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Pedagogical agents have been designed to support the significant challenges that learners face when self-regulating in advanced learning environments. Evidence suggests differences in learners' prior skills and abilities, in conjunction with excessive didactic support, can cause overreliance on these external aids, which in turn prevents deeper learning, and pedagogical agents can provide tailored scaffolding to accommodate learners' individual needs. However, there is less evidence about the impact of abstract scaffolding, such as the sharing of non-verbal metacognitive information via a pedagogical agent's facial expressions, on self-regulated learning. To assess factors in the passing of non-verbal metacognitive information via pedagogical agents in a multimedia learning environment, we used growth modeling with self-reports, eye-tracking, and log-file data collected from fifty (n = 50) undergraduates at a large North American university as they learned about human body systems while using MetaTutor-IVH, a multimedia learning environment with a pedagogical agent. We controlled for participant characteristics (perceived utility of emotions for self- and other-centered positive and negative emotions) and characteristics of the metacognitive monitoring information provided by a pedagogical agent (expression type and expression congruency) to assess factors in non-verbally communicating metacognitive information. Results suggest that learners attend to pedagogical agents less over time, but this rate of change is weaker when an agent is providing an expression that is congruent with the ground truth of the environment. Further, only the perceived information utility of other-centered negative emotions has a significant effect on this duration, suggesting learners are driven to consult pedagogical agents to avoid embarrassment or shame. We discuss design implications of these findings for technology-based learning environments.

Determining the level of difficulty and student development is important in the learning continuum, especially the anatomical and physiological aspects. This study aimed to collect teachers' opinions about the learning continuum of anatomical and physiological aspects based on its difficulty level. This survey research was conducted in the cities of Bantul and Yogyakarta using a questionnaire. The selection of respondents through convenience sampling, totaling 111 teachers consisting of 68 junior high school science teachers and 43 junior high school biology teachers. The data were analyzed using descriptive statistics to determine the mode of teachers' opinions. The results of this study indicate that the learning continuum in grade X of senior high school based on difficulty level in anatomical and physiological aspects, especially multicellular and unicellular concept has not yet been formed, with the difficulty at level 4. Therefore it is necessary to the provision of subject matter is sorted from easy to difficult and adjusted to the level of development of students at each level.

Fine needle puncture (FNP) is a widespread technique used to collect cellular samples. Its efficiency can be enhanced by the use of ultrasonography to guide the procedure. Ultrasound-guided FNP is therefore an operator-dependent exam. For this reason, it demands the acquisition of psychomotor skill, ability to recognize structures, and dexterity during the needle puncture. This study describes the development of an artisanal simulator made with gelatin to replace the use of live animals during practical classes in veterinary or medical sciences education. The experimental set consisted of three phases in which the student performed different tasks such as recognition of the target structure with ultrasound and injection of ink (phase 1) or aspiration (phase 2) of its content and evaluation of a parenchymatous organ (liver) and puncture of its surface (phase 3). A survey on the acceptance of the model was carried out, and students filled out a questionnaire elaborated with the visual analog scale system. Participants considered the artisanal model a strong method to teach ultrasound-guided FNP. Other attractive advantages of this simulator are the low manufacturing costs (compared with expensive high-technology devices) and the possibility to replace the use of live animals in practical classes.

Medical graduates are expected to apply scientific principles and explain the processes underlying common and important diseases. Evidence shows that integrated medical curricula, which deliver biomedical science within the context of clinical cases, facilitate student learning in preparation for practice. However, research has also shown that the student's perception of their knowledge can be lower in integrated compared to traditional courses. Thus the development of teaching methods to support both integrated learning and build student confidence in clinical reasoning is a priority. In this study, we describe the use of an audience response system to support active learning in large classes. Sessions, delivered by medical faculty from both academic and clinical backgrounds, were designed to build on the knowledge of the respiratory system in both health and disease through the interpretation of clinical cases. Results showed that student engagement was high throughout the session and students strongly agreed that the application of knowledge to real-life cases was a better way to understand clinical reasoning. Qualitative free text comments revealed that students liked the link between theory and practice and the active, integrated method of learning. In summary, this study describes a relatively simple but highly effective way of delivering integrated medical science teaching, in this case respiratory medicine, to improve student confidence in clinical reasoning. This educational approach was applied within the early years of the curriculum in preparation for teaching within a hospital setting, but the format could be applied across many different settings.

Contextual features of assessments can influence the ideas students draw from and the ways they assemble knowledge. We used a mixed-methods approach to explore how surface-level item context impacts student reasoning. In study 1, we developed an isomorphic survey to capture student reasoning about fluid dynamics, a crosscutting phenomenon, in two item contexts (blood vessels, water pipes), and administered the survey to students in two different course contexts: human anatomy and physiology (HA&P) and physics. We observed a significant difference in two of 16 between-context comparisons and a significant difference in how HA&P students responded to our survey compared with physics students. In study 2, we conducted interviews with HA&P students to explore our findings from study 1. Using the resources and framing theoretical framework, we found that HA&P students responding to the blood vessel protocol used teleological cognitive resources more frequently compared with HA&P students responding to the water pipes version. Further, students reasoning about water pipes spontaneously introduced HA&P content. Our findings support a dynamic model of cognition and align with previous work suggesting item context impacts student reasoning. These results also underscore a need for instructors to recognize the impact of context on student reasoning about crosscutting phenomena.

