Anatomy Dissection Course Improves the Initially Lower Levels of Visual-Spatial Abilities of Medical Undergraduates

Visual-spatial abilities are considered a successful predictor in anatomy learning. Previous research suggest that visual-spatial abilities can be trained, and the magnitude of improvement can be affected by initial levels of spatial skills. This case-control study aimed to evaluate (1) the impact of an extra-curricular anatomy dissection course on visual-spatial abilities of medical undergraduates and (2) the magnitude of improvement in students with initially lower levels of visual-spatial abilities, and (3) whether the choice for the course was related to visual-spatial abilities. Course participants (n = 45) and controls (n = 65) were first and second-year medical undergraduates who performed a Mental Rotations Test (MRT) before and 10 weeks after the course. At baseline, there was no significant difference in MRT scores between course participants and controls. At the end of the course, participants achieved a greater improvement than controls (first-year: ∆6.0 ± 4.1 vs. ∆4.9 ± 3.2; ANCOVA, P = 0.019, Cohen's d = 0.41; second-year: ∆6.5 ± 3.3 vs. ∆6.1 ± 4.0; P = 0.03, Cohen's d = 0.11). Individuals with initially lower scores on the MRT pretest showed the largest improvement (∆8.4 ± 2.3 vs. ∆6.8 ± 2.8; P = 0.011, Cohen's d = 0.61). In summary, (1) an anatomy dissection course improved visual-spatial abilities of medical undergraduates; (2) a substantial improvement was observed in individuals with initially lower scores on the visual-spatial abilities test indicating a different trajectory of improvement; (3) students' preferences for attending extracurricular anatomy dissection course was not driven by visual-spatial abilities.     

Does spatial awareness training affect anatomy learning in medical students?

Spatial ability (SA) is the cognitive capacity to understand and mentally manipulate concepts of objects, remembering relationships among their parts and those of their surroundings. Spatial ability provides a learning advantage in science and may be useful in anatomy and technical skills in health care. This study aimed to assess the relationship between SA and anatomy scores in first- and second-year medical students. The training sessions focused on the analysis of the spatial component of objects' structure and their interaction as applied to medicine; SA was tested using the Visualization of Rotation (ROT) test. The intervention group (n = 29) received training and their pre- and post-training scores for the SA tests were compared to a control group (n = 75). Both groups improved their mean scores in the follow-up SA test (P < 0.010). There was no significant difference in SA scores between the groups for either SA test (P = 0.31, P = 0.90). The SA scores for female students were significantly lower than for male students, both at baseline and follow-up (P < 0.010). Anatomy training and assessment were administered by the anatomy department of the medical school, and examination scores were not significantly different between the two groups post-intervention (P = 0.33). However, participants with scores in the bottom quartile for SA performed worse in the anatomy questions (P < 0.001). Spatial awareness training did not improve SA or anatomy scores; however, SA may identify students who may benefit from additional academic support.     

The Effect of Stereoscopic Augmented Reality Visualization on Learning Anatomy and the Modifying Effect of Visual-Spatial Abilities: A Double-Center Randomized Controlled Trial

Monoscopically projected three-dimensional (3D) visualization technology may have significant disadvantages for students with lower visual-spatial abilities despite its overall effectiveness in teaching anatomy. Previous research suggests that stereopsis may facilitate a better comprehension of anatomical knowledge. This study evaluated the educational effectiveness of stereoscopic augmented reality (AR) visualization and the modifying effect of visual-spatial abilities on learning. In a double-center randomized controlled trial, first- and second-year (bio)medical undergraduates studied lower limb anatomy with stereoscopic 3D AR model (n = 20), monoscopic 3D desktop model (n = 20), or two-dimensional (2D) anatomical atlas (n = 18). Visual-spatial abilities were tested with Mental Rotation Test (MRT), Paper Folding Test (PFT), and Mechanical Reasoning (MR) Test. Anatomical knowledge was assessed by the validated 30-item paper posttest. The overall posttest scores in the stereoscopic 3D AR group (47.8%) were similar to those in the monoscopic 3D desktop group (38.5%; P = 0.240) and the 2D anatomical atlas group (50.9%; P = 1.00). When stratified by visual-spatial abilities test scores, students with lower MRT scores achieved higher posttest scores in the stereoscopic 3D AR group (49.2%) as compared to the monoscopic 3D desktop group (33.4%; P = 0.015) and similar to the scores in the 2D group (46.4%; P = 0.99). Participants with higher MRT scores performed equally well in all conditions. It is instrumental to consider an aptitude–treatment interaction caused by visual-spatial abilities when designing research into 3D learning. Further research is needed to identify contributing features and the most effective way of introducing this technology into current educational programs.     

