Teaching anatomy using an active and engaging learning strategy

Early practice makes histology masters: The use of a formative assessment quiz to prepare histology learners for a high-stakes final examination

Assessment of learners in the anatomical sciences is a complex task as it not only tests students' fact knowledge, but also the analysis of visual information. Sometimes, novice histology learners must acquire image recognition skills of microscopic structures in a short time frame. This paper describes a strategy of offering first year dental students at the University of Michigan a short, non-grade contributing, formative assessment quiz in order to better prepare them for a high-stakes, final summative histology examination. Data collected over 7 years indicate that students, who made use of this formative assessment opportunity, performed significantly better in their summative examination than students, who did not. Especially early practice quiz users profited most. Students, who used the practice quiz until they achieved a perfect score, also had statistically higher final examination scores. Students, who did not use the practice quiz, had a significantly lower cumulative D1-year Grade Point Average (D1-GPA) than students, who did, indicating that academically weaker students often underuse supporting learning resources. In general, scores from the Dental Admission Test (DAT) were weak predictors of learning success in the DENT 510 histology course. In contrast, the D1-GPA values had a medium strength positive correlation with final histology examination scores. The major problem that was encountered with this practice quiz strategy was that many students waited until close to the day of the final examination before taking advantage of this feedback opportunity, thereby reducing its potential benefit for improving their overall learning strategy for histology.

Teaching pre-clinical medical students remotely in Nigeria post Covid-19 pandemic: can past experiences shape future directions?

PURPOSE

Online teaching has gained popularity in recent years, but changes have been slower to implement in Lower or Medium Income Countries (LMIC). The aim of this research was to build upon educators' experiences of remote teaching during Covid-19 to inform the development of a blended learning approach for teaching pre-clinical subjects at the Faculty of Biomedical Sciences at Obafemi Awolowo University, Ile-Ife, Nigeria (OAU).

METHODS

The Critical Incident Technique (CIT) was used in this exploratory study. Participants were invited to either complete an online qualitative questionnaire or take part in an online structured interview, which were hosted on Microsoft platforms. Data were obtained from eighteen educators and were analyzed using thematic analysis.

RESULTS

Findings suggest that most educators (72%) continued to engage with remote teaching post-pandemic. All lab-based practical topics returned to being in-person, and teachers' experiences highlighted that a new blended learning approach should focus on asynchronized online teaching of didactic subjects. Five main themes captured educators' experiences and lessons learned regarding online teaching including: skills and training, teachers' motivation and attitudes, internet and connectivity, learners' behaviors, and socio-economic constraints.

CONCLUSION

Findings provided additional evidence on the way in which educators in LMIC would like to build upon the positive aspects of online teaching and move towards a blended learning model. However, the implementation of such an approach should consider students' and faculty's needs and socio-economic constraints.

The protective role of sense of coherence in resident physicians facing secondary trauma due to patient death in intensive care-A qualitative inquiry

The salutogenic paradigm is increasingly used in research and practice but remains to be investigated in secondary trauma of health professionals. This qualitative study explored the main anchor of salutogenics, the sense-of-coherence, as a coping mechanism among resident physicians facing secondary trauma due to continuous exposure to patient suffering and deaths. Participants were sixteen resident physicians from intensive care units at emergency departments of two Israeli public tertiary hospitals. Data analysis employed reflexive thematic analysis. Findings suggest that while all residents described having comprehensibility, manageability and meaningfulness differed among residents. Some residents thrived, coped well with secondary trauma, centered on patient emotional needs, and drew meaningfulness from the challenges. Other residents suffered while providing care, reported poor well-being, were too overwhelmed to center patients, and doubted their career choices. Salutogenic-based interventions to cultivate the resilience of resident physicians experiencing secondary trauma are proposed.

Responding to the healthcare workforce shortage: A scoping review exploring anatomical pathologists' professional identities over time

Anatomical pathology (AP) is an anatomy-centric medical specialty devoted to tissue-based diagnosis of disease. The field faces a current and predicted workforce shortage, likely increasing diagnostic wait times and delaying patient access to urgent treatment. A lack of AP exposure is proposed to preclude recruitment to the field, as medical students are afforded only a limited understanding of who a pathologist is and what they do (their professional identity/PI and role). Anatomical sciences educators may be well placed to increase student understanding of anatomical pathologists' PI features, but until features of anatomical pathologists' PI are understood, recommendations for anatomy educators are premature. Thus, this scoping review asked: "What are the professional identity features of anatomical pathologists reported in the literature, and how have these changed over time?" A six-stage scoping review was performed. Medline and PubMed, Global Health, and Embase were used to identify relevant studies (n = 74). Team-based framework analysis identified that features of anatomical pathologists' professional identity encompass five overarching themes: professional practice, views about the role, training and education, personal implications, and technology. Technology was identified as an important theme of anatomical pathologists' PI, as it intersected with many other PI feature themes, including diagnosis and collaboration. This review found that pathologists may sometimes perceive professional competition with technology, such as artificial intelligence. These findings suggest unique opportunities for integrating AP-specific PI features into anatomy teaching, which may foster student interest in AP, and potentially increase recruitment into the field.

Integrating digital literacies and scientific communication in a multimedia anatomy group assignment to advance contextual learning

Anatomists are facing a new generation of learners who will study and work in a technology-rich environment. Indeed, digital technologies are tremendously changing how information and knowledge are communicated and retrieved. However, it remains unclear whether an anatomy assessment can be designed to promote contextual learning through integrating a digital communication strategy. To investigate this, assessment methods were diversified in the first-year neuroanatomy and third-year regional anatomy curricula through implementing a multimedia human anatomy group assignment integrating digital literacies and scientific communication. Through completing this multimedia assignment, students demonstrated their anatomy knowledge transfer using a range of approaches. The main mode of presentations chosen in the two anatomy units were non-animated video presentations (~50%), animated video presentations (~30%), storyboards (~10%), podcasts (~3%), and filmed videos (~3%). A 5-point Likert scale learning and teaching survey was conducted for a total of 195 undergraduate health science students to evaluate students' perception of this group assignment. The majority of students (70-80%) strongly agreed or agreed that the multimedia group assignment helped their teamwork skills. Students who produced animated videos significantly outperformed those who adopted the non-animated presentations during the end-of-semester theory examination (p < 0.05). This study demonstrates that an anatomy group assignment integrating digital literacy and scientific communication is an effective assessment strategy associated with a positive learning experience and outcome. This inquiry-based assignment promotes learning through assessment, allowing students to not only consolidate and extend anatomy knowledge but also developing effective digital communication skills, providing new insights into non-didactic anatomy assessments.

Development of the WeChat Public Account I Love Parasitology and its Preliminary Application in the Teaching of Human Parasitology

OBJECTIVE

To better construct teaching resources, enhance real-time interaction and feedback between teachers and students in and out of class, and improve the teaching quality of parasitology, our team set up a WeChat public account I love Parasitology.

METHODS

The data sources were mainly from original pictures and multimedia materials of different parasites collected and produced by our team, as well as related materials collected from traditional publications and digital media. With the instant interactive platform, course schedules and corresponding teaching contents were sent by push notifications, case-based learning was carried out, and 2-way communication between students and teachers was achieved. Teaching effectiveness was assessed using a self-evaluation questionnaire.

