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1.
The contribution of donor dissection to modern anatomy pedagogy remains debated. While short-term anatomy knowledge gains from dissection are questionable, studies suggest that donor dissection may have other impacts on students including influencing medical students' professional development, though evidence for such is limited. To improve the understanding of how anatomy education influences medical student professional development, the cross-sectional and longitudinal impacts of donor dissection on medical students' perceptions of ethics were explored. A cross-sectional and longitudinal qualitative study was undertaken at an Australian university where student responses to online discussion forums and in-person interviews were analyzed. Data were collected across the 1.5 years that undergraduate medical students received anatomy instruction (three semesters during first and second years). A total of 207 students participated in the online discussion forums, yielding 51,024 words; 24 students participated in at least 1 of 11 interviews, yielding over 11 hours of interview data. Framework analysis identified five themes related to ethics in an anatomical education context: (1) Dignity, (2) Beneficence, (3) Consent, (4) Justification for versus the necessity of dissection, and (5) Dichotomy of objectification and personification. The dominant themes of students' ethical perceptions changed with time, with a shift from focusing on donors as people, toward the utility of donors in anatomy education. Additionally, themes varied by student demographics including gender, ancestry, and religiosity. Together this study suggests a strong impact of donor dissection on priming students' focus on medical ethics and provides further advocacy for formal and purposeful integration of medical ethics with anatomy education.  相似文献   

2.
Studies have demonstrated that students experience a variety of intense emotions in anticipation of human anatomical dissection, including enthusiasm, gratitude, responsibility, apprehension, detachment, anxiety, and spiritual or moral reflection. The exercise described here provides an opportunity to start a conversation about the complexity of students’ emotional reactions to the anatomy experience. The intention of this exercise is to normalize the variety of emotions that anatomy students experience, both to demonstrate to students that their emotions are normal and to encourage the empathy for others' reactions which may differ from their own. In the lecture hall setting before the first day of dissection, students are asked to draw how they feel about the dissection experience and are provided an opportunity to discuss their drawings with their peers. The course director then provides a slide show demonstration of drawings from previous years, and experienced anatomy faculty facilitate a large group discussion in which students react to the drawing exercise and slide show and ask questions which are addressed by the faculty. This exercise provides an opportunity for students to practice appropriately communicating about emotionally complex experiences in a professional setting. The exercise is straightforward to implement and is easily modifiable for different class sizes and curricular structures.  相似文献   

3.
Changes in medical education have affected both curriculum design and delivery. Many medical schools now use integrated curricula and a systemic approach, with reduced hours of anatomy teaching. While learning anatomy via dissection is invaluable in educational, professional, and personal development, it is time intensive and supports a regional approach to learning anatomy; the use of prosections has replaced dissection as the main teaching method in many medical schools. In our graduate‐entry medical degree, we use an integrated curriculum, with prosections to teach anatomy systemically. However, to not exclude dissection completely, and to expose students to its additional and unique benefits, we implemented a short “Dissection Experience” at the beginning of Year 2. Students attended three two‐hour anatomy sessions and participated in dissection of the clinically relevant areas of the cubital fossa, femoral triangle, and infraclavicular region. This activity was voluntary and we retrospectively surveyed all students to ascertain factors influencing their decision of whether to participate in this activity, and to obtain feedback from those students who did participate. The main reasons students did not participate were previous dissection experience and time constraints. The reasons most strongly affecting students' decisions to participate related to experience (lack of previous or new) and new skill. Students' responses as to the most beneficial component of the dissection experience were based around practical skills, anatomical education, the learning process, and the body donors. We report here on the benefits and practicalities of including a short dissection experience in a systemic, prosection‐based anatomy course. Anat Sci Educ 6: 225–231. © 2013 American Association of Anatomists.  相似文献   

