Anatomy education in low-resourced countries: What are challenges and effective and affordable educational strategies? A qualitative study.

PURPOSE: With limited means, resource-deprived countries must find ways to organize education to meet standards. Few reports exist about anatomical education in LLMICs. This study explores how anatomy teaching is sustained in countries with few resources and which affordable educational strategies are applied to uphold quality. METHODS: A mixed-methods study with anatomy teachers from public medical schools in low or lower-middle income countries (LLMICs) in Africa, Asia, Europe, and Latin-American was performed through survey via email combined with semi-structured online interview with teachers, exploring survey results at a deeper level. RESULTS: LLMICs available to be surveyed, 13 and 8 were found to respond to a written survey and oral interview invitation, face significant teaching challenges, primarily due to lack of funds. These are faculty shortages (low salaries and high student-to-teacher ratio) and inadequate infrastructure (internet, electricity, poor classroom conditions). Solutions were associated with didactic strategies (social media, e-learning, image-based learning, applied anatomy), expanding teaching capacity with less qualified and part-time faculty, student-organized education, and self-financing (teaching resources subsidized by teachers and students). Which was triking was teacher commitment despite difficult circumstances. Teachers propose better faculty management, increased anatomy staff recruitment, and collaboration with other institutions. CONCLUSIONS: Anatomical education in LLMIC is forced to adapt to the socio-economic context, rather than to trends in medical education worldwide. These adaptations are supported mainly by the teachers 'commitment.'

Are We Facing the End of Gross Anatomy Teaching as We Have Known It for Centuries?

The status of anatomy education in undergraduate medical education has dramatically changed over the course of the past century. From the most important and time-consuming component of the preclinical program, anatomy education has reduced in size and status, and yielded in curricular space to accommodate other disciplines and topics. Meanwhile, radiology has become more prominent, as a means to visualize anatomy, not only in clinical care but also in education. For this perspective paper, the authors, all with backgrounds in anatomy, radiology and/or medical education, conducted structured conversations with several academic colleagues with similar backgrounds, reviewed pertinent literature and analyzed the causes of the historical decline of a knowledge domain of medical education, that nevertheless is widely considered essential for medical students and graduates. After this analysis, the authors propose four ways forward. These directions include systematic peer teaching and development of anatomy education as a scholarly domain, further vertical integration with postgraduate medical education, full integration with radiology education, and capitalizing on educational technology. Schools in several industrialized countries have made steps in these directions, which can be further strengthened. In less affluent countries, and in countries with curricula strongly determined by tradition, these steps are less easy to make. To respond to changes in global health and health care, combined with the inevitable technological progress, and international mobility, we believe all schools will move in these directions, slower or faster.

Approaches of anatomy teaching for seriously resource-deprived countries: A literature review.

Background: Teaching anatomy is an important but expensive part of the medical curriculum, potentially more than many countries can afford. In the search for efficient methods, cost-effectiveness is of utmost importance for such countries. The aim of this contribution is to provide a review of the literature on anatomy teaching methods, evaluating these for feasibility in resource-deprived countries. Methods: A literature review was carried out to identify distinct approaches to anatomy teaching published in the period 2000-2014, using the databases of PubMed, Wiley Online Library, Elsevier, HINARI, Springer, and ERIC. The approaches found were compared against their conceptual, operational, technical, and economic feasibility and Mayer's principles of effective instruction. Results: Our search yielded 432 papers that met the inclusion criteria. We identified 14 methods of teaching anatomy. Based on their conceptual feasibility, dissection and technology enhanced learning approaches appeared to have more benefits than others. Dissection has, besides benefits, many specific drawbacks. Lectures and peer teaching showed better technical and economic feasibility. Educational platforms, radiological imaging, and lectures showed the highest operational feasibility. Dissection and surgery were found to be less feasible with regard to operational, technical, and economic characteristics. Discussion: Based on our findings, the most important recommendations for anatomy teaching in seriously resource-deprived countries include a combination of complementary strategies in 3 different moments, lecturing at the beginning, using virtual learning environment (for self-study), and at the end, using demonstration through prosected specimens and radiological imaging. This provides reasonable insights in anatomy through both dead and living human bodies and their virtual representations.

Does an Additional Online Anatomy Course Improve Performance of Medical Students on Gross Anatomy Examinations?

AIM: An online learning course in anatomy was added to the regular academic anatomy course in the 2nd year of medicine at UNAN-Leon in Nicaragua, using the MOODLE platform. This study aims to determine the learning effect of this course. METHOD: Second-year medical students were randomly allocated to an experimental (N = 25) and control group (N = 50). Only the experimental group had access to the online learning module. We compared the performance of the experimental and the control group on both regular anatomy assessment and an objective structured practical exam (OSPE). Additionally, five focus groups were interviewed to learn about their experiences of the expanded course. RESULTS: Of students in the experimental group 94.1% and 81.6% of students in the control group took the OSPE. The experimental group significantly outperformed the control group (41.1 ± 19.3 points vs. 32.1 ± 23.1 points) on the OSPE. No differences between the two groups were found on the regular anatomy examination. Focus group interviews revealed students' opinions about the online course were generally positive. CONCLUSION: In general, the addition of an online course to the regular course was beneficial. The results of the qualitative evaluation of this intervention provides us with input about how to teach and evaluate the anatomy course and how to further improve the online course to enhance anatomy learning.

Correction to: Does an additional online anatomy course improve performance of medical students on gross anatomy examinations?

[This corrects the article DOI: 10.1007/s40670-019-00751-z.].