RESULTS

A WeChat public account suitable for our daily teaching of parasitology was established. The second recursion and implementation of the learning resources allowed students to conduct in-depth reading and get unrestricted access to high-quality resources through the public account. In addition, all contents were in digital forms and made the original resources reborn, which would make up for our current and future shortage of physical teaching specimens. Moreover, the results from the questionnaire indicated that all these actions encouraged students to master theoretical knowledge, improved their abilities of case analysis and communication, and increased their knowledge of academic progress.

CONCLUSION

Our WeChat public account can provide excellent learning materials for students and is a good supplement to the routine education of human parasitology.

The influence of collaborative learning and self-organisation on medical students' academic performance in anatomy

BACKGROUND

In 2021, university teaching at the Faculty of Medicine Tuebingen was transferred to a digital setting. Due to the discontinuation of face-to-face teaching, students lacked the temporal and spatial framework of the curriculum and the possibility to socialise with fellow students was extremely limited. Increased demands were placed on the students' self-organisation, and the possibility of collaborative learning was drastically limited. The present study investigated the extent to which these study conditions affected the academic performance of medical students in the oral exam after the 60-hour introductory anatomy lecture. Specifically, collaborative, and organisational learning strategies were considered.

METHODS

Learning strategies of 146 students were assessed by means of a questionnaire. The anatomy exam was used to assess the academic performance. In addition, students were asked to rate their own oral exam performance.

RESULTS

Students used strategies of collaborative learning (M = 3.30, SD = 0.88) and self-organisation (M = 3.28, SD = 0.72) about equally as often. A significant correlation was found between the use of collaborative learning strategies and the ability for realistic self-assessment (ρ = -0.22, P =.02). Collaborative behaviour could be divided into Initiative Collaborative Learning and Subordinate Collaborative Learning. Only the former had an influence on the ability for realistic self-assessment. Neither organisational learning strategies nor collaborative learning strategies had an influence on academic performance.

DISCUSSION AND CONCLUSION

Initiative collaborative learners showed a higher degree of realistic self-assessment. This could be explained through a more distinct social referencing, as fellow students' knowledge levels can be related early on to their own academic performance. There was no correlation between the learning strategies used and the exam result.

Effectiveness of E-learning on clinical application of dental injection anatomy via simulation manikins

PURPOSE

E-learning is frequently integrated into dental education, yet little is known on the effectiveness of e-learning in both instilling foundational knowledge and facilitating translation of newly acquired knowledge and skill into clinical application. The objective of this study was to investigate the impact of learning modality on acquisition of knowledge and translation to clinical skill using objective feedback from oral anesthesia manikins and subjects' self-reported confidence scores.

METHODS

This mixed-method study involved first year dental students (n = 52) who volunteered to participate in a learning intervention, simulation exercise, and survey in 2022. Students were randomly assigned to lecture (n = 26) or e-learning (n = 26) cohorts and then participated in the intervention, postintervention assessment, and a simulation to evaluate correct approaches for each dental block and attempts to success.

RESULTS

All subjects scored significantly higher on post-intervention assessment compared to pre-intervention assessment (8.2 vs. 5.9; p < 0.0001) with no significant differences between intervention groups when comparing preintervention and postintervention scores. Furthermore, there were no significant differences between the two cohorts when comparing abilities to correctly approach each dental block or attempts to success. Finally, all students reported a significant increase in confidence in most categories following intervention and simulation, with no significant differences between lecture and e-learning cohorts.

CONCLUSION

Our findings suggest students learning via e-learning are equally capable as those learning via lecture at demonstrating newly acquired knowledge and skill in both assessments and clinical simulations. Results support incorporating supplemental e-learning and oral anesthesia manikin exercises for students learning the anatomy of dental injections.

Effectiveness of an Innovative Card Game as a Supplement for Teaching Factual Content to Medical Students: A Mixed Method Study

Introduction Lectures and small group teaching are useful to transfer conceptual knowledge. Anatomy is the foundation of medical sciences, but it is perceived to be difficult to comprehend and recall. For such clinically relevant aspects of medical education that require memorization, educational card games can be very effective. As the complex concepts and terminology of Embryology are difficult to follow and retain, we designed a card game "MedFc" for a topic on pharyngeal arches. This study was planned to determine the effectiveness of the card game on curriculum comprehension, recall of factual topics among medical undergraduates, and its utility as a supplement to interactive lecture sessions. Methods The mixed method study was conducted in the Department of Anatomy of an undergraduate medical college. Ethical approval was obtained prior to beginning the study. Convenience sampling was done. From a batch of 50 first-year medical students, a total of 40 students consented to participate in the study, 24 (60%) were males and 16 (40%) were female participants. A lecture on the pharyngeal arches was conducted for the entire batch of 50 first-year medical students. After three weeks, the students who consented to participate in the study were randomly grouped into two groups of 20 each. The groups were the game group (which played the card game in teams of five) and the control group (which discussed the same topic in small groups of five). For both the group's pretests and posttests, 10 higher order multiple choice questions, were conducted and students' feedback regarding the effectiveness of the teaching technique was obtained. Results Students opined that playing the card game was a superb experience, a positive use of time, and a very effective method of comprehension and memorizing complex topics. The scores increased from the pretest to the posttest indicating that both methods effectively reinforced the embryological concepts, but a t test showed that card game is more effective than small group discussions, with p-value = 0.008. The improvement in scores of students who had achieved <50% in pretest for the game group was statistically significant with t-value = 0.0023, when compared with the improvement in scores of similar students from the control group. Conclusions The study has demonstrated the effectiveness of "MedFc" card game in the recall of factual topics and can be used as supplementary material for enhancing learning amongst medical graduates. This educational card game applies gamification to Anatomy education to create a fun filled learning experience and is a valuable addition to the learning resources.

Focus on evidence-based anatomy in contemporary anatomy education: Arguments in favor of a pragmatic approach

The concept of evidence-based anatomy (EBA) emerged in 2014 and has become a significant element in contemporary anatomy education. The evolving fabric of the medical education curriculum has necessitated critical changes in practice. EBA enables these changes to be incorporated seamlessly and implemented congruently into anatomy education programs. However, in parallel, non-evidence-based (classical) knowledge that has been built up through centuries of anatomical practice continues to be the core element of anatomy education in some countries/regions. Its inherent limitations hinder integration with clinical practice, leading to a rise in misadventures in the clinical setting. This viewpoint commentary highlights the strengths of EBA vis-à-vis the related attributes of classical anatomy. Appropriate arguments show that EBA helps to reduce cognitive load and enables knowledge to be delivered through innovative education tools. EBA also helps to create an inclusive learning environment in a technology-driven era. Moreover, empowered by robust resources, it is driving the pertinent amalgamation of anatomy knowledge with clinical practice. This viewpoint article endorses the adoption of EBA in contemporary anatomy education on the basis of its potential for shaping future anatomical practice.

