Anatomy Dissection Course Research Articles

Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students.

Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions.

Gross Anatomical Dissection of a Horseshoe Kidney: The Eighth Specimen in Our Medical School

Horseshoe kidney is a known congenital renal anomaly. During a gross anatomy dissection course for students in 2014, a horseshoe kidney was found in an 80-year-old female. The isthmus was formed by the fusion of the right and left kidneys at their lower poles and resulted in a U-shaped kidney. Both sides of the renal hilum opened ventrally. Four surplus renal arteries entered the horseshoe kidney. The first surplus renal artery arose from the right side of the abdominal aorta, and entered the lower part of the renal hilum. The second surplus artery arose from the ventral side of the abdominal aorta, and entered the left inferior part of the left renal hilum.The third surplus artery also arose from the ventral side of the abdominal aorta and entered the inferior border of the left part of the isthmus. The fourth surplus artery arose from the bifurcation of the common iliac arteries and distributed to the inferior border of the middle of the isthmus. One surplus renal vein arose from the lower border of the middle of the isthmus, descended dorsally to the abdominal aorta and the right common iliac artery, and then entered the upper wall of the left common iliac vein. The isthmus was made up of renal parenchymal structures. These findings will be useful as regards research and surgery on the horseshoe kidney. This was the eighth case of horseshoe kidney in our laboratory.

“Mors auxilium vitae”—Causes of death of body donors in an Austrian anatomical department

BackgroundAnatomical dissection is, despite several critical annotations, a highly valuable component of under- and postgraduate medical education and research. Our current causes-of-death statistics on our body donors is aimed to find out to which extent they are representative of the Austrian population. MethodsWe evaluated the causes of death stated in their death certificates of a total of 3399 people who donated their bodies to our department in the course of the last 25 years (1988–2013). The categorisation is based on the official ICD-10-WHO classification. ResultsOur data show a prevalence of cardiovascular diseases in about half of the donors (42%) examined; no gender difference could be revealed in cardiovascular diseases. Tumours were responsible for about 20% of deaths, lead by lung cancer; cancers showed a slight male excess. All other deaths were caused by diseases of the respiratory system, the digestive organs, the genitourinary system, the nervous system, alimentary and metabolic disorders, infections and blood diseases, psychiatric disorders, external and other causes in descending order. Compared to the official Austrian and German statistics, there are only minor deviations. ConclusionOur data clearly show that body donors, at least in our department, depict a representative sample of Austrian population in terms of their causes of death. Therefore anatomical dissection provides appropriate insight into the morbidity of the increasing major target population of medicine, the elders. Limitations in the acceptance by age, excluding either young or old donors, which appear to exist in other anatomical departments, will limit this representativeness. Being aware of these facts, the anatomical dissection course cannot only provide anatomical learning experiences but can also provide an introduction to the basics of epidemiology. Therefore, a topographical dissection course remains an indispensable method for both undergraduate and postgraduate training as well as for research.

Topography, syntopy and morphology of the human otic ganglion: A cadaver study

The human otic ganglion (OG) is not readily accessible during ordinary anatomical teaching courses because of insufficient time and severe difficulties encountered in dissection. Accordingly, most anatomical descriptions of its location, relation to neighbouring structures, size and shape are supported only by drawings, but not by photographs. The aim of this study has been to present the OG with associated roots and branches in dissected anatomic specimens. Following cumbersome dissection and precise photo-documentation, a detailed analysis of location, syntopy and morphology was performed. We carried out this study in 21 infratemporal fossae of 18 cadavers and were able to identify the OG, the mandibular-, the inferior alveolar- and the lingual nerve in all of them. We found no significant variation regarding the location of the GO in the infratemporal fossa and its syntopy to the adjacent structures. An OG resembling the classic description was found only in 90.50% of the cases. All 3 roots (parasympathetic, sympathetic and sensory) could be identified only in 82.3% of the specimens. The established presence of ganglionic branches varied from 0% (communicating rami to the meningeal branch of the mandibular nerve, to the greater petrosal nerve and to the lingual nerve) to 90% (r. communicans to n. canalis pterygoideus). We conclude that precise knowledge of this enormous variety might be very helpful not only to students of medicine and dentistry during anatomical dissection courses, but also to head and neck surgeons, ear-nose-throat specialists and neurosurgeons when treating pathology of pre- and postganglionic fibres.

