Anatomy Students Research Articles

Problem-solving strategies used in anatomical multiple-choice questions.

Background and AimsMultiple‐choice questions (MCQ) in the anatomical sciences are often perceived to be targeting recall of facts and regurgitation of trivial details. Moving away from this assumption requires the design of purposeful multiple‐choice questions that focus on higher‐order cognitive functions as opposed to rote memorization. In order to develop such questions, it was important to first understand the strategies that students use in solving multiple‐choice questions. Using the think‐aloud protocol, this study seeks to understand strategies students use in solving multiple‐choice questions. Specifically, it seeks to uncover patterns in the reasoning process and tactics used when solving higher and lower order MCQ in anatomy. The research also provides insights onto how these strategies influence the student's probability of answering questions correctly.MethodsMultiple‐choice questions were created at three levels of cognitive functioning based on the ideas, connections, extensions (ICE) learning framework. The think‐aloud protocol was used to unravel problem‐solving strategies used by 92 undergraduate anatomy students as they solved multiple‐choice questions.ResultsSixteen strategies were identified through the oral and written think‐alouds that students used to solve MCQ. Eleven of these have been described and supported by the literature, while the rest were utilized by our students when solving MCQ in anatomy. Domain‐specific strategies of visualizing and recalling had the highest use. Personal connection was a strategy that allowed students to achieve success in all ICE levels in the oral think‐alouds and in the I and E levels in the written think‐alouds.ConclusionsThis research argues that it is upon us as educators to make learning visible to our students, specifically through the use of think‐alouds. It also raises awareness that when educators facilitate the process of students making personal connections, it aids students in new knowledge being integrated effectively and retrieved accurately.

Facility-Related Factors Affecting Academic Performance of Medical Students in Human Anatomy.

IntroductionMedical students’ academic performance plays an important role in producing qualified graduates who will become great practitioners and workforce for the country’s health sector responsible for controlling, diagnosing, and treatment of diseases. The purpose of this study was to identify college facility-related factors affecting medical students’ academic performance in the human anatomy course.MethodsTo achieve the objective of this study, a cross-sectional study design was carried out between January 13 and March 30, 2019. One hundred twenty study participants were recruited in the study. Data were collected using self-administered questioners. Binary and multinomial logistic regression were applied to analyze the data.ResultsA total of 120 participants were included in the study. Of which, 81 (67.5%) were male while 39 (32.5%) were females. Dormitory crowdedness (AOR 3.16 (95% CI: 0.83–2.01, p= 0.11), large class size (AOR = 2.36; 95% CI: 1.11–4.64 p = 0.005), inadequate classroom facilities (AOR = 1.56; 95% CI: 1.51–4.91, p = 0.001), low internet access (AOR = 1.99; 95% CI: 1.07–3.22, p = 0.015) and inadequate anatomy-teaching model (AOR = 2.63; 95% CI: 1.17–6.12, p =0.003) were significantly associated with low performance of students in human anatomy course exam. However, college library (AOR = 0.23; 95% CI: 0.1–0.48 p = 0.061) did not show significant association with academic performance (p = 0.61).ConclusionDormitory crowdedness, large class size, inadequate classroom facilities, low internet access, and inadequate anatomy-teaching models were independent factors, which affect the performance of medical students in the human anatomy course exam. However, there was no significant association between the college library and the performance of study participants in this particular course.

Interprofessional team-based learning in basic sciences: students' attitude and perception of communication and teamwork.

ObjectivesTo explore whether a team-based learning strategy applied to an interprofessional course on basic science changes students' perception of communication and teamwork skills and attitudes as related to interprofessional learning. MethodsA mixed-methods approach was utilized. The participants were selected through an opportunity sample of 33 first-semester anatomy students from occupational therapy and orthoptics programs. Students completed an interprofessional questionnaire before and after the course. The data were analyzed descriptively. Fourteen students were selected randomly for group interviews. Qualitative data was interpreted using thematic analyses. ResultsThe pre-test scores for 'communication and teamwork skills' and 'interprofessional learning' were high with mean values of 26.58 and 34.24, respectively. The post-test scores were 27.30 and 34.27, respectively, indicating no relevant changes in students' perception and attitudes. Qualitative data suggested that team-based learning represents a valid strategy to encourage communication and teamwork skills but revealed a lack of interprofessional exchange during the course. Students reported that classroom activities must require the professional knowledge of all participating groups in order to prevent a negative attitudinal shift towards interprofessional education in the later years of their studies. ConclusionsImplementing team-based learning in basic sciences can encourage communication and teamwork among students. Mixed classes can help socialize students of different professional groups, although they carry a risk of a negative attitudinal shift towards interprofessional education. Whether, and in what ways, effective interprofessional exchange during the teaching of basic sciences can be achieved needs further investigation.

Attitudes of Anatomy Students toward Commemorations for Body Donors: A Multicultural Perspective.