Learning anatomy enhances spatial ability

Spatial ability is an important factor in learning anatomy. Students with high scores on a mental rotation test (MRT) systematically score higher on anatomy examinations. This study aims to investigate if learning anatomy also oppositely improves the MRT‐score. Five hundred first year students of medicine (n = 242, intervention) and educational sciences (n = 258, control) participated in a pretest and posttest MRT, 1 month apart. During this month, the intervention group studied anatomy and the control group studied research methods for the social sciences. In the pretest, the intervention group scored 14.40 (SD: ± 3.37) and the control group 13.17 (SD: ± 3.36) on a scale of 20, which is a significant difference (t‐test, t = 4.07, df = 498, P < 0.001). Both groups show an improvement on the posttest compared to the pretest (paired samples t‐test, t = 12.21/14.71, df = 257/241, P < 0.001). The improvement in the intervention group is significantly higher (ANCOVA, F = 16.59, df = 1;497, P < 0.001). It is concluded that (1) medical students studying anatomy show greater improvement between two consecutive MRTs than educational science students; (2) medical students have a higher spatial ability than educational sciences students; and (3) if a MRT is repeated there seems to be a test effect. It is concluded that spatial ability may be trained by studying anatomy. The overarching message for anatomy teachers is that a good spatial ability is beneficial for learning anatomy and learning anatomy may be beneficial for students' spatial ability. This reciprocal advantage implies that challenging students on spatial aspects of anatomical knowledge could have a twofold effect on their learning. Anat Sci Educ 6: 257–262. © 2013 American Association of Anatomists.     

Effect of binocular disparity on learning anatomy with stereoscopic augmented reality visualization: A double center randomized controlled trial

Binocular disparity provides one of the important depth cues within stereoscopic three-dimensional (3D) visualization technology. However, there is limited research on its effect on learning within a 3D augmented reality (AR) environment. This study evaluated the effect of binocular disparity on the acquisition of anatomical knowledge and perceived cognitive load in relation to visual-spatial abilities. In a double-center randomized controlled trial, first-year (bio)medical undergraduates studied lower extremity anatomy in an interactive 3D AR environment either with a stereoscopic 3D view (n = 32) or monoscopic 3D view (n = 34). Visual-spatial abilities were tested with a mental rotation test. Anatomical knowledge was assessed by a validated 30-item written test and 30-item specimen test. Cognitive load was measured by the NASA-TLX questionnaire. Students in the stereoscopic 3D and monoscopic 3D groups performed equally well in terms of percentage correct answers (written test: 47.9 ± 15.8 vs. 49.1 ± 18.3; P = 0.635; specimen test: 43.0 ± 17.9 vs. 46.3 ± 15.1; P = 0.429), and perceived cognitive load scores (6.2 ± 1.0 vs. 6.2 ± 1.3; P = 0.992). Regardless of intervention, visual-spatial abilities were positively associated with the specimen test scores (η² = 0.13, P = 0.003), perceived representativeness of the anatomy test questions (P = 0.010) and subjective improvement in anatomy knowledge (P < 0.001). In conclusion, binocular disparity does not improve learning anatomy. Motion parallax should be considered as another important depth cue that contributes to depth perception during learning in a stereoscopic 3D AR environment.     

