The use of artificial intelligence to detect students' sentiments and emotions in gross anatomy reflections

Students' reflective writings in gross anatomy provide a rich source of complex emotions experienced by learners. However, qualitative approaches to evaluating student writings are resource heavy and timely. To overcome this, natural language processing, a nascent field of artificial intelligence that uses computational techniques for the analysis and synthesis of text, was used to compare health professional students' reflections on the importance of various regions of the body to their own lives and those of the anatomical donor dissected. A total of 1365 anonymous writings (677 about a donor, 688 about self) were collected from 132 students. Binary and trinary sentiment analysis was performed, as well as emotion detection using the National Research Council Emotion Lexicon which classified text into eight emotions: anger, fear, sadness, disgust, surprise, anticipation, trust, and joy. The most commonly written about body regions were the hands, heart, and brain. The reflections had an overwhelming positive sentiment with major contributing words "love" and "loved." Predominant words such as "pain" contributed to the negative sentiments and reflected various ailments experienced by students and revealed through dissections of the donors. The top three emotions were trust, joy, and anticipation. Each body region evoked a unique combination of emotions. Similarities between student self-reflections and reflections about their donor were evident suggesting a shared view of humanization and person centeredness. Given the pervasiveness of reflections in anatomy, adopting a natural language processing approach to analysis could provide a rich source of new information related to students' previously undiscovered experiences and competencies.

Analysis of the regional anatomy of the retro-oesophageal right subclavian artery and surrounding structures

BACKGROUND

The retro-oesophageal right subclavian artery (RRSA) is a congenital anomalous branching of the arch of the aorta. Because its incidence is very low, it has not been fully understood how the RRSA develops during embryogenesis, and thus accumulation of observed findings in newly found cases is important to elucidate the aetiology of the RRSA.

MATERIALS AND METHODS

We encountered a case of the RRSA during the course of gross anatomy dissection for medical students.

RESULTS

The main findings in the present observations are that (a) the RRSA arose from the right side wall of the arch of the aorta as its last branch; (b) the detected RRSA was directed to the right and upward between the oesophagus and vertebral column; (c) the right vertebral artery branched from the RRSA and entered the sixth cervical foramen transversarium; (d) the suprema intercostal artery branched from the costocervical trunk on both sides and its distal branches were distributed to the first and second intercostal spaces; and (e) both sides of bronchial arteries originated from the thoracic aorta.

CONCLUSIONS

The present study gives further information about the morphological details of the RRSA leading to better understanding of its developmental process.

A peer-led kinesthetic forearm and wrist anatomy workshop: A multiple cohort study

An understanding of forearm and wrist anatomy is necessary for the diagnosis and treatment of various injuries. Evidence supports the use of peer-assisted learning (PAL) as an effective resource for teaching basic science courses. First-year medical students across three class years participated in an optional PAL kinesthetic workshop wherein participants created anatomically accurate paper models of forearm and wrist muscles. Participants completed pre- and post-workshop surveys. Participant and nonparticipant exam performances were compared. Participation ranged from 17.3% to 33.2% of each class; participants were more likely to identify as women than men (p < 0.001). Participants in cohorts 2 and 3 reported increased comfort with relevant content after the workshop (p < 0.001). Survey responses for cohort 1 were omitted due to low response rates; however, exam performances were assessed for all three cohorts. Cohort 2 participants scored higher than nonparticipants on forearm and wrist questions on the cumulative course exam (p = 0.010), while the opposite was found for cohort 3 (p = 0.051). No other statistically significant differences were observed. This is the first study to examine quantitative and qualitative results for a PAL intervention repeated for three separate cohorts. Although academic performance varied, two cohorts reported increased comfort with relevant course material after the workshop. Results of this study support the need for further exploration of PAL workshops as an instructional method in teaching anatomy and highlight the challenges associated with repeating interventions over multiple years. As more studies attempt replication across multiple years, these challenges may be addressed, thereby informing PAL best practices.

