Specialist anatomy: Is the structure of teaching adequate?

Payment with knowledge: A method for a training of anatomy near-peer teachers and formation of future anatomists

Near-peer teaching has been widely implemented in medical schools and the benefits for the near-peer teachers (NPTs), the students, and the institution have been well documented. However, NPT training methods and perceptions of such have been limited. A four-year clinical anatomy and surgical training program was established (est. 2019) as part of the continuous training timeline for NPTs (n > 60 total) formation at the Universidad Autónoma de Nuevo León, in Mexico. The program provides various training courses for the NPTs according to their hierarchy, including teaching skills, professional development, psychosocial aspects, and career objectives. A "Clinical Anatomy and Surgical Training Diploma" was planned with 12 modules to aid in developing these abilities, along with a higher understanding of clinical anatomy shared by expert clinical specialists, and diverse clinical and surgical skills such as suturing, catheterization, and basic surgical procedures. The program has a completion rate of approximately 15 NPTs/year. All, while creating an environment with a sense of belonging, and facilitating mentorship between fellow NPTs and educators. Near-peer teachers develop leadership, communication, and teaching skills. The program has provided a constant source of anatomy educators, avoiding any shortage.

The Future of Morphological Science Education: Learning and Teaching Anatomy in the Wake of the COVID-19 Pandemic

The COVID-19 Pandemic has conveyed an unprecedented worldwide challenge. Although there is much emphasis on caring for patients and communities, the high incidence of SARS-CoV-2 had seriously disturbed education and calls for prompt as well as serious consideration from educators in medical schools. The necessity to teach and prepare prospective medics, as well as clinicians, has certainly not been as intense as it is currently. The global effects of coronavirus disease 2019 may cause a permanent change in the education of future clinicians. The COVID-19 era presented logistical and practical obstacles and fears for the patients' well-being, taking into consideration the fact that students may be potential channels for the spread of the virus when asymptomatic and may get infected while being in training and attending lectures. This paper discusses the present state of morphological science education, depicting the effect of COVID-19 on learning environments, as well as highlights the probable effects of COVID-19 on medical instruction in the future.

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.

From Tutoring Gross Anatomy to Pancreatic Surgery Innovation

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

Anatomy Learning from Prosected Cadaveric Specimens Versus Plastic Models: A Comparative Study of Upper Limb Anatomy

Human cadaveric prosections are a traditional, effective, and highly appreciated modality of anatomy learning. Plastic models are an alternative teaching modality, though few studies examine their effectiveness in learning of upper limb musculoskeletal anatomy. The purpose of this study is to investigate which modality is associated with a better outcome, as assessed by students' performance on examinations. Overall, 60 undergraduate medical students without previous knowledge of anatomy participated in the study. Students were assigned into two groups. Group 1 attended lectures and studied from cadaveric prosections (n = 30) and Group 2 attended lectures and used plastic models in the laboratory (n = 30). A knowledge assessment, including examination with tag questions (spot test) and written multiple-choice questions, was held after the end of the study. Students' perceptions were also investigated via an anonymous questionnaire. No significant difference in students' performance was observed between the group using prosections and the group using plastic models (32.2 ± 14.7 vs 35.0 ± 14.8, respectively; P = 0.477). Similarly, no statistically significant difference was found regarding students' satisfaction from using each learning modality (P = 0.441). Plastic models may be a valuable supplementary modality in learning upper limb musculoskeletal anatomy, despite their limitations. Easy to use and with no need for maintaining facilities, they are highly appreciated by students and can be useful when preparing for the use of cadaveric specimens.

Rhinology: Simulation Training (Part 2)

Purpose of Review

Recently, there has been an expansion of novel technologies in simulation training. The aim of this review was to examine existing evidence about training simulators in rhinology, their incorporation into real training programmes and translation of these skills into the operating room. The first part focuses on the virtual and augmented reality simulators. The second part describes the role of physical (i.e. non-computer-based) models of endoscopic sinus surgery.

Recent Findings

We learned that an ideal sinus surgery model would score highly in all standard measures of validity whilst maintaining an attainable cost. This is a challenging goal that is worthy of pursuit given that simulation training has been shown to be cost-effective option in other domains. Non-AR or VR models are attractive ways to fill gaps in simulation training whilst reducing compared with computer-based models.

