National Survey on Canadian Undergraduate Medical Programs: The Decline of the Anatomical Sciences in Canadian Medical Education

Introducing Novel Surgical Clinical Correlations Into an Undergraduate Medical Anatomy Course

Anatomy education is a hallmark of many preclinical medical school curricula, but students are often unable to identify the clinical relevance of anatomy and its applications. Vertical curricula that integrate clinical concepts into the preclinical basic science years and vice versa have been shown to benefit student learning and increase educational enjoyment. This study explores second-year medical students' perceptions of the integration of clinical surgical concepts and surgical faculty into a preclinical digestive system (GI) anatomy course. The GI anatomy course at Rutgers New Jersey Medical School was modified to build on traditional anatomy content by correlating it directly with clinical surgical content. This included a novel, focused anatomy and surgery correlations booklet and surgical videos relevant to anatomical topics. Additionally, practicing general surgeons came to the anatomy lab to interact with the students and provide further clinical relevance. Survey data were collected regarding students' perceptions of integrating surgical concepts and surgeons into the anatomy curriculum, and exploring factors influencing their interest in a surgical career. The data revealed that students valued both the correlations booklet and interacting with surgeons in the anatomy lab. When ranked on a five-point Likert scale, students found both surgeons in the laboratory (M = 4.15, SD = 0.86) and the surgical correlation booklet (M = 3.52, SD = 0.51) helped them in learning the anatomy curriculum. The data did not suggest a direct relationship between interacting with surgeons in the anatomy lab and student surgical career interest. Instead, students reported additional experiences (i.e., shadowing and preceptorships) and anatomical dissection as influencing their career decisions. This study provides further evidence for the benefits of a vertical medical school curriculum by integrating clinical content and formal interactions with clinicians during the preclinical curriculum. The findings also demonstrate that further research should be completed to understand the factors influencing student interest in a surgical career.

A slide into obscurity? The current state of histology education in Australian and Aotearoa New Zealand medical curricula in 2022-2023

Australia and Aotearoa New Zealand (AANZ) medical schools have been impacted by curricular changes and the introduction of virtual microscopy (VM). No survey has explicitly described the outcome of these events on histology education in AANZ. This study provides a cross-sectional overview of histology education in accredited medical schools across AANZ in 2022-2023. Responses were received from 83% (19/23) of Australian medical schools, and 50% (1/2) of medical schools in Aotearoa New Zealand. VM, either exclusively (42%) or combined with traditional microscopy (37%), emerged as the preferred mode for delivering histology education. Common instructional methods included face-to-face lectures (26%) and synchronous online live lectures (26%). A significant proportion (84%) of educators supplemented resources with virtual microscopy websites. Integration of histology education was prevalent (79%), primarily with pathology (32%) or gross anatomy (26%). On average, medical students in the region spent a maximum of 21 ± 17 h in face-to-face histology laboratories throughout their degree. Histology education was predominantly taught by academics with a PhD degree. This study also examined the similarities and differences in histology education between AANZ and the global landscape. Through this examination, the present study positions AANZ within the broader context of histology education worldwide discusses key factors impacting histology education, and advocates for action to mitigate a looming shortage of pathologists in AANZ. In light of these findings, AANZ medical schools should integrate histology and pathology, establish a core curriculum, and promote flexible teaching modalities.

Studying the history of histopathology in preclinical medical education as a guide for the uniform integration of radiology in medical education

Radiology and pathology, though distinct fields within medical education, share a common foundation in their essential roles for accurate diagnosis and understanding of diseases. While pathology, particularly histopathology, has long been integrated into preclinical medical education in the United States, radiology education has traditionally been less emphasized. This paper examines the historical development of histopathology training in medical education and its central role, contrasting it with the comparatively peripheral position of radiology education. We explore the historical context of medical education in the United States, tracing the integration of histopathology following the Flexner Report of 1910. In contrast, radiology, emerging later as a specialized field, has faced challenges in achieving comparable integration into medical curricula. Despite the increasing importance of medical imaging in diagnosis and treatment, radiology education remains variable and often lacking in standardization across medical schools. We highlight the need for greater emphasis on radiology education to better prepare medical students for modern clinical practice, where medical imaging plays an increasingly pivotal role. A call for a comprehensive assessment of radiology education and advocacy for its integration into preclinical curricula is made, emphasizing the importance of collaboration between the radiology profession and accrediting bodies to ensure competence in imaging across medical specialties. As medical imaging continues to advance and become more integral to healthcare, it is imperative that medical education reflects this evolution by establishing radiology as a fundamental component of preclinical training.

Automated grading of anatomical objective structured practical examinations using decision trees: An artificial intelligence approach

An Objective Structured Practical Examination (OSPE) is an effective and robust, but resource-intensive, means of evaluating anatomical knowledge. Since most OSPEs employ short answer or fill-in-the-blank style questions, the format requires many people familiar with the content to mark the examinations. However, the increasing prevalence of online delivery for anatomy and physiology courses could result in students losing the OSPE practice that they would receive in face-to-face learning sessions. The purpose of this study was to test the accuracy of Decision Trees (DTs) in marking OSPE questions as a first step to creating an intelligent, online OSPE tutoring system. The study used the results of the winter 2020 semester final OSPE from McMaster University's anatomy and physiology course in the Faculty of Health Sciences (HTHSCI 2FF3/2LL3/1D06) as the data set. Ninety percent of the data set was used in a 10-fold validation algorithm to train a DT for each of the 54 questions. Each DT was comprised of unique words that appeared in correct, student-written answers. The remaining 10% of the data set was marked by the generated DTs. When the answers marked by the DT were compared to the answers marked by staff and faculty, the DT achieved an average accuracy of 94.49% across all 54 questions. This suggests that machine learning algorithms such as DTs are a highly effective option for OSPE grading and are suitable for the development of an intelligent, online OSPE tutoring system.

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.