Transforming musculoskeletal anatomy learning with haptic surface painting

Anatomical body painting has traditionally been utilized to support learner engagement and understanding of surface anatomy. Learners apply two-dimensional representations of surface markings directly on to the skin, based on the identification of key landmarks. Esthetically satisfying representations of musculature and viscera can also be created. However, established body painting approaches do not typically address three-dimensional spatial anatomical concepts. Haptic Surface Painting (HSP) is a novel activity, distinct from traditional body painting, and aims to develop learner spatial awareness. The HSP process is underpinned by previous work describing how a Haptico-visual observation and drawing method can support spatial, holistic, and collaborative anatomy learning. In HSP, superficial and underlying musculoskeletal and vascular structures are located haptically by palpation. Transparent colors are then immediately applied to the skin using purposive and cross-contour drawing techniques to produce corresponding visual representations of learner observation and cognition. Undergraduate students at a United Kingdom medical school (n = 7) participated in remote HSP workshops and focus groups. A phenomenological study of learner perspectives identified four themes from semantic qualitative analysis of transcripts: Three-dimensional haptico-visual exploration relating to learner spatial awareness of their own anatomy; cognitive freedom and accessibility provided by a flexible and empowering learning process; altered perspectives of anatomical detail, relationships, and clinical relevance; and delivery and context, relating to curricular integration, session format, and educator guidance. This work expands the pedagogic repertoire of anatomical body painting and has implications for anatomy educators seeking to integrate innovative, engaging, and effective learning approaches for transforming student learning.

Achievement of learning outcomes in non-traditional (online) versus traditional (face-to-face) anatomy teaching in medical schools: A mixed method systematic review

In recent years, the logistical challenges posed by the Covid-19 pandemic have prompted medical educators teaching gross anatomy to explore an expanded use of online instructional modalities. There is concern that this shift to online anatomy education in medical schools could affect long-term learning outcomes for future healthcare providers. In this systematic review, the educational effectiveness of online anatomy teaching is compared with traditional ("face-to-face") teaching methods, specifically in terms of students' academic performance and satisfaction. A search of four databases identified and screened 162 studies. Subsequently, 31 studies were analyzed, including both (a) teaching outcome measures (test scores) and (b) student satisfaction ratings. Authors chose studies, extracted data, assessed quality and examined risk of bias. Nineteen studies compared students' academic performances between online and face-to-face teaching methods. Twenty-six studies measured students' levels of satisfaction in both teaching methods. Both qualitative and quantitative analyses of the data revealed comparable academic performances with no statistical difference between the two teaching methods, but a higher level of satisfaction with face-to-face teaching. The findings confirm that students can learn from online teaching but are more satisfied with face-to-face teaching. The authors conclude that online teaching cannot replace traditional teaching and there is no preference for one type of modality over the other. Therefore, a multi-modal learning approach combining online with face-to-face educational modalities for medical students could be efficient and successful.

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.

Extent of Utilization of Radiologic Images in Gross Anatomy Teaching, the Experience of Ethiopian Medical Schools

BACKGROUND

One of the greatest developments in modern medicine is the strides taken in radiology. Today, thanks to high-tech devices like computer tomography (CT), magnetic resonance imaging (MRI), and ultrasound, a noninvasive glimpse into the human interior has been made possible. These recent developments have revolutionized how doctors see anatomy. To keep pace with this progress, many medical school anatomy curriculums have undergone a facelift. In these new curriculums, radiology has been presented as a practical and sufficient alternative tool for learning anatomy. This study, therefore, aimed to determine the extent of the use of radiologic images in the teaching of anatomy in Ethiopian medical schools.

METHODS

An online questionnaire was used to collect, compile and analyze data from anatomy instructors in Ethiopian medical schools.

RESULTS

The survey showed that 55.9% of the instructors used radiologic images of one form or another in their teaching. However, it also revealed radiological images comprise <5% of the total images used in teaching. The majority (73.5%) of the instructors lacked any prior training or coursework in radiologic anatomy. Despite full-time radiology faculties existing in the schools, a relationship between the anatomy and radiology department is virtually unheard of.

