Integrated Case-Based Learning Session for Breast and Upper Limb Anatomy.

Introduction: Medical students are frequently introduced to medical school curricula through anatomy coursework, which often includes histology and embryology content. As medical education has increasingly emphasized integration of content areas, use of activities such as case-based learning (CBL) sessions has grown. Little published work has demonstrated the effectiveness of CBL sessions in integrating anatomy, embryology, and histology on first-year medical students' ability to improve content mastery and adapt their study techniques. Methods: We developed a CBL session that included anatomy, embryology, and histology content covering the upper extremity and breast pathology that was taught to incoming first-year medical students (N = 51) during a prematriculation program in the summers of 2022 and 2023. The session involved completion of an individual pre- and postsession quiz; group completion of clinical cases involving image interpretation, matching exercises, and construction of diagrams, flowcharts, or tables; and a postsession survey with Likert-style and free-response questions about preparation and session effectiveness. Results: Postsession quiz scores significantly improved (p < .001). On the postsession survey (response rate: 59%), students commented that they enjoyed the real-life application and integration of the cases and that the sessions improved their understanding of the connections between content areas. Other comments demonstrated that students were evaluating and adapting their study approach in preparation for the sessions, often using techniques introduced and practiced in the sessions. Discussion: CBL sessions can provide opportunities to incoming first-year medical students to practice, adapt, and evaluate study techniques while delivering integrated content.

First patient project: Engaging pathology through the donor dissection experience and its role in professionalism.

The peer-reviewed anatomical education literature thoroughly describes the benefits and drawbacks of donor dissection. Gross anatomy laboratory environments utilizing donor dissection are generally considered to be a premier environment where students foster non-traditional discipline-independent skills (NTDIS), including the acquisition of professionalism, empathy, resilience, emotional intelligence, and situational awareness. Therefore, this IRB-approved study explored the impact of a formal humanism and pathology thread, the first patient project (FPP), on the personal and professional development of pre-professional undergraduate students in a gross anatomy dissection-based course. Five reflections from each student were collected across four cohorts (n = 74 students, 370 reflections). A post-course questionnaire collected data on student perceptions of the project. The framework method was used to analyze reflection and free response data and descriptive statistics were performed on Likert-style items using Excel. Three themes were identified to encompass the impacts of the FPP on professional development and include: Socialization (through collective dissection experience and pathology), Humanistic Qualities (respect for the donor and their history, and introspection), and Content and Skills (technical and NTDIS, anatomical knowledge). The end of course FPP survey was completed by 29 students across three cohorts (65%) and their perspectives were generally favorable regarding the promotion of respect, empathy, and humanization of their donors. This study underscores the value of incorporating humanism, pathology, and reflection, facilitated through formal curriculum for pre-professional undergraduate students. It provides evidence of the positive impact on their personal and professional development, supporting the integration of NTDIS in curricula across various disciplines.

Educator perspectives on non-technical, discipline-independent skill acquisition: An international, qualitative study.

Gross anatomy education utilizing body donors and human specimens assists the acquisition of non-traditional, discipline-independent skills (NTDIS) such as teamwork, communication, and leadership. Alterations to anatomy curricula, such as those resulting from the COVID-19 pandemic, likely impact NTDIS acquisition, yet how this manifests is unclear. This study, therefore, explored anatomy educator perspectives on NTDIS acquisition as a response to changes in teaching delivery. Gross anatomy educators across different countries were recruited and took part in one-on-one, semi-structured interviews that were audio recorded and transcribed. Data were analyzed using the framework method. Basic statistical analyses were performed on demographic and categorical data. Fifteen educators from five continents were interviewed (average length 32.5 min, range 17-51 min). Educator experience ranged from 0-4 years (n = 3) to 20+ years (n = 7). Most taught using dissection (n = 14) with prosection use (n = 13) also common. Themes relating to NTDIS included expected content (respect for donors, teamwork, communication skills, humanistic values), assessable content, assessment challenges, and impact of curriculum changes; NTDIS unique to anatomy education included cultural, ethical, and social considerations around dead bodies, including boundaries, and social norms. Informed by curriculum alterations during the COVID-19 pandemic, this first empirical study of anatomy educator perspectives on NTDIS highlights the potentially adverse educational impacts of decreased interaction with body donors and human specimens on NTDIS acquisition and difficulties with NTDIS assessment. Findings support gross anatomy education as unique in providing NTDIS that cannot easily be replicated elsewhere. Recommendations around NTDIS-specific educator competencies and promoting NTDIS are provided.