Doing more with less: Realistic stereoscopic three-dimensional anatomical modeling from smartphone photogrammetry

Traditional teaching methods struggle to convey three-dimensional concepts effectively. While 3D virtual models and virtual reality platforms offer a promising approach to teaching anatomy, their cost and specialized equipment pose limitations, especially in disadvantaged areas. A simpler alternative is to use virtual 3D models displayed on regular screens, but they lack immersion, realism, and stereoscopic vision. To address these challenges, we developed an affordable method utilizing smartphone-based 360° photogrammetry, virtual camera recording, and stereoscopic display (anaglyph or side-by-side technique). In this study, we assessed the feasibility of this method by subjecting it to various specimen types: osteological, soft organ, neuroanatomical, regional dissection, and a dedicated 3D-printed testing phantom. The results demonstrate that the 3D models obtained feature a complete mesh with a high level of detail and a realistic texture. Mesh and texture resolutions were estimated to be approximately 1 and 0.2 mm, respectively. Additionally, stereoscopic animations were both feasible and effective in enhancing depth perception. The simplicity and affordability of this method position it as a technique of choice for creating easily photorealistic anatomical models combined with stereoscopic depth visualization.

Creating evidence-based engaging online learning resources in neuroanatomy

Online anatomical resources are rising in popularity since the COVID-19 pandemic, but the pedagogical principles and effectiveness of their use remain unclear. This article aims to demonstrate evidence-informed ways in which fellow educators can create engaging online learning resources in clinical neuroanatomy and compare the effectiveness of text-based and online learning resources. Data were analyzed from the Soton Brain Hub (SBH) YouTube page. Separately, a cross-sectional study comparing the learning gain of using text-based and video resources was done. The knowledge gain and retention were compared between groups using a pre-teaching and post-teaching multiple choice questions. YouTube analytics showed the average time a viewer spends on a video was found to be highly correlated to the length of the video, r = 0.77, p < 0.001 (0.69-0.82). The cross-sectional study indicated a significant difference in mean normalized learning gain of video resources 61.9% (n = 53, CI 56.0-67.7%) versus text resources 49.6% (n = 23, CI 39.1-60.1%) (p = 0.030). However, there was no difference in retained learning gain between video resources 39.1% (n = 29, CI 29.2-49.0%) versus text-based 40.0% (n = 13, CI 23.9-56.1%) (p = 0.919). Students engage most with short videos less than 5 min which reduces the intrinsic load of learning. Online resources are as effective as text-based resources in providing learning gain and retention. In the future, the continued rise in popularity of online learning resources may result in further reduction in traditional face-to-face teaching.

Animated PowerPoint Videos: An Underutilized Anatomy Educational Tool?

The subject of anatomy is an integral component of medical and dental education which are constantly evolving. Hence, educators continuously attempt to take advantage of technological advancements to create resources that will improve students' higher cognitive skills. This article describes the creation of an e-learning resource in the form of an animated PowerPoint video that was designed based on evidence-based principles and educational theories to introduce the concept of tooth anatomy. Additionally, it outlines how this resource can be potentially integrated into a broader educational system as well as encourage anatomy and medical educators to use less complex technological equipment to create accessible educational resources.

Objects drawn from haptic perception and vision-based spatial abilities

Haptic perception is used in the anatomy laboratory with the handling of three-dimensional (3D) prosections, dissections, and synthetic models of anatomical structures. Vision-based spatial ability has been found to correlate with performance on tests of 3D anatomy knowledge in previous studies. The objective was to explore whether haptic-based spatial ability was correlated with vision-based spatial ability. Vision-based spatial ability was measured in a study group of 49 medical graduates with three separate tests: a redrawn Vandenberg and Kuse Mental Rotations Tests in two (MRT A) and three (MRT C) dimensions and a Surface Development Test (SDT). Haptic-based spatial ability was measured using 18 different objects constructed from 10 cubes glued together. Participants were asked to draw these objects from blind haptic perception, and drawings were scored by two independent judges. The maximum score was 24 for each of MRT A and MRT C, 60 for SDT, and 18 for the drawings. The drawing score based on haptic perception [median = 17 (lower quartile = 16, upper quartile = 18)] correlated with MRT A [14 (9, 17)], MRT C [9 (7, 12)] and SDT [44 (36, 52)] scores with a Spearman's rank correlation coefficient of 0.395 (p = 0.0049), 0.507 (p = 0.0002) and 0.606 (p < 0.0001), respectively. Spatial abilities assessed by vision-based tests were correlated with a drawing score based on haptic perception of objects. Future research should investigate the contribution of haptic-based and vision-based spatial abilities on learning 3D anatomy from physical models.

Human dissection for anesthesiology resident training augments anatomical knowledge and clinical skills

Anatomy is an essential component of clinical anesthesiology. The use of simulated patients and alternative materials, including embalmed human bodies, have become increasingly common during resident physician training due to the deemphasis on anatomical education during undergraduate medical training. In this report, the need for a more extensive review of relevant anatomy for the practice of anesthesiology was addressed by the design, evaluation, and dissemination of a human dissection course for procedural training of anesthesiology residents. The course utilized "freedom art" embalmed human bodies that allowed trainees to perform ultrasound-based regional and neuraxial techniques followed by detailed dissections of critical anatomy. One hundred and four residents participated in workshops and small group discussions and were evaluated using pre- and post-course assessments. A variety of clinical techniques were performed on the bodies, including regional blocks and neuraxial catheter placement. Insertion of peripheral/neuraxial catheters was successful, with dissections demonstrating the expected placement. Assessment scores improved following the course (pre-course mean 52.7%, standard deviation (σ) 13.1%; post-course mean 72.2%, σ 11.6%; t-test p < 0.0001) and feedback highlighted the usefulness and clinical relevance of course content. The ability to correlate ultrasound imaging with subsequent dissections of the "blocked" area and visualization of dye staining was extremely relevant for spatial understanding of the anatomy relevant for the clinical practice of these techniques. This manuscript demonstrates successful implementation of a comprehensive course for anesthesiology resident physicians to address gaps in undergraduate anatomical education and suggests that broader adoption of dissection courses may be beneficial for training anesthesiologists.

