Exploring the Impact on Student’s Learning and Experience – a two-phase comparative
study comparing virtual dissection (Anatomage Table) and cadaveric dissection on the
gross and cross-sectional human anatomy .
1
Author , Co-Author 1 1, Co-Author1, 2, Co-Auhtor 1
, 3, Co-Author 41, Co-Author 5 1, Co-Auhtor
2
, 6
Co-Auhtor 7 , Co-Author 8. , Co-Author 9
3 3 4
.
1 Department of Anatomy, ......... School of Medicine, University of ...............
2
Student, University of ..............................
3
Student, ............. College.
4
Division of Anatomy, ....................... School of Medicine, .....................University.
Research Team:
Principal Investigator: Dr. Author
Investigators for Phase-I Study: Dr. Co-Author 4, Dr. Co-Author 5, Dr. Co-Author 2.
Investigators for Phase-II Study: Dr. Co-Athor 3, Dr. Co-Athor 1, & Dr. Auhtor.
NTU collaborator: Dr. Co-Athor 9
Student Assistants: Ms. Co-Athor 3, Mr. Co-Athor 7, and Mr. Co-Athor 8.
Advisor: Professor A, Department of Anatomy.
=================================================================
Abstract:
From time immemorial, cadaveric dissection has been the gold standard for studying human
anatomy in medical schools. However, with the recent advancements in the field of Information
Technology (IT), newer teachings and learning tools have emerged. These have led to the
development of numerous possibilities and innovations as to how human anatomy can be taught,
reshaping anatomy learning as a whole–for instance, virtual visualization software such as the
Anatomage table are now available. The Anatomage table is a touch screen interactive device
that allows for virtual dissection. However, the educational efficacy and benefits of the
Anatomage Table’s virtual dissection, as compared to the traditional cadaveric dissection,
remains unclear. Although there have been studies conducted regarding the Anatomage Table,
they had vastly different research findings. Understanding the benefits of the Anatomage table,
especially in the ................ context, would be of great value as the education system and
teaching methods in Author's country are vastly different from other parts of the world. This study
will provide valuable insights into the use of the Anatomage table, enabling medical schools
around the globe to design a curriculum that can benefit students as a whole. Therefore, this
two-phased study is designed to ascertain whether the Anatomage table can augment the
learning of human anatomy among first year MBBS students, and aims to assess the medical
students’ performances and overall satisfaction. Students will be learning the gross anatomy of
the pelvis and perineum (P/P) and the brain. By collecting data through user experience surveys
and pre-validated questionnaires, we will explore the benefits the Anatomage table brings to
the students, from improving their content knowledge to the students’ ability to visualizing 3D
structures, with the assistance of statistical tools.
Background
Cadaveric dissection has been the main way to study human anatomy, but in recent years, the
imminent advancement of IT has brought about new ways of learning human anatomy that was
Bluenotes Community Research Grant Proposal – RLS 13 Dec 2021 1
not possible decades ago. For instance, due to the advent of Information Technology (IT),
innovations such as Massive Online Open Courses (MOOCs), virtual reality and especially the
Anatomage table have opened up new ways for students to learn human anatomy. The
Anatomage table is a touch screen interactive device with highly accurate real anatomy, being
the most technologically advanced 3D anatomy visualisation and virtual dissection equipment
available on the market, allowing for anatomy exploration more than what cadavers can offer.
Objectives:
The main objective of this two-phased study is to explore the impact of the use of the
Anatomage table on the students' performance and overall satisfaction, as compared to using
the traditional cadaveric dissection. Through the use of statistical tools, qualitative and
quantitative data would be obtained, analysed and discussed, which will then determine
whether the use of the Anatomage table has any significant advantage over the use of a
traditional cadaveric dissection. The analysis of the results will thus enable us to determine if
the Anatomage table is a gimmick, or is truly a significant innovation that should be
implemented into medical schools’ curriculum.
Research Methodology
A randomised controlled prospective study will be conducted, involving first year MBBS
students from the University of .......... (U) .................... School of Medicine
(SM) (n=48). This study is planned to be conducted in two phases.
In phase-I, students will learn the gross anatomy of the male and female pelvis and gross
anatomy of the perineum. Lectures will be provided beforehand. In phase-2 of the study, the
focus will be on the gross anatomy of the brain, including the common cross sections of the
brain. However, the intervention in phase-II will be performed before the students can attend
any lecture or practical session on the gross anatomy of the brain. Instead, Phase II students
will get a short introductory lecture of 20 mins using PowerPoint which teaches only basic
anatomy concepts of brain and a 20-minute video on how to use the Anatomage table. The
rationale behind this is so that we can also ascertain whether a series of
lectures/practicals/tutorials can make a significant difference in the final outcome of the
proposed study.
