Jennifer M. McBride

An update on the status of anatomical sciences education in United States medical schools

Curricular changes continue at United States medical schools and directors of gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses continue to adjust and modify their offerings. Developing and supplying data related to current trends in anatomical sciences education is important if informed decisions are going to be made in a time of curricular and course revision. Thus, a survey was sent to course directors during the 2012–2013 academic years to gather information on total course hours, lecture and laboratory hours, the type of laboratory experiences, testing and competency evaluation, and the type of curricular approach used at their institution. The data gathered were compared to information obtained from previous surveys and conclusions reached were that only small or no change was observed in total course, lecture and laboratory hours in all four courses; more gross anatomy courses were part of an integrated curriculum since the previous survey; virtual microscopy with and without microscopes was the primary laboratory activity in microscopic anatomy courses; and neuroscience/neuroanatomy and embryology courses were unchanged. Anat Sci Educ 7: 321–325.

The use of simulation in medical education to enhance students' understanding of basic sciences

Simulation! The deans talk about its use in medical education regularly. But how can it be used to teach the basic sciences to first- and second-year medical students? This article will help answer that question by providing information about various types of simulation activities being used in medical education and examples of their application to basic science education. The next step depends on your creativity.

Development of a synergistic case-based microanatomy curriculum.

This paper discusses the development of an interactive approach to teaching and assessing a microanatomy curriculum in an innovative medical school program. As an alternative to lectures and labs, students are engaged in interactive seminars focused on discussion of clinical and research‐based cases matched with normal histology and pathology slides. A virtual microscopic system is used rather than the traditional glass slide and light microscope. Evaluation of student performance consists of self‐assessment board style questions, concept appraisal problems, and utilization of a portfolio system where the assessment pieces are continuously integrated as part of written formative and summative assessments. Anat Sci Ed 1:102–105, 2008.

Validation of a method for measuring medical students' critical reflections on professionalism in gross anatomy

Improving professional attitudes and behaviors requires critical self reflection. Research on reflection is necessary to understand professionalism among medical students. The aims of this prospective validation study at the Mayo Medical School and Cleveland Clinic Lerner College of Medicine were: (1) to develop and validate a new instrument for measuring reflection on professionalism, and (2) determine whether learner variables are associated with reflection on the gross anatomy experience. An instrument for assessing reflections on gross anatomy, which was comprised of 12 items structured on five‐point scales, was developed. Factor analysis revealed a three‐dimensional model including low reflection (four items), moderate reflection (five items), and high reflection (three items). Item mean scores ranged from 3.05 to 4.50. The overall mean for all 12 items was 3.91 (SD = 0.52). Internal consistency reliability (Cronbachs α) was satisfactory for individual factors and overall (Factor 1 α = 0.78; Factor 2 α = 0.69; Factor 3 α = 0.70; Overall α = 0.75). Simple linear regression analysis indicated that reflection scores were negatively associated with teamwork peer scores (P = 0.018). The authors report the first validated measurement of medical student reflection on professionalism in gross anatomy. Critical reflection is a recognized component of professionalism and may be important for behavior change. This instrument may be used in future research on professionalism among medical students. Anat Sci Educ 6: 232–238.

A technical approach to dissecting and assessing cadaveric veins pertinent to chronic cerebrospinal venous insufficiency in multiple sclerosis

Abstract Objective: To establish a detailed technical procedure for studying the anatomical correlates of chronic cerebrospinal venous insufficiency in cadavers of multiple sclerosis and control subjects, and to present our findings of the normal anatomic venous structures, with reference to previous descriptions from the literature. Methods: This study examined the internal jugular veins (IJVs), the brachiocephalic veins, and the azygos vein from 20 cadavers (10 control and 10 multiple sclerosis). These veins were exposed, isolated by clamps from the rest of the venous system, flushed with water, and then injected with fluid silicone from the superior ends of both IJVs. After the silicone cured to its solid state, the venous tree was removed en bloc and dissected longitudinally to expose the luminal surface. All vein segments were analyzed for anatomic variation. Anatomical analysis for this manuscript focused on normal vein architecture and its variants. Results: Thirty-seven of 40 IJVs contained valves: 29 bicuspid, 6 tricuspid, and 2 unicuspid. The average circumferences of the right and left IJVs were 2·2 and 1·8 cm, respectively. Thirteen of 20 azygos veins contained a valve, located on average 3·6 cm away from the superior vena cava junction. Nine of the 13 azygos valves were bicuspid; four were tricuspid. Only one of the 40 brachiocephalic veins contained a valve. Discussion: We detailed a technical approach for harvesting cadaveric neck and thoracic veins with relevance to chronic cerebrospinal venous insufficiency. The anatomy of the venous system has significant variability, including differing number of valves in different regions and variable characteristics of the valves. Average vein circumference was less than that typically reported in imaging studies of live patients.

National Survey on Anatomical Sciences in Medical Education.