Pathologists aren't pigeons: exploring the neural basis of visual recognition and perceptual expertise in pathology

Visual (perceptual) reasoning is a critical skill in many medical specialties, including pathology, diagnostic imaging, and dermatology. However, in an ever-compressed medical curriculum, learning and practicing this skill can be challenging. Previous studies (including work with pigeons) have suggested that using reward-feedback-based activities, novices can gain expert levels of visual diagnostic accuracy in shortened training times. But is this level of diagnostic accuracy a result of image recognition (categorization) or is it the acquisition of diagnostic expertise? To answer this, the authors measured electroencephalographic data (EEG) and two components of the human event-related brain potential (reward positivity and N170) to explore the nature of visual expertise in a novice-expert study in pathology visual diagnosis. It was found that the amplitude of the reward positivity decreased with learning in novices (suggesting a decrease in reliance on feedback, as in other studies). However, this signal remained significantly different from the experts whose reward positivity signal did not change over the course of the experiment. There were no changes in the amplitude of the N170 (a reported neural marker of visual expertise) in novices over time. Novice N170 signals remained statistically and significantly lower in amplitude compared to experts throughout task performance. These data suggest that, while novices gained the ability to recognize (categorize) pathologies through reinforcement learning as quantified by the change in reward positivity, increased accuracy, and decreased time for responses, there was little change in the neural marker associated with visual expertise (N170). This is consistent with the multi-dimensional and complex nature of visual expertise and provides insight into future training programs for novices to bridge the expertise gap.

Comparing the emotional experiences of students in similar dissection- and prosection-based medical gross anatomy courses: A mixed-methods study

The anatomy laboratory can incite strong emotional reactions in students, which can in turn facilitate growth in empathy, care for vulnerable others, and professionalism. Despite this, little is known about the relative emotional impacts of different laboratory modalities. The response to the COVID-19 pandemic created an opportunity to compare the emotional experiences of students in similar courses in which one group of students dissected donors and the other group learned from prosected donors. The courses were otherwise the same in content, length, instructional design, and assessment. Students in the dissection-based (Fall 2019) and prosection-based (Fall 2020) courses completed a previously validated survey that used quantitative and qualitative questions to assess their feelings about the donors and the anatomy laboratory experience. Students in both cohorts reported overall appreciation for having had the experience. Negative themes experienced by both groups included feeling anxiety, worries about depersonalizing donors, and physical discomfort in the laboratory. Students in the dissection course reported stronger connections with the donors and the donors' families but also more frequently felt negative feelings such as disgust, anxiety, and feeling alone. Students in the prosection course reported more consistently positive responses but worried about not using the donors to the fullest extent possible. Regardless of pedagogical design, students have complex emotional experiences in the anatomy laboratory and our results indicate that these feelings may be more intense in the context of dissection. Anatomists should foster educational settings that enable students to learn to process complex or challenging emotions.

Rehearsal-based digital serious boardgame versus a game-free e-learning tool for anatomical education: Quasi-randomized controlled trial

Serious games may resolve problems relating to low motivation in complex medical topics such as anatomy. However, they remain relatively novel introductions to the science of learning, and further research is required to ascertain their benefits. This study describes the overall development and testing of a digital serious boardgame designed to facilitate the rehearsal of musculoskeletal anatomy based on self-determination theory with considerations for the psychological state of Flow. It was hypothesized that students assigned to the intervention game condition would attain higher Flow scores, a measure of engagement and intrinsic motivation, than students assigned to the game-free control, and that the intervention condition would report either superior or non-superior, but not inferior, scores on a surprise recall test. A total of 36 second-year undergraduate medical students participated in the quasi-randomized controlled trial, where the intervention groups went first and randomly drew questions that were mirrored into the control groups. All students were administered an identical 10-question baseline assessment before their interventions, the Short Flow Scale immediately after, and a surprise test four-to-six weeks later. Independent samples t-tests indicated that students of both conditions were of similar baseline knowledge (t = 0.7, p = 0.47), significantly higher Flow scores in the game condition (t = 2.99, p = 0.01), and no significant differences between surprise test scores (t = -0.3, p = 0.75). The game appears to be an appropriate game-based tool for student rehearsal of anatomical education, stemming from a strong theoretical base that facilitates high engagement and intrinsic motivation.

Examining Motivation of First-Year Undergraduate Anatomy Students Through the Lens of Universal Design for Learning (UDL): A Single Institution Study

Motivation is critical for meaningful learning among healthcare students studying anatomy. Learners are highly variable, and it is important to ensure learners are equally supported in the diverse aspects of an anatomy curriculum. The implementation of the educational framework, Universal Design for Learning (UDL), in anatomy curricula could potentially enhance student motivation. The multiple means of engagement principle of UDL refers to the enhancement of motivation among students. This study aimed to identify healthcare students' motivation levels at the start and end of their anatomy module and whether there was any change in motivation. The Motivated Strategies for Learning Questionnaire (MSLQ) was distributed to gather the self-reported motivation levels of first-year undergraduate medical, dental and occupational therapy (OT) and speech and language therapy (SLT) students studying anatomy at the start of their respective anatomy modules and again at the end of the module. The overall response rate was 74% and 69%, at the start and end of the study, respectively. Responses were analysed by the respective programme of study. Motivation to study anatomy among medical, dental, OT and SLT students ranged from medium to high on the MSLQ at the start of their respective anatomy modules. By the end of the anatomy modules, dental students reported high levels of motivation to study anatomy, whereas motivation among medical, OT and SLT students ranged from medium to high. A change in students' self-reported motivation levels while studying anatomy was identified. The study emphasises the benefits of UDL and its flexible nature to enhance motivation.