A mixed method analysis of student satisfaction with active learning techniques in an online graduate anatomy course: Consideration of demographics and previous course enrollment

Online learning has become an essential part of mainstream higher education. With increasing enrollments in online anatomy courses, a better understanding of effective teaching techniques for the online learning environment is critical. Active learning has previously shown many benefits in face-to-face anatomy courses, including increases in student satisfaction. Currently, no research has measured student satisfaction with active learning techniques implemented in an online graduate anatomy course. This study compares student satisfaction across four different active learning techniques (jigsaw, team-learning module, concept mapping, and question constructing), with consideration of demographics and previous enrollment in anatomy and/or online courses. Survey questions consisted of Likert-style, multiple-choice, ranking, and open-ended questions that asked students to indicate their level of satisfaction with the active learning techniques. One hundred seventy Medical Science master's students completed the online anatomy course and all seven surveys. Results showed that students were significantly more satisfied with question constructing and jigsaw than with concept mapping and team-learning module. Additionally, historically excluded groups (underrepresented racial minorities) were generally more satisfied with active learning than non-minority groups. Age, gender, and previous experience with anatomy did not influence the level of satisfaction. However, students with a higher-grade point average (GPA), those with only a bachelor's degree, and those with no previous online course experience were more satisfied with active learning than students who had a lower GPA, those holding a graduate/professional degree, and those with previous online course experience. Cumulatively, these findings support the beneficial use of active learning in online anatomy courses.

Consolidation Carnival: A Case-Based Approach to Reviewing Musculoskeletal Anatomy in an Undergraduate Medical Curriculum

Introduction

Recent changes in undergraduate medical curricula have resulted in time constraints that are particularly challenging, especially when students must learn large blocks of musculoskeletal anatomy content. Consequently, students have resorted to rote memorization to cope, which counteracts our established collaborative self-directed learning model.

Methods

For a 6-week musculoskeletal anatomy course, two structured case-based review sessions are described, each following the completion of two five-hour lab sessions, two on the upper extremities and two on the lower extremities. These largely self-directed review sessions consisted of 6 students rotating through 7 to 8 stations every 10 minutes where clinical cases with follow-up questions were projected on large screens. The students were expected to work collaboratively to solve the cases utilizing the prosected specimens provided and discuss the accompanying answers at the end of each case.

Results

Ninety-four per cent of the students who participated in this study agreed that the case-based review sessions provided a helpful overview of musculoskeletal anatomy content. Student performance on the open-ended, case-based musculoskeletal examination questions showed no significant difference in performance on shoulder, hand, hip, thigh, and leg questions. There was, however, a statistically significant decrease in the students' scores on a forearm question in 2021 compared to 2019.

Conclusion

This paper describes our integrated, collaborative musculoskeletal course, including case-based review sessions, which was positively received by students as having value in reviewing the musculoskeletal content though it was not found to improve examination performance.

Analysis of female pre-clinical students' readiness, academic performance and satisfaction in online learning: an assessment of quality for curriculum revision and future implementation

BACKGROUND

The acceptance of online courses by medical and dental students, especially during the coronavirus disease 2019 crisis, is substantial, as reported in various studies. However, the unfavourable online learning experiences of the students during the pandemic were also highlighted. As the teaching-learning process is returning to the "new normal," it is necessary to identify online learning domains implemented during the pandemic crisis that may be applied in pre-clinical courses in the future.

METHODS

A validated Student Online Learning Readiness questionnaire assessed pre-clinical students' online learning competence. Students' academic performance in face-to-face post-pandemic was compared with their performance in online settings during the pandemic crisis. Students' satisfaction with online learning was evaluated using a self-made survey questionnaire. Descriptive statistics, the t-test, and multiple regression analysis were used to analyze the data gathered with a p-value ≤ 0.05 considered statistically significant.

RESULTS

Except for social skills with classmates and groupmates, in which 47.5% of respondents indicated unreadiness, most students were prepared for online learning. Theory-wise, online learners outperformed traditional learners, but the difference was insignificant. In contrast, students' practical skills in face-to-face modality are significantly higher (p = 0.029). Students rated their satisfaction with online learning higher for interactions with instructors and staff and lower for interactions with classmates and group mates and skill acquisition.

CONCLUSION

Providing high-quality pre-clinical online teaching was achieved for theoretical components but not practical skills acquisition. Students' social engagement with peers is one of the key elements crucial to online learning success. Academic leaders and curriculum developers must recognize potential gaps as they transition to online learning.

A multi-year evaluation of medical student performance on and perceptions of collaborative gross anatomy laboratory examinations

Collaborative testing and its benefits have been reported in diverse disciplines across different types of academic institutions. However, there has been minimal research conducted on collaborative assessments in medical schools, particularly in the gross anatomy laboratory. The objectives of this study were to explore the effect of collaborative anatomy laboratory examinations on student performance and to gauge student perceptions of this assessment format. This study examined five academic years of medical students' performance on a two-stage, collaborative anatomy laboratory examination wherein each student's overall score was a weighted combination of scores from the individual and team examination. Analyses of a descriptive survey capturing students' perceptions of the assessment method were also performed. Individual examination averages increased since implementing the collaborative assessment (p < 0.001), and team examination averages were higher than individual examination averages (p < 0.001). Teams outperformed each of their team members 98% of the time. Teams had a greater than 0.90 incidence of answering a question correctly if more than one person in the group got the answer correct on the individual portion, and a 0.66 incidence of answering correctly if only one person in their group answered correctly on the individual portion. Student feedback identified the discussions and learning that took place during the team portion to be a beneficial feature of this assessment format. Students also reported that this collaborative assessment made them feel a higher level of responsibility to perform well, and that it improved their understanding of gross anatomy.

Virtual Reality as a Complementary Learning Tool in Anatomy Education for Medical Students

Virtual reality seems to be a promising tool to improve the study of anatomy; however, its efficacy compared to traditional methods remains unclear. This randomized experimental study included 42 first-semester medical students enrolled in a Morphology discipline, divided into two groups. Each group was interchangeably assigned to use virtual reality plus traditional methods or traditional methods alone in a four-section crossover design. Participants' scores in four distinct tests were compared between groups, as well as a motivation questionnaire. The results showed that virtual reality does not provide significant increase on scores neither short-, medium-, and long-term analysis. Nonetheless, in the motivation questionnaire, participants agreed virtual reality provides a better tridimensional view of the human body and therefore is a potential complementary tool when learning anatomy. We conclude virtual reality does not seem to have an impact on academic performance, but it was perceived as an engaging and promising complementary tool for the study of anatomy.

Transforming musculoskeletal anatomy learning with haptic surface painting

Anatomical body painting has traditionally been utilized to support learner engagement and understanding of surface anatomy. Learners apply two-dimensional representations of surface markings directly on to the skin, based on the identification of key landmarks. Esthetically satisfying representations of musculature and viscera can also be created. However, established body painting approaches do not typically address three-dimensional spatial anatomical concepts. Haptic Surface Painting (HSP) is a novel activity, distinct from traditional body painting, and aims to develop learner spatial awareness. The HSP process is underpinned by previous work describing how a Haptico-visual observation and drawing method can support spatial, holistic, and collaborative anatomy learning. In HSP, superficial and underlying musculoskeletal and vascular structures are located haptically by palpation. Transparent colors are then immediately applied to the skin using purposive and cross-contour drawing techniques to produce corresponding visual representations of learner observation and cognition. Undergraduate students at a United Kingdom medical school (n = 7) participated in remote HSP workshops and focus groups. A phenomenological study of learner perspectives identified four themes from semantic qualitative analysis of transcripts: Three-dimensional haptico-visual exploration relating to learner spatial awareness of their own anatomy; cognitive freedom and accessibility provided by a flexible and empowering learning process; altered perspectives of anatomical detail, relationships, and clinical relevance; and delivery and context, relating to curricular integration, session format, and educator guidance. This work expands the pedagogic repertoire of anatomical body painting and has implications for anatomy educators seeking to integrate innovative, engaging, and effective learning approaches for transforming student learning.