Could the altmetrics wave bring a flood of confusion for anatomists?

Altmetrics are non-traditional metrics that can capture downloads, social media shares, and other modern measures of research impact and reach. Despite most of the altmetrics literature focusing on evaluating the relationship between research outputs and academic impact/influence, the perceived and actual value of altmetrics among academicians remains nebulous and inconsistent. This work proposes that ambiguities surrounding the value and use of altmetrics may be explained by a multiplicity of altmetrics definitions communicated by journal publishers. A root cause analysis was initiated to compare altmetrics definitions between anatomy and medical education journal publishers' websites and to determine the comparability of the measurement and platform sources used for computing altmetrics values. A scoping content analysis of data from across eight publishers' websites revealed wide variability in definitions and heterogeneity among altmetrics measurement sources. The incongruencies among publishers' altmetrics definitions and their value demonstrate that publishers may be one of the root cause of ambiguity perpetuating confusion around the value and use of altmetrics. This review highlights the need to more deeply explore the root causes of altmetrics ambiguities within academia and makes a compelling argument for establishing a ubiquitous altmetrics definition that is concise, clear, and specific.

"A whole new perspective on how the body fits together"-An evaluation of a cadaver laboratory experience for high school students.

The Center for Anatomy and Physiology Education has hosted interactive human cadaver laboratory tours for local high schools (ages 14-18) and undergraduate university students since 2014 to expose students to healthcare careers. Students receive information on the history of body donation and healthcare careers and observe human anatomy on prosections and with isolated organs. The goal of this study was to evaluate students' perceptions of the anatomy laboratory tours and their impact on students' interests in healthcare careers. Students completed pre- and post-tour questionnaires. Responses were analyzed using thematic analysis and linguistic inquiry. Of the 261 students who completed pre-tour questionnaires, 204 (78%) completed the post-tour questionnaire. Before the tour, students anticipated learning about human anatomy and expected to only see but not touch a cadaver. Most students expressed excitement and/or nervousness. A few students viewed the laboratory tour as an opportunity to test if they could see themselves in a healthcare career. After the tour, most students indicated that the tour either met or exceeded their expectations. Students found the laboratory tour to be educational and interesting and were surprised by the opportunity to interact with the donor. Numerous students expressed an increased interest in healthcare careers after the tour. Overall, students perceived the tour as an engaging experience that improved their anatomical knowledge and reinforced/increased their interest in healthcare careers. Academic institutions can positively impact local students by implementing an anatomy tour, sharing access to their in-house human cadaver laboratory, and recruiting instructors to share their anatomy expertise.

Near-Peer Teaching Opportunities Influence Professional Identity Formation as Educators in Future Clinicians.