Historically, adverse events have reflected poorly on both the practice of dissection and the perception of the discipline of anatomy. The recent public dissection of a body donor is a regression to an unethical historical practice and was strongly denounced by anatomists around the world. The individual whose donated body was sourced from a 'for-profit" company in the United States had not given consent for a public dissection. This violates the ethics surrounding consent and body donation and potentially places the future of body donor programs in jeopardy as it compromises community frameworks around epistemic trust. Recent guiding frameworks by international anatomical associations on the ethical use of bodies have cemented the way in which body donor programs should operate. This viewpoint reflects on past and current events pertaining to public dissections and questions how these indignities may influence the public's interaction with human bodies. The authors argue that public dissection should be prohibited as it is against social mores. Social pressure should be applied to individuals or companies who wish to profit from unethical anatomical practice and legislation prohibiting public dissection should be introduced in those countries where it does not yet exist.

3D printing is a widely used technology in a number of STEM fields and can be incorporated into undergraduate education in order to engage students in active learning. Using the Technological Pedagogical Content Knowledge (TPACK) framework, this study examined student perceptions of completing 3D printing of a physical model in two different Biology courses, Anatomy and Physiology and Molecular Biology. Students completed surveys before and after engaging in a semester-long 3D printing project. Demographic information was also collected in order to assess student perceptions based on race and sex. Students reported increased confidence with 3D printing technology after completing their projects, and this effect occurred similarly across race and sex. Student attitudes towards their 3D printing experience were overwhelmingly positive, with general interest and excitement being the most common themes. These results suggest that 3D printing projects can be successfully implemented in undergraduate courses and generate positive student outcomes. Engaging women and underrepresented minority students with 3D printing technology may have significant implications for retention of these students in STEM programs.

In this research, the effects of science education using mobile augmented reality (MAR) application on students' attitudes towards science and technology and their academic achievement were determined and two socioeconomic levels were compared. In this research, a parallel pattern mixed method is used. The research, was carried out 143 sixth grade students of two schools with different socioeconomic levels in Turkey. MAR application, was used in the experimental groups. Quantitative data were collected through the "Science and Technology Attitude Scale" and "Systems Achievement Test." According to the ANCOVA results it was observed that the MAR application used in the processing of the lessons was effective in improving the academic achievement levels of the students but, not in attitudes towards science and technology. Results showed that the socioeconomic situation played an active role on the academic achievement of students but did not play an effective role on science and technology attitudes.

Mobile augmented reality (MAR) draws attention in terms of providing a flexible learning process and environment. It is thought that learning environments can be more effective using MAR technology. The research aimed to determine the secondary school students' views on the use of MAR technology in science teaching. The research was conducted with 143 students studying in the sixth grade at two different secondary schools in Turkey. In the research, convergent parallel patterns from mixed-method patterns were used. For eight weeks, the research was carried out to cover the systems unit in our body, situated in the 6th - grade science course curriculum. During the process, the Anatomy 4D application was used in the experimental group during the procedure, and the science course curriculum was used in the control group. In this paper, a part of the mixed research, the qualitative data collected from the experimental group's semi-structured interview form and diaries were analyzed. Descriptive analysis was used to analyze the data. As a result of the research, although the students do not have a clear idea about AR and MAR technologies at the beginning of the application, it is observed that their thoughts change over time, and MAR applications are effective on the success of the course.

The study aimed to examine AR-based teaching material's effect on viscera learning through algorithmic thinking by the primary school teacher candidates who are sophomores in the classroom teaching department in the spring term of the 2018-2019 academic year at a state university in the Eastern Black Sea and selected by convenience method. Viscera Information Form (VIF) and Application Process and AR Survey Form (APSF) were used as data collection tools in the study. VIF included subjects viscera in a human model and placed them in the skeletal structure. The other form, APSF, is about the application process and the material prepared with augmented reality. While the data obtained from VIF were analyzed under the researcher-defined categories regarding the participants' showing each viscera in a human torso model and placing them in the skeletal structure, the data obtained from APSF was processed with content analysis. The study results revealed that AR-based teaching material makes a positive contribution to the learning of viscera through algorithmic thinking. In addition, this is determined as AR-based teaching material contributes to understanding the related basic concepts through algorithmic thinking.

This article presents an educational experience with 30 high school students based on the flipped classroom methodology and inquiry-based learning on aspects related to the pathophysiology of the digestive system during the 2017/2018 academic year. The main goal of this study was to investigate the effectiveness and acceptability of the flipped classroom approach at this educational level. This study was also used to assess the level of inquiry competence that high school students present when they have to carry out a research project and the main difficulties encountered in carrying it out. The results of the study show that the experience was clearly positive, since there was not only a significant improvement in student learning but also greater autonomy for students to work with the content, prepare for classes and actively participate in the tasks or practical activities that take place in the classroom, demonstrating its applicability in high school classrooms. The results also indicate that the students perceived advantages in their learning after experiencing the flipped classroom pedagogical model. Most of the students presented serious difficulties in carrying out their research work, probably due to a lack of experience when facing each of the stages that make up the process of inquiry.

As a result of the current COVID-19 pandemic, converting traditional face-to-face instructional methods into online courses have been a challenge. Online teaching offers limited options and means for explaining human anatomy, inflicting significant hardships in perceiving the depth and organization of anatomy among graduate students. This article addresses the integration of a 3-D anatomy application into an online graduate anatomy course among ninety-five Occupational Therapy scholars with various academic backgrounds enrolled via an online survey. Complete 3-D Anatomy app was used as a reinforcement to teaching human anatomy within the format of online Zoom sessions. Students' test scores and survey responses were employed to gather the information presented in this review. Results showed that all scholars believed the anatomy app was a useful supplement to the understanding of human anatomy, while the app-user pupils earned a greater percentage of passing grades in comparison to their peers in the non-app user group. Adopting the 3-D anatomy app as a supplemental tool during online anatomy courses to enhance students' understanding of human anatomy was successful. For prospective anatomy courses, we plan to integrate and explore the influences of an individual tablet/iPad with 3-D apps for each student for distinct insights on the impact of maneuvering and examining anatomical structures.

