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 Table of Contents  
EDITORIAL
Year : 2021  |  Volume : 10  |  Issue : 3  |  Page : 109-111

Anatomy education amid the second wave of COVID-19 pandemic: Challenges and solutions for instructional delivery


1 Assistant Professor, Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Punjab, India
2 Professor, Department of Anatomy, Government Medical College Srinagar, Jammu and Kashmir, India
3 Professor (Additional), Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Date of Submission15-Jun-2021
Date of Decision20-Jun-2021
Date of Acceptance25-Jun-2021
Date of Web Publication30-Jul-2021

Correspondence Address:
Kumar Satish Ravi
Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/NJCA.NJCA_81_21

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How to cite this article:
Patra A, Bhat GM, Ravi KS. Anatomy education amid the second wave of COVID-19 pandemic: Challenges and solutions for instructional delivery. Natl J Clin Anat 2021;10:109-11

How to cite this URL:
Patra A, Bhat GM, Ravi KS. Anatomy education amid the second wave of COVID-19 pandemic: Challenges and solutions for instructional delivery. Natl J Clin Anat [serial online] 2021 [cited 2021 Sep 21];10:109-11. Available from: http://www.njca.info/text.asp?2021/10/3/109/322810



The second wave of the COVID-19 pandemic is much more disruptive and lethal than the first, leading to 374,305 deaths in India. As of June 15, 2021, there were 175,847,347 confirmed cases of COVID-19 worldwide, with 3,807,276 deaths.[1] With the second wave of the COVID-19 pandemic, most medical schools have switched over from offline teaching to online or virtual training. This time, it is a bit easier for the teachers as most of us were taking lectures online for the past year, so we are accustomed to such a switchover. However, for the new batch of MBBS (Batch 2020), learning anatomy in online mode is altogether unique. Although students are pretty tech-savvy and online classes are not new to them, the hitch is learning anatomy online. As a subject, anatomy was never meant to be taught outside the dissection hall, students are facing uncertainty and insecurity regarding their future. As anatomy teachers, we receive so many queries about understanding a particular topic and other future consequences. When we are writing up this editorial, we have not moved a single step forward; it looks like standing at the same tread of the stairs where we were 1 year back. For many, it has been a tough time, but for these young buds, it is daunting. Till now, they are managing somehow, but if the pandemic persists, as of now, with the second wave of massive outbreaks, students will likely need to switch between in-person and online anatomy teaching. Here is a glimpse of the difficulties medical undergraduates face and the possible ways to tackle them. This includes tips on how institutions/teachers can ensure online remote teaching–learning methodology helps them rather than hinders their learning.


  Challenges Students Face Top


What are the core difficulties students are experiencing with remote learning as dissection halls and classrooms remain primarily calm and slothful or operate with minimal staff as per government guidelines are? Cadaveric dissection is an invaluable experience for the improvement of fine motor skills in a stress-free environment. When students got deprived of access to dissection halls, they lost access to cadavers and a range of other ideal learning modalities, such as prosections, models, pathology specimens, skeletons, and others.[2],[3]

Lack of orientation

Most of the medical schools in India have started the new session 2020–2021 either in mid-January or even later in a conventional way. Amid the pandemic, the newcomers have created their new journey of joy and enthusiasm. As per the government guidelines (masking, hand hygiene, and social or physical distancing during a lecture or practical session), the teaching–learning process was going on smoothly and gradually reaching momentum. Due to the deadly second wave of the pandemic in India, institutions had to halt offline teaching as a safety measure. Hence, unlike the previous batch, the current collection batch did not get much time to orient themselves with the new environment or the new curriculum. They did not even get enough time to know their peers and teachers.

Lack of practical (dissection hall) sessions

Although anatomy teachers are making great efforts to teach students using different online platforms available, still practical work is missing. The pause in hands-on learning may result in a long-term “negative” impact on the young brain. Most of them accept dissection hall as the most exciting place to study in their curriculum. Cadaveric dissection gives them a real-time clinical medicine experience and helps them develop surgical skills at a very early stage. Hence, it is crucial for their development toward becoming professional.[3],[4],[5],[6] Due to this pandemic, students will miss out on prosections, museum specimens, clay models, imaging, and any augmented or virtual reality (VR) laboratories their institution provides.

