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Metacognition includes the processes that learners use to plan, monitor, and assess their learning and is tied to academic performance and growth-oriented attitudes toward learning. Learning anatomy presents challenges to learners at all levels, and for many, necessitates a change in learning strategies and metacognitive awareness. We sought to examine whether structured metacognitive training situated in an undergraduate anatomy course could improve these skills. At the beginning and end of the course, students completed the Metacognitive Awareness Inventory (MAI) and several short free response questions. Individually matched pre-and post-course MAI scores were compared using paired-sample t-tests. The authors conducted a directed content analysis for the free response questions using the "knowledge of cognition" (KC) and "regulation of cognition" (RC) domains and their associated subcategories. All three KC subcategories showed statistically significant increases from pre- to post-course questionnaires. Effect sizes were small to moderate. Only two of five RC subcategories showed significant differences between pre- and post-course questionnaires: Information Management strategies and Evaluation. Directed content analysis revealed that students displayed an increase in metacognitive knowledge, particularly in the KC domain. Although RC developed for some learners, others also had insightful comments about challenges in this area-particularly regarding planning, motivation, and focus while learning independently. These results show that metacognitive training in an undergraduate anatomy course can improve students' metacognitive awareness. However, more targeted, specific strategies may be useful to develop students' metacognitive regulation., (© 2024 American Association for Anatomy.)

Anatomy is essential for understanding healthy and disease states as well as for the successful completion of clinical clerkships and board examinations. This project provided structured workshops aimed to review anatomical concepts for clerkships and Step 1 and provided a means for medical students to assess their anatomical knowledge. We provided six optional anatomy workshops, in which students (1) took a pre-session quiz, (2) faculty reviewed key anatomy of a particular system (e.g., musculoskeletal), (3) students worked through clinical cases in small groups, and (4) students took a post-session quiz and responded to a post-session survey to rate satisfaction of session content and delivery on a five-point Likert scale. One session was excluded due to small sample size (n = 2). Results from five workshops, including brachial plexus, musculoskeletal, pelvic, gastrointestinal, and head and neck anatomy, showed that students performed significantly (p ≤ 0.05) better on the post-session quizzes compared to pre-session quizzes in all sessions. Post-session survey results indicated that students were satisfied with session content and facilitation, would attend future workshops, and would use session materials to study for Step 1. Based on these short-term benefits of the sessions, we plan to continue offering monthly workshops to medical students to increase knowledge retention of key anatomical concepts and increase preparedness for clerkships and Step 1. Future studies will longitudinally follow up with students post-Step 1 and clerkships to determine the long-term benefits of offering these workshops., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Peer-assisted learning and group facilitation have been proven to foster active participation in small-group learning, and these effective teaching modalities have been shown to enhance learning outcomes. This study introduced a student peer facilitator role in an anatomy small-group curriculum for pre-clerkship medical students and explored its impact on academic performance and retention. Students were required to rotate through this facilitator role and lead their small group during their designated sessions. Data collection methods included pre-course and post-course surveys, individual quiz grades, and retention quizzes sent 1 month after each quiz. Overall, the data revealed a significant increase in the overall combined quiz averages across the curriculum for facilitators compared to participants despite having no notable increase in preparation time (p = 0.004). While facilitators scored significantly higher on the course quizzes, the slight increase in their average retention quiz scores was not significant. This study was unable to identify any significant benefits to retention for either facilitators or participants. In all, this study suggests that a peer facilitation paradigm can be an effective educational modality for medical students, and future studies should explore ways to improve knowledge retention through this role., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Learning cardiac morphology largely involves spatial abilities and studies indicate benefits from innovative 3D visualization technologies that speed up and increase the learning output. Studies comparing these teaching tools and their educational output are rare and few studies include complex congenital heart defects. This study compared the effects of 3D prints, mixed reality (MR) viewing of 3D meshes and standard cardiac CT slice images on medical students' understanding of complex congenital heart defect morphology, measuring both objective level of understanding and subjective educational experience. The objective of this study was to compare morphological understanding and user experiences of 3D printed models, MR 3D visualization and axial 2D CT slices, in medical students examining morphological details in complex congenital heart defects. Medical students in the median 4th year of study (range 2nd to 6th) examined three of five different complex congenital heart defects by three different modalities: 3D printed model, MR viewed 3D mesh, and cardiac CT slices, answering a questionnaire on morphology and user experience. Time to complete task, diagnostic accuracy, and user experience data were collected and compared on group level. Task times were similar for all modalities. The percentage of correct answers was higher with MR visualization, which was also the preferred modality overall. Medical students both prefer and better understand the morphology of complex congenital heart disease with 3D models viewed using MR, without spending more time than with 3D prints or 2D CT images., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

The topic of vertical integration of the basic and clinical sciences is an area of great concern and active investigation in medical education. To explore the feasibility of integrating basic sciences into the clinical phase of medical education, gross anatomy was selected as an appropriate discipline. Anatomy faculty, clerkship directors, medical students, and graduate students developed case-based anatomy modules with a design consistent with the principles of self-directed learning. This pilot study aimed to explore medical student responses to the integration of anatomy sessions during clinical clerkships. One-hour anatomy sessions were conducted during rotations of the following clerkships: internal medicine, pediatrics, family medicine, neurology, obstetrics and gynecology, and general surgery during the academic year 2022-2023. Each session consisted of four case-based stations. Voluntary, anonymous surveys were distributed at the end of each session. Descriptive statistics of survey responses from the 490 participants revealed the overall ratings of the anatomy sessions to be above an 8.50 on a scale of 1.00 (low) to 9.00 (high). A small q thematic analysis of the open-ended survey questions revealed the following themes: relevance of clinical correlations presented, a timely review of anatomical content, appreciation for the collaborative setting and interactivity among the participants, and constructive feedback regarding areas needing improvement. Students reported a high overall rating of the anatomy sessions and shared positive comments about these vertically integrated anatomy experiences. With a reduction in the amount of anatomy instruction during the pre-clinical years and limited exposure during the clinical years, anatomy sessions like the ones proposed could allow for the fluid incorporation of gross anatomy across all 4 years of medical school., (© 2024 American Association for Anatomy.)

A profound grasp of anatomy is indispensable for shaping competent and safe medical practitioners. This knowledge acquisition is pivotal in the early stages of medical education and remains crucial throughout clinical training. However, the evolving landscape of medical education has ushered in changes to the anatomy curriculum, marked by a reduction in contact hours and a streamlined content structure to accommodate novel subjects and teaching methodologies. This transformation has precipitated a quandary in defining the essential scope and depth of anatomical knowledge to be imparted. Traditionally, surgeons assumed the role of anatomy instructors until Flexner's recommendations catalyzed the integration of trained anatomists. Nevertheless, the varied backgrounds of anatomists and the heterogeneity in anatomy curricula across institutions have introduced potential disparities in the quality of graduates. Addressing these challenges mandates the identification of key anatomy competencies tailored for undergraduate medical students. The imperative lies in ensuring that these competencies span cognitive, psychomotor, and affective domains, offering not only comprehensiveness but also direct applicability to clinical practice. Hence, this viewpoint highlights the necessity of adopting a systematic approach that includes gathering input from various stakeholders in developing and implementing a universal anatomy core competency framework, ensuring graduates are equipped for the multifaceted demands of clinical practice. Overall, the manuscript provides a comprehensive overview of the challenges and opportunities in anatomy education, with a clear call to action for a transformative approach to meet the evolving needs of medical practice., (© 2024 American Association for Anatomy.)

