Overall, students had a positive reaction to AD. In our institution, AD was introduced to solve crowding and other problems in the dissection laboratory. During dissection, four to five faculty members circulated around the room and help the students perform the dissections according to the dissection guide book. Dissections were usually preceded by lectures on the corresponding anatomical regions. The content and progression schedule for each dissection laboratory were pre-determined and announced to the students. Throughout the laboratory classes, one cadaver was assigned to each group of eight students. The 28 laboratory classes consisted of 10 extremity region sessions, nine trunk region sessions (including the thorax, abdomen, and pelvis), and nine head and neck region sessions. The Gross Anatomy course consisted of 48 of 50-minute lectures and 28 of 4-hour laboratory classes held over the first 12 weeks of the first year of a 4-year medical curriculum. The overall percentage of male students was 65.8% and 66.0% of the students were enrolled in the UEP. The number of students included in this study per year was around 155 ( Table 1). Seoul National University College of Medicine operated two MD programs: a 6-year undergraduate entry program (UEP) and a 4-year graduate entry program (GEP). These differing results caused us concern regarding the potential negative effects of AD on student learning outcomes. Furthermore, studies of the effects of AD on written examination scores showed somewhat conflicting results, including decreases, no changes or improvements. However, we had some concerns since the opportunity for each student to participate in a hands-on dissection, which is one of the best ways to obtain anatomy skills, was decreased. Thus, we adopted this strategy in 2014 with the expectation that it would improve the dissection learning environment. This kind of strategy has previously been adopted by some medical schools to reduce course time, resolve issues associated with class size and a high student-to-body and/or student-to-faculty ratio, or accommodate curricular changes. Keywords: Gross anatomy, Anatomy education, Cadaver dissection, Alternate dissectionĪnother possible solution is alternate dissection (hereafter abbreviated as AD), in which students are divided into two or three teams that take turns participating in the dissection laboratory. Therefore, this type of approach can be used to improve efficiency in dissection laboratories. The alternate dissection strategy described herein solved the crowding problem in the dissection laboratory at our institution and had no negative effects on student learning outcomes. Moreover, written examination scores improved both for the extremities and the head and neck regions in 2016. Despite this, the alternate dissection strategy did not influence practical examination scores, with the exception of a transient decrease in 2014, i.e., the first year of implementation. However, there was still some anxiety among the students regarding regions that they did not dissect themselves. The results showed that student perceptions were largely positive and became increasingly so each year. A survey on student perceptions of this new strategy was conducted at the end of anatomical courses held from 2014 to 2016, and practical and written examination scores from 2013 to 2016 were analyzed. The alternate dissection approach was first introduced at our institution for dissection of the head and neck region in 2014, and was expanded to encompass the extremities in 2016. To address the problems associated with crowding in dissection laboratory, especially for dissections of the head and neck region, we adopted an alternate dissection strategy and explored its effects on student learning, and student perceptions of the approach.
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