A Unique Student Cohort’s Perceptions and Preferences about Gross Anatomy Education in the Medical Curriculum: JABSOM Student Survey 2020

Liang, Collin
Takakusagi, Melia
Matsunaga, Masako
Lozanoff, Scott
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Introduction: The SARS-CoV-2 (COVID) pandemic made it necessary for medical schools to integrate online learning into the delivery of curriculum involving cadaveric-based gross anatomy instruction and dissection, which may benefit post-COVID instruction. Objectives: The purpose of this study was to assess the perceptions of a unique student cohort arising from the COVID pandemic with respect to gross anatomy instruction. The hypothesis tested was that the medical student class of 2023’s perceptions concerning the delivery of gross anatomy education, as well as its educational significance, would differ between students that elected to dissect (D) compared with those who did not (N). Methods: A survey was conducted at the conclusion of the 2020 medical gross anatomy course at JABSOM, and 79 medical students responded to questions about the usefulness of anatomy, preference of lectures (slide decks without lectures, in-person lectures, live online lectures, and pre-recorded lectures) and dissection laboratories (no lab, live online labs, class in-person labs, and hybrid labs). The preference levels were assessed by Likert scale (highest, high, low, lowest), from which binary scale results (high or low) were also analyzed. Fisher’s exact tests were used to examine differences in survey responses between D (n=40) and N students (n=39). Open-ended questions were used to probe these perceptions. Results: D students rated gross anatomy’s usefulness more positively than N students (overall 87%; D 100%, N 74%, p<.001). More N students considered that anatomy dissection should be elective (overall 68%; D 38%, N 100%, p<.001). Overall, the students’ preference levels were high for live online lectures and pre-recorded lectures, and low for slide decks without lectures and in-person lectures. Pre-recorded lecture was rated the most valued, notably by D students (overall 80%; D 90%, N 68%, p=0.03), while slide decks without lecture was rated the lowest lecture-based modality (overall 80%; D 90%, N 68%, p=0.03). More than 90% of responses to open questions about the usefulness of pre-recorded lectures were positive. Hybrid lab was the most preferred laboratory type (high preference levels: overall 82%; D 72%, N 79%, p=0.02). No lab was least preferred and more disfavored by D students (overall 79%; D 90%, N 67%, p=0.01). Through open questions, most D students responded positively (95%) and had no regrets dissecting (86%). Discussion: Most students found dissection to be a useful educational activity. The benefits for students who elected to dissect included more opportunities to ask questions to instructors, better visibility of structures, and flexibility with dissection time. Students who did not elect to dissect felt safe during a pandemic, spent more time with loved ones, and had less financial burden commuting to school. The results show a strong contrast in that in-person lectures and slide decks without lectures were not preferred compared to live online lectures and pre-recorded lectures. Students expressed that watching lectures at their convenience benefited anatomy comprehension since more time was available to prepare rather than pursuing dissection immediately after a lecture traditionally. Among the methods for laboratory instruction experienced, the only significant preference was that no lab was the least preferred by the overall class. Although D was more extreme in opinion, N showed a similar trend with a large majority opting against no lab. A small minority of N did express regret not being to dissect during the unit, whether for academic or camaraderie-building benefit. Future work will be directed at assessing student perceptions concerning use of online technology as supplemental instruction for gross anatomy.
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