Anatomy in occupational therapy program curriculum: practitioners' perspectives

A Comparative Analysis of Physical Therapy Anatomical Knowledge and Retention: Human Donor Dissection Versus Virtual Laboratory

INTRODUCTION

Despite a long history of using human donor dissection (HDD) for physical therapy (PT) anatomy education, there are no PT guidelines that require HDD. The purpose of this quantitative causal-comparative study was to determine if Doctor of Physical Therapy students who used HDD had different grades both within anatomy and within courses that require retention and application of anatomical knowledge (kinesiology and a foundational musculoskeletal course) compared with those who used virtual 3-dimensional anatomical software (VAS).

REVIEW OF LITERATURE

Numerous factors affect the decision to use HDD within PT anatomy, and few PT studies have compared the effectiveness of VAS to HDD.

SUBJECTS

All students who took anatomy in an entry-level PT program from 2018 to 2021 (232 total students, 115 who used HDD in 2018-2019 and 117 who used VAS in 2020-2021).

METHODS

Mann-Whitney tests were used to compare anatomy grades (course, written examination, and practical examination) and future grades in kinesiology and a foundational musculoskeletal course for students who used HDD or VAS.

RESULTS

Physical therapy students who used VAS had statistically significant higher anatomy course grades (VAS 93.81% ± 4.99% to HDD 92.20% ± 4.53%) and higher practical examination grades (VAS 97.43% ± 2.91% to HDD 93.55% ± 4.39%) compared with those who used HDD. However, there were no significant differences between groups on written anatomy examinations (VAS 89.42% ± 7.21% to HDD 90.40% ± 4.94%), kinesiology grades (VAS 91.86% ± 4.52% to HDD 92.80% ± 4.27%), or foundational musculoskeletal grades (VAS 89.50% ± 3.89% to HDD 89.77% ± 3.83%).

DISCUSSION AND CONCLUSION

The causal-comparative study design prevents concluding that PT student grade differences were due exclusively to either anatomy laboratory method. It does provide preliminary evidence that the PT anatomy laboratory method did not practically affect anatomy performance or long-term application of anatomy knowledge in future coursework.

Gross and Applied Anatomy Pedagogical Approaches in Occupational Therapy Education: A Scoping Review

Introduction. With technological advancements, anatomy teaching approaches in occupational therapy education have expanded. However, uncertainty remains regarding the approaches that best optimize academic and practice outcomes in student occupational therapists (OTs). Purpose. This scoping review mapped the pedagogical approaches used to teach musculoskeletal anatomy to student OTs. Methods. A scoping review was conducted, with a consultation exercise involving Canadian occupational therapy educators. Six databases were searched, with terms related to student OTs, anatomy, and education. Included articles were available in English, full text; featured empirical research of any study design and/or gray literature; featured a pedagogical approach used to teach anatomy; and targeted student OTs with the pedagogies. Results. Twenty-eight reports between 1978 and 2021 were included. Although technology-based pedagogies became more common with time, historically used pedagogies (e.g., lectures and labs) remained prominent and most common. Narrative synthesis regarding the effectiveness of anatomy pedagogical approaches identified five main factors: (a) anatomy competency; (b) teaching method diversity; (c) learner psychological considerations; (d) interprofessional education; and (e) optimal academic outcomes. Implications. This review demonstrates the importance of anatomy knowledge to occupational therapy education and practice. A diversity of pedagogical approaches, with and without technology, may foster better outcomes by addressing diverse learning needs.

How do practicing physical therapists perceive anatomy education?

