bluuebunny/crossref_metadata_2025 huggingface dataset:
Spinal process shape and vertebral immobility in hominoids and Hox9 mutant mice
Authors: Machnicki Allison L , Hrycaj Steven M , Wellik Deneen M , Reno Philip L
Published: November 2023

The nature of the human/chimpanzee last common ancestor is fundamental for understanding the evolution of human bipedalism. A particular focus is the conformation of its spine. There are multiple mechanisms for stiffening the spine of apes, including reduction of the number of lumbar vertebrae, the level of the transitional vertebra where the articular facets change from coronal to sagittal orientation, and the shape and angulation of the spinous processes. There is debate regarding whether these features are homologous or homoplastic, and thus whether bipedalism evolved from a short stiff back like great apes or a longer lumbar column more similar to monkeys and Miocene hominoids. Genetic modification of Hox9 in mice results in the correlated modification of spinous process shape and placement of the transitional vertebra independent of alternation in lumbar number, mimicking evolutionary changes observed in hominoids. This indicates that the articular facets and spinous processes may be associated developmental modules.

To test this hypothesis, we examined this change in spinous process across the thoracolumbar transition in hominoids and compared it to microCT scans of Hox9 modified mice. We used a NextEngine3D scanner to create surface scans of the lower thoracic and lumbar vertebrae of humans, gorillas, chimpanzees, orangutans, and gibbons in order to assess the angulation, orientation, and shape change of the spinous process relative to the position of the transitional vertebra and lumbar number. Humans and gibbons have a similar change in spinous process orientation and shape at the level of the transitional vertebra. Chimpanzees, gorillas, and orangutans each differ in their pattern of spinous process transition across the thoracolumbar boundary suggesting that mechanisms for lumbar stiffening in these taxa may be independently derived.

Support or Funding Information

This material is based upon work supported by the National Science Foundation under Grant No. DGE1255832, the Wenner Gren Foundation, and by the Pennsylvania State University Hill Fellowship.
Differences in Foramen Magnum Size and Shape among Sexes in Diverse Populations
Authors: Koons Aaron W , Russell Michelle L , Bliss Kaitlyn N , Mangus Kelsey R , Zdilla Matthew J
Published: November 2023

Study of the foramen magnum has cross‐disciplinary implications. Many studies have identified differences in the size of the foramen magnum among sexes; however, few have assessed the possibility of sexual differences in the shape of the foramen. Therefore, this study analyzed the size and shape foramen magnum in crania of diverse populations of males and females. Morphometric data demonstrated that males had a significantly longer transverse length than females with a mean difference of 1.56±0.44mm and a significantly longer sagittal length than females with a mean difference of 2.18±0.65mm. There was also a statistically significant difference between male and female foramen magnum area with a mean difference of 98.78±23.16mm 2. However, morphologic data did not reveal significant difference in circularity, solidity, aspect ratio, or roundness of the foramen magnum between sexes. Additionally, discriminant function analysis revealed no differences in the shape of female and male foramen magnums. Sexual dimorphism was determined to be present among morphometric measurements but not among morphologic measurements. Males had foramina that were larger than those of females but males and females have foramina that are the same shape, independent of size.

Support or Funding Information

WV Research Challenge Fund [HEPC.dsr.14.13]
The effect of dental senescence on fecal particle size for Propithecus diadema in the fragmented and pristine forests of Tsinjoarivo, Madagascar
Authors: Heffernan Katie SusAnn , Samonds Karen Elizabeth , Irwin Mitchell
Published: November 2023

Primate teeth wear over each animal's lifetime and this change in topography has the potential to affect nutrients absorbed, reproductive success, and fitness. There is therefore a complex interplay between tooth morphology and the evolution of primate diets and life history strategies. Many primates eat foods that require substantial processing to break into digestible pieces (e.g., leaves and hard fruit and seeds); changes in diet may increase rates of tooth wear and have deleterious effects on individuals' fitness and populations' long‐term viability. For example, King et al. suggested that for Propithecus edwardsi older females with dental senescence are unable to process certain types of foods, as demonstrated by larger particles in their feces, and suggested that this caused higher infant mortality rate during weaning in years with insufficient rain. However, King's hypothesis had a small sample size (n=1) and was not rigorously tested. Fecal particle size is an excellent non‐invasive tool to examine chewing efficiency in wild animals, especially when data can be linked to an individual animal's age, sex, and tooth topography. We analyzed 128 fecal samples from Propithecus diadema individuals collected in 2016. Fecal pellets were processed by water suspension and poured through a series of sieves in decreasing size. Particles were dried and weighed to calculate a dMEAN of fecal particle size, and variation linked to age, sex and habitat was assessed. Preliminary data contradicts the King et al. hypothesis, with no clear relationship between older animals (with more highly worn teeth) and particle sizes, suggesting that fitness may not be adversely affected by dental senescence. Future work will compare particle size directly to dental senescence using a more precise topographical scoring system of teeth.

