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Okafor IA, Nnaka JA, Chia T. Cadaver Dissection Experience for First-Time Dissectors: a Hypothetical Three-Pronged Approach for Student Preparation. MEDICAL SCIENCE EDUCATOR 2024; 34:257-269. [PMID: 38510414 PMCID: PMC10948661 DOI: 10.1007/s40670-023-01950-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 03/22/2024]
Abstract
This systematic review synthesized evidence for the development of a preparatory process for first-time dissectors, geared toward improving cadaver dissection (CD) experiences. Eleven studies focused on pre-CD intervention were selected from a literature search in PubMed, the Education Resources Information Centre (ERIC), Google Scholar, PsycNET, and the Cochrane Library. A three-pronged preparatory process was formulated for first-time dissectors based on the evidence from the review. The process includes (1) background assessment; (2) pre-CD education; and (3) gradual exposure and desensitization. The preparatory process shows some hypothetical potential for decreasing negative CD-related experiences, but it still needs validation before implementation.
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Affiliation(s)
- Izuchukwu Azuka Okafor
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University, PMB 5001, Nnewi Campus Nnewi, Nigeria
| | - Jude Amechi Nnaka
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University, PMB 5001, Nnewi Campus Nnewi, Nigeria
| | - Terkuma Chia
- Institute of Health Sciences Education, McGill University, Montréal, QC Canada
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Li H, Upreti T, Do V, Dance E, Lewis M, Jacobson R, Goldberg A. Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints. MEDICAL TEACHER 2024; 46:82-101. [PMID: 37405740 DOI: 10.1080/0142159x.2023.2231625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
PURPOSE Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary. METHODS Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed. RESULTS 221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once. CONCLUSIONS Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.
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Affiliation(s)
- Henry Li
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Tushar Upreti
- Max Rady College of Medicine, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
| | - Victor Do
- Department of Pediatrics, Faculty of Medicine, University of Toronto Temerty, Toronto, Canada
| | - Erica Dance
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Melanie Lewis
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Ryan Jacobson
- Office of Advocacy and Wellbeing, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Aviva Goldberg
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
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Qatanani AM, Fishman O, Khamar D, Rosenzweig S. Personal Preparation of Medical Students for the Human Dissection Experience: A Systematic Review. MEDICAL SCIENCE EDUCATOR 2023; 33:1271-1281. [PMID: 37886287 PMCID: PMC10597922 DOI: 10.1007/s40670-023-01868-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 10/28/2023]
Abstract
Anatomical dissection is a cause of distress for many medical students. Explicit pedagogical strategies are important in reducing student distress and supporting their personal development. A systematic review of PubMed, Ovid, PsycINFO, and Web of Science databases was conducted to examine quantitative data regarding medical school interventions to reduce the negative psychological and moral impact of anatomical dissection on medical students. Of 1189 unique abstracts, 14 papers met screening criteria. Student distress decreased with the use of educational audiovisual materials and graded exposure to donor bodies. Educational lectures, memorial ceremonies, and utilization of background music had mixed results.
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Affiliation(s)
- Anas M. Qatanani
- Geisinger Medical Center, 100 N Academy Drive, Danville, PA 17822 USA
- Drexel University College of Medicine, Philadelphia, PA USA
| | - Oren Fishman
- Drexel University College of Medicine, Philadelphia, PA USA
| | - Dhaval Khamar
- Drexel University College of Medicine, Philadelphia, PA USA
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Terrado J, Gómez O, Chicharro D, García-Manzanares M, Juárez M, Romo-Barrientos C, Mohedano-Moriano A, Criado-Álvarez JJ. Anxiety, emotions, and thoughts of veterinary medicine students during their first visit to the dissection room. ANATOMICAL SCIENCES EDUCATION 2023; 16:547-556. [PMID: 36695649 DOI: 10.1002/ase.2258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 05/11/2023]
Abstract
The use of cadavers is essential for veterinary anatomy learning. However, facing an animal corpse can be stressful for veterinary students because of their empathy toward animals. The objective of this study was to evaluate veterinary medicine students' emotions, feelings, and anxiety levels related to practicals with dog cadavers. Two questionnaires were administered to 1st year students (n = 168) at CEU Cardenal Herrera University in Valencia (Spain) before and after their first practical session with cadavers. The application of State-Trait Anxiety Inventory questionnaires showed that "state anxiety" decreased significantly (p < 0.05), from a score of 14.8 before the practical to 10.4 after, and that female students showed higher but not significantly different levels than males. Most (64%) of the students were not willing to donate the bodies of their pets, and those students were more stressed before the practical than their peers, although their anxiety levels significantly decreased by the end of the session. The majority of the students answered positively about emotions, such as feeling calm, safe, not nervous, relaxed and not worried before the practical, and this increased significantly to more than 80% by the end of the session. The visualization of educational videos prior to the session was evaluated positively by students. These results agree with those reported in other health science disciplines, showing that students face practical sessions with corpses in a similar way and suggesting that the use of videos can help decrease anxiety and enhance their learning experience.