Practical classes are an integral part of learning human anatomy. The importance of utilising 3-dimensional resources (such as cadavers and skeletons) is only overshadowed by the teacher/student interactions when determining a positive learning experience. As student diversity in Higher Education increases, teaching approaches must also evolve. This study was developed in response to increased student diversity within an anatomy course. It aimed to compare allied health students' perceptions of anatomy practical classes delivered via two different formats. In 2018, a team-taught format (comprising a lead demonstrator (LD), clinical demonstrator (CD) and near-peer demonstrator (NPD)) was introduced at the large, metropolitan campus, while the smaller regional campus continued the sole-taught format. Student data were collected via anonymous online surveys and interviews. Quantitative data were analysed using ANOVA or appropriate non-parametric testing and qualitative data underwent thematic analysis. Satisfaction scores significantly increased at the team-taught metropolitan campus compared with 2017 when all practical classes were sole taught. Four key themes were realised with the team-taught format: "Improved student learning experience;" "Diverse perspectives;" "Demonstrator characteristics"(Nurturing expert (LD); inspiring clinical contextualiser (CD); relatable study advisor (NPD)); Confidence and approachability. Findings demonstrated that both sole- and team-taught anatomy practical classes can provide students with a positive learning experience; however, a team-taught format of practical classes may provide students with a richer learning experience. The multiple perspectives of different demonstrators were highly valued by students and should be considered as an important approach to teaching students with diverse academic credentials, backgrounds and learning experiences. The interaction between students and teachers is key to instilling motivation and active participation, especially during practical sessions. Stressing key pedagogical (andragogical) principles such as introducing clinical examples and sharing personal experiences can be enhanced if the background of the teaching staff is varied.

Brief periods of wakeful resting have a positive effect on memory consolidation. To test the impact of mindful breathing exercises on the retention of new knowledge in a science class, we assigned lab sessions of Anatomy and Physiology I and II randomly to the intervention group or control group. During teaching periods, the intervention group lab sessions integrated mindfulness breaks by having students participate in guided breathing exercises every 25-30 minutes. With one exception, the average scores on the weekly retention quizzes taken at the end of the lab sessions were higher for the intervention group compared with the control group for all quizzes in both Anatomy and Physiology I and II. However, there was no significant difference in the average score between the intervention and control groups on formal quizzes and exams. Future studies should evaluate whether mindfulness techniques, such as mindful breathing exercises, used before exams lead to improved exam scores.

This study investigated small and large student group dynamics, personal development, dissecting experience, and learning approaches in cadaveric laboratories at Colorado State University and Rocky Vista University. Student interviews (n = 20) and a case study with thematic analysis were performed in conjunction with Forsyth's conceptual framework on group dynamics. Results indicated that both group sizes offer unique benefits and implications. The majority of participants were pleased with their group members in both the small and the large groups but preferred not to study (n = 13) or spend their free time together (n = 15). All the students in the small groups (n = 14) stated that they underwent a change in their development as a group member and many modified their learning strategies. Overall, students from both groups appreciated a smaller student-to-cadaver ratio as it provided more time to dissect and greater opportunities to engage with the material. This study generated findings critical for the understanding of how group work and the selection of group size in the cadaveric laboratory affect students in their learning approach, dissecting experience, and personal development. It offers a critical lens for restructuring curricula and incorporating effective methods into the scientific classroom. Educators teaching in any group setting should consider these effects to evaluate which group size will generate the desired results for their corresponding curriculum.

This study aims to reveal pre-service science teachers' (PSTs) levels of knowledge about the human reproductive system and their professional competence perceptions. The study was conducted using the case method. A form consisting of 6 open-ended questions was developed and applied to PSTs. The sample was composed of 62 PSTs, who were 3rd and 4th-year students in the Science Teaching Department of a university. It was found that the majority of the participants had a superficial understanding of the human reproductive system and they had various alternative concepts about the subject. The students attributed their incomplete understanding of the subject to the fact that they did not learn the subject effectively because they did not make a regular revision of their lessons, because the subject was taught superficially, and they felt embarrassed while the subject was being taught to them. It can be said that social life and the way individuals look at the subject play an essential part in obtaining such results. Based on the results, it can be said that offering teachers training on the subject by experts can yield positive results in teaching the subject.

Combining classical educational methods with interactive three-dimensional (3D) visualization technology has great power to support and provide students with a unique opportunity to use them in the study process, training, and/or simulation of different medical procedures in terms of a Human Anatomy course. In 2016, Riga Stradinš University (RSU) offered students the 3D Virtual Dissection Table "Anatomage" with possibilities of virtual dissection and digital images at the Department of Morphology. The first 3D models were printed in 2018 and a new printing course was integrated into the Human Anatomy curriculum. This study was focused on the interaction of students with digital images, 3D models, and their combinations. The incorporation and use of digital technologies offered students great tools for their creativity, increased the level of knowledge and skills, and gave them a possibility to study human body structures and to develop relationships between basic and clinical studies.

