Medical school faculty around the world showed creativity and innovation in their response to the shift to remote instruction brought on by the COVID-19 pandemic.
While digital tools helped transition many aspects of medical curriculum for virtual learning, there are some that are innately harder to teach virtually – one of them being anatomy. Faculty in anatomy were tasked with replicating hands-on dissection labs in a remote, online environment where students couldn’t explore cadavers on their own.
In this first installment of the Wolters Kluwer Expert Insights Webinar Series, moderator Vikram Savkar, Vice President and General Manager, Medicine Markets of Health Learning, Research & Practice at Wolters Kluwer, was joined by Dr. Wojciech Pawlina, Professor of Anatomy and Medical Education, Department of Clinical Anatomy, Mayo Clinic, Rochester MN and Editor-in-Chief of Anatomical Sciences Education, who shared how the Mayo Clinic transitioned its anatomy curriculum to hybrid remote instruction during the pandemic and how this is shaping the program’s future.
Three changes that made remote anatomy instruction successful
1. Live-streamed gross anatomy labs
While students and faculty could not be together in the anatomy lab, Dr. Pawlina and his colleagues wanted students to have at least some of the hands-on experience that they would typically get in the gross anatomy labs. The team transformed the anatomy lab into a studio for staging a live dissection feed. A faculty member would present prosection material directly from the lab on a live feed so that students could ask questions in real time, such as to show part of the cadaver again or to show it from a different angle. The dissections were recorded, and students indicated that they liked the opportunity to review the labs again on their own time. Students were also given the opportunity to attend optional lab rotations in groups of three to look at the prospected specimen and ask questions to faculty and teaching assistants.
2. Mix of synchronous and asynchronous learning
For the Mayo Clinic, the remote instruction model still needed to support active learning to align with an authentic, patient-centered care environment. Dr. Pawlina and his colleagues focused on including synchronous team-based learning in the remote curriculum. They set up daily interactive sessions on key anatomical concepts of clinical relevance that were presented through video and recorded. In these sessions, the faculty emphasized the concepts first and necessary details, then directed students to additional resources for self-directed, asynchronous learning. Students also attended daily audience response system (ARS) feedback sessions that provided an opportunity for active learning and developing clinical reasoning through reflection exercises in which the faculty would ask students questions and they would respond using their smartphones. The answers were then shown to the class and their scores and class averages were provided at the end of each session, so students had continuous feedback on their performance.
3. Emphasis on developing non-technical skills
When designing the remote anatomy curriculum, Dr. Pawlina and his colleagues wanted to maintain the development of non-traditional discipline-independent skills (NTDIS), or non-technical skills, including teamwork, professionalism and communication. Students completed an online module that introduced the concepts of NTDIS and explained the importance of non-technical skills for clinical practice. They also created smaller student groups to work on teamwork and communication skills. To assess students’ critical thinking and teamwork skills, Mayo Clinic implemented peer-assessments evaluating students on leadership and management, teamwork and cooperation, problem solving and decision making, and situational awareness. Students also wrote personal reflections and completed self-evaluations.
Insights for the future of anatomy instruction
One of Dr. Pawlina’s key takeaways from the remote anatomy instruction program was that students were asking more questions during the remote sessions compared to in-person lectures prior to the pandemic. He noted that students were asking questions more frequently throughout the semester during the question and answer sessions with faculty and in chat rooms. Finding these new ways to communicate with students was important to ensure that those who needed more help and guidance could get it. Another takeaway was students’ preference for the mix of synchronous and asynchronous learning with the interactive, team-based sessions and the access to recorded lectures and additional resources for studying on their own.
The need to quickly adapt to remote instruction at the beginning of the pandemic demonstrated the value of technology as a component of anatomy curriculum. For the future of anatomy education, Dr. Pawlina predicts that the new normal will be a hybrid of online and in-person learning with lectures that can be converted for either synchronous or asynchronous learning. He also foresees cadaver-based dissection returning but that it could shift to more advanced medical training as elective courses or as courses in residency programs.