Australia and Aotearoa New Zealand (AANZ) medical schools have been impacted by curricular changes and the introduction of virtual microscopy (VM). No survey has explicitly described the outcome of these events on histology education in AANZ. This study provides a cross-sectional overview of histology education in accredited medical schools across AANZ in 2022-2023. Responses were received from 83% (19/23) of Australian medical schools, and 50% (1/2) of medical schools in Aotearoa New Zealand. VM, either exclusively (42%) or combined with traditional microscopy (37%), emerged as the preferred mode for delivering histology education. Common instructional methods included face-to-face lectures (26%) and synchronous online live lectures (26%). A significant proportion (84%) of educators supplemented resources with virtual microscopy websites. Integration of histology education was prevalent (79%), primarily with pathology (32%) or gross anatomy (26%). On average, medical students in the region spent a maximum of 21 ± 17 h in face-to-face histology laboratories throughout their degree. Histology education was predominantly taught by academics with a PhD degree. This study also examined the similarities and differences in histology education between AANZ and the global landscape. Through this examination, the present study positions AANZ within the broader context of histology education worldwide discusses key factors impacting histology education, and advocates for action to mitigate a looming shortage of pathologists in AANZ. In light of these findings, AANZ medical schools should integrate histology and pathology, establish a core curriculum, and promote flexible teaching modalities., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Anatomy is the cornerstone of medical education. Virtual reality (VR) and augmented reality (AR) technologies are becoming increasingly popular in the development of anatomy education. Various studies have evaluated VR and AR in anatomy education. This meta-analysis aims to evaluate the effectiveness of VR and AR in anatomical education. The protocol was registered in Prospero. Scopus, PubMed, Web of Science, and Cochrane Library databases were searched. From the 4487 articles gathered, 24 randomized controlled trials were finally selected according to inclusion criteria. According to the results of the meta-analysis, VR had a moderate and significant effect on the improvement of knowledge scores in comparison with other methods (standardized mean difference = 0.58; 95% CI = 0.22, 0.95; p < 0.01). Due to the high degree of heterogeneity (I 2  = 87.44%), subgroup analyses and meta-regression were performed on eight variables. In enhancing the "attitude," VR was found to be more "useful" than other methods (p = 0.01); however, no significant difference was found for "enjoyable" and "easy to use" statements. Compared with other methods, the effect of AR on knowledge scores was non-significant (SMD = -0.02; 95% CI = -0.39, 0.34; p = 0.90); also, in subgroup analyses and meta-regression, the results were non-significant. The results indicate that, unlike AR, VR could be used as an effective tool for teaching anatomy in medical education. Given the observed heterogeneity across the included studies, further research is warranted to identify those variables that may impact the efficacy of VR and AR in anatomy education., (© 2024 American Association for Anatomy.)

Case-based learning (CBL) is a student-centered pedagogy where medical students are given a real-world clinical problem. At St George's University of London (SGUL), anatomy academics can volunteer to facilitate CBL sessions for pre-clinical undergraduate medical students. The major benefits of facilitating CBL sessions from the perspective of a non-medically qualified early career anatomy academic (ECAA) include exposure to clinical cases that help the academic develop an understanding over key clinical cases at the context of clinical anatomy and other disciplines including physiology, pathology, and pharmacology. Furthermore, facilitating CBL sessions assists in the acquisition of basic knowledge over history taking, the conduction of clinical examinations, the investigations performed for the diagnosis of a condition as well as how it is managed. The major benefits of facilitating CBL sessions from the perspective of a medically qualified ECAA include staying in touch with the clinical aspect of medicine and becoming familiar with the country's healthcare system and its professional standards. Perceived benefits shared by both the non-medically and medically qualified ECAA include the opportunity to become familiar with the structure and key elements of the pre-clinical medical curriculum as well as gain experience in facilitating small group teaching sessions. Overall, facilitating CBL sessions can help non-medically and medically qualified ECAAs in different contexts that may help them with their individual career goals, can encourage collaborative discussions between clinical and non-clinical anatomy academics as well as help bridge the gap between the anatomy teaching approaches employed by non-medically qualified and medically qualified anatomy academics., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Experts perceive and evaluate domain-specific visual information with high accuracy. In doing so, they exhibit eye movements referred to as "expert gaze" to rapidly focus on task-relevant areas. Using eye tracking, it is possible to record these implicit gaze patterns and present them to histology novice learners during training. This article presents a comprehensive evaluation of such expert gaze cueing on pattern recognition of medical students in histology. For this purpose, 53 students were randomized into two groups over eight histology sessions. The control group was presented with an instructional histology video featuring voice commentary. The gaze cueing group was presented the same video, but with an additional overlay of a live recording of the expert's eye movements. Afterward, students' pattern recognition was assessed through 20 image-based tasks (5 retention, 15 transfer) and their cognitive load with the Paas scale. Results showed that gaze cueing significantly outperformed the control group (p = 0.007; d = 0.40). This effect was evident for both, retention (p = 0.003) and transfer tasks (p = 0.046), and generalized across different histological contexts. The cognitive load was similar in both groups. In conclusion, gaze cueing helps histology novice learners to develop their pattern recognition skills, offering a promising method for histology education. Histology educators could benefit from this instructional strategy to provide new forms of attentional guidance to learners in visually complex learning environments., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Gross anatomy is a crucial course in medical school; it sets the foundation for future coursework and is highly valued by clinicians. While both medical students and faculty recognize the importance of pre-medical school anatomy experience, few medical schools require it as a prerequisite. Consequently, medical school gross anatomy courses have a diverse range of prior anatomy experience among students. Prior studies have shown mixed results regarding the impact of pre-medical school anatomy experience on medical school gross anatomy performance, often using final exam scores as the metric of analysis. In this study, we investigated the relationship between pre-medical school anatomy experience and medical school gross anatomy performance among students at New York Institute of Technology, College of Osteopathic Medicine. We surveyed students from all four matriculated years and analyzed their individual anatomy laboratory exam scores and final anatomy laboratory course scores. We found that students with prior anatomy experience performed significantly better on the first anatomy laboratory exam, leading to an overall positive effect on their final anatomy laboratory score. However, this advantage seemed to diminish in subsequent exams, suggesting that students without prior experience rapidly adjusted to the course challenges. Students with prior anatomy experience felt more prepared for the anatomy course, reported lower stress levels, and believed they had an advantage over peers without prior experience. Our study highlights the importance of pre-medical school anatomy experience, particularly for early performance in the anatomy course., (© 2024 American Association for Anatomy.)

