The attitudes of medical students in Europe toward the clinical importance of histology

Many studies have been undertaken to assess the attitudes of medical students to the clinical importance of gross anatomy. However, much less is known about their attitudes toward the clinical importance of histology. Using Thurstone and Chave methods to assess attitudes, over 2,000 early stage medical students across Europe provided responses to a survey that tested the hypothesis that the students have a high regard for histology's clinical relevance. Regardless of the university and country surveyed, and of the teaching methods employed for histology, our findings were not consistent with our hypotheses, students providing a more moderate assessment of histology's importance compared to gross anatomy but more positive than their attitudes toward embryology. Histology should play a significant role in medical education in terms of appreciating not just normal structure and function but also pathology. We conclude that teachers of histology should pay special attention to informing newly‐recruited medical students of the significant role played by histology in attaining clinical competence and in underpinning their status as being learned members of a healthcare profession. This work was conducted under the auspices of the Trans‐European Pedagogic Research Group (TEPARG). Clin. Anat. 30:635–643, 2017. © 2017 Wiley Periodicals, Inc.     

Gross anatomy: An outdated subject or an essential part of a modern medical curriculum? Results of a questionnaire circulated to final-year medical students

Final-year undergraduate medical students were given a questionnaire on the gross anatomy curriculum they had experienced in their first year at medical school 5 years earlier. They were asked to evaluate the relevance of the dissection course, lectures and seminars in gross anatomy for clinical courses, clerkships, and everyday practical work on the ward. About two-thirds of the students found the time spent on 10 different regions in anatomy to be adequate, and a considerable number of students would have liked even more details. The vast majority expressed a wish to repeat topographical anatomy during their clinical teaching. Furthermore, ～75% of the students showed interest in short, specialized dissection courses during the clinical curriculum. Medical students just before graduation ranked gross anatomy with the dissection course and integrated clinical topics as a keystone for their clinical courses. The results of such surveys should be taken into consideration when discussing modification to teaching gross anatomy or arguing about a balanced dissection course. © 1993 Wiley-Liss, Inc.     

Attitudes of medical and dental students to dissection

Guy's, King's, and St. Thomas's School of Medicine encourages students to learn anatomy from human dissection. Today, there is a worldwide move of anatomy-based teaching away from dissection to prosection. This study investigates how attitudes toward dissection vary with gender and ethnicity. We assessed students' reactions and concerns regarding the dissecting room, any coping strategies they use to combat them, and analyzed effective methods of teaching anatomy to medical and dental students. Three questionnaires were distributed amongst 474 first-year medical and dental students before dissection and 1 week and 12 weeks after exposure to the dissecting room. Over the 3 months we found significant changes in the concerns of students about dissection. There were also significant differences (P < 0.05) between medical and dental students, males and females, and students of differing ethnic backgrounds, which persisted over 12 weeks. Both medical and dental students found tutorials and textbooks of most value in learning anatomy. Dental students found prosection more useful than medical students (P < 0.001) though neither group demonstrated a significant preference for prosection over dissection. Of concern, 7% reported recurring images of cadavers and 2% insomnia after commencing dissection. Interest in the subject matter and discussion were the commonest methods used to combat stress. This study contributes to the ongoing debate about the value of the dissecting room in the medical school curriculum.     

On behalf of tradition: An analysis of medical student and physician beliefs on how anatomy should be taught