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Affiliation(s)
- José Terrado
- Department of Animal Medicine and Surgery, Universidad CEU Cardenal Herrera, CEU Universities, Alfara del Patriarca, Spain
| | - Olga Gómez
- Department of Animal Medicine and Surgery, Universidad CEU Cardenal Herrera, CEU Universities, Alfara del Patriarca, Spain
| | - Deborah Chicharro
- Department of Animal Medicine and Surgery, Universidad CEU Cardenal Herrera, CEU Universities, Alfara del Patriarca, Spain
| | - Maria García-Manzanares
- Department of Animal Medicine and Surgery, Universidad CEU Cardenal Herrera, CEU Universities, Alfara del Patriarca, Spain
| | - Miriam Juárez
- Department of Animal Medicine and Surgery, Universidad CEU Cardenal Herrera, CEU Universities, Alfara del Patriarca, Spain
| | - Carmen Romo-Barrientos
- Integrated Attention Management of Talavera de la Reina, Castilla-La Mancha Health Service (SESCAM), Talavera de la Reina, Spain
| | - Alicia Mohedano-Moriano
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - Juan José Criado-Álvarez
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Institute of Health Sciences of Castilla-La Mancha, Talavera de la Reina, Spain
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5
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Mueller CM, Allison SM. In their own words: impact of donor information and personal statements on humanization of donors in a gross anatomy course. ADVANCES IN PHYSIOLOGY EDUCATION 2022; 46:426-437. [PMID: 35695290 DOI: 10.1152/advan.00068.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Humanization of donors in gross anatomy courses has been reported to facilitate professional behavior in healthcare students. However, there is a lack of research investigating whether students' knowledge of donor information is associated with humanization of whole body donors. To address this gap, the present study aimed to 1) determine whether knowledge of donor information is associated with greater humanization of donors and 2) investigate student perceptions of receiving donor information. Donor information was provided to students at the beginning of the course (cohort A) or at midsemester (cohort B). Questionnaires utilized quantitative and qualitative methods to assess humanization and student perceptions at the beginning, middle, and end of the semester. Independent t tests demonstrated that there was no statistically significant difference in mean humanization scores between cohorts A and B before the first dissection [t(37) = 0.449, P = 0.656], at midsemester [t(35) = -1.546, P = 0.131], or at the end of the semester [t(28) = 0.004, P = 0.997]. Thematic analysis demonstrated that as the semester progressed students' view of dissection as an invasion of privacy and the donor as a patient decreased. Themes delineated from students' open-ended responses revealed that students felt a connection with their donors; that the donors' consenting information gave permission to dissect; and that the information gave students an invaluable learning experience. Students demonstrated detached concern toward their donor, viewing the donor as a learning tool or educator rather than a patient. However, their responses also indicated the development of a deeper, personal connection to donors.NEW & NOTEWORTHY A look at the use of donor personal statements and information to humanize donors and how it influenced students' experiences in a gross anatomy laboratory.