These regions of the human anatomy were chosen deliberately as they are challenging and
complicated; requiring visuo-spatial understanding for recognition and appreciation of
anatomical relationships from a three-dimensional perspective.
In phase-I, students will be divided randomly into a control group (traditional dissection /
prosected specimens) and intervention group (virtual dissection using anatomage table) evenly.
Following which, they will do a crossover in phase-II.
Before the study begins, a pre-test of 10 Multiple Choice Questions (MCQs) (20 mins) will be
administered to estimate the baseline knowledge of the anatomy of the pelvis and perineum
and the anatomy of the brain. No feedback and answers will be given to the students on their
pre-test performance.
Data collection and analysis: The participant demographics (age, sex, previous anatomy
training/exposure if any) will be captured. The pre and post test scores of both groups will be
collected and appropriate statistical analysis will be employed to investigate whether any
significant difference exist in test scores within and between the groups. The p-value less than
0.05 will be considered as significant. Cohen d will be used to measure the effect size of two
Bluenotes Community Research Grant Proposal – RLS 13 Dec 2021 2
modes of training/learning. Descriptive statistics (mean, range, and percentages) will be
prepared to present the Likert scale survey data.
Proposed Timeline of the Study:
Week -1 1 Description Remarks
Day-1 Two hours of lecture on gross anatomy PowerPoint will be
of the male and female pelvis. And used
anatomy of the male and female
reproductive system.
Day-2 One hour of pre-lab lecture on gross Video and
anatomy of the male and female pelvis. PowerPoint will be
And anatomy of the male and female used
reproductive system.
Day-2 One-hour Anatomy Practical on gross Hands-on Session
anatomy of the male and female pelvis. with interaction with
And anatomy of the male and female demonstrators
reproductive system.
Day-3 One-hour lecture of Microscopic PowerPoint will be
Anatomy (Histology) of male and female used
reproductive system.
Day-3 One hour practical of Microscopic Histology practical
Anatomy (Histology) of male and female using virtual
reproductive system. microscope
Day-4 Two hours of Anatomy Tutorial on gross Small group
anatomy of the male and female pelvis. interactive teaching
And anatomy of the male and female session.
reproductive system.
Week -21 Description Remarks
Day-1 Two hours of lecture on gross anatomy PowerPoint will be
of male and female perineum. used
Day-2 One hour of pre-lab lecture on gross Video and
anatomy of male and female perineum. PowerPoint will be
used
Day-2 One-hour practical session on gross Hands-on Session
anatomy of male and female perineum. with interaction with
demonstrators
Day-3 One-hour lecture of Microscopic PowerPoint will be
Anatomy (Histology) of male and female used
perineum.
Day-3 One-hour practical session on Histology practical
Microscopic Anatomy (Histology) of using virtual
male and female perineum. microscope
Day-4 Two hours of Anatomy Tutorial on male Small group
and female perineum interactive teaching
session
1
Activities stated in the table are planned by SM and cannot be adjusted for the study
Bluenotes Community Research Grant Proposal – RLS 13 Dec 2021 3
Phase-I, Interventional group (Week - 32)
A Pre-test will be conducted, before the activities stated in the description have been carried
out, to know the students’ baseline knowledge of the gross anatomy of the Pelvis and
Perineum.
Activities planned for Week - 3:
Description Remarks
20 minutes teaching session on essential Self-study handouts
anatomy of Pelvis and Perineum. will be provided to
20 minutes technical video on practical each student.
tips on how to use Anatomage table.
60 minutes interactive self-study Students will do the
session: Virtual Dissection Session using virtual dissection in
the Anatomage Table. To Study Gross groups of 6 students
Anatomy and cross-sectional anatomy of and will take turns.
the pelvis and perineum (P/P).
Phase-I, Control group (Week - 42)
A Pre-test will be conducted, before the activities stated in the description have been carried
out, to know the students’ baseline knowledge of anatomy of the Pelvis and Perineum.
Activities planned for Week – 4:
Description Remarks
20 minutes teaching session on essential Self-study handouts
anatomy of pelvis and perineum (P/P). provided to each
20 minutes pre-lab video on practical student.
approach to study the prosected
cadaveric specimens or cadaveric
plastinated specimens.