The purpose of this investigation was to explore the perceptions of the sufficiency and relevancy of physical therapy anatomy education among early, mid, and late career physical therapists. A survey was distributed via email through clinical networks in the greater Mid-Atlantic region, the American Physical Therapy Association Pennsylvania chapter (APTA-PA), and the American Council of Academic Physical Therapy (ACAPT) Educational Research division. 194 physical therapists responded to the survey. The survey included questions regarding how anatomy was learned in physical therapy school and Likert scale questions investigating opinions of anatomy education. Frequencies were calculated to determine the methods of anatomy education and Likert scale responses. One-way Analysis of Variance (ANOVA) was performed to compare the Likert scale responses from the groupings of survey participants. Respondents across all years of practice felt that their anatomy education was sufficient and relevant to their clinical practice and that schools dedicated enough time to teaching anatomy. Respondents who had a dissection component in their anatomy curriculum were more likely to view dissection as essential. Length of time in practice did not influence opinions on the sufficiency or relevancy of anatomy education. Dissection continues to be included in most physical therapy anatomy courses and perceived as essential for learning. Practicing physical therapists' anatomy education was viewed as sufficient and relevant with few recommendations for change. Perceptions of clinicians should be incorporated into curriculum design and reform and be gathered on an ongoing basis as more students from programs without anatomical donors graduate and enter clinical practice.

A workflow for the creation of photorealistic 3D cadaveric models using photogrammetry

Three-dimensional (3D) representations of anatomical specimens are increasingly used as learning resources. Photogrammetry is a well-established technique that can be used to generate 3D models and has only been recently applied to produce visualisations of cadaveric specimens. This study has developed a semi-standardised photogrammetry workflow to produce photorealistic models of human specimens. Eight specimens, each with unique anatomical characteristics, were successfully digitised into interactive 3D models using the described workflow and the strengths and limitations of the technique are described. Various tissue types were reconstructed with apparent preservation of geometry and texture which visually resembled the original specimen. Using this workflow, an institution could digitise their existing cadaveric resources, facilitating the delivery of novel educational experiences.

How human anatomy is being taught in entry-level occupational therapy programs in the United States

There has been a lack of empirical information regarding anatomy education for occupational therapists (OTs). Insufficient anatomy education can result in underprepared entry-level OTs, who may then produce increased practice errors and reduced patient care. The objective of this study was to investigate how human gross anatomy was taught in entry-level occupational therapy programs throughout the United States and evaluate faculty perspectives on its teaching. A mixed-methods survey was sent to the directors of entry-level occupational therapy programs in the United States. Survey responses were compiled to best represent the current occupational therapy education environment. Ten of sixty-eight participating programs did not teach anatomy as a part of their standard occupational therapy curriculum. Of the programs that featured entry-level occupational therapy anatomy courses, the majority were taught by either a non-clinician anatomist or an OT without specialized anatomy training in a region-based, standalone anatomy course during the first semester. In most programs, anatomy was taught to only occupational therapy students using lecture, models/plastination, and/or prosection. Teaching tools, methods, faculty, and programmatic factors were perceived as contributing to program strengths. The design, resources, and faculty involved in the occupational therapy anatomy course may negatively impact the perceived quality of an occupational therapy anatomy program and its students. Participants identified several consequences of insufficient anatomy preparedness, including academic, clinical reasoning, treatment skills, patient care, and professional identity concerns. Occupational therapy educators may want to be aware of the current climate of occupational therapy anatomy education in the United States when designing entry-level occupational therapy anatomy curricula.

A quality improvement apprenticeship: Gross anatomy in the time of Covid-19

The study of anatomy is a team-driven field in which anatomy instruction occurs in small groups in the laboratory with one faculty member guiding students through each anatomical region. One laboratory experience may include several small group instructors in one simultaneous learning session. In comparison, the education of future gross anatomists often happens in an apprenticeship model, where the optimal learning outcomes are met through training with an experienced mentor. It was the vision of the authors to further their education through initiating an inter-institutional exchange to apprentice with innovative mentors in order to bring new ideas back to their own gross anatomy courses. The Southeastern Conference, a consortium of the Universities in the Southern region of the United States often associated with intercollegiate sports, has a host of academic initiatives in addition to the athletic emphasis. The Southeastern Conference Faculty Travel Program is one mechanism by which the organization promotes scholarly excellence. In this case, the Faculty Travel Program provided a way for authors from the University of Kentucky to visit a nearby institution, Vanderbilt University, and learn from like-minded anatomy educators, with the goal of incorporating changes in their courses geared toward quality improvement. After this implementation, positive themes emerged in the student feedback on course evaluations. However, the collaboration was interrupted by the onset of the Covid-19 pandemic. This article examines the strengths of interinstitutional apprenticeship and the benefits of such practices in a time of accelerated change in anatomical instruction.