Many medical schools practice commemorative ceremonies to honor body donors. Attitudes of medical education stakeholders toward these ceremonies have not yet been fully investigated. The aim of this study was to explore anatomy students' attitudes toward commemorations at a multicultural institution which has not introduced these ceremonies yet. A survey was carried out on different groups of anatomy students that were exposed and not yet exposed to human remains. The survey was used to record basic demographic data from the respondents, ask if they would support the establishment of an anatomy commemoration and in which format. A total of 756 anatomy students participated in the survey (response rate 69.8%). The majority (76.3%) were in favor of introducing a commemoration for donors. The associations of students' gender, attitude toward body donation, and level of exposure to human remains with attitudes toward commemoration for donors were identified (P<0.05), whereas ethnicity and religion seemed to have no influence on attitudes (P>0.05). Most students believed that anatomy staff and students should organize the commemoration. There was a preference for the commemoration to be secular with revealed identities of donors, and not recorded for social media. The support for the establishment of commemorations transcended cultural and religious differences and confirmed students' respectful attitude toward donors. Anatomy commemorations seem to have potential not only to engage students with one another, and donor families, but also to pave the way for students to become life-long ethical and empathetic learners and practitioners.

Johann Adam Kulmus-on the importance of his anatomical tables for surgery in Europe and for medical training in Japan

This article describes the life and medical historical achievements of Johann Adam Kulmus (1689-1745), aGerman physician from Breslau and an anatomist in Danzig. His "Anatomical tables for students of anatomy" published in 1722 made him famous and were written in German, which for a textbook of anatomy was very unusual at that time. They became one of the most frequently published textbooks of anatomy in the eighteenth century and were also translated into other European languages and also Latin. In 1774 they even appeared in Japan after years of effort in the translation from the Dutch language into the national language and were intended to serve for a long time as the fundamental scientific anatomical textbook in the medical training. Therefore, the anatomical tables stand ipso facto for a successful example of efforts for the introduction of west European medicine in Japan, which had already begun since the beginning of the early modern period.

INFLUENCE OF VIRTUAL REALITY TOOLS ON HUMAN ANATOMY LEARNING

The paper considers virtual reality (VR) as an effective way of teaching and learning. It discusses the possibilities of modern educational information technologies implementation, the educational advantages and drawbacks of 3D technologies and highlights VR features which enable dynamic forms of learning by creating artifacts in virtual environment with activities triggered by learners’ interaction. The effective role of the means of VR in education is determined and theoretically substantiated. Approaches aimed at increasing the theoretical and practical readiness of learners for educational activity using VR tools are considered.&#x0D; The research participants were exposed to two learning modes: traditional (textbook style) and VR. The experiment was based on Human Anatomy VR Complete Edition by Virtual Medicine software which provided interaction with virtual models of human anatomy. Anatomy knowledge test and Students' Engagement in School Four-dimensional Scale were used to compare learning outcomes and the levels of student cognitive engagement between the two groups on the basis of ANOVA test.&#x0D; Participants in the VR mode improved learning performance (i.e. recollecting and reconstituting) and engagement scores (cognitive and agency subscales) compared to those in the traditional learning mode. Emotional self-ratings before and after the learning phase in the VR mode showed an increase in positive emotions and a decrease in negative emotions. Overall, participants in the VR mode displayed an improved learning experience when compared to traditional learning methods. The combination of visualization and interactivity makes VR learning mode advantageous for effective education. The directions of further research such as organizational and psycho-pedagogical conditions of VR implementation in education and teacher training are defined.

Anatomy Students That are "Team-Taught" May Achieve Better Results Than Those That are "Sole-Taught".

Anatomy practical classes have traditionally been taught by a team of demonstrators (team-taught) in a large dissection room. More recently, particularly in nonmedical contexts, practical classes have been taught by one teacher (sole-taught) to smaller student groups. The aim of this study was to compare student outcomes when the same course was delivered with practical classes team-taught at one campus (metropolitan) and sole-taught at a second campus (regional) while maintaining similar staff to student ratios. This anatomy course, for physiotherapy and lower academically credentialed exercise science/physiology students, utilized blended delivery whereby most content was delivered online and practical classes comprised the main face-to-face teaching. In 2018, the metropolitan campus introduced team-teaching practical classes while the regional campus continued with sole-teaching. Student marks and engagement with online content were compared between campuses and to the previous year (2017) when both campuses had sole-taught practical classes. While final marks for the course increased overall in 2018 (P<0.01), exercise science/physiology students at the metropolitan campus (team-taught) improved their final marks (53.5±1.1%) compared to a slight decrease for the regional (sole-taught) campus (44.8±1.4%) (P<0.01). There were no differences between campuses for physiotherapy students in 2018. Student engagement with online content did not contribute to the improvement in marks for exercise science/physiology students. Introduction of a team-teaching format improved student marks, particularly for the lower academically credentialed students. Team-teaching should be considered as the preferred format for anatomy practical classes, particularly in courses involving students with diverse academic credentials.