Human anatomy, one of the basic medical sciences, is a time‐honored discipline. As such, it is taught using traditional methods, cadaveric dissection chief among them. Medical imaging has recently gained popularity as a teaching method in anatomy courses. In light of a general tendency to reduce course hours, this has resulted in a decrease of dissection time and intense debates between traditional and modern approaches to anatomy teaching. In an attempt to explore trends in the attitudes of medical professionals toward the various methods of anatomy teaching, medical imaging in particular, the authors constructed a questionnaire and conducted a nationwide survey among medical students (in all stages at medical school), residents, and specialists in all fields of medicine. The survey results demonstrated indisputable appreciation of traditional methods of anatomy teaching, particularly cadaveric dissection, and showed that specialists believe significantly more strongly than clinical or preclinical students that anatomy and medical imaging should be taught separately. Strong correlations among the components of the traditional approach to anatomy instruction were also found. In light of the results, it was recommended that imaging should be incorporated into anatomy courses with caution, and, as far as possible, not at the expense of dissection time. It was advised that medical imaging has to be taught as a separate course, parallel to a traditional anatomy course. This will allow anatomical principles to be appreciated, which in turn will serve the students when they study radiology. “And we proceed in the following order: in front walks Nikolai with the slides or atlases, I come after him, and after me, his head humbly lowered, strides the cart horse; or else, if necessary, a cadaver is carried in first, after the cadaver walks Nikolai, and so on. At my appearance, the students rise, then sit down, and the murmur of the sea suddenly grows still. Calm ensues.” —From “A Boring Story: From the Notebook of an Old Man” by Anton Chekhov. Clin. Anat. 28:980–984, 2015. © 2015 Wiley Periodicals, Inc.     

Attitudes of professional anatomists to curricular change

Throughout the world, recent developments in medical curricula have led to marked changes in the teaching of gross anatomy. This change has involved decreasing curricular student contact time and the use of new methods for anatomical teaching. Some "modern" anatomists have welcomed the arrival of these novel methods while other, more "traditional," anatomists have fought to maintain the use of cadaveric dissection. Consequently, controversy over teaching methods has developed to the point that "modernist" and "traditionalist" views within the community of professional anatomists seem to have diverged such that the importance of gross anatomy in the medical curriculum is disputed and that cadaveric dissection by students is no longer the preferred method of teaching. This study tests this hypothesis using Thurstone and Chave attitude analyses to assess attitudes to educational change and the importance of anatomy in medicine and a matrix questionnaire that required professional anatomists to relate course aims to different teaching methods. In total, 112 completed questionnaires were received from anatomists who are employed at higher education institutions that use various teaching methods and who span the academic hierarchy. The results suggest that over 90% of anatomists favor educational change and approximately 98% of professional anatomists believe that gross anatomy has an important role to play in clinical medicine. A clear majority of the anatomists (69%) favored the use of human cadaveric dissection over other teaching methods (this method seeming to achieve a range of different course aims/objectives) (P < 0.001; Kruskal-Wallis). Using Kruskal-Wallis statistical tests, the order-of-preference for teaching methods was found to be as follows: 1. Practical lessons using cadaveric dissection by students. 2. Practical lessons using prosection. 3. Tuition based upon living and radiological anatomy. 4. Electronic tuition using computer aided learning (CAL). 5. Didactic teaching alone (e.g. lectures/class room-based tuition). 6. Use of models. The preference for the use of human cadaveric dissection was evident in all groups of anatomists, whether "traditionalist" or "modernist" (P = 0.002, Chi-squared). These findings are therefore not consistent with our initial hypothesis.     

Perception of medical students towards the clinical relevance of anatomy

Recent developments worldwide in medical curricula have often led to major cuts in the teaching of human anatomy. Indeed, it is perceived by some that gross (topographical) anatomy has an exaggerated importance in the initial training of doctors. The value of anatomy consequently has frequently been considerably diminished within medical curricula that have reduced factual content. To date, however, there have been no objective studies into the perceived relevance of anatomy to clinical medicine that have aimed to quantify the attitudes of medical students. On the basis of responses to an attitude analysis questionnaire devised according to the precepts of Thurstone and Chave (The Measurement of Attitude: A Psychophysical Method and Some Experiments with a Scale for Measuring Attitude Toward the Church. Chicago, IL: University of Chicago Press, 1951), we investigated the perception of medical students at Cardiff and Paris towards the importance of gross anatomy to clinical medicine. This was undertaken during the early stages of their studies (when they were newly-admitted to university and were about to commence anatomy courses), immediately after finishing their anatomy courses, and later in the final year of medical studies. The results suggest that, even where there might be geopolitical and cultural backgrounds, students at all stages of their medical course share with professional anatomists the view that anatomy is a very important subject for their clinical studies. Thus, contrary to the unquantified beliefs of those who are sceptical about the purpose and value of anatomy in an undergraduate medical curriculum, the students themselves do not appear to share such beliefs.     