The drivers for curricular change in medical education such as the addition of innovative approaches to teaching, inclusion of technology and adoption of different assessment methods are gaining momentum. In an effort to understand how these changes are impacting and being implemented in gross anatomy, microscopic anatomy, neuroanatomy/neuroscience, and embryology courses, surveys were sent out to course directors/discipline leaders at allopathic Medical Schools in the United States during the 2016‐2017 academic year. Participants in the study were asked to comment on course hours, student experiences in the classroom and laboratory, amount of faculty participation, the use of peers as teachers in both the classroom and laboratory, methods used for student assessment and identification of best practices. Compared to data published from a similar survey in 2014, a number of changes were identified: (1) classroom hours in gross anatomy increased by 24% and by 29% in neuroanatomy/neuroscience; (2) laboratory hours in gross anatomy decreased by 16%, by 33% in microscopic anatomy, and by 38% in neuroanatomy/neuroscience; (3) use of virtual microscopy in microscopic anatomy teaching increased by 129%; and (4) the number of respondents reporting their discipline as part of a partially or fully integrated curriculum increased by greater than 100% for all four disciplines. Anat Sci Educ 11: 7–14.

Longitudinal cohort study on medical student retention of anatomical knowledge in an integrated problem-based learning curriculum

Abstract Background: When modifying a curriculum to accommodate changes in the methods of subject matter presentation or fit within a shortened time frame, student retention of knowledge remains an important issue. Aim: This study evaluates medical student retention of anatomical knowledge as they matriculate through an anatomy curriculum where the instruction hours are less than half of the current national average. Method: Medical students completed an assessment tool developed to evaluate their baseline level of anatomical knowledge at the beginning of the first year. They then completed the instrument at the end of their 1st, 2nd, 3rd, and 4th years to assess their retention of anatomical knowledge during medical school. Data collection began in September 2010 and concluded in June 2015. Results: Results demonstrate that students began medical school with a low level of anatomical knowledge (baseline), that knowledge increased during their first year (p < 0.001), continued to increase during their second year (p < 0.001), but was over 90% maintained through years 3 and 4. Conclusion: In conclusion, an anatomy course with reduced hours (∼60), using active learning methods, contextual learning, cadaver demonstrations, increased exposure to imaging, and longitudinal reinforcement can help students build a strong foundation of anatomical knowledge.

Rewarding the Resident Teacher.

Residents routinely make significant contributions to the education of medical students. However, little attention has been paid to rewarding these individuals for their involvement in these academic activities. This report describes a program that rewards resident teachers with an academic appointment as a Clinical Instructor. The residents participate in the laboratory portion of the anatomy program at the Cleveland Clinic Lerner College of Medicine. They prepare weekly cadaver dissections and present these dissections to the first year medical students. Guidelines developed by the anatomy faculty and approved by the appropriate committees at both the Cleveland Clinic and Case Western Reserve University establish requirements that a resident must meet to qualify for an academic appointment. Evaluation of this program indicates that it has been very successful based on medical student feedback, resident interest in gaining teaching experience, and residency directors appreciation of the opportunity for residents to gain valuable teaching experience in an academic setting. Anat Sci Educ

Student perceptions of an interprofessional educational experience: The importance of goal articulation

The education of future health care professionals must involve activities where interprofessional collaboration and the functioning of interdisciplinary teams are the goals and not the exceptions. This type of interprofessional education (IPE) will benefit students as they will be better able to communicate with and mobilize the skills of other health care workers, work toward common goals related to patient care, and develop a more cost‐effective treatment strategy in the long term. Such an IPE program was initiated in the clinical anatomy course for physician assistant students from the University of Mount Union that was taught, in part, by medical students from the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Surveys of both student groups at the end of the course indicated that although this was a useful IPE experience, the value of this program as an IPE experience was not entirely appreciated by the participating students. It turned out that although the goals and importance of these types of IPE activities are clear to the faculty, they must also be made clear to all of the students. Anat Sci Educ 8: 381–385.

Student‐directed fresh tissue anatomy course for physician assistants

Healthcare providers in all areas and levels of education depend on their knowledge of anatomy for daily practice. As educators, we are challenged with teaching the anatomical sciences in creative, integrated ways and often within a condensed time frame. This article describes the organization of a clinical anatomy course with a peer taught unembalmed (fresh‐tissue) cadaver laboratory in the 2010 summer term of a new physician assistant program. To fit within the allotted 12 week time frame, students meet every Monday for both the classroom and laboratory component of the course. Students prepare for these sessions by reviewing a list of learning objectives and completing assigned textbook readings. Classroom sessions involve faculty presentations and are facilitated with the use of self‐assessment questions and accompanying images. The afternoon laboratory sessions which follow the classroom sessions are comprised of four to five stations presented by first‐ and second‐year medical students and a resident radiologist. End of course evaluations indicate that students felt that the course objectives were clear, achievable, and taught effectively with relevant clinical correlates. Anat Sci Educ.