Support or Funding Information

American Anatomist Association NIU Graduate School Travel GrantGraduate Women in ScienceNIU Biological Sciences Graduate GrantIdea Wild Equipment Donations
Synchondroses of the anterior chondrocranium in primates
Authors: Engel Serena , Wu Judi L , Llera Catherine , Zumpano Michael P , DeLeon Valerie B , Smith Timothy
Published: November 2023

The sphenoethmoidal synchondrosis or prespheno‐septal synchondrosis (PSept) is a chondrocranial joint_that does not fuse in humans until age six or seven and is suggested to fuse near birth in non‐human primates. As such, the PSept may play a role in variation in basicranial angulation or midfacial protrusion. Here, we assess indicators of cartilage growth and modeling activity at birth at the anterior end of the presphenoid bone in a broad range of primate species. A serially sectioned sample of 36 infant non‐human primates were studied using light microscopy. The cranial base region was examined to verify whether a synchondrosis separates the sphenoid and septum as well as distribution of osteoclasts along the anterior aspect of the presphenoid. Contrary to previous statements, all primates possess a synchondrosis on the anterior face of the presphenoid bone. In long faced primates (lemurs and lorises), the nasal septal cartilage articulates with the presphenoid in a blunt ended PSept. In contrast, the presphenoid invades the nasal septum in monkeys. Modeling patterns of the presphenoid differed among monkey species. For example, there is resorption of the lateral side of the presphenoid in small species such as marmosets and squirrel monkeys, resulting in a narrow interorbital septum. These findings demonstrate that the PSept is not fused in all non‐human primates at birth, as previously suggested. Because the presphenoid projects anteriorly to a different extent in the primate species under study, we suggest that the nature of PSept growth may affect variation in the facial shape more than basicranial angulation.

Support or Funding Information

Funded by the National Science Foundation; Grant numbers: BCS‐1231350, BCS‐1231717, BCS‐0959438, BCS/IOS‐0924592
Seriated CT‐scan of an egg in Aepornis maximus (Madagascar) and reconstructions
Authors: Le Floch‐Prigent Patrice Pierre , Gillot Jean‐Bernard , Verdeille Stéphane
Published: November 2023

Material

an egg in Aepornys (Madagascar, an extinct species) was 32,5 cm high, 22,5 cm wide, and 77,5cm in its largest, horizontal circumference. It weighed 1919 g and presented numerous, secondarily grossly stucked, natural fragments. The CT‐scan apparatus was a Siemens somatom sensitive one with 64 detectors.

Method

the egg was firstly CT‐scanned (thickness of about 1mm with jointed cross‐sections) all along its greatest axis. It was then reconstructed from the native sections in the two other planes. At last, external and internal surfaces' reconstruction were performed.

Results

the egg was totally empty with an homogeneous (near 1 cm) thickness and a good congruence of the fragments which largest ones had a curvature impossible to be given by an oystrich's egg (which shell is far more thinner); the radiological density of the shell was very high.

Conclusion

the CT‐scan proved that this reconstructed shell of a bird's egg was a very thick and dense, natural, real one which was reconstituted from an unique sample. It proved that it was really an Aepornys one. This species limited to the Madagascar Island disappeared five centuries ago. It exists written, european, historical testimonies which prove the existence of these enormous (500 kilograms) non flighting birds.
Changes in pectoral appendicular muscle anatomy and function over the water‐land transition in tetrapods
Authors: Molnar Julia , Hutchinson John , Diogo Rui , Pierce Stephanie
Published: November 2023

The question of how tetrapod limbs evolved from fins is one of the great puzzles of vertebrate biology. While paleontologists, developmental biologists, and geneticists have made great strides in explaining the origin and early evolution of limb skeletal structures, that of the muscles remains largely unknown. We sought to fill this gap by reconstructing pectoral appendicular muscles in three fossil taxa and measuring changes in muscle leverage about the shoulder and elbow joints over the fin‐limb and water‐land transitions. Building upon hypotheses of muscle homology recently published by our group and osteological correlates from the literature, we used extant phylogenetic bracketing and character optimization to reconstruct pectoral appendicular muscles in fossil taxa spanning the fin‐limb and water‐land transitions: the tetrapodomorph fish Eusthenopteron and the stem tetrapods Acanthostega and Pederpes. Then, we built 3D biomechanical models of the three fossil taxa, plus an extant lungfish and an extant coelacanth to compare the leverage of various muscle groups over a range of limb postures. Our preliminary results support the idea that one of the first major functional changes in the ancestors of tetrapods was the division of the superficial dorsal muscle mass of the shoulder into deltoid and latissimus dorsi muscles. This division would have provided leverage for forelimb protraction and retraction over a larger range of motion, likely facilitating tetrapod‐like gaits.

