Pawlina, Wojciech

Gross anatomy is now delivered in curricula that are increasingly compressed and integrated with other areas of medical training. At the same time, digital resources and physical models have become more common as supplementary tools in anatomy education. These shifts have renewed interest in the distinctive educational value of donor-based learning and in how preservation methods should be aligned with clinically meaningful learning objectives. This narrative review examines the use of fresh human donor tissue in anatomy teaching and clinically oriented procedural training. It focuses on unembalmed, non-fixed, and fresh-frozen tissue, while soft-preserved tissue is considered mainly as contextual and comparative evidence. Literature searches were conducted in MEDLINE, Scopus, Web of Science, and ERIC databases for English-language human studies published from 2015 through early 2026, with backward citation to identify older landmark comparator papers. Because the preservation-explicit educational literature was limited and heterogenous, findings were synthesized narratively. Across the included literature, fresh tissue appears most educationally valuable when learning objectives depend on functional tissue behavior, including tissue palpation, percussion, tissue-plane recognition, ultrasound-guided anatomy, or realistic procedural handling. Available studies suggest benefits in selected knowledge and performance outcomes, especially in clinically oriented examination and postgraduate refresher courses. Comparator evidence indicates that soft-preserved tissue may provide a pragmatic alternative when programs need repeated access or broader curricular integration while still preserving more realistic handling than formal fixed donors. Formalin fixed tissue remains useful for durable structural teaching despite reduced functional realism. Overall, preservation methods should be treated as a curricular design decision rather than a neutral technical detail. Fresh tissue therefore has a defensible place in competency-based anatomy education when used selectively for tasks requiring high functional fidelity, although stronger evidence for long-term clinical transfer remains limited.

Fundamental to medical education, gross anatomy first introduces medical students to human mortality, often provoking stress. Sense of purpose, a key aspect of well-being, may serve as a protective factor. We studied students’ sense of purpose during an anatomy course, examining its links to performance, spirituality, and belief in an afterlife. Fifty medical students who took a 7-week gross anatomy course in 2022 or 2023 completed the Life Engagement Test at the beginning, middle, and end of the course. We collected other data including demographics, religious/spiritual beliefs, and previous exposure to body donors. Practical and final examinations assessed course performance. Strong sense of purpose at the three measurement points was positively correlated with practical exam performance (r = 0.40, P = .004; r = 0.44, P = .003; r = 0.30, P = .047, respectively) but not National Board of Medical Examiners’ anatomy subject exam performance. Staunch believers and non-believers in an afterlife maintained a stable sense of purpose, while students uncertain about the afterlife experienced a decline from the beginning to the middle of the course and even more to the end ( P = .046; P = .008, respectively). These students also had significantly lower practical examination performance as compared to other students (95% CI [−10.84, −0.52]). In conclusion, a strong sense of purpose predicts better performance in a 7-week anatomy course. Both believers and non-believers in an afterlife do well, but students wavering in their beliefs experience a declining sense of purpose and lower grades. Supporting these students when they confront human mortality, including in other contexts such as palliative care/hospice settings, may be beneficial.

Introduction: As today’s healthcare model moves toward more streamlined and corporate industrialism, it is our responsibility, as doctors, to ensure the integrity of medicine’s foundation in professionalism. The erosion of professional values not only creates a climate of animosity, but reverberates negatively to impact the development of students, who model their behaviour after those they most respect. This hazard has spurred an evaluation of medical school curricula, with a new emphasis on professionalism in the philosophy of medical education. Courses such as Gross Anatomy that, in the past, offered “pure content,” are now being used to teach and evaluate professionalism. The goal of this study was to determine if peer evaluation and self-evaluation used in conjunction and implemented early in the medical curriculum, can serve as useful tools to assess and provide feedback regarding professional behaviour in first-year medical students. Materials and Methods: From 1999 to 2003, students at Mayo Clinic College of Medicine evaluated themselves and their peers during the Gross and Developmental Anatomy Course. Numerical evaluations and written comments were statistically analysed within established categories of professionalism and correlated with academic performance, gender, and peer rating and self-rating. Results: The majority of written comments pertained to inter-professional respect, responsibility, and excellence. Students who gave higher peer evaluation and selfevaluation scores provided more positive comments, and students performing well in the course provided more positive comments about their peers and themselves than did those struggling academically. Students consistently rated their peers higher than themselves, and male students rated themselves higher than did female students. Conclusions: Implementing peer evaluation and self-evaluation early in the medical curriculum is a valuable exercise in teaching first-year medical students assessment skills when evaluating their behaviour, as well as the behaviour of their colleagues.