Conventional teaching methods, such as 2-dimensional PowerPoint presentations, are among the most common anatomy teaching tools. However, these methods do not allow depth perception of anatomical structures. Therefore, the purpose of this article is to report the incorporation and student's perception of a 3D anatomy app to an Occupational Therapy class as an enhanced anatomical learning technique. For methods, the Complete 3D Anatomy app was used to teach the upper extremity structures. The students used the Likert scale to answer a survey regarding the different anatomical teaching tools that were integrated into the course. The results indicated that 85% of the students reported the anatomy app was very helpful (85%-39/46), helpful (9%-4/46) or good (2%-1/46) in aiding their comprehension of complex anatomical structures. Similarly, 100% of the students considered the anatomy app to be beneficial. Therefore, we conclude that using the 3D anatomy app was a tool for the comprehensive learning of human anatomy. The selection of the 3D app demonstrates this by graduate students as the second-best teaching tool to learn anatomy. For future courses, we will incorporate and explore the benefits of a personal tablet/iPad with 3D apps for each student, along with a virtual dissection table for the human cadaver laboratory.

Creativity is widely accepted to be a valuable skill to hone, but it is often difficult to define and even more difficult to measure. Artistic endeavors and creativity have historically had a close relationship with the sciences. However, recent trends have largely removed creativity from scientific inquiry and education. This shift has led to a large proportion of the coursework in anatomy fields to be strictly delivered via textbook and lecture and learning only gauged through quizzes and examinations. In the current work, we examined the assigning of creative projects during two semesters of a large undergraduate anatomy course at the University of Kentucky. We describe the showcasing of these creative works in both in-person and virtual formats. Future work will explore long-term impacts on student humanitarianism and professionalism as a result of the creative assignments.

Human anatomy and physiology are challenging courses for many undergraduate students often leading to low rates of academic success and persistence. Implementation of growth mindset strategies has shown promise in improving academic success in challenging courses; however, few studies have focused specifically on anatomy and physiology courses. To investigate the impact of growth mindset interventions on academic success, lab sections of a human anatomy course were randomly assigned to an intervention or control group. Five growth mindset interventions were integrated into course material for the intervention group at multiple points over the course of the semester. Performance on quizzes and exams, and overall academic success were compared between the groups. The intervention group increased scores in their growth mindsets and performance on low-stake assessments. There was no difference between performance on high-stake assessments and overall academic success. Potential future studies should focus on understanding the impacts this intervention has on specific participant demographics.

Anatomy and physiology lectures, traditionally held face-to-face at Florida Gulf Coast University, moved overnight to an online environment during the COVID-19 pandemic. Reflecting back on our teaching experience, a few goals to successful Zoom-based teaching emerged: make meaningful connections with the students, stay connected with students by using questions during lectures, and enjoy this new connection throughout the semester and beyond. This article discusses one strategy employed to stay connected to students during virtual, Zoom-based teaching: the use of "Are you awake?" questions. The questions were written to guide students in their review of material just learned. We felt that this method resulted in scaffolding the students' experience, preventing unnecessary lecturing, and reducing Zoom-fatigue. By emphasizing a process of regularly "checking in" with the student, a further relationship was established between the course faculty and students as well as among the students. Anecdotal evidence of this question technique is shared, with student feedback being positive. Based on our experience, emotional presence in the online environment correlates to student success.

Basic Human Anatomy at Indiana University is a large undergraduate anatomy class with nearly five hundred students in twelve lab sections. In the fall of 2018, we added the Virtual Human Dissector software on an interactive Sectra table to our lab to help students fill the gap between idealized anatomical models and fully prosected cadavers. We evaluated this new technology using a cross-over study design with pre- and post-module quizzes, exam questions related to the modules, and a survey of student perceptions. Results indicate that while not all students enjoyed using the new technology, even those who did not report enjoying it could still identify gaps that the technology helped to fill. Quiz results showed greater increases in knowledge for those who completed the modules, particularly during the second semester. However, exam results did not demonstrate a longer-term difference in knowledge between those who completed a specific module and those who did not.

A unique approach to improving student success in Human Anatomy and Physiology can be centered around teaching the students about metacognitive learning strategies. This perspective discusses the implementation of a metacognitive learning strategies session and highlights some of the outcomes that resulted from the session through exam wrapper responses. A one-hour session discussing metacognitive learning strategies was presented for the students through a pre-recorded video with embedded participation questions. Topics included methods for changing student studying habits to be more efficient and to retain a deeper level of understanding of the material. The session was also accompanied by exam wrappers to help the students to apply the concepts from the session.

This narrative study tells the teaching and learning story of the recently retired Dr. Peggy LePage, a longtime member of the Human Anatomy and Physiology Society with a career as a community college anatomy and biology professor spanning nearly three decades. Drawn from a lengthy narrative interview, this paper describes Dr. LePage's background as a nontraditional student and explores her resilience as a woman in science, technology, engineering, and mathematics (STEM). When Dr. LePage neared a breaking point early in her career, an encounter with a well-known advocate for active learning in science classrooms transformed her pedagogy. She also became involved with HAPS and never looked back. Narrative passages from her interview emphasize Dr. LePage's persistence in STEM, her shift toward a teacher as learner mentality, and the benefits of learning communities for anatomy and physiology instructors.

Our institution underwent a curricular revision to change the course approach for introductory anatomy and physiology courses from separate, discipline-specific human anatomy and human physiology courses to an integrated A&P I and A&P II course approach. Through a mixed-methods exploratory study, this research sought to determine undergraduate student perceptions of anatomy through this curricular revision. Data was collected through word associations, open-ended surveys, and course evaluation data. Our results indicate that undergraduate student perceptions of anatomy changed between the first course and the second course in the sequence, rather than between course approaches. Students in both course approaches reported similar interests, confusions, and difficulties related to anatomy education, and an awareness of the explicit and implicit curriculum was evident in student responses. However, some specific evaluation prompts exhibited a significant difference between course approaches. Results from this perception study can guide practitioners to consider the curricular context and unique challenges of anatomy and physiology students in meeting the expectations of the health care field.