In modern medical curricula, embryology is typically taught through lectures, with a few institutions providing tutorials. The use of 3-D videos or animations enables students to study these embryological structures and how they change with time. The aim of this study was to assess the quality of cardiac embryology videos available on YouTube. A systematic literature review regarding the use of YouTube in teaching or learning cardiac embryology identified no papers that examined this specific question, and next, a systematic search of YouTube was performed. A total of 1200 cardiac embryology videos were retrieved using 12 specific search terms, with 370 videos retrieved under two or more search terms and excluded. A further 511 videos were excluded under additional, specific criteria. The remaining 319 videos were evaluated with the YouTube Video Assessment Criteria (UTvAC), with 121 rated as "useful." Videos on YouTube are uploaded with a wide audience in mind, from children to cardiologists, and content control is imperfect. Multiple videos were identified as duplicates of videos from original channels, typically without attribution. While 49 videos showed operations or human material, none contained an ethical statement regarding consent, and only 10 of these included an age restriction or graphical advisory. While there are useful videos for medical students studying cardiac embryology on YouTube, intuitive search strategies will also identify many with irrelevant content and of variable quality. Digital competence and search strategies are not innate skills, so educators should teach students to assess information so as to avoid overload or "filter failure.", (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Embryology is an essential component to understanding human anatomy. It requires an in-depth understanding of 3D knowledge but is primarily taught with 2-dimensional resources. In particular, the development of the human heart is a complex process and difficult to understand using traditional teaching methods. We present here a series of heart embryology models created to supplement embryology education and aid students in understanding this complex process. Using Polydoh moldable plastic, models representing six different critical steps in heart formation are described, including: the fusing of the heart tubes (days 21-23), beginning of the cardiac loop (early day 23), fully formed cardiac loop (late day 23), four-week heart, formation of the endocardial cushions and septi (late fourth week), and heart with fully formed septi with functioning foramen ovale (sixth week). These models not only improve embryology education but also the understanding of heart pathologies. This method provides an affordable option for embryology education and provides students with learning tools that assist with the comprehension of the development of a complex organ., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Due to its haptic and interactive nature, virtual anatomy provides an opportunity for small-group learning, enabling students to develop their group work skills before they graduate. However, there is currently little practical guidance supported by pedagogic principles detailing how to incorporate it into curricula. Anatomy educators at the University of Plymouth conducted action research aiming to capture students' overall perceptions of the virtual anatomy platform Anatomage. Questioning the benefits and challenges students face while interacting with Anatomage prompted the creation of evidence-based interventions to be later evaluated. Although a plethora of themes were identified, this report specifically examines those relating to group work. Thematic analysis of initial focus group data found group size and group dynamics impacted students' experience with the platform. Following the implementation of interventions to resolve these issues, a questionnaire and second series of focus groups were conducted to determine whether they were successful. Additional subthemes found from these data included facilitation, social pressure, peer learning and working with friends. This study contributed to the improvement of small group learning and integration of virtual anatomy into curricula based on student and staff feedback. As such, these data support the development of effective group working skills which are fundamental for healthcare professionals and widely recognized by regulators such as the General Medical Council and Health and Care Professions Council. In this report, the authors provide practical advice informed by pedagogy and principles from management and psychology to provide a multidisciplinary perspective., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Understanding the fundamental role anatomy education plays in medical training and taking into consideration the nascence of online education in Nigeria, this study evaluated the perceptions of medical and allied-health students toward online anatomy education both during the COVID-19 lockdown in Nigeria and for the future. For this study, Google Form questionnaires were distributed via different social and academic platforms to medical and allied-health students in Nigeria between September 28 and December 17, 2020. A total of 954 students participated in the study and 947 valid responses were recorded. The results showed that 77.6% of the students had reported computer/IT skills and 12.1% admitted that they had never attended an online class. Interestingly, 60% of the respondents disapproved of online learning approaches as effective tools for instructions in the anatomical sciences. Majority of the students (84%) agreed that their performance in anatomy would have been better if the classes were face-to-face, while 55% found the online anatomy classes uninteresting. Furthermore, 91.5% agreed that anatomy educators needed advanced skills for online education, while 94.2% agreed that anatomy online teaching needs more advanced technology to be implemented in Nigeria. This study revealed an overall negative perception about the suitability and effectiveness of online anatomy education in Nigerian medical/health training. This study recommends further investigations into the challenges that were presented during online anatomy education at the peak of the pandemic. This will help direct the development and implementation of a workable and sustainable online education model for anatomical sciences in Nigeria., (© 2024 American Association for Anatomy.)

Human dissections in the current medical curriculum are conducted using a checklist approach to prioritize the exposure of anatomical structures. In this setting, anatomy educators are labored to enhance their engagement during the dissection. To address this issue, we considered the current medical education pedagogies and identified a novel approach of studio-based learning (SBL) for application in a Human Dissection Workshop. This study aimed to (1) evaluate students' perceptions of SBL, (2) appraise the impact of SBL on anatomical knowledge learning, and (3) interpret the results of a validated questionnaire. Workshop participants were recruited from Year 2 medical students at the Chinese University of Hong Kong from the 2020 and 2021 cohorts. Fifty-one students participated in the workshop (N = 24 [2020], N = 27 [2021]), and 50 of them completed the postworkshop questionnaire rated on a 5-point Likert scale. Nineteen items were validated using a factor analysis. The interpretation of the questionnaire results demonstrated the different learning outcomes of the workshop, which included (1) enhancing students' knowledge and spatial understanding of anatomical structures, (2) strengthening students' appreciation of gross pathologies and clinical relevance, and (3) promoting higher-order thinking skills. To our knowledge, this is the first study to introduce SBL in medical education. The successful implementation of the workshop reflects the promising potential of SBL for enhancing human dissection and supplementing the medical curriculum., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

This study assesses the acceptability, appropriateness, feasibility, and efficacy of a novel asynchronous video-based intervention for teaching respiratory physiology and anatomy to medical students in resource-limited settings. A series of short video lectures on pleural anatomy, pulmonary physiology, and pathophysiology was created using Lightboard and screen capture technology. These were uploaded to YouTube and Google Drive and made available to 1st-3rd year medical students at two Latin American universities for 1 week. Employing a parallel-convergent mixed methods design, we conducted surveys, focus groups, interviews, and pre/post testing for qualitative and quantitative data. Thematic Analysis was used to analyze qualitative data and McNemar's test for quantitative analysis. Seventy-six students participated. The videos' short format, interactivity, and Lightboard style were highly valued for their flexibility, time efficiency, and educational impact. Students recognized their clinical relevance and trusted their content, suggesting potential applicability in similar settings. Despite infrastructure and connectivity challenges, the use of flexible streaming and downloadable options facilitated learning. Survey results indicated high levels of feasibility (99%), appropriateness (95%), and acceptability (95%), with significant knowledge gains observed (37% correct pre-test answers vs. 56% post-test, p < 0.0001). Our findings demonstrate high acceptability, appropriateness, feasibility, and efficacy of a targeted asynchronous education centered on short-format videos in resource-limited settings, enabling robust learning despite local barriers. Flexible access is key for overcoming localized barriers. Taking an adaptive, learner-centered approach to content creation and delivery to address constraints was pivotal to success. Our modular videos could serve as versatile models for flexible education in resource-constrained settings., (© 2024 American Association for Anatomy.)

Traditional academic lectures have long been criticized as providing a passive learning environment to students. Often, they do not capture the audience's attention, resulting in learners being distracted or bored and thereby reducing their learning efficacy. Consequently, they are being abandoned by many schools and universities as an educational modus or modified into more learner-centered experiences. This descriptive article outlines a strategy of inserting active learning PowerPoint slides into traditional histology lectures. Suggestions and advice for adding or improving existing active learning slides are being offered to readers, who are planning to modify their own lecture presentations. The author's experience of using this formative assessment strategy with different types of histology learners is also discussed., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Teaching human histology is part of understanding the tissues of the human body and, therefore, it is part of the training curriculum of all health courses. The increase in technologies and active teaching methodologies has a positive impact on student learning, as it reduces the challenges present in the subject. Therefore, this work aimed to compare the performance of students in the histology discipline, when compared to traditional teaching methodology and its association with game-based learning and a basic histology teaching platform. Three classes of the medical course were selected between the years 2022 and 2023, each of which was separated into a group. One group did not have access to any platform, being called the Traditional Group (TG), a group that used Kahoot!, being called the Kahoot Group (KG), and a group that used the teaching platform, being called the Histoatlas Group (HG). Both KG and HG groups showed greater effectiveness in learning and improved performance, when compared to TG. These improvements in KG and HG were also highlighted as learning aids and easy to use. KG students performed better in the practical test when comparing groups. However, this difference was not observed in the students' averages. However, students pointed out the relevance of trying to improve the traditional teaching methodology. Therefore, this study points out that, even though the traditional teaching methodology is efficient in the student's teaching and learning process, there is a need on the part of students to make the subject more dynamic., (© 2024 American Association for Anatomy.)

