Anatomy in Practice: How Do Equine and Production Animal Veterinarians Apply Anatomy in Primary Care Settings?

To successfully prepare veterinary undergraduates for the workplace, it is critical that anatomy educators consider the context in which developing knowledge and skills will be applied. This study aimed to establish how farm animal and equine general practitioners use anatomy and related skills within their daily work. Qualitative ethnographic data in the form of observations and semi-structured interviews were collected from 12 veterinarians working in equine or farm animal first-opinion practice. Data underwent thematic analysis using a grounded theory approach. The five themes identified were relevant to both equine and farm animal veterinarians and represented the breadth and complexity of anatomy, its importance for professional and practical competence, as well as the requirement for continuous learning. The centrality and broad and multifaceted nature of anatomy was found to challenge equine and farm animal veterinarians, highlighting that essential anatomy knowledge and related skills are vital for their professional and practical competence. This aligns with the previously described experiences of companion animal clinicians. In equine practice, the complexity of anatomical knowledge required was particularly high, especially in relation to diagnostic imaging and assessing normal variation. This resulted in greater importance being placed on formal and informal professional development opportunities. For farm animal clinicians, anatomy application in the context of necropsy and euthanasia was particularly noted. Our findings allow anatomy educators to design appropriate and effective learning opportunities to ensure that veterinary graduates are equipped with the skills, knowledge, and resources required to succeed in first-opinion veterinary practice.

A city-wide survey of dental students' opinions on undergraduate oral surgery teaching.

PURPOSE: This study aimed to carry out a city-wide survey to evaluate undergraduate students' opinions on their oral surgery training by measuring their self-confidence. MATERIALS AND METHODS: A cross-sectional survey of 383 3rd year, 412 4th year and 363 5th year undergraduate dental students from six dental schools in Istanbul with a mean age of 22.73 ± 1.55 was conducted towards the end of the academic year. A web link to the questionnaire was sent to the contact person at the participating dental schools. The questionnaires were anonymously evaluated. Descriptive statistics were calculated, and Chi-square tests were performed to examine the data. A P-value of <.05 was considered to be statistically significant. RESULTS: In total, 1158 responses were returned, representing 67% of the overall students in the 2018-2019 academic year. The male respondents were significantly more self-confident than females in the general aspects of surgical skills. More than half of the respondents (53%) felt confident in oral surgery knowledge to undertake independent practice. Although 5th year respondents felt more confident in the general aspect of the questionnaire, their ability of differentiation of odontogenic and non-odontogenic pain was lower than their counterparts. The majority (86%) of the participants disagreed that the only knowledge required for oral surgery was that of tooth and jaw anatomy. CONCLUSION: This survey revealed perceived confidence in tooth and retained root extraction. The male respondents were found to be more self-confident. There is a need for improvement in surgical skills, recognition of malignancies and differentiation of the origin of the pain.

Can the simultaneous laparoscopic approach improve the learning of vaginal surgery with meshes in the anatomical model?

AIMS: To evaluate the usefulness of simultaneous laparoscopic assistance to improve understanding of the nonvisible surgical steps in Thiel-embalmed cadaver models for training in vaginal surgery using vaginal mesh kits and to evaluate opinions of this surgical learning procedure in comparison with other learning models. METHODS: Recording of anterior compartment prolapse repair with vaginal mesh kits using an external camera simultaneously with laparoscopic vision during the execution of the procedure at the dissection room. To measure the usefulness of this procedure, we designed an anonymous online survey that was made available to program participants via a computer application (a link to video 1 and the survey is available at encuesta@um.es). RESULTS: After watching the video, 97.2% of participants agreed that laparoscopic vision combined with the vaginal approach was useful in learning this surgical technique, and 95.8% agreed they had learned details of the surgical anatomy of the pelvis. All participants agreed that it should be mandatory to train in these techniques with cadavers before practice with live patients. In addition, 84.7% responded that the cadaveric model was superior to animal and other types of models. CONCLUSION: Laparoscopic inspection of the procedure performed with the vaginal approach allowed a better understanding of the surgical technique by making "visible" the anatomical structures that were commonly only palpated. Use of the cadaverous model was considered most efficient for training in this surgical technique.