Summary

In an era of improved computer technology and improved 3D printing, it will be increasingly important to focus on both the manufacture and validation process. One area that will benefit from further technological advancement is the realistic simulation of bleeding as this would obviate the need for animal models. Future studies on ESS simulation will also need to robustly demonstrate the validity of each model with the emphasis on the ability of a model to predict performance in operative environment.

A Look at the Anatomy Educator Job Market: Anatomists Remain in Short Supply

In 2002, a widely publicized report projected an anatomy educator shortage based on department chairpersons' perceptions. Now, 17 years later, the question lingers: "Does an anatomy educator shortage persist and, if so, how severe is the shortage?" Trends in the number, type, and fill rate of anatomy educator job openings were explored by analyzing job posting in the United States over the past two years. A survey was distributed to leaders of anatomy-related departments in the United States, Canada, and European Union. Most departmental leaders who responded (65% or more) from the United States/Canada (n = 81) and the European Union (n = 52) anticipate they will have "moderate" to "great" difficulty hiring anatomy educators in gross anatomy, histology, and embryology over the next five years. Within the United States, the number of anatomy educator job postings at medical schools more than doubled from at least 21 postings in 2017 to 52 postings in 2018. Twenty-one percent of postings between 2017 and 2018 were never filled. While the number of anatomy educator openings within the United States/Canada is perceived to remain in a steady state for the next five years, the European Union estimates a five-fold increase in the number of openings. Departmental leaders prioritize anatomy educator applicants who have teaching experience (mean ± SD = 4.64 ± 0.84 on five-point Likert scale), versatility in teaching multiple anatomy disciplines (3.93 ± 1.07), and flexibility in implementing various teaching pedagogies (3.69 ± 1.17). Collectively, these data suggest the shortage of anatomy educators continues in the United States/Canada and the European Union.

Musculoskeletal Radiology Teaching at a UK Medical School: Do We Need to Improve?

The United Kingdom is currently facing crisis due to a shortage of radiology consultants despite ever-increasing demand for medical imaging. The specifics of how best to teach radiology has generated increasing interest. This study aims to determine whether musculoskeletal (MSK) radiology teaching at the University of Nottingham (UoN) Medical School is perceived to be satisfactory by medical students, Foundation-Year doctors, and senior medical professionals in preparing students for the demands working as Foundation-Year doctors. Questionnaires were distributed to all medical students and Foundation-Year doctors that graduated from UoN (n = 307). Semi-structured interviews were conducted with consultants and teaching staff (n = 13). Forty-nine percent of preclinical medical students, 43% of clinical students and 27% of Foundation-Year doctors thought MSK radiology teaching was not sufficient in preparing them for the radiology challenges Foundation-Year doctors' face. This difference was statistically significant (P < 0.001). The consensus from senior medical professionals was that MSK Radiology teaching is currently adequate and producing competent students. Interestingly, only 5% of students were considering a career in radiology compared to 34% of Foundation-Year doctors. Overall, there seems to be concern among students regarding MSK radiology teaching and students have a lack of confidence with MSK radiology. Foundation-Year doctors and senior medical professionals do not share this view. This may be due to medical students' lack of clarity on what is required of them. Formal documentation of set learning objectives for MSK radiology throughout the curriculum may address this.

Students' Perception and Attitude on Methods of Anatomy Teaching in a Medical College of West Bengal, India

Introduction

Incorporating newer teaching aids over traditional one in Anatomy has been challenging both for the teachers and the learners. Different educational strategies are being used for teaching of Anatomy.

Aim

To elicit the perception and attitude toward teaching approaches in the Anatomy curriculum among first year medical students.

Materials and Methods

A cross-sectional, descriptive study was undertaken with the help of predesigned, pre-tested questionnaire to elicit knowledge in four domains of classroom teaching which were: a) gross anatomical structure; b) organ identification; c) topography; and d) radiological anatomy and self-assessment of acquired skills in respective fields among 114 first year students.

Results

A total of 57% of students opined good in gross structure of anatomy. A 60.5% of students preferred chalk and board method and 33.3% with LCD projector. Regarding acquiring knowledge, 72.8% of medical students gathered knowledge in gross anatomical structure domain whereas 58.8% in radiological anatomy. The overall mean score of attitude of the students regarding incorporating newer techniques in Anatomy teaching is 14.17±2.26.

Conclusion

The perception of Anatomy teaching and attitude among medicos have been studied and opinion from them had thrown light for incorporation of newer techniques in their teaching curriculum.

