Dissection Laboratory Research Articles

Impact of modified teaching strategies used in a gross anatomy course on the academic performance of dental students during the COVID-19 pandemic.

Modified teaching strategies (MTS), asynchronous online teaching and smaller dissection groups, were applied to a gross anatomy course for dental students in the National Taiwan University in April 2020 in response to the COVID-19 pandemic. This study aimed to investigate the effects and perceptions of MTS on dental students. Scores for anatomy examinations for 2018-2019 (without MTS) and 2019-2020 (with MTS) cohorts were compared to explore the effect on academic performance. Moreover, questionnaire from the 2019-2020 cohort was analysed to determine dental students' perceptions about MTS. The lecture performance in the final examination of the second semester for the 2019-2020 cohort was significantly higher than that of the first semester (pre-COVID-19) and that for the 2018-2019 cohort. However, the laboratory performance in the midterm examination of the second semester for the 2019-2020 cohort was significantly lower than that for the 2018-2019 cohort and showed no difference in the final examination of the first semester. The questionnaires revealed that the majority of students displayed positive attitudes towards MTS and agreed with the importance of peer discussion during laboratory dissection. Asynchronous online learning for anatomy lecture may be beneficial for dental students; however, a smaller dissection group accompanied by reduced peer discussion may temporarily exert negative effects on their laboratory performance at the beginning of the application. Furthermore, more dental students exhibited positive perceptions towards smaller dissection groups. These findings could illuminate the learning condition of dental students in anatomy education.

OpNotes and Clinical Exercises: Activities to Enhance the Clinical Context of the Preclerkship Anatomy Dissection Laboratory.

Despite numerous pedagogical approaches and technologies now available for medical gross anatomy, students can find it difficult to translate what occurs in a dissection laboratory into the context of clinical practice. Using complementary and collaborative approaches at 2 different medical schools, Virginia Commonwealth University (VCU) and University of Maryland (UM), we designed and implemented a series of clinical activities in the preclerkship medical gross anatomy laboratory that directly link dissected structures to clinical procedures. These activities specifically direct students to perform simulated clinically related procedures on anatomic donors during laboratory dissection sessions. The activities are called OpNotes at VCU and Clinical Exercises at UM. Each activity in the VCU OpNotes requires about 15 minutes of group activity at the end of a scheduled laboratory and involves faculty to grade the student responses submitted via a web-based-assessment form. Each exercise in UM Clinical Exercises also requires about 15 minutes of group activity during the schedule laboratory but does not involve faculty to complete grading. Cumulatively, the activities in OpNotes and Clinical Exercises both brought clinical context directly to anatomical dissections. These activities began in 2012 at UM and 2020 at VCU, allowing a multiyear and multi-institute development and testing of this innovative approach. Student participation was high, and perception of its effectiveness was almost uniformly positive. Future iterations of the program will work to assess the efficacy of the program as well as to streamline the scoring and delivery of the formative components. Collectively, we propose that the concept of executing clinic-like procedures on donors in anatomy courses is an effective means of enhancing learning in the anatomy laboratory while concurrently underscoring the relevance of basic anatomy to future clinical practice.

Virtual neurosurgery anatomy laboratory: A collaborative and remote education experience in the metaverse.

Advances in computer sciences, including novel 3-dimensional rendering techniques, have enabled the creation of cloud-based virtual reality (VR) interfaces, making real-time peer-to-peer interaction possible even from remote locations. This study addresses the potential use of this technology for microsurgery anatomy education. Digital specimens were created using multiple photogrammetry techniques and imported into a virtual simulated neuroanatomy dissection laboratory. A VR educational program using a multiuser virtual anatomy laboratory experience was developed. Internal validation was performed by five multinational neurosurgery visiting scholars testing and assessing the digital VR models. For external validation, 20 neurosurgery residents tested and assessed the same models and virtual space. Each participant responded to 14 statements assessing the virtual models, categorized under realism (n = 3), usefulness (n = 2), practicality (n = 3), enjoyment (n = 3), and recommendation (n = 3). Most responses expressed agreement or strong agreement with the assessment statements (internal validation, 94% [66/70] total responses; external validation, 91.4% [256/280] total responses). Notably, most participants strongly agreed that this system should be part of neurosurgery residency training and that virtual cadaver courses through this platform could be effective for education. Cloud-based VR interfaces are a novel resource for neurosurgery education. Interactive and remote collaboration between instructors and trainees is possible in virtual environments using volumetric models created with photogrammetry. We believe that this technology could be part of a hybrid anatomy curriculum for neurosurgery education. More studies are needed to assess the educational value of this type of innovative educational resource.

