Beyond the Classroom: Inspiring Medical and Health Science Students to Learn Surface Anatomy.

This qualitative and quantitative study offered students the opportunity to participate in engaging and inspiring activities "outside the classroom", to extend their experience and knowledge of surface anatomy. Medical and health science students benefit from studying surface anatomy as it is relevant to their future professions that deal with patients and clients. Surface anatomy is an essential part of the learning process that allows students an opportunity to identify anatomical structures on living people and to develop their palpation and tactile skills for physical examinations of patients. Body painting is a student-centred, engaging, and motivating approach to learn surface anatomy in anatomy practical classes. In this study, anatomy learning was extended "beyond the classroom" through extra-curricular body painting projects. These projects were run by student teams consisting of a student model, student artists (4-5), and a student photographer, under the direction of the chief investigator. A total of sixteen body painting projects were carried out from 2010 to show the skeletal system, the muscular system, pregnancy, respiratory and gastrointestinal systems, and the neurovascular systems of the entire body. A SurveyMonkey of 31/41 active participants suggested that participants enjoyed the projects (94-100%), found them relevant to their future profession (80-87%), and considered them to assist with deeper understanding (94%) and long-term memory (93%) of anatomy. Learning anatomy outside the classroom through extra-curricular body painting projects was a successful way to engage, motivate, and inspire participants and first year anatomy students to study surface anatomy and to develop their physical examination skills.

"Learning by Doing": a Mixed-Methods Study to Identify Why Body Painting Can Be a Powerful Approach for Teaching Surface Anatomy to Health Science Students.

Introduction: Teaching human anatomy to produce deeper understandings and knowledge retention in learners requires meaningful, engaging, and practical activities. Previous studies identify that most students who participated in body painting (BP) reported improved understanding of surface anatomy (SA). This study investigates the key factors underpinning how BP helps students learn SA. Methods: The study involved an explanatory mixed-methods approach. Towards the end of an anatomy course, a survey was administered to three cohorts of first-year chiropractic, osteopathy, and Chinese medicine students and second-year biomedical sciences students over 3 years (n = 311; response rate = 30%). The survey assessed the effectiveness of BP as a hands-on, group-based approach for learning SA in practical class. Three student focus groups (n = 13) explored the key survey findings. Results: Overall, 72% of student respondents reported BP activities helped them learn SA "quite a bit" or "very much". Multivariate analysis identified students found BP helped them learn SA by "remembering the position of the bones, joints, muscles, actions and insertions" (POR = 5.7; P < 0.001); "integrating textbook and other knowledge on a real live person" (POR = 2.4; P = 0.027); and "achieving a deeper understanding of SA" (POR = 5.2; P < 0.001). The qualitative findings describe specifically how BP helps students learn, understand, and remember SA. Conclusions: The findings show the majority of students believed BP benefitted their learning of SA through enhancing engagement in self-directed classroom and out-of-hours learning opportunities, deeper understandings of form and function, retention of knowledge, and practical physical examination experiences palpating the variations in form between individuals.

Novel and Innovative Approaches to Teaching Human Anatomy Classes in an Online Environment During a Pandemic.

In view of the current situation with a worldwide pandemic, the use of online teaching has become critical. This is difficult in the context of human anatomy, a subject contingent primarily on the use of human cadaveric tissues for learning through face-to-face practical laboratory sessions. Although anatomy has been taught using online resources including 3D models and anatomy applications, feedback from students and academic staff does not support the replacement of face-to-face teaching. At Charles Sturt University, we were obligated to cancel all classes on-campus in 2020 due to the COVID-19 pandemic. We ran exclusive online anatomy practical classes replacing classes usually run on campus. We designed an alternative program that consisted of twenty pre-recorded videos that were prepared in the anatomy laboratory using cadaveric tissues, and then discussed in live (and interactive) tutorials. Furthermore, innovative approaches to learning were shown and encouraged by the lecturer. Student survey responses indicated a positive response to both the anatomical videos and the innovative learning approaches. The results obtained by students showed a statistically significant increase in high distinctions and marked decrease in the amount of fail grades, compared with the previous three years (not online). The use of these videos and the encouragement of innovative learning approaches was a novel experience that will add valuable experiences for improved practice in online anatomy teaching. We propose that online anatomy videos of cadavers combined with innovative approaches are an efficient and engaging approach to replace face-to-face anatomy teaching under the current contexts.

AMD-like lesions in the rat retina: a latent consequence of perinatal hemorrhage.

