The Objective Structural Practical Examination (OSPE) is a timed examination that assesses topographical and/or applied knowledge of anatomy with the use of cadaveric resources and medical images. This study investigated whether elements of question design (provision of clinical context, type of visual resources used, gender context and difficulty) of an anatomy question affected students' performance and also whether there was any effect of basic demography or participation in various voluntary activities.Study participants were second year medical students (n = 150), 83 of whom consented to fill in a questionnaire collecting demographics, revision preferences and assessment preferences. The examination scores were matched with students' responses collected on the questionnaire and all data analyzed by multiple linear regression. Difficulty of the question was the only design element found to be significantly associated with the number of students that answered correctly (p=. 001); clinical context, visual resources used and gender of the question were not significant. When individual students marks were analyzed along with the questionnaire data, only the students' interest in participating in department's demonstrator program was a significant predictor of a high individual score, gender of the students showed a strong trend towards significance, with female students scoring on average higher than male students. The two part OSPE questions were dissociated and analyzed using binary logistic regression to determine whether a correct answer to part 1 was predictive of a correct answer to part 2, but no association was found.3

Anatomical examinations have been designed to assess topographical and/or applied knowledge of anatomy with or without the inclusion of visual resources such as cadaveric specimens or images, radiological images, and/or clinical photographs. Multimedia learning theories have advanced the understanding of how words and images are processed during learning. However, the evidence of the impact of including anatomical and radiological images within written assessments is sparse. This study investigates the impact of including images within clinically oriented single-best-answer questions on students' scores in a tailored online tool. Second-year medical students (n = 174) from six schools in the United Kingdom participated voluntarily in the examination, and 55 students provided free-text comments which were thematically analyzed. All questions were categorized as to whether their stimulus format was purely textual or included an associated image. The type (anatomical and radiological image) and deep structure of images (question referring to a bone or soft tissue on the image) were taken into consideration. Students scored significantly better on questions with images compared to questions without images (P < 0.001), and on questions referring to bones than to soft tissue (P < 0.001), but no difference was found in their performance on anatomical and radiological image questions. The coding highlighted areas of "test applicability" and "challenges faced by the students." In conclusion, images are critical in medical practice for investigating a patient's anatomy, and this study sets out a way to understand the effects of images on students' performance and their views in commonly employed written assessments. Anat Sci Educ 14: 342-351.

BackgroundAt a time of global interconnectedness, internationalization of medical education (IoME) has become an important part of medical education. Internationalization in higher education is "the intentional process of integrating an international, intercultural, or global dimension into the purpose, functions, and delivery of post-secondary education, in order

Introduction Student outbound mobility is a major element in internationalization of medical education and global health education. However, this approach is often criticized, as it is inherently inequitable. Internationalization at home is a newer concept that aims to provide students with international skills and experiences without exchange travel. We report detailed outcomes of an international online program during the COVID-19 pandemic, which aimed to include acquisition of cultural awareness and competency—similar to what the students would have obtained if they had travelled abroad. Method Sixty-eight students from 12 international universities participated in international small peer group collaborative work, and online networking. Perceived improvement of cultural competency using Likert scale and open-ended questions was used as a measure of success. Furthermore, students’ definition of cultural competency in the different countries was obtained. Results Students improved their cultural competency skills. Data analysis supported statistically significant improvement of the above skills after the program, in comparison to the start of the program. Discussion Internationalization of medical education can be achieved at home —via structured online peer exchanges—and can provide students with intercultural skills and networking opportunities that are typically achieved via international in-person travel. The above represents a socially just and equitable way to reach all students and can result in improvement of their cultural competency, preparing them for their work in global health, and thereby resulting in improvement of global health. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-021-01332-9.

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The caudate lobe of the liver has portal blood supply and hepatic vein drainage independent of the remainder of the liver and may be differentially affected in liver pathologies. Ultrasonographic measurement of the caudate lobe can be used to generate hepatic indices that may indicate cirrhosis. This study investigated the relationship of metrics of the caudate lobe and other morphological features of human livers from a northwest Indian Punjabi population (n = 50) and a UK Caucasian population (n = 25), which may affect the calculation of hepatic indices. The width of the right lobe of the liver was significantly smaller, while the anteroposterior diameter of the caudate lobe and both Harbin’s Index and the Hess Index scores were significantly larger in NWI livers than in UKC livers. The Hess Index score, in particular, is much larger in the NWI population (265 %, p < 0.005). Two caudate lobe features were significantly different between the two populations—the shape of the caudate lobe and the development of the caudate process. This study shows significant population differences exist in several metrics and morphological features of the liver. These differences may affect the calculation of hepatic indices, resulting in a greater percentage of false positives of cirrhosis in the NWI population. Population-specific data are required to correctly determine normal ranges.

Background During the COVID-19 pandemic, in-person cadaveric dissection laboratories for teaching anatomy were omitted by many schools around the world. While knowledge domains can be easily evaluated via remote exams, non-traditional discipline-independent skills such as those encouraged through reflection on the topic of death are often overlooked. This study investigated how different anatomy course formats played a role in initiating students’ reflections on death during the COVID-19 pandemic. Method In fall 2020, 217 medical, dental, premedical, and health sciences students from 13 international universities discussed differences in their anatomy courses online. Formats of anatomy courses ranged from dissection-based, prosection-based, hybrid (combination of dissection and prosection) to no laboratory exposure at all. Students’ responses to the question, “Did/does your anatomy course initiate your thinking about life's passing?” were collected, and they self-reported themes that were present in their reflections on death using a multiple-choice prompt. Statistical analyses to detect differences between students with and without exposure to cadavers were performed using the chi-squared test. Results When comparing students who had exposure to human anatomical specimens to those who had no exposure, the majority of students with exposure thought that the course did initiate thoughts about life’s passing, compared to students without exposure ( P < 0.05). Reflection themes were consistent across groups. Discussion These findings indicate that anatomy dissection courses are important for the initiation of students’ feelings about the topic of death. Omission of cadaveric dissection- or prosection-based laboratories will decrease the likelihood that students initiate reflection on this topic and gain important transferable skills.

Historically, Anatomy education is an in‐person discipline involving exposure to human body donors that facilitates personal and professional growth through, in part, the initiation of reflection on the topic of death. However, during the COVID‐19 pandemic the decreased exposure to cadaveric anatomy for many health professions students may have influenced the depth of their individual reflections on this topic. Accordingly, this study aimed to investigate the effect of an alternate approach—focus group discussions between peers with varying degrees of exposure to cadaveric material—that may offer one strategy to stimulate deep reflection on the topic of death. A programmatic intervention was introduced, wherein students (n = 221) from 13 international universities discussed differences in their anatomy courses during small focus group sessions as part of an online exchange program. An inductive semantic thematic analysis was conducted on responses to an open‐ended text–response question on how the activity influenced students' reflections about death. Resulting themes were organized into categories that described the content and topics of the students' discussions as they grappled with this sensitive topic. The students reportedly engaged in deep reflection and expressed an increased sense of connectedness with their peers, despite their disparate exposure levels to cadaveric anatomy and being physically distanced. This demonstrates that focus groups with students experiencing different laboratory contexts can be used to help all students reflect on the topic of death and that interchanges between dissecting and non‐dissecting students can initiate thoughts about death and body donation among non‐dissecting students.