Googling “Anatomy dissection”: Pre-pandemic, pandemic, and current scenario

The present study was proposed to assess if the online search behavior for Anatomy dissection was affected by actual dissection being performed in the labs. The interest in dissection was ascertained and compared between pre-pandemic, pandemic, and current times. Online web search behavior for key terms related to "Anatomy dissection" was noticed worldwide using Google Trends Tool. Relative search volume (RSV) was downloaded for these keywords worldwide using all categories, and web search settings during a period from January 1, 2018, to July 31, 2022. There was almost a similar google trend for the first three months in years 2018 and 2020, with a slightly lower RSV in March and a noticeable RSV decrease from April onwards in 2020. During the pre-pandemic period, the peak for RSV in the month of May was noticed. These peaks were missing in 2020 and 2021. In May 2022, RSV again increased. The top five countries with the highest search hit for "Anatomy Dissection" web were the Philippines, the United States, Canada, Australia, and India. There was lower search trend for "Anatomy dissection" during the pandemic period as compared to pre-pandemic period. The search trends may be associated with the closure of dissection labs and it may be concluded that Anatomy learners search for this term more often, if they are actually performing the dissections. The future integrated multi-country data and analysis from different set-ups about their ways of dissection and labs before and after the pandemic may further clarify.

A Closer Look at Anatomy Educator Safety: Identifying and Preventing Workplace Hazards: A narrative review.

Anatomy, one of medicine's vital subjects, demands extreme visualization to understand the intricate architecture of the human body. Although various other methods of virtual dissections are in place, an increasing number of anatomists, clinicians, and surgeons are advocating for re-enhancing anatomical education through traditional cadaveric dissection. These traditional pedagogies potentially expose anatomy educators to various risks in the dissection laboratory, which endangers their health and well-being. Unfortunately, no one is counting on them or the hazards they face. It's like saying, "Fall ill at your own peril." Various studies have revealed the occupational hazards anatomists are exposed to, but the issue remains unheard of or relatively heard. Hence, this narrative review aims to highlight numerous occupational risks that anatomists face worldwide, particularly in underdeveloped or developing nations. Simultaneously, the authors strongly advocate that competent authorities review and evaluate the working conditions of anatomy laboratories and frame policies that ensure the rights and optimal health of anatomy educators.

The failure on the effectiveness of formalin on cadaver disinfection and alternative methods

Objective: It was aimed to identify the contaminant and determine the alternative disinfectant detection in the microbial growth
 observed in various parts of the cadaver stored in the formalin tank in the dissection laboratory of Marmara University Anatomy
 Department. We also performed a literature review of this unusual pathogen.
 Materials and Methods: Swab samples were inoculated on agar mediums. After incubation, matrix-assisted laser desorption ionizationtime
 of flight mass spectrometry (MALDI-TOF MS) analysis was used to identify the isolate from the detected uniform colonies.
 Sample solution from the cadaver tank, freshly prepared 5% formalin and 0.55% ortho-phthalaldehyde were used to determine the
 disinfectant sensitivity of the isolate.
 Results: According to 16s rDNA sequence analysis, it was concluded as Skermanella aerolata with 99% similarity. In the disinfectant
 susceptibility test, it was observed that S. aerolata and control bacteria could grow in 5% formalin taken from the cadaver tank. No
 growth was detected in other disinfectants.
 Conclusion: To prevent cadaver contamination in anatomy laboratories, the quality control of the embalming solutions and indoor
 air filtration of the dissection rooms should be checked at regular intervals. Members of Skermanella genus have been identified as
 environmental organisms in several studies, however, recent researches reported this bacterium as a human pathogen.

