Comparison of student performance following in‐person or virtual gross anatomy labs during COVID‐19

Hillmer, Ryan; Krippendorf, Beth; Patitucci, Teresa

The global pandemic of coronavirus disease has significantly impacted medical education, including removing trainees from clinical environments, transitioning didactic sessions to virtual platforms, and necessitating creative solutions to provide interactive learning opportunities in a virtual, socially distant setting. Human gross anatomy education, with its emphasis on hands‐on, team‐based, active learning by body donor dissection, has been particularly impacted by these transitions. Dissection is considered the best practice for learning gross anatomy and has been shown to enhance learning over non‐dissection‐based methods. At the Medical College of Wisconsin, team‐based, body donor dissections are the basis for the Clinical Human Anatomy course. However, the pandemic necessitated changes to the format of laboratory activities. For the 2020‐2021 academic year, students either completed anatomy labs in‐person in a socially distant environment or virtually. This provided an opportunity to directly compare the effect of different laboratory instructional modalities on student performance within a single course. All first‐year medical students were enrolled in the same Clinical Human Anatomy course, attended identical didactic sessions, and were assessed by identical examinations that included lecture‐based questions as well as laboratory image‐based questions. As the semester progressed and coronavirus disease case numbers rose, students were offered two options for completing laboratory instruction: (1) continue dissections in socially distant pairs or (2) transition to a virtual lab format. The virtual lab format included a self‐directed module which guided students through the dissections they would have done in person. Each module consisted of a PowerPoint presentation that incorporated interactive software (3D4Medical Complete Anatomy) and dissection images. The self‐directed modules were followed by interactive Zoom sessions, wherein faculty reviewed a prosection and posed clinically relevant questions to the meeting attendees. Students who opted for the virtual lab format were able to review dissections in‐person on their own time or with a tutor. Likewise, students who opted to continue dissection had access to the virtual modules and recordings of the Zoom sessions. Comparison between students completing labs virtually or in‐person showed no difference in aggregate performance on examinations. This study examined medical knowledge and did not investigate other competencies impacted by lab activities (teamwork, dealing with death, and the “first patient” experience). We consider hands‐on dissection to be the gold‐standard format for learning gross anatomy, but this study showed by direct comparison in a single course, that multiple laboratory formats can yield equivalent understanding of the complex structure of the body.