The role of anatomy demonstrators: A surgical trainees' perspective

Core Surgical Trainees (CST) in the London (UK) Postgraduate School of Surgery receive clinical anatomy teaching in their first year of training, and, in their second year, give 30 sessions of anatomy teaching to medical and other students. This study set out to investigate the role of demonstrators from the perspective of the trainees. A focus group was convened to ascertain trainees' perspectives on demonstrating anatomy and to identify problems and improvement strategies to optimize their ability to enhance students' learning. A questionnaire was formulated and all second-year CST (n = 186-from two cohorts) in the London Postgraduate School of Surgery were invited. A total of 109 out of 186 trainees completed the questionnaire. A high percentage (98%) of trainees that completed the questionnaire responded that demonstrating was an invaluable part of their training. Sixty-two per cent responded that anatomy teaching they received in their first year of core surgical training helped them in their teaching role and 80% responded that it helped them prepare for surgical training. The study also revealed the need for improved communication between trainees and the London Postgraduate School of Surgery/Medical Schools/National Health Service Trusts to address issues such as trainees' perceived difficulty in fulfilling their teaching session requirement. The stakeholders have acknowledged and addressed the outcomes to improve the experience for both surgical trainees and students. The results indicate that anatomy demonstrating delivers important benefits to early surgical trainees, in addition to those received by the students that they teach. Clin. Anat. 31:409-416, 2018. © 2017 Wiley Periodicals, Inc.

Cadaveric dissection as an educational tool for anatomical sciences in the 21st century

Anatomical education has been undergoing reforms in line with the demands of medical profession. The aim of the present study is to assess the impact of a traditional method like cadaveric dissection in teaching/learning anatomy at present times when medical schools are inclining towards student-centered, integrated, clinical application models. The article undertakes a review of literature and analyzes the observations made therein reflecting on the relevance of cadaveric dissection in anatomical education of 21st century. Despite the advent of modern technology and evolved teaching methods, dissection continues to remain a cornerstone of anatomy curriculum. Medical professionals of all levels believe that dissection enables learning anatomy with relevant clinical correlates. Moreover dissection helps to build discipline independent skills which are essential requirements of modern health care setup. It has been supplemented by other teaching/learning methods due to limited availability of cadavers in some countries. However, in the developing world due to good access to cadavers, dissection based teaching is central to anatomy education till date. Its utility is also reflected in the perception of students who are of the opinion that dissection provides them with a foundation critical to development of clinical skills. Researchers have even suggested that time has come to reinstate dissection as the core method of teaching gross anatomy to ensure safe medical practice. Nevertheless, as dissection alone cannot provide uniform learning experience hence needs to be complemented with other innovative learning methods in the future education model of anatomy. Anat Sci Educ 10: 286-299. © 2016 American Association of Anatomists.

Venezuelan surgeons view concerning teaching human anatomical dissection

Currently, the importance of human anatomical dissection have come under debate in many countries but there are not references in Venezuela on this concern. This survey's aim is to assess the insights of Venezuelan surgeons and their outlines of usage of human anatomical dissection in teaching and learning human anatomy. Sixty-five Venezuelan surgeons at the Centro Médico Docente La Trinidad completed an anonymous survey on current and future teaching practices in human anatomy. Eighty-nine point two three percent of surveyed (n=58) conferred importance to human anatomical dissection despite the arrival of new innovations in learning human anatomy. The group surveyed view human anatomical dissection-based teaching as the most beneficial method of teaching human anatomy and it should be bolstered in human anatomical education with matching use of three-dimensional computerized tomography imaging as a complementary form for teaching and learning.

What anatomy is clinically useful and when should we be teaching it?

Anatomy teaching, once thought of as being the cornerstone of medical education, has undergone much change in the recent years. There is now growing concern for falling standards in medical graduates' anatomical knowledge, coupled with a reduction in teaching time and appropriately qualified teaching staff. With limited contact hours available to teach this important discipline, it is essential to consider what anatomy is taught within the medical curriculum to ensure it is fit for clinical practice. The views of medical students, junior doctors, and consultants were obtained from the University of Nottingham and the Trent Deanery in Nottingham, United Kingdom, to establish what core anatomical knowledge they feel medical students should study and assimilate during preclinical training. All participants felt strongly that medical students should be adept at interpreting modern diagnostic images before entering their clinical placement or specialty. Respondents proposed more teaching emphasis should be placed on specific anatomical areas (including lymphatic drainage and dermatome innervation) and illustrated other areas where less detailed teaching was appropriate. Recommendations from our study highlight a need for greater clinical emphasis in anatomy teaching during preclinical years. To successfully achieve this, it is essential that clinicians become integrally involved in the design and delivery of future medical undergraduate anatomy courses. Anat Sci Educ 9: 468-475. © 2016 American Association of Anatomists.

