Article

Human Cadavers Vs. Multimedia Simulation: A Study of Student Learning in Anatomy

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Abstract

Multimedia and simulation programs are increasingly being used for anatomy instruction, yet it remains unclear how learning with these technologies compares with learning with actual human cadavers. Using a multilevel, quasi-experimental-control design, this study compared the effects of "Anatomy and Physiology Revealed" (APR) multimedia learning system with a traditional undergraduate human cadaver laboratory. APR is a model-based multimedia simulation tool that uses high-resolution pictures to construct a prosected cadaver. APR also provides animations showing the function of specific anatomical structures. Results showed that the human cadaver laboratory offered a significant advantage over the multimedia simulation program on cadaver-based measures of identification and explanatory knowledge. These findings reinforce concerns that incorporating multimedia simulation into anatomy instruction requires careful alignment between learning tasks and performance measures. Findings also imply that additional pedagogical strategies are needed to support transfer from simulated to real-world application of anatomical knowledge. Anat Sci Educ. © 2013 American Association of Anatomists.

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... The current consensus is that teaching through anatomical dissection or prosected human cadaveric specimens is most beneficial to students learning anatomy (Aziz et al., 2002;Iwanaga et al., 2020;Saltarelli et al., 2014;Sriram & Thenmozhi, 2020;Van Wyk & Rennie, 2015). The use of human cadavers allows the learner to develop an appreciation of the fragility of tissues and organs in addition to understanding the size and relative positions of anatomical structures in the multidimensional body (Aziz et al., 2002;Brenton et al., 2007;Hisley et al., 2008;Moore, 1998;Schofield, 2014). ...
... However, many believe that there is a requirement for alternative delivery styles when teaching anatomy due to issues such as the expenses involved in maintaining human cadaveric facilities, increasing student numbers, time constraints within the classroom, psychological issues, adapting to a post-pandemic setting and, in some areas, the limited availability of cadavers. (Anderton et al., 2020;Brenton et al., 2007;Hancock et al., 1998;Saltarelli et al., 2014). In addition, students may find the cadaveric experience emotionally stressful, inducing adverse psychological and/or physical reactions (Chia, et al., 2020;Horne et al., 1990;Wisenden et al., 2018), which may hinder their learning (Watkins & Moulds, 2007;Wisenden et al., 2018). ...
... Traditionally anatomy is taught via a combination of lectures and through cadaveric specimens, though it is widely believed that teaching through anatomical dissection or prosected human cadaveric specimens is the most beneficial method (Aziz et al., 2002;Moore, 1998;Saltarelli et al., 2014). Cadaveric learning allows the learner to develop an understanding of the physical properties within the body as well as have exposure to the variability of organic structures in humans that may not be present in plastic models or textbooks (Aziz et al., 2002;Brenton et al., 2007;Hisley et al., 2008;McLachlan et al., 2004;Moore, 1998). ...
Article
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Anatomical dissections and prosected cadaveric specimens are currently believed to be the most beneficial delivery method for tertiary anatomy education. However, there is increasing demand within the tertiary medical education community for alternative delivery methods to complement current teaching practices, particularly in the complex field of neuroanatomy. To ensure that students learning of neuroanatomy is effective, it is necessary to take an evidenced-based approach. Therefore, this review will compare and contrast the different factors involved in learning neuroanatomy and the different modalities that can be used to teach this complex topic. Further, this review will also highlight the differences between individual and mixed-model delivery systems, which may influence the current pedagogies surrounding tertiary neuroanatomy in the dynamic educational setting.
... The current consensus is that teaching through anatomical dissection or prosected human cadaveric specimens is most beneficial to students learning anatomy (Aziz et al., 2002;Iwanaga et al., 2020;Saltarelli et al., 2014;Sriram & Thenmozhi, 2020;Van Wyk & Rennie, 2015). The use of human cadavers allows the learner to develop an appreciation of the fragility of tissues and organs in addition to understanding the size and relative positions of anatomical structures in the multidimensional body (Aziz et al., 2002;Brenton et al., 2007;Hisley et al., 2008;Moore, 1998;Schofield, 2014). ...
... However, many believe that there is a requirement for alternative delivery styles when teaching anatomy due to issues such as the expenses involved in maintaining human cadaveric facilities, increasing student numbers, time constraints within the classroom, psychological issues, adapting to a post-pandemic setting and, in some areas, the limited availability of cadavers. (Anderton et al., 2020;Brenton et al., 2007;Hancock et al., 1998;Saltarelli et al., 2014). In addition, students may find the cadaveric experience emotionally stressful, inducing adverse psychological and/or physical reactions (Chia, et al., 2020;Horne et al., 1990;Wisenden et al., 2018), which may hinder their learning (Watkins & Moulds, 2007;Wisenden et al., 2018). ...
... Traditionally anatomy is taught via a combination of lectures and through cadaveric specimens, though it is widely believed that teaching through anatomical dissection or prosected human cadaveric specimens is the most beneficial method (Aziz et al., 2002;Moore, 1998;Saltarelli et al., 2014). Cadaveric learning allows the learner to develop an understanding of the physical properties within the body as well as have exposure to the variability of organic structures in humans that may not be present in plastic models or textbooks (Aziz et al., 2002;Brenton et al., 2007;Hisley et al., 2008;McLachlan et al., 2004;Moore, 1998). ...
Article
Full-text available
Anatomical dissections and prosected cadaveric specimens are currently believed to be the most beneficial delivery method for tertiary anatomy education. However, there is increasing demand within the tertiary medical education community for alternative delivery methods to complement current teaching practices, particularly in the complex field of neuroanatomy. To ensure that students learning of neuroanatomy is effective, it is necessary to take an evidenced-based approach. Therefore, this review will compare and contrast the different factors involved in learning neuroanatomy and the different modalities that can be used to teach this complex topic. Further, this review will also highlight the differences between individual and mixed-model delivery systems, which may influence the current pedagogies surrounding tertiary neuroanatomy in the dynamic educational setting.
... When cadaveric dissection was compared with cadaveric prosection, students who used prosections performed the same or better on class quizzes/ exams, [16][17][18] had better retention of material, 8,19 and completed laboratory time faster than students in a cadaveric dissection program. 6,8,18,19 A multimodal approach with physical therapy students investigated computer-based learning (video dissection) and access to plastic models for learning anatomical content, with or without cadavers. 4,10 Consistent scores were reported between groups, 4 and the supplemental learning improved subjects' ability to name and associate anatomical structures from memory. ...
... 10 However, for a multimodal approach to be effective, it is important to ensure a careful alignment between learning tasks and performance outcomes measured. 6 When a novel learning experience was added to course work, the extraneous load in learning the modality may have hindered a student's performance in the class. 7 erefore, to have successful outcomes, transfer of learning must occur, or the ability to use knowledge in more than 1 context, perhaps indicating a need to integrate simulation experiences with actual cadaver-based experiences. ...
... 7 erefore, to have successful outcomes, transfer of learning must occur, or the ability to use knowledge in more than 1 context, perhaps indicating a need to integrate simulation experiences with actual cadaver-based experiences. 6 Academic performance improved when instruction was matched to a student's preferred learning style. A multimodal anatomy workshop (body painting, clay modeling, white boarding, and quizzes) was reported to accommodate students' learning styles and resulted in improved examination performance and a deeper approach to learning. ...
... 7 Adicionalmente, outras ferramentas como e-learning, áudios, vídeos, jogos e realidade tridimensional têm sido empregadas para complementar o ensino da Anatomia. [6][7][8][9] Apesar de, o uso de cadáveres ser reconhecidamente necessário para o ensino da anatomia, 6-9 o uso de peças sintéticas e outras tecnologias pode colaborar com o aprendizado. ...
... Ademais, muitos estudantes se mostram apreensivos antes de ver o cadáver pela primeira vez, e podem apresentar mal-estar, fraqueza e náusea ao entrar em contato com ele. 10 Estudos mostram que é relevante atentar-se as preferências dos estudantes, 6 as facilidades de cada recurso didático e as contribuições do uso de cadáveres e de tecnologias no ensino da anatomia. 9 Contudo, essas evidências são majoritariamente provenientes de pesquisas realizadas com estudantes da área médica 6, 8-9 e, em relação à enfermagem, há escassez de estudos que abordam tais características. 3,5 O ensino da anatomia para a enfermagem compõe o "eixo básico" para a compreensão das estruturas anatômicas (forma e localização) o que permite a comparação com as estruturas do indivíduo vivo; promove melhor entendimento da fisiopatologia, da avaliação clínica, e da Uso de peças cadavéricas e modelos sintéticos no ensino da anatomia nos... ...
... O uso de livros didáticos, imagens e réplicas sintéticas do corpo humano é visto, por alguns autores, como fantástico meio de estudo para os estudantes e profissionais da saúde, Uso de peças cadavéricas e modelos sintéticos no ensino da anatomia nos...| 14 Rev. Enferm. UFSM, Santa Maria, v10, p. 1-18, 2020 visto que tem facilitado a busca por informações e dão uma ideia das estruturas anatômicas contribuindo assim para sua visualização.3,9,18,24 Complementarmente, os softwares anatômicos também oferecem aos estudantes imagens tridimensionais das estruturas e são vistos como um suporte adicional para sua identificação.9,13,24 ...
Article
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Objetivo: identificar potencialidades e dificuldades do uso de peças cadavéricas e sintéticas no ensino de anatomia nos cursos de Enfermagem. Método: estudo quantitativo, transversal e descritivo. Um questionário contendo 23 perguntas foi enviado aos estudantes do curso de Enfermagem que finalizaram a disciplina de anatomia nos anos de 2015 e 2016. Os dados foram analisados com auxílio de software estatístico denotados por frequência absoluta e relativa. Resultados: participaram do estudo 132 estudantes, destes 80,3% concordaram que as peças cadavéricas ajudam na construção do conhecimento; 35,6% não apresentam dificuldades em relacionar peças sintéticas com as cadavéricas; 38,6% discordam que o uso somente de peças cadavéricas é suficiente para a aprendizagem e 55,3% consideram que a utilização concomitante das peças auxilia o entendimento. Conclusão: o uso de cadáveres no ensino da Anatomia apresenta mais potencialidades quando comparado ao uso de peças sintéticas. A utilização associada desses recursos facilita o processo de ensino-aprendizagem.
... Although computer-based instruction is frequently lauded as a supplemental resource (Durosaro et al., 2008;McNulty et al., 2009;Tam et al., 2010;Jaffar, 2012;Green & Hughes, 2013;Green et al., 2014;Topping, 2014;Srinivasan, 2020), students often prefer cadaverbased learning over computer-based alternatives (Azer & Eizenberg, 2007;Petersson et al., 2009;Kerby et al., 2011;Davis et al., 2014;Ogard, 2014;Attardi et al., 2016). In addition, numerous studies have shown computer-based learning to be less effective than traditional methods when used as a substitute in anatomy (Khot et al., 2013;Preece et al., 2013;Saltarelli et al., 2014;Mathiowetz et al., 2016), further suggesting that student performance and satisfaction may depreciate during the ERT phase. Other studies have reported that students experienced psychological distress after the onset of the Covid-19 pandemic (Cao et al., 2020;Li et al., 2020;Zhai & Du, 2020a), affecting students' learning and performance (Vogel & Schwabe, 2016). ...