Medical Students’ Fear of Death in a Gross Anatomy Course with Cadaveric Dissection

BackgroundPrior research suggests that medical students with higher fear of death are more likely to feel that providing care to terminally ill patients would have a negative personal impact. This negative perception concerning end‐of‐life care may carry into students’ careers as clinicians. Previous studies have shown that physicians with higher fear of death reported more difficulty in end‐of‐life communication and decision‐making. Because cadaveric dissection serves as an important introduction to death and dying issues, it is important to understand how this experience relates to students’ fear of death.AimThe current study aimed to identify which demographic characteristics are associated with medical student fear of death and describe how fear of death changes throughout the duration of a gross anatomy course with cadaveric dissection.MethodsProcedures were carried out according to the protocol approved by the Institutional Review Board of the University of Mississippi Medical Center (IRB # 2018‐0221) and informed consent was obtained from all participants. First year medical gross anatomy students’ were surveyed during the fall semester of 2019. Fear of death was surveyed using sixteen items from three subscales of the Multidimensional Fear of Death Scale (MFODS): Fear of the Dead (6 items), Fear of Being Destroyed (4 items), and Fear for the Body After Death (6 items). For each item, students use a Likert type scale to select the degree to which they agree or disagree with the statement, with lower scores indicating a higher fear of death. Baseline fear of death scores and demographic data (age, gender, undergraduate GPA, MCAT, and prior anatomy experience) were collected on the first day of the course, prior to beginning cadaveric dissection. These baseline scores were then correlated to demographics. To determine how fear of death changed throughout the course, the MFODS was also given at each of the four block examinations. This data was analyzed using repeated measures ANOVA.ResultsOf the 170 students invited to participate, 143 (84.1%) completed the baseline survey. Of those students, 57.3% had a prior anatomy experience while only 25.2% had prior exposure to cadavers. At the time of the baseline survey, average scores for the MFODS subscales were: Fear of the Dead (20.13 out of 30); Fear of Being Destroyed (13.57 out of 20); Fear for the Body After Death (22.99 out of 30). Complete data is currently being collected and analyzed.DiscussionResults of this study will determine if medical students’ fear of death is associated with specific demographic characteristics and how fear of death changes throughout a gross anatomy course. Understanding these relationships will allow instructors to implement interventions to support students with higher fear of death and identify a time point at which an intervention would be most beneficial. Ultimately, this would provide another means to support medical students and train physicians who are well equipped to handle end‐of‐life issues.

Anatomical software as a tool in the teaching‐learning process of human anatomy. Literature Review