CONCLUSION

The curriculum currently in use in Ethiopian medical schools is designed in a way both vertical and horizontal integration of the traditional subjects are achieved. This way, the introduction of clinical medicine early will provide context and relevance to the learning of basic science. Despite the curriculum's emphasis, we have observed limitations in the degree of integration of anatomy and radiology.

Anatomo-comparative study of formaldehyde, alcohol, and saturated salt solution as fixatives in Wistar rat brains

Although formaldehyde is the most widely used and largely available fixative for preserving cadavers through decomposition prevention, it promotes darkening and weight gain, in addition to being considered carcinogenic. Ethyl alcohol has been proven a potential substitute to formaldehyde due to its effectiveness in tissue penetration, thus preventing proliferation of microorganisms; however, it can only be used alone for fixation of small parts. In view of such fixatives limitations, saturated salt solution has been widely employed based on its antimicrobial effect and ability to maintain tissue similar to the original one, in addition to exerting no hazardous effects as there is no evaporation of harmful substances. This research aimed to observe anatomical brain behaviour submitted to formaldehyde, alcohol, and saturated salt solution as fixatives. Fixatives were tested in 15 adult Wistar rats' brain, submerged in 10 ml of intended solution after removal for 4 weeks. Weight of the brains fixed in saturated salt did not change over the weeks. However, the weight of formaldehyde-fixed brains increased and the weight in alcohol-fixed brains decreased; in addition, modifications in all solutions measures were also observed. Alcohol provides a peculiar dehydrating effect as formaldehyde clearly increases the length of the pieces. Thus, since the saturated salt solution showed no important adjustment over the experimental time, it proved an efficient alternative for replacing formaldehyde and alcohol as fixative solutions of anatomical study of the brain.

Anatomy applied to image diagnosis of the hind limb in the black-striped capuchin (Sapajus libidinosus Spix, 1823)

The knowledge of anatomy and imaging exams emerges as an important tool in the study of evolutionary processes of a species, in the elaboration of diagnosis, and the successful choice of the appropriate clinical and surgical procedures. Therefore, this study aims to describe the osteology of the hind limb of Sapajus libidinosus by means of gross, radiographic, and tomographic images. Four cadavers were used in the macroscopic analysis and five animals for the imaging exams, of which four were eventually euthanized and added to the macroscopic study. For imaging exams, they were kept anesthetized. All bones of the hind limb were documented, their structures were described, and compared with data in the literature from human and nonhuman primates. We have performed Student's t test for independent samples. There was no statistical difference between the sexes regarding the length of the hind limb bones. The coxal bone was largely well described using imaging methods. A small penile bone was present at the tip of the penis and it could be identified by all analysis methods. The femur, as well as the tibia and fibula, were not well portrayed in their proximal and distal epiphyses by radiography (Rx). However, they were well identified on tomography. No third trochanter was observed in the femur and the patella had a triangular shape. All the structures described by gross anatomy of the tarsus and metatarsus could be identified by Rx and tomography. More subtle structures, such as the popliteal notch on the tibia, and the gluteal tuberosity pectineal line and facies aspera on the coxal bone, were not identified by medical imaging. S. libidinosus presented anatomical characteristics that were similar to those of larger New World and Old World monkeys, including man. This suggests it's value as an experimental model for studies in recent primates.

