The objective of this proof-of-principle study was to assess whether UConn Health first year dental and medical students receiving (i) virtual anatomy instruction only, (ii) cadaveric anatomy instruction only, or (iii) combination of the two modalities (“combination cohort”) were most knowledgeable in applied surgical anatomy. The study was conducted in order to capitalize upon the strategic redesign in the basic medical science curriculum that was implemented at UConn Health in 2016, including introduction of the Anatomage® Table.
The virtual anatomy laboratory exists in conjunction with cadaveric anatomy, and consists of four Anatomage® tables. The Anatomage® Table is a life-sized, virtual, 3D representation of the human body through an interface created from image slices of a cadaver. Anatomage® serves as a hybrid between cadaveric anatomy and radiology, bridging the two learning modalities. Translation between these two disciplines has historically been a challenge for dental and medical students. Virtual anatomy instruction has the potential to successfully address this challenge and enhance anatomy education via its unique technology.
Of further note is the national debate that currently exists whether to preserve the traditional teaching paradigm of cadaveric anatomy, maintenance of which can be resource-intense. This limitation has led institutions to explore virtual anatomy instruction as an alternative educational resource . There is also evidence to suggest that virtual anatomy education, in addition to cadaveric anatomy rather than replacing it, can enhance student learning . However, current literature has not reported how virtual anatomy instruction can be utilized in this context to teach clinically relevant procedures that are integrated with teaching of first year gross anatomy.
The sample for the present study was composed of twenty-six first year medical and dental students in the Class of 2021. The assessment administered in May 2018 tested the students’ knowledge of critical anatomy in the Le Fort I and Bilateral Sagittal Split Osteotomy procedures. The predictor variable was the instruction modality (cadaveric, virtual, or combination). Outcome variables included individual multiple-choice assessment scores, overall assessment score of each group, and scores by individuals from each group for specific assessment questions. Descriptive statistics and an Analysis of Variance Test were computed, with p<0.05 significance level.
Students who viewed content from both cadaveric and virtual modalities (“combination cohort”) exhibited a modest improvement in assessment scores versus the other two cohorts. Mean assessment scores for the cadaver, virtual, and “combination cohort” groups were 50.3%, 52.5%, and 58.2% respectively. Across all groups, 372 total questions were answered correctly, for which the cadaver, virtual, and “combination cohort” groups correctly answered 32.5%, 29.8%, 37.6% respectively. For the 11 (41%) of 27 assessment questions/per student, the “combination cohort” scored higher than either the cadaver or virtual cohorts. No statistically significant differences existed among the groups.
This study suggests that virtual anatomy technology, in conjunction with traditional cadaveric anatomy, may improve students’ knowledge of orthognathic surgery. The major limitation of this study was sample size, which likely produced the lack of statistical significance. Given the encouraging trends, we are currently developing Phase II of this project for implementation with the Class of 2022, directed to (i) expanding sample size to more comprehensively reflect the students’ educational experience, (ii) introducing a cadaveric practical examination, and (iii) refining the survey questionnaire based upon metrics from the current survey.
Estai, Mohamed, and Stuart Bunt. “Best Teaching Practices in Anatomy Education: A Critical Review.” Annals of Anatomy - Anatomischer Anzeiger, vol. 208, 2016, pp. 151–157., doi:10.1016/j.aanat.2016.02.010.
Paech, Daniel, et al. “Cadaver-Specific CT Scans Visualized at the Dissection Table Combined with Virtual Dissection Tables Improve Learning Performance in General Gross Anatomy.” European Radiology, vol. 27, no. 5, 2016, pp. 2153–2160., doi:10.1007/s00330-016-4554-5.
Cadaveric Instructional Video Screenshots
Virtual Instruction Video Screenshot