Dissecting through barriers: interprofessional education, problem‐based learning, and gross anatomy (18.3)

Healthcare delivery is reliant on a team‐based approach. Interprofessional education (IPE) provides a means by which such collaboration skills can be fostered. IPE within healthcare programs has been associated with many benefits, including improvements in patient care and satisfaction, reducing clinical error rates, and diminishing negative professional stereotypes. In recognition of the need for IPE, an IP gross anatomy dissection course was founded at McMaster University in 2009. Data has been collected from 5 cohorts to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions.Annually, 28 students from various programs are randomly assigned into IPE teams for 10 weeks. Sessions involve an anatomy and scope‐of‐practice presentation, a small‐group case‐based session, and a dissection. The Interdisciplinary Education Perception Scale (IEPS) and Readiness for Interprofessional Learning Scale (RIPLS) quantitatively measure pre‐ and post‐course attitudes and perceptions towards IPE and other health professions. Weekly surveys and culminating profession‐specific focus groups qualitatively evaluate these variables.5 year pre‐ and post‐course IEPS and RIPLS scores show significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative results corroborated these findings and made suggestions for the development of similar longitudinal IPE curricula.The implementation of a 10‐week IPE dissection course provides a unique and effective venue for learning about scope‐of‐practice, fostering positive professional identity, and fostering positive attitudes toward IPE and IP collaboration.

Students as Teachers in an Anatomy Dissection Course

One way to improve students' learning outcomes and well-being is to change teaching practices to allow students to become more active participants. We used an anatomy dissection course to test a cooperative group work method in which first-year veterinary students took turns leading their peer group and were each responsible for teaching the anatomy of a particular topographic region. The important blood vessels, lymphatic system, and nerves of each region of the body were covered. Students felt that exploration of the entire topographic region helped them to acquire a comprehensive understanding of the respiratory apparatus and the cardiovascular and nervous systems. Assigning individual tasks to each group member resulted in sharing the workload equally. Open-ended comments revealed that support from other group members was important for the students' learning experience, but the results also offered insight into a lack of constructive criticism. While teaching was considered challenging, and even a stress factor that hindered learning for some students, group work was generally held to be supportive of learning. The results suggest that more thorough instruction of students in their group work and in their individual tasks is required. Some students experienced difficulty in expressing their concerns openly and in seeking guidance from teachers, demonstrating the need for further investigation regarding students' self-regulation skills. Comments from the open-ended responses suggest that use of a cooperative learning method in anatomy dissection courses not only deepens student understanding of a subject but also offers first-year students an opportunity to practice the generic skills that will be needed in their future profession.

Sex-based differences in subjective symptoms among medical students exposed to low-levels of formaldehyde in a gross anatomy dissection course

Background In our university, large-scale renovation for the installation of dissection tables equipped with local ventilation systems and the renewal of the general ventilation system was carried out in 2011 to reduce exposure of students to formaldehyde (FA) during a dissection course. These renovations caused the indoor FA levels to decrease dramatically. Not many reports are available on the health effects of a low FA level on medical students. We believe that there is a need to develop further strategies to reduce FA exposure in a low FA level environment. Women generally reported more health conditions than men. Therefore, we need to analyze the results according to sex. Aims To study the changes in subjective symptoms of medical students before, during, and 6 months after completion of the course according to sex. Methods We investigated the prevalence of 24 subjective symptoms in medical students before the start of a gross anatomy dissection course, during the course, and 6 months after completion of the course by using 2 self-administered questionnaires. Students completed the first survey at the end of the course, which focused on symptoms before and, during the course. The second survey was completed 6 months after the course ended. We investigated the difference in the pattern of subjective symptoms reported by men and women during 3?periods. Results The prevalence of most subjective symptoms was the lowest 6 months after completion of the course. Based on sex, the prevalence of most subjective symptoms was higher in women than in men during and 6 months after the course. The number of symptoms 6 months after the course was 17 in men and 5 in women, which indicated a significant decrease compared with the symptom prevalence during the course. Conclusions Our results indicate that the prevalence of subjective symptoms in women continued to be higher than in men 6 months after course completion. A countermeasure needs to be developed especially for women.