Pre-Clinical Medical Students' Use of Motivational and Cognitive Study Strategies During Anatomy Learning: A Three-Year Cross-Sectional Survey

Medical students' motivation and study strategies are crucial in determining academic performance. This study aimed to assess the motivation and learning strategies of medical students as well as their association with performance in anatomy examinations. The Motivated Strategies for Learning Questionnaire, two focus group discussions, and students' current anatomy cumulative grade point average (cGPA) were used. Generally, the medical students strongly felt that anatomy is fundamental to the practice of medicine and surgery. This result was consistent with high task value scores of 5.99 ± 1.25. They were also driven by extrinsic goal orientation (5.59 ± 1.42) and intrinsic goal orientation (5.08 ± 1.26). Most medical students typically relied on elaboration (5.35 ± 1.25) ahead of other cognitive strategies namely rehearsal (5.30 ± 1.11), organization (5.15 ± 1.34), and lowest-rated critical thinking (4.77 ± 1.19). The students also relied on resource management strategies, effort regulation (5.15 ± 1.20) and time and study environment regulation (5.03 ± 1.03) more than the moderately scored peer learning (4.95 ± 1.50) and help-seeking (4.95 ± 1.09). In the focus group discussions, students reported that they often narrate or explain to each other what they would have read and understood from anatomy lectures, tutorials, and textbooks. They also bemoaned the lack of institutional support for stress burdens. The motivation and learning strategies subscales were not correlated with anatomy cGPA. Males were driven by extrinsic goals and experienced significantly higher levels of test anxiety than females (P < 0.05). Knowing the motivation and learning strategies students employ early in the medical curriculum can be leveraged to promote self-directed learning and academic achievement.

From Tutoring Gross Anatomy to Pancreatic Surgery Innovation

The training for pancreatic surgery still is not conducted according to standardized protocols, and academic programs differ between countries and hospitals. Moreover, due to recent technological innovations such as minimally invasive and robotic surgery, and the broader indications for complex pancreatic procedures due to the use of neoadjuvant chemotherapy, training is continuously redefining itself. The historical paradigm of "see one, do one, teach one" has been challenged and might have become obsolete. Finally, the rising number of surgical residents along with the limited time required practicing during residency might represent a major limitation to becoming an independent surgeon. Gross anatomy is a solid practice for the active learning of human anatomy during medical school. With regards to the pancreas, it offers a unique opportunity to both actively study the pancreatic gland anatomy during dissection and simulate actual surgical procedures. A critical review of the literature was conducted, aiming to assess the role of gross anatomy in surgical training and possible future perspectives.

Emerging from emergency pandemic pedagogy: A survey of anatomical educators in the United Kingdom and Ireland

It is critical that academic opinion of pandemic pedagogy is comprehensively quantified in order to inform future practices. Thus, this study examines how anatomists in the United Kingdom (UK) and Republic of Ireland (ROI) perceive the teaching adaptations made in response to COVID-19, and how these adaptations have impacted their experiences teaching, their online work environment and community. Data was collected via a questionnaire from 24 anatomists across 15 universities in the UK (11) and ROI (4). With regards to teaching, 95.6% of academics have upskilled in new technologies to meet the demands of distance teaching. Academics (95.8%) preferred face-to-face delivery of practical sessions. Most universities (80.0%) reported that practical sessions will continue in a new form that ensures social distancing. However, 50.0% of academics are uncertain if these adaptations will improve student learning. Many anatomists believe that the new adaptations may hinder student-student (66.7%) and student-tutor (45.8%) interactions. Regarding assessment, 52.6% of academics preferred traditional methods to online. Remote online assessment was difficult to protect against collusion, but provided time saving opportunities for academics. Finally, in terms of working environment, 83.3% of academics stated that their workload increased; 54.2% preferred working on site rather than remotely and 79.2% think that staff interactions are better when working on site. These results demonstrate a widespread concern amongst anatomists regarding the pandemic-induced adaptations to teaching, assessment and working environment. However, important opportunities were also identified that could ultimately serve to benefit students and educators alike.