A longitudinal Q-study to assess changes in students' perceptions at the time of pandemic

The COVID-19 pandemic forced many universities and colleges to rapidly adopt online course delivery. As with any new foray, realizing the optimal aspects of a course to change became incredibly important for course instructors. In this study, we used a particularly sensitive method, i.e. Q-methodology, to evaluate changes based on students' perceptions from fall 2020 to winter 2021. Q-methodology is commonly used to uncover shared values, opinions, and preferences. Using Q-methodology, students participating in both semesters of an undergraduate anatomy and physiology course were surveyed in fall 2020 and winter 2021. The Q-sample included 44 statements. Data from fall 2020 were treated as the baseline and changes in students' perceptions from 2020 to 2021 were assessed. In total, 31 students completed both fall 2020 and winter 2021 course evaluations. Three salient factors emerged from the fall 2020 evaluation: Overtaxed students, Solo Achievers, and In-Person Learners. At the baseline, students were concerned mostly about the delivery of the course, then the winter 2021 evaluation showed how they were adjusting to online learning. The longitudinal Q-study proved to be robust in identifying changes in perceptions. These granular findings indicate how students might differ in viewing and evaluating online courses. This methodology can be used in redesigning and restructuring different components of an online course in higher education settings.

A comparative analysis of lecturers' satisfaction with Anatomage and Pirogov virtual dissection tables during clinical and topographic anatomy courses in Russian universities

Anatomy is increasingly taught using computer-assisted learning tools, including electronic interactive anatomy dissection tables. Anatomage was he first virtual anatomy dissection table introduced in Russian medical universities and gained popularity among lecturers and students. The Pirogov interactive anatomy table was recently released, but the strengths and weakness of each platform is currently unknown. The objective of this article is to survey lecturers in anatomy to understand their perspectives on the Pirogov versus Anatomage virtual dissection tables' application to teaching in medical universities. A total of 80 anatomy educators from 12 Russian universities, using Anatomage (n = 40) and Pirogov (n = 40) tables were surveyed regarding their satisfaction with the application of the respective tables. Using a five-point Likert scale, both tables were assessed, and responses were statistically analyzed. In addition, qualitative analysis was performed on free response comments provided by survey respondents. There was no significant difference in overall satisfaction ratings between Pirogov (4.38 ± 0.53) and Anatomage (3.94 ± 0.60) interactive tables (p > 0.05). The Anatomage table ranked significantly higher on the accuracy of displayed anatomical details, resolution of the images, and its suitability for teaching senior medical and postgraduate students. Pirogov table performed significantly better on survey items measuring ergonomics, ability to assess students' performance, and teaching basic anatomy to junior first- and second-year medical students. Thus, in summary, anatomists' responses indicated that while both tables are suitable for teaching anatomy, the Pirogov table was superior in undergraduate medical education and the Anatomage table was more beneficial for teaching more senior trainees.

Effect of binocular disparity on learning anatomy with stereoscopic augmented reality visualization: A double center randomized controlled trial

Binocular disparity provides one of the important depth cues within stereoscopic three-dimensional (3D) visualization technology. However, there is limited research on its effect on learning within a 3D augmented reality (AR) environment. This study evaluated the effect of binocular disparity on the acquisition of anatomical knowledge and perceived cognitive load in relation to visual-spatial abilities. In a double-center randomized controlled trial, first-year (bio)medical undergraduates studied lower extremity anatomy in an interactive 3D AR environment either with a stereoscopic 3D view (n = 32) or monoscopic 3D view (n = 34). Visual-spatial abilities were tested with a mental rotation test. Anatomical knowledge was assessed by a validated 30-item written test and 30-item specimen test. Cognitive load was measured by the NASA-TLX questionnaire. Students in the stereoscopic 3D and monoscopic 3D groups performed equally well in terms of percentage correct answers (written test: 47.9 ± 15.8 vs. 49.1 ± 18.3; P = 0.635; specimen test: 43.0 ± 17.9 vs. 46.3 ± 15.1; P = 0.429), and perceived cognitive load scores (6.2 ± 1.0 vs. 6.2 ± 1.3; P = 0.992). Regardless of intervention, visual-spatial abilities were positively associated with the specimen test scores (η² = 0.13, P = 0.003), perceived representativeness of the anatomy test questions (P = 0.010) and subjective improvement in anatomy knowledge (P < 0.001). In conclusion, binocular disparity does not improve learning anatomy. Motion parallax should be considered as another important depth cue that contributes to depth perception during learning in a stereoscopic 3D AR environment.

The effect of curricular reform on gross anatomy laboratory examination performance: An institutional analysis

Many medical schools have undergone curricular reform recently. With these reforms, time spent teaching anatomy has been reduced, and there has been a general shift to a pass/fail grading system. At Indiana University School of Medicine (IUSM), a new curriculum was implemented in fall 2016. The year-long human gross anatomy course taught in 2015 was condensed into an integrated, semester-long course starting in 2016. Additionally, the grading scale shifted to pass/fail. This study examined first-year medical student performance on anatomy practical laboratory examinations-specifically, among lower-order (pure identification) questions and higher-order (function, innervation) questions. Participants included medical students from a pre-curricular reform cohort (year 2015, 34 students) and two post-curricular reform cohorts (years 2016, 30 students and 2017, 33 students). A Kruskal-Wallis ANOVA test was used to determine differences of these questions among the three cohorts. Additionally, 40 of the same lower-order questions that were asked on gross anatomy laboratory examinations from medical student cohort year 2015 and year 2016 were further analyzed using an independent samples t-test. Results demonstrated that the pre-curricular reform cohort scored significantly higher on both lower-order (median = 81, p < 0.001) and higher-order questions (median = 82.5, p < 0.05) than both post-curricular reform cohorts. Additionally, when reviewing the selected 40 similar questions, it was found that the pre-curricular reform cohort averaged significantly higher (82.1 ± 16.1) than the post-curricular reform cohort from 2016 (69.3 ± 21.8, p = 0.004). This study provides evidence about the impact of curricular reform on medical student anatomical knowledge.

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.