Musculoskeletal education in undergraduate medical curricula-A systematic review

Rheumatic and musculoskeletal diseases encompass a vast spectrum of up to 200 conditions that are increasingly prevalent, with significant associated disability and socioeconomic burden. Their impact is pervasive, with musculoskeletal conditions being the second leading cause of years lived with disability worldwide, in addition to the 9th most common cause of disability-adjusted life years. It is therefore imperative that all graduating medical physicians are competent in their management, and that the quality of undergraduate musculoskeletal education is commensurate with patient and societal needs. A systematic literature review was conducted between April 1, 2021 and June 1, 2021 assessing the quality of undergraduate musculoskeletal education in medical schools. Educational interventions in musculoskeletal medicine were also included. Quality assessment appraisal of the studies was done using a Mixed Methods Appraisal Tool. One thousand and thirty-three titles were screened, and 44 studies were included in the final analysis. Our analysis of these studies showed that the quality of undergraduate musculoskeletal education, as determined by the cognitive mastery and clinical confidence of undergraduate medical students remains inadequate. Multiple educational interventions were assessed with mixed results. Despite the prevalence, and burden associated with rheumatic and musculoskeletal diseases, the musculoskeletal education of undergraduate medical students remains inadequate. Urgent international collaboration is required to devise teaching strategies and curriculum initiatives that are globally and reproducibly applicable and effective. Further research into educational interventions and teaching strategies is also required.

Universal design for learning in anatomy education of healthcare students: A scoping review

There are concerns among healthcare practitioners about poor anatomical knowledge among recent healthcare graduates. Universal Design for Learning (UDL) is a framework developed to enhance students' experience of learning and help students to become motivated learners. This scoping review identified whether UDL has been utilized in third level healthcare education and if so, whether it had been used to enhance student motivation to study anatomy. Seven online databases were searched for studies reporting the use of UDL in the curricula of medical, dental, occupational therapy (OT) or speech and language therapy (SLT) programs. Studies were screened for eligibility with set inclusion criteria. Data were extracted and analyzed. Analysis revealed that UDL was not specifically mentioned in any of the studies thus there are no published studies on UDL being formally applied in healthcare education. However, the authors identified 33 publications that described teaching methods which aligned with UDL in anatomy curricula and a thematic analysis yielded four main themes relating to teaching strategies being employed. Universal design for learning was not mentioned specifically, indicating that educators may not be aware of the educational framework, although they appeared to be utilizing aspects of it in their teaching. The review revealed that there is a lack of research concerning the anatomy education of OT and SLT students. The role of UDL in enhancing motivation to learn anatomy in medical, dental, OT and SLT programs has yet to be explored.

Impact of Audience Response System in Enhancing Teaching of Anatomy and Physiology for Health Sciences Students at King Saud bin Abdulaziz University for Health Sciences

Purpose

Instructional methods that offer students' opportunity for engagement are essential to develop an active learning environment. This paper aims (1) to assess whether the use of an Audience Response System (ARS) during anatomy and physiology lectures improves students' engagement, knowledge retention and academic achievement and (2) to evaluate the feasibility of introducing ARS as a formative tool from both instructors' and students' perspectives.

Materials and Methods

This quasi-experimental study was conducted across ten lectures for the second-year Pre-Applied Medical Science (PAMS) and Pre-Medical (PMED) students at the College of Sciences and Health Professions, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia. The ARS was integrated into five lectures, whereas the remaining were conducted without ARS. A comparison of the immediate post-lecture and prior laboratory session quiz scores between the lectures with and without ARS was performed using an independent sample t-test. An online survey was completed by the students as well as informal feedback was taken from the instructors to assess ARS usefulness.

Results

A total of 65 PMAS and 126 PMED students participated in the study. Students achieved significantly better scores for ARS lectures than non-ARS lectures: PAMS (p 0.038) and PMED (p 0.018). Students and instructors agreed that ARS was easy to use, allowing students to engage and actively participate in the teaching process by responding to questions and receiving instant and anonymous feedback about their learning progress.

Conclusion

Employing suitable interactive teaching methods facilitates students' learning and improves their retention of knowledge. Students and instructors positively view the ARS strategy as a means to promote learning in a traditional lecture setting. Increased practice on how to integrate its use into classrooms could lead to further utilization.

A comparative study of the effects of multimedia training materials on mini CEX scores of internal medicine residents in Isfahan University of Medical Sciences

BACKGROUND

Role of multimedia training materials on Mini-CEX scores of internal medicine residents. We aimed to assess the effect of multi multimedia training materials on Mini-CEX scores of internal medicine residents of Isfahan University of Medical Sciences.

SETTINGS AND DESIGN

A quasi-experimental action research study on 1^st, 2^nd, and 3^rd-year internal medicine residents were implemented.

MATERIALS AND METHODS

The Mini-CEX test measures students' performance in six core skills necessary for medical practice. Mini-CEX scores of 135 internal medicine residents in 2017-2018 were compared before and after the training with prepared multimedia materials. We used repeated measured ANOVA and Mann-Whitney U test to compare the distribution of Mini-CEX scores across corresponding groups. Analysis was done using the SPSS software version 23 (IBM SPSS Statistics for Windows. Armonk, NY, USA: IBM Corp).

RESULTS

The median Mini-CEX score (IQR) of students in preintervention and postintervention groups were 16.14 (5.19) and 19.62 (3.13), respectively. Findings of this study showed a significant increase in mini-CEX scores of the groups who used the multimedia learning material compared to those who did not use it (P < 0.001).

CONCLUSIONS

Multimedia learning resources demonstrated a promising influence on internal residents' mini-CEX scores in this study. They demonstrate significantly greater performance after using multimedia learning materials compared to their same-year residents who did not benefit from it. This demonstrates the favorable effect of multimedia on the acquisition of practical skills such as obtaining a history or performing a physical examination.

The blacksmith approach: a strategy for teaching and learning in the medical anatomy course (a qualitative study)

BACKGROUND

Anatomy is a symbolic, essential core topic and one of the fundamental pillars of medical and paramedical knowledge. Nevertheless, few exploratory data analyses have focused on how students approach learning anatomy. This study examined how students perceive their learning experience during anatomy lessons and how to make a model which promotes their meaningful learning and professional identity.

METHODS

Using purposive sampling with maximum variation, we conducted a qualitative content analysis at the Shiraz University of Medical Sciences in Iran (2020 to 2021). Twenty-four medical students and twelve faculty members of Iran's medical science universities were enrolled in the study. The data were collected through semi-structured interviews and analyzed according to the theme.

RESULTS

A conceptual model emerged from the data analysis with the main theme called the blacksmith approach, which included Three sub-themes: (1) making a new forge (adequate preparation and mindful beginning), (2) heating the students' hearts (considering supporting systems that learners need) and (3) using Sledgehammer's approach (teaching anatomy by using more active methods and engaging all neuroanatomical regions) and (Using fun for enjoyable learning). All the concepts were related to each other.