A focus on the gross morphological and ultrastructural characteristics of the oesophagus and stomach of Eurasian common moorhen (Gallinula chloropus chloropus, Linnaeus 1758)

The present work was the first attempt to examine the oesophagus and stomach of the Eurasian common moorhen grossly and by SEM. The oesophagus was composed of long cervical and short thoracic parts. The longitudinal folds of the cervical part were narrower than that of the thoracic part, while the depressions between these folds were shallower and wider in the cervical part. On the epithelial surface of the oesophagus, micropapillae were present and they were numerous and smaller at the level of the cervical part. The openings of the oesophageal glands were circular at the level of the cervical part and oval to elliptical at the thoracic part. The crop was absent. The proventriculus was fusiform in shape; its mucosa was arranged in several, concentrically arranged mucosal folds connected with each other by transverse folds. The proventriculus glands were oval and opened by raised papillae on the epithelial surface. The gizzard was oval; its mucosa was lined by a horizontal layer of cuticle appeared like the fish scales, while the vertical part of the cuticle appeared as thin rods. The folds of the oesophagus are functioning for the expansion for the passage of the food particles. The tunica musculosa of the gizzard was thick to help in grinding of the food particles.

Anatomic, computed tomographic, and ultrasonographic assessment of the lymph nodes in presumed healthy adult cats: The head, neck, thorax, and forelimb

Assessment of the lymph nodes is key in staging cancer patients. Descriptions of normal features of the feline lymph nodes using computed tomography (CT) and ultrasound (US) are limited. A prospective anatomic and comparative imaging study was performed. The frequency of identification and the size of the lymph nodes during gross pathology from 6 feline cadavers were compared to the images of lymph nodes from 30 presumed healthy adult cats obtained by CT and US. Measurements (length, width, and height) were compared among techniques. The CT and US features of the identified lymph nodes were also recorded. The frequency of identification of the lymph centers varied among techniques and individually. The mandibular lymph nodes were identified in 100% of the cadavers and in 100% of the healthy cats using CT and US. The medial retropharyngeal lymph nodes were identified in 100% of the cats using CT and US. The deep cervical lymph nodes were not visualized in the cadavers. The cranial mediastinal and tracheobronchial lymph nodes were not visualized using US. Lymph nodes showed a higher length on CT and higher width on US. The height was the most statistically significant variable measurement among techniques. On CT, lymph nodes were most frequently isoattenuating or slightly hypoattenuating to surrounding musculature, with homogeneous contrast enhancement. On US, most lymph nodes were isoechoic or hypoechoic to surrounding fat tissue. The lymph nodes were most frequently elongated or rounded.

Gross anatomical, computed tomographic and magnetic resonance imaging study of the metacarpo/metatarsophalangeal joint in Egyptian buffalo (Bubalus bubalis)

The current study aimed to describe the normal gross anatomy, computed tomography (CT) and magnetic resonance imaging (MRI) of the metacarpo/metatarsophalangeal (MCP/MTP) joint in Egyptian buffalo, and to determine the site of intra-articular injection of this joint. This study was conducted on eighteen fresh cadaveric distal limbs of healthy Egyptian buffaloes. Six cadaveric MCP/MTP joints were freshly dissected for studying their normal morphological features and determination of the suitable site for intra-articular injection. Another twelve MCP/MTP joints were imaged using a 16-slice CT scanner and a 1.5 Tesla MRI scanner, injected with coloured latex and then sectioned into dorsal, sagittal and transverse slices. The articular surface, joint cavity, ligaments and surrounding tendons of the MCP/MTP joint were identified and briefly described. CT and MRI provided identification of the bony and soft tissue structures of the MCP/MTP joint with variable signal intensities. The present study provided a brief description of the normal gross anatomy of MCP/MTP joint in buffalo to serve as a reference for the evaluation of CT and MRI images, which in turn could enable the veterinary clinicians in interpretation of the clinical diseases in this joint.