Teaching is a key role of a physician. Despite this, medical students are rarely exposed to the necessary skills and techniques throughout the duration of their education to prepare them for this component of their training. The gross anatomy lab provides a safe environment for students serving as near-peer educators to teach and learn to manage unexpected and uncomfortable situations. Students acting in near-peer teaching roles see a range of benefits from addressing personal weaknesses to improving communication skills and enhancing their anatomy and clinical knowledge, but there remains a lack of insight on how these experiences shape students' professional identity. This study examined how the professional identities of second-year medical students are shaped by serving as peer educators (PEs) in a gross anatomy laboratory. Gross anatomy PEs from the 2022 and 2025 cohorts recorded audio diary reflections at the end of each week they served as a PE highlighting how this role impacted how they view themselves as future physicians. Audio diary recordings were transcribed verbatim and analyzed using the framework method which includes familiarization, code application, and interpretation. A total of 26 audio diaries averaging 4 min in length were recorded across 11 PEs. Themes included Balancing Workload, Role of a Near Peer, Learning to Communicate, Learning to Collaborate, and Learning through Teaching. Students recognized that in addition to reinforcing their didactic training, serving as a peer educator in the gross anatomy lab helped them build skills necessary to fulfil their future role as a physician educator.

The impact of COVID-19 on professional identity.

BACKGROUND: The COVID-19 pandemic has had a profound impact on medical care and medical student education as clinical rotations were halted and students' clinical activities were drastically curtailed. Learning experiences in medical school are known to promote identity formation through teamwork, reflection, and values-based community discussion. This study explored the impact of the COVID-19 pandemic on medical students' professional identity formation (PIF). METHODS: Students in all cohorts of medical education were invited by email in May 2020 to submit a written reflection about their learning experiences and impact of the pandemic on their PIF. We used iterative individual and team reviews, known as the "immersion/crystallisation" method, to code and analyse the data. FINDINGS: Twenty-six students (20%) submitted reflections in which they discussed "changing conceptions of the role and image of a physician," "views about medical education," and the "role of students in a pandemic." Students viewed physicians as altruistic, effective communicators, and pledged to be like them in the future. Their perceptions of virtual learning were mixed, along with considerations of lost interactions with patients, and wanting to be more useful as professionals-in-training. DISCUSSION: COVID-19 has impacted students' views of themselves and reshaped their ideas, both negatively and positively, about the profession they are entering and their role(s) in it. CONCLUSION: Exploring PIF and the impact of disruptions has allowed us to address the issues raised regarding clinical learning now and into the future. Reflection enhances PIF and unexpected events, such as COVID-19, offer opportunities for reflection and development.

I am an Educator: Investigating Professional Identity Formation using Social Cognitive Career Theory.

PhenomenonClinician-educators (CE) are physicians who fill a unique role within academic medicine, as they are responsible both for patient care and for training future physicians via teaching, curricular design, and creation of educational scholarship. Development of a strong professional identity as an educator leads to greater career satisfaction and a higher likelihood of staying in academic medicine. However, little is known about how this identity develops, especially in the training environment where there are competing pressures to develop as a clinician and researcher. This study aimed to explore professional identity formation in residents and fellows interested in becoming educators. Approach: We used a longitudinal, qualitative approach to investigate professional identity formation in residents and fellows participating in the Clinician-Educator Training Pathway. The longitudinal nature allowed us to temporally explore which aspects of the program and experiences acted as barriers or facilitators of professional identity formation as a CE. Our study used the social cognitive career theory (SCCT) Career Choice Model, which considers contextual influences in addition to the three variables of self-efficacy beliefs, outcome expectations, and goals. Findings: We found that participants shared a common goal of building self-efficacy as an educator. Participants took actions to engage more deliberately in formal and informal teaching and acting as an educator by giving learner feedback, developing curricula, and consuming and conducting educational research, all of which increased self-efficacy as educators. At the beginning of the program, participants were unclear of the roles and trajectories followed to become CEs. Engaging with a community of CEs clarified pathways and presented role models that could be seen as possible selves. This study also elucidated contextual influences relating to personal factors, career opportunities, and potential for advancement that mediated the goals and actions taken by participants to become educators. Insights: This study demonstrates that the SCCT Career Choice Model provides an excellent framework for understanding professional identity formation in future educators. Our participants built self-efficacy, formed outcome expectations, and set goals and took specific actions toward the goal of becoming an educator. Participants tested the various role model attributes as possible selves to see how those would be effective in their own career. Reflection on expectations, career goals, and self-efficacy as a clinician and an educator can assist in identity formation as a CE and can assist those designing CE training programs to better support identity formation in their participants.