4.
The purpose of this study was to evaluate the extracurricular cadaveric dissection program available to medical students at an institution with a modern (time‐compressed, student‐centered, and prosection‐based) approach to medical anatomy education. Quantitative (Likert‐style questions) and qualitative data (thematic analysis of open‐ended commentary) were collated from a survey of three medical student cohorts who had completed preclerkship. Perceived benefits of dissection included the hands‐on learning style and the development of anatomy expertise, while the main barrier that limited participation was the time‐intensive nature of dissection. Despite perceived benefits, students preferred that dissection remain optional. Analysis of assessments for the MD2016 cohort revealed that dissection participation was associated with enhanced performance on anatomy items in each systems‐based unit examination, with the largest benefits observed on discriminating items that assessed knowledge application. In conclusion, this study revealed that there are academic and perceived benefits of extracurricular participation in dissection. While millennial medical students recognized these benefits, these students also indicated strong preference for having flexibility and choice in their anatomy education, including the choice to participate in cadaveric dissection. Anat Sci Educ 11: 294–302. © 2017 American Association of Anatomists.  相似文献   

5.
The role of physician assistant/associate (PA) has expanded from its inception in the United States over 50 years ago, to European countries including Ireland. While there is an increasing body of evidence exploring the role and training of PAs in clinical settings, there is a scarcity of research exploring PA students' perspectives in relation to their experience of anatomy dissection, or how these experiences may contribute to the development of their core professional identity. Students in the first two cohorts of PA Program at the Royal College of Surgeons in Ireland program were invited to interviews which solicited them to reflect and report on their own experiences of anatomical dissection during their course. Participants' responses were analyzed using a thematic inductive approach; common themes and patterns were organized into a hierarchical structure, which generated the final framework of themes. Ten participants took part in the study; only one had previous personal experience of dissection, while two further participants had some familiarity with prosected specimens. The first theme concerned the participants' expectation of anatomical dissection, with sub-themes of preconceptions, smell, and emotions. The second theme involves discussion of coping strategies that the participants used, including talking, viewing the cadaver as their first patient, and naming (or not naming) the cadaver. The third theme includes how the participants' talked about respect and compassion in the dissection room, development of team working skills, and awareness of bereavement and organ donation. A number of recommendations were also made for the experience and orientation of future students in such a program.  相似文献   

6.
For centuries cadaveric dissection has been a cornerstone of medical anatomy education. However, time and financial limitations in modern, compressed medical curricula, coupled with the abundance of alternate modalities, have raised questions about the role of dissection. This study was designed to explore student perceptions of the efficacy of a dissection program for learning musculoskeletal anatomy, and possible adaptations for appropriate inclusion of dissection in the modern medical curricula. A paper-based questionnaire was used to collect data from 174 medical students after completion of cadaveric dissections. Data were analyzed using both quantitative and qualitative methods. Students strongly believed that cadaver-based learning is essential to anatomy education and modern teaching modalities only complement this. Moreover, most students reported that dissection provided an additional, immersive learning experience that facilitated active learning and helped in developing manual competencies. Students with previous dissection experience or an interest in anatomy-related specialties were significantly more likely to attend dissection sessions. Students found that the procedural dissection components enhanced the knowledge of applied anatomy and is beneficial for the development of clinical skills. They welcomed the idea of implementing more procedure-based dissections alongside lectures and prosections-based practical (PBP) sessions. Cadaveric dissection plays an integral role in medical anatomy education. Time restraints and an increased focus on clinical significance, however, demand carefully considered adaptations of existing dissection protocols. The introduction of procedure-based dissection offers an innovative, highly engaging and clinically relevant package that would amalgamate skills essential to medical practice while retaining the benefits that have allowed dissection to stand the test of time.  相似文献   