A randomized trial comparing cadaveric dissection and examination of prosections as applied surgical anatomy teaching pedagogies

Anatomy is an important component in the vertical integration of basic science and clinical practice. Two common pedagogies are cadaveric dissection and examination of prosected specimens. Comparative studies mostly evaluate their immediate effectiveness. A randomized controlled trial design was employed to compare both the immediate and long-term effectiveness of dissection and prosection. Eighty third-year medical students undergoing their surgical rotation from the Yong Loo Lin School of Medicine were randomized into two groups: dissection and prosection. Each participated in a one-day hands-on course following a similar outline that demonstrated surgical anatomy in the context of its clinical relevance. A pre-course test was conducted to establish baseline knowledge. A post-course test was conducted immediately after and at a one-year interval to evaluate learner outcome and knowledge retention. A post-course survey was conducted to assess participant perception. Thirty-nine and thirty-eight participants for the dissection and prosection groups, respectively, were included for analysis. There was no significant difference between mean pre-course test scores between the dissection and prosection groups [12.6 (3.47) vs. 12.7 (3.16), P > 0.05]. Both the mean immediate [27.9 (4.30) vs. 24.9 (4.25), P < 0.05] and 1 year [23.9 (4.15) vs. 19.9 (4.05), P < 0.05] post-course test scores were significantly higher in the dissection group. However, when adjusted for course duration [dissection group took longer than prosection group (mean 411 vs. 265 min)], these findings were negated. There is no conclusive evidence of either pedagogy being superior in teaching surgical anatomy. Based on learner surveys, dissection provides a greater learner experience.

Anatomy education for medical students in the United Kingdom and Republic of Ireland in 2019: A 20-year follow-up

Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's "Tomorrow's Doctors." The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full-time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part-time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system-based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub-disciplines.

Teaching, Learning and Assessing Anatomy with Artificial Intelligence: The Road to a Better Future

Anatomy is taught in the early years of an undergraduate medical curriculum. The subject is volatile and of voluminous content, given the complex nature of the human body. Students frequently face learning constraints in these fledgling years of medical education, often resulting in a spiraling dwindling academic performance. Hence, there have been continued efforts directed at developing new curricula and incorporating new methods of teaching, learning and assessment that are aimed at logical learning and long-term retention of anatomical knowledge, which is a mainstay of all medical practice. In recent years, artificial intelligence (AI) has gained in popularity. AI uses machine learning models to store, compute, analyze and even augment huge amounts of data to be retrieved when needed, while simultaneously the machine itself can be programmed for deep learning, improving its own efficiency through complex neural networks. There are numerous specific benefits to incorporating AI in education, which include in-depth learning, storage of large electronic data, teaching from remote locations, engagement of fewer personnel in teaching, quick feedback from responders, innovative assessment methods and user-friendly alternatives. AI has long been a part of medical diagnostics and treatment planning. Extensive literature is available on uses of AI in clinical settings, e.g., in Radiology, but to the best of our knowledge there is a paucity of published data on AI used for teaching, learning and assessment in anatomy. In the present review, we highlight recent novel and advanced AI techniques such as Artificial Neural Networks (ANN), or more complex Convoluted Neural Networks (CNN) and Bayesian U-Net, which are used for teaching anatomy. We also address the main advantages and limitations of the use of AI in medical education and lessons learnt from AI application during the COVID-19 pandemic. In the future, studies with AI in anatomy education could be advantageous for both students to develop professional expertise and for instructors to develop improved teaching methods for this vast and complex subject, especially with the increasing paucity of cadavers in many medical schools. We also suggest some novel examples of how AI could be incorporated to deliver augmented reality experiences, especially with reference to complex regions in the human body, such as neural pathways in the brain, complex developmental processes in the embryo or in complicated miniature regions such as the middle and inner ear. AI can change the face of assessment techniques and broaden their dimensions to suit individual learners.

The Use of Ultrasound in Undergraduate Medical Anatomy Education: a Systematic Review with Narrative Synthesis

This systematic review aimed to synthesize the literature on how ultrasound is currently used in anatomy education within medical schools. A systematic search of Ovid MEDLINE, Scopus, and Educational Resources Information Centre was conducted. Thirty-four relevant unique articles were included from the 1,272 identified from the databases and analyzed via narrative synthesis. Thematic analysis generated two domain summaries: "Successful Aspects of Ultrasound Teaching" and "Barriers to Implementation," each with additional subthemes, aimed to help educators inform best teaching practices from the current evidence base in this field.

The effect of repetition- and scenario-based repetition strategies on anatomy course achievement, classroom engagement and online learning attitude

Anatomy is known to be the oldest and most fundamental branch among medical sciences. That is the reason why it is given at the beginning of medical education to form the basis for other medical sciences. Students who newly begin medical education need to spare plenty of time outside the course hours to study Anatomy which involves different and a lot of terminology. In this study, online repetitions were done outside the class using the repetition (classical presentation) and scenario-based repetition methods and the knowledge levels, course engagement statuses and online learning attitudes of the students were compared quantitatively and qualitatively between the groups.The study was conducted with 162 medical school year 2 students. These 162 students were randomized to experimental and control groups. The data were obtained with "Anatomy Achievement Test (AAT)", "Classroom Engagement Inventory (CEI)" and "Medical School Students' Attitudes Towards Online Learning Scale (MSSATOLS)". After administering the experimental procedure to the students who were randomized to the experimental and control groups, focus group interviews were held with 16 students from the experimental group, 8 who received the highest scores and 8 who received the lowest scores from the data collecting instruments. The collected research data determined that the affective engagement (AE) and the anatomy achievement test (AAT) performed pre- and post-study were higher in the group in which the scenario-based repetition strategy was applied. AAT pre-test (mean = 27.16) and post-test (mean = 27.15) scores of the repetition group were very close to each other. However, the AAT post-test (mean = 32.33) average of the scenario-based repetition group was above the mean pre-test scores (mean = 26.79) (p < .05). Similarly, the mean AE pre-test (mean = 17.79) and post-test (mean = 17.91) scores of only the repetition group were very close to one another. However, the AE post-test (mean = 19.46) mean score of the scenario-based repetition group was above the mean pre-test score (mean = 17.82) (p < .05). In summary, pre-test and post-test scores changed the anatomy achievement and affective engagement scores, and this change was in favour of experimental group and increasing the post-test scores.The responses given to the questions in the scales and the impressions obtained from qualitative interviews indicated that the students did not find adequate the lectures given in the form of presentations alone and thought that various methods and primarily scenario-based education should be used as part of anatomy education to be able to establish a good connection with clinical sciences and Anatomy education should be provided not only at the beginning of the medical education but also in the following years.