Community college students come from a variety of backgrounds and have different levels of educational preparedness compared to undergraduates in 4-year undergraduate schools. Historically, retention rates of these students in human physiology courses have been low, often due to non-passing grades. Incorporation of additional active learning techniques has the potential to benefit learning in this group, which might ultimately benefit retention. However, active learning activities need to be incorporated in a thoughtful manner, because some activities can increase anxiety in students, resulting in unintended consequences such as student withdrawal from such activities. This study introduced cooperative quizzes into community college human physiology classes to determine if they improved student exam performance and reduced student anxiety. The cooperative quizzes were intended to be given in face-to-face classes but were adapted for synchronous broadcast classes using Zoom due to the COVID-19 pandemic. In the sample of students studied, cooperative quizzes did not have a significant impact on exam grades. However, several students reported a preference for the cooperative quizzes over traditional quizzes. In addition, the intervention did not increase the reported anxiety scores among students, which adds support for the use of cooperative quizzes as an active learning strategy in STEM classes.

A challenge with large undergraduate classes is the provision of opportunities for students to construct educational documents and to obtain individualized feedback pertaining to their work. Being able to work as part of a group, to clearly express information both orally and in writing, and to self-reflect while providing constructive feedback are soft skills that are valued by employers in the healthcare professions. We describe a two-part assignment in which students first worked in small groups to construct an informative newsletter pertaining to either the gut microbiome or one of four assigned fad diets and then evaluated a newsletter created by a group of their peers. Survey data revealed that most students found the assignments valuable learning exercises and that the opportunity to evaluate a newsletter created by their peers was welcomed. These assignments provide a way for students studying anatomy and physiology to reflect on what they have learned in class and, through self-directed research, apply their new knowledge in a way that will serve them well once out in the workplace.

Guided inquiry is an active learning technique featuring collaborative group learning with a structured set of models and highly structured questions for students to discuss and answer. Moving this technique to an online delivery format presents challenges, leading to questions about the effectiveness of this technique during online instruction. This study looked at the synchronous online delivery of a sliding filament theory guided inquiry activity (Brown 2015) and scores on related exam questions in anatomy classes at Salt Lake Community College. Students who participated in the guided inquiry activity had a median score of 79% on questions related to the sliding filament theory of muscle contraction while those that did not participate in guided inquiry had a median score of 61%, revealing a medium effect on student test scores. This suggests that the guided inquiry activity was successful at improving student understanding and retention when delivered in the online teaching environment.

Engagement of multiple learning modalities has been shown to promote learning. This study aimed to develop resources for anatomical sciences educators interested in adding additional teaching modalities into their repertoire. Three review sessions were created for the muscle anatomy unit of an undergraduate anatomy and physiology course, each designed to engage a different learning modality. The first session was a kinesthetic experience in which students were cued through a sequence of body positions similar to yoga poses with instruction of muscle anatomy relevant to each position. The second session was a tactile experience in which students were instructed how to shape clay into models of muscles and place them on a corresponding plastic skeleton. The third session was an audience-response question and answer (Q&A) session in which students responded to questions and received feedback about their performance. Each of the three review sessions was successfully implemented in a large undergraduate course with 445 total students. The authors encourage other anatomy educators to adapt these sessions for use in their own teaching.

Students from a variety of majors take human anatomy and physiology courses--usually because they are required for their program of study. Many students find anatomy and physiology classes academically challenging and institutions across the country report high failure and withdrawal rates for these courses. Although research has shown that several factors may contribute to poor student performance, this study focused on the relationship between a student's major and their perceptions about the course to investigate whether these data were reflective of student success rates. Survey data was collected from students in the first semester of a two-semester, systems-based human anatomy and physiology course sequence. While the results did not show a statistical difference in successful completion of the anatomy and physiology course related to academic major, interesting preferences regarding learning styles, study habits, and perceived difficulty of the course were found.

The incorporation of mobile learning methods (iLearning) into human anatomy and physiology classrooms has been debated with regard to its effectiveness in higher education. This study aimed to understand how iLearning affects college-aged students' perception of learning and engagement in an introductory human anatomy and physiology course using a survey established by Rossing and coworkers (2012). Perceived learning was not significantly different from start to end of the semester while perceived engagement was significantly different in a negative direction. Mean scores were high for both dimensions at both time points which may have diminished meaningful interpretation. Nevertheless, the present study demonstrates that iLearning can be successfully implemented into higher education classroom settings while maintaining traditional classroom teaching and learning techniques.

Previously, we described a course-based undergraduate research experience (CURE) for first-year students that featured a unique approach to brain mapping in a model organism (rat). In response to the COVID-19 pandemic, we adapted this course for an online learning environment, emphasizing image analysis (identifying immunoreactive signal in an immunohistochemical stain, making neuroanatomical distinctions in a cytoarchitectural stain) and translation of image data to the brain atlas. Using a quasiexperimental mixed methods approach, we evaluated aspects of student engagement and perceived gains in student confidence with respect to the nature and process of science and student science identity development. Additionally, we examined the dynamics of mentorship and student connectedness experienced in the online-only context. We found that the majority of students reported positive affective outcomes for the course in domains such as project ownership and project engagement in addition to positive responses toward perceived mentorship received during the course. Unsurprisingly, students expressed frustration in not being able to freely communicate with members of the course in an organic face-to-face environment. Furthermore, we found that students encountered greater difficulty in mastering image software skills causing a delay in producing consistent-quality data maps. From our analysis of the course, we have identified both useful approaches and areas for course improvement in any future iterations of the online research course. New & Noteworthy: Herein, we describe the process of converting a novel, face-to-face neuroanatomy course-based undergraduate research experience (CURE) to an online-only research setting. We document student affective and skill gains resultant from participating in this course and examine best practices for structuring online CUREs to maximize student learning and success.

