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Many medical schools have implemented near-peer tutoring (NPT) programs based on the substantial benefits of these programs to both tutors and tutees. This study correlated the frequency of attending weekly NPT sessions to students' academic performance, and also compared performance of high and low attending students.Twenty-one weekly NPT sessions were delivered by fourth-year (M4) students to first-year (M1) students. Attendance was recorded, and accordingly students were divided into three groups, high (15-21 sessions), moderate (7-14 sessions), and low (0-6 sessions) attendance groups. Pearson product-moment correlation coefficient was computed to assess the relationship between students' frequency of attendance and their overall performance on overall basic medical sciences at the end of M1 year and M2 mid-year NBME® CBSE. Students' performance was also analyzed using ANCOVA and Bonferroni post hoc test to compare differences between the three attendance groups.An increase in number of attended NPT weekly sessions corresponds with an increase in students' performance on overall M1 basic sciences weighted average (Attending NPT weekly sessions is a valuable experience that is associated with an improvement in M1 medical students' academic performance. However, low performing students tend to miss attending NPT weekly sessions.

The term Metaverse ("meta" defined as beyond, transcendence or virtuality, and "verse" meaning universe or world) denotes a "virtual reality space" for anatomy teaching. To ascertain how many anatomists are familiar or are using this adjunct in teaching, we conducted a short survey at the 2022 annual meeting of the American Association of Clinical Anatomists (AACA). Interestingly, only six respondents (9.4%) had used a Metaverse for teaching anatomy. Moreover, the vast majority of attendees were anatomy educators or basic science faculty, but not practicing physicians/surgeons or other actively practicing health care professionals; a group where this technology has been used much more commonly. The present manuscript was authored by anatomy educators, practicing physicians and other actively practicing health care professionals with backgrounds in diverse medical fields, that is, anatomists, medical doctors, physician assistants, dentists, occupational therapists, physical therapists, chiropractors, veterinarians, and medical students. Many of these authors have used or have been exposed to a Metaverse in the clinical realm. Therefore, the aim of the paper is to better understand those who are knowledgeable of a Metaverse and its use in anatomy education, and to provide ways forward for using such technology in this discipline.

For the last 20 years, undergraduate medical education has seen a major curricular reform movement toward integration of basic and clinical sciences. The rationale for integrated medical school curricula focuses on the application of knowledge in a clinical context and the early ability to practice key skills such as critical thinking and clinical problem-solving. The method and extent of discipline integration can vary widely from single sessions to entire programs. A challenge for integrated curricula is the design of appropriate assessments. The goal of this review is to provide a framework for clinical anatomy educators with definitions of integration, examples of existing integration models, strategies, and instructional methods that promote integration of basic and clinical sciences.

This study examined the relationship between attendance at weekly near-peer tutoring (NPT) sessions offered in the second year of medical school and academic performance on basic science and USMLE Step 1 examinations.Twenty-four weekly NPT sessions were delivered across all modules in the second year of medical school. Attendance of the sessions was recorded and students were divided into three groups: high (16-24 sessions), moderate (7-15 sessions), and low-no (0-6 sessions) attendance groups. Pearson product-moment correlation coefficient was computed to determine the relationship between students' frequency of attendance and their performance on overall basic sciences, two NBME CBSEs, and USMLE Step 1 examinations. Students' academic performance was also analyzed using ANOVA and Bonferroni post hoc test (Pearson correlation analyses revealed that attending peer tutoring sessions was significantly correlated with students' performance in overall basic sciences, CBSE mid-year, CBSE final, and USMLE Step 1 examinations. The high attendance groups significantly outperformed the low-no attendance groups on overall basic sciences (Attending NPT sessions are significantly correlated with students' performance on basic sciences and on USMLE Step1 examinations. Attendance of weekly NPT sessions is a valuable experience for M2 students.

The world has changed rapidly since the emergence of the COVID-19 pandemic, and the education community has not been immune to these changes. With abrupt school closings and a rapid transition to online teaching and learning, the educational technologies have been stretched to their limits and pedagogic approaches blossomed. As the world strives to reestablish normalcy, it will be under the influence of the long-lasting impact of the pandemic. This manuscript provides recommendations for the online conversion of anatomical sciences curricula in health sciences programs. Strategic guidelines are emerging for building on these changes to enhance teaching and learning in the current pandemic era.