An initial preparation for human cadaveric dissection ameliorates the associated mental distress in students

It is universally recognized that cadaveric dissection is an essential part of anatomy training. However, it has been reported to induce mental distress in some students and impair their intrinsic motivation (IM) to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation of students for cadaveric dissection. Therefore, it is hypothesized that providing relevant information prior to cadaveric dissection will ameliorate the mental distress, enhance the IM of students, and improve their academic performance. A cohort of occupational therapy students enrolled in an anatomy course were psychologically prepared for cadaveric dissection. Students were provided with a curated list of YouTube videos and peer-reviewed journal articles related to cadaveric dissection prior to the commencement of the anatomy course. All students were also required to attend an oral presentation immediately before commencing dissection. The control group included students who had not been provided with any resources in preparation for cadaveric dissection. Compared to the control group, students who had been prepared demonstrated better quality of cadaveric dissection, improved academic performance, reported less mental distress and greater IM. Moreover, students reported the oral presentation to be most relevant and journal articles to be least useful in their preparation. Therefore, this is an effective approach in the amelioration of mental distress and improvement of performance in anatomy students. Consequently, this study represents a paradigm shift in the pedagogy of anatomy, and could represent a vital element in the evolution of a revitalized anatomy curriculum.

Gross and applied anatomy pedagogical approaches in occupational therapy education: protocol for a scoping review

INTRODUCTION

Historically, dissection is considered the 'gold standard' for teaching foundational anatomy to student occupational therapists. However, many programmes no longer have access to gross anatomy laboratory resources, as it is considered too costly. To address this limitation, applied anatomy instructors have developed innovative novel approaches to teach gross and applied anatomy to student occupational therapists, including live/surface anatomy, medical imaging, and more recently, computer-aided instruction. The types of different anatomy pedagogical approaches used and their impact on learning outcomes in occupational therapy education are unclear. The purpose of this scoping review is to map the types of musculoskeletal gross and applied anatomy pedagogical approaches used in occupational therapy curricula.

METHODS AND ANALYSIS

Using Arksey and O'Malley's (2005) six-stage scoping review framework, approximately 304 different search combinations will be searched across five electronic library databases (ie, MEDLINE, Embase, CINAHL, AMED and ERIC) from their inception to December 2021, in addition to conducting consultation exercises with relevant stakeholders. After title/abstract and full-text screening, included articles will be charted, collated and summarised.

ETHICS AND DISSEMINATION

This study will not involve human or animal subjects. Therefore, research ethics approval is not required. The proposed scoping review will help the research, institutional and clinical rehabilitation communities to better understand the types of musculoskeletal gross and applied anatomy pedagogical approaches used to foster, build and promote musculoskeletal foundational knowledge in occupational therapy education. This could potentially inform the future physical medicine course curricula in occupational therapy programmes. The findings of this review will be disseminated to occupational therapy instructors, occupational therapists, researchers and organisations offering occupational therapy programmes (eg, Universities).

On the job training in the dissection room: from physical therapy graduates to junior anatomy instructors

BACKGROUND

 The training of near-peer (NP) teachers and junior faculty instructors received major attention as a possible solution for the shortage of experienced anatomy instructors in faculties of medicine and health professions. Several studies described the training of NP teachers and junior instructors (≤ 2 years of teaching experience) using various methods. However, few publications include On the Job Training (OJT), which enables reflection and performance evaluation and encourages professionals to cope with their blind spots. Previous publications describing OJT did not include formal observation of the NP teacher or junior instructor. Therefore, this study aimed to present a novel approach to OJT inclusion during prosection laboratories based on the Lewinian experiential model.

METHODS

 Eight physical therapy (PT) graduates were recruited as junior anatomy instructors into the prosection laboratories. All participated in a unique training program during two consecutive academic years (2017, 2018) and received OJT during the teaching sessions. Two questionnaires were filled out to evaluate the educational impact of the training program. Eighty-three first-year PT students participated in prosection laboratories in anatomy taught by junior instructors, and filled out a questionnaire evaluating the performance of both junior and senior instructors. In addition, we compared the final grades in anatomy obtained by students taught by senior instructors to the grades of those taught by junior instructors.