The Effectiveness of an Augmented Reality Head-Mounted Display in Learning Skull Anatomy at a Community College

Despite an increase in the use of technology in undergraduate anatomy education, and the rising popularity of online anatomy courses at community colleges in the United States, there have been no reports on the efficacy of augmented reality on anatomy education in this population. The purpose of this study was to test the hypothesis that augmented reality is an effective and engaging tool for learning anatomy in community college students. Participants recruited from Cuyahoga Community College (Cleveland, OH) studied skull anatomy using either traditional tools (i.e., textbook and plastic skull model) or an augmented reality head-mounted display with an interactive virtual skull application. Comparison of knowledge before and following the study period revealed that augmented reality was an effective tool for learning skull anatomy: pre-quiz = 32.7% (± 25.2); mean (± SD), post-quiz = 61.8% (± 19.5); n = 15; t₍₂₈₎ = 3.53; P = 0.001. The traditional tools were equally effective: pre-quiz = 44.9 % (± 18.6), post-quiz = 67.9 % (± 17.3); n = 17; t₍₃₂₎ = 3.73; P = 0.0007. Students rated the augmented reality device as 9.6 (± 1.0); mean (± SD) when asked if it fit the statement “fun to use” on a semantic differential scale from 1 (poor) to 10 (excellent). In conclusion, this study found that augmented reality is an effective and engaging tool for the instruction of skull anatomy at a community college.     

Musculoskeletal anatomy knowledge in Australian chiropractors

Anatomy is a key knowledge area in chiropractic and is formally offered in the undergraduate component of chiropractic education. There is the potential for loss of anatomy knowledge before the opportunity to apply it in a clinical setting. This study aimed to determine whether chiropractic clinicians retain a level of anatomy knowledge comparable to that of chiropractic students and to compare chiropractors' self-rating of their anatomical knowledge against an objective knowledge assessment tool. A previously validated multiple-choice test was utilized to measure retention of limb musculoskeletal (MSK) knowledge in Australian chiropractors. One hundred and one registered chiropractors completed the questionnaire and responses were scored, analyzed, and compared to scores attained by undergraduate and postgraduate chiropractic students who had previously completed the same questionnaire. The results indicated that practitioners retained their anatomy knowledge, with a significantly higher total mean score than the undergraduate group [total mean score = 36.5% (±SD 13.6%); P < 0.01] but not significantly different to the postgraduate group [total mean score = 52.2% (±SD 14.1%); P = 0.74]. There was a weak positive correlation between chiropractors' self-rated knowledge and test performance scores indicating the effectiveness of this Australian chiropractic group in self-assessing their anatomy knowledge. This study found that Australian chiropractors' knowledge of MSK anatomy was retained during the transition from university to clinical practice and they accurately evaluated their own test performance.     

Optimizing quality of dental carving by preclinical dental students through anatomy theory reinforcement

Knowledge of dental anatomy is of great importance in the practice of dentistry, especially in oral rehabilitation, because without this knowledge, professional practice is not possible. Dental carving plays a major role in training dental students as it develops their manual dexterity. This randomized controlled trial aimed to evaluate the influence of didactic‐theoretical reinforcement on the theoretical and practical knowledge of dental anatomy of preclinical students by examining the quality of the anatomical restorations performed by these students before and after a didactic‐theoretical reinforcement. For the evaluation of theoretical knowledge, a questionnaire with closed questions about dental anatomy was used. To evaluate the effect of didactic reinforcement on dental carvings, two groups of 15 preclinical students were assessed. Experimental group (G1) received a three‐hour theoretical tutoring on dental anatomy, while the control group (G2) did not. The dental carving scores obtained by the two different groups were compared using Student's t‐test. Cohen's d was used to estimate the effect sizes between groups. The frequency of correct answers given for each theoretical knowledge question was compared in each group using Fisher's exact test. T‐test was also used to compare the means of the two groups' final scores of theoretical evaluations. To compare these final scores obtained in both carving and theoretical tests, a principal component analysis was performed with different items assessed in each test to obtain factor loading scores and a final weighted score, where factor loadings were considered for each item. Weighted scores were compared using t‐test. Also, scores obtained during the head and neck course were assessed and compared using t‐test. Spearman's correlation test was used to assess the correlation between scores obtained prior to the anatomy course and scores obtained in the dental carving exercise. The theoretical evaluation revealed no significant difference between the grades (mean ± SD) of G1 (85.1 ± 6.6%) and G2 (86.2 ± 9.1%) with the grades of a baseline test that was previously obtained when students submitted to the study (P = 0.725). Regarding the tooth carving assessment, the dental carving quality by students of G1 has significantly improved, except for tooth #23 (P = 0.096). Theoretical reinforcement of dental anatomy seems to improve the students' carving performance but does not enhance their knowledge about dental anatomy. Anat Sci Educ 11: 377–384. © 2017 American Association of Anatomists.     