Identification of cadaveric structures during anatomy summative practical examinations is a challenge for first-year medical students. To assist in cultivating this skill, we offered 12 formative laboratory activities (anatomy boot camps [ABCs]) that approximated the summative practical examination format using reciprocal and near-peer teaching. Students assisted in crafting the formative practical examination, then engaged in a self-review by scoring their individual answer sheets. Students performing below designated thresholds (≤60%) were offered laboratory review sessions led by medical student upperclassmen. Mann-Whitney U tests were used to compare the performance of participants who attended the ABC sessions leading up to each summative examination. Correlation analysis was utilized to examine the relationship between student participation in ABCs summative examinations. Voluntary surveys were administered to assess the perceived value of the experience. Mann-Whitney U tests indicated students who attended the ABC review preceding three of the four summative practical and two of the four written examinations scored consistently higher on these examinations than students who chose not to attend. Correlation analysis revealed that as the overall frequency of ABC attendance increased, students' performance on the summative practical and written examinations increased significantly (P < 0.001). These findings suggest that the provision of supplemental learning experiences, such as the ABCs, contributes to improved student learning outcomes. This sentiment was echoed in student surveys. This activity, which combines multiple peer teaching approaches, appears to be an effective strategy for guiding and enhancing student success in the anatomy practical examinations. Clin. Anat. 33:286-292, 2020. © 2019 Wiley Periodicals, Inc.

OBJECTIVES: This study examines differences in the Learning and Study Strategies Inventory (LASSI) 10-subscale scores between low and high academically performing medical students relative to internal and external examinations. METHODS: The LASSI instrument was administered to 180 medical students from three classes (2016, 2017, and 2018). To measure the strength of association between LASSI 10-subscale scores and performance on overall biomedical sciences and the United States Medical Licensing Examination (USMLE) Step 1, Pearson product-moment correlation analyses were performed. One-way ANOVA and Bonferroni post-hoc analyses were performed to identify statistically significant differences on LASSI scores between students grouped by quartiles according to their performance on USMLE Step 1 examination (external performance measure) and by their average letter grade in the overall biomedical sciences (internal performance measure). RESULTS: Significant associations were observed between Anxiety, Motivation, and Test Strategies and students’ performance on both overall biomedical sciences and USMLE Step 1 examinations. Anxiety, Motivation, and Test Strategies were different between “A” and “C” students in the overall biomedical sciences. Anxiety, Information Processing, Motivation, Selecting Main Idea, and Test Strategies were significantly different between the upper and lower quartiles in USMLE Step 1 student performance. CONCLUSIONS: Anxiety, Motivation and Test Strategies are the main LASSI subscales that were significantly different between high-performing and low-performing students for internal and external examinations. Interestingly, the same LASSI subscales Anxiety, Motivation, and Test Strategies were correlated with students’ performance in internal and external examinations.

Blended learning is the integration of different learning approaches, new technologies, and activities that combine traditional face-to-face teaching methods with authentic online methodologies. Although advances in educational technology have helped to expand the selection of different pedagogies, the teaching of anatomical sciences has been challenged by implementation difficulties and other limitations. These challenges are reported to include lack of time, costs, and lack of qualified teachers. Easy access to online information and advances in technology make it possible to resolve these limitations by adopting blended learning approaches. Blended learning strategies have been shown to improve students' academic performance, motivation, attitude, and satisfaction, and to provide convenient and flexible learning. Implementation of blended learning strategies has also proved cost effective. This article provides a theoretical foundation for blended learning and proposes a validated framework for the design of blended learning activities in the teaching and learning of anatomical sciences. Clin. Anat. 31:323-329, 2018. © 2018 Wiley Periodicals, Inc.

To enable early identification and intervention for students at risk for academic failure and for failure on the USMLE Step 1 Examination, three predictive models (pre-matriculation, end of M1, and end of M2) were developed that include both behavioral attributes (Learning and Study Strategies Inventory: LASSI subscale scores) and performance measures (internal examinations and National Board of Medical Examiners [NBME] Comprehensive Basic Science Examination [CBSE] progress tests). Pearson product moment correlation coefficients and multivariate regression modeling were used to determine optimal combinations of independent variables. The pre-matriculation prediction model includes MCAT scores and undergraduate overall GPA. The end of M1 model includes the progress test scores on the NBME CBSE administered at the end of first year medical school (M1), LASSI subscale scores, and weighted performance on M1 internal examinations. Finally, the end of M2 model includes CBSE progress test scores at the end of M1 and second year medical school (M2), LASSI subscale scores, and weighted performance on M1 and M2 internal examinations. Our pre-matriculation, end of M1, and end of M2 models explain 24, 62, and 81% of the variation in USMLE Step 1 performance, respectively. The inclusion of LASSI subscale scores improves the end of M1 model from 60 to 62% and end of M2 model from 79 to 81% in explaining variation in USMLE Step 1 scores. Continuous monitoring of student performance based on these multiple measures supports a holistic perspective on progress, areas of ongoing weakness, and potentially, identification of yet-undetected weakness for targeted interventions.