Back to basics.

The present study sought to establish findings and share views concerning the teaching of gross anatomy. The conclusions were drawn from feedback taken in 1995 from Year 1 (M1) through Year 5 (M5) (final year) medical students at the National University of Singapore. The survey was taken from two groups of students that had gone through two different curricula. The first group of M4 and M5 students studied under an old curriculum that taught anatomy over a period of three semesters. The second group of M1 through M3 students studied under a new curriculum of two semesters' duration. Altogether, 546 (M1: 147; M2: 120; M3: 78; M4: 107; M5: 97) completed questionnaires were analyzed. Throughout the years of study, the majority of students found dissection helpful (55.2-72. 7%) or very helpful (18.9-40.7%) in their understanding of gross anatomy. A minority of students (0-25.3%) found it not helpful. Taking all of the five years of students together, this would mean that 60.7% of the students found dissection helpful and 28% of them found it very helpful in their understanding of gross anatomy. Of the M3 students who had both dissection and demonstrations on prosected specimens, the majority of them found dissection helpful (55.2%) or very helpful (33.3%); they also found demonstrations on prosected specimens helpful (64.6%), or very helpful (27.8%). When asked whether dissection should be replaced completely by demonstrations on prosected specimens, 86.7% gave a resounding no. With regard to gross anatomy coverage, 11.7% of M4 and M5 students found it inadequate, 67.5% adequate, and 20.8% excessive. Only 1% of these students found that the gross anatomy they had learned was of no clinical relevance; 22.3% found it of little clinical relevance; and an overwhelming majority (76.7%) found it mostly clinically relevant. Most were grateful that they had been taught the basics of gross anatomy. These findings are discussed with an emphasis on the time needed and deep level approach required to gain conceptual understanding of anatomical organization.     

A critique of utilitarian and instrumentalist concepts for the teaching of gross anatomy to medical and dental students: Provoking debate

Medical and dental curricula, together with anatomical sciences courses, are increasingly having to change, mainly because there is a drive to being what is termed, without adequate definition, “clinically relevant.” The concept of “clinical anatomy” has accordingly been invented and it is expected that, at all times, the teaching of anatomy is directly focused on clinical scenarios, meaning almost invariably the disease‐based model of medicine and dentistry. Furthermore, students are not expected to have a detailed knowledge of gross anatomy and the time devoted to teaching and learning the subject has decreased significantly. The notion being fostered is that knowledge is not required “just in case” but “just in time.” However, the absence of agreed core syllabuses that are internationally accepted complicates a discussion about what is relevant practically and what does not need to be taught. In this article, we critique such an utilitarian and instrumentalist approach to the teaching of gross anatomy within medical and dental curricula. We draw attention to the need to embrace the functionality‐based model of medicine and dentistry by returning to an understanding that the role of the medical or dental practitioner is to value health and to restore to functionality the ill person or the pathologically affected region/organ/system. A fuller knowledge of anatomy than is presently taught is regarded as a prerequisite for appreciating normality and health. A further problem with the instrumentalist approach to medical education is that, by concentrating on what is seen to be at the time “useful” or “clinically relevant,” there is the danger of undermining, or discouraging, future developments that rely on what contemporaneously seems “useless” and “irrelevant” knowledge. Finally, the reliance instrumentalism has on just what is pragmatic and regardless of scientific validity is contrary to the ethos and practice of a university education that values deep learning and the development of learnèd professions. Clin. Anat. 30:912–921, 2017. © 2017 Wiley Periodicals, Inc.     