... Despite increases in student grades, roughly three out of every four students reported less confidence in their ability to learn, less knowledge gained, and less preparedness for the future during the ERT duration ( Figure 2). These results agree with previous studies demonstrating that computer-based learning is not as efficient as traditional methods to learn anatomy (Khot et al., 2013;Preece et al., 2013;Saltarelli et al., 2014;Mathiowetz et al., 2016). They also reinforce the notion that cadaver laboratories offer a "hidden curriculum", wherein students learn aspects of professionalism and ethics (i.e., "preparedness for the future") through their interactions with cadavers (Bamber et al., 2014;Sándor et al., 2015;Karunakaran et al., 2017;Evans et al., 2018;Kumar Gosh & Kumar, 2019). ...
Article
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Due to the Covid‐19 pandemic, the education system worldwide faced sudden and unforeseen challenges. Many academic institutions closed their doors, forcing both educators and students to transition to Emergency Remote Teaching (ERT) for the remainder of the semester. This transition eliminated hands‐on experiences, increased workload, and altered curricula. However, these aspects, as well as students’ perceptions, study habits, and performance in response to ERT remain poorly documented. This contribution describes changes in the curriculum of an undergraduate cadaver‐based laboratory, and explores students’ performance, self‐perceived learning, and overall satisfaction during this educational crisis. Online content delivery for this course included both asynchronous instruction and synchronous discussion sessions. While formative assessments remained the same, online spotter examinations included short answer, multiple choice, multiple answer, ordering, and true and false questions. Despite examination grades improving 20% during ERT, students reported lower levels of learning, confidence, and engagement with the course materials when compared to the face‐to‐face portion of the class. The most prevalent challenges identified by students were those related to the loss of access to cadaver‐based learning, including difficulty identifying and visualizing structures in three dimensions, and the loss of context and sensorial cues. Flexibility in taking examinations and learning the material at their own pace were recognized as positive outcomes of the ERT transition. While the resulting student perceptions and performances are unsurprising, they offer insight into the challenges of fostering a productive learning environment in a future threatened by epidemic outbreak and economic uncertainty.
... This is because anatomy educators widely acknowledge and believe that the laboratory practical sessions provide invaluable opportunities for students to directly perceive and experience for themselves the anatomical structures described in textbooks and lectures; a view that has been validated by research suggesting that these experiences might help students visualise and experience real anatomy (Wilhelmsson et al., 2010). Nevertheless, a consequence of the debate has been the opportunity for educators to reconsider their instructional methods and tools in light of newer technological advancements in areas such as medical imaging, multimedia, and information communication technology (Lombardi, Hicks, Thompson, & Marbach-Ad, 2014;May et al., 2013; P. Murphy et al., 2014;Palombi, Pihuit, & Cani, 2011;Saltarelli, Roseth, & Saltarelli, 2014;Waters, Van Meter, Perrotti, Drogo, & Cyr, 2011). ...
... Responding to the impetus for change, anatomy education research efforts have concentrated on evaluating and comparing the effectiveness of various laboratory pedagogy on student learning outcomes (DeHoff, Clark, & Meganathan, 2011;Dreher, DePhilip, & Bahner, 2014;Preece, Williams, Lam, & Weller, 2013;Saltarelli et al., 2014;Serrat et al., 2014;ten Brinke et al., 2014;Winkelmann, 2007). ...
Thesis
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Anatomy instructional methods research and the persistent debate regarding dissection have been criticised as being overly emotive and lacking the support of empirical evidence in both numbers and quality (Bergman, Van Der Vleuten, & Scherpbier, 2011; Winkelmann, 2007). This doctoral thesis applies conversation analysis (CA), a qualitative research method, to reveal the extent to which social-interaction profoundly shapes laboratory teaching and learning. The aim is to describe the defining features of the radiography anatomy laboratory community of practice, a term originally coined by Lave and Wenger (Hellermann, 2008), in order to understand how members (i.e. demonstrators and students) enact and renew their participant roles through interaction. This applied-CA investigation examines how previously identified social interaction principles that guide everday conversations are altered and adapted in an institutional setting such as the anatomy teaching-learning laboratory. In particular, this thesis builds upon the works of Benwell and Stokoe (2002, 2005), who in the context of university education in the United Kingdom (UK), have investigated how university tutors and students display and negotiate teaching-learning agenda and institutional membership roles, identities, and relationships during the tutorial openings. Similarly, the present investigation examines the social identities and relationships that are made relevant, embodied, and negotiated by the participants in the anatomy laboratory context. To study this, the CA method was applied to six video records of anatomy laboratory sessions. The recordings were made at pre-selected time points throughout the first-year radiography program at an Australian university. The CA analyses are grounded in previous investigations that conceptualise interaction as complex multi-layered social and cultural actions, which the participants co-construct and make sense of by drawing upon and making relevant a variety of interactional resources such as body language, sentence structure, tone, membership, affiliation and the local interaction contexts (Drew, 2012a; C. Goodwin, 2013; Mondada, 2007; Streeck, 2009). This investigation demonstrates that the seemingly ‘messy’ teaching-learning processes that often characterise laboratory classes can be systematically analysed and understood. Analyses show that participants collaboratively organise interactions by orienting to a set of implicit social and cultural principles that lead to emergent regular structures and patterns of interaction. Furthermore, data suggests that participants develop evolving cultural practices that are indicative of the formation of a community of practice. By making these practices visible, CA provides a means for anatomy educators to study, reflect upon, and reconceptualise their laboratory teaching practices. Additionally, guidelines may be recommended to educators to improve the quality of their pedagogical interaction. Most importantly, instructional approaches may be more accurately described before jumping to conclusions and interventions without a thorough understanding.
... More recently, Saltarelli, Roseth, and Saltarelli (2014) compared the performance of 233 undergraduate students, approximately 20% of whom were enrolled in an allied health program, who were randomly assigned to complete either an online or FTF human anatomy and physiology course. Specifically, student participants in the FTF format completed assignments using a human cadaver while those enrolled online used Anatomy and Physiology Revealed (APR) (Schneider, Morse, Bennett-Clarke, & Hankin, n.d.), a multimedia simulation, including audio pronunciations, imaging, and three-dimensional animations, of a human cadaver. ...
... PowerPoint® presentation that was used for active note taking, a "word of the week" activity, and text-and voice-based discussions. Saltarelli et al. (2014) employed a commerciallyavailable, interactive, multimedia learning system that included high-resolution images and animations. In contrast, the present investigation employed online media and online, web-based resources that primarily required passive participation on the part of student participants. ...
Article
Accurate pronunciation of anatomical terms in the clinical practice of speech-language pathology (SLP) and audiology (AUD) enables a clinician to express and comprehend a conversation with peers and other professionals. It is also an important component of ensuring patient safety and in providing quality, patient-centered care. To date, no studies have explored whether differences may exist between the pronunciation skills of students who elect to complete a human anatomy and physiology course online versus in a face-to-face (FTF) format. This pilot study explored the ability of 98 undergraduate student participants to correctly pronounce 20 identical key terms that were a part of the course Anatomy and Physiology of the Speech and Hearing Mechanism. Students were enrolled in either an online or a FTF format of this course. Student participants were also asked to self-rate their perceived ability to pronounce these terms correctly using a Likert-type rating scale. The results indicated that students enrolled in the FTF format produced a significantly greater percentage of correct terms and rated their pronunciation ability significantly higher compared to those enrolled online. Performance of both groups was positively correlated to the self-ratings of pronunciation accuracy. These results suggest that an Internet-based, multimedia teaching method that incorporates tools for improving the pronunciation skills of students who complete a human anatomy and physiology course is warranted.
... In most Chinese medical schools, human anatomy courses mainly include cadaver dissection and reading anatomical textbooks and atlases [5]. However, some of shortcomings of dissection include the destructive nature of dissection, possible shortage and costs of procuring cadavers, storage and infrastructure to properly house the specimens, and the fumes associated with working in cadavericbased learning environments [6][7][8]. This may leave students with less time to spend on actual observing and studying human anatomy. ...
... Therefore, the CVA course which combined the VAS can raise more students' interesting, satisfaction, curiosity, environment comfort, 3D spatial thinking ability and study e ciency compared with the TA course. (Table2 Q9, 14, 20) As a superior method of teaching anatomy, the VAS and the CVA course was well received by students, but the course which totally use 3D VAS cannot completely replace traditional dissection anatomy courses (Table2 Q16, Table3 Q9) [8,28,29]. The VAS provide the realistic anatomical structures, however, it lacks the sense of touch. ...
Preprint
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Background: Education of human anatomy has always experienced many difficulties, including the lack of anatomical specimens and limitations imposed by anatomical dissection techniques that damage and change the shape and position of the anatomical structures. Methods: A digital virtual anatomy system may be the solution to these difficulties. Based on high-resolution sectional anatomical images from the Chinese Visible Human dataset, a virtual anatomy system was created. In total, 170 undergraduate students from the Third Military Medical University were divided into two groups, namely the combining virtual anatomy (CVA) group and the traditional anatomy (TA) group. The CVA group was taught using both the virtual anatomy system and the traditional anatomy course, while the TA group was taught using only the traditional course. After completing the course, the teaching outcomes were assessed by written and practical examinations, and the satisfaction levels of the students and teachers were also assessed with questionnaires. Results: The examination scores and questionnaires showed that the CVA anatomy course provided a comfortable studying environment for medical students and greatly improved their self-learning ability, active thinking ability, 3D spatial thinking ability and interest in learning. Conclusions: The teaching mode adding the virtual anatomy course with the traditional anatomy course is a new and effective way to advance the teaching of human anatomy, which is better than traditional dissection.
... While it is too early to determine whether teaching methods based solely on digital resources are superior, such approaches have many promising advantages. For example, in contrast to cadaverbased instruction, digital resources enable students to quickly find a structure, watch an animation showing its function, read its label, and listen to its pronunciation, all with only a few keystrokes [5]. Digital resources also have more viewing angles and overlays, with all essential structures clearly labeled, and may be more accurate than cadaver-based learning options [5]. ...
... For example, in contrast to cadaverbased instruction, digital resources enable students to quickly find a structure, watch an animation showing its function, read its label, and listen to its pronunciation, all with only a few keystrokes [5]. Digital resources also have more viewing angles and overlays, with all essential structures clearly labeled, and may be more accurate than cadaver-based learning options [5]. ...
Article
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Background: In medical school, the teaching of anatomy is both time-consuming and complicated. As more schools allot less time to this subject, there is a growing need to restructure anatomy teaching methodologies. This paper examines digital dissection resources and identifies how and when they were implemented in the classroom. Methods: An online survey tool was sent to osteopathic medical schools throughout the United States to determine the resources and methods being used and to assess how students were performing in corresponding anatomy courses. The anatomy director at each school was given a predetermined set of questions to enable an evaluation of the curriculum and performance of the students. Results: After data were collected from the medical schools, the results were analyzed and indicated that the use of digital anatomy resources resulted in better overall performance and grades. Conclusion: Although the small sample size precluded proper hypothesis testing, several strong trends emerged that should be investigated with a larger sample. Most notably, these trends included strong associations among the prevalence of digital anatomy training, teaching using cadavers, and student competence.
... Online anatomy education can differ markedly from the gold standard of face-to-face learning by allowing content to be paused, replayed and viewed on demand [3,4]. However, online education also reduces or removes students' physical access to cadaver specimens, other media, and in-person interactions with teachers, which may affect cadaver-based identification and explanatory knowledge [5]. To what extent does face-to-face learning improve student performance in anatomy, compared to online learning? ...