Much of the content delivered during medical students' preclinical years is assessed nationally by such testing as the United States Medical Licensing Examination® (USMLE® ) Step 1 and Comprehensive Osteopathic Medical Licensing Examination® (COMPLEX-USA® ) Step 1. Improvement of student study/learning strategies skills is associated with academic success in internal and external (USMLE Step 1) examinations. This research explores the strength of association between the Learning and Study Strategies Inventory (LASSI) scores and student performance in the anatomical sciences and USMLE Step 1 examinations. The LASSI inventory assesses learning and study strategies based on ten subscale measures. These subscales include three components of strategic learning: skill (Information processing, Selecting main ideas, and Test strategies), will (Anxiety, Attitude, and Motivation) and self-regulation (Concentration, Time management, Self-testing, and Study aid). During second year (M2) orientation, 180 students (Classes of 2016, 2017, and 2018) were administered the LASSI survey instrument. Pearson Product-Moment correlation analyses identified significant associations between five of the ten LASSI subscales (Anxiety, Information processing, Motivation, Selecting main idea, and Test strategies) and students' performance in the anatomical sciences and USMLE Step 1 examinations. Identification of students lacking these skills within the anatomical sciences curriculum allows targeted interventions, which not only maximize academic achievement in an aspect of an institution's internal examinations, but in the external measure of success represented by USMLE Step 1 scores. Anat Sci Educ 11: 236-242. © 2017 American Association of Anatomists.

Introduction: Healthcare professional schools across the world are implementing near-peer tutoring (NPT) programs owing to numerous benefits to both tutors and tutees. This study determined whether higher attendance at NPT sessions led to improvements in course grades for high and low performing students. Methods: Fourth-year medical students used the USMLE Step 1 question format to tutor first-year medical students during the second half of the Structure and Function (SF) module, i.e., SF2. Attendance was recorded and students were accordingly divided into three groups: high, moderate, and low-no attendance. Students' performances in SF1 and SF2 were compared using Student's t-test. Differences among the three groups were analyzed using ANOVA and Scheffe post hoc test (P< 0.05). Students who earned 70-79% (C) in SF1 were further examined on the basis of their attendance rate and performance in SF2. Those who attended three or more sessions completed a survey evaluating the NPT program. Results: Course grades were significantly higher in SF2 than SF1 for all students, regardless of attendance rate. However, students who received a C grade in SF1 and had high or moderate attendance improved significantly in their SF2 course grade. Most students agreed that the NPT program was valuable and they evaluated the tutors highly. They also agreed that NPT prepared them for course exams and Step 1, but did not reduce anxiety and stress about Step 1. Conclusions: The positive effect of the NPT program resulted in its expansion to include all first-year modules. This article is protected by copyright. All rights reserved.

This study examines how the timing of Learning and Study Strategies Inventory (LASSI) administration affects scores on the 10 LASSI subscales, and whether or not there is a difference in the strength of association between subscale scores and student performance. The LASSI instrument was administered to 128 students during orientation at the beginning of the first and second years of medical school (M1and M2 years) for two classes. A paired t test was used to compare differences between the two administrations. To measure the strength of association between LASSI subscale scores and performance on overall biomedical sciences, National Board of Medical Examiners (NBME) Comprehensive Basic Sciences Exams (CBSE), and United States Medical Licensing Examination (USLME) Step 1, Pearson product-moment correlation analyses were performed. There is a significant difference between LASSI subscale scores at the beginning of M1 and at the beginning of M2. There were more significant correlations between LASSI subscale scores at the beginning of M2 with performance on overall biomedical sciences, NBME CBSE, and USMLE Step 1 exam. Significant associations were observed between LASSI subscales Anxiety, Selecting Main Ideas, and Test Strategies with students’ performance on overall biomedical sciences, NBME CBSE, and USLME Step 1. Information Processing was also correlated with NBME CBSE and USMLE Step 1. Assessing medical students’ learning and study-strategy skills is more accurate after a medical school experience than at the start of medical school. Anxiety, Selecting Main Ideas, and Test Strategies are correlated with students’ performance on both internal and external performance measures.

The setting for medical practitioners typically involves collaborative and interdisciplinary teams. Medical schools have embraced many teaching methods that use a group of learners to facilitate learning. However, the actual learning benefits of these methods require additional inquiry in the areas of team cognition and team processes. There is limited research that evaluates the value of the team process behaviors in medical education to improve collaborative learning outcomes. This conceptual article provides a framework for team learning processes based on the theoretical foundation of social learning and the development of group shared mental models during team interactions that impact a student’s performance.