Radiology is often incorporated into medical school anatomy courses. Radiology education furthers understanding of anatomical relationships and prepares students to apply anatomical knowledge in clinical practice. The aim of this study was to investigate how cognitive performance on the radiology components (RC) of a first‐year medical school anatomy course are related to performance on non‐radiological components (NRC). We hypothesized that there is no correlation between these two performance variables, because they rely on different cognitive skills. Thus, anatomy education alone will not prepare students for the interpretation of normal anatomy on radiological images. Medical students (n=51) enrolled in a first‐year anatomy course at Mayo Clinic School of Medicine were included in this study. Assessment data from three lab practical examinations were collected, and RC and NRC questions were compared. A bivariate linear regression and statistical tests were conducted. A subgroup analysis was used to compare students whose RC performance was greater than their NRC performance (RC>NRC, n=33) to students whose RC performance was less than their NRC performance (RC<NRC, n=18). When considering all three exams, students correctly answered 71.1% of the RC questions and 68.3% of NRC questions (p=0.047). Bivariate linear regression demonstrated a moderate positive correlation between RC and NRC performance (p<0.01, r= 0.51); however, performance on RC questions only accounted for 24% of the variability of NRC scores. Additionally, students in the RC>NRC group had significantly higher scores on RC questions than the students in the RC<NRC group (74% vs 66%, p<0.02). Conversely, students in the RC>NRC group had significantly lower scores on NRC questions than the students in the RC<NRC group (61% vs 74%, p=0.001). These results indicate that while RC performance has some influence on NRC performance it does not account for the majority of the difference observed. Such results suggest that the cognitive skills involved in both radiology and anatomy education are different. Therefore, dedicated radiology education is an important component of an anatomy course as it fosters the development of novel skills that are necessary when interpreting normal anatomy on radiological images in a clinical setting. Support or Funding Information None

Perceived self‐efficacy influences how one approaches goals, tasks, and challenges, and has been shown to affect motivation and academic behaviors. The ability to accurately assess one's competency and limitations is also a critical skill for physicians. Research has shown that medical students can underestimate their perceived clinical skills compared to observer assessment, but limited research has addressed perceived knowledge specific to anatomy. This study compares student perception and faculty evaluation of academic competency in a gross anatomy course. Additionally, this study revisits whether daily audience response system (ARS) questions is a predictor of academic success, and the impact of near‐peer tutoring on student performance. Data from 51 first year medical students in a 7‐week gross anatomy course were evaluated. At the end of week 3 of the course, students with a cumulate ARS grade below the 70% pass requirement were contacted by faculty with individualized formative feedback on academic performance and presented with opportunities for improvement and formal tutoring. All students irrespective of performance were made aware of opportunities for tutoring. Six near‐peer teaching assistants tutored students who requested help. Mean ARS scores and laboratory practice practical grades were evaluated before and after the students received formative feedback. Students were placed into one of four groups based on two factors: (1) their perceived ability to succeed in the course, and (2) faculty perception of their potential for success. Students in groups 1 and 3 were identified by faculty members as potentially at risk, whereas groups 2 and 4 were viewed as low risk. From the students' perspective, those in groups 1 and 2 self‐identified as needing assistance, whereas groups 3 and 4 felt that they were not at risk of failing the course. Of the 12 students contacted by faculty, 6 (12% of the class) requested a tutor (group 1). Additionally, 11 (21%) students who were not contacted by faculty requested a tutor (group 2). Six (12%) students that were contacted by faculty did not request a tutor (group 3), while 28 (55%) were not contacted by faculty and did not request a tutor (group 4). The averages of daily ARS scores between groups after feedback was significantly greater in group 4 compared to groups 1 and 2 (68% vs 61% and 63%, p=0.04 and 0.04, respectively). In addition, the post faculty feedback practical average scores were significantly higher in group 4 compared to group 1 (67% vs 56%, p=0.04). These data show that in an environment that fosters acceptance of academic support, students are more receptive to receiving and reaching out for help from near‐peer tutors. Formative feedback from ARS scores continue to be a reliable indicator for tracking student performance. Improvement of student performance in final course evaluation may be a positive indicator of success from near‐peer tutoring. Support or Funding Information None

