Confronting the Challenges of Anatomy Education in a Competency-Based Medical Curriculum During Normal and Unprecedented Times (COVID-19 Pandemic): Pedagogical Framework Development and Implementation

Abstract

Background Anatomy is considered to be one of the keystones of undergraduate medical education. However, recently, there has been drastic reduction, both in gross anatomy teaching hours and its context. Additionally, a decrease in the number of trained anatomists and an increase in the costs associated with procuring human cadavers have been noted, causing a diminution of cadaveric dissections in anatomy education. Objective To address these challenges, there is an ardent need for a pedagogical framework such that anatomy education can be disseminated through active learning principles, within a fixed time frame, using a small team of anatomists and a small number of cadaveric specimens (for live on-site sessions) as well as collaborative learning principles. The latter is particularly important when anatomy education is delivered through distance learning, as is the case currently during the COVID-19 pandemic. Methods Here, we have blueprinted a pedagogical framework blending the instructional design models of Gagne’s 9 events of instruction with Peyton’s 4-step approach. The framework’s applicability was validated through the delivery of anatomical concepts, using an exemplar from the structure-function course Head and Neck during the normal and COVID-19–mandated lockdown periods, employing the archetype of Frey syndrome. Preliminary evaluation of the framework was pursued using student feedback and end-of-course feedback responses. The efficiency of the framework in knowledge transfer was also appraised. Results The blueprinted instructional plan designed to implement the pedagogical framework was successfully executed in the dissemination of anatomy education, employing a limited number of cadaveric specimens (during normal times) and a social media application (SMA)–integrated “interactome” strategy (during the COVID-19 lockdown). Students’ response to the framework was positive. However, reluctance was expressed by a majority of the faculty in adopting the framework for anatomy education. To address this aspect, a strategy has been designed using Mento’s 12-step change management model. The long-term benefits for any medical school to adopt the blended pedagogical framework have also been explicated by applying Bourdieu’s Theory of Practice. Additionally, through the design of an SMA interactome model, the framework’s applicability to the delivery of anatomy education and content during the ongoing COVID-19 pandemic was realized. Conclusions In conclusion, the study effectively tackles some of the contemporary key challenges associated with the delivery of anatomy content in medical education during normal and unprecedented times.

An Analysis of Anatomy Education Before and During Covid‐19: May–August 2020

“…Overall, there was a significant transition from in‐person lecture delivery to not in‐person lecture delivery during Covid‐19. These results align with the findings published by Alkhowailed et al (2020), Cuschieri and Calleja (2020), Ferrel and Ryan (2020), Herr and Nelson (2020), Longhurst et al (2020), Naidoo et al (2020), and Pather et al (2020). Collectively, these changes reflect the national (Mervosh et al, 2020; NASHP, 2020) and international (Schramm and Melin, 2020) stay‐at‐home and physical distancing requirements, where large cohorts of learners physically present in a classroom, lecture hall, and/or laboratory setting would not be permitted.…”

“…Regardless of plans for laboratory experiences during Covid-19, there was a significant decrease in the use of cadavers and a significant increase in "other" teaching modalities across programs, anatomy courses, and institutions, likely due to stay-at-home orders. Decreased cadaver use during laboratory sessions corroborates earlier reports that demonstrated a decrease of in-person, cadaver-based instruction (Cuschieri and Calleja, 2020;Herr and Nelson, 2020;Longhurst et al, 2020;Naidoo et al, 2020;Pather et al, 2020).…”

“…Since March 2020, a small number of articles from both the national and international community have reported experiences and future opportunities for gross anatomy education due to Covid‐19 (Brassett et al, 2020; Cuschieri and Calleja, 2020; Herr and Nelson, 2020; Longhurst et al, 2020; Naidoo et al, 2020; Pather et al, 2020) as well as guidelines and information related to cadavers and Covid‐19 for body donation programs (Kramer et al, 2020). These articles provided informative examples, although they did not provide inferential statistics (Brassett et al, 2020; Longhurst et al, 2020; Pather et al, 2020; Naidoo et al, 2020) and were limited in their representation, with only 14 institutions from the United Kingdom and Republic of Ireland reported by Longhurst et al (2020), 10 institutions from Ireland, Scotland, England, and Germany described by Brassett et al (2020), 10 institutions from Australia and New Zealand reported by Pather et al (2020), and 1 institution from Malta, the United States, and the United Arab Emirates, characterized by Cuschieri and Calleja (2020), Herr and Nelson (2020), and Naidoo et al (2020), respectively. This literature demonstrates the global impact of the pandemic.…”

“…The authors reported that students scored higher on the practical examination than previous cohorts of dental students, but lower on the written examination (Herr and Nelson, 2020). Naidoo et al (2020) outlined how blended learning in anatomy education for medical students was transitioned to a fully distance format using video conferencing software, social media, and pre‐recorded lectures. While these are worthwhile suggestions that should be considered, they only provide program‐specific examples that might not provide a global representation of how anatomy educators are responding to the Covid‐19 pandemic.…”

Asynchronous Distance Learning of the National Institutes of Health Stroke Scale During the COVID-19 Pandemic (E-Learning vs Video): Randomized Controlled Trial

“…The swift strengthening of public health policies in the context of the COVID-19 crisis has wrought deep changes in the regular medical education curricula of many countries [ 1 - 4 ] while also increasing the need for health care professionals, including physicians. Senior medical students are being incrementally used on the front lines to address the shortage of these professionals [ 5 , 6 ], and other students may soon be required to follow suit [ 7 ].…”