7.
Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists.  相似文献   

8.
Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview-based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. All students oscillated involuntarily between seeing the cadaver as a specimen for learning and seeing the cadaver as a person, with some students intentionally cultivating one of these ways of seeing over the other. These views shaped students’ emotional and moral responses to the experiences of dissection. The “specimen” view facilitated a technical, detached approach to dissection, while the “person” view made students engage emotionally. Further, students who intentionally cultivated a “specimen” view generally felt less moral distress about dissection than students who intentionally cultivated a “person” view. The concept of respect gave students permission to perform dissections, but “person-minded” students developed more complex rules around what constituted respectful behavior. Both groups of students connected the gross anatomy experience to their professional development, but in different ways. “Specimen-minded” students intentionally objectified the body to learn the emotional control physicians need, while “person-minded” students humanized the body donor to promote the emotional engagement required of physicians. These findings support efforts to integrate professionalism teaching into gross anatomy courses, particularly content, addressing the balance between professional detachment and concern.  相似文献   

9.
Dissection has long been the accepted method for teaching anatomy to medical students. More recently, some educators have suggested that easier, cheaper, alternative methods are just as effective. But what do the students think? This paper aimed to identify what undergraduate medical students learn, how they cope, and what effects participating in dissection has on them as individuals. A cohort of 267 second year medical students at Otago Medical School were invited to complete three online surveys; before their first dissection laboratory class, after their first musculoskeletal system dissection and following the last semester of studying anatomy. Open‐ended questions showcasing the attitudes, beliefs, and opinions on what dissection had taught the medical students over years two and three were analyzed. A general inductive approach was used and common emergent themes were identified. In total, 194 students completed the second, and 108 students completed the third questionnaire. Students commonly conveyed dissection as an appropriate and valuable educational tool, useful for teaching and learning anatomical knowledge and relationships, appreciating the body in three‐dimension, teamwork, and how to cope with death/dead bodies. The noted effects of personal growth while participating in dissection were highly varied, but in general, impacted positively on the majority of students. This study shows that at Otago Medical School the students also believe that dissection is not only a useful tool to learn anatomy but also that it fosters teamwork, assists professional development and helps them come to terms with death and dying. Anat Sci Educ 11: 325–335. © 2017 American Association of Anatomists.  相似文献   

10.
Teaching time dedicated to anatomy education has been reduced at many medical schools around the world, including Nova Medical School in Lisbon, Portugal. In order to minimize the effects of this reduction, the authors introduced two optional, semester‐long cadaveric dissection courses for the first two years of the medical school curriculum. These courses were named Regional Anatomy I (RAI) and Regional Anatomy II (RAII). In RAI, students focus on dissecting the thorax, abdomen, pelvis, and perineum. In RAII, the focus shifts to the head, neck, back, and upper and lower limbs. This study prospectively analyzes students' academic achievement and perceptions within the context of these two, newly‐introduced, cadaveric dissection courses. Students' satisfaction was assessed anonymously through a questionnaire that included items regarding students' perception of the usefulness of the courses for undergraduate teaching, as well as with regards to future professional activity. For each of the three academic years studied, the final score (1 to 20) in General Anatomy (GA), RAI, and RAII was on average 14.26 ± 1.89; 16.94 ± 1.02; 17.49 ± 1.01, respectively. The mean results were lower in GA than RAI or RAII (P < 0.001). Furthermore, students who undertook these courses ranked them highly with regards to consolidating their knowledge of anatomy, preparing for other undergraduate courses, and training for future clinical practice. These survey data, combined with data on participating students' academic achievement, lend strong support to the adoption of similar courses as complementary and compulsory disciplines in a modern medical curriculum. Anat Sci Educ 10: 127–136. © 2016 American Association of Anatomists.  相似文献   