Perception does not equal reality for resident vascular trauma skills.

BACKGROUND: Experience with the management of vascular trauma by senior surgical residents is increasingly limited. When queried about their understanding of anatomy and ability to perform specific vascular exposures, residents express a moderately high level of confidence. We hypothesized that this perception does not equal reality. METHODS: A total of 42 senior surgical residents participating in an ongoing validation study of the Advanced Surgical Skills for Exposures in Trauma course were asked to self-assess their baseline (precourse) confidence of their understanding of the anatomy required to perform and their ability to perform exposure and control of the axillary, brachial, and femoral arteries, as well as lower extremity fasciotomy using a 5-point Likert scale. Residents then performed the four procedures on a fresh cadaver model and were scored in real time by experts using a global assessment of anatomic knowledge and readiness to perform." The Student t-test was used with α set at P < 0.05. RESULTS: Residents consistently rated their understanding of anatomy and their ability to perform the procedures significantly higher than expert evaluator ultimately scored them. Evaluators also deemed that residents would be unable to perform without help 65%-86% of the time. CONCLUSIONS: Senior residents are ill-prepared to perform the procedures studied and have an unwarranted confidence in their knowledge and abilities. Perception clearly does not equal reality in preparing these trainees to perform as advertized. The low global scores for anatomy and performance should be a wake-up call for surgical educators prompting curricular reform and evaluation.

Influences on anatomical knowledge: The complete arguments.

Eight factors are claimed to have a negative influence on anatomical knowledge of medical students: (1) teaching by nonmedically qualified teachers, (2) the absence of a core anatomy curriculum, (3) decreased use of dissection as a teaching tool, (4) lack of teaching anatomy in context, (5) integrated curricula (problem-based learning or systems-based curricula), (6) inadequate assessment of anatomical knowledge, (7) decreased anatomy teaching time, and (8) neglect of vertical integration of anatomy teaching. A recent review revealed a lack of evidence underpinning any of the claims owing to the poor quality of papers, and recommendations were made for education and research on teaching in context and the implementation of vertical integration and of assessment strategies. In this article, we will describe the alleged factors fully, revealing additional recommendations for improving anatomy education by promoting recognition for teaching in institutions, by enhancing the professional recognition of anatomists through the implementation of a national postgraduate training program, and by encouraging anatomists to participate in educational research.

Anatomical Prior-Based Automatic Segmentation for Cardiac Substructures from Computed Tomography Images.

Cardiac substructure segmentation is a prerequisite for cardiac diagnosis and treatment, providing a basis for accurate calculation, modeling, and analysis of the entire cardiac structure. CT (computed tomography) imaging can be used for a noninvasive qualitative and quantitative evaluation of the cardiac anatomy and function. Cardiac substructures have diverse grayscales, fuzzy boundaries, irregular shapes, and variable locations. We designed a deep learning-based framework to improve the accuracy of the automatic segmentation of cardiac substructures. This framework integrates cardiac anatomical knowledge; it uses prior knowledge of the location, shape, and scale of cardiac substructures and separately processes the structures of different scales. Through two successive segmentation steps with a coarse-to-fine cascaded network, the more easily segmented substructures were coarsely segmented first; then, the more difficult substructures were finely segmented. The coarse segmentation result was used as prior information and combined with the original image as the input for the model. Anatomical knowledge of the large-scale substructures was embedded into the fine segmentation network to guide and train the small-scale substructures, achieving efficient and accurate segmentation of ten cardiac substructures. Sixty cardiac CT images and ten substructures manually delineated by experienced radiologists were retrospectively collected; the model was evaluated using the DSC (Dice similarity coefficient), Recall, Precision, and the Hausdorff distance. Compared with current mainstream segmentation models, our approach demonstrated significantly higher segmentation accuracy, with accurate segmentation of ten substructures of different shapes and sizes, indicating that the segmentation framework fused with prior anatomical knowledge has superior segmentation performance and can better segment small targets in multi-target segmentation tasks.

Anatomy in the daily practice of the gynecologist, essential or just window dressing?