IntroductionFor several decades and centuries, the use of corpses and plastic samples have been the gold standard for teaching human anatomy in undergraduate. The constant technological evolution worldwide has not left human anatomy behind. In relation to this, since the end of the 20th century and the beginning of the 21st century an enormous amount of anatomical software has been developed to support the teaching of human anatomy. which have been well accepted by both students and academics, but to date they have not been an academic revulsion to be the gold standard tool in the teaching of human anatomy.MethodsA systematic search of the literature in different databases was carried out to answer the following research question: Does the use of anatomical software improve the teaching‐learning process of students of human anatomy? The articles were filtered through criteria of inclusion and exclusion defined by the authors of this review (Fig 1). The search was done using the following terms: “Anatomical software”, “anatomical education”, “learning anatomy”, “3D anatomical”, the terms were joined through the boolean connectors “AND” “OR” “NOT”, with the above more sensitivity was given to the search strategy of Potentially readable items.ResultsThe analysis of the full‐text studies revealed that there is a wide variety of studies available in the scientific literature, which detail how these technological tools contribute to the study of human anatomy, although 65 studies were found when conducting our search that met the inclusion criteria established, when analyzing only 8 reported that the software was used for the use of learning in undergraduate or graduate students (Table 1). The analysis of all studies was measured through short questionnaire surveys or saturation surveys in which the students presented their experiences and degree of satisfaction with anatomical software through guided questions previously established by the authors. The other number of studies only analyzed the quality of the software or detailed the processes of elaboration of these. Another of the relevant things that have been analyzed is that most of the software used in the articles corresponded to skull software. The distribution is detailed in table 2.ConclusionThis review leaves us with quite a lot of questions especially in relation to the fact that our question addressed how anatomical software could influence the teaching‐learning process since no study related how software influences this process. We hoped to find that answer through some type of evaluation or some type of brain activation analysis which would allow us to analyze some cortical areas that will be enhanced with the use of software, given the above we believe that this leaves a window open for the realization of new studies that can address the previously proposed in order to attribute characteristics of the anatomical software available for the study of human anatomy and how to use them in different teaching processes.Support or Funding InformationUniversity of the Americas (Chile) Summary of studies that conducted their studies on students of human anatomy. Author and year Title Number of subjects evaluated Type of evaluation Sofware used Effects on learning Agbetoba A, 2018 Educational Utility of Advanced 3‐Dimensional Virtual Imaging in Evaluating the Anatomical Configuration of the Frontal Recess 45 ENT students and 20 medical students from five academic institutions. Survey RadiAnt Dicom Viewer Version 1.9.16 from Medixant, Pozan, Pland) Compared to a 3D software When asked which learning modality most helped to understand the spatial orientation of the frontal sinus, 56 students (86%) chose 3D learning, 3 students (5%) chose traditional 2D learning, and the remaining 6 students (9%) reported no difference between the two modalities. Chen P. 2018 Teaching Residents Frontal Sinus Anatomy Using a Novel 3‐Dimensional Conceptualization Planning Software‐Based Module 50 subjects Evaluate the recognition of frontal sinus structures. Scopis building block Participants in the FSMC using innovative software demonstrated improvements in the ability to Softwares disponibles en la literature cientifica para el studio de la anatomia humana. Software available in the scientific literature for the study of human anatomy Software name Software link Specific contents of the software RadiAnt Dicom Viewer Version 1.9.16 from Medixant, Pozan, Pland) http://www.radiantviewer.com/radiant‐dicom‐viewer‐standard.php. 2D sphenoid bone Use of Amira software, version 5.2 https://www.thermofisher.com/cl/es/home/industrial/electron‐microscopy/electron‐microscopy‐instruments‐workflow‐solutions/3d‐visualization‐analysis‐software/amira‐life‐sciences‐biomedical.html Creation of an eye model with specific structures. SPM5 https://www.fil.ion.ucl.ac.uk/spm/software/spm5/ Brain 3D‐Slicer https://www.slicer.org/ Pterygopalatine fossa Scopis building block https://scopis.myshopify.com/ Frontal Sinus VOXEL‐MAN TemopoSurg https://www.voxel‐man.com/gallery/temposurg/ 3D frontal bone The Chinese Visible Human Project http://www.visageimaging.com/ Neck, specifically larynx InVesalius https://www.cti.gov.br/pt‐br/invesalius Skull Itk‐SNAP http://www.itksnap.org/pmwiki/prnwiki.php Skull VuePACS3D https://es.allypacs.com/?gclid=CjwKCAiA66_xBRBhEiwAhrMuLelC5M2K164Ejh‐‐ Skull

An Initial Preparation for Cadaveric Dissection Ameliorates the Associated Mental distress of Human Cadaveric Dissection

IntroductionIt is universally recognized that cadaveric dissection is an essential part of training in anatomy. However, it has also been reported to lead to mental distress in some students and can even impair their intrinsic motivation to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation for cadaveric dissection. Hence it is hypothesized that providing relevant information prior to cadaveric dissection will ameliorate the mental distress of students, and improve in their academic performance.MethodsA cohort of Masters of Occupational Therapy students enrolled in an Anatomy course were provided with a curated list of journal articles and videos related to cadaveric dissection, prior to the start of the course. All students were also required to attend an oral presentation related to cadaveric dissection, immediately before commencing of dissection. The control group consisted of students who had not been provided any information or prepared for cadaveric dissection.ResultsWhen compared to the control group, students who had been prepared for cadaveric dissection reported a lesser degree of mental distress. In addition, they also demonstrated greater intrinsic motivation, and better quality of cadaveric dissection. Moreover, students reported the oral presentation to be most relevant and journal articles to be least useful in this regard.ConclusionHence preparation for cadaveric dissection is a valuable approach in the amelioration of mental distress and improvement of academic performance in anatomy students. Therefore, it is suggested that this approach could be a requisite in human anatomy.Support or Funding InformationJoydeep D Chaudhuri Joydeep D Chaudhuri, MD Associate Professor, School of Occupational Therapy 314 Commons Husson University, 1 College Circle Bangor, ME 04401 Tel: 207 8528747 Email: chaudhurij@husson.edu

More than Words? An Analysis of the Sentiment Polarity of Anatomy Lectures in Medical and Allied Health Education