Changes in subjective symptoms and allergy state among medical students exposed to low-level formaldehyde 6 months after completion of a gross anatomy dissection course

Our purpose was to clarify whether subjective symptoms of low-level formaldehyde (FA) exposure in medical students were transient or persistent and to investigate whether the allergy state changed as a result of exposure. We surveyed the prevalence of medical students' subjective symptoms and their allergy state before, during, and 6 months after completion of a gross anatomy dissection course by using two self-administrative questionnaires. Students completed the first survey at the end of the anatomy course to assess symptoms before and during the course. The second survey was completed 6 months after course completion. The prevalence of most subjective symptoms was lower 6 months after the course than during the course. The major symptoms experienced during the course were eye fatigue, runny nose, and dry eyes. The most common symptom 6 months after the course was eye fatigue. Four students continued to experience symptoms even after course completion. Three students developed symptoms only after course completion. Forty-eight students had allergies before the course began and the severity of the allergies did not change after the course. Additionally, the prevalence of most subjective symptoms 6 months after the course was lower than before the course. The patterns of subjective symptoms in the three periods differed between male and female students; the prevalence of most subjective symptoms tended to be higher in females. Subjective symptoms resulting from FA exposure during a gross anatomy course were transient and did not affect students' allergy states.

Assessing the value of clay modeling as an effective adjunct to human donor dissection

Donor dissection remains a fundamental and inimitable component of first‐year medical education. Learning anatomy is an integral part of physician training that warrants the use of a multi‐modal program. Clay modeling (CM) is a unique adjunctive pedagogical tool that offers aspiring physicians the opportunity to improve their understanding of 3D anatomy by physically recreating organs within their proper topographical setting in an interactive and constructive kinetic learning environment. Our study examines the probative value of adding CM instruction to a medical school anatomy dissection course. Ten Downstate Anatomy students attended eight weekly 120‐minute interactive CM classes. Qualitative results suggest that, compared to students in the control group, students in the CM class reported a higher overall satisfaction rate with the anatomy course, stating they were better able to identify anatomical structures and their topographical relationships and felt more confident in answering anatomy questions extrapolated into hypothetical clinical scenarios. Quantitative comparison of pre and post‐test performance showed statistically significant differences within the CM group (p < 0.05). Our preliminary findings suggest CM to be an enhancing adjunct to traditional gross anatomy courses that facilitates deeper learning in a non‐traditional method of delivery. SUNY Downstate Alumni Association

Combining E‐learning With Practical Anatomy ‐ A New Dissection Manual

IntroductionBenefiting from the new technical possibilities concerning computer hard‐ and software and following the trend of e‐learning as well as blended‐learning, a new instruction manual for anatomical dissection courses was developed.Method and DesignThe documents were created with Adobe© InDesign© CS5.5 software. Each manual contains information on corresponding textbook chapters for reference as well as hyperlinks connecting dissectional photos and sketches to the text. In the photos, relevant structures were numbered. Moving the mouse over the number activates a “roll‐over”‐link revealing the correct name of the structure. In addition, together with the respective dissection protocol corresponding clinical learning objectives are listed and hyperlinks to dissection protocol‐corresponding clinical learning objectives as well as hyperlinks to videos of clinical procedures and visualizations of developmental key‐processes are provided.OutlookThis learning material follows the general trend of “blended learning”, which has also already demonstrated some benefits in teaching anatomy. By clinical connections and detailed photo‐documentation, the application will not be limited only to medical students, but could also provide for anatomical recapitulation in postgraduate training.Grant Funding Source: n/a

Live surgery in neurosurgical training courses: essential infrastructure and technical set-up

Training courses in neurosurgery are essential educational elements of residency. Teaching methods vary due to cultural differences, monetary restrictions and infrastructure conditions. Anatomical dissection courses combined with annotated live surgeries performed by senior surgeons have proved to be best accepted by students. In this technical note, we provide detailed information about the necessary requirements, resources and optimal performance of live surgeries in neurosurgical training courses. From 2007 to 2012, 12 neurosurgical training courses with live surgeries were organised at the Department of Neurosurgery. Here, we share our experience and report the essential set-up for these courses. Our department organised seven skull base, four cervical spine and one spinal cord stimulation hands-on dissection course with live surgeries. The course structure included lectures, cadaver dissections and live surgeries. The technical set-up included video transmission via an IP-based network with fibreglass backbone between the operating theatre (OR) and lecture room. During surgery, bidirectional discussions offered the participants the ability to interject and ask questions. Important issues included the careful selection of live operated patients with clearly presented pathology for the didactic cases used to demonstrate the technique. A live surgery should include the entire procedure: intraoperative set-up, positioning, anaesthesiological procedures and handling of intraoperative situations. A professionally prepared step-by-step educational program including surgical anatomy, cadaver dissection and live surgeries with online discussion offers a high level of training and enriches both the participants and instructors.