Inequality of access to online technology

On the college campus, all the students with the same environment and circumstances have equality in learning. Despite many online modalities or software programs available for students to use, they can often be expensive. Not every student can afford or has exclusive access to a device suitable for remote learning.[7] In country like India, where most of the students belong to rural and suburban, the nonavailability of reliable Internet connection makes the situation worse. Few of them are now living in a difficult domestic situation away from their hostel rooms. For sure students, financial crisis during this pandemic has also increased their caring responsibilities in the family. These students with rural and weaker economic backgrounds are under natural mental stress. The apprehension of lagging behind is traumatizing their souls.

Performance anxiety due to lack of confidence

Learning anatomy with virtual dissection is unrealistic. The pungent smell of formalin cladded dissection hall, the feel of touching the cadaver, incise the skin, and looking into the natural complexities of the body cannot be simulated perfectly. Anatomy education was never meant to be entirely online. Familiarization with online remote learning is a tough job for students and teachers. Simply providing an online atlas is unlikely to give students an “appreciation for the fabric of the human body.”[8] Rapid and unexpected implementation of online learning in anatomy raises worries about performance. Most of the undergraduates may not be ready for such a sudden switch over from conventional teaching–learning and assessment methods to newer ones. Few are concerned that such curriculum changes will compromise the quality of their medical education and hinder them from becoming competent medical graduates.

The feeling of isolation and abandonment

Before the sudden surge of COVID cases and cessation of conventional classes, students from locations lived in the hostel under the same roof, having the same meals in the hostel mess, sharing their belongings, sharing their joy, pain, frustrations, and emotions. Due to the current situation, they had to leave the hostel and college campus. As a result of premature abandonment of the institutions, most students feel unanchored from their fellow students and teachers. Of course, there is also the general social isolation and anxiety of not having in-person contact with teachers, peers, and friends.


  Possible Ways to Address the Issues Top


Technology can help in bridging the gap between teacher and learner, and it should be made uniformly available. Hence, educational institutions need to address equality of participation issues first before starting remote teaching. Institutions having resources to provide free access to these modalities should endeavor to do so. However, to reckon for equality of opportunity between institutions with varying financial freedom, software companies should come forward to consider providing all anatomy students with temporary free access to their programs during the pandemic.[9]

Faculty may also need to be more empathetic to their students while using online modalities for formal assessment.

In addition, technology alone is not enough. Various studies have illustrated that, despite being useful, online teaching–learning programs impart notably lower rates of self-perceived knowledge and contentment compared to dissection.[10] It is high time to suitably incorporate the online programs into the teaching curriculum and patiently groom students through an enthusiastic learning experience rather than merely making it available as another resource. Students need robust support systems and virtual learning environments that actively encourage them to learn through guided instruction, supervision, and interaction. For online learning to be useful, there must be an adequate and integrated curriculum for students to guide their learning, not only as a resource; so that students will be able to develop the necessary skills for hands-on practice of anatomical sciences.

According to Langfield et al.,[11] the addition of instructional dissection videos can be a part of the way toward normality, where students can essentially watch a prerecorded dissection taking place.

Online learning, in conjunction with digital photographs of cadaveric dissection interactive anatomy images, and the provision of self-testing tools,[12] students may feel supported in their online learning program.

The importance of personal online interactions cannot be overlooked. However, attempting to reduce the distance between teacher and learner through the provision of chat rooms, collaborative bulletin, discussion boards, flipped classroom approach, or real-time tutorials are vital elements to successful online learning.[13]

Although we are not quite yet in the age where we can use VR resources as a modern idea for home-based learning of anatomy,[14] some elements could be adapted to a remote learning environment. Indeed, most smartphones are compatible with Google Cardboard allowing students to experience VR from their phones if provided with suitable software.[15]

It would seem that a purposely designed online course that integrates several elements into a learning journey would potentially provide a solution to the current pause in face-to-face teaching.