Interactive anatomical teaching: Integrating radiological anatomy within topographic anatomy

INTRODUCTION

Hours attributed to teaching anatomy have been reduced in medical curricula through out the world. In consequence, changes in anatomical curriculum as well as in teaching methods are becoming necessary. New methods of teaching are being evaluated. We present in the following paper an example of interactive anatomical teaching associating topographic anatomy with ultrasonographic radiological anatomy. The aim was to explicitly show anatomical structures of the knee and the ankle through dissection and ultrasonography.

METHODS

One cadaver was used as an ultrasonographic model and the other was dissected. Anatomy of the knee and ankle articulations was studied through dissection and ultrasonography.

RESULTS

The students were able to simultaneously assimilate both anatomical aspects of radiological and topographic anatomy. They found the teaching very helpful and practical.

CONCLUSION

This body of work provides example of a teaching method combining two important aspects of anatomy to help the students understand both aspects simultaneously.

Posterior approach to kidney dissection: An old surgical approach for integrated medical curricula

Integrated medical curricular changes are altering the historical regional anatomy approach to abdominal dissection. The renal system is linked physiologically and biochemically to the cardiovascular and respiratory systems; yet, anatomists often approach the urinary system as part of the abdomen and pelvic regions. As part of an integrated curriculum, the renal system must be covered relatively quickly after the thorax in the cadaver laboratory, often without the opportunity to fully appreciate the rest of the abdominal contents. This article provides dissection instructions that follow one of the historical surgical approaches for nephrectomy, including preservation of the posterior abdominal wall neurovasclature. Dissection procedures were developed for first-year medical students, intending this posterior approach to the kidneys to be their first introduction to the renal system. It has been successfully implemented with the first-year medical students at the University of New England, College of Osteopathic Medicine. Utilizing this posterior approach to the kidney enabled the study of the anatomy of the kidneys, suprarenal glands, and renal vessels, as well as the muscles of the lumbar spine, while maintaining the integrity of the anterior abdominal wall and peritoneal cavity for future gastrointestinal and reproductive system-based dissections.

Medical student perceptions of radiology use in anatomy teaching

The use of radiology in the teaching of anatomy to medical students is gaining in popularity; however, there is wide variation in how and when radiology is introduced into the curriculum. The authors sought to investigate students' perceptions regarding methods used to depict and teach anatomy and effects of integrated radiology instruction on students' abilities to correctly identify imaging modalities and anatomical structures on radiological images. First-year medical students completed questionnaires at the beginning and end of the first academic year that incorporated ten hours of radiologic anatomy teaching in the anatomy curriculum. Questions used a combination of Likert scales, rankings, and binary options. Students were tested on their ability to identify radiology modalities and anatomical structures on radiology images. Preresponse and postresponse rates were 93% (157/168) and 85% (136/160), respectively. Postmodule, 96.3% of students wanted the same or more radiology integration. Furthermore, 92.4% premodule and 96.2% postmodule agreed that "Radiology is important in medical undergraduate teaching." Modality and structure identification scores significantly increased from 59.8% to 64.3% (P < 0.001) and from 47.4% to 71.2% (P < 0.001), respectively. The top three preferred teaching formats premodule and postmodule were (1) anatomy laboratory instruction, (2) interactive sessions combining radiology with anatomy, and (3) anatomy lectures. Postmodule, 38.3% of students were comfortable reviewing radiology images. Students were positive about integrating radiology into anatomy teaching and most students wanted at least the same level of assimilation but that it is used as an adjunct rather than primary method of teaching anatomy.