Previous research suggests that medical and allied health education can erode student empathy. The decline in student empathy seems to correlate with the “hidden curriculum” ‐ the attitudes and values conveyed, most often in an implicit, informal, and unintentional fashion, via the formal educational structures, practices, and culture of an educational institution. We typically think of education as simply the transmission of facts, but the words and images used to convey those facts can also shape attitudes, even if this impact is unintended. Our study examines variation in the sentiment polarity of lectures given within the anatomy curriculum at one institution. We tested the following hypotheses: 1) the sentiment polarity of first‐year anatomy lectures is significantly different from neutral and 2) the sentiment polarity of lectures is correlated with the percentage of total lecture time spent on clinical applications. Anatomy lectures (n = 120) recorded during the 2016–17 academic year across all programs (excluding veterinary medicine) at Midwestern University were anonymized and transcribed by work study students. We analyzed transcribed lectures using text mining and a published sentiment lexicon. We counted individual words that matched the lexicon with a positive or negative sentiment, in addition to total word count, and individual word frequency. Standard anatomical descriptors (i.e., “inferior”) were excluded from the analysis. The net sentiment score for each lecture was defined as the difference between the number of positive vs negative words. We quantified the clinical content of a lecture as the proportion of time (minutes) spent on clinical applications. We used a one‐sample Wilcox test to evaluate Hypothesis 1 and Spearman rank correlation to evaluate Hypothesis 2. We used the text mining package tidytext and ran all statistical tests in R. The median sentiment score across all lectures was −18.5, which was significantly different from zero (p &lt; .001). Sentiment score was negatively correlated with the proportion of lecture time spent on clinical applications (rho = −0.316, p &lt; .001). These results suggest that first‐year anatomy students might be at risk for empathy erosion especially in the context of clinical applications because of the relatively high frequency of words with negative sentiment. This study was approved by Midwestern IRB (#AZ 1111, Approved on 01/25/2018).

Synthetic Anatomy: arts based learning to explore the possibilities of form and function

We have developed an interdisciplinary module for students in their second year of undergraduate education which imports, into anatomy, the techniques and perspectives of success &amp; assessment practices of art school. The module brings together biomedical engineers and anatomy students to speculate on and design imagined bodies that probe the boundaries of clinical, evolutionary and developmental anatomy. The students produce a technical and critical reflective portfolio and participate in a small, collaborative group project to 3D print imagined anatomy. Teaching and assessment emphasise the freedom to take risks and learn from failed avenues of investigation. A key emphasis is on structural exploration and experimentation coupled with reflection rather than literature review or writing per se. Technical teaching on 3D prints is accompanied by class workshops that explore the dimensions of documentation, the language of visual presentation and value of reflection. Workshops are led by visiting artists and we have applied the technique of the “crit”, which is a widely used form of group reflection in art and architecture schools, as a means of delivering a high degree of rigour into the science classroom. Projects are completed by mixed teams of engineering and anatomy students. There is no exam but a final “show” of projects is assessed on outcomes that are in part designed by the class at the start of the module. For learning outcomes and assessment, in addition to applying a technical and cognitive taxonomy we have introduced elements of Bloom’s less well‐known, affective taxonomy to authentically assess student commitment, pride, value and engagement. We have found that students are highly satisfied with their learning experience regardless of assessed outcome and show an extraordinary commitment to the course. Our emerging conclusion is that by paying attention to the material craft of science and exploring and reflecting on its community of practice, we can design and deliver modules that are a more valid preparation for higher level research both in terms of skills and passion for this subject.Support or Funding InformationKings College London Cultural InstituteStudent project work from the Synthetic Anatomy moduleFigure 1

Cutting to the Chase: Sectioned Plastinated Heart Models Improved Performance and Confidence in Cardiac Ultrasound

At the University of Colorado School of Medicine, hands‐on ultrasound (US) labs are incorporated into medical and graduate gross anatomy courses. In regional US labs, students perform live US scanning to learn the basics of a clinical skill and image interpretation, while reviewing key anatomy concepts. Cardiac US scanning is particularly challenging due to heart position in the thorax, and standard US views (parasternal long axis/PLAX and parasternal short axis/PSAX) differing from typical imaging and dissection views. The study aimed to evaluate 3D plastinated heart models sectioned in PLAX &amp; PSAX views as resources during novice US training.In an IRB exempt study, eight plastinated human hearts were sectioned along standard US views (4 PLAX, 4 PSAX) creating 3D‐sectioned models. Graduate gross anatomy students (N=25) were recruited during a scheduled cardiac US lab. Small groups performed cardiac scanning for 50 minutes with instructions and PLAX/PSAX views handout. Students then received a survey with 7 Likert questions of self‐confidence in heart position, PLAX and PSAX probe orientation, and anatomical structure recall and identification. Students were assessed on 8 multiple choice questions (MCQ) categorized as Anatomical Identification (N=2), US View Identification (N=3), or Combined US &amp; Anatomy (N=3). Next, groups received a PLAX‐sectioned heart model with repeat PLAX/PSAX scanning instructions and views handout. After 20 minutes scanning with models, students received another Likert survey (2 repeat self‐confidence items &amp; 9 items on 3D‐sectioned heart models as aides) and MCQ quiz of 8‐items matched to pre‐quiz. Due to time, PSAX‐sectioned models were not provided.Participant responses (n=25, 100% response rate) showed PLAX‐sectioned models perceived useful for learning PLAX US (100% agreement; ratings 4 or 5) and sectioned heart models would be useful in learning PSAX (96% agreement). Self‐perceived confidence in PLAX and PSAX probe orientation significantly improved after PLAX‐sectioned model use (Mann‐Whitney U Tests, both p&lt;0.05). Statistical analysis showed overall significant improvement on MCQ assessment after PLAX sectioned model use (Mann‐Whitney U, p&lt;0.05). Performance within MCQ categories showed changes after PLAX model usage in Anatomical Identification (10–25% increase), US View Identification (range of −4‐2% change), and Combined (0–24% increase). No statistical significance (McNemar, p&gt;0.05) was seen on individual questions within each category, except one Anatomical Identification question (McNemar, p&lt;0.05).The PLAX‐sectioned heart models were perceived as useful resources for learning basic cardiac US, specifically for learner confidence orientating probes in standard US views. Overall, MCQ performance improved after PLAX‐sectioned heart model use. Improvement could not be linked to a specific item category possibly due to small sample size. Plastinated heart models may be a valuable resource for learning cardiac US early in medical training, especially given scanning complexity and time constraints in gross anatomy courses.