  Positive Impact on Students Top


There are few upsides for students in the current gloomy situation. Remote learning exposes them to a broader range of pedagogies and digital resources that may be more suited to their learning style in the coming days. Students now also have more scope for self-directed learning. Online pedagogy will certainly be more helpful for students to develop self guided learning. More over earlier exposure of medical students as a supportive skeleton of emergency response team will bring more confidence as a professional later on.[16],[17]


  Take-Home Messages Top


The COVID-19 crisis has injected turbulence and a hefty dose of uncertainty into anatomy students' education and career plans. Addressing these concerns requires digital solutions and pedagogical approaches that ensure students and their remote learning thrives online. We need to involve personalized support systems to reduce the gap between the learners and resources, thus enhancing their morale.[17] Disruption of anatomy education during the COVID 19 pandemic should be looked upon as an opportunity to elaborate anatomy education beyond conventional face-to-face lectures to virtual learning methods. Educators have to explore and innovate new teaching and assessment methods to reduce the suffering of the student community. It is hoped that in the post-COVOD 19 era, though the conventional teaching models will not become absolute; however, blended learning will be the norm.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
WHO 2020, WHO Coronavirus Disease (COVID-19) Dashboard. Available from: https://covid19.who.int/. [Last assessed on 2021 Jun 15].  Back to cited text no. 1
    
2.
Patra A, Ravi KS, Chaudhary P. COVID 19 reflection/experience on teaching-learning and assessment: story of anatomy teachers in India. Anat Sci Int 2021;96:174-5.  Back to cited text no. 2
    
3.
Sugand K, Abrahams P, Khurana A. The anatomy of anatomy: A review for its modernization. Anat Sci Educ 2010;3:83-93.  Back to cited text no. 3
    
4.
Smith CF, Martinez-Álvarez C, McHanwell S. The context of learning anatomy: Does it make a difference? J Anat 2014;224:270-8.  Back to cited text no. 4
    
5.
Krähenbühl SM, Čvančara P, Stieglitz T, Bonvin R, Michetti M, Flahaut M, et al. Return of the cadaver: Key role of anatomic dissection for plastic surgery resident training. Medicine (Baltimore) 2017;96:e7528.  Back to cited text no. 5
    
6.
Ravi KS. Dead body management in times of Covid-19 and its potential impact on the availability of cadavers for medical education in India. Anat Sci Educ 2020;13:316-7.  Back to cited text no. 6
    
7.
Patra A, Chaudhary P, Ravi KS. Adverse impact of covid-19 on anatomical sciences teachers of india and proposed ways to handle this predicament. Anat Sci Educ 2021;14:163-5.  Back to cited text no. 7
    
8.
Gregory SR, Cole TR. MSJAMA. The changing role of dissection in medical education. JAMA 2002;287:1180-1.  Back to cited text no. 8
    
9.
Franchi T. The impact of the Covid-19 pandemic on current anatomy education and future careers: A student's perspective. Anat Sci Educ 2020;13:309-12.  Back to cited text no. 9
    
10.
Mathiowetz V, Yu CH, Quake-Rapp C. Comparison of a gross anatomy laboratory to online anatomy software for teaching anatomy. Anat Sci Educ 2016;9:52-9.  Back to cited text no. 10
    
11.
Langfield T, Colthorpe K, Ainscough L. Online instructional anatomy videos: Student usage, self-efficacy, and performance in upper limb regional anatomy assessment. Anat Sci Educ 2018;11:461-70.  Back to cited text no. 11
    
12.
O'Byrne PJ, Patry A, Carnegie JA. The development of interactive online learning tools for the study of anatomy. Med Teach 2008;30:e260-71.  Back to cited text no. 12
    
13.
Stone DM, Barry DS. Improving virtual learning interactions: Reducing the transactional distance of online anatomy modules. Anat Sci Educ 2019;12:686-7.  Back to cited text no. 13
    
14.
Erolin C, Reid L, McDougall S. Using virtual reality to complement and enhance anatomy education. J Vis Commun Med 2019;42:93-101.  Back to cited text no. 14
    
15.
Izard SG, Juanes Méndez JA, Palomera PR. Virtual reality educational tool for human anatomy. J Med Syst 2017;41:76.  Back to cited text no. 15
    
16.
Franchi T. The impact of the covid-19 pandemic on current anatomy education and future careers: a student's perspective. Anat Sci Educ 2020;13:312-5.  Back to cited text no. 16
    
17.




 

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