Motivation and learning are inter-related. It is well known that motivating learners is clearly a complex endeavor, which can be influenced by the educational program and the learning environment. Limited research has been conducted to examine students' motivation as a method to assess the effectiveness of dissection in medical education. This study aimed to assess and analyze students' motivation following their dissection experience. A 29-item survey was developed based on the Attention, Relevance, Confidence, and Satisfaction model of motivation. Descriptive statistics were undertaken to describe students' motivation to the dissection experience. T-test and ANOVA were used to compare differences in motivational scores between gender and educational characteristics of students. Dissection activities appear to promote students' motivation. Gender difference was statistically significant as males were more motivated by the dissection experience than females. Comparison between students with different knowledge of anatomy was also significantly different. The study is an important step in the motivational design to improve students' motivation to learn. The outcome of this study provides guidance to the selection of specific strategies to increase motivation by generating motivational strategies/tactics to facilitate learning. Anat Sci Educ 10: 363-371. © 2016 American Association of Anatomists.

Faculty members in higher education are involved in many instructional design activities without formal training in learning theories and the science of instruction. Learning theories provide the foundation for the selection of instructional strategies and allow for reliable prediction of their effectiveness. To achieve effective learning outcomes, the science of instruction and instructional design models are used to guide the development of instructional design strategies that elicit appropriate cognitive processes. Here, the major learning theories are discussed and selected examples of instructional design models are explained. The main objective of this article is to present the science of learning and instruction as theoretical evidence for the design and delivery of instructional materials. In addition, this article provides a practical framework for implementing those theories in the classroom and laboratory.

Healthcare professional schools across the world are implementing near-peer tutoring (NPT) programs owing to numerous benefits to both tutors and tutees. This study determined whether higher attendance at NPT sessions led to improvements in course grades for high and low performing students. Fourth-year medical students used the USMLE Step 1 question format to tutor first-year medical students during the second half of the Structure and Function (SF) module, i.e., SF2. Attendance was recorded and students were accordingly divided into three groups: high, moderate, and low-no attendance. Students' performances in SF1 and SF2 were compared using Student's t-test. Differences among the three groups were analyzed using ANOVA and Scheffé post hoc test (P0.05). Students who earned 70-79% (C) in SF1 were further examined on the basis of their attendance rate and performance in SF2. Those who attended three or more sessions completed a survey evaluating the NPT program. Course grades were significantly higher in SF2 than SF1 for all students, regardless of attendance rate. However, students who received a C grade in SF1 and had high or moderate attendance improved significantly in their SF2 course grade. Most students agreed that the NPT program was valuable and they evaluated the tutors highly. They also agreed that NPT prepared them for course exams and Step 1, but did not reduce anxiety and stress about Step 1. The positive effect of the NPT program resulted in its expansion to include all first-year modules. Clin. Anat. 30:922-928, 2017. © 2017 Wiley Periodicals, Inc.

In the present study, we describe the innovative use of the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) as a progress test during the preclerkship medical curriculum. The main aim of this study was to provide external validation of internally developed multiple-choice assessments in a new medical school. The CBSE is a practice exam for the United States Medical Licensing Examination (USMLE) Step 1 and is purchased directly from the NBME. We administered the CBSE five times during the first 2 yr of medical school. Student scores were compared with scores on newly created internal summative exams and to the USMLE Step 1. Significant correlations were observed between almost all our internal exams and CBSE scores over time as well as with USMLE Step 1 scores. The strength of correlations of internal exams to the CBSE and USMLE Step 1 broadly increased over time during the curriculum. Student scores on courses that have strong emphasis on physiology and pathophysiology correlated particularly well with USMLE Step 1 scores. Student progress, as measured by the CBSE, was found to be linear across time, and test performance fell behind the anticipated level by the end of the formal curriculum. These findings are discussed with respect to student learning behaviors. In conclusion, the CBSE was found to have good utility as a progress test and provided external validation of our new internally developed multiple-choice assessments. The data also provide performance benchmarks both for our future students to formatively assess their own progress and for other medical schools to compare learning progression patterns in different curricular models.

This is a reflective essay based on the experience of developing a structure and function module within a new integrated medical curriculum. Our hope is that the insights we gained during a 4-yr journey in a new medical school will be transferable to others engaged with curriculum development. Here, we present an interpretive analysis of our personal experiences together with some original research data and a synthesis of the literature. We will argue that a focus on teaching faculty is the key to successful curriculum integration and suggest an agenda for faculty development. Our essay begins by exploring what curriculum integration really means and what its purpose might be. Our case study explores the challenges of building a shared understanding among stakeholders and of negotiating learning outcomes and methods of teaching as well as the process of developing content and assessment. We feel that many of our experiences in the new medical school are applicable in other settings, such as curriculum reform in established schools and for developers of competency-based premedical curricula. We conclude with recommendations to assist other curriculum planners and teachers by offering some benefits of hindsight.