Support or Funding Information

AAA Post‐doctoral Fellowship to J. Molnar
BlueLink Resources for Dental Head and Neck Anatomy: the Effectiveness of Tailored Multimedia
Authors: Fox Glenn M , Alsup Kathleen
Published: November 2023

BlueLink resources, which include dissection‐based lab manuals, cadaveric atlas images, and interactive quizzes, are used successfully in University of Michigan Medical School and undergraduate anatomy curricula (Alsup and Fox, 2016; Dudgeon et al., 2016). In Summer 2016, BlueLink resources were included in the DENT 545: Head & Neck Gross Anatomy curriculum for first‐year U‐M School of Dentistry students, in addition to the traditional assigned text, lecture, and dissection. Quantitative and qualitative survey results indicate that BlueLink resources are highly utilized and positively reviewed by dental students, particularly in comparison to the textbook and outside anatomical atlases. Ongoing studies testing the effectiveness of BlueLink materials with first year dental students help to shape future resource growth and development.
MacAnatomy Pathology Learning Tool Project
Authors: Cao Belle , Brual Xyza , Kurdina Anna , Bayer Ilana , Wainman Bruce
Published: November 2023

MacAnatomy is the current online portal, which was developed for the Education Program in Anatomy at McMaster that allows students to easily access learning content. Previous analysis of student perceptions of the website have guided the development of specific pathology learning tools. Prototypes were then developed using the six themes elucidated from student interviews that were most requested: design & layout, user interface, learning approach, assessment, multimedia, and maintenance.

Data was collected from 24 interviewees that had all participated in the anatomy curriculum, then those transcripts were analyzed by five independent assessors. We found that students predominantly placed value in having self‐assessments that were seamlessly integrated within their content. These could be as simple as incorporating exercises that allow for the comparison of pathological states to normal. One important aspect of increasing the appeal to students is ensuring the interface is maintained and updated, as well as having a modern aesthetic to design and layout. Another highly requested feature was to ensure that the learning tool content was relatable and relevant to course material.

With the increased student demand for accessible online content, there is an opportunity for anatomical education to move and adapt towards utilizing various technological platforms. Our prototypes were developed to reflect student demand and preference in order to create an optimal learning tool that will be beneficial to both students and educators in the Anatomy Program at McMaster.
Use of OneNote as a Platform for Anatomical Education
Authors: Campbell Anna , Wilson Katrina , Olson John
Published: November 2023

In anatomy courses, medical students are often overwhelmed by a daunting amount of resources, e.g., videos, podcasts, lectures, readings, anatomical plates, live demonstrations, and hands‐on dissections. Organizing a myriad of multi‐media materials into a cohesive and useful study resource has often times been difficult and inefficient because of the complex and vastly different formats of the material. Further, studies have demonstrated that physical note‐taking and kinesthetic learning (e.g., drawing instead of typing or audio recordings) lead to better educational outcomes for long‐term recall and high‐level understanding. We developed a pilot program to implement the use of an interactive, computer based note‐taking system to efficiently access, create, distribute, and organize study material. Multimedia course content was distributed in a cloud‐based OneNote class notebook, and was utilized by the students and faculty as a collaborative resource. Students were instructed in how to use the platform, including customizing the content library, taking digital longhand notes, generating digital renderings, concept maps, and audio/video recordings, collaborative note‐sharing, and utilizing complex search methods to organize content in a manner best suited to their individual learning styles. After the course was completed, surveys were distributed to the students (n=90) to gauge use and determine their level of acceptance of this technology. Our results demonstrate that though the learning curve was relatively steep and students were initially skeptical of using a university mandated electronic resource as a note‐taking tool, many reported increased efficiency and organization in their studying methods. The majority (97%) reported their intent to create a digital repository of content and plan to continue use of OneNote for the remainder of their medical education (88%). The preliminary findings of this study suggest that further integration of OneNote into anatomy and other areas of our curriculum is warranted. Future studies should evaluate the effect of this software platform on learning outcomes.

Support or Funding Information

This work was supported by an internal institutional grant from A.T. Still University.
A Pilot Study Examining the Impact of Two‐Dimensional Computer Images and Three‐Dimensional Stereoscopic Images of the Pelvic Muscles and Neurovasculature on Short‐term and Long‐term Retention of Anatomical Information for First‐Year Medical Students
Authors: Meyer Edgar R. , James Amber M. , Cui Dongmei
Published: November 2023