The "difficult" cadaver: weight bias in the gross anatomy lab

Background: The prevalence of overweight and obesity continues to rise and is associated with increased morbidity and mortality. Weight bias is common among physicians and medical students and limits the therapeutic alliance between providers and patients with overweight and obesity.Objective: The authors sought to explore the relationship between the gross anatomy course and medical student attitudes towards weight and obesity.Design: The authors employed a mixed-methods approach consisting of semi-structured interviews and anonymous web-based surveys of first-year medical students taking gross anatomy at one USA medical school. They analyzed transcripts of interviews and free-text survey responses using a grounded theory approach and performed tests of association to investigate the relationship between demographic information, responses to multiple-choice survey questions and weight bias.Results: A total of 319 (52%) first-year medical students (2015-2018) completed the survey and 33 participated in interviews. Of survey respondents, 71 (22%) responded that the course had changed how they felt about people with overweight/obesity. These respondents were also more likely to affirm that the course had affected their views toward their own bodies (p < 0.001). Qualitative data analysis identified three overarching themes within students' descriptions of the effects of the gross anatomy lab on attitudes toward bodies perceived to have excess weight: these bodies were described as 1) difficult, 2) unhealthy, and 3) evoking disgust. Students extrapolated from their experiences with cadavers to imagined interactions with future patients, relying heavily on the narrative of the difficult patient.Conclusions: At one USA medical school, students perceived their experiences in gross anatomy as shaping their attitudes toward individuals with overweight or obesity. Efforts to reduce medical student weight bias ought to target this previously unexplored potential site of weight bias.

Anatomic Characteristics of Tissues Attached to the Fifth Metatarsal Bone

Background

Two types of stress, bending stress and traction stress, have been reported to be involved in the mechanism of Jones fracture. However, little is known about the risk factors for traction stress.

Purpose

To classify the attachment position of the peroneus brevis muscle (PB), peroneus tertius (PT), lateral band of the plantar aponeurosis (LB), and the long plantar ligament (LPL), focusing on the zone where a Jones fracture occurs (zone 2), and to compare the footprint area of each tissue type.

Study Design

Descriptive laboratory study.

Methods

This study examined 102 legs from 55 Japanese cadavers. Type classification was performed by focusing on the positional relationship between each tissue attachment and the zone where Jones fracture occurs (zone 2). The classifications were as follows: type I, attached proximal to the border between zones 1 and 2; type IIa, attached to the border between zones 1 and 2 with one attached part; and type IIb, attached across the border between zones 1 and 2 with two or more attached parts. The footprint areas of the PB, PT, LB, and LPL were compared between tissue types and within each attachment classification.

Results

The PB was recorded as type I in 41 feet (40.2%), type IIa in 56 feet (54.9%), and type IIb in 5 feet (4.9%); the PT was recorded as type IIa in 54 feet (60.0%) and type IIb in 36 feet (40.0%); and the LB was recorded as type I in 27 feet (26.5%) and type IIa in 75 feet (73.5%). The LPL did not attach to the fifth metatarsal bone. No significant difference was found in the footprint area between type I PB and type I LB.

Conclusion

The results indicate that type I, which attaches proximal to zone 2, occurs with PB and LB, and there was no significant difference in the footprint area between them. These findings suggest that type I is involved in traction stress. In the future, biomechanical research based on the results of this study will be necessary.

Clinical Relevance

The results of this study provide basic research for investigating the mechanism of Jones fracture and the cause of delayed healing.

Anatomic characterisation of the parietal branches arising from the internal iliac artery in the foetal pig (Sus scrofa domestica)

BACKGROUND

It is critical for surgeons to have a full understanding of the complex courses and ramifications of the human internal iliac artery and its parietal branches. Although numerous anatomical studies have been performed, not all variations at this site are currently understood. Therefore, we characterised these blood vessels in foetal pigs to provide additional insight from a comparative anatomical perspective.

MATERIALS AND METHODS

Eighteen half-pelvis specimens from foetal pigs were dissected and examined on macroscopic scale.

RESULTS

Among our findings, we identified the internal iliac artery as a descending branch of the abdominal aorta. A very thick umbilical artery arose from the internal iliac artery. The superior gluteal, inferior gluteal, and internal pudendal arteries formed the common arterial trunk. Although the superior gluteal artery emerged from the common trunk from inside the pelvis, the inferior gluteal and internal pudendal arteries bifurcated at deep layer within the gluteus muscles after leaving pelvic cavity. We were unable to detect an typical obturator artery emerging from the internal iliac artery. A branch supplying the hip adductors was identified as arising from the inferior epigastric artery which itself was derived from the distal end of the external iliac artery.