RESULTS

 Each junior anatomy instructor participated in four OJT sessions. Based on self-reported measures, all professional and didactic aspects of the training program received a median score of 4.5 or higher on a five-point Likert scale. Students obtained similar grades in anatomy when taught by junior instructors compared with senior ones, and were similarly satisfied from the teaching performance of both senior and junior anatomy instructors.

CONCLUSIONS

 OJT is applicable in a small-sized PT program facing a shortage of anatomy instructors. Including junior anatomy instructors in prosection laboratories for PT students is a viable solution to the shortage of experienced anatomy instructors. Further study, involving a larger cohort with a longer follow up will strengthen the preliminary results presented here.

The Integration of Prelaboratory Assignments within Neuroanatomy Augment Academic Performance, Increase Engagement, and Enhance Intrinsic Motivation in Students

The study of neuroanatomy imposes a significant cognitive load on students since it includes huge factual information and therefore demands diverse learning strategies. In addition, a significant amount of teaching is carried out through human brain demonstrations, due to limited opportunities for cadaveric dissection. However, reports suggest that students often attend these demonstrations with limited preparation, which detrimentally impacts their learning. In the context of student learning, greater levels of engagement and intrinsic motivation (IM) are associated with better academic performance. However, the maintenance of engagement and the IM of students in neuroanatomy is often challenging for educators. Therefore, this study aimed to explore the role of prelaboratory assignments (PLAs) in the improvement of academic performance, augmentation of engagement, and enhancement of IM in occupational therapy students enrolled in a human neuroanatomy course. One cohort of students in the course was expected to complete PLAs prior to each brain demonstration session. The PLAs contained a list of structures, and students were expected to write a brief anatomical description of each structure. Another cohort of students who were not provided with similar PLAs constituted the control group. Students who completed PLAs had a higher score on the final examinations as compared to students who were not required to complete PLAs. These students also demonstrated greater engagement and IM, and indicated that they perceived PLAs to be valuable in the learning of neuroanatomy. Therefore, PLAs represent a useful teaching tool in the neuroanatomy curriculum.

A collaborative escape room as gamification strategy to increase learning motivation and develop curricular skills of occupational therapy students

BACKGROUND

This study presents an experiment regarding the introduction of gamification strategies in occupational therapy courses. Based on previous studies, the objective is to adapt the idea of recreational escape rooms to educational environments of health sciences like occupational therapy to increase student motivation and promote game-based learning and key skills, such as teamwork.

METHODS

Computer software was created for a collaborative escape room which allows on-line simultaneous play of up to 24-30 students. It was tested three times in an occupational therapy degree program with 75 students and it was based on two different subjects, although it can be adapted to others. The escape room was evaluated using feedback surveys and comparing students' performances before and after the game. Descriptive exploratory statistical analysis was performed using SPSS version 24.

RESULTS

An appropriate use of educational escape rooms can have significant positive impacts on students' engagement and learning. Students were found to prefer using gamification tools in their learning. Their degrees of satisfaction exceeded their expectations.

CONCLUSIONS

Educational escape rooms may have a positive impact on students' motivation and a statistically significant improvement of test scores after playing was found. Comments from the feedback surveys were used to improve successive versions of the software and design of the game.

TRIAL REGISTRATION

T.F.G. n° 2020.038 (Research Ethics Committee of the Principality of Asturias).

Inclusion and perception of hand therapy content in occupational therapy programs: A mixed-method study

STUDY DESIGN

Mixed-methods with cross-sectional survey and interviews.

INTRODUCTION

Hand therapy is a specialty area of practice for occupational (OT) and physical therapists (PT), requiring experience and certification beyond entry-level generalist education. Perspectives and inclusion of content related to hand therapy differs among entry-level OT programs and faculty.

PURPOSE

Perception and inclusion of hand therapy content in OT programs was examined in this mixed-method study to better understand the trends in academia regarding integration of content related to hand therapy.

METHODS

A survey was developed, peer-reviewed, and emailed to all accredited entry-level masters and doctorate OT programs via Survey Monkey (SurveyMonkey, Inc., San Mateo, CA). Respondents were also given the opportunity to participate in an interview (n = 2; 5%).

