Macro and micro ethics in fetal and embryological collections: Exploring the paradigms of informed consent among Australian education-focused stakeholders.

The management of human fetal and embryological collections presents an ethical challenge that can be explored from different perspectives, particularly when considering informed consent. The "micro ethics" level focuses on parties engaged in giving and receiving human tissue while the "macro ethics" level focusses on the collective responsibility of the discipline and society. Additionally, adopting a framework, where ways of working are designed with relevant communities, requires understanding the perspectives of individuals, communities, and organizations. The aim of this study therefore was to assess the perceptions of education-focused Australian stakeholders. A survey collected the perspectives of 198 participants. The majority of participants (61.6%; n = 122/198) indicated that human fetal and embryological remains obtained prior to era of informed consent should be retained for use in education/research. It is likely that their perspective is based on the notion that if human fetal and embryological collections are used for good, then disposing of them would deny this benefit. Women (p < 0.001) indicated a preference for obtaining fetuses and embryos with informed consent for education and research (38.4%; n = 76/198). Majority were in favor of recording both maternal (MI) (59.6%; n = 118/198) and paternal information (PI) (58.1%; n = 115/198) with each donation. Majority (56.1%; n = 111/198) expressed that donations should be accepted from both parental sources. Consideration of stakeholder perspectives is important in developing guidelines regarding these collections. The results from this study demonstrate a level of discomfort with respect to collections without informed consent, which should be considered at the macro ethical and micro ethical level.

A global perspective on embryological and fetal collections: Where to from here?

Human fetal and embryos collections (FECs) peaked in the late 19th century, an era before informed consent, and hence have unclear provenance. These collections are not only historical artifacts, but prized resources for education and research. This study aimed to determine, via a narrative review, the present location, status, and profile of reported human fetal and embryonic collections. Twenty-seven articles that reported on collections appropriate to the study were selected from an initial search pool of 120 articles. The reported collections were in: Australia (n = 1), Germany (n = 6), Japan (n = 1), Spain (n = 1), and the United States (n = 5). The largest collection is reported to contain 45,000 prenatal remains and the smallest, three remains. The purpose of establishing majority of the collections was for education and research. Eight collections contain both embryos and fetuses, one collection contained embryos, exclusively. Another collection contained only fetuses and one neonatal cadaver. The provenance, where mentioned, specified gynecologists and obstetricians as the main source of remains (n = 5). Except for the Kyoto Collection, information regarding informed consent from the next-of-kin was lacking. This paper draws upon the three themes of purpose, provenance, and profile and highlights the need to establish agreed international guidelines for the most appropriate ethical and sustainable practice with respect to establishment, procurement of remains, access, and maintenance of these collections. Nine domains for these guidelines are recommended: consent, privacy, commercial gain, digital and emerging technologies, commemorations and memorials, destruction and disposal, dignity of donors, global database and collaboration, and sustainability.

Anatomy commemoration for body donors at Macquarie University, Sydney, Australia / Conmemoración de la anatomía para donantes de cuerpos en la Universidad Macquarie, Sydney, Australia

SUMMARY: Modern anatomy education is imbued with humanistic values which manifest primarily in the ethical acquisition of bodies for research and education, and respectful treatment of these bodies in anatomy laboratories. This humanistic approach is best embedded in the organisation of commemorative ceremonies for body donors. This paper presents experiences of preparation and implementation of a commemorative ceremony at Macquarie University, Sydney. Local cultural context and university infrastructure were considered when preparing the commemoration. It was decided that it will be introduced in stages, starting with a ceremony for anatomy students. Students were surveyed about the introduction of the ceremony and their attitudes about its format. The results of the survey influenced the format in which the commemoration was conducted. The commemoration was introduced in 2019, embedded in the first anatomy lecture. Such format was cost effective, caused little disturbance to a complex timetable and was aligned with learning outcomes and students' cultural preferences. It also enabled easy transition to the online modes of the delivery caused by the COVID-19 pandemic in Australia. In the next stage commemorative ceremony will be inclusive of donor family members as well as students.

RESUMEN: La educación en anatomía moderna está incentivada de valores humanistas que se manifiestan principalmente en la adquisición ética de cuerpos para la investigación y la educación, y en el trato respetuoso de estos cuerpos en los laboratorios de anatomía. Este enfoque humanista se integra mejor en la organización de ceremonias conmemorativas para donantes de cuerpos. Este documento presenta las experiencias de preparación e implementación de una ceremonia conmemorativa en la Universidad Macquarie, Sydney. Se tuvo en cuenta el contexto cultural local y la infraestructura universitaria al preparar la conmemoración. Se decidió que se presentará por etapas, comenzando con una ceremonia para estudiantes de anatomía. Los estudiantes fueron encuestados sobre la presentación de la ceremonia y sus actitudes sobre su formato. Los resultados de la encuesta influyeron en el formato en el que se llevó a cabo la conmemoración. La conmemoración se introdujo en 2019, como parte de la primera conferencia de anatomía. El formato era rentable, causaba pocas alteraciones en un horario complejo y estaba alineado con los resultados del aprendizaje y las preferencias culturales de los estudiantes. También permitió la transición a los modos en línea de la entrega causada por la pandemia de COVID-19 en Australia. En la siguiente etapa, la ceremonia conmemorativa incluirá a los miembros de la familia donante y a los estudiantes.

Attitudes of Anatomy Students toward Commemorations for Body Donors: A Multicultural Perspective.