Although there are a number of studies concerned with the construction of three‐dimensional images, there are currently few studies which explore whether stereoscopic models help medical students retain the information regarding the three‐dimensional orientation of structures. This pilot study examines the effects of first‐year medical students' exposure to two‐dimensional versus three‐dimensional images of the musculature, arteries, and nerves of the pelvis and their corresponding short‐ and long‐term retention of the anatomical information of these regions. Students who volunteer to participate will be administered a series of tests: baseline‐test, post‐2D test, pre‐3D test, short‐term 3D post‐test, and long‐term 3D/2D post‐tests pertaining to the pelvis before and after their 3D learning experience. These students will complete an initial survey inquiring about their perceptions of three‐dimensional imaging in general and of the effectiveness of its use in teaching anatomical material and a second survey to inquire about their own perception of the effectiveness of three‐dimensional imaging in improving their long‐term retention of anatomical information pertaining to the pelvis. Results will be analyzed using a Wilcoxon rank‐sum test and linear regression analysis to compare short‐term and long‐term post tests on 2D and 3D groups. Final results will determine whether 3D pelvis models improve students' short‐term and/or long‐term retention of anatomical information. Future studies should address the effectiveness of stereoscopic imaging of other complex regions of the body on first‐year medical students' short‐ and long‐term retention of anatomical information.
Assessing the usefulness of ultrasound as a tool for teaching anatomy to the medical student
Authors: Dilley Andrew , Smith Claire
Published: November 2023

Ultrasound is becoming an important tool for teaching anatomy in modern medical curricula, which is largely because of improved image quality and portability. In contrast to traditional teaching methods, ultrasound provides students with a live window into the body so that functional anatomy can be viewed in real‐time. Importantly, ultrasound provides a clinically relevant approach to learning anatomy. At Brighton and Sussex Medical School, ultrasound has been fully integrated into year 1 and 2 of the MBBS medical curriculum in small group teaching sessions (n = 15), which total 12 hours. To determine the usefulness of ultrasound for teaching anatomy, students completed an evaluation questionnaire consisting of 15 questions following each systems‐based module in years 1 and 2. All responses (n = 49 −111) were scored on a five point Likert scale. At the end of year 2, 86.4% of students agreed (combined agreed and strongly agreed scores) that understanding anatomy through ultrasound is very relevant to clinical practice and 62.1% agreed that using ultrasound has helped in their understanding of gross anatomy. Half of students (51.5%) agreed that they found it easy to identify organs on ultrasound and more than 64.7% of students could identify different musculoskeletal structures (i.e. blood vessels, bone and muscle). When asked whether students found it easy to move between 2D and 3D when using ultrasound, 43.2% of students agreed with this statement. However, following examination of the heart in year 1, only 8% of students agreed. In summary, interpretation of an ultrasound image can be challenging for students. In particular, students find it difficult to orientate a 2D slice through organs such as the heart, which is largely because small adjustments in probe orientation can result in unfamiliar views. Students clearly understand the clinical relevance of ultrasound. With increasing use of ultrasound in clinics, early exposure will undoubtedly help prepare students for clinical practice. Finally, this work clearly emphasizes the need for better learning resources in this field.
Evaluation of a New Temporally and Fiscally Economical Ultrasound Training Program for First‐Year Medical Students
Authors: Mason Nena Lundgreen , Puglisi Jose , Mullen Alexandra , Kim Brendan
Published: November 2023

Ultrasound is a safe and effective imaging modality that is becoming a powerful clinical and educational tool with numerous applications across many medical disciplines. Consequently, a movement to include ultrasound training in undergraduate medical education is slowly taking place. However, many educational institutions are still hesitant to include formal ultrasound training as part of their curriculum for several reasons. In this study we present an evaluation of an ultrasound training program for first‐year medical students. This training program is both temporally and fiscally economical. It requires minimal faculty time, and is structured as an independent short course of six 30‐minute sessions rather than as an additional component in already brimming anatomy or medical skills curricula. Sessions covered topics related to 11 commonly used sonographical imaging categories spanning 4–7 weeks of training. Subjective and objective data presented in this study shows that first‐year medical students can demonstrate competency both in operating an ultrasound machine, and in obtaining diagnostic quality images in all 11 imaging categories. This study provides a temporally and fiscally economical alternative to more regimented ultrasound training programs. Additionally, our data shows that effective ultrasound training does not require many expensive machines or numerous instructors, and can be conducted easily as a short course running longitudinally with established courses. It is our intent that these conclusions negate the concerns of many educational institutions that they do not have adequate time or resources to teach ultrasound skills to medical students starting in the first year.
A Pilot Study Into Flipping Neuroanatomy – Student Performance And Experience Results
Authors: Jennings Ernie , Long Sharron
Published: November 2023

Background & Aim

James Cook University (JCU) has an undergraduate entry Dentistry Course where students are taught with the more traditional face –to – face method using lectures and practicals. Like many universities JCU is moving towards a blended approach to learning, offering a more interactive, self‐guided learning experience (Ma'arop and Embi 2016). The students admitted to dentistry are high achieving, and could be expected to readily engage with online material, and an earlier study (Long and Jennings 2016) indicates that this is the case. The aim of this study was to examine student engagement, experience and performance in neuroanatomy content usually delivered in 1 week.