Enhancing Anatomical Instruction: Impact of a Virtual Canine Anatomy Program on Student Outcomes

Innovative reforms in medical education will require instructional tools to support these changes and to give students more flexibility in where and how they learn. At Colorado State University, the software program Virtual Canine Anatomy (VCA) was developed to assist student learning both inside and outside the anatomical laboratory. The program includes interactive anatomical photographs of dissected canine cadavers, dissection instructions with accompanying videos and diagrams, radiographs, and three-dimensional models. There is a need to evaluate the effectiveness of instructional tools like VCA so that decisions on pedagogical delivery can be evidence-based. To measure the impact of VCA on student outcomes in a dissection laboratory, this study compared student attitudes, quiz scores, dissection quality and accuracy, and instructor reliance between students with and without access to VCA. Students with VCA needed less time with teaching assistants (P < 0.01), asked teaching assistants fewer questions (P = 0.04), felt that the dissection was easier (P = 0.02), and were in stronger agreement that they had access to adequate resources (P = 0.02). No differences were found in the dissection quality or accuracy, quiz scores, or attitudes regarding overall enjoyment of the activity between the two groups. This study shows that VCA increases student independence and can be used to enhance anatomical instruction.

One year of anatomy teaching and learning in the outbreak: Has the Covid-19 pandemic marked the end of a century-old practice? A systematic review

At the end of 2019, the Covid-19 pandemic spread caused restrictions in business and social spheres. Higher education was also severely affected: universities and medical schools moved online to distance learning and laboratory facilities closed. Questions arise about the long-term effects of this pandemic on anatomical education. In this systematic review, the authors investigated whether or not anatomical educators were able to deliver anatomical knowledge during this pandemic. They also discuss the challenges that anatomical education has faced over the last year. The search strategy was conducted between July 2020 and July 2021. Two hundred and one records were identified, and a total of 79 studies were finally included. How best to deliver anatomy to students remains a moot point. In the last years, the advent of new technologies has raised the question of the possible overcoming of dissection as the main instrument in anatomical education. The Covid-19 pandemic further sharpened the debate. Remote learning enhanced the use of technologies other than cadaveric dissection to teach anatomy. Moreover, from the analyzed records it appears that both from students' perspective as well as teachers' there is a clear tear between those who endorse dissection and those who believe it could be easily overcome or at least integrated by virtual reality and online learning. The authors strongly believe that the best anatomy teaching practice requires the careful adaptation of resources and methods. Nevertheless, they support cadaveric dissection and hope that it will not be replaced entirely as a result of this pandemic.

Instructional Approaches: Anatomy Education of Physical Therapists

The profession of physical therapy has undergone an evolution since its inception. Since the early 1900s it has grown from a technical training program to a doctorate level degree. Human anatomy courses remain a requirement for physical therapist educational curricula. However, changes in anatomy pedagogy have been trending within health profession educational models, leading to questions regarding which method is best for student learning. The objective of this study was to determine if anatomy instructional method used within physical therapist educational curricula impacted current anatomy knowledge. Licensed physical therapists were recruited to complete a demographic survey and a questionnaire to demonstrate their knowledge of anatomy topics. Anatomy topics included six regional components: (1) upper limb; (2) lower limb; (3) thorax and abdomen; (4) pelvis; (5) spine; and (6) head. Each regional component contained five questions regarding systemic subsets related to joints and osteology, muscles, nervous system, vasculature, and special areas (e.g., spatial orientations, structures within spaces, pathways of nerves). Within the thorax and abdominal region, data analysis indicated that the dissection instruction method, when compared to no laboratory instruction, led to statistically significant greater anatomical knowledge (P = 0.02). Dissection also showed greater means when compared to the no laboratory method (P = 0.02) and the prosection method in the head region (P = 0.01). However, the variance explained by instructional method was small. This study adds empirical evidence regarding current anatomy knowledge exhibited by physical therapists as the level of anatomical knowledge exhibited small differences based on instructional methods.

An analysis of anatomy education before and during Covid-19: August-December 2020

Coronavirus disease-2019 (Covid-19) disrupted the in-person teaching format of anatomy. To study changes in gross anatomy education that occurred during August-December, 2020 compared to before the pandemic, an online survey was distributed to anatomy educators. The 191 responses received were analyzed in total and by academic program, geographic region, and institution type. Cadaver use decreased overall (before: 74.1 ± 34.1%, during: 50.3 ± 43.0%, P < 0.0001), as well as across allopathic and osteopathic medicine, therapy, undergraduate, and veterinary programs (P < 0.05), but remained unchanged for other programs (P > 0.05). Cadaver use decreased internationally and in the US (P < 0.0001), at public and private (P < 0.0001) institutions, and among allopathic medical programs in Northeastern, Central, and Southern (P < 0.05), but not Western, US geographical regions. Laboratories during Covid-19 were delivered through synchronous (59%), asynchronous (4%), or mixed (37%) formats (P < 0.0001) and utilized digital resources (47%), dissection (32%), and/or prosection (21%) (P < 0.0001). The practical laboratory examination persisted during Covid-19 (P = 0.419); however, the setting and materials shifted to computer-based (P < 0.0001) and image-based (P < 0.0001), respectively. In-person lecture decreased during Covid-19 (before: 88%, during: 24%, P = 0.003). When anatomy digital resources were categorized, dissection media, interactive software, and open-access content increased (P ≤ 0.008), with specific increases in BlueLink, Acland's Videos, and Complete Anatomy (P < 0.05). This study provided evidence of how gross anatomy educators continued to adapt their courses past the early stages of the pandemic.