RESULTS

A total of 43 participants responded to the survey, representing a 23% response rate. Quantitative results revealed that 65% of OT programs report including 41+ hours of hand therapy content and 54% report integration of hand therapy content in 2-3 courses. Qualitative trends included the perception of hand content as necessary and beneficial to other areas of practice as well as the perspective that it is too specialized and advanced for generalist curriculum.

DISCUSSION

Educators have a largely positive opinion regarding inclusion and generalizability of hand therapy content within OT curricula with varied content inclusion. While hand therapy related content is valued, increased emphasis on occupation during didactic instruction is recommended for more holistic understanding and occupation-based practice.

CONCLUSION

While trends of hand therapy content inclusion were revealed in the survey, perceptions of hand therapy within the broad spectrum of OT curricula were diverse, indicating a possible lack of unity within the profession regarding this specialty area of practice.

Changes in the learning styles and approaches of students following incorporation of drawing during cadaveric dissection

The teaching of anatomy is challenging due to the constraints of material and personnel resources. Research has established that the learning preferences of students are malleable and determined by the requirements of the course. Further, drawing has been reported to aid learning in anatomy by facilitating problem solving and reducing the cognitive overload in students. Considering these issues, the aims of the study were to investigate (a) if positive changes occur in the learning styles and approaches following the incorporation of drawing during cadaveric dissection, and (b) whether they are associated with improved learning outcomes. One cohort of students in an anatomy course received training in creating scientific drawings from dissected human cadavers, while two cohorts of students did not receive such training. The learning preferences of students and their final examination grades were assessed at the commencement and conclusion of the course. Majority of student who had training in drawing transitioned from being bimodal, to trimodal or quadrimodal learners. This was associated with efficient learning approaches and a significant (p < .05) improvement in learning outcomes in these students. There were no changes in any parameters in students who had not received training in drawing. Therefore, the modulation of learning preferences of students through drawing is a pragmatic approach in anatomy teaching.

Online instructional anatomy videos: Student usage, self-efficacy, and performance in upper limb regional anatomy assessment

Allied health professionals concur that a sound knowledge of practical gross anatomy is vital for the clinician, however, human anatomy courses in allied health programs have been identified as high-risk for attrition and failure. While anatomists and clinicians agree that learning anatomy via human cadaveric instruction is the preferred method, students vary in their reaction to the cadaveric learning experience and have differing levels of anatomy self-efficacy. This study investigated whether student self-efficacy had an effect on student usage of supplemental instructional videos and whether the use of videos had an impact on student self-efficacy and/or learning. Anatomy self-efficacy differed based on gender and prior performance. Student usage of the videos varied widely and students with lower self-efficacy were more inclined to use the resources. The provision of the videos did not improve overall cohort performance as compared to a historical cohort, however, those students that accessed all video sets experienced a greater normalized learning gain compared to students that used none or one of the four sets of videos. Student reports and usage patterns indicate that the videos were primarily used for practical class preparation and revision. Potentially, the videos represent a passive mode of teaching whereas active learning has been demonstrated to result in greater learning gains. Adapting the videos into interactive tutorials which will provide opportunity for feedback and the development of students' self-evaluation may be more appropriate. Anat Sci Educ 11: 461-470. © 2017 American Association of Anatomists.

Anatomy education in occupational therapy curricula: Perspectives of practitioners in the United States

The study of human anatomy is an integral component in the education of future occupational therapists, yet there is a paucity of research that explores the anatomy needs of students and new practitioners. As a follow up from a pilot study that surveyed a small cohort of practicing therapists, this article aimed to determine occupational therapy (OT) practitioners' views on anatomy course structure and content deemed important to include in OT curricula, entry level practitioners' anatomy knowledge, and application of anatomy in current practice. A Likert scale and free text questionnaire was distributed to practicing occupational therapists across the United States. Fifty-four percent of the participants in this cohort favored a standalone course, as compared to 94% in the pilot study group. Anatomy course content areas were comparable across groups. Systems identified as essential to cover in an OT anatomy course included skeletal, muscular, and nervous. Regions included the upper limb, thorax/trunk, head and neck, and lower limb. Seventy percent of participants in both groups felt that entry-level practitioners had adequate anatomy knowledge; 30% did not. Practice areas requiring anatomy knowledge included assessment of joint movement, muscle strength, pain, and functional mobility. Qualitative analysis of free text response data revealed the importance of anatomy knowledge in OT assessment and intervention strategies, determining the impact of injury or disease on occupational performance, client safety, and communication with other health care professionals and families. Anat Sci Educ 11: 243-253. © 2017 American Association of Anatomists.