Analysis of Feasibility and Acceptability of an E-Learning Module in Anatomy

Recent advance in medical education is in correlation with the advances in information technology and thus computer-based learning is being increasingly employed. The objective of the present study was to design and evaluate an e-learning module in anatomy and assess the perceptions of students and faculty about this e-learning module. The participating students were randomized into three groups by block stratified randomization and Google groups were created for each of the three groups. The e-learning module was implemented in three sessions by rotating the three groups. Validated questionnaires were sent to faculty and participating students via Google forms to obtain feedback. The results of ANOVA showed that there was a significant difference among the groups in terms of marks obtained with conventional (F = 2.403, P = 0.103), online (F = 6.050, P = 0.005), and blended (F = 5.801, P = 0.006). Post hoc comparisons using the Tukey HSD test, about the gain of knowledge, indicated that the results were insignificant when comparing the conventional group with the online group, but were significant when comparing the blended group with the conventional and online group. The qualitative data regarding the perception of students toward e-learning were analyzed using thematic analysis. The introduction of an interactive e-learning module in anatomy was effective and well received by the students and faculty. The study showed that blended learning has a positive impact on the students' learning by improving cognitive gain and receptive perception for e-learning.     

An Alternative Method for Anatomy Training: Immersive Virtual Reality

The aim of this study was to investigate the effect of immersive three-dimensional (3D) interactive virtual reality (VR) on anatomy training in undergraduate physical therapy students. A total of 72 students were included in the study. The students were randomized into control (n = 36) and VR (n = 36) group according to the Kolb Learning Style Inventory, sex, and Purdue Spatial Visualization Test Rotations (PSVT-R). Each student completed a pre-intervention and post-intervention test, consisting of 15 multiple-choice questions. There was no significant difference between the two groups in terms of age, sex, Kolb Learning Style Inventory distribution, and the PSVT-R (P > 0.05). The post-test scores were significantly higher compared to pre-test scores in both the VR group (P < 0.001) and the control group (P < 0.001). The difference between the pre-test and post-test results was found to be significantly higher in favor of the VR group (P < 0.001). In this study, anatomy training with a 3D immersive VR system was found to be beneficial. These results suggest that VR systems can be used as an alternative method to the conventional anatomy training approach for health students.     

Spatial Visualization of Human Anatomy through Art Using Technical Drawing Exercises

Spatial visualization, the ability to mentally rotate three-dimensional (3D) images, plays a significant role in anatomy education. This study examines the impact of technical drawing exercises on the improvement of spatial visualization and anatomy education in a Neuroscience course. First-year medical students (n = 84) were randomly allocated into a control group (n = 41) or art-training group (n = 43). Variables including self-reported artistic drawing ability, previous technical drawing experience, or previous anatomy laboratory exposure were gathered. Participants who self-identified as artistic individuals were equally distributed between the two groups. Students in the art-training group attended four 1-hour sessions to solve technical drawing worksheets. All participants completed two Mental Rotations Tests (MRT), which were used to assess spatial visualization. Data were also collected from two neuroscience written examinations and an anatomical “tag test” practical examination. Participants in the art-training and control groups improved on the MRT. The mean of written examination two was significantly higher (P = 0.007) in the art-training group (12.95) than the control group (11.48), and higher (P = 0.027) in those without technical drawing experience (12.44) than those with (11.00). The mean of the anatomical practical was significantly higher (P = 0.010) in those without artistic ability (46.24) than those with (42.00). These results suggest that completing technical drawing worksheets may aid in solving anatomy-based written examination questions on complex brain regions, but further research is needed to determine its implication on anatomy practical scores. These results propose a simple method of improving spatial visualization in anatomy education.     