Global versus local: A regional core embryology syllabus for medical students

"Core syllabus" in this work refers to knowledge topics that an instructor should necessarily and indispensably address during a discipline. This study describes the process of developing a regional human embryology core syllabus for undergraduate medical courses in Brazil, using a two-round modified Delphi method as a tool for reaching consensus. A list of 679 human embryology topics was generated based on three textbooks. The Delphi panel consisted of specialists (n = 51) with at least 2 years' medical experience in activities related to the contents of embryology or health sciences professionals with at least 5 years' experience in undergraduate medical education of embryology and other cognate disciplines. The panel rated the relevance of each topic on a Likert scale. Following consensus analysis, a list of 69 "core" topics was obtained. Then, in a second Delphi round, the panel was asked to "accept," "accept with modifications," or "reject" the new list. The research team performed a final revision/screening process and generated a core human embryology syllabus comprised of 63 topics. Comparing this regional syllabus with two international core syllabuses also built Delphi panels, 60.3% of the topics overlap with both syllabuses, and 39.7% of its content is unique. This study can be a valuable tool for decision-making in the embryology curriculum for health courses and reinforces the importance of local evaluation of international curricula of human embryology before implementing them, since the incidences of congenital anomalies vary in different regions of the world.

Mexican Educators Survey on Anatomical Sciences Education and a Review of World Tendencies

Anatomical sciences curricula have been under constant reform over the years, with many countries having to reduce course hours while trying to preserve laboratory time. In Mexico, schools have historically been autonomous and unregulated, and data regarding structure and methods are still lacking. A national survey was sent by the Mexican Society of Anatomy to 110 anatomical sciences educators. The questionnaire consisted of 50 items (open and multiple choice) for gross anatomy, microscopic anatomy, neuroanatomy, and embryology courses in medical schools across Mexico. A clinical approach was the most common course approach in all disciplines. Contact course hours and laboratory hours were higher in Mexican anatomy education compared to other countries, with the highest reported contact hours for embryology (133.4 ± 44.1) and histology (125 ± 33.2). There were similar contact hours to other countries for gross anatomy (228.5 ± 60.5). Neuroanatomy course hours (43.9 ± 13.1) were less than reported by the United States and similar to Saudi Arabia and higher than the United Kingdom. Dissection and microscopy with histological slides predominate as the most common laboratory activities. Traditional methods prevail in most of the courses in Mexico and only a few educators have implemented innovative and technological tools. Implementation of new methods, approaches, and curricular changes are needed to enhance anatomical sciences education in Mexico.

Are Anatomy PhDs Nearing Extinction or Adapting to Change? United States Graduate Education Trends in the Anatomical Sciences

Faculty qualified to teach in the anatomical sciences are growing scarce just as the need for trained anatomists is greater than ever. Enrollments are surging in anticipation of a large physician shortfall; meanwhile, many anatomists are reaching retirement age. Who will fill the teaching gap? This study assessed trends in doctorates awarded in Anatomy and related fields within the United States (US) since 1969 and evaluated modern graduate education in the anatomical sciences. Data were compiled from the National Science Foundation Survey of Earned Doctorates. The total number of doctorates in the anatomical sciences and number of doctorates by sex and race/ethnicity were plotted for trend analysis. The number of PhD anatomy training programs within US medical schools was also assessed. Curricula and major characteristics of all active programs were evaluated through website searches and program director interviews. While doctorates in cell biology, developmental biology, and neuroscience have grown, the number of PhDs awarded in Anatomy has declined, on average, by 3.1 graduates per year to a 50-year low of only 8 graduates in 2017. Currently, 21 active doctoral programs in anatomy operate within US medical schools and fall into three general categories: anatomy education (n = 8), classic anatomy (n = 8), and anthropology/evolutionary anatomy (n = 5). Without a concerted effort by stakeholders to address the shortage, anatomists may face extinction. Expansion of the anatomy education doctoral degree may represent a necessary evolution of the field to meet job market needs and to thwart the extinction threat.

Development of a Novel Peer-sharing Application to Supplement Learning from Cadaveric Dissection

Gross anatomy dissection in contemporary medical education must balance the traditional value of learning from the cadaver with the possibilities created by the use of digital tools as supplemental resources that personalize and deepen the student learning experience. This study broadly examined the design, implementation, and use of AnatomyShare, a novel iPad application employing learner-generated content that allows students to securely share annotated images of their dissections with each other and take faculty-generated image-based quizzes during their first-year medical school gross anatomy course. Almost all students enrolled in the course used the application (N = 176; 91% use based on analytics). Seventy-five students responded to a survey asking how and when they used the application, along with their perceptions of its usefulness and contribution to learning. More students reported using the application outside of laboratory (97.3%) than during laboratory (85.3%), despite only in-laboratory use being required. Taking quizzes using the "Exam" feature was the highest rated use of AnatomyShare, and students cited that the application exposed them to anatomical variation and motivated them to correctly identify structures during dissection. While steps need to be taken to combat low-quality learner-generated content and to enhance meaningful student interaction and collaboration, AnatomyShare was a feasible and highly rated supplement to dissection that provided valuable assessment opportunities for students. Future research will examine the impact of use on course grades and engagement in gross anatomy dissection.

Physicians' viewpoints on faculty anatomists and dissection of human bodies in the undergraduate medical studies

BACKGROUND

Studies abound regarding the views of faculty anatomists and medical students on the importance of anatomy and the dissection of human bodies, but very little is known about the views of practicing physicians.

METHODS

A survey was distributed among physicians and surgeons practicing in Spain in order to find out their views on the practice and consequences of human dissection by undergraduate students of medicine. The most relevant definition to qualify faculty anatomists of medical schools was also requested. Responses were repeatedly clustered into characteristic subgroups for analysis.

RESULTS

In total, 536 physicians and surgeons belonging to 36 different specialties in seven Spanish hospitals responded to the survey. The results highlighted two main facts. Firstly, faculty anatomists were perceived as teachers, above any other professional identity (namely: physician, biologist or scientist); nonetheless, the ascription of identities varied between specialties (p=0.009); and it also depended on whether the respondents had dissected in their undergraduate degree (p=0.03) and on the respondent's gender (p=0.03). Secondly, physicians and surgeons confirmed that dissecting human cadavers serves the undergraduate student not only for acquiring anatomical knowledge, but also essential skills and attitudes, including professionalism.