The relationships between learning outcomes and methods of teaching anatomy as perceived by professional anatomists

Changes in the teaching of gross anatomy have often involved decreasing student contact time alongside the use of new methods for teaching. However, there remains controversy over teaching methods and about whether cadaveric dissection by students should remain the preferred method. Furthermore, decisions concerning changes to curricula are more likely to be taken by choosing a method of teaching rather than by proper evaluation of what are the desired learning outcomes for a course in anatomy. The purpose of this study was to ascertain the attitudes of anatomists in Europe towards the methods of teaching best fitting a series of learning outcomes for anatomy and secondarily to test the hypothesis that, from evaluation of learning outcomes, anatomy is best taught by cadaveric dissection by the students. About 113 completed questionnaires were received from anatomists who are employed at higher education institutions that use various teaching methods. Most anatomists (69%) favored the use of cadaveric dissection above other teaching methods when considering the whole series of learning comes, this method seeming to achieve a range of different course aims/objectives, P < 0.001; Kruskal-Wallis). Consequently, these findings are consistent with our initial hypothesis. However, when individual learning outcomes were considered, the relationship was not so clear cut and, for example, little difference was discernible between teaching methods when considering learning outcomes related to the acquisition of anatomical knowledge. The use of human cadaveric dissection gained more approval when the skills-base was considered rather than just the content(knowledge)-base of an anatomical course.     

The future of gross anatomy teaching

A survey of U. S. departments of anatomy, physiology, and biochemistry shows that 39% of the respondent anatomy departments reported declines in the numbers of graduate students taking the human gross anatomy course. Similarly, 42% of the departments reported decreases in the numbers of graduate students teaching human gross anatomy. These decreases were greater in anatomy than in physiology and in biochemistry. The percentages of departments reporting increases in students taking or teaching their courses was 6% for human gross anatomy and 0% to 19% for physiology and biochemistry courses. To reverse this trend the establishment of specific programs for the training of gross anatomy teachers is advocated. These new teachers will be available as the need for them is increasingly recognized in the future. © 1995 WiIey-Liss, Inc.     

Medical students' attitudes towards science and gross anatomy,and the relationship to personality

Assessment of the personalities of medical students can enable medical educators to formulate strategies for the best development of academic and clinical competencies. Previous research has shown that medical students do not share a common personality profile, there being gender differences. We have also shown that, for French medical students, students with personality traits associated with strong competitiveness are selected for admission to medical school. In this study, we further show that the medical students have different personality profiles compared with other student groups (psychology and business studies). The main purpose of the present investigation was to assess attitudes to science and gross anatomy, and to relate these to the students'' personalities. Questionnaires (including Thurstone and Chave analyses) were employed to measure attitudes, and personality was assessed using the Big Five Inventory (BFI). Data for attitudes were obtained for students at medical schools in Cardiff (UK), Paris, Descartes/Sorbonne (France), St George''s University (Grenada) and Ankara (Turkey). Data obtained from personality tests were available for analysis from the Parisian cohort of students. Although the medical students were found to have strongly supportive views concerning the importance of science in medicine, their knowledge of the scientific method/philosophy of science was poor. Following analyses of the BFI in the French students, ‘openness’ and ‘conscientiousness’ were linked statistically with a positive attitude towards science. For anatomy, again strongly supportive views concerning the subject''s importance in medicine were discerned. Analyses of the BFI in the French students did not show links statistically between personality profiles and attitudes towards gross anatomy, except male students with ‘negative affectivity’ showed less appreciation of the importance of anatomy. This contrasts with our earlier studies that showed that there is a relationship between the BF dimensions of personality traits and anxiety towards the dissection room experience (at the start of the course, ‘negative emotionality’ was related to an increased level of anxiety). We conclude that medical students agree on the importance to their studies of both science in general and gross anatomy in particular, and that some personality traits relate to their attitudes that could affect clinical competence.     