CONCLUSION

Medical students experience a challenging fundamental evolution into professional doctors. Educational systems focus primarily on teaching and learning, while students' transition can be facilitated by a three-step model called the Blacksmith Approach. It best serves as an educational framework for any pivotal, preclinical course capable of helping students acquire new roles and tackle challenges. Further research should be conducted to confirm how hard work leads to satisfying results with the opportunity to create enjoyable learning.

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.

Educational Approaches That Enhance Online Clinical Clerkship during the COVID-19 Pandemic

Objective This cross-sectional national study determined which educational approaches are associated with the effectiveness of online clerkship for medical students. Method A survey was conducted for medical students at 78 medical schools in Japan from May 29 to June 14, 2020. It comprised the following aspects: (a) participants' profiles, (b) number of opportunities to learn from each educational approach (lecture, medical quiz, assignment, oral presentation, observation of a physician's practice, clinical skill practice, participation in interprofessional meetings, and interactive discussions with physicians) in online clerkship, (c) frequency of technical problems, and (d) educational outcome measurement (satisfaction, motivation, knowledge acquisition, skill acquisition, change in self-study time, and understanding of the importance of medical care team). Results Of the 2,640 respondents, 2,594 (98.3%) agreed to cooperate. Ultimately, 1,711 matched our inclusion criteria. All educational approaches but assignments were positively associated with satisfaction and motivation. All educational approaches excluding assignment submission and interprofessional meeting were positively associated with knowledge acquisition. Observation, practice, and interprofessional meeting were positively associated with skill acquisition. Only assignment submission was positively associated with the change in self-study time. Educational approaches excluding medical quizzes were positively associated with understanding the importance of the medical care team. Technical problems were negatively associated with motivation, knowledge acquisition, and skill acquisition. Conclusions Educators should implement various educational approaches, especially observation and practice, even in online clinical clerkship. They also need to minimize the technical problems associated with the Internet, as they reduce the effectiveness of online clerkship.

With the New Challenges of COVID- 19, Can We Depend Entirely on Online Learning for Higher Education in the Medical Schools?

BACKGROUND

Due to the COVID-19 pandemic, medical education has gone online. Human anatomy is a three-dimensional subject that requires a clear understanding of the relationships between structures through the study of human cadavers, microscopic samples, and models.

OBJECTIVE

This study aimed to examine the attitudes and perceptions of students regarding teaching anatomy before and after the lockdown period and ways of improving the challenges they faced.

METHODS

This cross-sectional study was conducted at AL Imam University School of Medicine. Structured surveys were designed to understand students' attitudes and opinions towards offline versus online teaching of anatomy and suggestions to improve the online teaching process.

RESULTS

The mean attitude scores for the conventional lectures, seminars, and practical sessions were significantly higher. Students expressed positive attitudes towards the three teaching modules. Students agreed that themes related to computer skills and technical Internet infrastructure (71.55%) and administrative procedures (61.74%) are essential for improving the online teaching process.

CONCLUSION

Conventional learning is the main target of student learning. Improvements in computer skills, technical Internet infrastructure, learning resources, staff communication, examinations, and development of blended learning will enrich the learning process, especially during the impending challenges.

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.

A constructivist approach to teach neuroanatomy lab: Students' perceptions of an active learning environment

BACKGROUND

A recent trend in medical education is developing a more dynamic and integrated curriculum. Team-based learning (TBL) increases students' engagement and the active construction of anatomical knowledge. This initial study aimed to empirically observe medical students' perceptions of their achievement of learning outcomes and the construction of their neuroanatomy knowledge, critical thinking, and problem-solving using an interactive whiteboard (IWB) as a teaching strategy.

METHODS

An independent neuroanatomy lab survey collected students' perceptions and comments about their learning experiences using the IWB on a questionnaire using a 5-point Likert scale.

RESULTS

Student participants felt that using the IWB has facilitated their learning experience. 94.2% of student participants endorsed feelings that new technology has helped them achieve their learning outcomes, helped them integrate both their basic science and clinical science/skills knowledge (90.4%), enhanced their problem-solving skills (92.3%), facilitated their interaction with the neuroanatomy faculty (96.2%) and increase their critical thinking (88.4%).

CONCLUSION

Collecting such empirical data about students' perceptions and their learning environment should help neurosciences faculty in medical schools better outline their activities to faculty at other medical institutions. Applying these methods may enhance the learning process, save time during neuroanatomy lab, and it could also help overcome the shortage of qualified neuroanatomy educators.

The impact of asynchronous online anatomy teaching and smaller learning groups in the anatomy laboratory on medical students' performance during the Covid-19 pandemic

Due to the Covid-19 pandemic, National Taiwan University anatomy teachers adopted asynchronous online video teaching and reduced the size of anatomy laboratory groups in April 2020. The aim of this study was to investigate the impact of these changes on medical students' learning. Before Covid-19, the performance of the 2019-2020 cohort was significantly better than that of the 2018-2019 cohort. However, the implementation of modified teaching strategies significantly lowered the laboratory midterm score of the 2019-2020 cohort in the second semester. Conversely, the final laboratory examination score of the 2019-2020 cohort was significantly higher than that of the 2018-2019 cohort. Through correlation analysis, lecture and laboratory examination scores were highly correlated. Additionally, the difference in lecture and laboratory z-scores between two cohorts, the Likert scale survey and free-text feedback of the 2019-2020 cohort, were conducted to show the impact of modified teaching strategies. There were several important findings in this study. First, the change in teaching strategies may temporarily negatively influence medical students to learn anatomy. Besides, analyzing the performance of laboratory assessments could be a complementary strategy to evaluate online assessments. Applying lecture examination scores to predict laboratory performance was a feasible way to identify students who may have difficulty in learning practical dissection. Finally, reducing group size together with reduced peer discussion may have a negative effect on learning cadaver dissection for students with low academic performance. These findings should be taken into consideration when anatomy teachers apply new teaching strategies in anatomy courses.

Modern and synchronized clinical anatomy teaching based on the BDIE method (board-digital dissection-imaging-evaluation)

PURPOSE

Anatomy has historically been taught via traditional medical school lectures and dissection. In many countries, practical or legal issues limit access to cadaveric dissection. New technologies are favored by students and could improve learning, complementing traditional teaching.

METHODS

All students in second-year medicine at a single medical school were submitted to a novel anatomical course with digital tool exposure. We explored a new combined teaching method: a physical blackboard lesson synchronized with digital dissection, imaging and direct evaluation (BDIE). Synchronized dissection is broadcast live in the classroom and in partner medical schools. Following the course, students completed a short survey about their perception of this new anatomic clinical course.

RESULTS

The survey included 183 students whom 178 completed the questionnaire, i.e., a 97% response rate. Ninety-nine percent of students thought this synchronized method useful to improve their understanding of anatomy and 90% stated it helped them retain this learning.

CONCLUSION

This BDIE method, in conjunction with teaching guidelines and dissection, is highly appreciated by students who consider it helps them to acquire lasting knowledge.

