Of mice (dogs, horses, sheep) and men: A novel comparative anatomy dissection course in a United Kingdom university.

At the University of Bristol, we established a novel dissection course to complement our anatomy degree. Students enrolled in this undergraduate course are trained as comparative anatomists, with equal time given to both human and veterinary anatomy. Historically, students opted to dissect either human or veterinary donors as part of the course. To fully reflect the comparative nature of the degree, the dissection course was redesigned so students could dissect both human and veterinary specimens as part of the same course. This facilitated a wide-ranging experience of anatomy, encouraging detailed knowledge of a multitude of species and allowing for multifaceted anatomy graduates to be ready for employment in a wide and competitive job market. Across three iterations of the amended version of the course, median marks ranged from 58.7% to 62.0%, with between 22 and 39 students enrolled. In comparison to the course prior to the introduction of the change, median marks ranged from 59.8% to 62.8%, with between 16 and 24 students enrolled. There was no significant difference between marks before or after the introduction of the concurrently comparative aspect. This paper describes the course, with learning materials and assessments considered, along with some reflection on its value. The course offers benefits to students by widening their perspective on anatomical knowledge and making them more equipped for the job market. It also broadens their understanding of form-function relationships. However, student feedback implied that having the choice between human or veterinary dissection was preferable, and this may outweigh the perceived benefits of the course.

Collaborative, Two-Directional Live Streaming to Deliver Hands-on Dissection Experience during the COVID-19 Lockdown.

Cadaveric dissection is widely used in anatomy teaching worldwide. This method develops anatomical knowledge and practical dissection skills, as well as communication and team working. At the School of Anatomy, University of Bristol, two of our undergraduate units depend on dissection as a teaching tool.Social distancing guidelines brought about by COVID-19 brought challenges and meant it was not possible for all students to be present around a cadaver simultaneously. We adapted with secure, two-way live streaming, facilitated by ceiling-mounted cameras.Our units utilised the technology in slightly different ways. In a larger cohort, students were not able to attend the dissection room simultaneously and 2-4 students from each group attended, with the remainder (6-8 students) attending via Zoom. In the smaller cohort, all students attended, though only two students could be present around the cadaver, with Zoom used to stream the dissection to those distanced around the room. Those present narrated and ensured visibility of the dissection, whilst posing questions to those at home. The home group provided feedback, generated discussion, and conducted research.This chapter reflects on our experiences using this innovative teaching method. It was a valuable alternative to being in person. Whilst students might have spent less time in the dissection room, their dissection time equalled or was greater than pre-pandemic. Students developed digital confidence and built cohorts, and whilst we reflect on the need for effective communication and digital equity, we offer our best practice and solutions.Whilst in-person teaching has resumed in 2021-2022, investment in this technology enables us to rapidly pivot to a reduced in-person, or an entirely online delivery where required, and we are confident that our delivery will be effective in either case. There are also exciting opportunities for new forms of delivery as well as national and international collaborations.

Exploration of colonic looping patterns in undisturbed cadaveric specimens.

INTRODUCTION: This study examines sex differences in the disposition of the sigmoid and transverse segments of the colon in undisturbed cadaveric abdomens and relates these findings to the anecdotal observation that colonoscopy is more challenging in females through the formation of tortuous bowel loops. MATERIALS AND METHODS: One hundred and twenty two undisturbed cadaveric abdomens were inspected. Three distinct configuration grades were separately assigned to the sigmoid and transverse segments of the colon on the basis of the pattern of the bowel loops observed in situ. Pearson's chi-squared test was used to analyze sex differences in bowel loop configuration and Spearman's rank correlation coefficient was calculated to identify co-occurrence of configuration grades in the subjects. RESULTS: For the transverse segment, females had higher configuration grades corresponding to longer bowel loops with greater redundancy, compared to males (p = .000047). There was no sex difference in the sigmoid segment grade (p = .21636). Sigmoid and transverse segment grades were highly correlated in the subjects (coefficient = 0.9994). CONCLUSION: Sex differences in the configuration grades of the sigmoid or transverse colonic segments may be a significant contributing factor to increased difficulty of colonoscopy in females.

Implementing ultrasound sessions to highlight living anatomy for large medical student cohorts.