Methods

De‐identified student data and responses were collected following roll out of the content. This study was covered by the College of Medicine and Dentistry's Teaching Evaluation Human Ethics Approval. Eight short (10–20 mins) videos of the content were developed. These contained embedded multiple choice questions (MCQ). The videos were delivered over the Blackboard Student Learning System and averaged data of engagement with material and performance in the embedded MCQs is presented here. A survey looking at student experience was administered at the end of semester.

Results

In the six weeks since the videos were made available, there were 1961 hits on these videos. Of the 87 students enrolled in the Anatomy subject an average of 44 (range 41–46) completed the MCQs in the eight videos gaining an average score of 75% (range 62 – 91 %).

Conclusions

Similar to the results of Gaida et al 2016, our students referred to the online material numerous times and most found it helpful in their studies. There was a strong indication that the students would like more online material to assist them in their studies of the subject especially the anatomical component. These preliminary data indicate that the dentistry students are willing to interact with online videos.

Support or Funding Information

This study was supported the the College of Medicine and Dentistry, James Cook University.
Developing a Team‐Based Learning Module for Large Classes in Medical School
Authors: Prange‐Kiel Janine , Champine Julie G. , Winkler Alisa J. , Twickler Diane M.
Published: November 2023

In addition to early exposure to clinically relevant topics and integration of various disciplines, teaching team skills has become a priority in medical education. Many forms of small‐group teaching, which promote the development of team skills, require a large number of teaching personnel. This can be problematic when these activities are to be implemented in the large classes (i.e., more than 100 students) typical of many Medical Schools. Team‐based learning (TBL) is considered to be a strategy for active learning that enables a single teacher to facilitate learning in multiple small groups simultaneously in the same room. We have developed a TBL module for medical students in the pre‐clerkship period that integrates embryology, anatomy, and radiology of the head and neck region. The TBL module was developed initially in 2015 for a class of 234 students and has been used in 2016 for the second time with a class of comparable size (231 students). Here, we describe the resources available through our institution's Office of Medical Education, and how they were used to adapt TBL for a large class: (1) Various tools of the school's online learning management system, MoodleRooms, were utilized to deliver the pre‐reading material and to present the applications to the students. (2) The computer‐based testing tool, ExamSoft, was used to deliver the questions for the readiness assurance tests (RATs). While the individual RAT was completely performed in ExamSoft, the answers for the group RAT questions were recorded with Immediate Feedback Assessment Technique scratch cards. (3) A dedicated room had been built to accommodate the entire class engaged in small‐group activities (in particular TBL). The room includes 40 tables; each is seating a TBL group and is equipped with a microphone and a monitor the students can connect to wirelessly. There are additional monitors on the walls, and a central instructor station enables the facilitator to control all monitors in the room.

A student survey was performed after each of the TBLs; in both years the students evaluated the TBL positively, with even better results in the second year. In our experience, exact time management and aiming for a seamless transition between activities during a TBL session are important to keep students motivated and engaged. In conclusion, TBL with large classes has specific challenges, most of which can be overcome with appropriate measures including institutional support and careful planning.
The Use of Clay Models to Teach Pelvic Anatomy to First and Second Year Medical Students at OUWB School of Medicine
Authors: Schmidt Brianna , Thompson Brent J , Chang Aleah
Published: November 2023

Introduction

Pelvic anatomy is often a difficult concept for medical students to grasp due to difficulties in dissections and visualization of the three‐dimensional aspects of anatomical relationships. To improve student knowledge of pelvic anatomy and increase student perceptions of confidence in that knowledge, a new pelvic anatomy workshop has been developed.

Methods

Second year Oakland University William Beaumont School of Medicine (OUWB) students attended a workshop employing a new method of teaching pelvic anatomy. This workshop assisted students in assembling pelvic structures using a bony pelvis and colored clay. The efficacy of this workshop in helping medical students learn and retain the anatomical relationships of the pelvis was assessed using pre‐ and post‐surveys with Likert scales, and multiple choice questions. Since the participation number was small (n=16), we assessed changes in confidence and knowledge for the group rather than the individual. Descriptive statistical analysis will compare frequencies and mean scores of the pre and post data.

Results

The preliminary data show that students attending the workshops had a statistically significant increase in their confidence of knowledge of the pelvis/perineum, average increase of 1.36 (p<0.001). The testing was done using a paired t‐test. Students also had an average increase of 1.86 in their confidence to teach another student the anatomy of the pelvis/perineum (p<0.05). An exact McNemar test was used to examine the pretest‐posttest changes in the proportion of students that reported correct responses before and after the workshop.