Reduced hours of instruction are reported within the gross anatomy education literature. Anatomy instruction continues to be challenged with motivating and inspiring learners to value the contribution of gross anatomy knowledge to their career development alongside increased organizational demands for efficiency and effectiveness. To address these demands, this retrospective study sought to understand how the relative timing and amount of gross anatomy instruction were related to examination performance. Undergraduate and graduate students between 2018 and 2022 were assigned to three cohorts determined by enrollment in prosection-based anatomy only (n = 334), concurrent enrollment in prosection- and dissection-based anatomy in the same semester (n = 67), or consecutive enrollment in the courses one year apart (n = 43). Concurrent students had higher prosection-based anatomy examination scores than prosection-only and consecutive students. Consecutively, enrolled students outperformed concurrently enrolled students on the first two dissection examinations but showed no performance differences on the third and fourth dissection examinations. While the results on the timing and presentation of anatomical instruction were inconclusive, the results do support increased instructional time using both prosection and dissection modalities concurrently to improve performance on identification-based gross anatomy examinations., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Undergraduate introductory human anatomy and human physiology courses are either taught as discipline-specific or integrated anatomy and physiology (A&P) sequences. An institution underwent a curricular revision to change the course approach from discipline-specific Human Anatomy and Human Physiology to an integrated A&P I and II sequence, allowing the unique opportunity to explore the potential role of contextual learning in academic achievement and content retention. Mediation and moderation analysis was used to evaluate lecture examinations, laboratory practical examinations, and anatomical content retention between the different course approaches. Undergraduate students in the integrated A&P I course approach performed significantly better on lecture assessments and had a higher anatomy content retention rate at the end of the year than students enrolled in the standalone Human Anatomy course. The lecture examination averages between Human Physiology and A&P II (the second course in the sequence), as well as the anatomy laboratory practical examinations, were not significantly different between discipline-specific and integrated course approaches. The results suggest contextual learning-providing physiological context to anatomical structures-increases the anatomical content retention and academic achievement overall., (© 2024 American Association for Anatomy.)

Supplemental instruction (SI) confers student success, as represented by grades, knowledge retention, and student engagement. However, studies often report professional, not undergraduate, program findings. To measure these effects, students studying human anatomy at a university in Ontario, Canada, attended structured (peer-assisted) or unstructured (nonpeer-assisted) SI sessions and completed a pre-/post-survey. Fifty-eight learners (39 systems (SYS) and 19 musculoskeletal (MSK) anatomy) completed both surveys and had responses analyzed. Both cohorts, maintained initial perceptions across pre-/post-analyses (MSK p = 0.1376 and SYS p = 0.3521). Resource usage was similar across both cohorts with discrepancies in skeletal model and textbook use. No MSK learner ranked any lab resources as "not at all useful." MSK learners felt more prepared to write a graded assessment (p = 0.0269), whereas SYS learners did not (p = 0.0680). Stratification of learners in MSK and SYS revealed learners spending between 30 and 60 min in SI sessions during the study period had the highest grades compared to students who spent less than 30 (p = 0.0286) or more than 60 (p = 0.0286) min attending SI sessions, respectively. Most learners in MSK (89.4%) and SYS (66%) concluded that they preferred structured over unstructured SI. Sentiment/thematic analysis using a generative AI-driven large language model revealed learners held positive perceptions of SI, emphasizing structured learning, resources, personalized learning, and support offered as the most prevalent themes surrounding SI. Ultimately, this study provides evidence that supports SI for improving student outcomes related to perceived preparedness for completing assessments and preferred teaching/learning styles in undergraduate human anatomy., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Fidelity between teaching activities and assessment methods is an important goal of knowledge and performance evaluations in medical education. Ideally, assessment methods provide evidence of learning that reflects the types of knowledge described in the learning objectives of the course. The most reliable assessments involve the same or similar tasks as those used during the instructional components of the course. Our preclinical human anatomy course includes, in addition to traditional lecture and cadaver-based laboratory learning activities, a series of applied human anatomy learning activities intended to emphasize human anatomy as it is encountered in living human individuals. The learning activities involve psychomotor behaviors including inspection, palpation, and auscultation, techniques used in the physical examination, as well as other activities designed to emphasize anatomical structures and tissues as they may be found in patient populations. We describe here our method for measuring student success in learning human anatomy in this manner, highlighting the direct linkage between the learning activities and the assessment tasks. We describe our performance scoring method and how we include this data in the calculation of an anatomy examination grade. As an indicator of our success with this approach, we include performance scores for the applied anatomy questions included on the laboratory component of our unit examinations for two successive academic years. We conclude with summary comments from students regarding the applied anatomy learning activities and assessment approach and offer suggestions for addressing specific challenges associated with the use of these types of assessment methods., (© 2024 American Association for Anatomy.)

Many medical schools in the United States have integrated anatomy into an organ-based preclinical curriculum with some schools using anatomy as the cornerstone of their reorganization efforts. Curricular change could affect one or more of the three domains of learning, with the cognitive domain often scrutinized exclusively. A previous study reported the impact of anatomy integration on the affective domain, specifically, student attitudes toward learning anatomy. This mixed methods follow-up study asked if the observed attitudinal changes and lack of effect on student knowledge and confidence persisted using knowledge and confidence surveys, focus groups, internal and national surveys, and United States Medical Licensing Examination ® performance metrics. Results evidenced the persistence of specific attitudinal differences between cohorts with blocked versus integrated anatomy with no apparent short- or long-term differences in anatomy learning or confidence in this learning. Altered attitudes included lower value placed on working in teams and reflective practices, and less recognition of anatomy's contribution (or less contribution of anatomy learning) to professional identity formation. These attitudinal changes could result in a weaker foundation for building collaborative skills throughout the medical curriculum. A decreased sense of student engagement also followed curricular change, as assessed by data from the American Association of Medical Colleges Year 2 Questionnaire. Overall, results emphasized the necessity of anticipating, monitoring, and if necessary, addressing changes in the affective domain when undertaking curricular change., (© 2024 American Association for Anatomy.)