Many medical schools practice commemorative ceremonies to honor body donors. Attitudes of medical education stakeholders toward these ceremonies have not yet been fully investigated. The aim of this study was to explore anatomy students' attitudes toward commemorations at a multicultural institution which has not introduced these ceremonies yet. A survey was carried out on different groups of anatomy students that were exposed and not yet exposed to human remains. The survey was used to record basic demographic data from the respondents, ask if they would support the establishment of an anatomy commemoration and in which format. A total of 756 anatomy students participated in the survey (response rate 69.8%). The majority (76.3%) were in favor of introducing a commemoration for donors. The associations of students' gender, attitude toward body donation, and level of exposure to human remains with attitudes toward commemoration for donors were identified (P < 0.05), whereas ethnicity and religion seemed to have no influence on attitudes (P > 0.05). Most students believed that anatomy staff and students should organize the commemoration. There was a preference for the commemoration to be secular with revealed identities of donors, and not recorded for social media. The support for the establishment of commemorations transcended cultural and religious differences and confirmed students' respectful attitude toward donors. Anatomy commemorations seem to have potential not only to engage students with one another, and donor families, but also to pave the way for students to become life-long ethical and empathetic learners and practitioners.

Team-based learning in neuroanatomy.

OBJECTIVE: Team-based learning (TBL) is an active learning method in which student teams participate in individual work, teamwork, and the application of learned concepts to problem solving. It has been widely adopted in the education of health professions. The aim of this study was to assess whether TBL in tutorials would be beneficial to students' assessed knowledge and subjective sense of satisfaction as compared to traditional modes of teaching. METHODS: In 2018, TBL was introduced into the tutorials of a clinically oriented undergraduate course of neuroanatomy, and its benefits in improving student grades and satisfaction were assessed. The Welch 2 sample t test was used for group differences in continuous variables, and Pearson's χ2 test with Yates' continuity correction was used for group differences in dichotomous variables. Linear modeling was used to look for group differences while adjusting for significant baseline characteristics. RESULTS: Our study found that in comparison to more traditionally delivered teaching, TBL did not improve grades or alter overall satisfaction. A post hoc pairwise comparison of satisfaction among lectures, tutorials, and practical classes showed that students appeared to be most dissatisfied with the TBL. CONCLUSION: Analysis of our methods, results, student comments, and the literature indicate that the length of the tutorials, at 1 hour, was too short to conduct TBL to the standards required. In addition, there is an imperative to persist in preparing students for a different knowledge-transfer paradigm, and it takes a few iterations to improve the approach and application of this method of teaching.

Students' perceptions and usage of short anatomy videos: a preliminary study / Percepciones de los estudiantes y el uso de videos cortos de anatomía: un estudio preliminar

The efficacy of videos in anatomy education is still being debated. It appears that one of the major factors discouraging learners to use videos has been their length. To counteract this, 24 short videos (the longest lasting 1 minute and 13 seconds), were created for a course on musculoskeletal anatomy. Videos focused on identification of muscles of the limbs and their relations by area. The aim of this preliminary study was to assess students' perception of value of the videos and their utilisation. The number of views for each video was recorded. A questionnaire based survey was carried out focusing on students' perception of the educational usefulness of the videos. On average, each video had 339.5 views. Out of 312 students enrolled in the course, 210 completed the survey (67.3 % response rate). A total of 181 respondents (86.2 %) watched the videos and a majority perceived them useful in: Learning about the anatomy of the limbs (68 %), preparation for the laboratory (56.9 %), post-laboratory revision (65.6 %) and preparation for the practical test (66.3 %). Asked for feedback, students requested an increase in the number of videos to include structures other than muscles. Students reported to perceive videos as a useful resource in their musculoskeletal anatomy course. The shortness of the videos made them easy to access and use repeatedly. Future, more in-depth studies, based on the utilisation of the existing and newly produced videos, might throw more light on their full educational potential.

Actualmente, aún se está debatiendo la eficacia de los videos en la educación de la anatomía. Posiblemente, uno de los principales factores que desalientan a los estudiantes a usar videos ha sido el tiempo de duración. Para contrarrestar esto, se crearon 24 videos cortos (el más duradero de 1 minuto y 13 segundos) para un curso sobre anatomía musculoesquelética. Los videos se enfocaron en la identificación de los músculos de los miembros y sus relaciones por área. El objetivo de este estudio preliminar fue evaluar la percepción de los estudiantes sobre el valor de los videos y su utilización. Se registró el número de visitas para cada video. Se llevó a cabo una encuesta basada en cuestionarios que se centraron en la percepción de los estudiantes de la utilidad educativa de los videos. En promedio, cada video tuvo 339,5 visitas. De los 312 estudiantes matriculados en el curso, 210 completaron la encuesta (67,3 % de índice de respuesta). Un total de 181 encuestados (86,2 %) vieron los videos y la mayoría los percibieron útiles en: Aprender sobre la anatomía de los miembros (68 %), preparación para el laboratorio (56,9 %), revisión posterior al laboratorio (65,7 %) y preparación para la prueba práctica (66,3 %). Cuando se les pidió retroalimentación, los estudiantes solicitaron un aumento en la cantidad de videos para incluir estructuras distintas de los músculos. Los estudiantes informaron que perciben a los videos como un recurso útil en el curso de anatomía musculoesquelética. La brevedad de los videos los hizo de fácil acceso y posibles de utilizar repetidamente. Estudios más amplios a futuro, basados en la utilización de los videos existentes, como también aquellos producidos recientemente, podrían arrojar más luz sobre su total potencial educativo.