This article describes the development of an interactive computer-based laboratory manual, created to facilitate the teaching and learning of medical histology. The overarching goal of developing the manual is to facilitate self-directed group interactivities that actively engage students during laboratory sessions. The design of the manual includes guided instruction for students to navigate virtual slides, exercises for students to monitor learning, and cases to provide clinical relevance. At the end of the laboratory activities, student groups can generate a laboratory report that may be used to provide formative feedback. The instructional value of the manual was evaluated by a questionnaire containing both closed-ended and open-ended items. Closed-ended items using a five-point Likert-scale assessed the format and navigation, instructional contents, group process, and learning process. Open-ended items assessed student's perception on the effectiveness of the manual in facilitating their learning. After implementation for two consecutive years, student evaluation of the manual was highly positive and indicated that it facilitated their learning by reinforcing and clarifying classroom sessions, improved their understanding, facilitated active and cooperative learning, and supported self-monitoring of their learning.

Motivation and learning are inter-related. It is well known that motivating learners is clearly a complex endeavor, which can be influenced by the educational program and the learning environment. Limited research has been conducted to examine students' motivation as a method to assess the effectiveness of dissection in medical education. This study aimed to assess and analyze students' motivation following their dissection experience. A 29-item survey was developed based on the Attention, Relevance, Confidence, and Satisfaction model of motivation. Descriptive statistics were undertaken to describe students' motivation to the dissection experience. T-test and ANOVA were used to compare differences in motivational scores between gender and educational characteristics of students. Dissection activities appear to promote students' motivation. Gender difference was statistically significant as males were more motivated by the dissection experience than females. Comparison between students with different knowledge of anatomy was also significantly different. The study is an important step in the motivational design to improve students' motivation to learn. The outcome of this study provides guidance to the selection of specific strategies to increase motivation by generating motivational strategies/tactics to facilitate learning. Anat Sci Educ 10: 363-371. © 2016 American Association of Anatomists.

Background: Online quizzes are simple, cost-effective methods to provide formative assessment, but their effectiveness in enhancing learning and performance in medical education is unclear. Purpose: The purpose of this article is to determine the extent to which online quiz performance and participation enhances students’ performance on summative examinations. Methods: A retrospective case study investigating relationships between formative and summative assessment in terms of use and outcomes. Results: Online quiz scores and the rates of quiz participation were significantly correlated with corresponding performance on summative examinations. However, correlations were not dependent on the specific quiz content, and changes in patterns of quiz use were not reflected in corresponding changes in summative examination performance. Conclusions: The voluntary use of online quizzes, as well as the score attained, provides a useful general indicator of student performance but is unlikely to be sensitive enough ...

This study used qualitative and quantitative approaches to evaluate the effectiveness of self-learning modules (SLMs) developed to facilitate and individualize students' learning of basic medical sciences. Twenty physiology and nineteen microanatomy SLMs were designed with interactive images, animations, narrations, and self-assessments. Of 41 medical students, 40 students voluntarily completed a questionnaire with open-ended and closed-ended items to evaluate students' attitudes and perspectives on the learning value of SLMs. Closed-ended items were assessed on a five-point Likert scale (5 = high score) and the data were expressed as mean ± standard deviation. Open-ended questions further evaluated students' perspectives on the effectiveness of SLMs; student responses to open-ended questions were analyzed to identify shared patterns or themes in their experience using SLMs. The results of the midterm examination were also analyzed to compare student performance on items related to SLMs and traditional sessions. Students positively evaluated their experience using the SLMs with an overall mean score of 4.25 (SD ± 0.84). Most students (97%) indicated that the SLMs improved understanding and facilitated learning basic science concepts. SLMs were reported to allow learner control, to help in preparation for subsequent in-class discussion, and to improve understanding and retention. A significant difference in students' performance was observed when comparing SLM-related items with non-SLM items in the midterm examination (P < 0.05). In conclusion, the use of SLMs in an integrated basic science curriculum has the potential to individualize the teaching and improve the learning of basic sciences.

This research is an effort to best utilize the interactive anatomical images for instructional purposes based on cognitive load theory. Three studies explored the differential effects of three computer-based instructional strategies that use anatomical cross-sections to enhance the interpretation of radiological images. These strategies include: (1) crosssectional images of the head that can be superimposed on radiological images, (2) transparent highlighting of anatomical structures in radiological images, and (3) crosssectional images of the head with radiological images presented side-by-side. Data collected included: (1) time spent on instruction and on solving test questions, (2) mental effort during instruction and test, and (3) students' performance to identify anatomical structures in radiological images. Participants were 28 freshmen medical students (15 males and 13 females) and 208 biology students (190 females and 18 males). All studies used posttest-only control group design, and the collected data were analyzed by either t test or ANOVA. In self-directed computer-based environments, the strategies that used cross sections to improve students' ability to recognize anatomic structures in radiological images showed no significant positive effects. However, when increasing the complexity of the instructional materials, cross-sectional images imposed a higher cognitive load, as indicated by higher investment of mental effort. There is not enough evidence to claim that the simultaneous combination of cross sections and radiological images has no effect on the identification of anatomical structures in radiological images for novices. Further research that control for students' learning and cognitive style is needed to reach an informative conclusion.