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Affiliation(s)
- Caroline M Mueller
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio
| | - Sara M Allison
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan
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Chaudhuri JD. An initial preparation for human cadaveric dissection ameliorates the associated mental distress in students. ANATOMICAL SCIENCES EDUCATION 2022; 15:910-927. [PMID: 34143562 DOI: 10.1002/ase.2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Joydeep Dutta Chaudhuri
- School of Occupational Therapy, College of Health Sciences, Husson University, Bangor, Maine, USA
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Attardi SM, Gould DJ, Pratt RL, Roach VA. YouTube-based course orientation videos delivered prior to matriculation fail to alleviate medical student anxiety about anatomy. ANATOMICAL SCIENCES EDUCATION 2022; 15:685-697. [PMID: 34048140 DOI: 10.1002/ase.2107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/07/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
Gross anatomy is a source of anxiety for matriculating medical students due to the large volume of information presented in a truncated timeline, and because it may be their first exposure to human cadavers. This study aimed to assess if video-based resources would affect matriculating medical students' anatomy state anxiety levels. Videos were designed to be short, YouTube-based units that served to provide orientation information about the anatomy course, dissection facilities, and available study resources to dispel anxiety around beginning their anatomy studies. To evaluate the impact of the videos, students in two consecutive matriculating years (2018 and 2019) completed the validated State-Trait Anxiety Inventory and a demographic questionnaire. The 2019 cohort (n = 118) served as the experimental group with access to the videos; while the 2018 cohort (n = 120) without video access served as a historical control. Analyses revealed that the groups were equivalent in terms of trait anxiety (P = 0.854) and anatomy state anxiety even when student video exposure was controlled (P = 0.495). Anatomy state anxiety was only significantly lower in students with prior formal anatomy exposure (P = 0.006). Further inquiry into students' prior anatomy experience identified that individuals with post-secondary dissection experience were significantly less anxious than those without formal anatomical experience (P = 0.023). These results may serve as a cautionary tale to educators; while preference for video-based instructional materials is prevalent in the literature, videos delivered on public social media platforms fail to prepare students for the psychological impact of studying human anatomy.
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Affiliation(s)
- Stefanie M Attardi
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Douglas J Gould
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Rebecca L Pratt
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Victoria A Roach
- Division of Healthcare Simulation Science, Department of Surgery, University of Washington, Seattle, Washington, USA
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Lachman N, Pawlina W. Reconsidering laboratory-based anatomy within the backdrop of digital transformation: Bringing an old practice into a new world. ANATOMICAL SCIENCES EDUCATION 2022; 15:439-446. [PMID: 35429369 DOI: 10.1002/ase.2182] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Nirusha Lachman
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Wojciech Pawlina
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
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9
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Mi M, Wu L, Zhang Y, Wu W. Integration of arts and humanities in medicine to develop well-rounded physicians: the roles of health sciences librarians. J Med Libr Assoc 2022; 110:247-252. [PMID: 35440898 PMCID: PMC9014948 DOI: 10.5195/jmla.2022.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Over the past ten years, there has been a growing interest in integrating arts and humanities in medicine to increase learners' empathy and resilience; improve personal well-being, communication, and observational skills; enhance self-reflection; and promote professionalism. These desired skills and qualities are becoming increasingly important for the physicians of tomorrow. Parallel to curricular interventions of integrating arts and humanities to medical education, there has been an increasing research interest in investigating the impact of such interventions on medical students with respect to improving and sustaining students' empathy as they progress in their medical education and develop their professional identity. Research has yielded interesting findings on the types and effect of the interventions in the medical curriculum. The Association of the American Medical Colleges (AAMC), recognizing the unique and unrealized role of arts and humanities in preparing and equipping physicians for twenty-first-century challenges, proposed seven recommendations for advancing arts and humanities integration into medical education to improve the education, practice, and well-being of physicians and physician learners across the spectrum of medical education. Institutional initiatives of arts and humanities integration in the medical curriculum in response to the AAMC's recommendations afford health sciences librarians expansive opportunities and a new landscape of playing an important role in these initiatives. With their diverse educational background in arts, humanities, social sciences, and many other disciplines and fields, health sciences librarians are poised for meaningful contributions to their institutional goals in developing a humanistic, compassionate workforce of future physicians.