CONCLUSIONS

The results strongly suggest that dissection practice should be reinforced and enriched in undergraduate medical school. As this is important in itself, the results of the study could also help with the development of strategies to alleviate the current shortage of adequately trained anatomists for medical degrees.

A Pilot Study of a Physical Therapy Cadaveric Anatomy Course: Assessing the Impact of Examination Format on the Learning Environment

Anatomy education continues to evolve in health professional programs as curricula shift to competency-based models and contact hours decrease. These changes in curricula may significantly alter the learning environment for students. Importantly, changes in learning environment have been shown to impact student learning strategies and well-being. It follows, then, that an investigation of students' perceptions of the learning environment is key to understand the impact of modern anatomy curriculum alterations. The current pilot study evaluated the impact of modifying examination format on the learning environment of physical therapy students participating in a human cadaveric anatomy course. Two study cohorts of first year (entry-level) physical therapy students were invited to complete a preliminary learning environment questionnaire with 13 visual analog scale items and four short answer items. One study cohort was tested with a viva (oral) practical examination, and the other, with a bell-ringer practical examination. Analysis of quantitative items revealed two significant findings: physical therapy students in the bell-ringer cohort found it was more difficult to prepare for their examination, and that they had inadequate time to respond to questions compared to the viva cohort. Analysis of qualitative items revealed distinct themes that concerned physical therapy student learning environment specific to cadaveric anatomy. These results demonstrate that examination format can influence the learning environment of physical therapy students studying cadaveric anatomy. As a result, care needs to be taken to ensure that modernized curricula align the examination format to the method of instruction and the future application of students' knowledge in clinical practice.

Assessing Anatomy Education: A Perspective from Design

Medical and healthcare practice is likely to see fundamental changes in the future that will require a different approach to the way in which we educate, train, and assess the next generation of healthcare professionals. The anatomical sciences will need to be part of that challenge so they continue to play a full role in preparing students with the knowledge and ever increasingly the skills and competencies that will contribute to the fundamentals of their future capacity to practice effectively. Although there have been significant advances in anatomical science pedagogy, by reviewing learning and assessment in an apparently unrelated field, provides an opportunity to bring a different perspective and enable appropriate challenge of the current approaches in anatomy. Design learning has had to continually reimagine itself in response to the shifting landscape in design practice and the threats associated with technology and societal change. Design learning has also long used a student-centric active pedagogy and allied authentic assessment methods and, therefore, provides an ideal case study to help inform future changes required in anatomical learning and assessment.

An Approach to Economic Evaluation in Undergraduate Anatomy Education

Medical education research is becoming increasingly concerned with the value (defined as "educational outcomes per dollar spent") of different teaching approaches. However, the financial costs of various approaches to teaching anatomy are under-researched, making evidence-based comparisons of the value of different teaching approaches impossible. Therefore, the aims of this study were to report the cost of six popular anatomy teaching methods through a specific, yet generalizable approach, and to demonstrate a process in which these results can be used in conjunction with existing effectiveness data to undertake an economic evaluation. A cost analysis was conducted to report the direct and indirect costs of six anatomy teaching methods, using an established approach to cost-reporting. The financial information was then combined with previously published information about the effectiveness of these six teaching methods in increasing anatomy knowledge, thereby demonstrating how estimations of value can be made. Dissection was reported as the most expensive teaching approach and computer aided instruction/learning (CAI/L) was the least, based on an estimation of total cost per student per year and assuming a student cohort size of just over 1,000 (the United Kingdom average). The demonstrated approach to economic evaluation suggested computer aided instruction/learning as the approach that provided the most value, in terms of education outcomes per dollar spent. The study concludes by suggesting that future medical education research should incorporate substantially greater consideration of cost, in order to draw important conclusions about value for learners.

Attitudes of Anatomy Students toward Commemorations for Body Donors: A Multicultural Perspective

Many medical schools practice commemorative ceremonies to honor body donors. Attitudes of medical education stakeholders toward these ceremonies have not yet been fully investigated. The aim of this study was to explore anatomy students' attitudes toward commemorations at a multicultural institution which has not introduced these ceremonies yet. A survey was carried out on different groups of anatomy students that were exposed and not yet exposed to human remains. The survey was used to record basic demographic data from the respondents, ask if they would support the establishment of an anatomy commemoration and in which format. A total of 756 anatomy students participated in the survey (response rate 69.8%). The majority (76.3%) were in favor of introducing a commemoration for donors. The associations of students' gender, attitude toward body donation, and level of exposure to human remains with attitudes toward commemoration for donors were identified (P < 0.05), whereas ethnicity and religion seemed to have no influence on attitudes (P > 0.05). Most students believed that anatomy staff and students should organize the commemoration. There was a preference for the commemoration to be secular with revealed identities of donors, and not recorded for social media. The support for the establishment of commemorations transcended cultural and religious differences and confirmed students' respectful attitude toward donors. Anatomy commemorations seem to have potential not only to engage students with one another, and donor families, but also to pave the way for students to become life-long ethical and empathetic learners and practitioners.

A Surgical View of Anatomy: Perspectives from Students and Instructors

As curricular emphasis on anatomy in undergraduate medical education continues to evolve, new approaches to anatomical education are urgently needed to prepare medical students for residency. A surgical anatomy class was designed for third- and fourth-year medical students to explore important anatomical relationships by performing realistic surgical procedures on anatomical donors. Under the guidance of both surgeons and anatomists, students in this month-long elective course explored key anatomical relationships through performing surgical approaches, with the secondary benefit of practicing basic surgical techniques. Procedures, such as left nephrectomy, first rib resection for thoracic outlet syndrome, and carotid endarterectomy, were adapted from those used clinically by multiple surgical subspecialties. This viewpoint commentary highlights perspectives from students and instructors that suggest the value of a surgical approach to anatomical education for medical students preparing for procedure-oriented residencies, with the goals of: (1) describing the elective at the authors' institution, (2) promoting similar efforts across different institutions, and (3) encouraging future qualitative and quantitative studies of similar pedagogic efforts.