Exploring Resilience Factors in Medical Students with Adverse Childhood Experiences: a Pilot Study.

OBJECTIVE: The primary purpose of this study was to investigate the factors that medical students consider to have promoted their resilience and are thought to be protective against risks associated with a high number of adverse childhood experience (ACEs). METHODS: The authors invited medical students in all 4 years of education at a single medical school to complete an online survey (n = 1440). The survey included the 10-item ACE Study Questionnaire and simultaneously added the number of "yes" responses. Participants who reported experiencing four or more ACEs were asked to provide their email address if they consented to a follow-up interview to discuss protective factors and resilience. The authors analyzed survey data using descriptive statistics and used the framework method of thematic analysis to analyze the qualitative data. RESULTS: A total of 131 (9%) students completed the ACEs questionnaire. The mean ACE score was 1.69, with 25 students reporting 4 or more ACEs (19%). Five students participated in a follow-up interview (25%) which averaged 1 h in length. Thematic analysis revealed four protective and resilience factors: non-parental support, role models, volunteering, and use of mental health services. CONCLUSIONS: Medical students reported comparable prevalence of ACEs as the general population and all interviewees with 4 or more ACEs endorsed the use of mental health services in medical school to promote resilience. Medical students with ACEs should be encouraged to use mental health services and have access to mentors and role models to promote resilience and combat risks of ACEs.

Investigating Student Perceptions of a Dissection-Based Undergraduate Gross Anatomy Course Using Q Methodology.

The demand for upper-level undergraduate dissection-based anatomy courses is growing, as professional programs require more advanced anatomy training prior to matriculation. To address this need, Indiana University School of Medicine (IUSM) partnered with Indiana University-Purdue University Indianapolis-a large, urban, life science-focused campus nearby to IUSM-to offer an undergraduate, dissection-based course in regional gross anatomy. Because this is a new course, a deeper post-course evaluation of student perceptions was conducted using Q methodology. In this study, Q methodology was used to evaluate student views of the overall course structure, pre-laboratory materials and activities, assessments, and quality of instruction. Of the 15 students in the spring semester 2018 cohort, 80% (n = 12) participated in the evaluation, and 10 of those students followed up with written explanations for their rationale in selecting the four statements with which they most strongly agreed and disagreed. The Q methodology sorted the students into one of three statistically significant groups: Motivated Dissectors (n = 6), Traditional Students (n = 3), and Inspired Learners (n = 3). Motivated Dissectors and Inspired Learners felt strongly that the course did not encourage self-directed learning and that the pre-laboratory materials were not adequate to prepare them for quizzes. Traditional Students, however, disagreed, having a favorable opinion of the pre-laboratory materials, even though this group felt most strongly that the amount of material covered in the course was overwhelming. This study demonstrates the utility of Q methodology to evaluate courses to elucidate student perspectives and inform future course modifications.

A review of U.S. Medical schools' promotion standards for educational excellence.