Evaluating dissection in the gross anatomy course: Correlation between quality of laboratory dissection and students outcomes

Anatomy learned by active exploration through dissection has many proven benefits including improvement of anatomic knowledge. Decreased laboratory time may affect the quality of dissection and ultimately lower student performance in anatomy translating to lower knowledge acquisition. The aim of this study was to determine whether the quality of students' dissection in teams correlates with their performance in the gross anatomy course. Quality of dissections for each team enrolled in a gross anatomy course at Mayo Medical School was evaluated biweekly using a five-point rubric based on course learning objectives. Assessment of anatomic knowledge was based on sequential laboratory practice practical examination scores, achievements on daily audience response system (ARS) quizzes, and final practical, written, and National Board of Medical Examiners(®) (NBME(®) ) Gross Anatomy and Embryology Subject Examinations. Twelve teams comprising 48 students were included in the study. There was a positive correlation between dissection quality and practice practical examination score (R = 0.83) and a negative correlation between dissection quality and ARS quizzes (R = -0.985). Dissection teams with a passing score on their dissection evaluations (>70%) performed better on their final examinations. Based on an end of course survey, students agreed that dissection evaluations should continue to be a part of the course. This study showed that better quality of dissection was associated with higher scores on practice practical examinations, final practical, written, and NBME examinations. The study demonstrated a positive correlation between dissection evaluations, accompanied by formative feedback during the course, and higher scores on final course assessments.

Interactive radiological anatomy eLearning solution for first year medical students: Development, integration, and impact on learning

A technology enhanced learning and teaching (TELT) solution, radiological anatomy (RA) eLearning, composed of a range of identification-based and guided learning activities related to normal and pathological X-ray images, was devised for the Year 1 nervous and locomotor course at the Faculty of Medicine, University of Southampton. Its effectiveness was evaluated using a questionnaire, pre- and post-tests, focus groups, summative assessment, and tracking data. Since introduced in 2009, a total of 781 students have used RA eLearning, and among them 167 Year 1 students in 2011, of whom 116 participated in the evaluation study. Students enjoyed learning (77%) with RA eLearning, found it was easy to use (81%) and actively engaged them in their learning (75%), all of which were associated to the usability, learning design of the TELT solution and its integration in the curriculum; 80% of students reported RA eLearning helped their revision of anatomy and 69% stated that it facilitated their application of anatomy in a clinical context, both of which were associated with the benefits offered by the learning and activities design. At the end of course summative assessment, student knowledge of RA eLearning relevant topics (mean 80%; SD ±16) was significantly better as compared to topics not relevant to RA eLearning (mean 63%; SD ±15) (mean difference 18%; 95% CI 15% to 20%; P < 0.001). A well designed and integrated TELT solution can be an efficient method for facilitating the application, integration, and contextualization of anatomy and radiology to create a blended learning environment.

Medical student knowledge regarding radiology before and after a radiological anatomy module: implications for vertical integration and self-directed learning

Objectives

To examine the impact that anatomy-focused radiology teaching has on non-examined knowledge regarding radiation safety and radiology as a specialty.

Methods

First-year undergraduate medical students completed surveys prior to and after undertaking the first-year anatomy programme that incorporates radiological anatomy. Students were asked opinions on preferred learning methodology and tested on understanding of radiology as a specialty and radiation safety.

Results

Pre-module and post-module response rates were 93 % (157/168) and 85 % (136/160), respectively. Pre-module and post-module, self-directed learning (SDL) ranked eighth (of 11) for preferred gross-anatomy teaching formats. Correct responses regarding radiologist/radiographer roles varied from 28-94 % on 16 questions with 4/16 significantly improving post-module. Identification of modalities that utilise radiation significantly improved for five of eight modalities post-module but knowledge regarding relative amount of modality-specific radiation use was variable pre-module and post-module.

Conclusions

SDL is not favoured as an anatomy teaching method. Exposure of students to a radiological anatomy module delivered by senior clinical radiologists improved basic knowledge regarding ionising radiation use, but there was no improvement in knowledge regarding radiation exposure relative per modality. A possible explanation is that students recall knowledge imparted in didactic lectures but do little reading around the subject when the content is not examined.

Teaching Points

• Self-directed learning is not favoured as a gross anatomy teaching format amongst medical students.

• An imaging anatomy-focused module improved basic knowledge regarding ionising radiation use.

• Detailed knowledge of modality-specific radiation exposure remained suboptimal post-module.

• Knowledge of roles within a clinical radiology department showed little change post-module.