The Willed Body Donor Interview project: Medical student and donor expectations

The Anatomical Donations Program at the University of Michigan Medical School (UMMS) has begun a multiphase project wherein interviews of donors will be recorded and later shown to medical students who participate in the anatomical dissection course. The first phase of this project included surveys of both current UMMS medical students and donors concerning their perceptions of such a program. A five-question survey administered via Qualtrics software was electronically mailed to all current medical students at UMMS, and a survey was mailed to registered and potential donors requesting information from the UMMS on anatomical donations. A total of 224 medical student responses (response rate 33%) and 54 donor responses (response rate 27%) were received. Seventy-four percent of students and 81% of donors reported they would participate in this program if it existed. Students and donors supported the implementation of this program for varying reasons, though many felt strongly they would not want to participate in a donor interview program. These qualitative results support those of previous studies that show a majority of students desire a closer personal relationship with the donor, and these are the first results to be reported on donor perceptions of a donor interview program. Although many students and donors are in favor of instituting this program, others feel strongly that such an experience could be traumatic. The causes of these differing reactions need to be further explored, and the opinions of those who object to this study will be respected by maintaining voluntary participation in future phases of this study.

Anatomy of the levator claviculae, with an overview and a literature survey

We report here an anatomical study of the levator claviculae discovered during an anatomical dissection course for medical students. The muscle was identified on the left side, and followed a typical topography to previous detections, originating from the transverse process of the fourth cervical vertebra and attaching to the upper facet of the middle part of the clavicle. Innervation to this muscle came from both the third and fourth rami of the cervical spinal nerves. Blood supply to the muscle could not be identified clearly. In this report, we undertook a comprehensive literature survey of this muscle dating back ca. 170 years, and attempted to ascertain the phylogenic and ontogenetic explanations for the development of this muscle.

Advance organizers in a gross anatomy dissection course and their effects on academic achievement

We presented two kinds of advance organizers (AOs), video clips and prosection, for a gross anatomy dissection course and compared their effects on academic achievement and student perception of the learning experience. In total, 141 students at Chonnam National University Medical School were randomly assigned to two groups: Group 1 (n = 70) was provided with video clips AO, whereas Group 2 (n = 71) was provided with prosection AO, the use of cadaveric specimens dissected by the course instructor. Student self-assessment scores regarding the learning objectives of upper limb anatomy improved significantly in both groups. Academic achievement scores in Group 2 were significantly higher than those in Group 1, although the self-assessment scores were not significantly different between the groups. Additionally, students in Group 2 responded significantly more positively to the statements about perception of the learning experience such as helping them understand the course content and concepts, decreasing anxiety about the dissection course, and participating actively in the dissection. It would seem that the application of prosection as an AO improved academic achievement and increased student engagement and satisfaction. This study will contribute to designing effective AOs and developing a teaching and learning strategy for a gross anatomy dissection course.

Effect of Large-Scale Repair Work on Indoor Formaldehyde Levels and Subjective Symptoms in Medical Students during Gross Anatomy Dissection Course

To examine the effect of large-scale repair work on indoor formaldehyde (FA) levels and subjective symptoms in medical students during a gross anatomy dissection course. We measured the indoor FA levels, room air temperature, and room humidity during a gross anatomy dissection course. In addition, the prevalence of subjective symptoms, keeping allergy state, and wearing personal protective equipment were surveyed in two groups of students using a self-administered questionnaire. The mean indoor FA levels before and after repair work were 1.22 ppm and 0.14 ppm, respectively. The mean indoor FA level significantly decreased after repair work. The prevalences of most subjective symptoms before the anatomy practice were similar before and after the repair work. However, the prevalences of most subjective symptoms during the anatomy practice were lower after the repair work. The mean indoor FA levels and prevalences of subjective symptoms decreased after the repair work. We have to continuously monitor indoor FA levels, carry out private countermeasures to minimize exposure to FA, and maintain equipment for ventilation to be able to conduct practice in a comfortable environment.