Traditionally, anatomy was one of the basic pillars of medical training. However, due to the expansion of medical science and medical knowledge in general, anatomy teaching has steadily declined and the way anatomy is taught has changed. These changes go hand in hand with growing literature about a perceived and proven lack of anatomical knowledge. While anatomy is important for all doctors, these developments seem to be more worrying for surgical residents. At the same time, little is known about how clinicians use anatomy in daily practice. The primary aim of this study was to increase understanding of the role of anatomy in the daily practice of gynecologists. An explorative qualitative study was performed to answer the question "What is the tangible utility of solid anatomical knowledge in the daily practice of the gynecologist"? Semi-structured interviews with gynecologists and obstetrics and gynecology (ObGyn) residents from Belgium and the Netherlands were held and the responses were analyzed using a phenomenographic inductive coding approach. Anatomical knowledge was important and used for technical skills and non-technical achievements in the daily practice of gynecologists, and three themes were distinguished. Specifically, anatomical knowledge was important and used (1) for daily activities, (2) for the feeling of self-efficacy, and (3) to gain a respected name as a doctor. These findings are discussed in light of (perceived) insufficient anatomical knowledge, and recommendations are made for the postgraduate education of ObGyn doctors.

Anatomical knowledge based level set segmentation of cardiac ventricles from MRI.

This paper represents a novel level set framework for segmentation of cardiac left ventricle (LV) and right ventricle (RV) from magnetic resonance images based on anatomical structures of the heart. We first propose a level set approach to recover the endocardium and epicardium of LV by using a bi-layer level set (BILLS) formulation, in which the endocardium and epicardium are represented by the 0-level set and k-level set of a level set function. Furthermore, the recovery of LV endocardium and epicardium is achieved by a level set evolution process, called convexity preserving bi-layer level set (CP-BILLS). During the CP-BILLS evolution, the 0-level set and k-level set simultaneously evolve and move toward the true endocardium and epicardium under the guidance of image information and the impact of the convexity preserving mechanism as well. To eliminate the manual selection of the k-level, we develop an algorithm for automatic selection of an optimal k-level. As a result, the obtained endocardial and epicardial contours are convex and consistent with the anatomy of cardiac ventricles. For segmentation of the whole ventricle, we extend this method to the segmentation of RV and myocardium of both left and right ventricles by using a convex shape decomposition (CSD) structure of cardiac ventricles based on anatomical knowledge. Experimental results demonstrate promising performance of our method. Compared with some traditional methods, our method exhibits superior performance in terms of segmentation accuracy and algorithm stability. Our method is comparable with the state-of-the-art deep learning-based method in terms of segmentation accuracy and algorithm stability, but our method has no need for training and the manual segmentation of the training data.

Healthcare Practitioners Knowledge of Shoulder Injury Related to Vaccine Administration (SIRVA).

Background: Vaccine pharmacovigilance is at the forefront of the public eye. Shoulder Injuries Related to Vaccine Administration (SIRVA) is a poorly understood Adverse Event Following Immunisation, with iatrogenic origins. Criteria for medicolegal diagnosis of SIRVA is conflicting, current literature and educational materials are lacking, and healthcare practitioner knowledge of the condition is unknown. Methods: A cross-sectional, convenience sampled survey, utilising a validated online questionnaire assessed practitioner knowledge of SIRVA, safe injecting, and upper limb anatomy, and preferred definition for SIRVA. Results: Mean scores were moderate for safe injecting knowledge (69%), and poor for knowledge of anatomy (42%) and SIRVA (55%). Non-immunising healthcare practitioners scored significantly (p = 0.01, and < 0.05, respectively) higher than immunising practitioners for anatomy (2.213 ± 1.52 vs. 3.12 ± 1.50), and safe injecting knowledge (6.70 ± 1.34 vs. 7.14 ± 1.27). Only 52% of authorised vaccinators accurately selected a 40 × 20 mm area recommended for safe injecting. Majority (91.7%) of respondents thought nerve injuries should be included in the diagnostic criteria for SIRVA. Discussion and conclusions: Greater education and awareness of SIRVA is needed in all healthcare disciplines. Consensus regarding SIRVA definition is paramount for accurate reporting and improved future understanding of all aspects of SIRVA.

Effect of Dental Course Cycle on Anatomical Knowledge and Dental Carving Ability of Dental Students.