Article
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Introduction This study aimed to estimate the causal effect of face-to-face learning on student performance in anatomy, compared to online learning, by analysing examination marks under a causal structure. Methods We specified a causal graph to indicate how the mode of learning affected student performance. We sampled purposively to obtain end-semester examination marks of undergraduate and postgraduate students who learned using face-to-face (pre-COVID, 2019) or online modes (post-COVID, 2020). The analysis was informed by the causal graph. Marks were compared using linear regression, and sensitivity analyses were conducted to assess if effects were robust to unmeasured confounding. Results On average, face-to-face learning improved student performance in the end-semester examination in undergraduate students (gain of mean 8.3%, 95% CI 3.3 to 13.4%; E-value 2.77, lower limit of 95% CI 1.80) but lowered performance in postgraduate students (loss of 8.1%, 95% CI 3.6 to 12.6%; E-value 2.89, lower limit of 95% CI 1.88), compared to online learning. Discussion Under the assumed causal graph, we found that compared to online learning, face-to-face learning improved student performance in the end-semester examination in undergraduate students, but worsened student performance in postgraduate students. These findings suggest that different modes of learning may suit different types of students. Importantly, this is the first attempt to estimate causal effects of the mode of learning on student performance under a causal structure. This approach makes our assumptions transparent, informs data analysis, and is recommended when using observational data to make causal inferences.
... Our ethnographic account is offered as a testament to the commitment of those involved in HBD and CBS. As we become more technologically capable, and high-fidelity models become increasingly sophisticated and more readily available (Saltarelli et al., 2014), HBD is, to some degree, at risk. This threat is even more pronounced as we find ourselves in the midst of the COVID-19 pandemic, engaging in educational innovations that allow for physical distancing (Iwanaga et al., 2021). ...
Article
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Human body donation (HBD) serves an essential function in many medical schools, particularly in institutions where people engage in cadaver-based simulation (CBS) as a pedagogical approach. The people who facilitate HBD and CBS have a highly specialized skill set, yet their expertise remains largely unacknowledged, and takes place out of sight from the broader medical school community. This manuscript, based on a two-year practice-based ethnography (Structured Observations n = 68 h, Unstructured Observations n = 150 + hours; Interviews n = 24; and Document/Policy Analysis n = 14) illuminates the complex work of HBD. We identify three primary functions of HBD and CBS (1. Cadaver Intake & Administration, 2. Cadaver Preparation, and 3. Cadaver-Based Pedagogy). We describe how medical educators involved in CBS have developed a skillset specific to their role: negotiating humanity.
... Implementing an assessment involving project development and research presentation in anatomy curricula actively applies the "authentic learning" pedagogy (Pawlina & Drake, 2016) in anatomy, representing an innovative pedagogical strategy to support the transfer from digital-based learning to real-world application of anatomical knowledge (Saltarelli et al., 2014). This multimedia anatomy project approach not only promotes active learning but ultimately advances anatomy discipline and research innovation, providing new evidence that innovative assessment approaches supplement to traditional exams can be incorporated in anatomy curriculum to encourage experiential learning and knowledge translation. ...
Article
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Anatomy is shifting towards a greater focus on adopting digital delivery. To advance digital and authentic learning in anatomy, a flipped classroom model integrating multimodal digital resources and a multimedia group assignment was designed and implemented for first‐year neuroanatomy and third‐year regional anatomy curricula. A five‐point Likert scale learning and teaching survey was conducted for a total of 145 undergraduate health science students to evaluate students’ perception of the flipped classroom model and digital resources. This study revealed that over two‐thirds of participants strongly agreed or agreed that the flipped classroom model helped their independent learning and understanding of difficult anatomy concepts. The response showed students consistently enjoyed their experience of using multimodal digital anatomy resources. Both first‐year (75%) and third‐year (88%) students strongly agreed or agreed that digital tools are very valuable and interactive for studying anatomy. Most students strongly agreed or agreed that digital anatomy tools increased their learning experience (~ 80%) and confidence (> 70%). The third‐year students rated the value of digital anatomy tools significantly higher than the first‐year students (P = 0.0038). A taxonomy‐based assessment strategy revealed that the third‐year students, but not the first‐year, demonstrated improved performance in assessments relating to clinical application (P = 0.045). In summary, a flipped anatomy classroom integrating multimodal digital approaches exerted positive impact upon learning experience of both junior and senior students, the latter of whom demonstrated improved learning performance. This study extends the pedagogy innovation of flipped classroom teaching, which will advance future anatomy curriculum development, pertinent to post‐pandemic education.
... Differing ideological perspectives surrounding the pedagogic strengths and limitations of human specimens, and conflicting views regarding the respective value of the usage of cadaveric material for dissection versus prosection, have been debated comprehensively within the anatomy education literature (Ghosh 2017;Guttmann et al. 2004;Mclachlan et al. 2004;Sheikh et al. 2016;Winkelmann 2007;Wilson et al. 2018;Topp 2004;Granger 2004;Pawlina and Lachman 2004). Further debate has surrounded the integration of technologyenhanced learning approaches within anatomy curricula to supplement or even replace cadaveric anatomy, a conversation which has increased at pace during the last two decades (Moore et al. 2017;Sheikh et al. 2016;Miller 2016;Slon et al. 2014;Biasutto et al. 2006;Fasel et al. 2016;Aziz et al. 2002;Keenan and Ben Awadh 2019;Saltarelli et al. 2014). Moreover, the decisions of individual institutions when choosing and maintaining preferred embalming techniques may have pragmatic rather than scholarly underpinnings and may be determined by contextual factors relating to technical skills, programme curricula, and anatomy teaching approaches (Balta et al. 2015a). ...
Chapter
Within the discipline of anatomical education, the use of donated human cadavers in laboratory-based learning activities is often described as the 'gold standard' resource for supporting student understanding of anatomy. Due to both historical and educational factors, cadaveric dissection has traditionally been the approach against which other anatomy learning modalities and resources have been judged. To prepare human donors for teaching purposes, bodies must be embalmed with fixative agents to preserve the tissues. Embalmed cadavers can then be dissected by students or can be prosected or plastinated to produce teaching resources. Here, we describe the history of cadaveric preservation in anatomy education and review the practical strengths and limitations of current approaches for the embalming of human bodies. Furthermore, we investigate the pedagogic benefits of a range of established modern embalming techniques. We describe relevant cadaveric attributes and their impacts on learning, including the importance of colour, texture, smell, and joint mobility. We also explore the emotional and humanistic elements of the use of human donors in anatomy education, and the relative impact of these factors when alternative types of embalming process are performed. Based on these underpinnings, we provide a technical description of our modern Newcastle-WhitWell embalming process. In doing so, we aim to inform anatomy educators and technical staff seeking to embalm human donors rapidly and safely and at reduced costs, while enhancing visual and haptic tissue characteristics. We propose that our technique has logistical and pedagogic implications, both for the development of embalming techniques and for student visualisation and learning.
... Human body dissection has been described as a critical educational experience for the mastery of anatomical structures, concepts, and spatial relationships (Aziz et al., 2002;Rizzolo & Stewart, 2006). Studies have shown the benefit and effectiveness of cadaveric dissection compared to computer-based and multimedia simulation resources (Khot et al., 2013;Saltarelli et al., 2014), and Weeks et al. (1995) has suggested that the student encounter with a body donor reinforces respect and compassion, traits critical to student development and successful clinical practice. State and/or institutional Anatomical Donation Programs (ADPs) are tasked with the responsibility of acquiring body donors for basic and clinical science curricula. ...
Article
Introduction The inclusion of human body dissection in anatomical science curricula has been described as a critical educational experience for the mastery of anatomical structures and concepts. To ensure that body donors are ethically acquired and suitable for anatomy education, Anatomical Donation Programs (ADPs) are tasked with the responsibility of acquiring body donors for basic and clinical science curricula. Considering the personal and institutional impact of SARS-CoV-2, a national survey was conducted to examine the current effect of the pandemic on ADP protocols, body donation, and the sustainability of ADPs in the United States (U.S.). Materials and Methods Eighty-nine U.S. ADPs were identified and contacted for optional participation in a survey to assess the impact of the SARS-CoV-2 pandemic on their programs. Survey data were collected and managed using REDCap electronic data capture tools. Results Thirty-six ADPs (40.5% response rate) from the nine U.S. Divisions are represented in the survey results. Data were collected on ADP descriptions and demographics, SARS-CoV-2 impact on ADPs and protocols, and body donation and ADP sustainability. Conclusions Almost all ADPs reported that the pandemic has affected their ADP operations in some way; however, the sustainability for the majority of ADPs appears likely and donor availability remains stable due to a proportional decrease in body donations and body donor requests. As the long-term impact on ADPs has yet to be determined, the authors plan to reevaluate the lasting impact of the SARS-CoV-2 pandemic on body donation, ADP sustainability, and anatomical science education throughout the year 2021.
... This is the same trajectory observed for other living species (Bennett, 2017). And, like other native species, cadavers can be challenged by competition within the ecosystem (Saltarelli et al., 2014). There are many competitors for time and attention in the anatomy laboratory ecosystem such as physical models and digital cadavers. ...
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This article explores the effects of the coronavirus disease 2019 (Covid-19) pandemic on the evolution of both physical and digital cadavers within the unique ecosystem of the anatomy laboratory. A physical cadaver is a traditional and established learning tool in anatomy education, whereas a digital cadaver is a relatively recent phenomenon. The Covid-19 pandemic presented a major disturbance and disruption to all levels and types of education, including anatomy education. This article constructs a conceptual metaphor between a typical anatomy laboratory and an ecosystem, and considers the affordances, constraints, and changing roles of physical and digital cadavers within anatomy education through an ecological lens. Adaptation of physical and digital cadavers during the disturbance is analyzed, and the resiliency of digital cadaver technology is recognized. The evolving role of the digital cadaver is considered in terms of increasing accessibility and inclusivity within the anatomy laboratory ecosystem of the future.
... In the case of visualization, the question is whether students can apply what they learn with images or digital models (one context) on actual human specimens (another context). There has been conflicting evidence with one study of first-year medical students showing that they failed to apply their knowledge on digital images having initially learned with human cadavers (Hisley et al., 2008); while another study of students undertaking an undergraduate human anatomy course showing the polar opposite with students failing to apply knowledge learned from digital images on human cadavers (Saltarelli et al., 2014). Successful transfer is considered by some to be a positive sign of learning (Perkins and Salomon, 2012) but in the above cases, the transfer of learning failed to take place and this raised concerns. ...
Article
The impact of the medical curricular reform on anatomy education has been inconclusive. A pervasive perception is that graduates do not possess a sufficient level of anatomical knowledge for safe medical practice; however, the reason is less well‐studied. This qualitative study investigated the perceived challenges in learning anatomy, possible explanations, and ways to overcome these challenges. Unlike previous work, it explored the perceptions of multiple stakeholders in anatomy learning. Semi‐structured interviews were conducted and the transcripts were analyzed by a grounded theory approach. Three main themes emerged from the data: (1) visualization of structures, (2) body of information, and (3) issues with curriculum design. The decreasing time spent in anatomy laboratories forced students to rely on alternative resources to learn anatomy but they lacked the opportunities to apply to human specimens, which impeded the “near” transfer of learning. The lack of clinical integration failed to facilitate the “far” transfer of learning. Learners also struggled to cope with the large amount of surface knowledge, which was pre‐requisite to successful deep and transfer of learning. It was theorized that the perceived decline in anatomical knowledge was derived from this combination of insufficient surface knowledge and impeded “near” transfer resulting in impeded deep and “far” transfer of learning. Moving forward, anatomy learning should still be cadaveric‐based coupled with complementary technological innovations that demonstrate “hidden” structures. A constant review of anatomical disciplinary knowledge with incremental integration of clinical contexts should also be adopted in medical curricula which could promote deep and far transfer of learning.