Anatomy education in medical and dental schools in Japan

We studied the anatomy education and the view of anatomy professors on it in medical and dental schools in Japan. In most schools anatomy is taught in the second year. In medical schools, the systematic education separating macroscopic and microscopic anatomy is prevalent. Although the tutorial system has been introduced in 80% of medical schools, its introduction into anatomy education has remained at 30%. The tutorial system is regarded to be more effective by engaged professors than non-engaged. Some kinds of clinical anatomy education have been introduced in half of the medical schools surveyed. In dental schools, on the other hand, macroscopic and microscopic anatomy tend to be taught in combination. One third of the dental schools have introduced clinical anatomy but few schools have a tutorial system. The overwhelming majority of professors are evaluated by students and have regarded the evaluation useful for improving their teaching. They also have thought that the questionnaire and the timing of the evaluation must be considered carefully, and that the evaluation should not be directly used for purposes other than the improvement of education. We have made the proposals for further improvement in anatomy education based upon this study.     

Status of gross anatomy in the U.S. and Canada: Dilemma for the 21st century

As a component of a recent academic review, the Department of Anatomy and Neurosciences faculty at the University of Texas Medical Branch in Galveston, Texas, developed a questionnaire designed to compare the curricula, direction, and challenges of their department with the approximately 140 anatomy departments in the U. S. and Canada. The response was overwhelming in that over 80% of the schools returned a completed questionnaire. One of the areas of interest revealed by this survey was a growing concern over significant changes in both medical school curricula and the future of anatomy departments. Most departments still used traditional lectures to present course material and the majority of the scheduled contact hours were in the dissection laboratory; however, other teaching formats, such as case studies and small group discussions, accounted for significantly more of the teaching effort. Nearly 20% of the schools were making major modifications in their teaching methods. The general trend was to include more integrated, problem-based learning and computer-assisted teaching while reducing overall content, didactic lectures, and rote memorization. The role and need for traditionally trained gross anatomists in medical education appeared to be diminishing as curricular reform moved toward more student-directed, faculty-facilitated programs. Concurrently, the recruitment and career development of gross anatomy faculty appeared to be influenced more by funding status than by academic training or teaching experience, as most departmental chairman were willing to hire non-anatomists and “train” them to assume an often reduced teaching load in gross anatomy courses. In addition, fewer graduate students were being trained in classical gross anatomy, a trend that better suited the emerging student-directed medical school curricula. The reduction in classically trained anatomists also appeared to reflect the widespread practice whereby anatomy faculty were rewarded far more for research than for teaching. Although the continued inclusion of gross anatomy in medical education appeared to be assured, its traditional mode of presentation and academic prominence will likely change by the turn of the century. © 1994 Wiley-Liss, Inc.     

Are medical students being taught anatomy in a way that best prepares them to be a physician?

Reasoning in a clinical context is an attribute of medical expertise. Clinical reasoning in medical school can be encouraged by teaching basic science with a clinical emphasis. The aim of this study was to investigate whether anatomy is being taught in a way that facilitates the development of clinical reasoning. Two multiple‐choice tests on thoracic anatomy were developed using a modified Delphi approach with groups of four clinical consultants and four teachers, respectively, expressing their opinions about knowledge relevant to thoracic anatomy. Validity was assessed by administering the tests to clinical consultants, anatomy teachers, and pre‐course medical students. Post‐course medical students took both tests to explore the focus of the course, i.e., whether it facilitated clinical reasoning. The pre‐course students scored significantly lower than the teachers and post‐course students on both tests and lower than the consultants on the consultants’ test (P < 0.001 for all comparisons). The teachers significantly outperformed the consultants (P = 0.03 on the consultants’ test, P < 0.001 on the teachers’ test) and the medical students (P < 0.001 on both tests). The post‐course students scored significantly lower on the consultants’ test (P = 0.001) and significantly higher on the teachers’ test (P = 0.02) than the consultants. This study demonstrates poor performances by medical students on a test containing clinically relevant anatomy, implying that the teaching they have received has not encouraged clinical reasoning. Clin. Anat. 28:568–575, 2015. © 2015 Wiley Periodicals, Inc.     

