Periosteum: Functional Anatomy and Clinical Application

@#Periosteum is a connective tissue that envelopes the outer surface of bones and is tightly bound to the underlying bone by Sharpey’s fibers. It is composed of two layers, the outer fibrous layer and the inner cambium layer. The periosteum is densely vascularised and contains an osteoprogenitor niche that serves as a repository for bone-forming cells, which makes it an essential bone-regenerating tissue and has immensely contributed to fracture healing. Due to the high vascularity of inner cambium layer of the periosteum, periosteal transplantation has been widely used in the management of bone defects and fracture by orthopedic surgeons. Nevertheless, the use of periosteal graft in the management of bone defect is limited due to its contracted nature after being harvested. This review summarizes the current state of knowledge about the structure of periosteum, and how periosteal transplantation have been used in clinical practices, with special reference on its expansion.

The Benefits and Challenges of Clinical Work-based Surface Anatomy Learning Among Preclinical Medical Students

@#Knowledge on surface anatomy enables medical students and graduates to locate anatomical structures exteriorly, improve their clinical and procedural skills and interpret ultrasonographic and radiographic images. Hence, a standard surface anatomy knowledge is essential for attainment of clinical skill competency. Nevertheless, there is lack of attention given on surface anatomy in the medical curriculum as it is usually delivered didactically or during selfstudy by the students. Owing to limitations in cadaveric dissection in many institutions, lecture-based instruction, e-learning materials, living anatomy models, radiological imaging and anatomy software are used in teaching surface anatomy; however, none of these methods proved to be effective over the others. Furthermore, some of these teaching resources lack clinical relevancy, possibly impeding students’ appreciation on learning surface anatomy. Hence, integrating clinical input during surface anatomy teaching by involving patients in an actual clinical environment is pertinent. This article demonstrates the benefits and challenges of teaching surface anatomy in the clinical setting to medical students and highlights the need to design an evidence-based framework of work-based surface anatomy learning.

Exploring the Potential Use of Supplementary E-learning Tools for Integrated Anatomy-Radiology Teaching

@#The evolution of anatomy education yields a variety of instructional strategies to enhance students’ comprehension of gross anatomy. Apart from these multi-modality approaches, various studies suggest that anatomy instruction is more effective when it is taught with radiological integration during the early phase of the medical curriculum. Studies have shown that the introduction of basic radiological knowledge in anatomy learning enhances visuospatial skills, which are important for safe clinical practice. Nevertheless, considerable variation in the radiological anatomy teaching exists in terms of delivery methods, radiological materials, and teaching time. One way to address these limitations is by using integrated radiology anatomy e-learning platforms. Recent advancements in technology have given rise to immense attention to e-learning platforms, which have been considered to be an effective modality in optimising the student learning process. Hence, this article explores the potential use of e-learning tools, namely integrated with radiological imaging, in teaching gross anatomy.

Medical Students’ Perception of Anatomy Education Environment in Universiti Putra Malaysia

@#Introduction: Measuring students’ perception of anatomy education environment provides important information for quality assurance and improvement in anatomy education. This study evaluated medical students’ perception of anatomy education environment in Universiti Putra Malaysia by using a validated tool, the Anatomy Education Environment Measurement Inventory (AEEMI). Methods: A cross-sectional study was conducted in the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia between August and September 2020. Stratified random sampling was used to ensure balance sampling of two sociodemographic parameters: gender and study phase. The AEEMI was distributed online to 384 consenting students who rate their perceptions on the six factors of AEEMI: anatomy teachers and instructor, importance of anatomy knowledge, intrinsic interest in learning anatomy, anatomy learning resources, students’ effort to learn anatomy and quality of histology learning facilities, using a five-point Likert scale. The average score of each factor was calculated and compared between male and female respondents, and between preclinical and clinical ones, using SPSS version 25. Results: All factors was rated to be positive with scores > 4.00, except for histology practical facilities that was perceived as an area for improvement (score 3 – 4.99). There was no significant difference of the scores between male and female respondents, and between preclinical and clinical ones. The scores were found to be consistent across gender and study phase. Conclusion: Anatomy education environment in UPM are positive and caters for the differences in gender and study phase. Nevertheless, the histology practical facilities may require further attention for improvement.

The Outcomes of Team-based Learning on Test Performance, Cognitive Engagement and Motivation in Preclinical Anatomy Practical Classes

@#Introduction: Designing an engaging teaching strategy that enhances the clinical application of anatomy knowledge is important for effective learning. Hence, this study was carried out to evaluate the outcomes of team-based learning (TBL) approach on students’ learning during gross anatomy practical classes. Method: A randomised-controlled trial was conducted on 215 pre-clinical year medical students, who were divided into TBL and control groups. Both groups attended the same anatomy lecture before the practical session. The TBL group underwent three phases of activities, which were pre-practical assignment (Phase-1), individual and team readiness assurance tests followed by a debriefing session (Phase-2), and group application task (Phase-3). Concurrently, the control group received a reading material as their pre-practical assignment and attended a practical session in the form of an anatomy model demonstration. Pre- and post-practical assessments were measured 30 minutes before and after the practical sessions. The students’ cognitive engagement and motivation were also measured after the practical sessions. Results: The TBL group among the Year-1 students outperformed the control group in all the test performance measures. The TBL group of the Year-1 students was also found to have greater improvement of test scores compared to their control counterparts. The TBL group was found to have significantly higher cognitive engagement scores only among the Year-2 students. However, the internal motivation scores were not significant in both cohorts. Conclusion: These results indicate that the TBL session contributes positive outcomes to students’ learning in anatomy context.