... Exams covered material based on the on-line lectures and in-class activities. We have used similar achievement measures, administered in similar settings and created by the same veteran instructor in our prior work (e.g., Robinson et al, 2017;Roseth et al., 2018;Saltarelli et al., 2014). The first exam scores were used to assess differences in missing data on Time 2 selfreports, whereas the second exam scores were used as the achievement outcome measure. ...
Article
The present study compares the structure, the longitudinal relation, and the predictive roles of emotions in-class and emotions while watching online video lectures outside of class. Participants (N = 269) reported their emotions, attentional control, and behavioral engagement associated with in-class activities and online lecture viewing at two time points in a large “flipped” undergraduate anatomy course. Overall, the longitudinal and cross-contextual relations among emotions, from emotions to learning behaviors, and from emotions to achievement were similar, whereas distinct patterns of relations were found for learning behaviors, and from learning behaviors to academic achievement. These findings are discussed within the Control-Value Theory and provide implications for supporting adaptive emotions and learning in flipped classrooms.
... For example, undergraduate CSD students enrolled in a face-to-face 'human anatomy and physiology' course were found to produce a significantly higher percentage of correct terms, in comparison to those enrolled in the online format, with a significantly higher self-rating of pronunciation ability [8]. Similar findings have also been reported by Saltarelli et al. [9] who indicated that undergraduate students in a face-to-face 'human anatomy' course performed significantly better in the identification and explanation of key anatomical structures on a human cadaver; this was in contrast to the poorer demonstration of cadaver-based knowledge and performance in learning tasks among students who were enrolled in the online section of the same course. ...
... Thus, lack of familiarization with cadaveric images seemed to be no problem for the plastic models group. This observation supports "the transfer of learning" theory, namely the extent to which knowledge learned in one context is applied in another 51,52 . Students performing dissection or using prosections were unable to transfer their knowledge to atlas' images. ...
Article
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Anatomy teaching has traditionally been based on dissection. However, alternative teaching modalities constantly emerge, the use of which along with a decrease in teaching hours has brought the anatomy knowledge of students and young doctors into question. In this way, the goal of the present study is to a. compare the efficacy of the most common teaching modalities and b. investigate students’ perceptions on each modality. In total, 313 medical students were taught gross anatomy of the upper limb, using four different learning modalities: dissection (n = 80), prosections (n = 77), plastic models (n = 84) and 3D anatomy software (n = 72). Students’ knowledge was examined by 100 multiple-choice and tag questions followed by an evaluation questionnaire. Regarding performance, the dissection and the 3D group outperformed the prosection and the plastic models group in total and multiple-choice questions. The performance of the 3D group in tag questions was also statistically significantly higher compared to the other three groups. In the evaluation questionnaire, dissection outperformed the rest three modalities in questions assessing students’ satisfaction, but also fear or stress before the laboratory. Moreover, dissection and 3D software were considered more useful when preparing for clinical activities. In conclusion, dissection remains first in students’ preferences and achieves higher knowledge acquisition. Contemporary, 3D anatomy software are considered equally important when preparing for clinical activities and mainly favor spatial knowledge acquisition. Prosections could be a valuable alternative when dissection is unavailable due to limited time or shortage of cadavers. Plastic models are less effective in knowledge acquisition but could be valuable when preparing for cadaveric laboratories. In conclusion, the targeted use of each learning modality is essential for a modern medical curriculum.
... The perception of students in this study that physical models of fossils are more beneficial to learning than digital models is borne out in the teaching and learning literature in anatomical sciences. For example, Saltarelli et al. (2014) found that anatomy students performed worse in assessments when trained using multimedia simulations rather than cadavers. Similarly, Preece et al. (2013) assessed the effect of learning from textbook illustrations, physical models and digital models on students' ability to identify anatomical structures. ...
Article
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Photogrammetry allows overlapping photographs of fossils to be taken and converted into photo-realistic three-dimensional (3-D) digital models. These models offer potential advantages in teaching palaeontology: they are cheap to produce, can be easily shared and allow the study of rare and delicate specimens. Here I describe approaches for using photogrammetric models in the teaching and learning of palaeontology. Little is known about how students perceive these models and whether they find them valuable in their learning. To address this, first-year university students taught using both fossil specimens and digital models were surveyed about their experience through an anonymous online survey. Most students found that the digital models were easy to use, helped them understand anatomy and were more useful than studying photographs. However, most did not see the models as a substitute for studying real fossils and felt they could learn more from physical models. Digital models are a useful addition to palaeontological education that can supplement real fossils and allow palaeontological education to take place in circumstances where handling of specimens is not possible.
... 17 -22 However, the previous studies reported that replacing the cadaver laboratory entirely with e-learning had a negative impact on the students' anatomy grades. 17,19 Due to the COVID-19 pandemic, we resorted to adopting blended learning in the anatomy course, which we had not initially intended or prepared for. Although the students' responses to online anatomy teaching were remarkably positive, the teachers of the anatomy department were skeptical, and concerned about the effectiveness of altered teaching methods in whether the students' performance could reach the intended learning outcomes. ...
Article
Background: The impact of coronavirus disease 2019 (COVID-19) has profoundly affected education, with most universities changing face-to-face classes to online formats. To adapt to the COVID-19 pandemic situation, we adopted a blended learning approach to anatomy instruction that included online lectures, pre-recorded laboratory dissection videos, and 3D anatomy applications, with condensed offline cadaver dissection. Methods: We aimed to examine the learning outcomes of a newly adopted anatomy educational approach by 1) comparing academic achievement between the blended learning group (the 2020 class, 108 students) and the traditional classroom learning group (the 2019 class, 104 students), and 2) an online questionnaire survey on student preference on the learning method and reasons of preference. Results: The average anatomy examination scores of the 2020 class, who took online lectures and blended dissection laboratories, were significantly higher than those of the 2019 class, who participated in an offline lecture and dissection laboratories. The questionnaire survey revealed that students preferred online lectures over traditional large group lecture-based teaching because it allowed them to acquire increased self-study time, study according to their individual learning styles, and repeatedly review lecture videos. Conclusion: This study suggests that a blended learning approach is an effective method for anatomy learning, and the advantage may result from increased self-directed study through online learning.
... There are many articles put forward on this subject. Some anatomists have argued that the digital world is very effective and useful, while others have stated that the digital world will very difficultly replace education with cadaver and reality perception (Theoret et al., 2007;Triepels et al., 2020;Saltarelli et al., 2014;Turhan, 2020). In this article, the subject was presented to the students' opinions with important questions, using the comments and the literature on the effects of digital education on the field of anatomy. ...
... 5,6 In recent years, the development of medical technology has made a large impact not only on the therapeutic field for disease treatment but also on the academic field for boosting the learning curve of medical competencies and clinical skills. [6][7][8][9] Advanced medical technology is playing a more and more important role in the educational system with the aim of assisting medical students to "learn faster and learn better." ...
Article
Background: Up-to-date technology has been increasingly useful for learning resuscitation skills in the emergency and resuscitation settings. It improves the learning curve of the learners and helps them to avoid making mistakes on real patients. This study aimed to evaluate the educational efficiency for tracheal intubation by comparing Macintosh (direct) laryngoscope (DL) and video laryngoscope (VL) learning in novices. Methods: This prospective randomized controlled study was conducted in an emergency department between 2013 and 2014. Fifth- and sixth-year medical students were enrolled and assigned to normal airway and difficult airway groups, respectively. They were then further randomized into using a VL or DL for tracheal intubation learning. Participants had three practices before proceeding to the post-course assessment. Our primary outcome was post-course assessment performance, which included intubation success rate, total intubation time and best glottic view. The secondary outcome was the sum of total intubation learning times during the three practices. Results: We recruited 177 undergraduate students. Of these, 97 were assigned to the normal airway group (49 VL and 48 DL) and 80 were placed in the difficult airway group (40 each for VL and DL). VL significantly quickened the intubation learning time in both the normal airway and difficult airway groups (140 s vs. 158 s, 141 s vs. 221.5 s; both p < 0.05). The learning curve was much improved with VL when compared using time-to-event analysis (p < 0.001). VL also improved the glottic view performance during post-course assessments. Conclusions: VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.
... Green et al., 2014;Konschake and Brenner, 2014;Rajasekhar et al., 2016;Rokade and Bahetee, 2013). Cadaveric dissection has been shown to be a superior learning tool when compared to virtual learning simulation, which reflected a lesser proficiency of anatomical identification and threedimensional features as well as spatial orientation (Abdulrahman, 2020;Rizzolo and Stewart, 2006;Saltarelli et al., 2014). Medical students in the United Kingdom find learning anatomy through cadaveric dissections more beneficial (Ali et al., 2015;Lempp, 2005). ...
Article
Introduction: The value of learning anatomy through cadaveric dissection is widely acclaimed; however, the demand for cadavers exceeds supply. For the number of donors to increase, there needs to be a broader understanding of what influences an individual's perception towards whole-body donation. The hypotheses were that individuals with a biomedical background or with higher levels of education would respectively have a more positive perception towards whole-body donation than those with an arts background or less education. Dissection experience was predicted to affect an individual's perception of whole-body donation negatively. Methods: To assess perceptions of whole-body donation, an online questionnaire was created consisting of statements developed using Thurstone and Chave's method. After ethical approval, the survey was distributed to students, academics, businesses and charities. Responses were allocated a mean score based on agreed statements. The Mann-Whitney U test was used to assess significance. Results: Significant difference in scores of individuals with biomedical science education compared to those with an arts education (P = 0.028, U = 39). No significant difference in scores of individuals with and without dissection experience (P = 0.394, U = 654.5). A significant difference in scores of postgraduates compared to graduates (P = 0.036, U = 13.5) CONCLUSION: Individuals with a biomedical science education reflected a significantly higher positive perception of whole-body donation in comparison to individuals with an arts background. Although postgraduates had a significantly higher positive perception of whole-body donation compared to graduates, there was no trend between level of education and score. Individuals with dissection experience didn't have a more negative perception of whole-body donation.
... In this work, several precautions are suggested to decrease this risk as shown in Table 14. 1. The risk of exposure to FA emissions in mortuaries can be eliminated by using virtual reality (VR) and augmented reality (AR) as effective and capable resources for anatomy teaching in terms of both academic achievement and student satisfaction (Heather et al., 2019).But VR and AR can't eliminate this risk completely as Saltarelli et al. (2014) found that the human cadaver laboratory offered a significant advantage over the multimedia simulation program on cadaver-based measures of identification and explanatory knowledge. 2. Also, this risk can be eliminated by using human-tissue-mimicking materials such as natural rubber nanocomposite, silicon, and Polyvinyl Chloride (PVC) instead of human cadavers (Murniatia et al.,2017;Wanget al., 2014;Li et al., 2015). ...
... The authors cited several articles to show that the role of multimedia technologies as substitute of traditional anatomy teaching methods is unproven (Pawlina and Lachman, 2004;Fitzgerald et al., 2008;Saltarelli et al., 2014;Peterson and Mlynarczyk, 2016;Vertemati et al., 2018). However, should these technologies function as "substitute" in order to demonstrate their effectiveness? ...
Article
It was our pleasure to read the article by Robinson et al. (2020), who performed a review concerning cadaveric simulation training in cardiothoracic surgery. The authors mentioned several advantages of this type of simulation, highlighting its importance for surgical training. However, regarding the subject of the article, which is cardiothoracic surgical simulation, the advantage of cadaver-based training in relation to other methods has not been, in our opinion, proven.