11.
The professional behavior of future doctors is increasingly important in medical education. One of the first subjects in the curriculum to address this issue is gross anatomy. The Tuebingen Medical Faculty implemented a learning portfolio and a seminar on medical professionalism during the dissection course. The aims of this research project are to get an overview of how students form a professional identity in the dissection course and to compare the content of both their oral and written reflections on the course. A qualitative analysis was conducted of the oral and written reflections on the dissection laboratory experience. This study was conducted during winter term 2013/2014 with a cohort of 163 participants in the regular dissection course. Written reflection texts (from n = 96 students) and audio recordings from four oral reflection seminar discussions (with n = 11 students) were transcribed and deductively categorized with Mayring’s qualitative content analysis method. Both qualitative analyses show that students reflected on many topics relevant to professional development, including empathy, respect, altruism, compassion, teamwork, and self-regulation. Quantitative analysis reveals that students who attended the oral reflection wrote significantly more in their written reflection than students who did not. There is, however, no difference in the reflection categories. Reflection content from students corresponds with categories derived from existing competency frameworks. Both the seminar (oral reflections) and the learning portfolio (written reflections) present excellent opportunities to foster professional development during anatomy education; the key is using them in conjunction with the dissection course.  相似文献   

12.
Anatomy education continues to evolve in health professional programs as curricula shift to competency-based models and contact hours decrease. These changes in curricula may significantly alter the learning environment for students. Importantly, changes in learning environment have been shown to impact student learning strategies and well-being. It follows, then, that an investigation of students' perceptions of the learning environment is key to understand the impact of modern anatomy curriculum alterations. The current pilot study evaluated the impact of modifying examination format on the learning environment of physical therapy students participating in a human cadaveric anatomy course. Two study cohorts of first year (entry-level) physical therapy students were invited to complete a preliminary learning environment questionnaire with 13 visual analog scale items and four short answer items. One study cohort was tested with a viva (oral) practical examination, and the other, with a bell-ringer practical examination. Analysis of quantitative items revealed two significant findings: physical therapy students in the bell-ringer cohort found it was more difficult to prepare for their examination, and that they had inadequate time to respond to questions compared to the viva cohort. Analysis of qualitative items revealed distinct themes that concerned physical therapy student learning environment specific to cadaveric anatomy. These results demonstrate that examination format can influence the learning environment of physical therapy students studying cadaveric anatomy. As a result, care needs to be taken to ensure that modernized curricula align the examination format to the method of instruction and the future application of students' knowledge in clinical practice.  相似文献   

13.
Mercer University School of Medicine utilizes a problem-based learning (PBL) curriculum for educating medical students in the basic clinical sciences. In 2014, an adjustment was piloted that enabled PBL cases to align with their corresponding cadaver dissection that reviewed the content of anatomy contained in the PBL cases. Faculty had the option of giving PBL cases in sequence with the cadaveric dissection schedule (sequential group) or maintaining PBL cases out of sequence with dissections (traditional group). During this adjustment, students’ academic performances were compared. Students’ perception of their own preparedness for cadaveric dissection, their perceived utility of the cadaver dissections, and free-response comments were solicited via an online survey. There were no statistically significant differences when comparing student mean examination score values between the sequential and traditional groups on both multidisciplinary examinations (79.39 ± 7.63 vs. 79.88 ± 7.31, P = 0.738) and gross anatomy questions alone (78.15 ± 10.31 vs. 79.98 ± 9.31, P = 0.314). A statistically significant difference was found between the sequential group's and traditional group's (63% vs. 29%; P = 0.005) self-perceived preparedness for cadaveric dissections in the 2017 class. Analysis of free-response comments found that students in the traditional group believed their performance in PBL group, participation in PBL group and examination performance was adversely affected when compared to students with the sequential schedule. This study provides evidence that cadaveric dissections scheduled in sequence with PBL cases can lead to increased student self-confidence with learning anatomy but may not lead to improved examination scores.  相似文献   