Background: There is an intrinsic link between radiology and anatomy and the importance of being able to convert knowledge from 3D structure to 2D image, and vice versa. Medical students must learn how to use anatomical knowledge to interpret radiological images, and with the increasing use of point-of-care ultrasound in clinical practice, the ability to interpret ultrasound scans is becoming more of a core skill for graduating doctors. Rationale: Several recent systematic reviews of the literature have been undertaken showing the benefits of incorporating ultrasound in anatomy teaching, including appreciation of the dynamic nature of living anatomy, better understanding of anatomical structure, and improved motivation to study. However, there is a lack of consensus in the way ultrasound teaching should be incorporated into undergraduate medical anatomy. Approach: This article reflects on a pilot of integrating ultrasound into the medical undergraduate anatomy teaching in the School of Anatomy at the University of Bristol. It shares the experience and how some of the challenges cited in the literature have been approached. Recommendation: To help others negotiate the challenges of implementing this valuable teaching experience, a 'Six Step Model' for developing a live ultrasound pilot for undergraduate medical anatomy is offered: Expertise, Education, Ethics, Environment, Equipment, Enlist.

Evidence for plical support of the patella.

There is a consensus that there is no overt anterior joint capsule in the knee. However, other anterior structures act in lieu of a joint capsule: the quadriceps tendon and patellar retinacular fibres. In the absence of a capsule, the synovium forms the suprapatellar pouch. Other synovial structures, the plicae, are more controversial. They are often described as embryonic remnants with no function, despite surrounding the patella. We aimed to identify plical anatomy and histology on cadaveric dissection and to examine their embryology using the human virtual embryo website. Plicae were identified by two independent observers. Plical histology was examined using a panel of stains: H&E, Ab H&E, EVG and MSB trichrome. Embryonic knees were examined from Carnegie stages 20-23. Each knee had a suprapatellar plica and mediopatellar plica (MPP). The lateropatellar plica (LPP) appeared as a band in 5/10 cadavers, and as a ridge in the remainder. The overall impression, consistent across all specimens, was that the plicae formed a continuous band of synovial tissue around the proximal three-quarters of the patella. The infrapatellar fat pad (IFP) surrounded the remainder. Histologically, the plicae and IFP consisted of three layers (in order): a synovial layer, an undulated collagenous layer, and an adipose or areoloadipose layer. The subsynovial collagenisation is normally associated with the synovio-capsular boundary. Embryologically, plicae were not seen in either knee at any level for any given Carnegie stage. We suggest that plicae, along with the dynamic IFP, provide internal support to the patella mirroring the external support of retinacular fibres. Thus, the plicae complete the tissue complex acting in lieu of an anterior joint capsule. Evidence of plical functionality lends credence to the theory that the plicae are anatomical structures not functionless embryonic remnants.

Student attitudes toward cadaveric dissection at a UK medical school.

A more humanistic approach toward dissection has emerged. However, student attitudes toward this approach are unknown and the influences on such attitudes are little understood. One hundred and fifty-six first-year medical students participated in a study examining firstly, attitudes toward the process of dissection and the personhood of the cadaver and secondly, the extent to which gender, anxiety, exposure to dissection, bereavement and prior experience of a dead body influenced these attitudes. Attitudes toward dissection were assessed by of levels of agreement toward eleven statements and by selection of adjectives describing possible feelings toward dissection. Students were asked about recent bereavement, whether they had seen a dead body prior to starting their course and exposure to dissection when completing the questionnaire. Validated instruments were used to measure disposition toward generalized anxiety (Hospital Anxiety and Depression Scale) and toward death anxiety (Collett-Lester Death Anxiety Scale). Between 60% and 94% of students held positive attitudes toward the process of dissection and over 70% of students selected 2 or fewer negative adjectives. Students' attitudes toward the personhood of the cadaver were more disparate. Disposition toward anxiety (particularly death anxiety), and exposure to dissection, influenced attitudes. Female gender and recent bereavement exerted a negative influence. Students with higher levels of anxiety experienced more negative feelings and those recently bereaved were less enthusiastic about dissection. Anticipation of dissection may be worse than reality. Sensitive preparation of students prior to entering the dissecting room for the first time may be beneficial.