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Affiliation(s)
- Misa Mi
- , Interim Director, Medical Library; Professor, Department of Foundational Medical Studies; Oakland University William Beaumont School of Medicine Medical Library, Rochester, MI
| | - Lin Wu
- , Assistant Director/Associate Professor, Research & Learning Services, Health Sciences Library, University of Tennessee Health Science Center, Memphis, TN
| | - Yingting Zhang
- , Research Services Librarian, RWJ Library of the Health Sciences; Adjunct Assistant Professor, Department of Medicine; Rutgers, The State University of New Jersey, New Brunswick, NJ
| | - Wendy Wu
- , Librarian IV, Shiffman Medical Library, Wayne State University; Detroit, MI
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Zumwalt AC. Anticipatory Feelings About Dissection: An Exercise for the First Day of a Gross Anatomy Course. ANATOMICAL SCIENCES EDUCATION 2021; 14:828-835. [PMID: 33369234 DOI: 10.1002/ase.2048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
Studies have demonstrated that students experience a variety of intense emotions in anticipation of human anatomical dissection, including enthusiasm, gratitude, responsibility, apprehension, detachment, anxiety, and spiritual or moral reflection. The exercise described here provides an opportunity to start a conversation about the complexity of students' emotional reactions to the anatomy experience. The intention of this exercise is to normalize the variety of emotions that anatomy students experience, both to demonstrate to students that their emotions are normal and to encourage the empathy for others' reactions which may differ from their own. In the lecture hall setting before the first day of dissection, students are asked to draw how they feel about the dissection experience and are provided an opportunity to discuss their drawings with their peers. The course director then provides a slide show demonstration of drawings from previous years, and experienced anatomy faculty facilitate a large group discussion in which students react to the drawing exercise and slide show and ask questions which are addressed by the faculty. This exercise provides an opportunity for students to practice appropriately communicating about emotionally complex experiences in a professional setting. The exercise is straightforward to implement and is easily modifiable for different class sizes and curricular structures.
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Affiliation(s)
- Ann C Zumwalt
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
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Holland JC, Ní Dhónaill R, Clarke M, Joyce P. Physician Associate Students' Experience of Anatomy Dissection. ANATOMICAL SCIENCES EDUCATION 2021; 14:52-61. [PMID: 32452170 DOI: 10.1002/ase.1984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
The role of physician assistant/associate (PA) has expanded from its inception in the United States over 50 years ago, to European countries including Ireland. While there is an increasing body of evidence exploring the role and training of PAs in clinical settings, there is a scarcity of research exploring PA students' perspectives in relation to their experience of anatomy dissection, or how these experiences may contribute to the development of their core professional identity. Students in the first two cohorts of PA Program at the Royal College of Surgeons in Ireland program were invited to interviews which solicited them to reflect and report on their own experiences of anatomical dissection during their course. Participants' responses were analyzed using a thematic inductive approach; common themes and patterns were organized into a hierarchical structure, which generated the final framework of themes. Ten participants took part in the study; only one had previous personal experience of dissection, while two further participants had some familiarity with prosected specimens. The first theme concerned the participants' expectation of anatomical dissection, with sub-themes of preconceptions, smell, and emotions. The second theme involves discussion of coping strategies that the participants used, including talking, viewing the cadaver as their first patient, and naming (or not naming) the cadaver. The third theme includes how the participants' talked about respect and compassion in the dissection room, development of team working skills, and awareness of bereavement and organ donation. A number of recommendations were also made for the experience and orientation of future students in such a program.
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Affiliation(s)
- Jane C Holland
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Maeve Clarke
- Department of Oncology, Beaumont Hospital, Dublin, Ireland
| | - Pauline Joyce
- Physician Associate Program, Royal College of Surgeons in Ireland, Dublin, Ireland
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Chaudhuri JD. Changes in the learning styles and approaches of students following incorporation of drawing during cadaveric dissection. Clin Anat 2020; 34:437-450. [PMID: 32893909 DOI: 10.1002/ca.23673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/14/2020] [Accepted: 08/26/2020] [Indexed: 11/08/2022]
Abstract
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.
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Affiliation(s)
- Joydeep Dutta Chaudhuri
- School of Occupational Therapy, College of Health Sciences, Husson University, Bangor, Maine, USA
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Cornwall J, Hildebrandt S. Anatomy, Education, and Ethics in a Changing World. ANATOMICAL SCIENCES EDUCATION 2019; 12:329-331. [PMID: 31125503 DOI: 10.1002/ase.1898] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/09/2019] [Accepted: 05/21/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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