Uncovering Hidden Curricula: Use of Dark Humor in Anatomy Labs and its Implications for Basic Sciences Education

Anatomy outreach: A conceptual model of shared purposes and processes

Anatomy outreach is a well-documented practice by many academic institutions, defined here as when anatomy-related services are provided to external communities. However, most of the current literature on this topic is largely descriptive, focusing on the 'what' of anatomy-related outreach, rather than the generalizable 'why' or 'how'. There exists no shared conceptual model of what anatomy outreach tries to achieve from the perspective of 'outreachers', and how anatomists support these goals. Thus, this study aimed to explore the comprehension of anatomy outreach as a social phenomenon in the anatomy education community. This qualitative research used constructivist grounded theory to explore the perspectives of anatomists with experience facilitating anatomy outreach. A total of 18 participants completed semi-structured interviews. Analysis resulted in the construction of nine broad categories of themes relating to anatomy outreach: types of outreach, specific activities, goals of outreach, subject benefit (why anatomy?), enablers, challenges, appraisal, motivators/drivers, and community perspectives from the immediate anatomy community and wider field (Science, Technology, Engineering, and Mathematics (STEM) and health professions education (HPE)). These results were constructed into a conceptual model of anatomy outreach. The findings suggest that anatomists view the subject matter as a socially connecting experience that can engage a wide variety of individuals. The multimodal nature of anatomy, combined with teaching expertise, lends well to productive outreach. Most 'outreachers' do not have a strong understanding of the impact of their activities, however, and operate on a level of optimism that activities will support diversity, belonging, and health/anatomical literacy.

Impact of group work on the hidden curriculum that induces students' unprofessional behavior toward faculty

BACKGROUND

Hidden curriculum (HC) can limit the effects of professionalism education. However, the research on how HC triggers unprofessional behavior among medical students is scant. Furthermore, there is no established approach for how faculty members may create a context, such as an educational environment and education system, that prevents students' unprofessional behavior. This study aimed to develop an educational approach to prevent unprofessional behavior and clarify how faculty members consider HC that triggers students' unprofessional behavior.

METHODS

The study sample comprised 44 faculty members and eight medical students from the Chiba University School of Medicine. The participants were divided into groups and asked the following question: "What attitudes, statements, and behaviors of senior students, physicians, and faculty members trigger medical students' unprofessional behavior?" The responses were collected using the affinity diagram method. The group members discussed the causes and countermeasures for the selected attitudes, statements, and behaviors of senior students, physicians, and faculty members based on the affinity diagram. The impact of the group work on the faculty members was surveyed using questionnaires immediately after its completion and six months later. Furthermore, the cards in the group work were analyzed using content analysis.

RESULTS

The responses to the questionnaire on group work indicated that some faculty members (43.8%) improved HC, while others suggested conducting group work with more participants. The content analysis revealed six categories - inappropriate attitude/behavior, behavior encouraging unprofessional behavior, lack of compliance with regulations, harassment of other medical staff, inappropriate educational environment/supervisor, and inappropriate self-control - and 46 subcategories.

CONCLUSIONS

The HC that triggers students' unprofessional behavior includes the words and actions of the educator, organizational culture, and educational environment. Group work makes faculty members aware of the HC that triggers unprofessional behavior, and induces behavioral change for HC improvement in the educational activities. Educators should refrain from using words and actions that encourage unprofessional behavior, such as personal anecdotes, as they reduce students' learning motivation.

The Effects of Humor in Clinical Settings on Medical Trainees and the Implications for Medical Educators: A Scoping Review

Background

Clinical settings represent the site of patient care and clinical training for medical students and residents. Both processes involve social interaction, and humor is a fundamental component of social interaction that remains underexplored in medical education. This study investigated the impact of humor on medical trainees in the context of the clinical learning environment and examined the implications for medical educators.

Methods

Following scoping review methodology, the authors systematically searched six databases and Google Scholar in February 2021 and March 2022. Articles were screened and selected according to inclusion/exclusion criteria, and findings from included articles were synthesized using procedures of metasynthesis.

Results

Fifteen articles met inclusion criteria. Six themes emerged relating to the functions and effects of humor in clinical training settings: (1) managing emotions; (2) demarcating insider vs outsider status; (3) facilitating camaraderie; (4) ensuring conformity; (5) negotiating power differentials; and (6) fostering discrimination.