Many researchers have explored how people share and construct similar mental models in teams. They have claimed that successful team performance depends on a shared mental model of team members about task, team, equipment and situation. Most of the literature has illustrated simplified relationships between a team's mental model and their performance without a valid instrument addressing the confined and relevant constructs of a shared mental model. This paper describes the instrument development steps and the conceptual framework for factors associated with shared mental models. After development and refinement, the instrument was finalized for use to measure team-related knowledge. The final instrument consists of 42 items that are linked to the five emergent factors of shared mental models including general task and team knowledge, general task and communication skills, attitude toward teammates and task, team dynamics and interactions, and team resources and working environment.

In improving the teaching and learning of anatomical sciences, empirical research is needed to develop a set of guiding principles that facilitate the design and development of effective dynamic visualizations. Based on cognitive load theory (CLT), effective learning from dynamic visualizations requires the alignment of instructional conditions with the cognitive architecture of learners and their levels of expertise. By improving the effectiveness and efficiency of dynamic visualizations, students will be able to be more successful in retaining visual information that mediates their understanding of complex and difficult aspects of anatomy. This theoretical paper presents instructional strategies generated by CLT and provides examples of some instructional implications of CLT on the design of dynamic visualizations for teaching and learning of anatomy.

Observations from extratesticular rete-ligated, mature goats indicated that epithelial morphology in the tail of the epididymis can be maintained without any input from testicular fluid (Goyal et al., Acta Anat., 1994;150:127–135). Hence, the objective of this study was to determine whether the tail of the epididymis and/or other regions of the male excurrent ducts can differentiate prior to the appearance of lumen in the seminiferous tubules, which is an indicator for the onset of seminiferous tubular fluid secretion. Based on age and scrotal circumference (SC), 20 male goats were divided into four groups of five animals each: 1–4 weeks (SC, 6.5–7.5 cm), 7–10 weeks (SC, 8.5–11.0 cm), 12–15 weeks (SC, 11.0–14.0 cm), and 15–25 weeks (SC, 16.0–19.0 cm). Tissues were collected from the testis, six regions of the epididymis (proximal, middle and distal head; proximal and distal body; and tail), and the ductus deferens, and were processed for light and electron microscopic examination. Changes in epithelial height and cytological features associated with absorption (microvilli, pinocytotic and coated vesicles) and protein secretion (RER, Golgi body) were used as markers for differentiation. Differentiation of all of these features was comparable to that observed in the 15–25-week-old animals in the ductus deferens by ≥1 week, in the tail of the epididymis by ≥7 weeks, in the distal body of the epididymis by ≥12 weeks, and in the proximal body of the epididymis and all three regions of the head of the epididymis by ≥15 weeks. Seminiferous tubules developed lumens between 12 and 15 weeks. In conclusion, epithelial differentiation in the ductus deferens, tail of the epididymis, and distal body of the epididymis follows a time-dependent, spatial, ascending order and is achieved before lumen formation in the seminiferous tubules. Conversely, epithelial differentiation in all three regions of the head and the proximal body of the epididymis occurs simultaneously and after lumen formation in the seminiferous tubules. Anat Rec 254:508–520, 1999. © 1999 Wiley-Liss, Inc.

Background: Since androgens and/or estrogens must bind with specific receptors in order to elicit a response at the target organ(s), it is important to understand factors that regulate expression of androgen receptors (AR) and estrogen receptors (ER). Hence, the objective of the study is to determine the relative significance between circulating andro- gen (CA) and luminal androgen (LA) in maintaining normal expression of AR and ER in male excurrent ducts. Methods: Mature Nubian goats were subjected for 15 days each to the following treatments: (1) bilateral orchidectomy, (2) bilateral orchidec- tomy and testosterone treatment, (3) unilateral ligation of the extratesticu- lar rete, and (4) unilateral orchidectomy. Tissues from different segments of the excurrent ducts were fixed in 4% paraformaldehyde and embedded in Paraplast-plust. Antigenic sites for AR and ER were immunolocalized using PG-21 rabbit antirat/human antibody and H-222 rat antihuman monoclonal antibody, respectively. The avidin-biotin horseradish peroxi- dase procedure was used to identify positive immunoreactivity. Negative controls included incubation of sections with irrelevant IgG in place of primary antibody. Results: In intact animals, whereas AR were found in epithelial, connec- tive tissue, and peritubular smooth muscle cells of the efferent ductules, regions I-V of the epididymis, and ductus deferens, ER were confined to nonciliated cells of the efferent ductules. Bilateral orchidectomy caused a severe loss of both AR and ER staining. Testosterone replacement to orchidectomized animals restored staining of both AR and ER to the intact level. Neither unilateral ligation of the extratesticular rete nor unilateral orchidectomy had any effect on AR or ER immunostaining. Conclusion: Circulating androgen alone, without any input from lumi- nal androgen or other rete fluid contents, can regulate expression of both androgen receptor and estrogen receptor. Anat. Rec. 250:164-171, 1998.