An Objective Structured Practical Examination (OSPE) is an effective and robust, but resource-intensive, means of evaluating anatomical knowledge. Since most OSPEs employ short answer or fill-in-the-blank style questions, the format requires many people familiar with the content to mark the examinations. However, the increasing prevalence of online delivery for anatomy and physiology courses could result in students losing the OSPE practice that they would receive in face-to-face learning sessions. The purpose of this study was to test the accuracy of Decision Trees (DTs) in marking OSPE questions as a first step to creating an intelligent, online OSPE tutoring system. The study used the results of the winter 2020 semester final OSPE from McMaster University's anatomy and physiology course in the Faculty of Health Sciences (HTHSCI 2FF3/2LL3/1D06) as the data set. Ninety percent of the data set was used in a 10-fold validation algorithm to train a DT for each of the 54 questions. Each DT was comprised of unique words that appeared in correct, student-written answers. The remaining 10% of the data set was marked by the generated DTs. When the answers marked by the DT were compared to the answers marked by staff and faculty, the DT achieved an average accuracy of 94.49% across all 54 questions. This suggests that machine learning algorithms such as DTs are a highly effective option for OSPE grading and are suitable for the development of an intelligent, online OSPE tutoring system., (© 2023 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Anatomical drawing traditionally involves illustration of labeled diagrams on two-dimensional surfaces to represent topographical features. Despite the visual nature of anatomy, many learners perceive that they lack drawing skills and do not engage in art-based learning. Recent advances in the capabilities of technology-enhanced learning have enabled the rapid and inexpensive production of three-dimensional anatomical models. This work describes a "drawing on model" activity in which learners observe and draw specific structures onto three-dimensional models. Sport and exercise sciences (SES, n = 79) and medical (MED, n = 156) students at a United Kingdom medical school completed this activity using heart and femur models, respectively. Learner demographics, their perceptions of anatomy learning approaches, the value of the activity, and their confidence in understanding anatomical features, were obtained via validated questionnaire. Responses to 7-point Likert-type and free-text items were analyzed by descriptive statistics and semi-quantitative content analysis. Learners valued art-based study (SES mean = 5.94 SD ±0.98; MED = 5.92 ± 1.05) and the "drawing on model" activity (SES = 6.33 ± 0.93; MED = 6.21 ± 0.94) and reported enhanced confidence in understanding of cardiac anatomy (5.61 ± 1.11), coronary arteries (6.03 ± 0.83), femur osteology (6.07 ± 1.07), and hip joint muscle actions (5.80 ± 1.20). Perceptions of learners were independent of both their sex and their art-based study preferences (p < 0.05). Themes constructed from free-text responses identified "interactivity," "topography," "transformative," and "visualization," as key elements of the approach, in addition to revealing some limitations. This work will have implications for anatomy educators seeking to engage learners in an inclusive, interactive, and effective learning activity for supporting three-dimensional anatomical understanding., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Gross anatomy laboratories frequently utilize dissection or prosection formats within medical curricula. Practical examination scores are consistent across the formats, yet these examinations assessed larger anatomical structures. In contrast, a single report noted improved scores when prosection was used in the hand and foot regions, areas that are more difficult to dissect. The incorporation of prosected donors within "Head and Neck" laboratories provided an opportunity to further characterize the impact of prosection in a structurally complex area. Retrospective analysis of 21 Head and Neck practical examination questions was completed to compare scores among cohorts that utilized dissection exclusively or incorporated prosection. Mean scores of practical examination questions were significantly higher in the prosection cohort (84.27% ± 12.69) as compared with the dissection cohort (75.59% ± 12.27) (p < 0.001). Of the 12 questions that performed better in the prosection cohort (88.42% ± 8.21), 10 items mapped to deeper anatomical regions. By comparison, eight of nine questions in the dissection cohort outperformed (88.44% ± 3.34) the prosection cohort (71.74% ± 18.11), and mapped to anatomically superficial regions. Despite the mean score increase with positional location of the questions, this effect was not statically significant across cohorts (p = 1.000), suggesting that structure accessibility in anatomically complex regions impacts performance. Student feedback cited structure preservation (71.5%) and time savings (55.8%) as advantages to prosection; however, dissection was the perceived superior and preferred laboratory format (88.6%). These data support combined prosection and dissection formats for improving student recognition of deeply positioned structures and maximizing student success., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Anatomical education is pivotal for medical students, and innovative technologies like augmented reality (AR) are transforming the field. This study aimed to enhance the interactive features of the AEducAR prototype, an AR tool developed by the University of Bologna, and explore its impact on human anatomy learning process in 130 second-year medical students at the International School of Medicine and Surgery of the University of Bologna. An interdisciplinary team of anatomists, maxillofacial surgeons, biomedical engineers, and educational scientists collaborated to ensure a comprehensive understanding of the study's objectives. Students used the updated version of AEducAR, named AEducAR 2.0, to study three anatomical topics, specifically the orbit zone, facial bones, and mimic muscles. AEducAR 2.0 offered two learning activities: one explorative and one interactive. Following each activity, students took a test to assess learning outcomes. Students also completed an anonymous questionnaire to provide background information and offer their perceptions of the activity. Additionally, 10 students participated in interviews for further insights. The results demonstrated that AEducAR 2.0 effectively facilitated learning and students' engagement. Students totalized high scores in both quizzes and declared to have appreciated the interactive features that were implemented. Moreover, interviews shed light on the interesting topic of blended learning. In particular, the present study suggests that incorporating AR into medical education alongside traditional methods might prove advantageous for students' academic and future professional endeavors. In this light, this study contributes to the growing research emphasizing the potential role of AR in shaping the future of medical education., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Recently, there has been an emphasis on keeping the study of anatomy using donor material confined to the domain of medical and allied healthcare professionals. Given the abundance of both accurate and inaccurate information online, coupled with a heightened focus on health following the COVID-19 pandemic, one may question whether it is time to review who can access learning anatomy using donors. In 2019, Brighton and Sussex Medical School (BSMS) obtained a Human Tissue Authority Public Display license with the aim of broadening the reach of who could be taught using donor material. In 2020, BSMS received its first full-body donor with consent for public display. Twelve workshops were delivered to student groups who do not normally have the opportunity to learn in the anatomy laboratory. Survey responses (10.9% response rate) highlighted that despite being anxious about seeing inside a deceased body, 95% felt more informed about the body. A documentary "My Dead Body" was filmed, focusing on the rare cancer of the donor Toni Crews. Viewing figures of 1.5 million, and a considerable number of social media comments highlighted the public's interest in the documentary. Thematic analysis of digital and social media content highlighted admiration and gratitude for Toni, the value of education, and that while the documentary was uncomfortable to watch, it had value in reminding viewers of life, their bodies, and their purpose. Fully consented public display can create opportunities to promote health-conscious life choices and improve understanding of the human body., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Plastination, a permanent preservation method for human tissues and organs, is increasingly being used in anatomy education. However, there is a paucity of systematic reviews and meta-analyses summarizing the educational efficacy of plastinated specimens. This meta-analysis compared the assessment scores of students exposed to plastinated specimens against those exposed to other common instructional methods. A systematic search was conducted through four databases, from 2000 to July 2022. Titles and abstracts of the retrieved records were screened according to predetermined eligibility criteria. Of the 159 records screened, 18 were subjected to full-text review. Among the 18 studies, five articles reported post-intervention test scores for intervention (plastinated) and control (other modalities) groups. Studies were subjected to GRADE quality assessment, and four studies with moderate to high ratings were included for meta-analysis. Students' perceptions (n = 15 studies) were qualitatively analyzed using an inductive narrative analysis. No significant effect was detected between the intervention (n = 417) and control groups (n = 422) (standardized mean difference = 0.08; 95% CI [-0.36, 0.52]; p = 0.73). Four themes emerged from students' perceptions: ease of use, motivation to study, spatial understanding, and learning preference. Overall, student performance outcomes comparing the use of plastinated specimens versus other instructional modalities are very limited. This meta-analysis suggests that knowledge gained from plastinated specimens is comparable to learning achieved through other modalities; though this outcome should be interpreted with caution as there is currently insufficient evidence for definitive conclusions., (© 2024 American Association for Anatomy.)

While traditional anatomy education often emphasizes passive learning and rote memorization, it seldom employs constructivist theories that focus on active, hands-on experiences for effective learning. This study tests the hypothesis that tactile experiences with modeling clay enhance geometric mental representation more effectively than verbal descriptions. We examine the potential of clay modeling to reflect and evaluate students' mental representation of anatomical structures. Utilizing a prospective randomized, open, blind endpoint (PROBE) design, we engaged 36 participants divided into three groups: blind, visually impaired, and a control group. The primary outcome measure was the difference between post-touch score and pre-touch score, which gauged the efficacy of tactile intervention in enhancing the participants' capacity to mentally reconstruct a well-designed anatomical fiction structure. Scoring was executed using a double-blind double-evaluation methodology, positioning clay model reconstruction as both an objective reliable assessment and a pedagogical tool. The analysis demonstrated a pronounced improvement in mental representation of anatomical structures, particularly in spatial comprehension and detailed textural discernment, with the mean score soaring from 47.81 pre-touch to 85.09 post-touch. Distinct cognitive processing adaptations were evident across groups, with the blind group excelling in tactile acuity and the visually impaired group showing the most significant gains in spatial understanding post-intervention (Cohen's d = 2.74). The application of modeling clay as a tactile intervention tool can significantly improve the learning of anatomy among medical students. The study underscores the value of active, multisensory engagement and customized teaching strategies for effective anatomy education among this demographic., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

In recent years, there has been a growing recognition of the importance of integrating ultrasound into undergraduate medical curricula. However, empirical evidence is lacking as to its effect on anatomy learning and related student cognition. Therefore, the present study compared the impact of echocardiography-based instruction with narrated videos on students' understanding of anatomical relationships, as well as the interaction with students' autonomous motivation, self-efficacy beliefs, mental load, and attitudes. Second-year medical students were given the opportunity to enroll in a supplementary booster course about cardiac anatomy. On the base of a randomized controlled trial with a cross-over design, we studied the effect of taking this course on spatial anatomical knowledge. After completing a pre-test (T0), students were allocated randomly to either the echocardiography-based teaching condition (cohort A) or the narrated anatomy video condition (cohort B). Next, participants were crossed over to the alternative intervention. Immediately after each phase in the intervention, students were asked to rate their mental load. Additionally, a spatial anatomical knowledge test, an autonomous motivation scale, and a self-efficacy scale were administered before (T0) and after the first intervention (T1) and at the end of the study (T2). Finally, each student completed a perception-based survey. The study design allowed a comparative evaluation of both interventions at T1, while the cross-over design facilitated the assessment of the most optimal sequencing in the interventions at T2. A total of 206 students participated (cohort A: n = 99, cohort B: n = 107). At T1, no significant differences in the knowledge test and the autonomous motivation scale were observed between cohorts A and B. However, cohort A showed higher self-efficacy beliefs compared to cohort B (p = 0.043). Moreover, cohort A reported higher levels of perceived mental load (p < 0.001). At T2, the results showed that neither sequence of interventions resulted in significant differences in anatomy scores, autonomous motivation, or self-efficacy. However, a significant difference in mental load was found again, with students in cohort B reporting a higher level of mental load (p < 0.001). Finally, based on the perception-based survey, students reported favorably on the echocardiography experience. In conclusion, the hands-on echocardiography sessions were highly appreciated by the medical students. After participating in the ultrasound sessions, they reported higher levels of self-efficacy beliefs compared to the video-based condition. However, despite embodied cognition principles, students in the echocardiography condition did not outperform students in the narrated anatomy video condition. The reported levels of mental load in the ultrasound condition could explain these findings., (© 2024 American Association for Anatomy.)