Conclusions

The use of humor by medical educators plays an integral role in trainees' everyday experiences. Positive humor helps with coping and communication, while negative humor serves as an indirect medium for communicating ridicule and prejudice. Further research drawing on social psychology theories may identify ways to reduce effects of negative humor and promote well-being and diversity in medical education.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01769-0.

The Anatomy Course During COVID-19: The Impact of Cadaver-Based Learning on the Initiation of Reflection on Death

BACKGROUND

During the COVID-19 pandemic, in-person cadaveric dissection laboratories for teaching anatomy were omitted by many schools around the world. While knowledge domains can be easily evaluated via remote exams, non-traditional discipline-independent skills such as those encouraged through reflection on the topic of death are often overlooked. This study investigated how different anatomy course formats played a role in initiating students' reflections on death during the COVID-19 pandemic.

METHOD

In fall 2020, 217 medical, dental, premedical, and health sciences students from 13 international universities discussed differences in their anatomy courses online. Formats of anatomy courses ranged from dissection-based, prosection-based, hybrid (combination of dissection and prosection) to no laboratory exposure at all. Students' responses to the question, "Did/does your anatomy course initiate your thinking about life's passing?" were collected, and they self-reported themes that were present in their reflections on death using a multiple-choice prompt. Statistical analyses to detect differences between students with and without exposure to cadavers were performed using the chi-squared test.

RESULTS

When comparing students who had exposure to human anatomical specimens to those who had no exposure, the majority of students with exposure thought that the course did initiate thoughts about life's passing, compared to students without exposure (P < 0.05). Reflection themes were consistent across groups.

DISCUSSION

These findings indicate that anatomy dissection courses are important for the initiation of students' feelings about the topic of death. Omission of cadaveric dissection- or prosection-based laboratories will decrease the likelihood that students initiate reflection on this topic and gain important transferable skills.

Trauma-Informed Care in the Classroom: Our Experience with a Content Warning in a Medical School Course

Trauma is now recognized as a common human experience that has consequences, including adverse effects on learning outcomes. Principles of trauma-informed care include awareness of the impact of trauma and use of strategies to prevent retraumatization. While well-described in medical and mental health care, these principles have been inconsistently applied in the medical education classroom. Content warnings can be part of a trauma-informed classroom approach that notifies learners about potentially distressing topics, allows individuals to employ self-care, and seeks to resist retraumatization. This article describes our experience integrating a content warning about reproductive topics in a second-year medical school course.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01559-0.

Anatomy: An Opportunity for South African Health Science Students to Discuss Their Emotional Responses to Human Remains in the Laboratory

Human dissection remains a cornerstone of the anatomy learning experience. However, the emotional response of students to the use of human remains for learning is influenced by a number of factors and is not always positive. Therefore, this study explored the students’ emotional response to and factors affecting their perceptions of the use of human remains for learning anatomy in a South African context. Four hundred and eighty of the 1538 health sciences students enrolled in human anatomy courses at the University of the Witwatersrand, South Africa during 2016 and 2017, completed a voluntary survey. The survey included closed and open-ended questions on students’ emotional responses, coping mechanisms and the factors that affected their perceptions of the use of human remains and dissection. Overall, the students had a positive emotional response. Their perceptions of dissection were affected in positive and negative ways by their religious and cultural beliefs. Feelings of gratitude and respect toward the cadaver were informed by belief systems. However, anxiety was caused by the delay of accepted sociocultural burial practices. Peer discussions were the preferred coping method, which may provide an approach for students to discuss how their beliefs influence their dissection experience.

Colonization, cadavers, and color: Considering decolonization of anatomy curricula

Anatomy is a discipline that, despite its universal nature, offers limited diversity in terms of representation in cadavers, imagery, technology, and models used within teaching. The universal move toward inclusive curricula has put anatomy education under the microscope, particularly with respect to efforts to decolonize curricula. This paper considers the challenges and opportunities to diversify the anatomy curriculum. Decolonizing anatomy education curricula will entail addressing the ingrained cultures within the disciplines, such that produces a number of challenges including: underrepresentation of certain bodies, difficulty talking about difference, and the hidden curriculum in anatomy education. In order to aid educators in achieving inclusive anatomy curricula, a toolkit and considerations are presented, alongside both do's, don'ts and case examples. We highlight the black-or-white dichotomy, and the absence of brown in between. The paper is a conversation starter for what it means to begin the process of decolonizing the curriculum within anatomy education.