Fetal pig dissection lab with detailed images

Fetal pig dissection lab with detailed images

Petroclival Clinoidal Folds and Relationships with Arachnoidal Membranes of Medial Incisural Space: Old Neuroanatomical Terms for a New Neurosurgical Speech in Cadaver Labs with Limited Resources Era. Part III: Arachnoid Membranes, Cranial Nerves, and Surgical Implications.

BACKGROUND Anatomical dissections play an irreplaceable role in the training of new generations of effective neurosurgeons, especially when addressing skull base lesions is required.The Authors describe an inter-laboratory dissection study aimed at improving the knowledge of a complex region of the skull base. The anterior and middle incisural spaces are of remarkable anatomical and surgical interest due to complex relationships between bony, dural, arachnoidal, and neurovascular structures. The primary purposes of this study are to describe the anatomy of this region with particular emphasis on the relationships between the anterior margin of the free edge of the tentorium and the sphenoid and petrous bone; to identify surgical implications in many different types of neurosurgical procedures dealing with this challenging complex anatomic area.METHODS Thirteen anatomical specimens, including five injected specimens, were dissected in this study. In the formalin-fixed specimens, vessels were injected with colored silicone.RESULTS The anatomical study focused on the description of the relationships between bony dural, arachnoid, and neurovascular structures. Surgical implications are described accordingly.CONCLUSIONS Detailed anatomical knowledge of this region finds concrete applications in neurosurgical practice since the anterior and middle incisural spaces are often surgically exposed in neoplastic and vascular diseases. The high-definition pictures reported in this study could represent useful support to understand the anatomy of this complex region.Finally, our study could provide guidance to neurosurgical centers in which resources are limited that are either planning to establish their own cadaver dissection laboratory or failed to do so because of the supposed high-costs.

Petroclival Clinoidal Folds and Relationships with Arachnoidal Membranes of Anterior and Middle Incisural Spaces: Old Neuroanatomical Terms for a New Neurosurgical Speech in Cadaver Labs with Limited Resources Era. Part II: Free Edge of the Tentorium, Petroclinoid Folds, and Incisural Spaces.

BACKGROUND Anatomical dissections play an irreplaceable role in the training of new generations of effective neurosurgeons, especially when addressing skull base lesions is required.The Authors describe an inter-laboratory dissection study aimed at improving the knowledge of a complex region of the skull base. The anterior and middle incisural spaces are of remarkable anatomical and surgical interest due to complex relationships between bony, dural, arachnoidal, and neurovascular structures. The primary purposes of this study are to describe the anatomy of this region with particular emphasis on the relationships between the anterior margin of the free edge of the tentorium and the sphenoid and petrous bone; to identify surgical implications in many different types of neurosurgical procedures dealing with this challenging, complex anatomic area.METHODS Thirteen anatomical specimens, including five injected specimens, were dissected in this study. In the formalin-fixed specimens, vessels were injected with colored silicone.RESULTS The anatomical study was focused on the description of the relationships between bony dural, arachnoid, and neurovascular structures. Surgical implications are described accordingly.CONCLUSIONS Detailed anatomical knowledge of this region finds concrete applications in neurosurgical practice since the anterior and middle incisural spaces are often surgically exposed in neoplastic and vascular diseases. The high-definition pictures reported in this study could represent useful support to understand the anatomy of this complex region.Finally, our study could provide guidance to neurosurgical centers in which resources are limited that are either planning to establish their own cadaver dissection laboratory or failed to do so because of the supposed high-costs.

From Lecture Halls to Zoom Links: How Can Educational Theory Help Us to Deliver Effective and Engaging Teaching in an Online Environment?

