mental Rotations Test (EMRT). The effects of guidance were evaluated using 33 individuals with low mental rotation ability, in a counterbalanced crossover design. Individuals were placed in one of two treatment groups (late or early guidance) and completed both a guided, and an unguided EMRT. A third group (no guidance/control) completed two unguided EMRTs. All groups demonstrated an increase in EMRT scores on their second test (P < 0.001); however, an interaction was observed between treatment and test iteration (P = 0.024). The effect of guidance on scores was contingent on when the guidance was applied. When guidance was applied early, scores were significantly greater than expected (P = 0.028). These findings suggest that by guiding individuals with low mental rotation ability “where” to look early in training, better search approaches may be adopted, yielding improvements in spatial reasoning scores. It is proposed that visual guidance may be applied in spatial fields, such as STEMM (science, technology, engineering, mathematics and medicine), surgery, and anatomy to improve student's interpretation of visual content. Anat Sci Educ. © 2018 American Association of Anatomists.     

How Haptics and Drawing Enhance the Learning of Anatomy

Students’ engagement with two-dimensional (2D) representations as opposed to three-dimensional (3D) representations of anatomy such as in dissection, is significant in terms of the depth of their comprehension. This qualitative study aimed to understand how students learned anatomy using observational and drawing activities that included touch, called haptics. Five volunteer second year medical students at the University of Cape Town participated in a six-day educational intervention in which a novel “haptico-visual observation and drawing” (HVOD) method was employed. Data were collected through individual interviews as well as a focus group discussion. The HVOD method was successfully applied by all the participants, who reported an improvement of their cognitive understanding and memorization of the 3D form of the anatomical part. All the five participants described the development of a “mental picture” of the object as being central to “deep learning.” The use of the haptic senses coupled with the simultaneous act of drawing enrolled sources of information that were reported by the participants to have enabled better memorization. We postulate that the more sources of information about an object, the greater degree of complexity could be appreciated, and therefore the more clearly it could be captured and memorized. The inclusion of haptics has implications for cadaveric dissection versus non-cadaveric forms of learning. This study was limited by its sample size as well as the bias and position of the researchers, but the sample of five produced a sufficient amount of data to generate a conceptual model and hypothesis.     

Assessment of Middle Ear Anatomy Teaching Methodologies Using Microscopy versus Endoscopy: A Randomized Comparative Study

Teaching methodologies for the anatomy of the middle ear have not been investigated greatly due to the middle ear’s highly complex structure and hidden location inside of the temporal bone. The aim of this randomized study was to quantitatively compare the suitability of using microscope- and endoscope-based methods for teaching the anatomy of the middle ear. We hypothesize that the endoscopic approach will be more efficient compared to the microscopic approach. To answer the study questions, 33 sixth-year medical students, residents and otorhinolaryngology specialists were randomized either into the endoscopy or the microscopy group. Their anatomical knowledge was assessed using a structured anatomical knowledge test before and after each session. Each participant received tutoring on a human cadaveric specimen using one of the two methods. They then performed a hands-on dissection. After 2–4 weeks, the same educational curriculum was repeated using the other technique. The mean gains in anatomical knowledge for the specialists, residents, and medical students were +19.0%, +34.6%, and +23.4%, respectively. Multivariate analyses identified a statistically significant increase in performance for the endoscopic method compared to the microscopic technique (P < 0.001). For the recall of anatomical structures during dissection, the endoscopic method outperformed the microscopic technique independently of the randomization or the prior training level of the attendees (P < 0.001). In conclusion, the endoscopic approach to middle ear anatomy education is associated to an improved gain in knowledge as compared to the microscopic approach. The participants subjectively preferred the endoscope for educational purposes.     

An education that pierces what the knife cannot: A student perspective

If personalized medicine is the way of the future, and the physician's approach to each patient becomes more individualized and team‐based, so must the professors' approach to the medical student experience. Mayo Medical School has an innovative curriculum designed to respect and enhance the individual interests of its students. A former educator herself, and now a medical student, the author advocates for further creative curriculum design to enhance healthy student attitude learning in medical school. In her personal testimony to the healing power of art and story, she cautions institutions that ignore integrating humanities into their curriculum that their student physicians will build self‐protective barriers without self‐reflection. She argues students must have more avenues to express their emotions during difficult transitions and ethical dilemmas. This commentary describes extracurricular student projects during anatomy, and includes an example of student reflective writing in anatomy. The author suggests that narrative medicine as an emerging discipline would be an effective educational strategy when applied to any aspect of the medical curriculum, and should be considered by more medical schools for further progress in medical education. Anat Sci Educ, 2010. © 2010 American Association of Anatomists.     