... It has been used by anatomists for centuries and attempts to substitute the human cadaver have proven to have a negative effect on http://jmscr.igmpublication.org/home/ ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.50 the quality of teaching, research in anatomy [4] [2] [5] as well as medical education in general . Historically, anatomists have depended on the gallows, jails, or poorhouses as sources of bodies, but the 1960s and 1970s saw the rise of a viable alternative: body donation, or informed consent of the deceased during his or her lifetime [6] The voluntary body donation program was started at the Department of Human Anatomy, Medical University of Silesia, Poland in 2003) [7] . ...
Article
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Background: The use of unclaimed bodies for anatomical dissection has been the main method of instruction at most Nigerian medical institutions. The dearth of cadavers and increasing numbers of medical school has prompted the need for body donation for teaching and research. This study aimed at assessing the disposition of anatomists towards body donation in Nigeria. Methods: A survey was conducted at the Anatomical Society of Nigeria (ASN) 2019 conference held at University of Calabar, Cross River state Nigeria in November 2019 to test two hypotheses: Anatomists approve of the donation of their own bodies for medical education and research; Disposition towards body dissection and donation are not dependent upon incentives, gender or upon the extent of teaching experience. Responses to questionnaires were analysed qualitatively. Results: Our findings showed that Anatomists disposition towards body donation are dependent upon gender, teaching experience, culture, religion, doubts about honor and dignity maintained in the dissection halls while performing dissections. Among one hundred anatomists that responded to the survey; Males (77.8%) were more receptive to the concept of body donation. Most teachers (61%) said they were unwilling to donate their bodies, and 39% said they would donate their entire bodies. Conclusion: Our study highlighted the issue of unwillingness to donate bodies amongst anatomist. We therefore strongly recommend awareness campaign for body donation and sensitization of handlers of cadavers about dignity and respect of the donated body.
... Focusing on outcomes of learning process, studies compared between undergraduates taught through established classical teaching tools (e.g., plastinated or cadaveric dissection laboratories) against 3D computer-based teaching approaches showed contradictory results. In one hand few studies showed no differences between the two approaches (Codd & Choudhury, 2011); while other experiments on contrary revealed better enhancement of learning among students using physical models in anatomy laboratories (Preece et al., 2015;Saltarelli, Roseth, & Saltarelli, 2014). ...
... Another study of the review by Triepels et al. (2020), performed by Saltarelli et al. (2014), compared 3D technologies with cadaveric dissection. The latter method led to significantly better students' examinations results than the former. ...
... [9] is an augmented reality-based solution meant to be deployed in mobile applications, fiducial markers are used to augment the 3d models and the option to manipulate the rendered models are provided. Though this system might be better than the conventional methods of teaching [10] it's been found to be less effective than cadaver dissection [11], which might be due to the lack of immersion compared to a HMD based mixed experience where the 3d models might resemble and react to the environment like a physical object. ...
Article
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Mixed Reality (MR) has opened up new means of imparting education, especially in the medical field. Students could view the whole human anatomy and it’s components at multiple levels of scale to learn their location and naming nomenclature, and also interact with them separately to familiarize themselves with their functions. In this paper we propose a platform for Medical education in MR which creates shared experiences, providing support for teaching within classrooms. The application would also work as a standalone experience, augmenting important information over the anatomy model for the student’s reference when a shared experience is not in session, thereby facilitating self-study. The platform would be built in such a way that the instructors would also have the option to add 3D models and relevant content to the existing courseware and have it rendered in the mixed reality space.
... A wide variety of instructional practices are common, including cadaveric dissection and prosection, physical models, and clay modeling (Lombardi et al. 2014;Motoike et al. 2009;Waters et al. 2005). Digital models are used to supplement or replace more established pedagogical tools (Fredieu et al. 2015;Saltarelli et al. 2014), and virtual reality and 3D printing are the newest additions to the toolkit of anatomy educators (Fredieu et al. 2015;McMenamin et al. 2014). From this great diversity of visualization tools, each institution makes choices based on pedagogical rationale, budgetary concerns, the educational level of the students, and/or the level of experience and expertise of those in the position to make such decisions. ...
Article
HAPS Educator, Journal of the Human Anatomy and Physiology Society, 23 (2), 446-456. https://www.hapsweb.org/page/hapsed_home The Flavor Perception Game was designed with the goals of developing an interactive and hands-on activity, providing a platform to review chemical senses of the five tastes, promoting student investment in the course material, and providing a basis for discussion on chemical senses of the five tastes. Knowledge of taste sensation is useful for nursing and exercise sciences students, as human physiology is integral to both baccalaureate curricula. The game is inexpensive, easy to incorporate into a 50-minute lecture period, and free of chocolate allergens. Student participants (N=34) tasted three candies and completed a voluntary anonymous poll regarding their detection of the presence of umami, bitter, sweet, salty and/or sour taste modalities in the different candies. During the three stages of this classroom game, a total of 214 taste selections were made, following which students discussed various aspects of taste sensation including its importance in healthcare.
... This virtual system can constitute an interactive teaching resource directly used for anatomy teaching, self-study, and dissection. Anatomical specimens required for anatomy teaching can be replaced to some extent by 3D digital anatomical models in this virtual anatomy teaching, not being limited to teaching laboratories [1,15,16]. Teaching with a virtual anatomy teaching system has many outstanding advantages over traditional anatomy teaching, such as the non-destructive nature of the specimens, the arbitrary combination of 3D structure displays, and the rapid positioning and association of various forms of anatomical knowledge. These can make up for the shortcomings in current anatomy teaching, enhancing the teaching effect [14,17]. ...
Article
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Abstract Specimen observation and dissection have been regarded as the best approach to teach anatomy, but due to the severe lack of anatomical specimens in recent years, the quality of anatomy teaching has been seriously affected. In order to disseminate anatomical knowledge effectively under such circumstances, this study discusses three key factors (modeling, perception, and interaction) involved in constructing virtual anatomy teaching systems in detail. To ensure the authenticity, integrity, and accuracy of modeling, detailed three-dimensional (3D) digital anatomical models are constructed using multi-scale data, such as the Chinese Visible Human dataset, clinical imaging data, tissue sections, and other sources. The anatomical knowledge ontology is built according to the needs of the particular teaching purposes. Various kinds of anatomical knowledge and 3D digital anatomical models are organically combined to construct virtual anatomy teaching system by means of virtual reality equipment and technology. The perception of knowledge is realized by the Yi Chuang Digital Human Anatomy Teaching System that we have created. The virtual interaction mode, which is similar to actual anatomical specimen observation and dissection, can enhance the transmissibility of anatomical knowledge. This virtual anatomy teaching system captures the three key factors. It can provide realistic and reusable teaching resources, expand the new medical education model, and effectively improve the quality of anatomy teaching.
Article
Purpose/objectives: Dental students' levels of engagement and comprehension were assessed using tactile learning (with physical teeth) versus virtual learning (using computer images) in a dental histology course. Differences in engagement and comprehension by learning preferences were also examined. Methods: One hundred first-year dental students were randomly divided into twenty teams of five students. Conditions were counterbalanced such that half the students were given physical tooth models (Group A) while the other half were given access to virtual images of tooth models (Group B) during the first session. Conditions were switched for a second session. Both groups completed the same learning exercise and formative assessment (quiz) after each session. A survey assessed students' learning preferences and attitudes. Results: There were no differences by group assignment in both formative assessment scores and learning preferences (p > 0.10). For all students, comprehension of material was significantly higher in the tactile condition (with physical teeth) compared to the virtual experience (p = 0.01), but there was no difference in engagement between conditions (p = 0.35). Students who preferred learning with physical tooth models had higher engagement when using the physical tooth models compared to those who preferred virtual tooth models (p = 0.04), and significantly more positive attitudes toward physical tooth models (p's < 0.0001). Conclusion: Results suggest that for dental students, learning activities involving handling physical teeth may produce greater comprehension than viewing virtual images of teeth on a screen. More research is needed to determine the circumstances when virtual images can be substituted for physical models or be a beneficial adjunct method.
Article
Unlabelled: Given the decline of cadavers as anatomy teaching tools, immersive virtual reality (VR) technology has gained popularity as a potential alternative. To better understand how to maximize the educational potential of VR, this scoping review aimed to identify potential determinants of learning anatomy in an immersive VR environment. A literature search yielded 4523 studies, 25 of which were included after screening. Six common factors were derived from secondary outcomes in these papers: cognitive load, cybersickness, student perceptions, stereopsis, spatial understanding, and interactivity. Further objective research investigating the impact of these factors on anatomy examination performance is required. Supplementary information: The online version contains supplementary material available at 10.1007/s40670-022-01701-y.
Chapter
The undergraduate medical programme at Newcastle University (NU) includes a fundamental ‘Essentials of Medical Practice’ (EOMP) phase comprising the first 2 years of study. This period is designed to support entrants in their transition from further education into the advanced study and practice of clinical medicine. The anatomical sciences of gross anatomy, histology and embryology, and life sciences including physiology, pharmacology and genetics are key disciplines taught within the integrated case-based EOMP curriculum. Learners apply basic science knowledge to clinical scenarios during training in practical examination, communication and reasoning skills. Within the modern pedagogic landscape, the development and introduction of technology-enhanced learning strategies have enhanced the provision of remote learning resources in pre-clinical education. However, the emergence of COVID-19 has resulted in widespread technological challenges for educators and learners, and has raised pedagogic, logistical and ethical concerns. Nonetheless, the pandemic has produced favourable conditions for the creation of valuable digital visualisation strategies for learning and teaching, and for developing and modernising universal approaches to remote education. Here, we describe our technology-enhanced adaptations to COVID-19 across the domains of teaching, learning and academic support for pre-clinical learners studying basic life sciences and clinical skills. Moreover, we outline research-informed digital visualisation solutions to pandemic-era challenges and reflect upon experiences gained within our own educational context. In doing so, we provide insights into the impacts and successes of our interventions. While providing a record of unprecedented contemporary circumstances, we also aim to utilise our observations and experiences of COVID-19 pedagogy when developing ongoing strategies for delivering curricula and futureproofing educational practice.