Problem-based learning with gross anatomy specimens: One year trial

A problem-based learning experience was implemented at the University of Florida College of Medicine during the Fall, 1989 gross anatomy course for first year medical and dental students. A problem for deliberation was selected by students at one dissecting table (two medical and two dental) that related to the cadaver they were dissecting. Each member of the group picked a single topic and researched that subject either through use of the library or personal contacts with basic science or clinical faculty. Specific times within the course were established for the problem-based sessions. Each student gave a 5 to 10 minute oral presentation to a faculty member and one or two other groups of students. The overall rating for the sessions by the students was positive (72.5% ranked them either outstanding or above average). Eighty-two percent of the students felt that these sessions were a useful method of providing clinical correlations with gross anatomy and 81.6% stated they thought the program should be continued next year. Conversely, approximately 20% of the students responded that they could have been doing something more productive with their time and several felt it was unfair that their sessions were scheduled just prior to an examination. Overall, the opinion of the faculty was that the sessions were a positive experience, encouraged cooperation between medical and dental students, and generated additional interest in the dissecting experience.     

Provision of anatomical teaching in a new British medical school: getting the right mix

In response to a government report, which recommended a substantial increase in the number of medical students in the United Kingdom by 2005, several new medical schools have been set up throughout the country. One such school, the Brighton and Sussex Medical School (BSMS), recently opened its doors to new students. BSMS offers a 5-year medical curriculum that uses an integrated systems-based approach to cultivate academic knowledge and clinical experience. Anatomy is one of the core elements of the program and, as such, features strongly within the modular curriculum. The challenge for the anatomy faculty has been to decide how best to integrate anatomy into the new curriculum and what teaching modalities should be used. A multidisciplinary approach has been taken using both traditional and contemporary teaching methods. Unlike most of the other new medical schools, BSMS uses cadaveric dissection as the cornerstone of its teaching, as the faculty believes that dissection still provides the most powerful technique for demonstrating anatomy as well as enhancing communication and teamwork skills. The dissection experience is handled using an understanding and professional way. However, to ensure that our students do not become detached from the process of patient-focused care, emphasis in the dissecting room environment is also placed on respect and compassion. To enhance conceptual understanding of structure and function and provide further clinical relevance, we are using imaging technology to demonstrate living anatomy. Unique to the BSMS curriculum is the teaching of the anatomy in the later years of the program. During specialist rotations, students will return to the dissecting room to study the anatomy relevant to that area. Such vertical integration ensures that core anatomical knowledge is gained at the most appropriate level relative to a student's clinical experience.     

Anatomy of the thorax and shoulder girdle displayed by magnetic resonance imaging

In 1971, radiographic anatomy of the human body was added to the gross anatomy course at UCLA. Radiographic contrast studies and plain anatomical displays were formulated into teaching packages for all organ systems. Residents presented each package to first-year medical students in the dissection laboratory to augment the teaching of anatomy. In November 1984, magnetic resonance imaging was instituted in the radiology department. Imaging the chest produced coronal and axial planes which displayed the muscles and soft tissues of the thorax. In 1986, the authors presented their study of MR anatomy of the chest and shoulder girdle to the American Association of Anatomists. The purpose of this presentation is to demonstrate the anatomy of the thorax and shoulder girdle as displayed by magnetic resonance, correlated with regional anatomy, with emphasis on soft tissue structures.     