Phenomenon: Given the growing number of medical science educators, an examination of institutions' promotion criteria related to educational excellence and scholarship is timely. This study investigates the extent to which medical schools' promotion criteria align with published standards for documenting and evaluating educational activities. Approach: This document analysis systematically analyzed promotion and tenure (P&T) guidelines from U.S. medical schools. Criteria and promotion expectations (related to context, quantity, quality, and engagement) were explored across five educational domains including: (i) teaching, (ii) curriculum/program development, (iii) mentoring/advising, (iv) educational leadership/administration, and (v) educational measurement and evaluation, in addition to research/scholarship and service. After independent review and data extraction, paired researchers compared findings and reached consensus on all discrepancies prior to final data submission. Descriptive statistics assessed the frequency of referenced promotion criteria. Findings: Promotion-related documents were retrieved from 120 (of 185) allopathic and osteopathic U.S. medical schools. Less than half of schools (43%; 52 of 120) documented a well-defined education-related pathway for advancement in academic rank. Across five education-specific domains, only 24% (12 of 50) of the investigated criteria were referenced by at least half of the schools. The least represented domain within P&T documents was "Educational Measurement and Evaluation." P&T documents for 47% of schools were rated as "below average" or "very vague" in their clarity/specificity. Insights: Less than 10% of U.S. medical schools have thoroughly embraced published recommendations for documenting and evaluating educational excellence. This raises concern for medical educators who may be evaluated for promotion based on vague or incomplete promotion criteria. With greater awareness of how educational excellence is currently documented and how promotion criteria can be improved, education-focused faculty can better recognize gaps in their own documentation practices, and more schools may be encouraged to embrace change and align with published recommendations.

Using generalizability analysis to estimate parameters for anatomy assessments: A multi-institutional study.

With integrated curricula and multidisciplinary assessments becoming more prevalent in medical education, there is a continued need for educational research to explore the advantages, consequences, and challenges of integration practices. This retrospective analysis investigated the number of items needed to reliably assess anatomical knowledge in the context of gross anatomy and histology. A generalizability analysis was conducted on gross anatomy and histology written and practical examination items that were administered in a discipline-based format at Indiana University School of Medicine and in an integrated fashion at the University of Alabama School of Medicine and Rush University Medical College. Examination items were analyzed using a partially nested design s×(i:o) in which items were nested within occasions (i:o) and crossed with students (s). A reliability standard of 0.80 was used to determine the minimum number of items needed across examinations (occasions) to make reliable and informed decisions about students' competence in anatomical knowledge. Decision study plots are presented to demonstrate how the number of items per examination influences the reliability of each administered assessment. Using the example of a curriculum that assesses gross anatomy knowledge over five summative written and practical examinations, the results of the decision study estimated that 30 and 25 items would be needed on each written and practical examination to reach a reliability of 0.80, respectively. This study is particularly relevant to educators who may question whether the amount of anatomy content assessed in multidisciplinary evaluations is sufficient for making judgments about the anatomical aptitude of students. Anat Sci Educ 10: 109-119. © 2016 American Association of Anatomists.

How the distinctive cultures of osteopathic and allopathic medical schools affect the careers, perceptions, and institutional efforts of their anatomy faculties: A qualitative case study of two schools.

Anatomy faculties are integral to basic science instruction in medical schools, particularly given the preponderance of anatomic instruction in the preclinical curriculum. Recent years have witnessed major curricular restructuring and other emerging national trends that pose significant challenges to anatomists. An examination of anatomy faculty perceptions at two philosophically distinct medical schools within this shifting climate provides an indicator of how different institutional characteristics may impact anatomy instruction and other faculty responsibilities. Semistructured interviews of anatomy faculty from a large, well-established allopathic medical school (Indiana University School of Medicine) and a small, new osteopathic medical school (Marian University College of Osteopathic Medicine) were explored using qualitative thematic analysis. Four overarching themes were identified: (1) Institutional philosophies, such as affiliation with osteopathic versus allopathic medicine, have minimal impact on how the anatomical sciences are taught. (2) Differences in anatomy faculty experiences at these two institutions are largely driven by the institution's size and history. There is a disparity between institutions in the relative importance of teaching and research, but an ability to do research is important for both faculties. (3) Anatomy instruction and research agendas are driven by personal philosophies and interests rather than institutional philosophy. (4) Autonomy is highly valued by anatomists at both institutions. All the participants share a devotion to educating future physicians. In fact, this study identified more similarities than differences in these two faculties. Finally, we argue that shared educational resources and research collaborations can improve anatomy education and faculty development at both institutions. Anat Sci Educ 9: 255-264. © 2015 American Association of Anatomists.