Chapter
The study of human anatomy has long been inseparable from illustration, as the portrayal of the dissected body alongside a descriptive text supports the understanding of this complex topic. With the advent of new technologies, applications for revealing the details of the human body have increased to include Computed Tomography and Magnetic Resonance Imaging scanning, digital photography and videography, and three-dimensional (3D) printing. In addition, the distribution of the captured image has become widespread in both online teaching and in hard copy textbooks. While these digital images and applications are invaluable for online teaching, particularly during pandemics, anatomists must consider whether the use of the images and data derived from human bodies (either donor or unclaimed) is ethical, as it is not always clear whether permission has been obtained for their creation.Questions regarding the ethical sourcing and use of images will become more urgent as the utilization of electronic data becomes routine. Particularly concerning is the distribution of images and videos in the public domain on social media, where the context and link with education may be severed. Other considerations include respect for the privacy of the deceased, ownership of images, and commercialization. An initial question that should be posed is “Who is responsible for the oversight of digital and 3D printed models of bodies?” The ethical use of such images needs to be considered by the global anatomy community in order to ensure that anatomists do not retreat into the ethical mire of their forefathers.KeywordsDigital technologyIllustrationAnatomical educationDissectionEthicsBody donation programmes
Article
Background: Anatomy has been the cornerstone of medical education for centuries. However, given the advances in the Internet of Things, this landscape has been augmented in the past decade, shifting toward a greater focus on adopting digital technologies. Digital anatomy is emerging as a new discipline that represents an opportunity to embrace advances in digital health technologies and apply them to the domain of modern medical sciences. Notably, the use of augmented or mixed and virtual reality as well as mobile and platforms and 3D printing in modern anatomy has dramatically increased in the last 5 years. Objective: This review aims to outline the emerging area of digital anatomy and summarize opportunities and challenges for incorporating digital anatomy in medical science education and practices. Methods: Literature searches were performed using the PubMed, Embase, and MEDLINE bibliographic databases for research articles published between January 2005 and June 2021 (inclusive). Out of the 4650 articles, 651 (14%) were advanced to full-text screening and 77 (1.7%) were eligible for inclusion in the narrative review. We performed a Strength, Weakness, Opportunity, and Threat (SWOT) analysis to evaluate the role that digital anatomy plays in both the learning and teaching of medicine and health sciences as well as its practice. Results: Digital anatomy has not only revolutionized undergraduate anatomy education via 3D reconstruction of the human body but is shifting the paradigm of pre- and vocational training for medical professionals via digital simulation, advancing health care. Importantly, it was noted that digital anatomy not only benefits in situ real time clinical practice but also has many advantages for learning and teaching clinicians at multiple levels. Using the SWOT analysis, we described strengths and opportunities that together serve to underscore the benefits of embracing digital anatomy, in particular the areas for collaboration and medical advances. The SWOT analysis also identified a few weaknesses associated with digital anatomy, which are primarily related to the fact that the current reach and range of applications for digital anatomy are very limited owing to its nascent nature. Furthermore, threats are limited to technical aspects such as hardware and software issues. Conclusions: This review highlights the advances in digital health and Health 4.0 in key areas of digital anatomy analytics. The continuous evolution of digital technologies will increase their ability to reinforce anatomy knowledge and advance clinical practice. However, digital anatomy education should not be viewed as a simple technical conversion and needs an explicit pedagogical framework. This review will be a valuable asset for educators and researchers to incorporate digital anatomy into the learning and teaching of medical sciences and their practice.
Article
Résumé Le but de cette étude était d’évaluer les connaissances en anatomie de l’appareil uro-génital des urologues en formation (internes et chef de clinique). Un examen composé de 10 questionnaires à choix multiples (QCM) chronométré (16 minutes) issu des évaluations d’anatomie uro-génitale des étudiants en diplôme de formation générale des sciences médicales (DFGSM3) a été envoyé en mai 2018 aux membres de l’association française des urologues en formation (AFUF) afin de réaliser une comparaison des notes moyennes entre ces deux populations. En complément, un questionnaire renseignant des données épidémiologiques, l’avis quant à la qualité de la formation en anatomie et la volonté d’avoir plus de cours sur ce sujet a été intégré à l’examen. Le même barème sur 20 a été appliqué aux deux populations. Parmi les 501 membres de l’AFUF sollicités, 144 membres avaient répondu à l’intégralité des questions (28,7 %). La note moyenne des urologues était plus faible que celle des étudiants en DFGSM3 (10,56 ± 1,82 vs 11,4 ± 2,37 respectivement) (p = 0,0013). La volonté d’une formation plus poussée en anatomie est d’ailleurs largement répandue chez les urologues (87 %). D’après notre étude, les urologues ont de moins bonnes connaissances en anatomie uro-génitale que les étudiants de DFGSM3. De nombreux moyens sont mis en place ou disponibles afin de remédier à cette carence, d’autant que la majorité des urologues en formation estime que la formation en anatomie est insuffisante au cours du cursus et souhaiterait recevoir une formation plus poussée en anatomie. Niveau de preuve 3.
Article
Dissection is a unique multisensory educational experience and is essential to learning the anatomical construction of the human and animal bodies. This study aims to introduce a specialized design for assessment of dissection and to discuss the assessment's attributes. The design was a product of the "assessment drives learning" concept and was developed to motivate students to dissect. Students were awarded "dissection points" based on prior group dissection and identification of structures. Students' perception of the design was examined, and content analysis was performed. The assessment consisted of two parts: the first assigning each student group structures to "pin" on their previously dissected cadavers; the second was a group peer evaluation. The most critical factor for the assessment's success was careful selection of structures assigned to students to pin. The assessment was fit for the purpose, valid, reliable, and had a significant educational impact. Eighty‐three percent of students (n = 116) recommended maintaining the assessment design, as they felt it promoted a deep approach to learning as well as teamwork while reducing stress to a minimum. A strong correlation (Spearman’s rho = 0.46, P < 0.0001) was present between the high rating of the design and the number of structures learned, as well as, high rating and lower stress level (Spearman’s rho = 0.40, P < 0.0001). There was no apparent influence of grades on student perception of the effectiveness of the assessment. This specific design of evaluation could be used as part of anatomy education in veterinary and medical schools.
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Innovative reforms in medical education will require instructional tools to support these changes and to give students more flexibility in where and how they learn. At Colorado State University, the software program Virtual Canine Anatomy (VCA) was developed to assist student learning both inside and outside the anatomical laboratory. The program includes interactive anatomical photographs of dissected canine cadavers, dissection instructions with accompanying videos and diagrams, radiographs, and three‐dimensional models. There is a need to evaluate the effectiveness of instructional tools like VCA so that decisions on pedagogical delivery can be evidence‐based. To measure the impact of VCA on student outcomes in a dissection laboratory, this study compared student attitudes, quiz scores, dissection quality and accuracy, and instructor reliance between students with and without access to VCA. Students with VCA needed less time with teaching assistants (P < 0.01), asked teaching assistants fewer questions (P = 0.04), felt that the dissection was easier (P = 0.02), and were in stronger agreement that they had access to adequate resources (P = 0.02). No differences were found in the dissection quality or accuracy, quiz scores, or attitudes regarding overall enjoyment of the activity between the two groups. This study shows that VCA increases student independence and can be used to enhance anatomical instruction.
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The study of neuroanatomy imposes a significant cognitive load on students since it includes a huge factual information and therefore demands diverse learning strategies. In addition, significant amount of teaching is carried out through human brain demonstrations, due to limited opportunities for cadaveric dissection. However, reports suggest that students often attend these demonstrations with limited preparation, which detrimentally impacts their learning. In the context of student learning, greater levels of engagement and intrinsic motivation (IM) are associated with better academic performance. However, the maintenance of engagement and the IM of students in neuroanatomy is often challenging for educators. Therefore, this study aimed to explore the role of prelaboratory assignments (PLAs) in the improvement of academic performance, augmentation of engagement and enhancement of IM in occupational therapy students enrolled in a human neuroanatomy course. One cohort of students in the course were expected to complete PLAs prior to each brain demonstration session. The PLAs contained a list of structures, and students were expected to write a brief anatomical description of each structure. Another cohort of students who were not provided with similar PLAs constituted the control group. Students who completed PLAs had a higher score on the final examinations as compared to students who were not required to complete PLAs. These students also demonstrated greater engagement and IM, and indicated that they perceived PLAs to be valuable in the learning of neuroanatomy. Therefore, PLAs represent a useful teaching tool in the neuroanatomy curriculum.
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Cadaver Dissection (CD) is a longstanding but indispensable method of teaching human gross anatomy. However, there are several kinds of stress associated with CD which could cause learning difficulties amongst students especially in poor-resource countries where standard CD laboratories are in great shortage. This review highlighted some causes of stress during CD, with a focus on Nigeria as a resource-poor setting. Also, it has proposed background music (BM) as a simple, cheap, and effective alternative that can be used to curb CD-related stress in such settings where cost-effectiveness is prioritized. The possible challenges that may be faced during the incorporation of BM into CD laboratories have also been pointed out, with important recommendations made on how to deal with these challenges.
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The novelty of three‐dimensional visualization technology (3DVT), such as virtual reality (VR), has captured the interest of many educational institutions. This study’s objectives were to (1) assess how VR and physical models impact anatomy learning, (2) determine the effect of visuospatial ability on anatomy learning from VR and physical models, and (3) evaluate the impact of a VR familiarization phase on learning. This within‐subjects, crossover study recruited 78 undergraduate students who studied anatomical structures at both physical and VR models and were tested on their knowledge immediately and 48 hours after learning. There were no significant differences in test scores between the two modalities on both testing days. After grouping participants on visuospatial ability, low visuospatial ability learners performed significantly worse on anatomy knowledge tests compared to their high visuospatial ability counterparts when learning from VR immediately (P = 0.001, d = 1.515) and over the long‐term (P = 0.003, d = 1.279). In contrast, both low and high visuospatial ability groups performed similarly well when learning from the physical model and tested immediately after learning (P = 0.067) and over the long‐term (P = 0.107). These results differ from current literature which indicates that learners with low visuospatial ability are aided by 3DVT. Familiarizing participants with VR before the learning phase had no impact on learning (P = 0.967). This study demonstrated that VR may be detrimental to low visuospatial ability students, whereas physical models may allow all students, regardless of their visuospatial abilities, to learn similarly well.
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Dissection is an important learning tool for any surgical procedure especially in endoscopic nasal and sinus surgeries as it demands coordination of hand movements under endoscopic visualization in a narrow three-dimensional nasal and sinus cavities [1, 2]. A number of modern simulators and sinus models are available for hands-on real-time dissection. Cadaver dissection has no substitute and dissection-based teaching is crucial to anatomy education till date. Surgical training tools are equally important and traditional training helps the residents in attaining surgical dexterity.
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In many educational and clinical settings we are increasingly looking into methodologies for accurate 3D representations of structures and specimens. This is relevant for anatomy teaching, pathology, forensic and anthropological sciences, and various clinical fields. The question then arises which tool best suits the task at hand – both 3D scanning and photogrammetry are options. For the use in medical education the aim is to create 3D models of anatomical specimens with high quality and resolution. Various qualitative and quantitative criteria determine the performance fidelity and results of 3D scanning versus photogrammetry. In our work we found that photogrammetry provides more realistic surface textures and very good geometries for most specimens. 3D surface scanning captures more accurate geometries of complex specimens and in specimens with reflective surfaces. The 3D scanning workflow and capture method is more practical for soft specimens where movement of the sample can lead to distortions. Overall, both methods are highly recommended dependent on the nature of the specimen and the use case of the 3D model.
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Science courses containing English-language terminology are a common implement in "English as a foreign language" (EFL) countries across the globe. In many of these countries, licensing examinations place added significance on terminology competence by requiring health science graduates to demonstrate mastery of English-language anatomy terms. In recent years, a wealth of research has shown active learning can offer many benefits over lecture-based, didactic approaches. Despite this work, very little has been done to test the potential of active learning in improving medical terminology performance. The present study explores this potential in two human gross anatomy lecture courses in South Korea, collecting performance and survey data from 399 undergraduates over a period of four years. Jigsaws, retrieval practice, and regular cumulative quizzing were used to mitigate three learning challenges specific to the study context: high vocabulary volume, low feelings of control over learning, and difficulties with exam preparation. The results show the reforms significantly improved both performance and learning attitudes, with students overwhelmingly favoring the use of new methods over lecture when taught using a mixture of both. Given that science learning often resembles the process of learning a foreign language, this study offers broad potential for improving terminology competence across disciplines, even for non-EFL students.