Approach to the educational opportunities provided by variant anatomy, illustrated by discussion of a duplicated inferior vena cava

Variant anatomy recognized during routine cadaveric dissection in the first year of medical school offers great learning potential by allowing students to gain enhanced understanding of an array of important subjects. It provides a framework for reviewing common morphology and embryogenesis of the structure in question, and through the help of appropriate faculty, yields insight into the potential medical, radiologic, and surgical implications. The frequency of clinically important anatomic variation is high enough to allow the gross anatomy laboratory to serve as an excellent teaching platform in this regard. Through anatomy, the student is introduced to the concept of patient individuality, and to the individualization of medical and surgical therapies. Recently, one of the variations encountered in our lab was a duplicated inferior vena cava. We describe our approach to such findings through a systematic discussion of the anatomy and embryology, as well as the radiologic and clinical correlates.     

微创临床局部解剖学教学体系的建立和探索

目的随着临床医学中微创手术的广泛开展,传统局部解剖学的教学模式明显不切合于现在的临床应用,我们在近3年的局部解剖学教学中,尝试建立基础与临床相结合的临床微创局部解剖学教学体系,实现了医学生培养上的多赢。方法在北京大学医学部的3个年级临床医学专业的医学生中,分成传统局部解剖学(局解组)和微创局部解剖学(微创局解组)。微创局解组同学借助模拟腔镜等微创手术器械,开展微创临床解剖学的教学。结果与传统局解组相比,微创局解组同学在学习兴趣,学习的主动性,知识的牢固性,解剖动手能力,临床思维能力,解剖和临床知识的互补性,讨论及交流能力和师生互动等方面均有不同程度的提高。结论微创解剖学教学体系不仅能够满足医学生尤其是临床医学生早期接触临床微创手术及手术器械的需要,并且还可以促进解剖学老师深入了解临床手术的进展,有利于进一步明确教学目的,并促进了基础解剖与临床进展的交流。     

Do we need dissection in an integrated problem-based learning medical course? Perceptions of first- and second-year students

BACKGROUND: The introduction of a problem-based learning (PBL) curriculum at the School of Medicine of the University of Melbourne has necessitated a reduction in the number of lectures and limited the use of dissection in teaching anatomy. In the new curriculum, students learn the anatomy of different body systems using PBL tutorials, practical classes, pre-dissected specimens, computer-aided learning multimedia and a few dissection classes. The aims of this study are: (1) to assess the views of first- and second-year medical students on the importance of dissection in learning about the anatomy, (2) to assess if students' views have been affected by demographic variables such as gender, academic background and being a local or an international student, and (3) to assess which educational tools helped them most in learning the anatomy and whether dissection sessions have helped them in better understanding anatomy. METHODS: First- and second-year students enrolled in the medical course participated in this study. Students were asked to fill out a 5-point Likert scale questionnaire. Data was analysed using Mann-Whitney's U test, Wilcoxon's signed-ranks or the calculation of the Chi-square value. RESULTS: The response rates were 89% for both first- and second-year students. Compared to second-year students, first-year students perceived dissection to be important for deep understanding of anatomy (P < 0.001), making learning interesting (P < 0.001) and introducing them to emergency procedures (P < 0.001). Further, they preferred dissection over any other approach (P < 0.001). First-year students ranked dissection (44%), textbooks (23%), computer-aided learning (CAL), multimedia (10%), self-directed learning (6%) and lectures (5%) as the most valuable resources for learning anatomy, whereas second-year students found textbooks (38%), dissection (18%), pre-dissected specimens (11%), self-directed learning (9%), lectures (7%) and CAL programs (7%) as most useful. Neither of the groups showed a significant preference for pre-dissected specimens, CAL multimedia or lectures over dissection. CONCLUSIONS: Both first- and second-year students, regardless of their gender, academic background, or citizenship felt that the time devoted to dissection classes were not adequate. Students agreed that dissection deepened their understanding of anatomical structures, provided them with a three-dimensional perspective of structures and helped them recall what they learnt. Although their perception about the importance of dissection changed as they progressed in the course, good anatomy textbooks were perceived as an excellent resource for learning anatomy. Interestingly, innovations used in teaching anatomy, such as interactive multimedia resources, have not replaced students' perceptions about the importance of dissection.