Predicting the effectiveness of the online clinical clerkship curriculum: Development of a multivariate prediction model and validation study

Given scientific and technological advancements, expectations of online medical education are increasing. However, there is no way to predict the effectiveness of online clinical clerkship curricula. To develop a prediction model, we conducted cross-sectional national surveys in Japan. Social media surveys were conducted among medical students in Japan during the periods May–June 2020 and February–March 2021. We used the former for the derivation dataset and the latter for the validation dataset. We asked students questions in three areas: 1) opportunities to learn from each educational approach (lectures, medical quizzes, assignments, oral presentations, observation of physicians’ practice, clinical skills practice, participation in interprofessional meetings, and interactive discussions with physicians) in online clinical clerkships compared to face-to-face, 2) frequency of technical problems on online platforms, and 3) satisfaction and motivation as outcome measurements. We developed a scoring system based on a multivariate prediction model for satisfaction and motivation in a cross-sectional study of 1,671 medical students during the period May–June 2020. We externally validated this scoring with a cross-sectional study of 106 medical students during February–March 2021 and assessed its predictive performance. The final prediction models in the derivation dataset included eight variables (frequency of lectures, medical quizzes, oral presentations, observation of physicians’ practice, clinical skills practice, participation in interprofessional meetings, interactive discussions with physicians, and technical problems). We applied the prediction models created using the derivation dataset to a validation dataset. The prediction performance values, based on the area under the receiver operating characteristic curve, were 0.69 for satisfaction (sensitivity, 0.50; specificity, 0.89) and 0.75 for motivation (sensitivity, 0.71; specificity, 0.85). We developed a prediction model for the effectiveness of the online clinical clerkship curriculum, based on students’ satisfaction and motivation. Our model will accurately predict and improve the online clinical clerkship curriculum effectiveness.

Practice and exploration of the "student-centered" multielement fusion teaching mode in human anatomy

Purpose

Human anatomy is a core course of basic medicine and the first professional course for medical students. Traditional teaching includes "teacher-centered" instruction, passive learning, and a lack of interaction between teachers and students as well as between students. The aim of this study was to develop a "student-centered" multielement fusion teaching mode to address the mentioned drawbacks.

Methods

A total of 141 clinical medical students from grades 2016 and 2017 of Chengde Medical University participated in this study. The students were randomly divided into four classes: two experimental classes and two control classes. The experimental classes experienced a "student-centered" multielement fusion teaching mode, while the control classes experienced a traditional teaching method. Formative assessments and questionnaires were used to assess the students' preferences and obtain feedback. Theoretical and experimental tests were carried out to detect the students' scores at the end of the semester.

Results

The results of the questionnaires demonstrated that 100% of the students agreed that the multielement teaching mode was better. In the experimental test, the students in the experimental group achieved a mean score of 16.50 ± 0.3203, which was significantly higher than that of the control group 12.65 ± 0.4731 (P < 0.01). In the theoretical test, the average score of the experimental group was 45.86 ± 0.6273 and that of the control group was 46.59 ± 0.6636; thus, there was no significant difference between the two groups (P > 0.05).

Conclusion

The application of a "student-centered" multielement fusion teaching mode obtained strong approval from the students. This teaching mode not only improved students' interest in learning and increased the interaction between teachers and students as well as between students but also enhanced students' competence and will lay a solid foundation for their future careers.

Integration of innovative educational technologies in anatomy teaching: new normal in anatomy education

COVID-19 pandemic has created a lot of turmoil in medical teaching, the magnitude of impact is many folds in the subject of anatomy, as it is practical based. A major challenge for anatomy teachers is to replicate the experience of practical exposures. These exposures range from cadaveric dissection to demonstration of bones, museum specimens, and histology slides, where they will have interactive communication with students, and thus help in the enhancement of communication and clinical skills among them. In recent days, anatomy teachers throughout the globe started using various advanced technology to make the teaching-learning session more interesting. In pre-pandemic era, usage of such advancements in information and communication technology was a 'choice'. But pandemic has changed the situation drastically, what was a 'choice' earlier is now an 'obligation.' Presently although infection rate is low, vaccination rate is high, most of the medical schools re-opened for usual offline teaching, still body donation is all time low making the situation 'back to square one'. Keeping such unprecedented situations in mind, we need to incorporate various innovative educational technologies in day-to-day teaching-learning methodologies.

Does team-based learning affect test scores of the basic medical sciences students in a modular curriculum?

Objectives

The aim of the study was to determine the effectiveness of team-based learning (TBL) sessions as a learning tool and to assess the satisfaction level of medical students towards TBL in modular curriculum.

Methods

Using the quasi-experimental study design, TBL sessions were conducted, involving students of 1^st and 2^nd year of Bachelor of Medicine and Bachelor of Surgery. The TBL infrastructure comprised of pre-class preparation, in-class individual readiness assurance pre-test and post-test, before and after group discussion, respectively. The responses of the students regarding TBL satisfaction were recorded through a structured questionnaire (5-point Likert-type scale) while Wilcoxon signed rank test was applied to measure the effectiveness of TBL sessions.

Results

Out of 192 students, 85% agreed or strongly agreed that TBL helped them think critically, identify their knowledge gaps, boosted their confidence, and motivated them in group participation. Significantly better post-test scores were found in all modules where TBL was used as a teaching tool (Z range = -5.33 to -11.81, P < 0.00).

Conclusion

TBL increases the post-test score in majority of the students, indicating improved learning process. It not only keeps students engaged throughout the learning process but incites critical thinking, problem solving skills, and confidence. Further studies are required to see long-term benefit of TBL in students' learning.

Perceptions of Medical Undergraduate Students on Curricular Changes in Anatomy: An Embedded Design Mixed Method Study

INTRODUCTION

Implementation of competency-based medical education (CBME) offers challenges to the faculty and students. As a part of the new curriculum by the National Medical Council of India, we introduced certain teaching and assessment modifications in anatomy. There are few studies on the actual implementation of CBME. The current study aimed to assess the perceived usefulness of the teaching, learning, and assessment methodology (TLAM) based on written feedback from students.

METHODS

All the 147 first MBBS students of the batch who had undergone the new teaching learning methodology answered the questionnaire on usefulness of the various TLAMs on a 3-point Likert scale which was taken as quantitative data. They were also asked to pen down their opinions and suggestions about the TLAM which was thematically analysed and considered as qualitative data. Face and content validity was assessed prior to administration of the questionnaire. Descriptive statistics were used for quantitative variables. Qualitative data were analysed by thematic analysis.

RESULTS

100% of the students found vertical integration and small group teaching as useful. Seminars and quizzes were reported as useful to extremely useful by 75.5% of the students. Self-directed learning and near-peer teaching was also appreciated well by 78% of students. In Embryology and Neuroanatomy, these active learning methods were not found to be useful as these topics were difficult to understand. Overall, the new TLAM introduced as per the new medical curriculum was found useful for the majority of students.

CONCLUSION

This study provides valuable insights on the teaching, learning, and assessment methods as formulated by the competency-based medical curriculum. Though active learning methods are the integral principles of andragogy, the concepts which are difficult to understand need to be taught using the traditional teaching methodology.

Exploring the experience of nursing undergraduates in using gamification teaching mode based on the flow theory in nursing research: A qualitative study

BACKGROUND

With the development of evidence-based nursing practice, nursing research courses are important in undergraduate programs. However, nursing research courses are highly theoretical, which is difficult for students to understand. Improving the teaching quality of nursing research courses is a challenge for educators.

OBJECTIVES

To understand the learning experience and the effect of gamification teaching on nursing undergraduates, and to provide new ideas for nurse educators.

