Integration of Scientific Competence into Gross Anatomy Teaching Using Poster Presentations: Feasibility and Perception among Medical Students

Scientific competencies, as defined in the German competency framework, describe the ability to think independently and act scientifically which is a central component of medical education. This report describes integration of scientific competencies into anatomical teaching. Based on findings seen in two consecutive years of dissection courses, students worked on either a case report (n = 70) or an original research study (n = 6) in the format of a scientific poster while learning to use primary literature. Posters were evaluated by juror teams using standardized evaluation criteria. Student perception of the project was assessed by quantitative and qualitative data obtained from the faculty's course evaluation and an online-survey. Overall, students worked collaboratively and invested extra-time (median 3.0 hours) in poster creation. Primary literature was integrated in 90.8% of the posters. Overall poster quality was satisfactory (46.3 ± 8.5 [mean ± standard deviation] out of 72 points), but several insufficiencies were identified. Students integrated information gained from the donor's death certificate, post-mortem full-body computed tomography (CT) scan (22.4%), and histopathological workup (31.6%) in their case reports. Students responded positively about learning new scientific skills (median 4.0 on a six-point Likert scale), but free-text answers revealed that some students experienced the project as an extra burden in a demanding gross anatomy course. In summary, it was feasible to introduce students to scientific skills during the dissection course and to increase interest in science in approximately a third of the survey respondents. Further adjustments to ensure the posters' scientific quality might be necessary for the future.     

What factors motivate male and female Generation Z students to become engaged as peer teachers? A mixed-method study among medical and dental students in the gross anatomy course

Peer-teaching is widely established in anatomy teaching and offers well-described advantages. Nevertheless, at Ulm University, Germany, a reduction in the number of peer teacher applicants for the dissection course was observed. This study examined factors related to the attractiveness of a position as a peer teacher for Generation Z students. Participants of the gross anatomy course were asked to evaluate factors influencing the attractiveness of a peer teacher position using a six-point Likert scale. Additionally, open-ended questions were analyzed qualitatively. Sex-specific subgroup analysis was performed comparing students of low and high motivation to apply for a tutorship. Of the 374 students who participated in this study (response rate 53%), 38% stated that they were intending to apply as peer teachers. Data indicated that students displayed intrinsic motivation to apply for a tutorship because of the opportunity to improve their anatomy knowledge and/or their pleasure in teaching. In contrast, extrinsic factors like remuneration of the tutorship and its relevance for their curriculum vitae were least important. Anatomy educators underestimated the demotivating factor of the workload associated with the tutorship and encouraged students less frequently to apply than peer teachers. Only minor sex-specific differences could be identified. Nevertheless, female students were encouraged less frequently to apply than their male peers. In summary, Generation Z students apply as peer teachers because they are enthusiastic about the task. To motivate students to commit to extracurricular activities like a tutorship, anatomy educators should actively encourage students—particularly females—more frequently to apply.     

Development and implementation of a three-dimensional (3D) printing elective course for health science students

Three-dimensional (3D) printing technology has become more affordable, accessible, and relevant in healthcare, however, the knowledge of transforming medical images to physical prints still requires some level of training. Anatomy educators can play a pivotal role in introducing learners to 3D printing due to the spatial context inherent to learning anatomy. To bridge this knowledge gap and decrease the intimidation associated with learning 3D printing technology, an elective was developed through a collaboration between the Department of Anatomy and the Makers Lab at the University of California, San Francisco. A self-directed digital resource was created for the elective to guide learners through the 3D printing workflow, which begins with a patient's computed tomography digital imaging and communication in medicine (DICOM) file to a physical 3D printed model. In addition to practicing the 3D printing workflow during the elective, a series of guest speakers presented on 3D printing applications they utilize in their clinical practice and/or research laboratories. Student evaluations indicated that their intimidation associated with 3D printing decreased, the clinical and research topics were directly applicable to their intended careers, and they enjoyed the autonomy associated with the elective format. The elective and the associated digital resource provided students with the foundational knowledge of 3D printing, including the ability to extract, edit, manipulate, and 3D print from DICOM files, making 3D printing more accessible. The aim of disseminating this work is to help other anatomy educators adopt this curriculum at their institution.     