An approach toward the development of core syllabuses for the anatomical sciences

There is increasingly a call for clinical relevance in the teaching of the biomedical sciences within all health care programs. This presupposes that there is an understanding of what is "core" material within the curriculum. To date, the anatomical sciences have been poorly served by the development of core syllabuses, although there have been commendable attempts to define a core syllabus for gross anatomy in medicine and for some medical specialties. The International Federation of Associations of Anatomists and the European Federation for Experimental Morphology aim to formulate, on an international basis, core syllabuses for all branches of the anatomical sciences. This is being undertaken at the initial stage using Delphi Panels consisting of a team of anatomists, scientists, and clinicians who evaluate syllabus content and accord each element/topic "essential," "important," "acceptable," or "not required" status. Their initial conjectures, published on the International Federation of Associations of Anatomists' website, provide merely a framework to enable anatomical (and other cognate learned) societies and individual anatomists, clinicians, and students to comment upon the syllabuses. This article presents the concepts and methodological approaches underlying the hybrid Delphi process employed. Preliminary findings relating to the development of a neuroanatomy core syllabus are provided to illustrate the methods initially employed by a Delphi Panel. The approach is novel in that it is international in scope, is conceptually democratic, and is developmentally fluid in terms of availability for amendment. The aim is to set internationally recognized standards and thus to provide guidelines concerning anatomical knowledge when engaged in course development.

Anatomy in occupational therapy program curriculum: practitioners' perspectives

Anatomy education is undergoing significant transformation. It is unknown whether changes are in accordance with occupational therapy (OT) practice needs. The purpose of this pilot study was to survey OT clinicians to determine their perspectives on the value of anatomy in OT curricula, and anatomical knowledge required for practice. In addition to demographics, the survey asked questions on the value of a standalone anatomy course, integration of anatomical content in other coursework, practice areas requiring anatomy knowledge, course content, teaching media recommendations, and their opinions regarding whether graduates have adequate anatomy knowledge for competent practice. Surveys were distributed to OT practitioners in the state of Arizona (n = 107). Response rate was 51% on electronic surveys, 29% on mailed surveys. All respondents recommended an anatomy course in OT curricula; 97% as a standalone course with integration of course content throughout the curriculum. The most recommended teaching method was cadaver dissection. Content areas identified as important to cover included skeletal, muscular, and nervous systems. Regions recommended were the upper limb, thorax/trunk, head and neck, and lower limb. Practice areas requiring anatomy knowledge included joint range of motion and strengthening treatment interventions, goniometry, muscle strength testing, assessing muscle tone, wheelchair assessment/prescription, orthotics, physical agent modalities, and activity adaptation. Eighty-one percent felt that entry-level practitioners had adequate knowledge for competent practice. This study supports inclusion of a separate anatomy course in OT curricula, continued use of cadavers, and the importance of including input from practicing clinicians when determining anatomy course content.

Doing dissections differently: a structured, peer-assisted learning approach to maximizing learning in dissections

Areas of difficulty faced by our veterinary medicine students, with respect to their learning in dissection classes, were identified. These challenges were both general adult-learning related and specific to the discipline of anatomy. Our aim was to design, implement, and evaluate a modified reciprocal peer-assisted/team-based learning format--Doing Dissections Differently (DDD)--to complement existing dissection classes, with the intention of enhancing both student learning and the student learning experience. Second year veterinary medicine students (n = 193), in their usual dissection groups, were randomly assigned to one of four roles: anatomist, clinician, radiologist, and learning resources manager. Students attended a preparatory workshop outlining the skills required for effective execution of their role. They were then asked to perform their roles throughout five consecutive musculoskeletal dissection classes. Student attitudes to dissection classes before and after DDD were evaluated by questionnaire (146 respondents). There was a significant (P = 0.0001) improvement after DDD in a number of areas: increased perceived value of dissection classes as an anatomy learning aid; improved appreciation of the clinical relevance of anatomy; increased use of resources before and during dissection classes; and longer preparation time for dissection classes. Before DDD, 45% of students felt that at least one peer did not contribute usefully to the group during dissection classes; no improvement was seen in this measure after DDD. Although the new format highlighted a potential need to improve teamwork, most students actively engaged with DDD, with dissection classes valued more highly and utilized more effectively.