This study assessed the effect of the course cycle on theoretical knowledge of dental morphology and the dental carving ability of dental students. Thirty-two dental students from the third semester (initial cycle) and 30 students from the eighth and tenth semesters of the dental course (end cycle) had their theoretical knowledge on dental morphology assessed using a questionnaire with ten closed questions. Their dental carving ability was also assessed using wax carvings in macro models of plaster (for the third [S3] and eight [S8] semesters) and natural-sized artificial teeth (for the tenth [S10] semester). The teeth chosen for the dental carving activity were #16 and #47. The scores were statistically analyzed using the t-test, Kruskal-Wallis test, and Mann-Whitney test (α = 0.05). Students from the initial cycle presented better theoretical knowledge than the other groups did (P < 0.007). No significant differences in carving score were found between the initial and end cycles (P > 0.05), although S10 students obtained a higher score for teeth #16 and #47 (P < 0.05). Natural-sized artificial teeth received a higher evaluation score in dental carvings than the macro models (P < 0.001). Within the limits of this study, it was possible to conclude that students from the initial cycle (S3) presented higher theoretical knowledge, whereas no difference in carving ability was observed between the initial and end cycles. The tenth semester (S10) students performed dental carvings with better quality. Furthermore, carvings in natural-sized artificial teeth presented better quality compared with the macro models.

Learning Spatiotemporal Probabilistic Atlas of Fetal Brains with Anatomically Constrained Registration Network.

Brain atlases are of fundamental importance for analyzing the dynamic neurodevelopment in fetal brain studies. Since the brain size, shape, and anatomical structures change rapidly during the prenatal period, it is essential to construct a spatiotemporal (4D) atlas equipped with tissue probability maps, which can preserve sharper early brain folding patterns for accurately characterizing dynamic changes in fetal brains and provide tissue prior informations for related tasks, e.g., segmentation, registration, and parcellation. In this work, we propose a novel unsupervised age-conditional learning framework to build temporally continuous fetal brain atlases by incorporating tissue segmentation maps, which outperforms previous traditional atlas construction methods in three aspects. First, our framework enables learning age-conditional deformable templates by leveraging the entire collection. Second, we leverage reliable brain tissue segmentation maps in addition to the low-contrast noisy intensity images to enhance the alignment of individual images. Third, a novel loss function is designed to enforce the similarity between the learned tissue probability map on the atlas and each subject tissue segmentation map after registration, thereby providing extra anatomical consistency supervision for atlas building. Our 4D temporally-continuous fetal brain atlases are constructed based on 82 healthy fetuses from 22 to 32 gestational weeks. Compared with the atlases built by the state-of-the-art algorithms, our atlases preserve more structural details and sharper folding patterns. Together with the learned tissue probability maps, our 4D fetal atlases provide a valuable reference for spatial normalization and analysis of fetal brain development.

An anatomical knowledge-based MRI deep learning pipeline for white matter hyperintensity quantification associated with cognitive impairment.

Recent studies have confirmed that white matter hyperintensities (WMHs) accumulated in strategic brain regions can predict cognitive impairments associated with Alzheimer's disease (AD). The knowledge of white matter anatomy facilitates lesion-symptom mapping associated with cognition, and provides important spatial information for lesion segmentation algorithms. However, deep learning-based methods in the white matter hyperintensity (WMH) segmentation realm do not take full advantage of anatomical knowledge in decision-making and lesion localization processes. In this paper, we proposed an anatomical knowledge-based MRI deep learning pipeline (AU-Net), handcrafted anatomical-based spatial features developed from brain atlas were integrated with a well-designed U-Net configuration to simultaneously segment and locate WMHs. Manually annotated data from WMH segmentation challenge were used for the evaluation. We then applied this pipeline to investigate the association between WMH burden and cognition within another publicly available database. The results showed that AU-Net significantly improved segmentation performance compared with methods that did not incorporate anatomical knowledge (p < 0.05), and achieved a 14-17% increase based on area under the curve (AUC) in the cohort with mild WMH burden. Different configurations for incorporating anatomical knowledge were evaluated, the proposed stage-wise AU-Net-two-step method achieved the best performance (Dice: 0.86, modified Hausdorff distance: 3.06 mm), which was comparable with the state-of-the-art method (Dice: 0.87, modified Hausdorff distance: 3.62 mm). We observed different WMH accumulation patterns associated with normal aging and cognitive impairments. Furthermore, the characteristics of individual WMH lesions located in strategic regions (frontal and parietal subcortical white matter, as well as corpus callosum) were significantly correlated with cognition after adjusting for total lesion volumes. Our findings suggest that AU-Net is a reliable method to segment and quantify brain WMHs in elderly cohorts, and is valuable in individual cognition evaluation.