Factors impacting the rapid transition of anatomy curricula to an online environment in response to Covid-19

Due to the Covid-19 pandemic, many academic institutions had to rapidly transition education to a remote online environment. While a hurdle for most educators, this transition posed an even greater challenge for anatomy educators, many of whom were forced to depart from the traditional cadaver-based laboratory to a virtual format. Recent publications have discussed the rapid transition to online formats necessitated by Covid-19 and the accompanying difficulties, but none have identified specific factors that influenced the difficulty of this transition. Anatomy educators were surveyed to examine how this transition was accomplished and perceived. Of the 165 educators who responded, the majority utilized cadaver-based laboratory instruction. Educators felt that transitioning the laboratory portion of their courses was significantly more difficult and required more time than converting lecture materials. Factors that impacted the difficulty of the transition included a number of pedagogical aspects of the pre-Covid-19 curricula, including the delivery format of prior content, availability of pre-existing electronic materials, and the laboratory technique previously used. Additionally, the length of time an educator had been teaching prior to Covid-19 impacted their perception of difficulty, with newer and more senior educators finding this much more challenging than mid-tenure educators. Ease of transition may be related to previous exposure to curricular reform, experience with multiple anatomy pedagogies, and educator adaptability. While not surprising that converting a cadaver-based laboratory to an online format was challenging, knowledge of the alignment of this difficulty with prior educator pedagogy can help guide future innovations to anatomy education.     

Dyad pedagogy in practical anatomy: A description of the implementation and student perceptions of an adaptive approach to cadaveric teaching

Prior to the challenges imposed by the Covid-19 pandemic, anatomy practical sessions at Trinity College Dublin involved eight to 10 students per donor station, rotating between digital learning, anatomical models/osteology, and dissection activities for three hours weekly. To maintain cadaveric participation in the anatomy laboratory while adhering to distancing guidelines, a transition to dyad pedagogy was implemented. This mode of delivery allowed two students per donor station to spend one hour per week in the anatomy laboratory with all digital learning elements transferred to the virtual learning platform Blackboard as pre- and post-practical session learning activities. Dyad pedagogy has been explored in clinical settings and simulation procedural-based training but is yet to be fully verified in anatomy education. To determine the effectiveness of hybrid practical sessions and reduced donor to student ratios, the opinions of first year medical students were examined using an online questionnaire with a 51% response rate. Although students recognized the merits of more time in the anatomy laboratory, including opportunities for self-directed study and exposure to anatomical variation, they felt that having two students per station enabled sufficient hands-on time with the donor body and fostered learning opportunities that would not be possible with larger groups. Strong preferences for quality time with the donor body supported by online resources suggests this modality should be a key consideration in course design for anatomy curricula and emphasizes the importance of gauging students' preferences to optimize satisfaction and learning output when pivoting to blended learning strategies in anatomy education.     

城镇职工医疗保险统筹住院次均费用增长分析和对策

次均费用反映了当今社会普遍关注的看病贵难题,体现医疗保险制度效率。次均费用受多种因素影响,经济、人口结构和质量、医药卫生体制和新诊疗技术的使用是主要影响因素。增加过度治疗的机会成本,当边际成本超过边际收益时定点机构才会加强自律,规范治疗。引导就医流向可以降低来自参保人行为导致的费用增长。医保管理者在控制次均费用增长问题上责任重大,并大有作为。实行按病种支付、对三级医院重点检查、增加平均住院日指标、规定大型设备阳性检查率、充分利用信息平台加强管理等有利于控制次均费用不合理增长。     

循证决策视角下的患者健康咨询主题分析

[目的/意义]为了将大数据更好地用于循证决策,文章构建了循证决策视角下的患者健康主题分析模型。[方法/过程]首先使用LDA主题模型对高血压问答数据进行主题探测,并结合文献提炼出高血压八大主题;再次使用问卷调查法和层次分析法对主题探测结果进行评估;最后对得到的证据进行实践讨论。[结果/结论]文章对大数据和循证决策的结合做了尝试性探索,结果表明循证决策视角下的患者健康主题分析模型,具有一定的实用性和创新性。     

循证决策视角下的患者健康咨询主题分析

[目的/意义]为了将大数据更好地用于循证决策,文章构建了循证决策视角下的患者健康主题分析模型。[方法/过程]首先使用LDA主题模型对高血压问答数据进行主题探测,并结合文献提炼出高血压八大主题;再次使用问卷调查法和层次分析法对主题探测结果进行评估;最后对得到的证据进行实践讨论。[结果/结论]文章对大数据和循证决策的结合做了尝试性探索,结果表明循证决策视角下的患者健康主题分析模型,具有一定的实用性和创新性。     

CAI结合PBL教学模式对于提高学生免疫学学习能力的探讨

笔者结合多年来的教学经验和体会,发现计算机辅助教学（CAI）与问题式学习（PBL）相结合的教学模式在医学免疫的教学中发挥着非常重要的作用。 CAI技术可增加课堂信息量,节约时间,使教学内容生动、形象。 PBL教学则可以激发学生的学习热情和求知欲望,使学生动手能力、文献查找能力、分析问题和解决问题能力等综合素质得到提高。二者的结合可以使枯燥的教学内容变得生动、活泼,从而达到理想的教学效果。