Anatomical education has a long and colourful history, ranging from the anatomical theatre and artistic flourish of the renaissance period to modern-day virtual reality. Over the centuries, the body has been taken apart and mapped in exquisite detail. We are now able to access virtual models of the body anywhere, anytime, which allow for unlimited dissection and manipulation. Despite this progress, the majority of anatomical educators continue to deliver anatomy in a laboratory setting, using hands-on learning approaches such as dissection of cadaveric material. These methods are robustly supported by educational theories, such as information processing theory and experiential learning but require students to be present in a dissection room with access to human cadaveric material.The 2020 COVID-19 pandemic forced anatomy educators out of familiar dissection laboratories and into unfamiliar and uncomfortable virtual environments. When moving online during the pandemic, active learning theories, which form the basis of face-to-face classes, were used to construct interactive anatomy webinars to replace the on-campus practical laboratory-based teaching. The focus of these webinars was on student interactivity, and visual content with drawing activities, breakout groups, virtual three-dimensional models, and identifying activities being integrated into each session. Student feedback showed an appreciation of the interactive nature of these sessions, and staff were surprised at how well the webinars delivered engaging and interactive teaching at a time of limited social contact. This approach was not only useful during the restrictions of a pandemic but could offer a complementary approach to delivering practical anatomy teaching as we return to blended and on-campus learning again.

Safety and Management Status of Anatomical Labs in Medical Schools

It is necessary to install ventilation facilities in the laboratory and to regularly monitor harmful gases including formalin for safe environment of the dissection laboratory. However, there are no indicators that can identify the current status of ventilation facilities, safety equipment, and protective equipment in the dissection laboratory. In this study, the status of safety management of anatomical lab at domestic medical, dental, and oriental medical universities are investigated through an online questionnaire. Of the total 32 universities, 7 universities (21.8%) regularly monitor harmful gases such as formalin in the dissection lab, 13 universities (40.6%) do it on an irregular basis, and 12 do not do it at all. Seven universities (21.8%) are using the exhaust-type dissection table, 24 universities (75%) are not using it. Regarding the need for standards for manpower and facilities in the management of the anatomy lab, 7 universities (21.8%) are mediocre, 21 universities are necessary (65.6%), and 4 universities (12.5%) are very necessary. The responsibility for anatomy lab is 27 universities (84.3%) of the schools that responded as head professors of the department of anatomy, 3 universities (9.3%) of technicians, and 2 universities (6.2%) of the dean of the medical school. Regarding the need for standards for the anatomical lab, 7 universities (21.8%) are very necessary, 21 universities (65.6%) are necessary, and 4 universities (12.5%) are mediocre. Based on this data, the standard for the quality improvement and safety of anatomical education should be prepared.

Mastering the Trans-Labrynthine Approach to Internal Acoustic Meatus: A Cadaveric Temporal Bone Study.

The Trans-labrynthine approach, through Otic capsule gives direct approach to the cerebellopontine angle (CPA) and internal auditory meatus (IAM) with preservation of the facial nerve. Mastering the approach to IAM in a cadaver with anatomical landmarks is important to the budding Otologist & Neurotologist to approach the CPA with functional preservation of the Facial nerve in patients with Vestibular Schwannoma & other procedures. Transitioning surgical skills and anatomic knowledge from surgical anatomy textbooks and laboratory training to the operative room is challenging. 30 adult wet human cadaveric temporal bones were studied by performing Trans-labrynthine approach to the IAM by using ZEISS microscope in a temporal bone dissection lab. Photographs were taken by HD phone camera, imported into computer & labeled the anatomical landmarks. Wide exposure & 3D visualization of complex anatomical landmarks were noted in each step by step approach from basic to advanced procedure of Trans-labrynthine approach to IAM. The step by step approach to the IAM from basic to advanced procedure in a cadaveric temporal bone offers great orientation & opportunity to become a master of the complex surgical anatomy of IAM and in acquiring a 3D orientation of the critical structures.