PURPOSE: Hemorrhaging is a commonplace event in the human retina around the time of birth. This study was conducted to examine the potential long-term sequelae of hemorrhaging in the eyes of rats that exhibited transient spontaneous microhemorrhages a few days after birth. METHODS: Retinas of Dark Agouti rats aged from day of birth to 2 years old were analyzed histologically, histochemically, and by immunocytochemistry. Fetal human retinas were also examined anatomically and histochemically for evidence of hemorrhages. RESULTS: Dark Agouti rats from our colony consistently exhibited spontaneous focal hemorrhages at the vitread surface of the retina between postnatal days 3 and 6. Erythrocytes were subsequently cleared by macrophages, which accumulated hemosiderin. These macrophages remained in focal patches in the inner retina for the duration of the study. For at least 6 months after the initial transient hemorrhages, the retinas exhibited no overt histologic damage. At approximately 8 to 9 months, photoreceptor degenerative changes were apparent in spatial register with the patches of macrophages in the inner retina. Additional events such as breakdown of Bruch's membrane, glial remodeling, neovascularization, ingress of RPE cells into the retina and accumulation of drusen-like autofluorescent structures were also observed in topographic register with macrophage-laden patches in aged animals. CONCLUSIONS: Microhemorrhages in the retina may initiate the formation of focal lesions, months or years after the initial insult. The lesions exhibit key features of AMD. These animals may represent a useful model for studying the potential basis of the pathogenesis of AMD.

EAAT1 and D-serine expression are early features of human retinal development.

In the developing central nervous system (CNS), the activation of N-methyl-D-aspartate (NMDA) receptors is probably an important regulator of processes such as synaptogenesis and neurite growth. NMDA receptor activation is dependent upon the homeostasis of glutamate and the presence of co-agonists such as D-serine. We have investigated the expression of the glutamate transporter excitatory amino acid transporter-1 (EAAT1 or GLAST) as the key regulator of retinal extracellular glutamate levels, and the ontogeny of D-serine expression in the developing human retina. The expression of EAAT1 and D-serine was compared to the temporal and spatial distribution of the synaptic vesicle marker synaptophysin and the synaptic vesicle glutamate transporter vGLUT1. We also examined the co-expression of EAAT1 and cellular retinaldehyde-binding protein (CRALBP), and the co-expression of EAAT1 and D-serine. Human retinae aged 10-20 weeks' gestation (WG) were prepared for immunocytochemistry or for Western blotting. Expression of EAAT1 was evident at 10 WG in cell bodies, processes and end-feet of radial glia-like cells at all retinal eccentricities. D-serine immunolabelling was also evident in radial glia-like cells by 12 WG. In contrast, immunoreactivity for synaptophysin only started to appear in the central retina at 12 WG whilst immunoreactivity for vGLUT was slightly later. EAAT1 and d-serine were co-localised to the same cell population. In addition, EAAT1 and CRALBP were also co-localised to the same cell population of radial glia-like cells, suggesting that the EAAT1 and D-serine-positive cells may be Müller cells. This study shows that key potential modifiers of NMDA receptor activity are present before synaptic vesicle proteins are evident and may thus play a role in shaping synaptogenesis in the developing human retina.

Immunocytochemical analysis of D-serine distribution in the mammalian brain reveals novel anatomical compartmentalizations in glia and neurons.

D-Serine is a co-agonist at the NMDA receptor glycine-binding site. Early studies have emphasized a glial localization for D-serine. However the nature of the glial cells has not been fully resolved, because previous D-serine antibodies needed glutaraldehyde-fixation, precluding co-localization with fixation-sensitive antigens. We have raised a new D-serine antibody optimized for formaldehyde-fixation. Light and electron microscopic observations indicated that D-serine was concentrated into vesicle-like compartments in astrocytes and radial glial cells, rather than being distributed uniformly in the cytoplasm. In aged animals, patches of cortex and hippocampus were devoid of immunolabeling for D-serine, suggesting that impaired glial modulation of forebrain glutamatergic signaling might occur. Dual immunofluorescence labeling for glutamate and D-serine revealed D-serine in a subset of glutamatergic neurons, particularly in brainstem regions and in the olfactory bulbs. Microglia also contain D-serine. We suggest that some D-serine may be derived from the periphery. Collectively, our data suggest that the cellular compartmentation and distribution of D-serine may be more complex and extensive than previously thought and may have significant implications for our understanding of the role of D-serine in disease states including hypoxia and schizophrenia.