Background Because of the significance of androgens and estrogens in prenatal and postnatal differentiation of the testis and excurrent ducts, it is important to understand the developmental pattern of androgen receptor (AR) and estrogen receptor (ER) in these organs. Methods Tissues from 1–23-week-old goats were fixed in 4% paraformaldehyde and embedded in Paraplast-plus®. Antigenic sites for AR and ER were immunolocalized using the PG-21 rabbit anti-rat/human antibody and the H-222 rat anti-human monoclonal antibody, respectively. The avidin-biotin horseradish peroxidase procedure was used to identify positive immunoreactivity. Controls included incubation of sections with irrelevant IgG in place of primary antibody. Results Within the testis, immunostaining for AR in the nuclei of Sertoli cells increased gradually from mild at week 1 to strong at week ≥19. In contrast, nuclei of peritubular myoid cells and Leydig cells exhibited moderate to strong reaction for AR in all animals. Germ cells were negative. Within the rete testis, efferent ductules, regions I–V of the epididymis, and ductus deferens, nuclei of all epithelial cells, peritubular myoid cells, and intertubular connective tissue cells expressed moderate to strong staining for AR at all ages. ER were confined to nonciliated cells of the efferent ductules, which displayed moderate staining in all animals, beginning from week 1. Conclusions Nuclear AR staining, found in all testicular cells (except germ cells) and excurrent duct cells examined, was observed to change in an age-related manner only in Sertoli cells, where staining intensity increased between week 1 and week 19. Staining for ER, confined to nonciliated epithelial cells of the efferent ductules, was not affected by postnatal age. Anat. Rec. 249:54–62, 1997. © 1997 Wiley-Liss, Inc.

The study was conducted as part of an overall evaluation for an outreach program to evaluate the clinical status of all the participating children, identify management problems, if any, and offer relevant recommendations.All the participating children were subjected to a detailed clinical evaluation using a structured questionnaire developed for the purpose. The subjects of this study were registered in the Center for Disabled Children in Buraidah and Unaizah, Al-Qassim region, Kingdom of Saudi Arabia. This study was conducted in 1998 to include all registered children in the centers, which were established in 1994.One hundred and eleven children were evaluated, 51.8% were males. Average age was 72.31 months (standard deviation 32.99). The children fell into 3 diagnostic groups: Cerebral palsy (CP) group (n=41), chromosomal abnormalities group (n=36) and miscellaneous group (n=34). Mothers were the direct care-givers in 98.1% of cases. The sample as a whole suffered from a number of disabilities, the most common of which was severe speech difficulty (88.3%). Fifty seven percent of the children were severely malnourished. The CP group suffered most, as they were significantly fewer mobiles and more dependants on the care-giver. History of neonatal asphyxia and severe malnutrition at the time of examination were also significantly more common in this group.This group of disabled children is enjoying a comprehensive rehabilitation service delivered through an efficient outreach program. It was observed that the families need extra support to improve mobility, nutrition and communication abilities of the participating children.

This article describes the development of an interactive computer-based laboratory manual, created to facilitate the teaching and learning of medical histology. The overarching goal of developing the manual is to facilitate self-directed group interactivities that actively engage students during laboratory sessions. The design of the manual includes guided instruction for students to navigate virtual slides, exercises for students to monitor learning, and cases to provide clinical relevance. At the end of the laboratory activities, student groups can generate a laboratory report that may be used to provide formative feedback. The instructional value of the manual was evaluated by a questionnaire containing both closed-ended and open-ended items. Closed-ended items using a five-point Likert-scale assessed the format and navigation, instructional contents, group process, and learning process. Open-ended items assessed student's perception on the effectiveness of the manual in facilitating their learning. After implementation for two consecutive years, student evaluation of the manual was highly positive and indicated that it facilitated their learning by reinforcing and clarifying classroom sessions, improved their understanding, facilitated active and cooperative learning, and supported self-monitoring of their learning.