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

BackgroundDuring the COVID-19 pandemic, in-person cadaveric dissection laboratories for teaching anatomy were omitted by many schools around the world. While knowledge domains can be easily evaluated via remote exams, non-traditional discipline-independent skills such as those encouraged through reflection on the topic of death are often overlooked. This study investigated how different anatomy course formats played a role in initiating students’ reflections on death during the COVID-19 pandemic.MethodIn fall 2020, 217 medical, dental, premedical, and health sciences students from 13 international universities discussed differences in their anatomy courses online. Formats of anatomy courses ranged from dissection-based, prosection-based, hybrid (combination of dissection and prosection) to no laboratory exposure at all. Students’ responses to the question, “Did/does your anatomy course initiate your thinking about life's passing?” were collected, and they self-reported themes that were present in their reflections on death using a multiple-choice prompt. Statistical analyses to detect differences between students with and without exposure to cadavers were performed using the chi-squared test.ResultsWhen comparing students who had exposure to human anatomical specimens to those who had no exposure, the majority of students with exposure thought that the course did initiate thoughts about life’s passing, compared to students without exposure (P < 0.05). Reflection themes were consistent across groups.DiscussionThese findings indicate that anatomy dissection courses are important for the initiation of students’ feelings about the topic of death. Omission of cadaveric dissection- or prosection-based laboratories will decrease the likelihood that students initiate reflection on this topic and gain important transferable skills.

Transfer of anatomy during surgical clerkships: an exploratory study of a student-staff partnership.

This qualitative study aims to explore how fourth-year medical students on the surgery course perceived a clinical anatomy workshop organised by near-peer student teachers in partnership with faculty. Forty-seven medical students participated in a workshop on clinical anatomy in the dissection laboratory. A voluntary response sampling method was used. The students' perceptions of the workshop were explored through a thematic content analysis of transcribed, semi-structured group interviews and written comments. A majority of the students had not revisited the dissection laboratory since their second year, and all students described the workshop as a unique opportunity to vertically integrate anatomical knowledge. Four main themes were identified as most valuable for the students' learning experience, namely that the workshop 1) was taught by knowledgeable and friendly near-peer tutors (NPTs), 2) consisted of highly relevant anatomical content, 3) offered a hands-on experience of cadavers in the dissection laboratory, and 4) was taught in a focused session in the middle of the surgery course. This study shows how hands-on workshops in clinical anatomy, developed in student-staff partnerships and taught by NPTs, can enable senior medical students to recall and vertically integrate anatomical knowledge during surgical clerkships. The results have implications for curriculum design, giving voice to senior students' wishes for spaced repetition and vertical integration of pre-clinical anatomy knowledge during their clinical training. Moreover, this study may inspire other students and faculty to develop similar near-peer teaching activities through student-staff partnerships.

Porta hepatis in relation to portal vein among Indians.

The porta hepatis / hilum of liver is a transverse fissure located in the inferior surface, where the major vessels and ducts enter or leave the organ. The major structures traversing the porta hepatis are the portal vein, the hepatic artery and the hepatic duct. Porta hepatis is an area of surgical and radiological significance. The knowledge of variations in structures traversing the porta hepatitis will reduce the risk of surgeries involving this area. Study was conducted in the department of anatomy dissection lab after obtaining ethical clearance. 30 liver specimens were used for these studies which were removed from the cadaver during under graduate teaching. Anatomical knowledge of variations in relations of structures present in porta hepatis is of immense help to surgeons and radiologists when they engage patients for clinical procedures like liver transplant, cholecystectomy and diagnostic procedures. Hence this study was aimed to observe the relations of portal vein in porta hepatis.

Ann's Final Gift.