CONCLUSIONS

We identified the anatomic characteristics of the internal iliac artery and its parietal branches in the foetal pig. Our findings provide new insight into the comparative anatomy of the internal iliac artery and will promote understanding of related morphogenetic processes.

The distribution of the jejunal arteries in the cat

The arterial supply of the cat jejunum was studied by gross dissection and polyurethane corrosion cast. The results showed that the jejunal arteries, which originate from the cranial mesenteric artery, varied from 5 to 15 in number. Their number was independent of the length of the cranial mesenteric artery as well as of the length of the jejunum. These arteries divided into branches giving rise to a series of orders of division from a minimum of 1 to a maximum of 7. The last orders of division terminated in a series of anastomosing arcades which resulted in a marginal artery coursing only a few millimeters from the mesenteric margin of the jejunum. This artery gave rise to straight arteries (vasa recta), whose mean number was 450 ± 60. According to their length, the vasa recta can be differentiated into short (vasa brevia) and long (vasa longa) branches. The vasa brevia ended branching into the mesenteric side of the jejunum whereas the vasa longa coursed beneath the serosa on the lateral jejunal surfaces, and reached the antimesenteric border. During their course, the vasa recta ramified and anastomosed with each other. Numerous antimesenteric anastomoses between opposing vasa longa were also observed. Based on the literature consulted, due to the large number of vasa recta (approximately one vessel per 2.9 mm of jejunal length) and the rich anastomotic network, the cat jejunum might have a better intramural distribution of blood flow and would seem less predisposed to ischemic phenomena than that of other mammals.

The Use of Clinical Reasoning Skills in the Setting of Uncertainty: A Case of Trial Femoral Head Migration

Clinical skills and medical knowledge enable physicians to overcome the uncertainty of emergent and rare clinical scenarios. Recently, a growing emphasis on evidence-based medicine (EBM) has flooded medical curricula of universities across the globe with guideline-based material, and while it has given teachers and students new tools to improve medical education, clinical reasoning must be reaffirmed in its capacity to provide physicians with the ability to solve unexpected clinical scenarios. Anatomical education in medical school should have two main objectives: to acquire anatomical knowledge and to develop the skill of applying that knowledge in clinical scenarios. The authors present a clinical scenario in which an unexpected and rare complication occurred during a routine elective hip replacement surgery. The general surgeon presiding over the case, also an anatomy professor, solved the problem using clinical reasoning and anatomical knowledge. It was a clear example of how clinical reasoning is key in approaching unprecedented, rare, or unknown complications. The intention of this scenario is to remind colleagues and medical schools that, although EBM is the standard, educators must uphold sound clinical reasoning to best prepare health care providers for their careers.

A core syllabus for the teaching of gross anatomy of the thorax to medical students

Discussion is ongoing concerning the need to ensure the clinical relevance of the biomedical sciences. However, clinical relevance within health care courses presupposes that there is internationally agreed core material to be taught and learned. For anatomy, by the initial use of Delphi Panels that comprise anatomists, scientists, and clinicians, the International Federation of Associations of Anatomists (IFAAs) is developing internationally accepted core syllabuses for all anatomical sciences disciplines in the health care professions. In this article, the deliberations of a Delphi Panel for the teaching of thoracic anatomy in the medical curriculum are presented, prior to their publication on the IFAA's website. To develop the syllabus further, it is required that anatomical societies, as well as individual anatomists and clinicians, comment upon, elaborate, and amend this draft recommended syllabus. The aim is to set internationally recognized standards and thus to provide guidelines concerning the knowledge of the human thorax expected of graduating medical professionals. Such information should be borne in mind by those involved in the development of medical courses. Clin. Anat. 33:300-315, 2020. © 2019 Wiley Periodicals, Inc.