Importance of anatomy in dental implant surgery.

BACKGROUND: The knowledge of nerves and vessels in the maxillofacial region, particularly the anatomical structures in the maxilla, mandible, tongue muscles, and salivary glands, is essential for dental surgeons. In addition, the structures in the mandibular canal, palate, and maxillary sinus should be understood well. HIGHLIGHT: The arteries and nerves in the maxillofacial region were observed in this study. Some variations in the origin of the inferior alveolar artery were found. Notably, the variations in the origin of the inferior alveolar artery from that of the external carotid artery and a double origin of the inferior alveolar artery were observed. Thus, the maxillary artery may originate from the external carotid and stapedial arteries. The following points are important. (1)The greater palatine artery is always located deeper than the greater palatine nerve. (2)The posterior superior alveolar artery often runs through the compact bone of the maxilla. Using CT scans, the canal of the artery can be observed. (3)Variations in origins of the inferior alveolar artery have been observed. The origin of the inferior alveolar nerve may differ depending on the course of the maxillary artery. CONCLUSIONS: Dental practitioners should, therefore, have a comprehensive knowledge of the anatomy of the maxillofacial region and its variations. Without this knowledge, they should not operate on patients.

Educational Interventions to Improve Dental Anatomy Carving Ability of Dental Students: A Systematic Review.

This systematic review aimed to identify the level of impact of educational strategies for teaching tooth carving on the carving ability of undergraduate dental students. The PubMed-NCBI, Cochrane-CENTRAL, LILACS, Ibecs, BBO, Web of Science, and Scopus databases were searched in May 2019, for randomized controlled trials (RCTs) and two-arm non-randomized studies of interventions (NRSI) addressing educational interventions toward the dental carving of undergraduate students. Studies from the year 2000 until the search date, written in English, Portuguese, and Spanish were included. Study screening and data extraction were performed in duplicate and blinded. The data were presented narratively, considering the dental carving ability of students the primary outcome. The risk of bias was assessed using the RoB tool 2.0 and ROBINS-I, and the level of evidence was determined with GRADE. Of 3,574 studies, 6 were included, with 3 RCTs and 3 NRSIs. Very low level of evidence was provided from the NRSIs that flipped classroom (1 study; n = 140) and a student-driven revised module (1 study; n = 264) improved the carving ability of students. Additionally, there was moderate evidence of online complementary material (1 RCT; n = 30) and reinforcement class improving the carving ability of students (1 RCT; n = 29). The replacement of traditional classes by an instructional DVD (1 RCT; n = 73) and assessment of carving projects through digital systems (1 NRSI; n = 79) did not enhance the carving ability of students. Study design, risk of bias, and imprecision downgraded the level of evidence. There was a very low to moderate evidence on the effectiveness of student-driven educational approaches and complementary classes of dental anatomy in improving the dental carving ability of students.

Evaluation of a 3D-MC examination format in anatomy.