The study of organism structural composition, known as anatomy, is essential in comprehending the intricate arrangements of life and plays a crucial role in medical education and practice. It bridges foundational and clinical disciplines, shaping medical education, and practice. With evolving technology, medical education faces new challenges necessitating pedagogical innovations. This article explores the changing landscape of anatomical education, encompassing teaching methods, and curricular shifts. Advancements in information technology and bibliometrics shed light on anatomy's evolution, yet research on anatomy teaching reform (ATR) remains scarce. This study employs advanced analytical tools like CiteSpace and VOSviewer to uncover research hotspots and frontiers in ATR. By scrutinizing focal points and emerging directions in ATR, this research provides insights into the future of pedagogical strategies and clinical research in anatomy., (© 2024 American Association for Anatomy.)

Three-dimensional (3D) modeling is a recent, innovative approach to teaching anatomy. There is little literature, however, to suggest how 3D modeling is best used to teach students and whether or not students can gain the same level of understanding as they might use more traditional, hands-on, teaching methods. This study evaluated the use of a 3D modeling software in both a flipped classroom curriculum and as an active learning tool in comparison to traditional, physical model-based teaching. Pre- and post-course content-based assessments were used to evaluate students' learning. Our findings indicated no significant difference between standard and flipped classroom learning; however, the students who used 3D modeling software as an active learning tool significantly underperformed students in the standard group (F(2,1060) = 112.43, p < 0.0001). These findings suggest that these technologies may not yet be useful as a primary means of instruction. Possible explanations may include cognitive overload in navigating the system, intrinsic limitations of the software, or other factors. Further development and research of these technologies is necessary prior to their adoption into teaching practices in anatomy., (© 2024 American Association for Anatomy.)

Recent controversies over the mismanagement of body donors in US medical schools have raised public concerns over the ethical treatment of bodies in "anatomical gift" programs. Despite widespread moral outrage at such cases, medical students may still make seemingly inconsequential mistakes or jokes that in fact constitute acts of disrespect. This may partially be attributed to the process of desensitization in working with human remains, and indicates a further need to inculcate into medical students the ethical responsibilities of working with body donors. Donation agreement statements that lack specific information about the respectful treatment of bodies in the anatomy laboratory may serve as an additional point of concern for potential donors seeking reassurance about the future treatment of their bodies. This viewpoint draws from the anecdotal experiences of medical students to portray two scenarios of medical students' disrespectful conduct toward body donors, and constructs an account of moral respect for human remains based on respect for posthumous autonomy and respect in attitude. It then provides suggestions for US medical schools to incorporate this ethical framework into their anatomy curricula to instill respectful dispositions in its students and facilitate a more robust informed consent process for potential donors who entrust their bodies to medical students., (© 2023 American Association for Anatomy.)

Neuroanatomy is a notoriously challenging subject for medical students to learn. Due to the coronavirus disease-19 (COVID-19) pandemic, anatomical education transitioned to an online format. We assessed student performance in, and attitudes toward, an online neuroanatomy assessment compared to an in-person equivalent, as a marker of the efficacy of remote neuroanatomy education. Participants in the National Undergraduate Neuroanatomy Competition (NUNC) 2021 undertook two online examinations: a neuroanatomically themed multiple-choice question paper and anatomy spotter. Students completed pre- and post-examination questionnaires to gauge their attitudes toward the online competition and prior experience of online anatomical teaching/assessment. To evaluate performance, we compared scores of students who sat the online (2021) and in-person (2017) examinations, using 12 identical neuroradiology questions present in both years. Forty-six percent of NUNC 2021 participants had taken an online anatomy examination in the previous 12 months, but this did not impact examination performance significantly (p > 0.05). There was no significant difference in examination scores between in-person and online examinations using the 12 neuroradiology questions (p = 0.69). Fifty percent of participants found the online format less enjoyable, with 63% citing significantly fewer networking opportunities. The online competition was less stressful for 55% of participants. This study provides some evidence to suggest that student performance is not affected when undertaking online examinations and proposes that online neuroanatomy teaching methods, particularly for neuroradiology, may be equally as effective as in-person approaches within this context. Participants perceived online examinations as less stressful but raised concerns surrounding the networking potential and enjoyment of online events., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

As a result of the COVID-19 pandemic, anatomy education was forced to adopt online modes of delivery. Previous research on student views revealed areas of strong preference (asynchronous lectures) and strong dislike (virtual specimens) in online anatomy courses. The current study seeks to compare the views of a single cohort of students experiencing both online and in-person undergraduate introductory anatomy and physiology courses. This comparison can highlight what students consider beneficial to their education and can inform future hybrid course offerings. Q-methodology was used to assess the opinions of students. Students sorted 41 statements on anatomy education in a quasi-normally distributed grid based on their degree of agreement with the statements. The rankings underwent a by-person factor analysis which categorized students with shared perceptions into groups. Data were collected from 246 students in the primarily online fall semester and 191 students in the primarily in-person winter semester. Analysis revealed three distinct factors (groups) in the cohort. Factor one (n = 113 (fall), n = 93 (winter)), was satisfied overall with the course materials and delivery. Factor two (n = 52 (fall), n = 18 (winter)) had a deep dislike of online learning, and factor three (n = 37 (fall), n = 49 (winter)) had a strong preference for online learning. While many students were comfortable in both online and in-person learning environments, this was not the case for all learners. The strengths and weaknesses of each teaching modality suggest the opportunity to explore hybrid learning as an option for future course offerings and specifically highlight valuable aspects to incorporate from each environment., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

In 1993, an increase was observed in the spatial IQ scores of the volunteers who listened to Mozart's sonata K448 for 10 min, and this phenomenon entered the literature as the "Mozart effect." Other studies have shown that this effect is particularly evident in spatial skill tests. A large body of research has provided evidence that spatial ability is associated with success in learning anatomy. In this study, Kastamonu University Faculty of Medicine students were divided into two groups during 16-h practical training spanning 30 days. While one of the groups listened to Mozart's K448 sonata as the background music in all lessons, the control group attended the lessons in their standard form. At the end of each lesson, all students solved a modified mental rotation test including questions involving anatomical structures. Before starting the study, after the first laboratory class, on the 15th and 30th day of the study, blood samples were taken from the participants, and plasma brain-derived neurotrophic factor (BDNF) levels were determined. The effect of time on mental rotation score and plasma BDNF level was significant (p < 0.001 for both). The effect of group was also significant (p < 0.001 for both). Pairwise comparisons showed significance in the fifth, sixth, seventh, and eighth mental rotation test (p < 0.001, p = 0.041, p < 0.001, p < 0.001, respectively) and in the third (Day 15) and fourth (Day 30) BDNF measurement (p < 0.001 for both). Our findings may indicate that specific background music may be useful for anatomy teaching., (© 2024 American Association for Anatomy.)