The reeking smell of formaldehyde lingered in the hallway outside of the anatomy lab. To an outsider, this may have seemed like an ordinary afternoon at the medical school. But to me, this day was momentous: I was meeting my anatomy donor for the very first time and I was unsure how to feel. On one hand, I was genuinely excited to begin learning the anatomy of the human body. Anatomy dissection lab would be my first real dive into the world of medicine, and I was eager to begin. At the same time, I felt uneasy because I would be learning about the human body not from a textbook, but from the body of an actual human being. After taking one final deep breath to calm my nerves, I slowly entered. Laying silently on the table in front of me was our donor, Ann. The body that experienced every memory, feeling, and thought, from her first breath to her last, lay still on that cold, metal surface. When I first viewed Ann’s body, I was taken aback by her duality: While it appeared strangely inhuman due to the preservation process, she was, and is, a unique individual. Despite my internal discomfort, I tried my best to listen earnestly as the professor spoke. Still, my mind began to wander from the present conversation toward ponderings of Ann’s personality—What was she like? Did she have any family? What brought her joy? When I walked out of the anatomy lab that day, I quietly offered my sincerest gratitude for Ann’s willingness to donate her body for my medical education. As the course progressed, I became more accustomed to studying Ann’s anatomy, although certain dissections—particularly those of her head and neck—posed a challenge for me as I balanced remembering Ann’s humanity and learning her anatomical structures. While my hands carefully performed each step of the dissection, my mind grappled with the notion of reducing Ann’s face to a group of muscle fibers and nerves. How could I, a first-year medical student, be worthy of cutting into such a sacred part of Ann’s body? At times, I had to pause my dissection to allow an overwhelming wave of guilt to pass. Though I still sought to learn as much as I could, I decided to focus less on the anatomy comprising Ann’s face and more on appreciating the feelings that the muscles of her face had expressed: joy, laughter, hope, and serenity. Regardless of how much needed to be done in lab, I made it my daily goal to see Ann as a person and acknowledge our shared humanity. To me, she was much more than just the sum of her anatomical components. Even though I never knew Ann while she was alive, I, in a way, came to know her in a more intimate and personal way than even her closest friends and family did. Over time, Ann’s humanity became strangely comforting to me. As we examined the muscles of her face, I contemplated what her smile would have looked like. As we dissected her tumor, I grieved over the pain and suffering she likely experienced in her final days. As I looked into her pale blue eyes, I realized that we had both seen the same brilliant sunsets and starry night skies. The realization that Ann and I are not so different underneath our skin brought me a sense of peace. Despite the emotional challenges that my anatomy course presented, I feel reaffirmed in my desire to pursue medicine and now understand the beautiful complexity of the human body in a way I never could have before. Although I still struggle with the fact that I used Ann for my own learning, I remember how truly blessed I am to have had the opportunity to learn from Ann’s body and enter a profession of service. I have a newfound appreciation for the common humanity that all patients, both living and dead, share with one another and for the differences that make each of us unique. I feel called to ensure that all patients are treated not as a series of body parts or a list of problems, but as a valued and respected human being. Finally, I remain eternally grateful for Ann’s final gift.

3D‐Printing Offers Dry Replication and New Insight into Unique Museum Specimens

Students dissection classes again and again reveal unique anatomical variations and pathologies, which are usually preserved and stored in fluid. Due to their unique nature and hazardous conservation fluids, they neither ever leave their display case again nor are handed over to students at the dissection lab.Thus the present study aims at routinely generating solid, dry, and numerically unlimited 3D‐replica of such unique specimens.We have selected a particularely severe case of Mönckebergs aortic valve sclerosis and a transcatheter aortic valve implantation (TAVI)‐treated valve to develop a standard scanning, segmentation and multicolor 3D‐printing protocol for soft and hard tissue specimens.Subsequent to anatomical dissection of the appropriate valve segment from the ventricular outlet and the ascending aorta, scanning was performed on a Skyscan 1173 micro‐CT at a x‐y‐z resolution of 30µm. Soft tissue, calcified tissue, and the TAVI's wire cage were segmented separately using the software packages Slicer and Medtool. For 3D‐printing, the Prusa MK3S filament printer and the Prusa SL 1 resin printer were used.The overall time expense for scanning (40 minutes), data processing and segmentation (about 16 hours) was around two to three working days per model. The 3D‐printing took from 5 hours (single‐color resin printing at a scale of 1:1) up to 4 days (triple‐color filament printing at a scale of 3:1).The generated display models range from real size, opaque surface models to semi‐vitreous visualizations of the calcification pattern and the implanted TAVI.Taken together, after a substantial time expenditure for initial data processing and modeling, with small time requirements not only hands on replica for teaching can be easily reproduced at different scales without limitation by specimen durability or chemical hazards. Additional impact is achieved by the ability to highlight and analyze internal structures in situ, making laborious, traditional whole mount staining and ‐clearing dispensable. In a next step, the adaption of colors and material characteristics will approximate the haptic experience to the real specimen.