Conclusion

Expanding the use of learning styles that go beyond the standard lectures and dissections, used in most first and second year medical school courses, will allow students to take what they learn and create a simpler, visually concrete model to study from. Quantitate data from this preliminary study indicate that the use of clay modeling to learn pelvic anatomy increases students' confidence in their knowledge of pelvic anatomy and in their ability to share this knowledge with other students. Based on these findings we believe that the use of modeling to learn pelvic anatomy warrants further investigation.
Effectiveness of computer assisted learning in anatomy and physiology
Authors: Hilvano Nestor T
Published: November 2023

Traditional hands‐on learning continues to provide benefits using anatomic models, histology slides and dissections to convey knowledge about the relevant organ system. Hands‐on laboratory experience is perceived to enhance students' ability to apply information and widen their appreciation of knowledge gain. Recent investigation shows that computer assisted learning (CAL) may improve teaching and learning environment to provide an effective supplement for the better understanding of materials and create interactive opportunities for the learners. The goal of this study is to determine the effectiveness of CAL in teaching anatomy and physiology course for nursing, physical therapy and other allied health undergraduate education. The majority of students felt that CAL enabled laboratory sessions to gain more information with use of digital histology images (95%) and help them to understand better the material presented in lectures (95%). They perceived that digital anatomy dissections improve understanding of the location and relationship of structures and functions of the musculoskeletal system (89%). However, 70% of students thought that CAL influence them into student‐directed studies prior to actual laboratory sessions.

Support or Funding Information

None
Case‐Based Learning Using Cadaveric Pathology Specimens Enhances Learner Engagement in Reviewing Normal Anatomy
Authors: Moon Mary , O'Donoghue Daniel , Miller Frederick , Klump Kathryn , Halliday Nancy
Published: November 2023

The University of Oklahoma College of Medicine implemented a major curricular change in 2010 that resulted in a shift from discipline‐based courses to integrated systems‐based pre‐ clinical courses. In the process, the traditional 16‐week Gross Anatomy course was transformed into a 6.5‐week foundational Human Structure course that includes gross anatomy, embryology, histology, radiologic anatomy, and clinical application of anatomical knowledge. The intent was to provide a foundational knowledge of anatomy that would be re‐visited in the subsequent systems‐based courses. During the 2011–2014 academic years, we provided review anatomy lectures in the Gastrointestinal/Hepatobiliary, and Reproductive Medicine courses. The education literature suggests that passive lectures are the less effective in producing desired learning outcomes than active learning methodologies.

Study Objective

Determine if it is possible to review anatomy at an appropriate level and cover adequate content in a more active learning process than traditional lectures.

Hypothesis

Students will successfully review systems‐based anatomy with improved engagement and retention of material by actively exploring anatomically‐based pathologies in cadavers and their corresponding case studies.

Intervention

We developed an innovative way to review anatomy while also engaging students in clinical problem‐solving. Laboratory based case‐studies based on actual cadaveric pathologies were implemented in the MS2 CRR and Reproductive Medicine courses, and the MS1 GIH course.

Results

Data collected on student attitudes, student learning outcomes, and faculty perceptions of the laboratories was analyzed to determine perceived effectiveness of the intervention. End of course evaluations indicate that students successfully review anatomy content and gain a deeper understanding of specific anatomically‐based pathologies. In addition, clinical faculty facilitators rated the teaching/learning experience highly.

Conclusion

Learners and faculty facilitators report that the experiential learning promoted by the pathology‐based laboratory review is engaging, enjoyable, and effective in reviewing systems‐based anatomy. Learners indicate that the case‐based anatomy laboratory enhanced their understanding of clinical applications throughout the remainder of the course.
Enhancing anatomy learning by combining body painting, ultrasound, clinical investigation and peer‐teaching
Authors: Filgueira Luis , Eppler Elisabeth
Published: November 2023

Traditional anatomy teaching to medical students is based on lectures, combined with practical courses using dissection, prosections or models, with delivery of content as a one‐way procedure from teachers to students. Anatomy teaching is often based on images, models and prosections of dead bodies, neglecting the dynamic live and functional aspect of anatomical structures. Anatomy is usually taught at the early stage of medical programs and the acquired knowledge is only occasionally enhanced and applied later in a clinical setting. The aim of our study was to enhance knowledge of anatomy, translate traditional first acquired knowledge into a more clinical setting focusing on functional/live anatomy, as well as teaching the students the tools and providing the opportunity to enhance self‐directed learning, literature research, team‐learning, oral communication/peer teaching, peer‐evaluation, writing skills and self‐reflection.

The study was done with 20 students. The content focused on the locomotion system, including some major conditions. The students had learnt the basics of the locomotion system one year earlier through a dissection course. New knowledge was elaborated in small groups and delivered through peer‐teaching. Applied/clinical anatomy was enhanced through practical sessions using body painting, ultrasound and clinical investigation, supervised by an experienced anatomist and clinical teachers. The students reported on their learning experience through a reflective diary and by answering a questionnaire.