In modern medical curricula, anatomists share responsibility for training the next generation of health care providers. As expectations for medical professionals continue to evolve, anatomy teachers are strategically positioned to support students' acquisition of the core anatomy knowledge together with skills and attitudes necessary to produce caring and effective health care providers. Anatomists must ensure that learners not only possess the necessary breath of knowledge in anatomical sciences but also skills such as leadership, teamwork, communication and professionalism among others. To attain this, anatomy curricula need to follow a path of authentic learning in which students are expected to exercise higher levels of thinking and clinical reasoning through discovery and inquiry. Learning‐by‐doing is the most effective learning strategy not only in the laboratory and interactive classroom, but also in the real‐life environment of imaging technologies. To ensure the success of this strategy, students must receive frequent performance feedback to advance their learning and capability for improvement. When anatomists embrace the maxim “the needs of the patient come first,” the learning becomes as much social as cognitive, as much solid as intangible, and becomes entwined with judgment and exploration just as it is in the real clinical world.

Leadership, among other non‐technical discipline‐independent skills, has been identified as an important parameter in promoting patient safety and quality improvement in healthcare. While literature suggests that early exposure to non‐technical skill development positively correlates with improved technical skill, incorporating this into medical school curricula remains challenging. For first‐year medical students, team‐based learning environments provide an opportunity to demonstrate and reflect on leadership roles when assessment of non‐technical skills is incorporated as a formal component of their final grade. At Mayo Medical School, 20% (subjective faculty (10%) and peer (10%)) of the final anatomy and histology grade is awarded for performance of non‐technical skills. As part of our quality improvement initiative, we analyzed five consecutive years of data regarding leadership feedback in order to better understand: (1) student interpretation of leadership (2) student level of confidence in displaying leadership skills (3) student ability to critically assess leadership skills. Quantitative data from self and peer assessment were compared with qualitative analysis of leader and peer reflections. We found that leader assertiveness or lack thereof was a common theme in written feedback to team leaders, being mentioned at least once in 69% of all groups. We also discovered that 71% of leaders gave themselves a score lower than the aggregate team member score on leadership metrics. Despite this, score assignment on several individual components of leadership including respect, integrity, responsibility, compassion, problem‐solving, commitment to excellence, and overall professionalism was highly congruent between leaders and team members; leader selfscores matched aggregate team scores within two points 90% of the time. These results suggest that first‐year medical students strongly associate a proper level of assertiveness with leadership skills, are less confident in their own leadership abilities than the peers they are leading, and tend to agree with peers on relative areas of leadership strengths and weaknesses. Better understanding of medical student perception of leadership will help to direct leadership skill discussion during faculty‐driven direct feedback sessions.