Neuroanatomy Learning: Augmented Reality vs. Cross-Sections

Neuroanatomy education is a challenging field which could benefit from modern innovations, such as augmented reality (AR) applications. This study investigates the differences on test scores, cognitive load, and motivation after neuroanatomy learning using AR applications or using cross-sections of the brain. Prior to two practical assignments, a pretest (extended matching questions, double-choice questions and a test on cross-sectional anatomy) and a mental rotation test (MRT) were completed. Sex and MRT scores were used to stratify students over the two groups. The two practical assignments were designed to study (1) general brain anatomy and (2) subcortical structures. Subsequently, participants completed a posttest similar to the pretest and a motivational questionnaire. Finally, a focus group interview was conducted to appraise participants’ perceptions. Medical and biomedical students (n = 31); 19 males (61.3%) and 12 females (38.7%), mean age 19.2 ± 1.7 years participated in this experiment. Students who worked with cross-sections (n = 16) showed significantly more improvement on test scores than students who worked with GreyMapp-AR (P = 0.035) (n = 15). Further analysis showed that this difference was primarily caused by significant improvement on the cross-sectional questions. Students in the cross-section group, moreover, experienced a significantly higher germane (P = 0.009) and extraneous cognitive load (P = 0.016) than students in the GreyMapp-AR group. No significant differences were found in motivational scores. To conclude, this study suggests that AR applications can play a role in future anatomy education as an add-on educational tool, especially in learning three-dimensional relations of anatomical structures.     

A Hands-On Organ-Slicing Activity to Teach the Cross-Sectional Anatomy

The presentation of pre-sliced specimens is a frequently used method in the laboratory teaching of cross-sectional anatomy. In the present study, a new teaching method based on a hands-on slicing activity was introduced into the teaching of brain, heart, and liver cross-sectional anatomy. A randomized, controlled trial was performed. A total of 182 third-year medical students were randomized into a control group taught with the prosection mode (pre-sliced organ viewing) and an experimental group taught with the dissection mode (hands-on organ slicing). These teaching methods were assessed by testing the students' knowledge of cross-sectional specimens and cross-sectional radiological images, and analyzing students' feedback. Using a specimen test on three organs (brain, heart, and liver), significant differences were observed in the mean scores of the control and experimental groups: for brain 59.6% (±14.2) vs. 70.1% (±15.5), (P < 0.001, Cohen's d = 0.17); for heart: 57.6% (±12.5) vs. 75.6% (±15.3), (P < 0.001, d = 0.30); and for liver: 60.4% (±14.5) vs. 81.7% (±14.2), (P < 0.001, d = 0.46). In a cross-sectional radiological image test, better performance was also found in the experimental group (P < 0.001). The mean scores of the control vs. experimental groups were as follows: for brain imaging 63.9% (±15.1) vs. 71.1% (±16.1); for heart imaging 64.7% (±14.5) vs. 75.2% (±15.5); and for liver imaging 61.1% (±15.5) vs. 81.2% (±14.6), respectively. The effect sizes (Cohen's d) were 0.05, 0.23, and 0.52, respectively. Students in the lower tertile benefited the most from the slicing experiences. Students' feedback was generally positive. Hands-on slicing activity can increase the effectiveness of anatomy teaching and increase students' ability to interpret radiological images.     

Is remote near-peer anatomy teaching an effective teaching strategy? Lessons learned from the transition to online learning during the Covid-19 pandemic