The aims of the study were well achieved. The students enhanced their knowledge in anatomy and were highly satisfied with this new course and especially with the student‐focused activities in a clinically‐oriented setting.
Training of Near‐peer Tutors in the Gross Anatomy Laboratory
Authors: Hunter Shelley Dawn , O'Donoghue Daniel , Miller Frederick , Halliday Nancy
Published: November 2023

The University of Oklahoma College of Medicine utilizes fourth year medical students as near‐peer (NP) mentors/tutors with the goal of providing experienced near‐peer assistants for dissections to aid first year medical students in the gross anatomy laboratory. Recent research, by others, indicates learner perceptions regarding the value of NP tutor instruction increases when the tutors are trained in the content area, prior to instruction. Fourth year medical students volunteered for NP tutoring in anatomical areas of interest. They were required to performed a prosection, with faculty guidance, the day prior to learner dissections. In past courses NP assistants were not trained, and learner post‐course evaluations concerning NPs effectiveness were negative. After initiating NP training, negative comments from learners were greatly reduced.

Support or Funding Information

none
Clinical Anatomy and Imaging Lab: Vertical Integration in a Preclinical Reproductive Organ Systems Course
Authors: Hankin Mark , Hoops Heather , McLaren Patrick , Hecht Sarah , Stadler Diane , O'Reilly Meg
Published: November 2023

BACKGROUND

Gross anatomy in the School of Medicine at Oregon Health and Science University is presented within an integrated, organ systems curriculum. In the Developing Human (DEVH) course, anatomy lectures are limited and dissection occurs in a single, four‐hour lab. Although lectures by clinician are offered, students nevertheless struggle to connect the foundational anatomy learned in the anatomy lab to disease processes discussed in these lectures. To enhance these experiences, anatomists and clinical faculty collaborated to create a Clinical Anatomy and Imaging Lab (CAIL) that would allow students to scaffold their foundational knowledge by placing it in a clinical context.

THE REPRODUCTIVE ANATOMY CAIL

This CAIL explored the anatomy of the female and male reproductive systems in a number of clinical conditions. It was held just after the initial anatomy lab and concurrent anatomy lectures to vertically integrate and reinforce the anatomy from dissection. Resources included dissected embalmed cadavers, fresh unembalmed cadavers with laparoscopes or cystoscopes, anatomical models, and specialized surgical instrumentation. Five stations, each mentored by clinical and anatomy faculty, guided students as they explored the anatomy of common conditions and procedures and potential complications used for treatment: (1) Hysterectomy – students explored relevant pelvic organs laparoscopically in a fresh cadaver; (2) Ectopic Pregnancy – students explored relevant pelvic organs laparoscopically in a fresh cadaver; (3) Vaginal Delivery and Obstetric Laceration – students explored relevant anatomy in models; (4) Enlarged Prostate – students explored the bladder and urethra cystoscopically in a fresh cadaver and discussed different conditions that may lead to an enlarged prostate; and (5) Inguinal Hernia – students explored the inguinal region in a surgical preparation on an embalmed cadaver and discussed anatomical and surgical considerations for different types of hernia (laparoscopy in a fresh cadaver was also planned for this station but did not occur due to lack of a donor).

RESULTS & CONCLUSIONS

In preliminary feedback, students felt the initial anatomy dissection lab and the clinical anatomy lab experiences helped to integrate the material at an appropriate educational level and enhanced their understanding of the foundational anatomy of the female and male reproductive systems. The opportunity to learn from clinicians how the basic anatomy was used and visualized in the clinic was a key element of the exercise. The hands‐on experiences simulated the clinical setting and added a further dimension of interactive learning. The integration of foundational and applied anatomy will be assessed in the end‐of‐course comprehensive exam. This clinical anatomy lab expanded upon a previous model (see Hankin et al., AAA/EB 2016: program #783.1).
Learning with Concept Maps and evaluation of individually prepared concept maps versus concept maps prepared in groups
Authors: Anand Mahindra Kumar
Published: November 2023

Introduction

Medical education aims not only to prepare students to learn existing knowledge but to generate new knowledge and apply that knowledge to solve complex problems. Research suggests that complex problems can be solved with the help of knowledge integration. The use of concept maps as teaching tool facilitates knowledge integration. Present study was undertaken to compare learning with individually prepared concept maps versus learning with concept maps prepared in groups. Individually and collaboratively prepared concept maps were assessed to compare knowledge gain.

Methods

A randomized cross sectional prospective study was conducted on 80 medical students of 1st year. Students were divided into 2 groups A and B. Group A studied “Gross anatomy of knee joint” by developing concept maps in number of small subgroups. Group B studied with concept maps developed individually by each student. Pre and posttest were conducted for both groups with pre validated questionnaire. Each concept map was evaluated as per Novak and Gowins system of assessment and knowledge gain was compared for individually prepared concept maps versus concept maps prepared in groups. Students T test was applied for statistical analysis.