DESIGN

A qualitative research design using individual semi-structured interviews.

SETTINGS

Gamification teaching was applied in an undergraduate nursing research course over one semester at a university in Central China.

PARTICIPANTS

Purposive sampling was adopted to select nine undergraduate nursing students who had recently completed gamification teaching in a nursing research course.

METHODS

Data were collected through semi-structured interviews and analyzed using Colaizzi's phenomenological method.

RESULTS

Three major themes and seven subthemes emerged from the interviewees' experience: (1) positive attitude (e.g., acceptance with pleasure and flow experience); (2) self-perceived competence improvement (e.g., creative thinking, collaboration, and knowledge internalization and application); and (3) challenges of gamification teaching (e.g., learning pressure and rationality of game design).

CONCLUSIONS

The gamification teaching mode based on the flow theory had a positive effect on the students' learning experience in the nursing research course. It is recommended to improve the game design model and to enhance its effectiveness for classrooms in the future.

Changing paradigms in anatomy teaching-learning during a pandemic: Modification of curricular delivery based on student perspectives

Objectives

Methods

Results

Conclusion

Evaluation of Anatomy Course Teaching and Learning Outcomes for Iraqi Pharmacy Students: Internet-based Learning versus Blended Learning During the Pandemic

BACKGROUND: Academic courses of human anatomy need to be reviewed periodically by students to ensure better learning outcomes, especially when the teaching process became internet-dependent during the pandemic. AIM: Our study aims to explore pharmacy students’ opinions concerning the theoretical and practical elements of the anatomy course taught in the College of Pharmacy at Al-Rafidain University. MATERIALS AND METHODS: The ethical committee of the College of Pharmacy at Al-Rafidain University approved the study. We prepared a questionnaire (Cronbach’s Alpha = 0.735) to evaluate the positive and negative aspects of the teaching process. The questionnaire was presented as an online survey to pharmacy students (n = 305) who finished their anatomy course in two learning modalities, Internet-based learning (n1 = 105, 34.43%) and blended learning (BL) (n2 = 200, 65.57%). RESULTS: Participants of both groups were satisfied with the syllabus, using internet-based materials, and problem-based learning concerning the theoretical aspect of the course. Concerning practical knowledge, both groups preferred using cadavers instead of dummies, and they verified the beneficial effect of online educational materials and computer-based applications. Pharmacy students demanded more than one anatomy course, while students from the BL group considered the anatomy course duration insufficient. Concerning the practical knowledge, students’ marks were superior for students using BL, and the opposite was the case with theoretical knowledge. CONCLUSIONS: BL is favored by Iraqi undergraduate pharmacy students; perhaps, it is attributed to the lively interaction between students and the teaching staff. We conclude that internet resources can be supportive of the classical teaching of anatomy.

Is remote near-peer anatomy teaching an effective teaching strategy? Lessons learned from the transition to online learning during the Covid-19 pandemic

In response to the Covid-19 pandemic, medical educators have transformed pre-clerkship anatomy curricula into online formats. The purpose of this study was to evaluate the effectiveness and student perceptions of an online near-peer anatomy curriculum. The classes of 2022 and 2023 completed identical foundational anatomy curricula in-person, whereas the class of 2024 completed an adapted curriculum for remote online learning. Quantitative and qualitative responses were used to compare attitudes between instructional methods. Assessment scores and evaluation survey responses were collected from the classes of 2022 (n = 185), 2023 (n = 184), and 2024 (n = 183). Mean assessment scores (±SD) for the classes of 2022, 2023, and 2024 were 93.64% (±5.86), 93.75% (±4.09), and 92.04% (±4.83), respectively. Post hoc group comparisons showed the class of 2024 scored significantly lower than the two previous classes [2022: (H(1) = 18.58, P < 0.001), 2023: (H(1) = 18.65, P < 0.001)]. Mean survey results concerning curriculum quality were 4.06/5.00 for the class of 2023 and 3.57/5.0 for the class of 2024 (t(365) = 2.67, P = 0.008). Considering a small effect size (η² = 0.034), there was no meaningful difference in student assessment scores. A potential drawback of online near-peer anatomy teaching remains in student perceptions of course quality; qualitative feedback suggested technological limitations and perceptions of online course instructors were partly responsible for lower student satisfaction. Following the Covid-19 pandemic, medical educators should incorporate the lessons learned from this unique educational inflection point to improve curricula moving forward.

Medical and public health instructors' perceptions of online teaching: A qualitative study using the Technology Acceptance Model 2

Many universities in the U.S. shifted from in-person teaching to online teaching due to the COVID-19 pandemic. Instructors' acceptance of online teaching plays a crucial role, as the acceptance level can impact instructors' online teaching behaviors. This qualitative study examined medicine and public health instructors' perceptions of online teaching using the Technology Acceptance Model 2 (TAM2) model. Through semi-structured interviews with ten instructors in a Midwest university in the U.S., this study found that instructors had a high level of acceptance of online teaching. Instructors perceived the usefulness of online teaching in terms of learning objectives, assessment, instructional methods, and learning experience. Online teaching was perceived as useful overall, although challenges existed, such as online interaction, assessment, and hands-on practices. Regarding ease of use in online teaching, instructors perceived technology was easy to use; yet some pedagogical challenges existed, such as class engagement, the focus of learners' attention, and transforming hands-on lab or clinical sessions online. The blended model is recommended to use for teaching and learning in medical and public health education post the pandemic. Detailed implications for practice and research were discussed in the end.

A pragmatic approach to effective anatomy teaching and learning to medical students: a ten-year experience using evidence-based principles

This article was migrated. The article was marked as recommended. Teaching and learning of anatomy for medical students have been extensively studied. However, we believe that a 'gold-standard' of an anatomy teaching and learning model is difficult to establish as every educational institution faces unique. For the past ten years at the University of Notre Dame Australia, School of Medicine Sydney, the anatomy faculty has implemented evidence-based teaching strategies adopted from medical schools around the world and supported by timely student feedback to deliver cost-effective and sustainable anatomy learning. Student evaluations of this program have been positive and associated with improved summative anatomy results. This article describes ten principles pursued by our faculty, which we hope will help others in restructuring or enhancing their anatomy teaching and learning program.

Using Instagram as a tool to enhance anatomy learning at two US dental schools

Although growing evidence supports the inclusion of social media in education, no studies to date have investigated the potential role of Instagram in anatomy education for dental students. Anatomists at University of Texas School of Dentistry (UTSD) and University of Nebraska Medical Center (UNMC) College of Dentistry created unique Instagram pages supplemental to traditional pedagogy, aiming to provide easily-accessible, interactive content for our tech-savvy students. The aim of this study was to evaluate students' perspectives of the use of social media in education and their respective professor's Instagram page. In the fall of 2020, 170 students (86 from UTSD and 84 from UNMC) voluntarily participated in a survey via Qualtrics. The majority of respondents (85.1%) had seven or more years of experience with social media, and 96.9% of students reported using social media as a source of information with 92.5% using for educational purposes. All students agreed that their respective professor's page has been helpful for anatomy study and review, added to their understanding of anatomy, is convenient, engaging, and professional. While consistent themes emerged between cohorts, UNMC students had a higher level of agreement regarding their page's added relevance to learning in the class/clinic (p = 0.0016), while UTSD students reported feeling more comfortable asking their professor questions through Instagram (p = 0.015). Among all variables, female students and Generation Z students responded more favorably than male or Generation Y counterparts. Here, the authors describe benefits and considerations for others interested in using Instagram as an educational tool.