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Introduction An unusual vascular implant found during routine cadaver dissection influenced instructors and students to learn more about the underlying disease and the surgical technique used to treat this disorder triggering an inquiry-based learning. Presentation of case This report describes a case of peripheral arterial disease (PAD) with an aortobifemoral arterial bypass implant that was never found before in any of the previously dissected cadavers at our university. Discussion PAD develops due to impaired blood flow to the lower extremities that causes numbness, weakness, and lower leg pain. The treatments can aim to improve the long-term cardiovascular outcomes. If therapeutic medications do not improve outcomes of PAD, revascularization by endovascular repair or aortofemoral bypass grafting is considered. Conclusion We would like to note that accidental discoveries of pathologies or surgical procedures during routine cadaveric dissections present a unique possibility for inquiry-based learning among future healthcare providers.
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Online resources are expected within healthcare education, and a plethora of online or technology-based delivery methods are available. Reusable learning objects (RLOs) are a form of digitally supported education that can be used multiple times in various locations; they are especially favoured by nurses. Little is understood about the issues involved in their creation. This article examines the development of an RLO in respiratory physiology for first-year nurses and how those creating it worked together. Feedback during the development of the RLO was gathered over 1 year from academics, technologists and students. Issues that arose included variations and misunderstanding regarding terminology and academics' not appreciating the time it took to develop the resource and its potential. Practical matters included sourcing royalty-free or in-house images, record-keeping and version control, and addressing production logic in case developers moved to other projects. It is important to include students during the design process rather than in just evaluating the final product because user experience and navigation have to be considered together with pedagogical content. Addressing these issues when developing an RLO will help streamline the process and generate a student-focused output.
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Objective: Students commonly perceive gross anatomy lectures as difficult because they contain complex information that requires three-dimensional visualisation in order to be understood. Without prior preparation, a gross anatomy topic expounded via lecture can be cognitively challenging. Hence, this study aimed to investigate the impact of a pre-lecture activity in the form of viewing a video on students' lecture comprehension. Method: A quasi-experimental study was conducted using 254 first-year medical students with no prior exposure to the lecture topic during the 2016/17 and 2017/18 academic sessions. The students from each batch were divided into two groups and exposed to different video material. Group A watched an action movie, while Group B watched an educational video related to the lecture topic. After 15 min, both groups attended a lecture on the gross anatomy of the heart, which was delivered by a qualified anatomist. At the end of the lecture, their understanding of the material was measured through a post-lecture test using ten vetted multiple choice true/false questions. Results: Group B's test scores were found to be significantly higher than Group A's (p > 0.001, t-stats [df] = -4.21 [252]). Conclusion: This study concluded that the pre-lecture activity had successfully provided the students with some prior knowledge of the subject before they attended the lecture sessions. This finding was aligned with cognitive load theory, which describes a reduction in learners' cognitive load when prior knowledge is stimulated.
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The purpose of this discussion is to explain and sharpen different points of view about the impact of media and attributes of media on learning, motivation and efficiency gains from instruction. This paper is an attempt to summarize my arguments about the research and theory in this area and to respond to Robert Kozma's criticism of my earlier discussion of these issues. I will first briefly summarize my arguments about media effects; next I will attempt to characterize the many reactions to the controversial claim that media do not influence learning or motivation. Finally, I will respond to the specific criticisms advanced by Robert Kozma this issue.
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ognitive load theory (CLT) can provide guidelines to assist in the presentation of information in a manner that encourages learner activities that optimise intellectual performance. It is based on a cognitive architecture that consists of a limited working memory, with partly independent processing units for visual and audio information, which interacts with an unlimited long-term memory. According to the theory, the limitations of working memory can be circumvented by coding multiple elements of information as one element in cognitive schemata, by automating rules, and by using more than one presentation modality. This special issue consists of six articles from four countries and three continents on the instructional implications of CLT. The articles cover presenting instructional techniques for increasing germane CL in studying worked examples (van Merriënboer, Schuurman, De Croock, & Paas), effects of example elaboration training on decreasing cognitive interference and overload (Stark, Mandl, Gruber, & Renkl), CLT-based instructional design when dealing with very high element interactivity material (Pollock, Chandler, & Sweller), effects of worked examples on CL in older learners (Van Gerven, Paas, & Schmidt), a cognitive theory of multimedia learning (Mayer & Moreno), and the use of external representations to help manage CL in Computer Supported Collaborative Learning environments (Van Bruggen, Kirschner, & Jochems).
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Much previous research has established that perceived ease of use is an important factor influencing user acceptance and usage behavior of information technologies. However, very little research has been conducted to understand how that perception forms and changes over time. The current work presents and tests an anchoring and adjustment-based theoretical model of the determinants of system-specific perceived ease of use. The model proposes control (internal and external--conceptualized as computer self-efficacy and facilitating conditions, respectively), intrinsic motivation (conceptualized as computer playfulness), and emotion (conceptualized as computer anxiety) as anchors that determine early perceptions about the ease of use of a new system. With increasing experience, it is expected that system-specific perceived ease of use, while still anchored to the general beliefs regarding computers and computer use, will adjust to reflect objective usability, perceptions of external control specific to the new system environment, and system-specific perceived enjoyment. The proposed model was tested in three different organizations among 246 employees using three measurements taken over a three-month period. The proposed model was strongly supported at all points of measurement, and explained up to 60% of the variance in system-specific perceived ease of use, which is twice as much as our current understanding. Important theoretical and practical implications of these findings are discussed.
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To evaluate the 2010 "Anatomy by whole body dissection" course, a 7-week elective course offered to senior medical students at the University of Sydney at the end of their third year. In the 2010 course, 29 students divided into eight groups carried out whole-body dissections on eight cadavers over a 34-day period. Surgical trainees acted as demonstrators, and surgeons and anatomists as supervisors. The students were assessed by practical tests involving the identification of 20 tagged structures in four wet specimens before, during, at the end of, and 1 month after the course. In addition, students were asked to complete an anonymous feedback questionnaire about the course. Acquisition of topographical anatomical knowledge, and student feedback on the usefulness of the course. A significant increase in topographical clinical anatomical knowledge was demonstrated among the participants and was maintained in the short term. The median pre-course assessment score was 8/20 (interquartile range [IQR], 4) and the median post-course assessment score was 19/20 (IQR, 1). This difference was statistically significant (P<0.001). All students rated the course as "very good", and unanimously recommended that the course be available to all students as part of the medical curriculum. Students' knowledge of anatomy improved significantly between the pre-course and post-course assessments, and all students rated the course very favourably. This supports our view that dissection anatomy should be an integral component of medical education.
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As a multidisciplinary field, medical informatics draws on a range of disciplines, such as computer science, information science, and the social and cognitive sciences. The cognitive sciences can provide important insights into the nature of the processes involved in human- computer interaction and help improve the design of medical information systems by providing insight into the roles that knowledge, memory, and strategies play in a variety of cognitive activities. In this paper, the authors survey literature on aspects of medical cognition and provide a set of claims that they consider to be important in medical informatics.
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Two experiments investigated alternatives to split-attention instructional designs. It was assumed that because a learner has a limited working memory capacity, any increase in cognitive resources required to process split-attention materials decreases resources available for learning. Using computer-based instructional material consisting of diagrams and text, Experiment 1 attempted to ameliorate split-attention effects by increasing effective working memory size by presenting the text in auditory form. Auditory presentation of text proved superior to visual-only presentation but not when the text was presented in both auditory and visual forms. In that case, the visual form was redundant and imposed a cognitive load that interfered with learning. Experiment 2 ameliorated split-attention effects by using colour coding to reduce cognitive load inducing search for diagrammatic referents in the text. Mental load rating scales provided evidence in both experiments that alternatives to split-attention instructional designs were effective due to reductions in cognitive load. Copyright © 1999 John Wiley & Sons, Ltd.
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Despite a century's worth of research, arguments surrounding the question of whether far transfer occurs have made little progress toward resolution. The authors argue the reason for this confusion is a failure to specify various dimensions along which transfer can occur, resulting in comparisons of "apples and oranges." They provide a framework that describes 9 relevant dimensions and show that the literature can productively be classified along these dimensions, with each study situated at the intersection of Various dimensions. Estimation of a single effect size for far transfer is misguided in view of this complexity. The past 100 years of research shows that evidence for transfer under some conditions is substantial, but critical conditions for many key questions are untested.
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Two experiments investigated alternatives to split-attention instructional designs. It was assumed that because a learner has a limited working memory capacity, any increase in cognitive resources required to process split-attention materials decreases resources available for learning. Using computer-based instructional material consisting of diagrams and text, Experiment 1 attempted to ameliorate split-attention effects by increasing effective working memory size by presenting the text in auditory form. Auditory presentation of text proved superior to visual-only presentation but not when the text was presented in both auditory and visual forms. In that case, the visual form was redundant and imposed a cognitive load that interfered with learning. Experiment 2 ameliorated split-attention effects by using colour coding to reduce cognitive load inducing search for diagrammatic referents in the text. Mental load rating scales provided evidence in both experiments that alternatives to split-attention instructional designs were effective due to reductions in cognitive load. Copyright
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Three-dimensional (3D) information plays an important part in medical and veterinary education. Appreciating complex 3D spatial relationships requires a strong foundational understanding of anatomy and mental 3D visualization skills. Novel learning resources have been introduced to anatomy training to achieve this. Objective evaluation of their comparative efficacies remains scarce in the literature. This study developed and evaluated the use of a physical model in demonstrating the complex spatial relationships of the equine foot. It was hypothesized that the newly developed physical model would be more effective for students to learn magnetic resonance imaging (MRI) anatomy of the foot than textbooks or computer-based 3D models. Third year veterinary medicine students were randomly assigned to one of three teaching aid groups (physical model; textbooks; 3D computer model). The comparative efficacies of the three teaching aids were assessed through students' abilities to identify anatomical structures on MR images. Overall mean MRI assessment scores were significantly higher in students utilizing the physical model (86.39%) compared with students using textbooks (62.61%) and the 3D computer model (63.68%) (P < 0.001), with no significant difference between the textbook and 3D computer model groups (P = 0.685). Student feedback was also more positive in the physical model group compared with both the textbook and 3D computer model groups. Our results suggest that physical models may hold a significant advantage over alternative learning resources in enhancing visuospatial and 3D understanding of complex anatomical architecture, and that 3D computer models have significant limitations with regards to 3D learning. Anat Sci Educ. © 2013 American Association of Anatomists.
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Research in the area of educational technology has often been critiqued for a lack of theoretical grounding. In this article we propose a conceptual framework for educational technology by building on Shulman's formulation of "pedagogical content knowledge" and extend it to the phenomenon of teachers integrating technology into their pedagogy. This framework is the result of 5 years of work on a program of research focused on teacher professional development and faculty development in higher education. It attempts to capture some of the essential qualities of teacher knowledge required for technology integration in teaching, while addressing the complex, multifaceted, and situated nature of this knowledge. We argue, briefly, that thoughtful pedagogical uses of technology require the development of a complex, situated form of knowledge that we call Technological Pedagogical Content Knowledge (TPCK). In doing so, we posit the complex roles of, and interplay among, three main components of learning environments: content, pedagogy, and technology. We argue that this model has much to offer to discussions of technology integration at multiple levels: theoretical, pedagogical, and methodological. In this article, we describe the theory behind our framework, provide examples of our teaching approach based upon the framework, and illustrate the methodological contributions that have resulted from this work.