In response to the Covid-19 pandemic, medical educators have transformed pre-clerkship anatomy curricula into online formats. The purpose of this study was to evaluate the effectiveness and student perceptions of an online near-peer anatomy curriculum. The classes of 2022 and 2023 completed identical foundational anatomy curricula in-person, whereas the class of 2024 completed an adapted curriculum for remote online learning. Quantitative and qualitative responses were used to compare attitudes between instructional methods. Assessment scores and evaluation survey responses were collected from the classes of 2022 (n = 185), 2023 (n = 184), and 2024 (n = 183). Mean assessment scores (±SD) for the classes of 2022, 2023, and 2024 were 93.64% (±5.86), 93.75% (±4.09), and 92.04% (±4.83), respectively. Post hoc group comparisons showed the class of 2024 scored significantly lower than the two previous classes [2022: (H(1) = 18.58, P < 0.001), 2023: (H(1) = 18.65, P < 0.001)]. Mean survey results concerning curriculum quality were 4.06/5.00 for the class of 2023 and 3.57/5.0 for the class of 2024 (t(365) = 2.67, P = 0.008). Considering a small effect size (η² = 0.034), there was no meaningful difference in student assessment scores. A potential drawback of online near-peer anatomy teaching remains in student perceptions of course quality; qualitative feedback suggested technological limitations and perceptions of online course instructors were partly responsible for lower student satisfaction. Following the Covid-19 pandemic, medical educators should incorporate the lessons learned from this unique educational inflection point to improve curricula moving forward.     

Examining the Short-, Medium-, and Long-Term Success of an Embodied Learning Activity in the Study of Hand Anatomy for Clinical Application

A student's own body provides an often disregarded site of knowledge production and corporeal wisdom. Learning via cognitive processes anchored in physical movement and body awareness, known as embodied learning, may aid students to visualize structures and understand their functions and clinical relevance. Working from an embodied learning perspective, the current article evaluates the use of an offline physical learning tool (Anatomical Glove Learning System; AGLS) for teaching hand anatomy for clinical application in medical students. Two student samples (N₁ = 105; N₂ = 94) used the AGLS in two different ways. In the first sample, the AGLS was compared to a traditional approach using hand bones, models and prosected specimens. Secondly, the AGLS and traditional approach were combined. The evaluation consisted of three outcomes: short-term learning (post-test), medium-term applications (mock-objective structured clinical examination, MOSCE), and longer-term assessment (objective structured clinical examination, OSCE). Findings from the first sample indicated no significant differences between the AGLS and traditional laboratory groups on short- (F_(1,78) = 0.036, P = 0.849), medium- (F_(1,50) = 0.743, P = 0.393), or longer-term (F_(1,82) = 0.997, P = 0.321) outcomes. In the second sample using the AGLS in combination with a traditional approach was associated with significantly better short-term post-test scores (F_(2,174) = 5.98, P = 0.003) than using the AGLS alone, but demonstrated no effect for long-term OSCE scores. These results suggest an embodied learning experience alone does not appear to be advantageous to student learning, but when combined with other methods for studying anatomy there are learning gains.     

Enhancement of Anatomical Education Using Augmented Reality: An Empirical Study of Body Painting

Students in undergraduate premedical anatomy courses may experience suboptimal and superficial learning experiences due to large class sizes, passive lecture styles, and difficult-to-master concepts. This study introduces an innovative, hands-on activity for human musculoskeletal system education with the aim of improving students’ level of engagement and knowledge retention. In this study, a collaborative learning intervention using the REFLECT (augmented reality for learning clinical anatomy) system is presented. The system uses the augmented reality magic mirror paradigm to superimpose anatomical visualizations over the user’s body in a large display, creating the impression that she sees the relevant anatomic illustrations inside her own body. The efficacy of this proposed system was evaluated in a large-scale controlled study, using a team-based muscle painting activity among undergraduate premedical students (n = 288) at the Johns Hopkins University. The baseline knowledge and post-intervention knowledge of the students were measured before and after the painting activity according to their assigned groups in the study. The results from knowledge tests and additional collected data demonstrate that the proposed interactive system enhanced learning of the musculoskeletal system with improved knowledge retention (F_(10,133) = 3.14, P < 0.001), increased time on task (F_(1,275) = 5.70, P < 0.01), and a high level of engagement (F_(9,273) = 8.28, P < 0.0001). The proposed REFLECT system will be of benefit as a complementary anatomy learning tool for students.     