Anatomical study of the ventral rami of thoracic spinal nerves in Sapajus apella (Primates: Cebidae)

This study aimed to describe the gross anatomy of the ventral rami of the thoracic spinal nerves in capuchin monkey (Sapajus apella) and compare with humans and other primate species. Eight specimens, prepared in 10% formalin solution and dissected following routine standard techniques, were used. The animals presented 13-14 pairs of thoracic spinal nerves emerging from the intervertebral foramen and divided into dorsal and ventral rami. The ventral rami of the first 12 or 13 pairs represented intercostal nerves and the latter referred to the subcostal nerve. The intercostal and subcostal nerves gave off muscular and cutaneous branches (lateral and ventral), which promote innervation of muscles and skin associated with the chest and abdominal wall. Atypical anatomy was verified for the 1st, 2nd and 7th to 13th intercostal nerves as well as for the subcostal nerve. The morphological characteristics were similar to those observed in humans and some non-human primates, especially in the absence of collateral branches.

Opinions of South African physiotherapists on gross anatomy education for physiotherapy students

Background

Physiotherapists know the depth of gross anatomical knowledge required for safe and effective clinical practice. They can offer insightful opinions on inclusions for and teaching of an anatomy curriculum for physiotherapy students.

Objectives

The aim of this study was to gather opinions of physiotherapists as to what they perceive as necessary anatomy curricular content for undergraduate physiotherapy students and identify pedagogy that should be used.

Method

A qualitative methodology using a grounded theory approach incorporating semi-structured interviews was utilised in this study. Theoretical sampling was used to identify representative South African physiotherapists. An inductive process, using continuous manual analysis of data by two independent coders, was undertaken. Data were collapsed until themes were identified. Triangulation and other strategies for trustworthiness of data were instituted.

Results

Theoretical saturation was reached after five focus groups (n = 32). Demographical information indicated physiotherapists of all age groups and both genders working in diversified clinical areas. Seven themes were identified and incorporated information from ‘structure’, ‘content’ and ‘pedagogy’ for anatomy programmes to the psychological impact of course aspects on a student’s psyche. Vertical integration of anatomy into later preclinical years, incorporation of physiotherapists to teach anatomy, a ‘physiotherapist personality’ and ‘anatomy know how’ for clinical practice were included.

Conclusion

Opinions of physiotherapists are important in identifying curricular and teaching considerations that can be incorporated into an anatomy programme designed for physiotherapy students.

Clinical implications

Targeted anatomy education for physiotherapy students can aid learning and retention of anatomical knowledge necessary for effective and safe clinical practice.

Effects of an Educational Film About Body Donors on Students' Empathy and Anxiety Levels in Gross Anatomy

While most German anatomy institutes provide only limited information about body donors and their lives, students have expressed a desire to learn more about these individuals, especially about their motivations to donate their bodies for the sake of medical education. In order to gratify this wish, as well as to further humanize body donors, an educational film was compiled, and a study designed to capture the film's effects on medical students. This is the first study using standardized, validated psychological tools to evaluate the impact of an educational film about body donors on students' empathy and psychological stress levels. The study followed a longitudinal, controlled, and cluster randomized design, including 77 (48 females/29 males) participants who watched the video either before, midway, or after the dissection course. Questionnaires were completed at four points in time applying the Jefferson Scale for Empathy (JSPE-S) and the Interpersonal Reactivity Index (IRI) to measure empathy. Psychological stress levels were recorded by the Brief Symptom Inventory (BSI). Overall, students recommended the film to be shown to all students (median 6.0; maximum on the six-point Likert scale). Viewing the film revealed no significant changes between study groups or over time in JSPE-S sum scores. All groups demonstrated a significant reduction of BSI values before the dissection course actually started and increased values during the course, but both developments appeared not to be associated with the intervention. Overall, the educational film did not correlate with any negative effects on students' empathy and psychological stress levels, and it was strongly approved of by students, as it provided more humanizing personal information about body donors without violating their anonymity.