Changes in anatomy instruction and USMLE performance: empirical evidence on the absence of a relationship

Anatomy instruction has evolved over the past two decades as many medical schools have undergone various types of curricular reform. To provide empirical evidence about whether or not curricular changes impact the acquisition and retention of anatomy knowledge, this study investigated the effect of variation in gross anatomy course hours, curricular approach (stand-alone versus integrated), and laboratory experience (dissection versus dissection and prosection) on USMLE Steps 1 and 2 Clinical Knowledge (CK) scores. Gross anatomy course directors at 54 United States schools provided information about their gross anatomy courses via an online survey (response rate of 42%). Survey responses were matched with USMLE scores for 6,411 examinees entering LCME-accredited schools in 2007 and taking Step 1 for the first time in 2009. Regression analyses were conducted to examine relationships between gross anatomy instructional characteristics and USMLE performance. Step 1 total scores, Step 1 gross anatomy sub-scores, and Step 2 CK scores were unrelated to instructional hours, controlling for MCAT scores. Examinees from schools with integrated curricula scored slightly lower on Steps 1 and 2 CK than those from stand-alone courses (effect sizes of 2.1 and 1.9 on score scales with SDs of 22 and 20, respectively). Examinees with dissection and prosection experience performed slightly better on Step 2 CK than examinees in courses with dissection only laboratories (effect size of 1.2). Results suggest variation in course hours is unrelated to performance on Steps 1 and 2 CK. Although differences were observed in relation to curricular approach and laboratory experience, effect sizes were small.

Modernization of an anatomy class: From conceptualization to implementation. A case for integrated multimodal-multidisciplinary teaching

It has become increasingly apparent that no single method for teaching anatomy is able to provide supremacy over another. In an effort to consolidate and enhance learning, a modernized anatomy curriculum was devised by attempting to take advantage of and maximize the benefits from different teaching methods. Both the more traditional approaches to anatomy teaching, as well as modern, innovative educational programs were embraced in a multimodal system implemented over a decade. In this effort, traditional teaching with lectures and dissection was supplemented with models, imaging, computer-assisted learning, problem-based learning through clinical cases, surface anatomy, clinical correlation lectures, peer teaching and team-based learning. Here, we review current thinking in medical education and present our transition from a passive, didactic, highly detailed anatomy course of the past, to a more interactive, as well as functionally and clinically relevant anatomy curriculum over the course of a decade.

Design and validation of a novel learning tool, the "Anato-Rug," for teaching equine topographical anatomy

Recognition of anatomical landmarks in live animals (and humans) is key for clinical practice, but students often find it difficult to translate knowledge from dissection-based anatomy onto the live animal and struggle to acquire this vital skill. The purpose of this study was to create and evaluate the use of an equine anatomy rug ("Anato-Rug") depicting topographical anatomy and key areas of lung, heart, and gastrointestinal auscultation, which could be used together with a live horse to aid learning of "live animal" anatomy. Over the course of 2 weeks, 38 third year veterinary students were randomly allocated into an experimental group, revising topographical anatomy from the "Anato-Rug," or a control group, learning topographical anatomy from a textbook. Immediately post activity, both groups underwent a test on live anatomy knowledge and were retested 1 week later. Both groups then completed a questionnaire to ascertain their perceptions of their learning experiences. Results showed that the experimental groups scored significantly higher than the control group at the first testing session, experienced more enjoyment during the activity and gained more confidence in identifying anatomical landmarks than the control group. There was not a significant difference in scores between groups at the second testing session. The findings indicate that the anatomy rug is an effective learning tool that aids understanding, confidence, and enjoyment in learning equine thorax and abdominal anatomy; however it was not better than traditional methods with regards to longer term memory recall.

Review of nomenclature in colonic surgery--proposal of a standardised nomenclature based on mesocolic anatomy

The standardisation of the surgical management of rectal cancer has been facilitated by adoption of an anatomic surgical nomenclature. Thus, "total mesorectal excision" substituted "anterior resection" or "proctosigmoidectomy" and implies resection of both rectum and mesorectum. Similar trends towards standardisation of colonic surgery are ongoing, yet there remains a heterogeneity of terminology utilised (eg, "right hemicolectomy", "ileocolic resection", and "total mesocolic excision"). Recent descriptions of mesocolic anatomy provide an opportunity to standardise colonic resection according to a more precise and informative anatomic nomenclature. This article aims to firstly emphasise the central importance of the mesocolon and from this propose a related nomenclature for resectional colonic surgery. Introduction of a standardised nomenclature for colonic resection is a necessary step towards standardisation of colonic surgery in general.