Formolized Cadaveric Specimens Immersion‐Recovery Protocol

Cadaveric dissection, promoted by multiple anatomists and institutions as a fundamental area of medical education and training , requires embalming of the bodies to disinfect and preserve them. Therefore, despite being a known toxic and carcinogenic agent, formaldehyde is still widely used for its characteristics and results. Our objective is to introduce a Formolized Cadaveric Specimens Immersion‐Recovery Protocol developed at our laboratory, the chemical reagents used, performed processes and results. The protocol consists on specimen’s immersion in an aqueous solution of potassium hydroxide (KOH) for its maceration, this process causes chemical reactions like lipids saponification and proteins breakdown. The immersion time varies from one specimen to another; however, KOH concentration should never exceed 10% (w/v), otherwise tissue hydrolysis may occur. After a profuse wash, oxidative degradation is carried out: oxidizing formaldehyde into H2O and CO2 through the degradation of hydrogen peroxide (H2O2). It is extremely important to avoid the contact of this agent with the previously used KOH, which would cause the decomposition of H2O2 into H2O, O2 and hydroxyls, without obtaining a proper formaldehyde oxidation. For this purpose, sodium hypochlorite can also be used, with variable results. To ignore this chemical basis limits the achievement of ideal results. This processes allow to obtain 60% more joint movement on goniometry measures compared with formolized specimens, with a change from grey color generated by formaldehyde to ocher. Likewise, the degradation of formaldehyde allows obtaining minimum levels of it in treated specimens, thus reducing health impact on those who handle the specimens. After the recovery process, our specimens were preserved with a low formaldehyde solution. Anatomy students were invited to a peer‐guided extracurricular activity, they interacted with both formolized and recovered specimens, and a likert questionnaire was used to evaluate their experiences with both techniques. Students referred that recovered specimens looked more realistic and considered them better to work with. They also mentioned recovered corpses had less sensory hassles, like eye watering, airway irritation and coughing. Previous studies have compared Thiel solution and formaldehyde fixation. Thiel‐preserved bodies are considered to be a better choice on dissection and surgical training, since tissues offer a more realistic experience. Nonetheless, this technique has disadvantages such as higher costs, vacuum conservation, and the need of trained personal to handle the specimens. Moreover, some chemicals and infrastructure are not available worldwide. An example of the former scenario is present with Ammonium Nitrate, key component in Thiel’s, which is strictly regulated in several countriesSupport or Funding InformationAnatomy Laboratory, Universidad de Los Andes, School of Medicine

Plastinated Human Samples Are Efficient Tools In Anatomy Teaching

Most of the medical schools in the United States teach human anatomy using cadavers and/or collections of human organs and tissues stored in preservatives. Cadaveric dissections engage students in learning anatomy with real human samples and also provide them an opportunity to use their hands managing surgical tools and some surgical procedures. However, cadaveric dissection could be time‐consuming and may conflict with the current tendency of reducing contact hours in medical school curricula, particularly in gross anatomy teaching. Maintaining cadavers, organs and tissues require special space and additional time of management. Computer aided 3‐D technology as a complementary element to facilitate anatomy learning brings students a wealth of data in a short period of time. Especially, the deepest structures can be easily shown on computers (Apps). However, one major concern from students is that they are not able to recognize these structures in human bodies because “they look different to Atlas/Apps”. In this study, we aim to provide a novel approach in teaching gross anatomy. At UTRGV SOM, we equipped our anatomy lab with plastinated human samples. Plastination is a preservation technique in which polymers are used in substituting formaldehyde to fix tissues. Plastinates are dry, long‐lasting, and odorless. Students save time studying plastinates as opposed to working on cadaver dissections. In addition, exposures to possible toxic chemicals is limited to a low level while working with plastinates. Furthermore, plastinates could accurately reveal structures and structural relationships in comparison with 3‐D technology. However, due to the restriction of the techniques, plastinates are rigid and do not allow learners to investigate hidden structures and several plastinates with different preparations are required to serve the need of the demonstration from different aspects. In conclusion, from our experience, plastinates could be a novel approach to replace traditional cadaver dissection in teaching first‐ and second‐year medical students’ human anatomy. Using plastinates, our students benefit from real human sample experience and efficient content learning.