Progressive drawing: A novel “lid–opener” and “monotony–breaker”

An innovative strategy called “progressive drawing” was used at the beginning (lid‐opener) and later (monotony‐breaker) during gross anatomy lectures. Diagrams were drawn on the classroom blackboard with anatomic structures added one by one. Students identified and labeled the diagrams and predicted the next structures to be drawn. Students felt that the strategy helped to activate prior knowledge, created interest in the current lecture, and made lecture sessions more interactive. The strategy has appeal for visual, auditory, read/write, and kinesthetic learners. Anat Sci Educ, 2010. © 2010 American Association of Anatomists.     

Lessons to be learned from the history of anatomical teaching in the United States: The example of the University of Michigan

Although traditional departments of anatomy are vanishing from medical school rosters, anatomical education still remains an important part of the professional training of physicians. It is of some interest to examine whether history can teach us anything about how to reform modern anatomy. Are there lessons to be learned from the history of anatomical teaching in the United States that can help in the formulation of contents and purposes of a new anatomy? This question is explored by a review of US anatomical teaching with special reference to Franklin Paine Mall and the University of Michigan Medical School. An historical perspective reveals that there is a tradition of US anatomical teaching and research that is characterized by a zeal for reform and innovation, scientific endeavor, and active, student‐driven learning. Further, there is a tradition of high standards in anatomical teaching through the teachers' engagement in scientific anatomy and of adaptability to new requirements. These traditional strengths can inform the innovation of modern anatomy in terms of its two duties—its duty to anatomy as a science and its duty toward anatomical education. Anat Sci Educ 3:202–212, 2010 © 2010 American Association of Anatomists.     

Explorable three‐dimensional digital model of the female pelvis,pelvic contents,and perineum for anatomical education

The anatomy of the pelvis is complex, multilayered, and its three‐dimensional organization is conceptually difficult for students to grasp. The aim of this project was to create an explorable and projectable stereoscopic, three‐dimensional (3D) model of the female pelvis and pelvic contents for anatomical education. The model was created using cryosection images obtained from the Visible Human Project, in conjunction with a general‐purpose three‐dimensional segmentation and surface‐rendering program. Anatomical areas of interest were identified and labeled on consecutive images. Each 2D slice was reassembled, forming a three‐dimensional model. The model includes the pelvic girdle, organs of the pelvic cavity, surrounding musculature, the perineum, neurovascular structures, and the peritoneum. Each structure can be controlled separately (e.g. added, subtracted, made transparent) to reveal organization and/or relationships between structures. The model can be manipulated and/or projected stereoscopically to visualize structures and relationships from different angles with excellent spatial perception. Because of its ease of use and versatility, we expect this model may provide a powerful teaching tool for learning in the classroom or in the laboratory. Anat Sci Educ. © 2010 American Association of Anatomists.     

A human dissection training program at Indiana University School of Medicine‐Northwest

As human cadavers are widely used in basic sciences, medical education, and other training and research venues, there is a real need for experts trained in anatomy and dissection. This article describes a program that gives individuals interested in clinical and basic sciences practical experience working with cadavers. Participants are selected through an open application process and attend sessions focused on anatomical terminology, gross anatomy and radiography, and some of the educational applications of human cadavers. Dissection skills are honed during an intensive, two‐day cadaver dissection and orthopedic workshop. Participants communicate the knowledge they gain through table‐side discussions, reflect upon the experience during a memorial service, and submit written program evaluations. Additionally, the dissection and preparation of cadaveric materials accomplished in this course are used in the medical school gross anatomy course during the next academic year. From 2004 through 2008, the annual number of applicants increased from 40 to 167, and the number of participants increased from 25 to 43 per year. Program participants have represented diverse ethnic, educational, and professional backgrounds. Feedback from participants has been remarkably positive, including comments on the large amount of learning that takes place during the sessions, the positive impact the program has had on career choice, and the desire for program expansion. This program, which could be replicated at other institutions, teaches anatomy, prepares cadaveric prosections for teaching and training others, and encourages participants to pursue careers in anatomical and biomedical sciences. Anat Sci Educ 3: 77–82, 2010. © 2010 American Association of Anatomists.     

Quick dissection of the segmental bronchi

Knowledge of the three‐dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde‐fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the bronchopulmonary segments. Anat Sci Educ 2010. © 2010 American Association of Anatomists.