Purpose: Team-based learning (TBL) is an instructional design that has been increasingly used in anatomy and physiology education. The appropriateness of TBL methods for students with diverse preferred sensory learning modalities has not been adequately examined. This study aimed to show the influence of students' preferred sensory modality for learning on TBL outcomes. Method: Communication sciences and disorders majors enrolled in anatomy and physiology courses completed VARK (Visual, Aural, Read/write, and Kinesthetic), a questionnaire quantifying their preferred learning modality. Students' traditional and TBL measures of academic success were compared by preferred learning modality. Results: A multivariate analysis of variance failed to find any difference in TBL or other outcomes by preferred learning modality (p = 0.252). Conclusions: The results of this study show no evidence of differences in academic outcomes in TBL projects between learners with different preferred learning modalities as measured by VARK. The role of TBL and of instructional sensory modality on learning outcomes should continue to be examined.

Researchers have long been interested in understanding how different learning approaches impact learning outcomes. Learning approaches are often conceptualized as a dichotomy of superficial and deep, and learning outcomes are typically viewed on a cognitive scale that ranges from lower- to higher-order. While there appears to be an inherent relationship between learning approach and outcomes where superficial approaches lead to lower-order learning and deep approaches result in higher-order learning, this concept is not well documented. The purpose of this study is to better understand this relationship by evaluating whether student performance on higher- and lower-order examination questions is influenced by the approach a student takes when studying. To investigate this, survey and examination data were collected from an upper-level undergraduate Human Anatomy course at the University of Cincinnati. Results indicate that, on average, students in the course favored a deep approach to learning. The impact that learning approach had on examination performance was investigated using a series of analytical approaches, which revealed that students who took a deep approach to learning performed marginally better on both higher- and lower-order examination questions in lecture and practical examination settings. These results are contextualized within the literature, which highlights the need for more research surrounding the interrelatedness and dependency of categories within both learning approaches and cognitive levels.

Internet-based platforms present vital new venues for sex education. However, research is limited on the ways adolescents utilize these resources, particularly within user-generated content contexts. This study assesses the sexual health content adolescents seek online through a qualitative, directed content analysis of 365 user-generated posts in an open sexual health community forum. An adapted version of the National Sex Education Standards, a comprehensive, evidence-based sexual health framework, was used as the schema for this data analysis. Collectively, our results highlight and confirm the importance of providing comprehensive, medically accurate sexual health information to adolescents. Our analysis further supports the need to provide information on pleasure in sexual health and well-being, as well as guidance on social and emotional aspects of sexual health, and for education to be supportive and inclusive of all individuals. Ultimately, our results can help guide effective public health interventions, including sex education efforts, aimed at promotion of adolescent sexual health by offering direct insight into adolescents' perceived information needs.

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.

At Kansas City University, anatomy laboratories were delivered via remote (REM) or on-campus (OC) formats due to COVID-19, creating an opportunity to evaluate student perceptions of differences in laboratory delivery format. A six-item survey of Likert scale and open-ended questions explored the utility of anatomy software, prelab instruction handouts, and prosection reviews. Likert scale validity was analyzed using Cronbach's a; responses were compared among REM and OC formats using Chi-square. Descriptive codes were applied to summarize responses, which were grouped and converted into percentages. Statistically significant differences in REM versus OC formats were determined for the helpfulness of the prelab handouts ([chi-squared], 28.00; df, 4; p < 0.001) and effectiveness of cadavers in learning anatomy ([chi-squared], 20.58; df, 4; p < 0.0004). Trends in responses noted disagreement in the effectiveness of anatomy software (REM, 69.8%; OC, 51.08%), but agreement with the helpfulness of prosection reviews (REM, 85.9%; OC, 61.6%) (Cronbach a: REM, 0.648; OC, 0.646). Themes from narrative REM comments (n = 496) noted anatomy software was difficult to use (33.1%) and had issues with orientation (15.5%), as well as a student preference for OC laboratories (12.5%). The OC format responses (n = 456) noted poor software design (47.9%), unnecessary for studying (35.4%), and preference for in-person laboratories (7.4%). Qualitative analysis of narrative comments detailed other resources used, including Complete Anatomy™ and YouTube™. Trends highlighted the prelab handouts and prosection reviews for learning, the ineffectiveness of anatomy software, and a preference for OC laboratories. We highlight student perspectives of REM versus OC laboratory formats in response to COVID-19.

Anatomical dissection is known to serve as an integral tool in teaching gross anatomy, including postgraduate training. A variety of embalming techniques exist, resulting in different haptic and optical tissue properties. This study aimed to objectify learning outcomes and medical student perceptions related to the use of two widely used embalming techniques, namely Thiel and ethanol-glycerin embalming. Between 2020 and 2022, first- and second-year medical students enrolled in the course on topographic anatomy participated in this study. Objective structured practical examinations were carried out for the head, neck, thorax, abdomen, pelvis, and extremity regions following regional dissection just before the oral examinations began. Six to ten numbered tags were marked in prosections of each region in Thiel- and ethanol-glycerin-embalmed specimens. Following the examinations, the students were surveyed regarding the suitability of the two embalming techniques with respect to preservation, colorfastness, tissue pliability, and the suitability in preparing for their anatomy examinations. Consistently higher scores were achieved for the thoracic and abdominal regions in ethanol-glycerin-embalmed specimens when compared to Thiel. No benefit was found for Thiel-embalmed upper or lower extremities. Tissues embalmed with ethanol-glycerin were rated higher for preservation and suitability to achieve the learning objectives, tissue pliability was rated higher for Thiel-embalmed tissues. Ethanol-glycerin embalming appears to offer certain advantages for undergraduate students in recognizing visceral structures, which may align with students' ideas on tissue suitability for their learning. Consequently, the benefits reported for Thiel embalming for postgraduate study unlikely reflect its suitability for novices.