The present retrospective, descriptive, and quasi-experimental study aimed to explore students' perceptions of traditional teaching combined with gamified and nongamified e-tests for postlecture reinforcement. Midterm knowledge retention and academic performance were also analyzed. The study was conducted from February 2021 to May 2022, involving a single group of first-year medical and physiotherapy students enrolled in equivalent core subjects on human histology at the University of Las Palmas de Gran Canaria (ULPGC). Lectures were supplemented with gamified Quizizz (QQ) or nongamified Moodle questionnaires (MQ) after lecture (t0) and 30 days later (t30). From 171 attendees, 162 volunteers were surveyed on their perceptions on the experience. Furthermore, 97 volunteers participated in the DOCENTIA-ULPGC survey on the students' satisfaction, and 123 participants individually answered 20 QQ and 20 MQ. Data were analyzed using the program Jamovi 2.3.24. The survey on volunteers' perception comprised 11 Likert items and 3 numerical scale items. The former showed acceptable internal consistency (ω-McDonald, 0.70) and validity (KMO, 0.58). Both types of e-questionnaires facilitated learning and motivated pre-reading contents but QQs were preferred. Reinforced lectures were rated higher than those unreinforced. Volunteers expressed higher overall satisfaction though DOCENTIA-ULPGC survey than the prepandemic control group. Average scores peaked at t0 with higher MQ rates. At t30, MQ and QQ scores were acceptable and similar. Participants' outcomes in the final exam tended to improve compared to the prepandemic control group, but without statistical significance. In summary, gamified and nongamified e-quizzes enhanced the student satisfaction and motivation and facilitated midterm knowledge retention., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Immersive virtual reality (i-VR) is a powerful tool that can be used to explore virtual models in three dimensions. It could therefore be a valuable tool to supplement anatomical teaching by providing opportunities to explore spatial anatomical relationships in a virtual environment. However, there is a lack of consensus in the literature as to its effectiveness as a teaching modality when compared to the use of cadaveric material. The aim of our study was to compare the effectiveness of i-VR in facilitating understanding of different anatomical regions when compared with cadaveric prosections for a cohort of first- and second-year undergraduate medical students. Students (n = 92) enrolled in the MBBS program at Queen Mary University of London undertook an assessment, answering questions using either Oculus i-VR headsets, the Human Anatomy VR™ application, or prosection materials. Utilizing ANOVA with Sidak's multiple comparison test, we found no significant difference between prosections and i-VR scores in the abdomen (p = 0.6745), upper limb (p = 0.8557), or lower limb groups (p = 0.9973), suggesting that i-VR may be a viable alternative to prosections in these regions. However, students scored significantly higher when using prosections when compared to i-VR for the thoracic region (p < 0.0001). This may be due to a greater need for visuospatial understanding of 3D relationships when viewing anatomical cavities, which is challenged by a virtual environment. Our study supports the use of i-VR in anatomical teaching but highlights that there is significant variation in the efficacy of this tool for the study of different anatomical regions., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

It can be difficult for some students to learn three-dimensional anatomical structure concepts. While virtual reality (VR) systems have been reported as helpful for learning, there has been scarce research on either VR teaching strategies or the influence of visually induced motion sickness (VIMS) in the context of large anatomy classes (i.e., over 100 students). The study thus aimed to (1) establish a VR anatomy instruction video for a large class; (2) determine how many students experience VIMS when watching a VR anatomy instruction video; (3) evaluate the influence of VIMS on VR anatomy video-based learning; and (4) examine whether a small screen size alleviates VIMS. Laboratory course students viewing a VR anatomy instruction video about the vascular system were invited to participate in the questionnaire survey. Anatomy faculty and staff participated in an experimental trial to determine whether small screen size could alleviate VIMS. The Likert scale survey revealed that students reported the VR strategy as advantageous and appropriate for large classes, but that it cannot replace practical dissection. Of the total participants, 32% reported experiencing VIMS, and 40% of those experiencing VIMS agreed that this could negatively impact their learning through a VR anatomy instruction video. Adjusting the screen size from large to small significantly delayed the onset of VIMS. In conclusion, the VR anatomy instruction video strategy is feasible and helpful for large classes, but educators should consider VIMS when planning their use of this teaching approach., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Basic competency in radiological imaging is essential for physicians to identify and manage diseases. An optimal place in which to include imaging in the medical curriculum is during anatomy as students can correlate the 3D anatomy from their body donors with the 2D cross-sectional anatomy. The goal of this project was to enhance first-year medical students' knowledge of cross-sectional imaging in the gross anatomy lab and to investigate whether there are benefits to learning cross sectional imaging via scans from body donors versus living individuals. Student participant performance was evaluated on laboratory practical examinations, CT image questions and spatial anatomical knowledge in the thorax and abdomen sections of gross anatomy. Students learned the cross-sectional imaging during dissections where they accessed the images relevant to their study on Pacsbin, a web-based Digital Imaging and Communication in Medicine viewer, via iPads. Results showed no statistically significant differences in practical examination scores, spatial anatomical knowledge, or identification of anatomical structures on CT image questions between participants who learned from images on body donors versus living individuals. In a questionnaire given at the end of the course, participants cited that the CT images improved their anatomical and imaging knowledge and that they felt better prepared to use imaging software and interpret diagnostic imaging results upon entering clerkships. While there were no differences in academic performance between the groups, positive outcomes regarding student perceptions of anatomical and imaging knowledge and preparedness for use of imaging software were identified in this study., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

At the University of Bristol, we established a novel dissection course to complement our anatomy degree. Students enrolled in this undergraduate course are trained as comparative anatomists, with equal time given to both human and veterinary anatomy. Historically, students opted to dissect either human or veterinary donors as part of the course. To fully reflect the comparative nature of the degree, the dissection course was redesigned so students could dissect both human and veterinary specimens as part of the same course. This facilitated a wide-ranging experience of anatomy, encouraging detailed knowledge of a multitude of species and allowing for multifaceted anatomy graduates to be ready for employment in a wide and competitive job market. Across three iterations of the amended version of the course, median marks ranged from 58.7% to 62.0%, with between 22 and 39 students enrolled. In comparison to the course prior to the introduction of the change, median marks ranged from 59.8% to 62.8%, with between 16 and 24 students enrolled. There was no significant difference between marks before or after the introduction of the concurrently comparative aspect. This paper describes the course, with learning materials and assessments considered, along with some reflection on its value. The course offers benefits to students by widening their perspective on anatomical knowledge and making them more equipped for the job market. It also broadens their understanding of form-function relationships. However, student feedback implied that having the choice between human or veterinary dissection was preferable, and this may outweigh the perceived benefits of the course., (© 2024 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Dissection of human body donors is a common component of anatomy curricula, as it provides opportunities for tactile and intellectual engagement unmatched otherwise. Additionally, interaction with human body donors contributes to the "hidden curriculum" of allowing students to begin to ethically practice patient care with empathy, respect, and compassion. With this, there have been various proposed guidelines for the ethical treatment of human body donors, with most focusing on student reflections and a final ceremony for honoring the donors, but there are numerous other ways throughout the course to incorporate ethical values and to guide students to consider the humanity of the donor. This article proposes that institutions consider the incorporation of five easily implemented formalized ethical themes for working with human body donations into daily practices: (1) reflect the donor as possessing human dignity, (2) recognize the donor's role of the "First Patient" or "Silent Teacher," (3) honor the gift of human body donation, (4) recognize the decedent's family, and (5) consider inclusivity in memorialization practices. Multiple recommendations for integrating these five themes throughout the course are provided. The incorporation of these five core themes can assist in alleviating the psychological stress that some students struggle with in dissection courses, foster the feelings and attributes that comprise the hidden curriculum and are the desired characteristics of a caring medical provider, and discourage misuse and mistreatment of donors., (© 2024 American Association for Anatomy.)