The Role of Anatomy Computer-Assisted Learning on Spatial Abilities of Medical Students

Currently, medical education context poses different challenges to anatomy, contributing to the introduction of new pedagogical approaches, such as computer-assisted learning (CAL). This approach provides insight into students' learning profiles and skills that enhance anatomy knowledge acquisition. To understand the influence of anatomy CAL on spatial abilities, a study was conducted. A total of 671 medical students attending Musculoskeletal (MA) and Cardiovascular Anatomy (CA) courses, were allocated to one of three groups (MA Group, CA Group, MA + CA Group). Students' pre-training and post-training spatial abilities were assessed through Mental Rotations Test (MRT), with scores ranging between 0-24. After CAL training sessions, students' spatial abilities performance improved (9.72 ± 4.79 vs. 17.05 ± 4.57, P < 0.001). Although male students in both MA Group and CA Group show better baseline spatial abilities, no sex differences were found after CAL training. The improvement in spatial abilities score between sessions (Delta MRT) was correlated with Musculoskeletal Anatomy training sessions in MA Group (r = 0.333, P < 0.001) and MA + CA Group (r = 0.342, P < 0.001), and with Cardiovascular Anatomy training sessions in CA Group (r = 0.461, P = 0.001) and MA + CA Group (r = 0.324, P = 0.001). Multiple linear regression models were used, considering the Delta MRT as dependent variable. An association of Delta MRT to the amount of CAL training and the baseline spatial abilities was observed. The results suggest that CAL training in anatomy has positive dose-dependent effect on spatial abilities.     

Cadaveric Dissection in Relation to Problem-Based Learning Case Sequencing: A Report of Medical Student Musculoskeletal Examination Performances and Self-Confidence

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.     

Quantitative and qualitative change in children's mental rotation performance

This study investigated quantitative and qualitative changes in mental rotation performance and solution strategies with a focus on sex differences. German children (N = 519) completed the Mental Rotations Test (MRT) in the 5th and 6th grades (interval: one year; age range at time 1: 10–11 years). Boys on average outperformed girls on both occasions (d_T1 = 0.45; d_T2 = 0.35). Strong quantitative change was reflected in increased test scores from time 1 to time 2. The increase was equivalent for girls (d = 1.04) and boys (d = 1.05). Qualitative change was investigated in a multigroup latent transition analysis (LTA) of the MRT items. LTA confirmed findings from prior studies showing that children used different solution strategies to solve the MRT problems. Girls tended to use less efficient strategies than did boys. Moreover, LTA revealed that participants showing inefficient solution strategies at time 1 tended to improve their performance less than students who already showed more elaborate strategies at time 1.     

The Spectrum of Learning and Teaching: The Impact of a Fourth-Year Anatomy Course on Medical Student Knowledge and Confidence

There is growing demand from accrediting agencies for improved basic science integration into fourth-year medical curricula and inculcation of medical students with teaching skills. The objective of this study was to determine the effectiveness of a fourth-year medical school elective course focused on teaching gross anatomy on anatomical knowledge and teaching confidence. Fourth-year medical student “teacher” participants' gross anatomy knowledge was assessed before and after the course. Students rated their overall perceived anatomy knowledge and teaching skills on a scale from 0 (worst) to 10 (best), and responded to specific knowledge and teaching confidence items using a similar scale. First-year students were surveyed to evaluate the effectiveness of the fourth-year student teaching on their learning. Thirty-two students completed the course. The mean anatomy knowledge pretest score and posttest scores were 43.2 (±22.1) and 74.1 (±18.4), respectively (P < 0.001). The mean perceived anatomy knowledge ratings before and after the course were 6.19 (±1.84) and 7.84 (±1.30), respectively (P < 0.0001) and mean perceived teaching skills ratings before and after the course were 7.94 (±1.24) and 8.53 (±0.95), respectively (P = 0.002). Student feedback highlighted five themes which impacted fourth-year teaching assistant effectiveness, including social/cognitive congruence and improved access to learning opportunities. Together these results suggest that integrating fourth-year medical students in anatomy teaching increases their anatomical knowledge and improves measures of perceived confidence in both teaching and anatomy knowledge. The thematic analysis revealed that this initiative has positive benefits for first-year students.