An Online Magnetic Resonance Imaging Approach Using Augmented Reality Visualizations for Introducing Students to Their “Silent Teachers”

The initial interaction between medical students and their “Silent Teacher” in the dissection lab is an important experience in the process of establishing a professional ethos. However, COVID19 complicated this process and the optimal approach to achieve this introduction remains unclear. The purpose of this study was to develop an online case‐based approach as the basis for donor introduction to medical students based on Magnetic resonance imaging (MRI) reports. MRI scans of 16 body donors were assessed by a radiologist and observations were uploaded to a web‐based DICOM viewer (www.rad3d.com). A list of learning objectives were generated for each donor and radiology reports were constructed based on: chief complaints, medical history, radiology and pathology that were reviewed prior to the class. Within the lab and following COVID19 restriction policy, students read through the radiology reports and viewed the augmented reality (AR) visualizations of the MRI scans using z‐space computers providing additional dissection team interactions. Finally, surface anatomy exercises were undertaken that corresponded to the primary pathology providing a direct interaction with the donor. This process included Sketchfab and other links to underscore anatomical correlations (Figure 1). A survey was conducted to assess student perceptions of the experience. The study design comprised a voluntary survey tool to assess student level of anxiety and whether the online approach was effective. Response scales were either bimodal or Likert‐base (5 scale) and analyzed with Fisher's exact test. Follow up open ended questions were also presented to the students. The response rate was 33/80 (41.25%). Most students (82.7%) felt anxious first, but the anxiety decreased in time (60.7%). They mostly accomplished the tasks (surface exercises 97%; reviewing MRIs 87.9%) and found surface exercises useful in terms of reducing anxiety (90.6%), and initiating team work (100%). A total of 79.3% of the students found MR useful for learning radiology (Table 1). More than half of the students (55.6%) indicated that the first encounter was not as they expected and stated that they thought it would be more intimidating. Several emotions were indicated such as: confused, uncomfortable, somber, excited, grateful, thankful, professional. They all agreed that using a case based approach as an introductory laboratory prior to first dissection is useful. There was one prominent suggestion almost all students stated: video resources prior to the lab. Results suggest that humanizing the donor, implementing clinical reasoning, and initiating teamwork provided a positive first lab experience using online resources. Future work will be aimed at further development of online resources organized around clinical presentation using MR scans.