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This study was designed to determine whether an interactive three-dimensional presentation depicting liver and biliary anatomy is more effective for teaching medical students than a traditional textbook format presentation of the same material. Forty-six medical students volunteered for participation in this study. Baseline demographic information, spatial ability, and knowledge of relevant anatomy were measured. Participants were randomized into two groups and presented with a computer-based interactive learning module comprised of animations and still images to highlight various anatomical structures (3D group), or a computer-based text document containing the same images and text without animation or interactive features (2D group). Following each teaching module, students completed a satisfaction survey and nine-item anatomic knowledge post-test. The 3D group scored higher on the post-test than the 2D group, with a mean score of 74% and 64%, respectively; however, when baseline differences in pretest scores were accounted for, this difference was not statistically significant (P = 0.33). Spatial ability did not statistically significantly correlate with post-test scores for the 3D group or the 2D group. In the post-test satisfaction survey the 3D group expressed a statistically significantly higher overall satisfaction rating compared to students in the 2D control group (4.5 versus 3.7 out of 5, P = 0.02). While the interactive 3D multimedia module received higher satisfaction ratings from students, it neither enhanced nor inhibited learning of complex hepatobiliary anatomy compared to an informationally equivalent traditional textbook style approach. .
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This research effort compared and contrasted two conceptually different methods for the exploration of human anatomy in the first-year dissection laboratory by accomplished students: "physical" dissection using an embalmed cadaver and "digital" dissection using three-dimensional volume modeling of whole-body CT and MRI image sets acquired using the same cadaver. The goal was to understand the relative contributions each method makes toward student acquisition of intuitive sense of practical anatomical knowledge gained during "hands-on" structural exploration tasks. The main instruments for measuring anatomical knowledge under this conceptual model were questions generated using a classification system designed to assess both visual presentation manner and the corresponding response information required. Students were randomly divided into groups based on exploration method (physical or digital dissection) and then anatomical region. The physical dissectors proceeded with their direct methods, whereas the digital dissectors generated and manipulated indirect 3D digital models. After 6 weeks, corresponding student anatomical assignment teams compared their results using photography and animated digital visualizations. Finally, to see whether each method provided unique advantages, a visual test protocol of new visualizations based on the classification schema was administered. Results indicated that all students, regardless of gender, dissection method, and anatomical region dissected performed significantly better on questions presented as rotating models requiring spatial ordering or viewpoint determination responses in contrast to requests for specific lexical feature identifications. Additional results provided evidence of trends showing significant differences in gender and dissection method scores. These trends will be explored with further trials with larger populations.
Article
The view that new doctors have inadequate knowledge of anatomy is not supported by the evidence, argues John Collins , but greater effort is needed to capitalise on the learning potential of new technologies Recent reports from the United Kingdom1 and Australia2 claim the teaching and learning of anatomy in universities is in crisis. This is attributed to less time being allocated to the subject and decreased opportunities to dissect cadavers. Although everyone would agree anatomy is important, few lament the move away from endless hours of cadaver dissection and didactic lectures. Efficient use of new technology and teaching methods should allow better teaching and understanding. The evidence most frequently quoted for the so called crisis is Raftery’s assertion that there has been a “vast increase in claims associated with the lack of anatomical knowledge.”3 This claim was based on the finding that “damage to underlying structures” was the commonest reason for settlements of claims relating to general and vascular surgery.4 Lack of knowledge of anatomy is but one cause of such intraoperative errors, albeit an important one. And many of the errors are likely to have been made by surgeons who graduated before changes in the teaching of anatomy. A reduced focus on learning and assessment of anatomy in some postgraduate surgical training programmes has been reported3 5 and may be important. Media coverage of the introduction of newer methods for teaching and learning anatomy has tended to focus on the negative, with little if any discussion of the value of cadaver dissection.6 Last year, the Australian reported, “Less than four in ten medical students agreed they will know enough anatomy to become competent doctors.”2 This was based on responses from students to a survey conducted by the Australian Medical Students’ Association. …
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Restricted maximum likelihood (REML) is now well established as a method for estimating the parameters of the general Gaussian linear model with a structured covariance matrix, in particular for mixed linear models. Conventionally, estimates of precision and inference for fixed effects are based on their asymptotic distribution, which is known to be inadequate for some small-sample problems. In this paper, we present a scaled Wald statistic, together with an F approximation to its sampling distribution, that is shown to perform well in a range of small sample settings. The statistic uses an adjusted estimator of the covariance matrix that has reduced small sample bias. This approach has the advantage that it reproduces both the statistics and F distributions in those settings where the latter is exact, namely for Hotelling T2 type statistics and for analysis of variance F-ratios. The performance of the modified statistics is assessed through simulation studies of four different REML analyses and the methods are illustrated using three examples.
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The dissection experience has evolved over the past 500 years, following broader cutural trends in science and medicine. Through this time each period has recruited human gross anatomic dissection for characteristic purposes. Key variables have been: (1) the motivating philosophies of medicine and science, (2) how well clinical medicine and basic science have been integrated by anatomy, and (3) how explicity thoughts or feelings about death and dying have been addressed in the context of anatomy. The authors are especially interested in the third variable, and suggest that although anatomy is scientifically in decline, dissection is currently enjoying a revival as a vehicle for teaching humanist values in medical school. Changes in the culture of medicine have carried anatomy from a research science, to a training tool, nearly to a hazing ritual, to a vehicle for ethical and moral education. Physicians, scientists, and medical students, as well as observers such as sociologists and writers, have been only intermittently aware of these cultural shifts. Yet anatomic dissection has been remarkably persistent as a feature of medical education-indeed it stands out as the most universal and universally recognizable step in becoming a doctor. This paper attempts to explore and interpret in detail the history of anatomy education, drawing on both subjective commentary and objective data from each period.
Article
Major national and international critiques of the medical curriculum in the 1980s noted the following significant flaws: (1) over-reliance on learning by rote memory, (2) insufficient exercise in analysis and synthesis/conceptualization, and (3) failure to connect the basic and clinical aspects of training. It was argued that the invention of computers and related imaging techniques called to question the traditional instruction based on the faculty-centered didactic lecture. In the ensuing reform, which adopted case-based, small group, problem-based learning, time allotted to anatomical instruction was severely truncated. Many programs replaced dissection with prosections and computer-based learning. We argue that cadaver dissection is still necessary for (1) establishing the primacy of the patient, (2) apprehension of the multidimensional body, (3) touch-mediated perception of the cadaver/patient, (4) anatomical variability, (5) learning the basic language of medicine, (6) competence in diagnostic imaging, (7) cadaver/patient-centered computer-assisted learning, (8) peer group learning, (9) training for the medical specialties. Cadaver-based anatomical education is a prerequisite of optimal training for the use of biomedical informatics. When connected to dissection, medical informatics can expedite and enhance preparation for a patient-based medical profession. Actual dissection is equally necessary for acquisition of scientific skills and for a communicative, moral, ethical, and humanistic approach to patient care. Anat Rec (New Anat) 269:20-32, 2002.
Article
Despite a century's worth of research, arguments surrounding the question of whether far transfer occurs have made little progress toward resolution. The authors argue the reason for this confusion is a failure to specify various dimensions along which transfer can occur, resulting in comparisons of "apples and oranges." They provide a framework that describes 9 relevant dimensions and show that the literature can productively be classified along these dimensions, with each study situated at the intersection of various dimensions. Estimation of a single effect size for far transfer is misguided in view of this complexity. The past 100 years of research shows that evidence for transfer under some conditions is substantial, but critical conditions for many key questions are untested.
Article
Anatomy learning is generally seen as essential to medicine, and exposure to cadavers is generally seen as essential to anatomy learning around the world. Few voices dissenting from these propositions can be identified. This paper aims to consider arguments relating to the use of cadavers in anatomy teaching, and to describe the rationale behind the decision of a new UK medical school not to use cadaveric material. First, the background to use of cadavers in anatomy learning is explored, and some general educational principles are explored. Next, arguments for the use of human cadaveric material are summarised. Then, possible arguments against use of cadavers, including educational principles as well as costs, hazards and practicality, are considered. These are much less well explored in the existing literature. Next, the rationale behind the decision of a new UK medical school not to use cadaveric material is indicated, and the programme of anatomy teaching to be employed in the absence of the use of human remains is described. Curriculum design and development, and evaluation procedures, are briefly described. Issues surrounding pathology training by autopsy, and postgraduate training in surgical anatomy, are not addressed in this paper. Evidence relating to the effect on medical learning by students not exposed to cadavers is scant, and plainly opportunities will now arise through our programme to gather such evidence. We anticipate that this discussion paper will contribute to an ongoing debate, in which virtually all previous papers on this topic have concluded that use of cadavers is essential to medical learning.
Article
The time devoted to the teaching of anatomy to medical students has long been under pressure. Much work has been devoted to how best to teach anatomy in both a time-efficient and cost-effective manner. This article discusses the main methods of teaching anatomy and their respective advantages and disadvantages as evidenced in the literature. Suggestions are made as to how best to teach anatomy to medical students in the future.
Article
This study aimed to implement innovative teaching methods--blended learning strategies--that include the use of new information technologies in the teaching of human anatomy and to analyse both the impact of these strategies on academic performance, and the degree of user satisfaction. The study was carried out among students in Year 1 of the biology degree curriculum (human biology profile) at Pompeu Fabra University, Barcelona. Two groups of students were tested on knowledge of the anatomy of the locomotor system and results compared between groups. Blended learning strategies were employed in 1 group (BL group, n = 69); the other (TT group; n = 65) received traditional teaching aided by complementary material that could be accessed on the Internet. Both groups were evaluated using the same types of examination. The average marks presented statistically significant differences (BL 6.3 versus TT 5.0; P < 0.0001). The percentage pass rate for the subject in the first call was higher in the BL group (87.9% versus 71.4%; P = 0.02), reflecting a lower incidence of students who failed to sit the examination (BL 4.3% versus TT 13.8%; P = 0.05). There were no differences regarding overall satisfaction with the teaching received. Blended learning was more effective than traditional teaching for teaching human anatomy.
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Computer-aided instruction is used increasingly in medical education and anatomy instruction with limited research evidence to guide its design and deployment. To determine the effects of (a) learner control over the e-learning environment and (b) key views of the brain versus multiple views in the learning of brain surface anatomy. Randomised trial with 2 phases of study. Participants Volunteer sample of 1st-year psychology students (phase 1, n = 120; phase 2, n = 120). Interventions Phase 1: computer-based instruction in brain surface anatomy with 4 conditions: (1) learner control/multiple views (LMV); (2) learner control/key views (LKV); (3) programme control/multiple views (PMV); (4) programme control/key views (PKV). Phase 2: 2 conditions: low learner control/key views (PKV) versus no learner control/key views (SKV). All participants performed a pre-test, post-test and test of visuospatial ability. A 30-item post-test of brain surface anatomy structure identification. The PKV group attained the best post-test score (57.7%) and the PMV group received the worst (42.2%), with the 2 high learner control groups performing in between. For students with low spatial ability, estimated scores are 20% lower for those who saw multiple views during learning. In phase 2, students with the most static condition and no learner control (SKV) performed similarly to those students in the PKV group. Multiple views may impede learning, particularly for those with relatively poor spatial ability. High degrees of learner control may reduce effectiveness of learning.
Hierarchical Linear Models: Applications and Data Analysis Methods An Introduction to the Theory of Mental and Social Measurements Determinants of perceived ease of use: Integrating control, intrinsic motivation, and emotion into the technology acceptance model
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Impact of multimedia technology on academic performance and student perception in the anatomy laboratory. Ohio Assoc Two Year Coll
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Nasr P. 2007. Impact of multimedia technology on academic performance and student perception in the anatomy laboratory. Ohio Assoc Two Year Coll J 31: 30–36.
Impact of multimedia technology on academic performance and student perception in the anatomy laboratory
  • Nasr