Toward an Intelligent Textbook for Human Gross Anatomy Curricula

Hundreds of publications have been written on methods for teaching human gross anatomy and closely related human physiology topics. As students find both the breadth and depth of the material challenging, various new approaches have arisen over the decades to complement or supplant the traditional methods of teaching. Concurrently, the time‐honored method of students dissecting cadavers in groups has been criticized as extremely time‐consuming, with cadavers and gross anatomy laboratories increasingly expensive to maintain and difficult to staff. Recent publications have suggested replacing cadaver dissection with the study of models and plastinated specimens. Nevertheless, this approach shows some of the same limitations as traditional dissection as students must still master diverse topics that are difficult to integrate into a coherent body of knowledge.In the present study we propose the use of a new model, an intelligent textbook underpinned by a hierarchical causal concept map based intelligent tutoring system (ITS) platform. Intelligent tutoring systems are a form of artificial intelligence (AI) that provides sophisticated one‐on‐one tutoring by modeling human knowledge. Our platform takes as input causal concept maps: diagrams of human knowledge where the components are causally linked. The hierarchical nature of these concept maps allows entire concept maps to be linked to one another, i.e., each component could be considered as a process which contains its own lower‐level concept map. This particular architecture allows our platform to address a number of the difficulties faced by students of human gross anatomy: connecting facts and concepts learned separately, building hierarchies among those concepts, and understanding that the causal relations between these concepts happen simultaneously.For example, a student studying the interaction of the cardiovascular and respiratory systems might be asked to explain shortness of breath in cases of both physical exercise and altitude change. A causal concept map on the topic explains part of this phenomena via the interaction of three components: a ratio between oxygen demand and oxygen supply, respiratory volume, and the process of respiration itself. Causally, the increase in the ratio of oxygen demand to oxygen supply causes an increase in respiratory volume, contributing to an increase in respiration, which permits an increase in the original oxygen demand to oxygen supply ratio, completing the homeostatic loop. If a student wished to explore one of these components more deeply, the hierarchically connected concept map allows for that. For example, respiratory volume could be explained as follows: an increase in diaphragmatic muscle contraction amount causes an increase in the intercostal muscle contraction amount, leading to an increase in thoracic volume, which allows for an increase in both volume of air inhaled and exhaled. Explicitly detailing the concepts as well as their relationships through an intelligent textbook supplement allows students the opportunity to interact with these topics at individually appropriate levels.Support or Funding InformationNot applicable

Increasing Success of Underserved Students in Human Anatomy

The Student Academic Success Center is a multicultural learning community that supports students who are low income, first generation, and underrepresented at the University of Colorado Boulder. In order to improve undergraduate science outcomes for students who are traditionally underserved in higher education, our department offers small sections of high risk gateway courses. Prompted by low performance in the large main campus section of Human Anatomy, we developed a small section this course for our department. Our small section of Human Anatomy used the same lecture material and exams as the main campus sections. We added a recitation that met for 75 minutes per week. During the recitation, students completed a variety of activities including concept maps, worksheets, and clay‐building facilitated by undergraduate Instructional Assistants. Students also completed weekly quizzes during the recitation. Students in our community who took the main campus section of Human Anatomy had an average success rate (defined as a final grade of A or B) of 40% and a D/F rate of 31%. In the small section of Human Anatomy, we observed an average success rate of 45% and D/F rate of 7%. These results indicate that the small class model embedded in a community with extra support may increase the success of underrepresented students in Human Anatomy and has implications for increasing persistence of a diverse student body in health career trajectories.

Do Undergraduate Choices Predict Medical Gross Anatomy Performance?

A 2019 study conducted by Robertson et al. suggested that the amount of prior anatomy experience does not predict the performance of first‐year medical students in medical gross anatomy at the University of Mississippi Medical Center (UMMC). In recent years, it has not been possible for UMMC to accept non‐state residents to its medical program. Thus, nearly seventy‐five percent of first‐year medical students matriculate from one of five major in‐state institutions. At current writing, four of the five schools directly communicate with the UMMC admissions program regarding the relationship between their courses and UMMC’s specific institutional mission. First‐year students enter UMMC with a wide range of previous undergraduate and graduate degrees. The undergraduate choices investigated were which institution(s) students attended, what type and how many degree(s) they attained, and whether they took an anatomy course prior to attending UMMC. We hypothesized 1) that undergraduate degree does not predict performance in a medical gross anatomy course, 2) individuals with science majors are more likely to have prior anatomy experience, 3) the collaboration of the previous institution with UMMC does not predict performance in a medical gross anatomy course, and 4) students from Mississippi College who have prior anatomy experience will perform better in the medical gross course at UMMC. Mississippi College implements a gross anatomy curriculum that is nearly identical to the course taught at UMMC. Data was collected from 280 first‐year medical students at UMMC in the fall of 2016 and fall of 2017. Using a self‐reported survey, data was collected on the number and type of prior degrees and prior anatomy experience. The course director provided student performance data in the medical gross anatomy course. The office of admissions of the medical school confirmed the prior degrees and previous academic institutions of the students. Quantitative analysis was used to determine the validity of the research hypotheses. The results of this study could provide additional guidance to undergraduate students during the degree selection process prior to applying to medical school.