Ultrasound imaging is a dynamic imaging technique that uses high-frequency sound waves to capture live images of the structures beneath the skin. In addition to its growing use in diagnosis and interventions, ultrasound imaging has the potential to reinforce concepts in the undergraduate medical curriculum. However, research assessing the impact of ultrasound on anatomy learning and student cognition is scarce. The purpose of this study was to compare the impact of ultrasound-based instruction versus narrated videos on students' understanding of anatomical relationships, as well as the role of intrinsic motivation, self-efficacy beliefs, and students' attitudes in this process. A booster course on anterior leg and wrist anatomy was offered to second-year medical students. A randomized controlled trial with a cross-over design allocated students to either an ultrasound-based teaching condition (cohort A) or a narrated anatomy video condition (cohort B). Next, participants were crossed to the alternative intervention. At the start of the study (T0), baseline anatomy knowledge, intrinsic motivation, self-efficacy beliefs, and spatial ability were measured. After the first intervention (T1) and at the end of the study (T2), both cohorts were administered an anatomy test, an intrinsic motivation scale, and a self-efficacy scale. In addition, each student was asked to fill out a perception survey after the ultrasound intervention. Finally, building on the cross-over design, the most optimal sequence of interventions was examined. A total of 181 students participated (cohort A: n = 82, cohort B: n = 99). Both cohorts performed comparably on the baseline anatomy knowledge test, spatial ability test, intrinsic motivation, and self-efficacy scale. At T1, cohort B outperformed cohort A on the anatomy test (p = 0.019), although only a small effect size could be detected (Cohen's d = 0.34). Intrinsic motivation and self-efficacy of both cohorts were similar at T1. At T2, the anatomy test, intrinsic motivation, and self-efficacy scale did not reflect an effect after studying either sequence of the interventions. Students reported favorably about the ultrasound experience, but also mentioned a steep learning curve. Medical students found the hands-on ultrasound sessions to be valuable, increasing their interest in musculoskeletal anatomy and ultrasound imaging. However, the addition of ultrasound did not result in superior spatial anatomy understanding compared to watching anatomy videos. In addition, ultrasound teaching did not have a major effect on student cognition. Ultrasound-based teaching of musculoskeletal anatomy is regarded as difficult to learn, and therefore it is hypothesized that too high levels of cognitive load might explain the presented results.

As hours devoted to human anatomy curricula fall under threat and curricular delivery methods remain in flux, many new teaching innovations are emerging, which require comprehensive evaluation to ensure evidence-based teaching is maintained. Although grades are the predominant measure of 'learning', alternative metrics can assess more nuanced and meaningful outcomes. Two common predictors of students' three-dimensional understanding of the body and depth of learning are visuospatial abilities and approaches to learning, respectively. This study evaluated and compared the relative predictive power of these metrics on written and laboratory-based assessments in a human anatomy course. Deep approaches to learning and visuospatial abilities were expected to positively correlate with overall performance, with visuospatial abilities being the more salient predictor, especially on laboratory-based assessments. Additionally, visuospatial abilities were expected to positively correlate with deep learning approaches and negatively correlate with surface learning approaches. Multiple linear regression models controlling for covariates found that both visuospatial abilities (p = 0.049; p = 0.014) and deep learning approaches (p = 0.001; p = 0.001) were independent significant predictors of final and laboratory-based grades, while only deep learning approaches were significantly predictive of written grades (p = 0.007). There was no significant relationship between visuospatial abilities and approaches to learning. Given these findings and the increased reliance on visuospatially demanding digital learning activities in anatomy, both metrics should be considered when evaluating the impact of teaching innovations. Further, educators should design learning resources and environments that train visuospatial abilities and promote deeper learning approaches to maximize students' success.

The COVID-19 pandemic caused major disruption to anatomical teaching worldwide with both lectures and practicals being moved online. Throughout this period anatomists were able to find new and innovative ways to teach and to aid student learning via a variety of delivery modes. This study aimed to interview anatomists who were involved in teaching undergraduate medical students at UK universities to document the changes that occurred and to understand academic perceptions of pandemic delivery to comprehend how anatomy education may change in the long term. Results suggest that academics are likely to continue to deliver anatomical lectures online post-pandemic akin to a flipped classroom approach, although caution was noted regarding 'at-risk' student groups. No academics wished to see continued delivery of practical classes online, however, resources designed or invested in during the pandemic will be integrated into practical classes or pre-class preparation allowing for a more complete student experience. No clear picture emerged as to the preferred way staff and students will communicate in the current post-pandemic hybrid working environment and beyond. This will likely only be resolved when a new pattern of home working evolves in UK institutions. This report is the first to detail the academic vision of anatomy teaching in a post-pandemic world and will be useful to those adapting to these changes and for those pedagogical researchers targeting where anatomical education research should focus moving forward.