Identifying educational priorities for occupational therapy students to prepare for mental health practice in Australia and New Zealand: Opinions of practising occupational therapists

BACKGROUND

The effective preparation of occupational therapy students for mental health practice is critical to facilitate positive consumer outcomes, underpin optimal practice and support new graduates' professional identity. This project was established to determine a set of 'educational priorities' for occupational therapy students to prepare them for current (and future) entry-level practice in mental health, from the perspective of mental health occupational therapists in Australia and New Zealand.

METHODS

The study included two phases. In Phase One, participants identified what they considered to be important educational priorities for occupational therapy students to prepare them for practice in mental health. For Phase Two, an 'expert panel' was assembled to review and rank these using a Policy Delphi approach.

RESULTS

Eighty-five participants provided educational priorities in Phase One. These were grouped into a total of 149 educational themes. In Phase Two, the expert panel (consisting of 37 occupational therapists from diverse locations and practice settings) prioritised these themes across three Delphi rounds. A final priority list was generated dividing educational themes into three prioritised categories: 29 'Essential', 25 'Important' and 44 'Optional' priorities. Highest-ranked priorities were: clinical reasoning, client-centred practice, therapeutic use of self, functional implications of mental illness, therapeutic use of occupation and mental health fieldwork experience.

CONCLUSION

The priority list developed as part of this project provides additional information to support the review of occupational therapy curricula across Australia and New Zealand to ensure that new graduates are optimally prepared for mental health practice.

Emphasis on various subtopics in the anatomy curriculum for chiropractic training: An international survey of chiropractors and anatomists

OBJECTIVE

The aim of this study was to conduct an international survey of the perceived optimal level of anatomy teaching from anatomy academics and practicing chiropractors. We hypothesized that the optimum level of anatomical understanding for chiropractic students does not differ between the anatomists teaching the students and practicing chiropractors.

METHODS

The opinion of anatomists teaching in a chiropractic course (n = 16) was compared to practicing chiropractors (n = 589). The students' level of understanding was based on the revised Bloom's taxonomy for 16 different curriculum areas. Anatomists were recruited by contacting the accredited chiropractic courses worldwide. Snowball sampling was used for the practicing chiropractors. Independent-samples Mann-Whitney U tests were used to compare the results of anatomists and chiropractors.

RESULTS

Opinions differed between anatomists and chiropractors on 9 out of the 16 questions. Where opinions differed, chiropractors recommended a higher standard of anatomical knowledge. The level suggested by chiropractors for these curriculum areas is equal to the "evaluating" level where chiropractic students can remember, understand, apply, and analyze anatomical knowledge to be able to justify a clinical decision.

CONCLUSION

Compared to anatomists working in chiropractic programs, chiropractors suggest a higher standard of anatomy be taught to undergraduates. Collaboration between chiropractors and anatomists would likely be beneficial in creating or modifying anatomy curricula for chiropractic students.

The intermingled history of occupational therapy and anatomical education: A retrospective exploration

Few research articles have addressed the anatomical needs of entry-level occupational therapy students. Given this paucity of empirical evidence, there is a lack of knowledge regarding anatomical education in occupational therapy. This article will primarily serve as a retrospective look at the inclusion of anatomical education in the occupational therapy curriculum. Focusing on the historical inclusion is the first step to address the gap in existing knowledge. Examining the history of anatomy in occupational therapy provides an educational context for curricular developments and helps current anatomical educators understand the evolution of occupational therapy as a profession. Exploring the educational history also offers anatomy educators an identity, as significant contributors, in the training and preparedness of entry-level professionals while focusing on the ideals of occupational therapy. However, there is a critical need for empirical evidence of best teaching practices in occupational therapy and anatomical education. This manuscript provides a foundation and a starting point for further investigation into the anatomical competencies for entry-level occupational therapists.