Haptic perception is used in the anatomy laboratory with the handling of three-dimensional (3D) prosections, dissections, and synthetic models of anatomical structures. Vision-based spatial ability has been found to correlate with performance on tests of 3D anatomy knowledge in previous studies. The objective was to explore whether haptic-based spatial ability was correlated with vision-based spatial ability. Vision-based spatial ability was measured in a study group of 49 medical graduates with three separate tests: a redrawn Vandenberg and Kuse Mental Rotations Tests in two (MRT A) and three (MRT C) dimensions and a Surface Development Test (SDT). Haptic-based spatial ability was measured using 18 different objects constructed from 10 cubes glued together. Participants were asked to draw these objects from blind haptic perception, and drawings were scored by two independent judges. The maximum score was 24 for each of MRT A and MRT C, 60 for SDT, and 18 for the drawings. The drawing score based on haptic perception [median = 17 (lower quartile = 16, upper quartile = 18)] correlated with MRT A [14 (9, 17)], MRT C [9 (7, 12)] and SDT [44 (36, 52)] scores with a Spearman's rank correlation coefficient of 0.395 (p = 0.0049), 0.507 (p = 0.0002) and 0.606 (p < 0.0001), respectively. Spatial abilities assessed by vision-based tests were correlated with a drawing score based on haptic perception of objects. Future research should investigate the contribution of haptic-based and vision-based spatial abilities on learning 3D anatomy from physical models., (© 2023 American Association for Anatomy.)

Anatomy instructional methods varied widely during the COVID-19 pandemic and programs are assessing innovations for retention. Learning preferences were assessed among medical students dichotomized as elective dissectors (ED) or non-dissectors (ND) during the COVID-19 partial re-opening in 2020 (preclinical) and again in 2022 after clinical exposure (post-clinical) to assess the viability of elective dissection post-pandemic. A mixed-method approach was used for the assessment of test scores, learning preference surveys, learning activities rankings, and thematic analyses. No significant differences occurred in anatomy examination scores. Dissection was considered useful by both preclinical groups but significantly more so by ED, while the presence of an instructor was significantly preferred by ED although a majority of ND agreed. Elective dissection was significantly preferred by ND but also by a large minority of ED students. Pre- and post-clinical ND believed that elective dissection offered more academic flexibility, did not hinder clinical learning, and did not negatively impact medical education. The corresponding ED stated that confidence improved, clinical experiences were enhanced, and dissection was irreplaceable. Preclinical ND preferred self-learning, while ED students preferred online learning, but these differences largely disappeared post-clinically. Learning activity rankings were not significantly different among all groups (ND, ED, preclinical, and post-clinical). A hybrid laboratory with a virtual learning environment ranked highest across groups and preferences increased over time suggesting that students benefited from this instructional method during clinical exposure. The absence of laboratory experience ranked lowest, and preference decreased over time suggesting that anatomy dissection is valued., (© 2023 American Association for Anatomy.)

Difficulty in visualizing anatomical structures has been identified as a challenge in anatomy learning and the emergence of three-dimensional printed models (3DPMs) offers a potential solution. This study evaluated the effectiveness of 3DPMs for learning the arterial supply of the head and neck region. One hundred eighty-four undergraduate medical students were randomly assigned to one of four learning modalities including wet specimen, digital model, 3DPM, and textbook image. Posttest scores indicated that all four modalities supported participants' knowledge acquisition, most significantly in the wet specimen group. While the participants rated 3DPMs lower for helping correct identification of structures than wet specimens, they praised 3DPMs for their ability to demonstrate topographical relationships between the arterial supply and adjacent structures. The data further suggested that the biggest limitation of the 3DPMs was their simplicity, thus making it more difficult for users to recognize the equivalent structures on the wet specimens. It was concluded that future designs of 3DPMs will need to consider the balance between the ease of visualization of anatomical structures and the degree of complexity required for successful transfer of learning. Overall, this study presented some conflicting evidence of the favorable outcomes of 3DPMs reported in other similar studies. While effective for anatomy learning as a standalone modality, educators must identify the position 3DPM models hold relative to other modalities in the continuum of undergraduate anatomy education in order to maximize their advantages for students., (© 2023 American Association for Anatomy.)

The peer-reviewed anatomical education literature thoroughly describes the benefits and drawbacks of donor dissection. Gross anatomy laboratory environments utilizing donor dissection are generally considered to be a premier environment where students foster non-traditional discipline-independent skills (NTDIS), including the acquisition of professionalism, empathy, resilience, emotional intelligence, and situational awareness. Therefore, this IRB-approved study explored the impact of a formal humanism and pathology thread, the first patient project (FPP), on the personal and professional development of pre-professional undergraduate students in a gross anatomy dissection-based course. Five reflections from each student were collected across four cohorts (n = 74 students, 370 reflections). A post-course questionnaire collected data on student perceptions of the project. The framework method was used to analyze reflection and free response data and descriptive statistics were performed on Likert-style items using Excel. Three themes were identified to encompass the impacts of the FPP on professional development and include: Socialization (through collective dissection experience and pathology), Humanistic Qualities (respect for the donor and their history, and introspection), and Content and Skills (technical and NTDIS, anatomical knowledge). The end of course FPP survey was completed by 29 students across three cohorts (65%) and their perspectives were generally favorable regarding the promotion of respect, empathy, and humanization of their donors. This study underscores the value of incorporating humanism, pathology, and reflection, facilitated through formal curriculum for pre-professional undergraduate students. It provides evidence of the positive impact on their personal and professional development, supporting the integration of NTDIS in curricula across various disciplines., (© 2023 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Limited research has been conducted on the spatial ability of veterinary students and how this is evaluated within anatomy assessments. This study describes the creation and evaluation of a split design multiple-choice question (MCQ) assessment (totaling 30 questions divided into 15 non-spatial MCQs and 15 spatial MCQs). Two cohorts were tested, one cohort received a 2D teaching method in the academic year 2014/15 (male = 15/108, female 93/108), and the second a 3D teaching method in the academic year 2015/16 (male 14/98, female 84/98). The evaluation of the MCQ demonstrated strong reliability (KR-20 = 0.71 2D and 0.63 3D) meaning the MCQ consistently tests the same construct. Factor analysis of the MCQ provides evidence of validity of the split design of the assessment (RR = 1.11, p = 0.013). Neither cohort outperformed on the non-spatial questions (p > 0.05), however, the 3D cohort performed statistically significantly higher on the spatial questions (p = 0.013). The results of this research support the design of a new anatomy assessment aimed at testing both anatomy knowledge and the problem-solving aspects of anatomical spatial ability. Furthermore, a 3D teaching method was shown to increase students' performance on anatomy questions testing spatial ability., (© 2023 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

The efficacy of the various pedagogies that are used in human anatomy laboratories has been extensively debated. Nevertheless, an important question remains relatively unexamined-how the learning experience in the anatomy laboratory impacts students' mastery and application of anatomical knowledge beyond the laboratory setting. In this study, the effect of a prosection-based anatomy laboratory on overall comprehension and mastery of anatomical knowledge was evaluated in an upper division undergraduate anatomy curriculum that consists of a mandatory lecture course and an optional laboratory course. This flexible curricular structure permitted assessing the merit of laboratory learning on the written examination performance of the lecture course. In 2019 and 2022, the anatomy laboratory was taught in-person using prosections, while in 2021 due to the Covid-19 pandemic related regulations, it was taught remotely with live-streaming of prosections using document cameras. In both in-person and remote instructive formats, written examination scores of the lecture course were compared between two cohorts of students: Those enrolled in lecture only and those enrolled in both lecture and laboratory. Results showed that the cohort enrolled in both lecture and laboratory courses consistently outperformed the lecture-only cohort by one full letter grade. Furthermore, when the degrees of improvement on written examination scores were compared between the two instructive formats, in-person laboratory had a greater increase compared to remote laboratory. Altogether this study demonstrates that the prosection-based anatomy laboratory enhances students' mastery of anatomical knowledge beyond the laboratory setting by promoting comprehension of spatial relationships of anatomical structures., (© 2023 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)