Summing up 10 years in a new medical school: Per aspera ad astra

Opening a new medical school and introducing an anatomy course is a rare opportunity for medical anatomy educators. Here we sum our experience in an ongoing 10‐year anatomy program, emphasizing the challenges we endured, the hardships and successes in the hope that others can learn from our experience.In February 2010, Bar Ilan University was chosen by the Israeli Council for Higher Education to open a new, fifth, medical faculty. A mere eight months later, the school opened its gates to a class of 70 students in the northern city of Safed. This new faculty, dedicated to establishing connections to the local community, enabled us to develop and implement a new anatomy curriculum.The basic course incorporated frontal lectures, dissection labs, basic systematic physiology, clinical correlation lectures and imaging labs. The initial curriculum included trunk and Head &amp; neck regions spanning 5 weeks. After the first couple of years, the length and contents of the course started to change and adapt according to the needs of our faculty, and by input from physicians as well as students. Over the years student number rose to 100, and the course expanded to 10 weeks to incorporate the entire body aside from neuroanatomy, which is taught in a separate course. Histology and embryology were included; ultrasound hands‐on labs were added; and virtual anatomy sessions were integrated to the program. Clinical and physiological correlate lectures were cut down, with the understating, backed by students’ evaluations, that this was too early for them, and focus should remain on basic normal anatomy. On the other hand, more time was added to imaging sessions and lectures, as most modern physicians use these techniques in their everyday clinical practice. While originally relaying on retired physicians to serve as dissection instructors, we initialed a near‐peer students dissection instructors’ program that was met with great success.In the last couple of years our program and indeed the entire medical school was heavily impacted by the ongoing Covid‐19 pandemic. While lectures were taken to virtual platform, we decided to continue dissection sessions as normally as possible, with strict mandatory regulations including personal protective gear and keeping students’ number within the lab to a minimum of 15, 7‐8 students per cadaver. Students were highly appreciative of our efforts, and course scoring was exceptionally high.The last 10 years has shown us that anatomy, a basic and important tradition, could be taught in many exceptional ways, and we should always strive to improve. But perhaps even more important is the understating that we are educators to whom our students look up to, and endurance, perseverance, resourcefulness, and professionalism are just as important as scholastic knowledge.

An Exploration of Metacognitive Practices in Gross Anatomy Educators

INTRODUCTIONMetacognition, the ability to monitor and regulate one’s thought processes, has been shown to benefit instructors by improving their effectiveness as teachers. Particularly with dissection‐based gross anatomy, instructors are dynamically using metacognitive processes to monitor student learning and adapt teaching strategies at table‐side. Therefore, the purpose of this study was to explore the metacognitive processes of gross anatomy instructors as they taught in an anatomy course for allied health students.METHODSAll instructors in a doctoral‐level dissection‐based gross anatomy course, including faculty, associate instructors (AIs), and near‐peer teaching assistants (TAs), were invited to participate in this IRB‐approved study. All instructors participated in facilitating lab dissections. At the start and end of the course, instructors were invited to complete pre‐ and post‐questionnaires which included the Teacher Metacognition Inventory (TMI), a 28‐item survey that assesses metacognition as it relates to teaching. Pre‐ and post‐TMI scores were analyzed using Wilcoxon Signed Rank and Kruskal‐Wallis H tests. After the dissection labs, instructors who were in attendance were asked to complete reflective journals to provide deeper insight into their metacognitive processes. Topics included self‐evaluations of teaching, emotions associated with teaching, and plans for future teaching sessions. Reflective journals were thematically analyzed using both deductive and inductive coding.RESULTSAll seven female instructors participated in this study, including two faculty, one AI, and four TAs (54% of instructors in the course). Due to the small number of participants, statistical significance could not be calculated for all tests. Between the start and end of the course, total TMI score increased from 106.9 to 114.0. TAs exhibited the greatest increase in total TMI score (Δmean=13.3) followed by the AI (Δmean=3.5) and faculty (Δmean=2.5). In the pre‐questionnaire, TAs, AIs, and faculty exhibited the greatest difference in Metacognitive Knowledge of Self. However, this difference was reduced in the post‐questionnaire, indicating that TAs demonstrated the greatest increase in this parameter. Several specific themes were identified through thematic analysis. For example, TAs were more internally‐focused on personal traits and content mastery whereas faculty were externally‐focused on interpersonal factors (e.g. student names, inclusive language, etc.).CONCLUSIONOverall, gross anatomy instructors improved their metacognition, particularly in relation to the metacognitive knowledge of their own strengths and weaknesses. TAs exhibited the most metacognitive growth while faculty remained consistent, possibly due to a ceiling effect. Upon reflection, TAs tended to focus on personal aspects while faculty focused on interpersonal aspects of teaching.SIGNIFICANCEThese insights into the metacognitive processes and educational priorities of anatomy instructors can inform how to best support their professional development at different stages in their careers. Novices may benefit more from content reviews while experienced instructors may benefit from pedagogical or communications training.