Strategies of presenting instructional information affect the type of cognitive load imposed on the learner's working memory. Effective instruction reduces extraneous (ineffective) cognitive load and promotes germane (effective) cognitive load. Eighty first-year students from two veterinary schools completed a two-section questionnaire that evaluated their perspectives on the educational value of a computer-based instructional program. They compared the difference between cognitive loads imposed by paper-based and computer-based instructional strategies used to teach the anatomy of the canine skeleton. Section I included 17 closed-ended items, rated on a five-point Likert scale, that assessed the use of graphics, content, and the learning process. Section II included a nine-point mental effort rating scale to measure the level of difficulty of instruction; students were asked to indicate the amount of mental effort invested in the learning task using both paper-based and computer-based presentation formats. The closed-ended data were expressed as means and standard deviations. A paired t test with an alpha level of 0.05 was used to determine the overall mean difference between the two presentation formats. Students positively evaluated their experience with the computer-based instructional program with a mean score of 4.69 (SD=0.53) for use of graphics, 4.70 (SD=0.56) for instructional content, and 4.45 (SD=0.67) for the learning process. The mean difference of mental effort (1.50) between the two presentation formats was significant, t=8.26, p≤.0001, df=76, for two-tailed distribution. Consistent with cognitive load theory, innovative computer-based instructional strategies decrease extraneous cognitive load compared with traditional paper-based instructional strategies.

Researchers have claimed that successful team performance depends on shared mental models. While there are a number of techniques that have been employed to measure shared knowledge, Johnson and colleagues (2007) developed and validated an instrument for measuring team-related knowledge. This chapter focuses on the application of the Team Assessment and Diagnostic Instrument (TADI). Using the results of this five-factor model (including general task and team knowledge, general task and communication skills, attitude toward teammates and task, team dynamics and interactions, and team resources and working environment), TADI is used to assess the current state of team alignment with respect to the five team-related knowledge factors. Based on the alignment and degree of response, this measure can be used to assess the level of team synergy as well as determine misalignment in specific areas of teammates’ mental models. With this information, team members, leaders, and coaches can better anticipate team problems thereby guiding the selection of team performance interventions ultimately mitigating team problems and improving team learning and performance.

Working in teams is an important aspect of clinical practice and medical education. Medical educators have embraced instructional strategies that use multiple learners to facilitate learning. Howev...

With the increasing use of computers in the classroom and the advancement of information technology, a requirement to investigate and evaluate different strategies for the presentation of verbal information in interactive and dynamic visualizations has risen to a high level of importance. There is a need for research efforts that apply cognitive load theory (CLT), cognitive learning strategies, and established principles of multimedia design to conduct empirical research that will add to our knowledge of designing and developing dynamic visualizations for teaching and learning anatomy. The impact of improved teaching and learning of anatomical sciences and the development of a set of guiding principles to facilitate the design and development of effective dynamic visualizations represent a significant achievement for medical education with wide application. This theoretical paper presents the foundations of CLT, cognitive learning strategies, and principles of multimedia design to guide the needed research on dynamic visualizations.

This study evaluated the use of computer-based interactive imagery on students' achievement scores when compared with paper-based static imagery. It also assessed students' perceptions about the two imagery strategies and their different components. Sixty-four freshmen veterinary students (50 females, 14 males), enrolled in a comparative anatomy course, volunteered to participate in the study. This study used a pretest/posttest comparison group design and data was examined by analysis of covariance (ANCOVA). A close-ended questionnaire was administered to collect students' perceptions about the two imagery strategies. The mean difference in students' perceptions between the two strategies was analyzed using a two-tailed paired t-test. No significant differences were observed between computer-based interactive imagery and paper-based static imagery in the immediate recall of anatomical information. There was a significant difference in students' opinions toward the two strategies: students perceived computer-based interactive imagery as a better strategy in the assimilation of anatomical information than paper-based static imagery. Clin. Anat. 18:457–464, 2005. © 2005 Wiley-Liss, Inc.

In an effort to design and implement effective anatomy educational programs, this study was conducted to evaluate students' perceptions toward using two computer-based self-directed instructional modules (e.g., digestive system and canine skull) that were designed utilizing interactive imagery strategy for teaching and learning veterinary anatomy. Sixty-eight freshmen veterinary students and one graduate student participated in this study. Open-ended and close-ended questionnaires were administered to evaluate the utilization of computer-based interactive imagery strategy in developing anatomy instructional programs, and to collect data about the students' perceptions toward the use of interactive images in teaching and learning of anatomy. Means and standard deviations were calculated and analyzed for close-ended items. The open-ended questionnaire items were analyzed to identify shared patterns or themes in the students' experience after using the two instructional anatomy modules. Students reported positive attitudes toward the interactive imagery strategy used in the development of computer-based anatomy modules. Based on our findings, this study outlines the characteristics of effective instructional images that will serve as guidelines for the preparation and selection of anatomical images, as well as, how to utilize these images to develop computer-based instructional anatomy programs. Students perceived interactive imagery as an effective design strategy that helped them learn anatomical concepts. Clin. Anat. 18:68–76, 2005. © 2004 Wiley-Liss, Inc.