Result

There was significant improvement in knowledge in both group A and B students. This improvement was more marked in regards to high cognitive type MCQs. There was significant difference of marks (p value 0.0002) between group A and Group B students. Concept maps prepared in groups got higher scoring than individually prepared concept maps.

Discussion and Conclusion

Learning with collaboratively developed concept maps leads to higher knowledge retention in comparison to the learning with concept maps developed individually in gross anatomy. Teaching‐learning with development of concept maps individually or collaboratively facilitates higher cognitive learning. Preparation of concept maps in groups facilitates better understanding of concepts.

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Creating Milestones and Exit Competencies for Medical School Education in Histology
Authors: Pinder Karen , Ford Jason
Published: November 2023

There is a growing international consensus that the adoption of competency‐based curricula will improve undergraduate medical education. Competencies define measurable behaviours that are expected of graduating medical students and which are attained through a series of progressive milestones that begin on the first day of medical school and continue through to graduation.

As part of a curriculum renewal project that embraces milestones and exit competencies, faculty at the medical school at the University of British Columbia (UBC) have generated milestones and competencies in all foundational and clinical medical science domains. This was a significant undertaking for the foundational medical sciences because, although the existing literature provides several examples of medical student exit competencies for clinical specialties, foundational medical science competencies are lacking.

We here report on our generation of milestones and exit competencies for a core foundational medical science, histology. The milestones and competencies are brief, coherent and measurable histology‐related skills that will be required of each graduating UBC medical student. Significantly, by framing our competencies with exemplars, we clearly demonstrate how each of our histology exit competencies can be mapped to clinical scenarios that both medical students and post‐graduate physicians will encounter. These examples of milestones and competencies for a core foundational medical science will be useful for educators who are exploring or implementing competency‐based undergraduate medical curricula.
Histology Education in the Next Generation
Authors: Shaw Phyllis Ann , Hernandez Matthew
Published: November 2023

Pre‐clinical medical education methodologies that employ the most novel technologies to increase student's appreciation of basic sciences in clinical reasoning, disease diagnosis, treatment, and global health, within a competency based framework, have changed dramatically over the past ten years. Not only has the number of “in class” histology hours been reduced, the notion of a “flipped histology classroom” has been suggested as a way to partially eliminate the loss of these histology hours. This trend across medical education was aided by the introduction of the Virtual Microscope (digital slides of thin sections of tissues and organs) that permitted easy manipulation of histological material. With the introduction of new additions into the first year curriculum, it became necessary to decrease the number of hours of some courses and to integrate others. At Icahn School of Medicine at Mount Sinai, histology (22 hrs) was integrated into the Structures course (nine‐weeks; 140 hours), which includes gross anatomy and embryology (18 hrs). In this most recent semester (2016), Matt Hernandez, an MD/PhD student and Senior Histology Fellow, designed guided Virtual Histology Videos for the laboratories covering cell structure, and epithelial, connective, nervous, and muscle tissues (corrected and edited by Shaw). The cell structure video was aired in the first laboratory; then the students viewed the other labs outside of class. We report here the integration of Histology in the Structures course and the success of the five histology lab videos. Moreover, we are creating a complete series of histology lab videos to be used as the “flipped classroom” histology labs in the future.
Evaluation of objectives‐based learning outcomes in a compressed presentation of human structure
Authors: Klump Kathryn E. , Moon Mary , Miller Frederick , O'Donoghue Daniel L. , Halliday Nancy
Published: November 2023

Introduction

Systems‐based curricular changes at the University of Oklahoma College of Medicine led to the recognition that course content should be guided by specific, competency‐based, objectives and more precisely, session‐objective‐linked learning outcomes. In our compressed Human Structure curriculum, test items are aligned to both the stated Course Objectives (CO) and given Session Learning Objectives (SO). End of course surveys show our students generally appreciate the conduct of the course, the quality of the lecturers and course content. Faculty were confounded, however, by student self‐reports indicating they are unaware of the presence of CO or concerns that objectives were not made clear. If the students are not aware of CO, then how certain can faculty be that students are accomplishing those objectives and are able to achieve desired learning outcomes.

Study Objective

Evaluate student perceptions of confidence in areas covered by twelve COs before and after the 6.5 week Human Structure in the context of learning outcomes as measured by changes in perceived confidence and SO‐linked test item performance.

Results

Our data indicates that Medical, Dental and Physician Associate students' perception of confidence significantly increased in areas covered by each of the twelve objectives measured during the Human Structure course. A few students began their studies with high confidence in several of the CO areas; these students indicated that their confidence was greatly enhanced by the course work. Preliminary analysis of objectives linked assessments data showed a positive correlation between self‐reported level of confidence and performance on objectives‐linked outcome measures.