Teaching gross anatomy during the Covid-19 pandemic: Effects on medical students' gain of knowledge, confidence levels and pandemic-related concerns

Abstract

For medical students the dissection course is the preferred method to learn gross anatomy. However, the added value of active cadaver dissection on knowledge gain in multimodal curricula offering a diversity of e-learning resources is unknown. The Covid-19-related lockdown forced educators to replace the dissection course by e-learning resources. At the end of the summer term 2020 loosening of pandemic-related regulations allowed offering a compact, voluntary active dissection course of the head-neck region to first-year medical students at Hannover Medical School. A study was conducted comparing a dissection group (G1, n = 115) and a non-dissection group (G2, n = 23). Knowledge gain and confidence level were measured with a multiple-choice (MC-)test. The use of e-learning resources was recorded. A questionnaire measured motivation, interest and level of concern regarding Covid-19 and anatomy teaching. No differences between groups were found regarding motivation and interest in anatomy of the head-neck region. G2, however, had significantly higher concerns regarding the Covid-19 pandemic than G1. Neither before nor after the educational intervention, differences in the scores of the MC-test were found. However, after the course G1 answered more MC-questions with highest confidence level than G2 (6.7 ± 6.0 vs. 3.6 ± 4.6, p < 0.05) and demonstrated by trend an increased improvement in the scores of image-based questions (30.8 ± 18.2 % vs. 17.1 ± 14.8 %, p = 0.06). In general, frequent users of online quizzes, a part of the e-learning resources, scored significantly better in the knowledge test. Active dissection improves self-assurance to identify anatomical structures and should be re-implemented in multimodal, blended-learning-based anatomical curricula in the post-pandemic era.

Keywords: Active cadaver dissection; Confidence level; Covid-19; Head-neck region; Learning outcome.

Fig. 1

Study design and participants. All first-year medical students were allowed to participate in the surveys. The survey at time point 1 (T1) was conducted before the voluntary dissection course (baseline), whereas the survey at time point 2 (T2) was conducted afterwards. The surveys included two parts: First a self-assessment and second an anatomical knowledge test. Participants were only included in the analyses if they at least finished the self-assessment part. For analysis of the second part only data of completely finished knowledge tests were included.

Fig. 2

Representative examples of text-based and image-based multiple-choice questions. Correct answers are marked with a blue dot.

Fig. 3

Use of teaching material. Percentage rates of dissection course (G1) and non-dissection course group (G2) regarding the use of online teaching material. Upload frequency of teaching material is indicated in brackets. w = week.

Fig. 4

Confidence levels of correct and incorrect answers at time point 1 (T1: upper row) and time point 2 (T2: lower row) for the dissection course (G1) and non-dissection course group (G2). The survey at T1 was conducted before the voluntary dissection course, whereas the survey at T2 was conducted afterwards. Confidence level ranged from 1 = 0 % to 6 = 100 %.**p < 0.01 between G1 and G2. Statistical analysis was performed by a two-way ANOVA.

Fig. 5

Covid-19 pandemic-related self-assessment before dissection course (T1). Same significance levels for every item at T2 (detailed results not shown in this figure). Items: a)I would rather stay at home due to the Covid-19 pandemic, even if hygiene standards were fulfilled during active participation. b)I am worried about getting infected with SARS-CoV2 during the dissection course. c)I could not focus on the dissection course due to concerns about Covid-19. d)I am worried about infecting others (e.g., relatives) with SARS-CoV2. e)I am worried that my studies will be negatively affected by the Covid-19 pandemic. The survey at time point 1 (T1) was conducted before the voluntary dissection course (baseline), whereas the survey at time point 2 (T2) was conducted afterwards. Likert scale range from 1 = strongly disagree to 6 = strongly agree.*p < 0.05 or * *p < 0.01 between G1 and G2. Statistical analyses were performed by Student’s t-test or Mann-Whitney Rank Sum test.