Retrieval Enhances Higher and Lower Order Thinking in Anatomy and Physiology Students

Retrieval practice is a learning strategy that was developed by cognitive scientists and is based on the act of recalling information after exposure. Over the last two decades, many dozens of studies have found that retrieval‐based strategies can enhance learning and memory more effectively than more commonly‐used strategies such as repetitive reading. Although the advantages of retrieval practice have been demonstrated in both well‐controlled laboratories and real‐world settings such as middle school and university classrooms, the evidence also indicates that most educators and students remain unaware of the benefits of the strategy. It is especially unfortunate when such an effective learning strategy is underutilized in courses that cover anatomy and physiology information because many students find those subjects to be particularly complex, overwhelming, and difficult to learn. The purpose of this presentation is to review key studies that examined the effects of retrieval practice on lower and higher orders of thinking with anatomy, physiology, and medical information. Lower orders of thinking include the abilities to identify, define, and distinguish; whereas higher orders of thinking include the abilities to transfer, critique, and evaluate. The evidence reviewed in this presentation demonstrates that retrieval practice is a relatively effective means by which to increase both higher and lower order thinking with anatomy and physiology information.Support or Funding InformationNone

Breaking Down Barriers to Learning with Stereoscopic 3D Technology: Comparison of Google Cardboard, Red‐Cyan Anaglyphs &amp; Glasses‐Free 3D

INTRODUCTIONWe previously developed a free‐to‐download 3D virtual reality (VR) anatomical quiz app (VRBR https://play.google.com/store/apps/details?id=ca.MacAnatomy.VRBR2) and provided it to 850 undergraduate anatomy and physiology students in Sept 2018, along with the required Google Cardboard headsets. The app utilized Google Cardboard to allow for an inexpensive VR viewing experience of digitally‐pinned side‐by‐side (SBS) stereo pairs from David L. Bassett’s A Stereoscopic Atlas of Human Anatomy. Survey data was collected to determine how students used this new technology as a self‐test in their learning. Students expressed multiple barriers to using the app, including: the quiz questions were separate from the 3D images (31%), the app was too large (20%), students felt nauseated (19%), or the app was incompatible with their smartphone (8%). These issues led to much lower student usage than expected. Bottom line: it doesn’t matter how effective a new technology may be for learning, if students won’t use it in the first place.The PURPOSE of our study was to evaluate if student usage increases when barriers to use are removed by using alternate 3D viewing formats. We chose to compare red‐cyan anaglyphs to SBS stereo pairs because anaglyphs could address several of the concerns expressed by students.METHODSDigitally labeled anaglyphs were hosted on the learning management system (LMS) used by the university. Student usage of the anaglyphs was tracked over the first semester of the 2019–20 year and compared to the usage of the SBS stereo pairs over the first semester of the 2018–19 year. Student usage was determined from the number of quiz submissions on the university’s LMS at 3 time points during the term. Statistical analysis was performed with Graphpad Prism.RESULTSBetween the start of term and the start of the midterm recess (5 wks) the anaglyph study aid increased usage by 82% over the prior year using SBS stereo pairs. Prior to the practice practical exam at midterm, the anaglyph study aid usage was 138% greater than SBS stereo pairs. The average number of quiz submissions per week using the anaglyphs vs SBS stereo pairs increased by 135% (n=3, one‐tailed student t‐test, p&lt;0.02).CONCLUSIONOur results demonstrate that red‐cyan anaglyphs are more readily used by students to view 3D images in a self‐study application compared to SBS stereo pairs on Google Cardboard. This suggests that students are more willing to utilize a new technology when the barriers to use are minimized. Although the use of anaglyphs increased the number of quiz submissions, the red‐cyan format distorts colors, introducing a new barrier to use. It is likely that a 3D format that also removes this new barrier would increase the use of the study aid even further. We plan to test this hypothesis by comparing anaglyphs to images presented on a glasses‐free 3D display (Alioscopy http://www.alioscopy.com/en/3Ddisplays.php). Qualitative data on the ease of use as well as quantitative data on quiz performance will be compared.