The traditional format for neuroanatomy lab practical exams involves stations with a time limit for each station and inability to revisit stations. Timed exams have been associated with anxiety, which can lead to poor performance. In alignment with the universal design for learning (UDL), "Timed Image Question" and "Untimed Image Question" exam formats were designed to determine which format supports student success, especially for those who performed poorly in the traditional format. Only the "Untimed Image Question" format allowed students to revisit questions. All three formats were administered in a randomized order within a course for three cohorts of medical students. When all students' scores were analyzed together, the type of format had no effect. However, when analyses were conducted only on students who performed poorly in the traditional format, the type of format had an effect. These students increased their score, on average, by at least one grade level in the "Untimed Image Question" format compared to the traditional format. Students who performed well in the traditional format maintained their A, on average, in the two new formats. More students indicated "Untimed Image Question" as their most preferred format after experiencing all three formats. Most students associated the inability to revisit questions with high levels of anxiety. A neuroanatomy lab exam format was therefore identified as consistent with the UDL framework such that all students, regardless of test anxiety levels, can equally demonstrate what they learned. This format allowed for unlimited time per question and ability to revisit questions.

This article investigates the level of anatomical knowledge of the Hong Kong public and uses the data to help suggest public engagement activities and health campaigns to raise health literacy in the general population. In the annual public engagement event organized by the University of Hong Kong, 250 attendees took a survey assessing basic anatomical knowledge by putting organs/structures in their correct positions. Description analysis, correlation analysis, independent sample t-test, and one-way ANOVA analysis were conducted by SPSS 27.0. Overall, a mean score of 6.5 out of 20 was achieved. Differences between various demographic parameters were analyzed, and the results showed that better performance on the survey was associated with younger age, higher educational levels, and having healthcare experience. There was also a statistically significant difference in correctly positioning the thyroid between males and females. Interestingly, some misconceptions were thought to arise from the bespoke use of the Chinese language in the survey. The data reflected room for improvement in the level of anatomical knowledge among the public, notably in the older age groups. This was attributed partially to a lack of public outreach initiatives and established anatomy-focused programs, which has restricted public exposure to anatomical knowledge and hindered the development of anatomical sciences in Hong Kong. In conclusion, the knowledge of the public on the human body needs to be improved and possible solutions to improve public awareness of health were raised.

Anatomy serves as a foundational course in physical therapy education, but, due to its early placement in the curriculum, may have limited clinical application at that point of a student's education. Thus, augmenting a standard dissection course with surgical procedures can enhance the clinical relevance and knowledge of the anatomical structures involved in those surgeries. Doctor of Physical Therapy students viewed a variety of cadaveric orthopedic and cardiothoracic surgeries performed by a surgeon. Students unable to participate live viewed the recorded surgeries. Participants completed a 10-point Likert scale survey, developed by the researchers, pre- and post-viewing, on self-efficacy of knowledge, patient intervention and communication. Data analysis revealed improved self-efficacy of knowledge of the anatomy and the surgical procedures, confidence in treating patients undergoing those surgeries, and confidence communicating with surgeons, regardless of whether students viewed the surgeries live or recorded. Students participating in this experience expressed a clear value enhancement on their education. Programs should feel confident that this type of experience in the curriculum, whether live or recorded, will have a positive effect on student self-efficacy as related to the relationships and pertinence of anatomical structures involved in the surgeries, the surgical procedures, treating patients having undergone those surgeries, and interprofessional communication.

Three-dimensional (3D) segmentation, a process involving digitally marking anatomical structures on cross-sectional images such as computed tomography (CT), and 3D printing (3DP) are being increasingly utilized in medical education. Exposure to this technology within medical schools and hospitals remains limited in the United Kingdom. M3dicube UK, a national medical student, and junior doctor-led 3DP interest group piloted a 3D image segmentation workshop to gauge the impact of incorporating 3D segmentation technology on anatomical education. The workshop, piloted with medical students and doctors within the United Kingdom between September 2020 and 2021, introduced participants to 3D segmentation and offered practical experience segmenting anatomical models. Thirty-three participants were recruited, with 33 pre-workshop and 24 post-workshop surveys completed. Two-tailed t-tests were used to compare mean scores. From pre- to post-workshop, increases were noted in participants' confidence in interpreting CT scans (2.36 to 3.13, p = 0.010) and interacting with 3D printing technology (2.15 to 3.33, p = 0.00053), perceived utility of creating 3D models to aid image interpretation (4.18 to 4.45, p = 0.0027), improved anatomical understanding (4.2 to 4.7, p = 0.0018), and utility in medical education (4.45 to 4.79, p = 0.077). This pilot study provides early evidence of the utility of exposing medical students and healthcare professionals in the United Kingdom to 3D segmentation as part of their anatomical education, with additional benefit in imaging interpretation ability.

Ongoing research has attempted to discern the optimal way to teach surgical anatomy. This study investigated the relative effectiveness of drawing and clay modeling on learning spinal anatomy among medical students. Participants were recruited from a first-year medical school class to participate in an optional educational session in their regular course schedule. Seventy-eight students participated, and 62 completed pre- and post-session tests. Participants were randomized to one of three groups, either learning spinal anatomy by (1) drawing, (2) clay modeling, or (3) reviewing a 3D anatomy application (control). All groups referenced the anatomy application; the control group had no additional learning modality. Students had 15 min to learn major anatomical structures in the lumbar spine according to their assigned modality. Learning was evaluated in terms of score differential on pre- and post-session anatomy tests, with questions focused on anatomy applied in different contexts such as pathophysiology and radiology. Improved pre- to posttest scores were expected for the drawing and modeling groups compared to control. On average, the drawing group's scores significantly improved by 11% from pre- to posttest. Scores in the clay and control groups did not significantly improve. Drawing is thus an effective strategy for learning basic and applied spinal anatomy, and drawing and clay modeling (with adequate time) may be useful for teaching medical students to apply surgical anatomical knowledge in various contexts. These modalities are generalizable to any surgical anatomical education, and should be further explored among surgical residents given their efficacy, feasibility, and minimal use of resources.