Visit to the human anatomical dissection course is effective for PT/OT students: Efficacy and evaluation

Visit to the human anatomical dissection course is effective for PT/OT students: Efficacy and evaluation

Medical students' perceptions of the body donor as a “First Patient” or “Teacher”: A pilot study

University of Michigan Medical School (UMMS) students attending a seminar on the history and ethics of anatomical dissection were fascinated by a report on the dissection room experience in Thailand that relates the body donor's status as a teacher. The students felt that they had naturally adopted the "body as teacher" approach in their dissection course, rather than the "body as first patient" approach that is encouraged by faculty. It was decided to explore the question whether other medical students shared these perceptions. A questionnaire was sent out to all UMMS students who had finished the anatomical dissection course. One hundred twenty-eight responses from a population of 500 students were received. Results indicate that students believe the "body as teacher" approach is more effective in engendering respect and empathy towards the body and towards future patients, and in facilitating students' emotional development. Students also reported wanting a more personal relationship with their donors. Eighty four percent of students preferred the "body as teacher" approach to the currently taught "body as first patient" approach. The results support the hypothesis that students' desired closer personal relationship with donors might be better facilitated by the "body as teacher" approach, and that this closer relationship engenders empathy and respect towards the donor and future patients. A new model for anatomy programs could introduce the donor first as a teacher and later transition into viewing the donor as a patient.

The gross anatomy course: An analysis of its importance

The gross anatomy dissection course is a cost-intensive piece of undergraduate medical education that students and professionals alike describe as very important within the overall medical curriculum. We sought to understand more explicitly students' valuation of gross anatomy as an "important" course and so developed a quantitative longitudinal questionnaire. Medical students (n = 124) enrolled in the winter term 2006/2007 gross anatomy course at the Ulm University Faculty of Medicine were surveyed anonymously prior to, in the middle of, and at the end of the dissection course. Subgroups of students expressing rising or falling opinions of course value were identified and correlated with student opinions about the course's ability to convey professional competencies. Five-point Likert scales were used for each survey item, which included such standardized instruments as the NeoFFI, BSI, and FBM. The study confirmed that medical students believe dissection to be valuable. Students indicated that participation in the course facilitated acquisition of anatomy knowledge as well as skills related to teamwork, coping with stress, and, to a lesser extent, time management. Students also noted that they developed less empathy than expected beforehand. Significant subgroup differences were observed relative to the competencies of teamwork, stress coping strategies, and empathy, as well as in students' stress levels associated with having to take a dissection course. Our study builds on previous work that has shown dissection courses help students develop professional competencies. The increase in professionalism might be a reason for the generally high value students place on the gross anatomy dissection course.

Production of instructional videos to use in anatomical dissection courses

Faculty members at LSUHSC teach anatomy dissection courses to dental, medical, allied health and nursing students. Our department now operates an anatomy media studio equipped with lighting, cameras, sound equipment, and editing software. The aim of our program is to produce high quality videos to demonstrate various aspects of human anatomy. An arcing camera boom has been constructed to help render a three dimensional view in the recorded videos. A series of video clips would include osteology, surface anatomy, and a short demonstration of how to execute the dissection exercise to be conducted in the laboratory that day. Numerous large LCD screens have been installed in the anatomy lab to present the videos. For example, we have begun a sequence on the thorax, which includes an introduction to the bony thorax, surface landmarks, and dissection instructions using a cadaver to demonstrate how to remove the chest plate, lungs and heart. Last summer, dental students were involved in the dissections, recording, and editing of the material. The students have responded favorably to our efforts and we plan to expand our program and to involve students in the summer months when they are available between the first and second years of their respective professional schools.

Student learning preferences and the impact of a multimedia learning tool in the dissection course at the University of Munich

How do students use multimedia tools to support their learning during a gross anatomy dissection course? We investigated this question in the anatomic dissection course for first year medical students at the University of Munich (n=850) by giving all participating students access to an anatomical multimedia CD-ROM. The use of this multimedia learning tool was voluntary and it was not essential for the end-of-course examination. After the examination, two questionnaires (return rate first questionnaire n(1)=347, approximately 41%; return rate second questionnaire n(2)=644, approximately 76%) were given to the surveyed students with the following content: evaluation of the multimedia learning tool, details about the usage of different kinds of available learning media, and finally an evaluation of the media used for teaching during the course. Furthermore we collected personal data from participants such as age, gender and the score achieved in the examination. Classical textbooks and anatomical atlases were used by 84% of students for preparation. The multimedia learning tool was used by 34% as an additional media for learning. The multimedia learning tool was not used alone. The data showed differences with regard to gender and performance of students, but not relating to age. Students rated the computer-specific features, e.g. three-dimensional (3D) models, virtual simulations, and an interactive quiz module, as major reasons for using the multimedia learning tool. Our results show that medical students use anatomic multimedia learning tools primarily as an additional medium for learning, and thus lead to the conclusion that the main learning media are still textbooks and anatomic atlases.