Use of ultrasound as a diagnostic tool is fast becoming an expectation in clinical practice. With formal outcomes now being included as competencies in many residency programs, earlier exposure to use of ultrasound is being achieved through informal activities embedded within medical school curricula. Using ultrasound to learn anatomy is now standard practice for many courses in the United States. However, very few if any offer formal opportunities to assess student skill and anatomical knowledge at the same time. As part of the Mini Ultrasound Skills Institute (MUSI) in Anatomy, a component of the first year anatomy course, students were expected to complete a team‐based, hands‐on ultrasound skills assessment. Throughout the course, students received both didactic briefing sessions and hands‐on training on ultrasound basics, image interpretation, and scanning techniques. The ultrasound content was presented in parallel to anatomy and radiology curriculum. In the past, ultrasound knowledge was assessed via static images; however, due to the contextual nature of ultrasound interpretation, a live, hands‐on method was devised to assess student learning. At regular intervals during the course, students completed an ultrasound skills assessment. In their dissection teams of four, students completed four tasks: setup the machine, obtained, oriented, and labeled a desired image using a live model. Each student was given a unique role within this exercise. Students were graded on a rubric scale for each of the four components and given an overall team score. At the conclusion of the course, students completed a graded ultrasound objective structural practical examination (OSPE). Rotating through four stations, students completed the four tasks on four different structures. Students rotated through roles within their team as they moved between stations. OSPE grade was incorporated into their final laboratory practical grade. Preliminary data from formative OSPE assessments ‐‐‐‐showed an average score of 72% (±21%) with a minimum of 50%, maximum of 100%. Within the skill specific breakdown, students were very comfortable at labeling obtained images (100%) and had the most challenging time with either selecting the correct probe or setting up the scanner 40% (±51%). Overall, team‐based OSPE is an effective method to promote and evaluate ultrasound skills learned in an anatomy course.

Medical error is an important cause of patient morbidity/mortality. Disclosing medical errors to patients is an important component of safe practice. There is a growing need to assess the inherent nature of how physicians in training approach such unanticipated outcomes. With limited exposure for medical students to the idea of medical error disclosure, which is an important area of professionalism in medicine, we believe that a reflective writing exercise can be an efficient tool to objectively assess how students acknowledge and address medical errors early in their medical career. Every year, students in the 1 st year gross anatomy course are asked to respond to a scenario in which a medical student's cellular phone conversation with a friend in a public area (i.e. post office) was overheard by a family member of a cadaver donor to Mayo Medical School. Students were asked to write an apology email to the offended party (Mrs. X) as though they were the student who made the mistake. Students were given 48 hours to complete and submit the assignment. We retrospectively reviewed the medical error disclosure assignment of medical students in the first‐year gross anatomy course at Mayo Medical School between 2005 and 2015. An instrument for assessing medical error disclosure, consisting of fifteen items evaluated on Likert scale (1–5, 1 is the lowest and 5 is the highest), was developed. Using this evaluation tool, we assessed the basic elements of medical error disclosure – acknowledgement of error/system failure, expression of regret, awareness of its impact, description of future behavior, and proper tone as an apology letter. Preliminary data from years 2005, 2008, 2011, and 2014 indicated the mean error disclosure scores of 3.49 ± 0.83, 3.32 ± 0.81, 3.29 ± 0.84, and 3.25 ± 0.75, respectively. The word count in those four class years were 246.9 ± 84.0, 236.3 ± 86.4, 211.2 ± 92.3, and 242.3 ± 79.1 words, respectively. The proportion of students who claimed to have spoken with his/her mother was 2 out of 42 (4.7%), 4 out of 49 (8.2%), 0 out of 48 (0%), and 20 out of 51 (39%) students, respectively. Across the four class years, there was a non‐significant but uniform trend of reduced mean error disclosure score over time, while the mean word count did not show a certain pattern. One notable trend over the class years was an increasing attribution to their mother as the person they spoke with, possibly a way to help alleviate Mrs. X's frustration by eliciting empathy. Overall, this efficient, integrated writing exercise serves as a sensitive tool to objectively gauge skills in the basic areas of medical error disclosure in a preclinical anatomy course. Support or Funding Information My sponsor is Dr. Wojciech Pawlina, the senior author of the abstract. Funding will be considered by the Department of Anatomy, Mayo Clinic College of Medicine, Rochester, MN.