14.
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15.
This study used qualitative and quantitative approaches to evaluate the effectiveness of self‐learning modules (SLMs) developed to facilitate and individualize students' learning of basic medical sciences. Twenty physiology and nineteen microanatomy SLMs were designed with interactive images, animations, narrations, and self‐assessments. Of 41 medical students, 40 students voluntarily completed a questionnaire with open‐ended and closed‐ended items to evaluate students' attitudes and perspectives on the learning value of SLMs. Closed‐ended items were assessed on a five‐point Likert scale (5 = high score) and the data were expressed as mean ± standard deviation. Open‐ended questions further evaluated students' perspectives on the effectiveness of SLMs; student responses to open‐ended questions were analyzed to identify shared patterns or themes in their experience using SLMs. The results of the midterm examination were also analyzed to compare student performance on items related to SLMs and traditional sessions. Students positively evaluated their experience using the SLMs with an overall mean score of 4.25 (SD ± 0.84). Most students (97%) indicated that the SLMs improved understanding and facilitated learning basic science concepts. SLMs were reported to allow learner control, to help in preparation for subsequent in‐class discussion, and to improve understanding and retention. A significant difference in students' performance was observed when comparing SLM‐related items with non‐SLM items in the midterm examination (P < 0.05). In conclusion, the use of SLMs in an integrated basic science curriculum has the potential to individualize the teaching and improve the learning of basic sciences. Anat Sci Educ 3: 219–226, 2010. © 2010 American Association of Anatomists.  相似文献   

16.
The Anatomy Learning Experiences Questionnaire (ALEQ) was designed by Smith and Mathias to explore students' perceptions and experiences of learning anatomy. In this study, the psychometric properties of a slightly altered 34‐item ALEQ (ALEQ‐34) were evaluated, and correlations with learning outcomes investigated, by surveying first‐ and second‐year undergraduate medical students; 181 usable responses were obtained (75% response rate). Psychometric analysis demonstrated overall good reliability (Cronbach's alpha of 0.85). Exploratory factor analysis yielded a 27‐item, three‐factor solution (ALEQ‐27, Cronbach's alpha of 0.86), described as: (Factor 1) (Reversed) challenges in learning anatomy, (Factor 2) Applications and importance of anatomy, and (Factor 3) Learning in the dissection laboratory. Second‐year students had somewhat greater challenges and less positive attitudes in learning anatomy than first‐year students. Females reported slightly greater challenges and less confidence in learning anatomy than males. Total scores on summative gross anatomy examination questions correlated with ALEQ‐27, Pearson's r = 0.222 and 0.271, in years 1 and 2, respectively, and with Factor 1, r = 0.479 and 0.317 (all statistically significant). Factor 1 also had similar correlations across different question types (multiple choice; short answer or essay; cadaveric; and anatomical models, bones, or radiological images). In a retrospective analysis, Factor 1 predicted poor end‐of‐semester anatomy examination results in year 1 with a sensitivity of 88% and positive predictive value of 33%. Further development of ALEQ‐27 may enable deeper understanding of students' learning of anatomy, and its ten‐item Factor 1 may be a useful screening tool to identify at‐risk students. Anat Sci Educ 10: 514–527. © 2017 American Association of Anatomists.  相似文献   

17.
Assessment of the personalities of medical students could enable medical educators to formulate strategies for the best development of academic and clinical competencies. In this article, we focus on the experience of students in the anatomy dissecting room. While there have been many attempts to evaluate the emotional responses of medical students to human cadaveric dissection, there has been no investigation into how different personality traits affect the responses. The main hypothesis tested was that there is a relationship between personality traits and attitudes toward the dissection room. For the present study, a group of French medical students (n = 403; mean age 21.3 ± 1.6; 65.3% female) completed a "Big Five" personality inventory and a questionnaire to assess their attitudes in regard to human dissection. The findings are consistent with our hypothesis, in that we found a relationship between reporting anxiety and four of the "Big Five" dimensions (all except openness). The rated level of anxiety was positively correlated with negative affectivity, more strongly at the beginning than at the end of the course. There were significant gender differences in attitudes toward dissection. The findings are discussed in relation to the possibility of preparing students for the dissecting room experience and also in relation to the students' understanding of mortality issues.  相似文献   