INTRODUCTION: The quality of education in medical anatomy is a fundamental pillar of good clinical practice. Current reforms of the medical curriculum have resulted in major methodological changes in the teaching and testing of anatomy. A number of recent studies have however described a decrease in positive metrics of anatomical knowledge among students so taught. It has been suggested that the reduced anatomical knowledge measured in these studies may endanger patient safety. As proxy measures of exam quality, evaluation of the levels of students 'achievement in the examinations, assessment of the subjectively perceived level of question difficulty and analysis of exam satisfaction are each suitable parameters of investigation of medical education. MATERIAL AND METHODS: To address these issues with regard to medical education at the Charité-Universitätsmedizin Berlin, we have analyzed students' levels of achievement in the anatomical Three Dimensional Multiple Choice (hereafter, 3D-MC)-examination of 2,015 students matriculated in medical studies from Summer Semester of 2014 through Summer Semester of 2017. We either compared students' achievement levels of identical 3D-MC questions using models or prepared anatomical specimen. Furthermore, we have analyzed the type and frequency of cognitive levels used in the anatomical questions in relation to the students' level of achievement. Finally, we conducted an anonymous survey to measure students' (n = 207) and instructors' (n = 16) satisfaction with the 3D-MC-examination in comparison to other employed anatomical testing strategies. RESULTS: Students' achievement is significantly enhanced with anatomical questions using models relative to those utilizing anatomical specimen. Over 80% of the anatomical questions in the 3D-MC-examinations assessed the lowest cognitive levels and higher cognitive question levels were accompanied by a significant decrease of the levels of students' performance. Our survey further revealed that both, students and instructors preferred the practical examinations in anatomy and that the difficulty levels of the 3D-MC-examination was perceived as being the lowest in comparison to the other anatomical testing strategies. DISCUSSION: Testing levels of anatomical understanding using anatomical models is not comparable to human specimen, and thus using specimen before models should be preferred to learn and test close to an authentic medical situation. The application of anatomical models and low cognitive question levels in the examination reduces the subjectively perceived level of difficulty, encourages superficial learning, and therefore decreases the retention of anatomical knowledge. CONCLUSION: Although students and instructors prefer practical examinations in anatomy, the current development does not reflect these results. Therefore, it would be recommendable to rethink the development of anatomical testing strategies based on the existing evidence.

The Thiel cadaveric model for pelvic floor surgery: Best rated in transferable simulation-based training for postgraduate studies.

OBJECTIVE: To determine whether the Thiel cadaveric model is better and more realistic than other surgical simulation techniques for learning pelvic floor and perineal surgical procedures according to the opinions of urogynecologists and surgeons participating in international postgraduate pelvic floor surgery courses using cadavers embalmed by the Thiel method. STUDY DESIGN: An observational prospective study was performed in urogynecologists and surgeons attending international postgraduate pelvic floor and perineal surgery courses using cadavers embalmed by the Thiel method. A survey was completed by the participants after finishing the course. Based on the answers collected, we analyzed the differences, including in the satisfaction degree and teaching level for each surgical procedure, between different surgical simulation models that the participants had already used and the Thiel simulation method employed. RESULTS: The students recognized that Thiel cadavers present more similarities to patients than other simulation methods. The Thiel cadaveric method was considered by most responders to be the best for the simulation of surgical procedures on the pelvic floor and perineum. Most of the surgeons surveyed recommended conducting these courses with Thiel cadavers for different colleagues in other specialties as a reliable simulation method for training for difficult surgical procedures. CONCLUSIONS: Participants in the course on pelvic floor surgery in Thiel cadavers recognized that this is the most realistic model for surgical simulation and the best way to gain confidence, self-determination and precise surgical skills for performing pelvic floor and perineal surgery.

Anatomy-Guided Convolutional Neural Network for Motion Correction in Fetal Brain MRI.

Fetal Magnetic Resonance Imaging (MRI) is challenged by the fetal movements and maternal breathing. Although fast MRI sequences allow artifact free acquisition of individual 2D slices, motion commonly occurs in between slices acquisitions. Motion correction for each slice is thus very important for reconstruction of 3D fetal brain MRI, but is highly operator-dependent and time-consuming. Approaches based on convolutional neural networks (CNNs) have achieved encouraging performance on prediction of 3D motion parameters of arbitrarily oriented 2D slices, which, however, does not capitalize on important brain structural information. To address this problem, we propose a new multi-task learning framework to jointly learn the transformation parameters and tissue segmentation map of each slice, for providing brain anatomical information to guide the mapping from 2D slices to 3D volumetric space in a coarse to fine manner. In the coarse stage, the first network learns the features shared for both regression and segmentation tasks. In the refinement stage, to fully utilize the anatomical information, distance maps constructed based on the coarse segmentation are introduced to the second network. Finally, incorporation of the signed distance maps to guide the regression and segmentation together improves the performance in both tasks. Experimental results indicate that the proposed method achieves superior performance in reducing the motion prediction error and obtaining satisfactory tissue segmentation results simultaneously, compared with state-of-the-art methods.