Physician Associate Students' Experience of Anatomy Dissection

The role of physician assistant/associate (PA) has expanded from its inception in the United States over 50 years ago, to European countries including Ireland. While there is an increasing body of evidence exploring the role and training of PAs in clinical settings, there is a scarcity of research exploring PA students' perspectives in relation to their experience of anatomy dissection, or how these experiences may contribute to the development of their core professional identity. Students in the first two cohorts of PA Program at the Royal College of Surgeons in Ireland program were invited to interviews which solicited them to reflect and report on their own experiences of anatomical dissection during their course. Participants' responses were analyzed using a thematic inductive approach; common themes and patterns were organized into a hierarchical structure, which generated the final framework of themes. Ten participants took part in the study; only one had previous personal experience of dissection, while two further participants had some familiarity with prosected specimens. The first theme concerned the participants' expectation of anatomical dissection, with sub-themes of preconceptions, smell, and emotions. The second theme involves discussion of coping strategies that the participants used, including talking, viewing the cadaver as their first patient, and naming (or not naming) the cadaver. The third theme includes how the participants' talked about respect and compassion in the dissection room, development of team working skills, and awareness of bereavement and organ donation. A number of recommendations were also made for the experience and orientation of future students in such a program.

Impact of the Application of Computer-Based 3D Simulation on Acquisition of Knowledge of Guidance of Mandibular Movement

Recently, computer-aided three-dimensional (3D) simulation has expanded to modern education. This study aims to investigate the effects of 3D computer simulation on the learning and self-assessment of the guidance of the mandibular movement. Sixty second-grade dental students were randomly distributed into three groups in an occlusion class. Various teaching protocols were used for each group. Students in the first group (lecture (L)) were taught exclusively through a textbook and two-dimensional illustrations. The conventional lecture method followed by computer-aided 3D simulation was applied to the second group (lecture-to-simulation (LtS)). Lastly, students in the third group (lecture with simulation (LwS)) were simultaneously taught using the conventional lecture and computer-aided 3D simulation methods. After teaching each group, a paper-based examination was conducted; actual and expected scores were obtained on the same day as the occlusal class. Analyses of variance with Tukey’s post-hoc analysis were used to compare the teaching protocols, whereas the independent t test was used for comparing between actual and expected scores (α = 0.05). The LwS group exhibited significantly higher actual and student-expected scores than the L and LtS groups (p < 0.001). The expected score was significantly lower than the actual score in the L group (p = 0.035). However, in the LtS and LwS groups, no statistical difference was observed between expected (p = 0.114) and actual (p = 0.685) scores. The distribution of actual scores in the grading systems indicated higher percentages of excellent (grade A) and good (grade B) scores in the LwS (96.7%) and LtS (79.7%) groups, respectively, than in the L group (53.4%). Using computer-aided 3D simulation to teach the guidance of mandibular movement improved the learning outcomes and self-assessment of students, especially when 3D simulation was combined with conventional lecturing.

Flipped classroom combined with human anatomy web-based learning system shows promising effects in anatomy education

Flipped classroom has received much attention in medical education. The aim of this study was to evaluate the efficacy of flipped classroom combing with human anatomy web-based learning system in anatomy education.A total of 89 freshmen in medical specialty were enrolled and randomly allocated into either the experimental group (receiving the flipped classroom with human anatomy web-based learning system, n = 45) or control group (receiving the traditional classroom teaching, n = 44). A pre-quiz and a post-quiz were conducted before and after the classes, respectively. The improvement in scores between groups was compared. A 5-point Likert scale questionnaire was used to evaluate perceptions and experience.The mean pre-quiz scores of the 2 groups were comparable (all P > .05). However, the mean post-quiz score in the experimental group was significantly higher than that in the control group (91.44 ± 6.25 vs 86.13 ± 11.67, P < .05). The results of questionnaires showed that 44 (97.8%) students agreed with flipped classroom combined with human anatomy web-based learning system, 43 (95.6%) students obtained improved study interest in anatomy learning, and 42 (93.3%) students felt that the interactive, applied in-class activities during the class greatly enhanced their learning.Flipped classroom combined with human anatomy web-based learning system can be used as an effective learning tool for anatomy education.

Challenges and Opportunities of Preclinical Medical Education: COVID-19 Crisis and Beyond

COVID-19 pandemic has disrupted face-to-face teaching in medical schools globally. The use of remote learning as an emergency measure has affected students, faculty, support staff, and administrators. The aim of this narrative review paper is to examine the challenges and opportunities faced by medical schools in implementing remote learning for basic science teaching in response to the COVID-19 crisis. We searched relevant literature in PubMed, Scopus, and Google Scholar using specific keywords, e.g., "COVID-19 pandemic," "preclinical medical education," "online learning," "remote learning," "challenges," and "opportunities." The pandemic has posed several challenges to premedical education (e.g., suspension of face-to-face teaching, lack of cadaveric dissections, and practical/laboratory sessions) but has provided many opportunities as well, such as the incorporation of online learning in the curriculum and upskilling and reskilling in new technologies. To date, many medical schools have successfully transitioned their educational environment to emergency remote teaching and assessments. During COVID-19 crisis, the preclinical phase of medical curricula has successfully introduced the novel culture of "online home learning" using technology-oriented innovations, which may extend to post-COVID era to maintain teaching and learning in medical education. However, the lack of hands-on training in the preclinical years may have serious implications on the training of the current cohort of students, and they may struggle later in the clinical years. The use of emergent technology (e.g., artificial intelligence for adaptive learning, virtual simulation, and telehealth) for education is most likely to be indispensable components of the transformative change and post-COVID medical education.

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

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

Challenges and Opportunities of Preclinical Medical Education: COVID-19 Crisis and Beyond

COVID-19 pandemic has disrupted face-to-face teaching in medical schools globally. The use of remote learning as an emergency measure has affected students, faculty, support staff, and administrators. The aim of this narrative review paper is to examine the challenges and opportunities faced by medical schools in implementing remote learning for basic science teaching in response to the COVID-19 crisis. We searched relevant literature in PubMed, Scopus, and Google Scholar using specific keywords, e.g., "COVID-19 pandemic," "preclinical medical education," "online learning," "remote learning," "challenges," and "opportunities." The pandemic has posed several challenges to premedical education (e.g., suspension of face-to-face teaching, lack of cadaveric dissections, and practical/laboratory sessions) but has provided many opportunities as well, such as the incorporation of online learning in the curriculum and upskilling and reskilling in new technologies. To date, many medical schools have successfully transitioned their educational environment to emergency remote teaching and assessments. During COVID-19 crisis, the preclinical phase of medical curricula has successfully introduced the novel culture of "online home learning" using technology-oriented innovations, which may extend to post-COVID era to maintain teaching and learning in medical education. However, the lack of hands-on training in the preclinical years may have serious implications on the training of the current cohort of students, and they may struggle later in the clinical years. The use of emergent technology (e.g., artificial intelligence for adaptive learning, virtual simulation, and telehealth) for education is most likely to be indispensable components of the transformative change and post-COVID medical education.