18.
Integration of anatomy and clinical teaching is a theoretical ideal, yet there is a worldwide paucity of such amalgamation. These teaching models provide support for medical trainees, an important element in Germany where orthopedic intern numbers have declined and anecdotal evidence suggests disinterest in orthopedics. The aim of the study was to develop an integrated anatomy‐surgical course for undergraduate medical training, assess the model developed, and explore how medical students perceive orthopedics as a career. The course was to deliver medical anatomy and clinical orthopedic training, focusing on interdisciplinary teaching and learning, vertical integration of clinical knowledge and skills, and professional interaction. Survey evaluation of the course and students' perceptions of orthopedic careers was performed, including Likert‐type responses rating variables of interest. A phased‐concept program of five courses, each optional and under one‐week in duration, was developed parallel to the undergraduate medical program. Delivered by anatomists and surgeons, courses included biomechanics, advanced dissection, surgical approaches, casts and implants, and sports medicine. Course data indicate positive support for course format, stimulation of interest, and high clinical relevance. Students are generally interested in surgery, and identify hierarchy, lawsuits, bureaucracy and physical stress as barriers to orthopedic careers. This novel phased‐concept successfully delivers combined anatomy and surgery training in a vertically‐integrated format while addressing students' clinical and professional skills. The format facilitates an appreciation of potential career options in orthopedics, while fostering professional skills during medical training. Barriers to careers in orthopedics can now be addressed in future courses. Anat Sci Educ 10: 372–382. © 2016 American Association of Anatomists.  相似文献   

19.
Assessment is an important aspect of medical education because it tests students' competence and motivates them to study. Various assessment methods, with and without images, are used in the study of anatomy. In this study, we investigated the use of extended matching questions (EMQs). To gain insight into the influence of images on the validity of test items, we focused on students' cognitive processes while they answered questions with and without images. Seventeen first‐year medical students answered EMQs about gross anatomy, combined with either labeled images or answer lists, while thinking aloud. The participants' verbal reports were transcribed verbatim and then coded. Initial codes were based on a task analysis and were adapted into final codes during the coding process. Results showed that students used more cues from EMQs with images and visualized more often in EMQs with answer lists. Ready knowledge and verbal reasoning were used equally often in both conditions. In conclusion, EMQs with and without images elicit different results in this think aloud experiment, indicating different cognitive processes. They seem to measure different skills, making them valid for different testing purposes. The take‐home message for anatomy teachers is that questions without images seem to test the quality of students' mental images while questions with images test their ability to interpret visual information. It makes sense to use both response formats in tests. Using images from clinical practice instead of anatomical drawings will help to improve test validity. Anat Sci Educ 7: 107–116. © 2013 American Association of Anatomists.  相似文献   

20.
Cadaveric dissection offers an important opportunity for students to develop their ideas about death and dying. However, it remains largely unknown how this experience impacts medical students' fear of death. The current study aimed to address this gap by describing how fear of death changed during a medical gross anatomy dissection course and how fear of death was associated with examination performance. Fear of death was surveyed at the beginning of the course and at each of the four block examinations using three of the eight subscales from the Multidimensional Fear of Death Scale: Fear of the Dead, Fear of Being Destroyed, and Fear for the Body After Death. One hundred forty-three of 165 medical students (86.7%) completed the initial survey. Repeated measures ANOVA showed no significant changes in Fear of the Dead (F (4, 108) = 1.45, P = 0.222) or Fear for the Body After Death (F (4, 108) = 1.83, P = 0.129). There was a significant increase in students' Fear of Being Destroyed (F (4, 108) = 6.86, P < 0.0005) after beginning dissection. This increase was primarily related to students' decreased willingness to donate their body. Concerning performance, there was one significant correlation between Fear for the Body After Death and the laboratory examination score at examination 1. Students with higher fears may be able to structure their experience in a way that does not negatively impact their performance, but educators should still seek ways to support these students and encourage body donation.  相似文献   

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