Team Assessment in Laboratory Setting (TAILS): a Novel Approach Using Cadavers to Assess Collaborative Learning in the Gross Anatomy Lab.

Team assessment in laboratory setting (TAILS) is a feasible and a novel method of testing the application of anatomical knowledge using the available institutional resources (cadavers) within the anatomy laboratory setting. For preclinical medical students, this method augments clinical authenticity and facilitates collaborative learning.

Acquiring Clinical Knowledge from an Online Video Platform: A Randomized Controlled Experiment on the Relevance of Integrating Anatomical Information and Clinical Practice.

Basic subjects in medical education, such as anatomy, are often taught through teaching formats that do not always sufficiently demonstrate the relevance of this basic information for clinical practice. Accordingly, it is a recent trend in anatomy education to link anatomical information more explicitly to clinical practice. This article presents an online video platform (Tuebingen's Sectio Chirurgica [TSC]) as one means of explicitly integrating preclinical anatomical knowledge and clinical application. The purpose of the study presented here was to examine the effects of videos through which medical students were educated about Anterior Cruciate Ligament reconstruction. A TSC video about this surgical procedure was compared to a video with a traditional lecture providing the identical information. Participants (n = 114) perceived the TSC video to be superior in comprehensibility of the presentation (P = 0.003) and conceivability of the surgical procedure (P = 0.027), and to be more entertaining (P < 0.001). Moreover, participants in the TSC condition acquired more clinical knowledge than in the lecture condition (P = 0.043) but did not differ in their acquisition of anatomical knowledge. Mediation analyses indicated that the effect on the acquisition of clinical knowledge was mediated by comprehensibility, conceivability, and entertainment. These findings are discussed regarding their implications for medical education in terms of contributing to the general trend of linking preclinical anatomical knowledge to clinical application. A discussion about the limitations of the study and suggestions for future research are also provided.

Optimizing quality of dental carving by preclinical dental students through anatomy theory reinforcement.

Knowledge of dental anatomy is of great importance in the practice of dentistry, especially in oral rehabilitation, because without this knowledge, professional practice is not possible. Dental carving plays a major role in training dental students as it develops their manual dexterity. This randomized controlled trial aimed to evaluate the influence of didactic-theoretical reinforcement on the theoretical and practical knowledge of dental anatomy of preclinical students by examining the quality of the anatomical restorations performed by these students before and after a didactic-theoretical reinforcement. For the evaluation of theoretical knowledge, a questionnaire with closed questions about dental anatomy was used. To evaluate the effect of didactic reinforcement on dental carvings, two groups of 15 preclinical students were assessed. Experimental group (G1) received a three-hour theoretical tutoring on dental anatomy, while the control group (G2) did not. The dental carving scores obtained by the two different groups were compared using Student's t-test. Cohen's d was used to estimate the effect sizes between groups. The frequency of correct answers given for each theoretical knowledge question was compared in each group using Fisher's exact test. T-test was also used to compare the means of the two groups' final scores of theoretical evaluations. To compare these final scores obtained in both carving and theoretical tests, a principal component analysis was performed with different items assessed in each test to obtain factor loading scores and a final weighted score, where factor loadings were considered for each item. Weighted scores were compared using t-test. Also, scores obtained during the head and neck course were assessed and compared using t-test. Spearman's correlation test was used to assess the correlation between scores obtained prior to the anatomy course and scores obtained in the dental carving exercise. The theoretical evaluation revealed no significant difference between the grades (mean ± SD) of G1 (85.1 ± 6.6%) and G2 (86.2 ± 9.1%) with the grades of a baseline test that was previously obtained when students submitted to the study (P = 0.725). Regarding the tooth carving assessment, the dental carving quality by students of G1 has significantly improved, except for tooth #23 (P = 0.096). Theoretical reinforcement of dental anatomy seems to improve the students' carving performance but does not enhance their knowledge about dental anatomy. Anat Sci Educ 11: 377-384. © 2017 American Association of Anatomists.