60 minutes interactive self-study: Students will study
Hands-on practical session using the human anatomy
prosected cadaveric specimens and using prosected and
plastinated cadaveric specimens. To plastinated
study gross anatomy and cross-sectional specimens in groups
anatomy of the pelvis and perineum of 6 students and
(P/P). will take turns.
2
The specific time and date for the activities stated in the description of the tables will only be confirmed at a
later date once the AY 2021-2022 Academic semester-2 for SM has commenced
Bluenotes Community Research Grant Proposal – RLS 13 Dec 2021 4
Phase-II, Interventional group (Week – 52)
A Pre-test will be conducted, before the activities stated in the description have been carried
out, to know the students’ baseline knowledge of the anatomy of the brain.
Activities planned for Week - 5:
Description Remarks
20 minutes teaching session on essential Self-study handouts
anatomy concepts of brain and cross provided to each
section of the brain. student.
20 minutes technical video on practical
tips on how to use the Anatomage table.
60 minutes self-study virtual dissection Students will do the
session using the Anatomage Table. To virtual dissection in
study gross anatomy and cross-sectional groups of 6 students
anatomy of Brain. and will take turns.
Phase-II, Control Group (Week – 62)
A Pre-test will be conducted, before the activities stated in the description have carried out,
to know the students’ baseline knowledge of the anatomy of the brain.
Activities planned for Week - 6:
Description Remarks
20 minutes teaching session on essential Self-study handouts
anatomy concepts about the brain. provided to each student.
20 minutes pre-lab video on the practical
approach to perform cadaveric dissection of
the brain and cross sections of the brain.
60 minutes self-study dissection session Students will do the
using human cadaveric brain: Study gross actual dissection using
anatomy and cross-sectional anatomy of cadaveric brain in
real human cadaveric Brain. groups of 6 students and
will take turns.
After the self-learning segment, a post-test, designed by a blinded observer, will be
administered to evaluate the effectiveness of both modes of training/learning. Through the use
of the 5-point Likert scale survey (1=strongly disagree to 5=strongly agree) and a free-text
comment section: a section where students will be free to give their opinions openly with
regards to the study. Students’ feedback will be collated, discussed and analysed so as to better
understand the students’ point of view – be it with regards to their learning satisfaction or self-
efficacy in anatomy – during the study.
Bluenotes Community Research Grant Proposal – RLS 13 Dec 2021 5
Note:
For Phase-II: Both Interventional group (Anatomage table) and Control group will be done
BEFORE the students have their regular traditional lectures, prelab, Anatomy hands-on
practical, Microscopic anatomy lectures and Anatomy tutorial.
The SAME research methodology used in phase-I will be employed for phase-II, but changing
the topic to anatomy of the brain. The research team will ensure that students who utilised the
Anatomage table in phase-I will be allocated to the traditional (control) group and vice versa
All students who participate in this study will NOT be deprived of any education content they
would normally learn as first year MBBS students. In other words, they will NOT be deprived ,
in any way, of any knowledge they would normally get. The students who participated in this
study [whether in the intervention group or control group] will have an advantage of getting
exposed to Anatomage table or to brain dissection, which will be in addition to content they
would normally learn in their first year of MBBS at SM. In conclusion, students who
participate in this study will NOT be selectively disadvantaged if they choose to volunteer and
partake in this study.
All students who participate in this study will also be given a copy of the Robbins & Cotran
Pathologic Basis of Disease 10th [2020] edition E-Book, a book which is essential and used by
every medical student at SM for educational purposes. This is NOT regarded as an
incentive to partake in this study, but is instead a token of appreciation for the amount of time
and effort spent to partake in the study.
All students who participate in this research study will undergo a mandatory safety and
laboratory training on how to handle sharps, how to promote personal safety and safety of peers.
=====================
Bluenotes Community Research Grant Proposal – RLS 13 Dec 2021 6
Budget Proposal:
Item Cost Additional Information
Robbins & Cotran Pathologic Basis of Disease $3801 One e-book voucher will
10th [2020] edition E-Book [Cost $73 per e- be given to each student
book] for their participation in
the study. A total of 52
e-book will be
purchased.
Includes 3 extra copies:
One e-book for each of
the student volunteers
who helped in the
smooth conduct of this
study. Plus 1 spare copy.
Rental & shipping charges of Plastinated Models $2193 Rental duration – two
months
To & Fro shipping
charges from Germany.
Gubener Plastinate
GmbH / von Hagens
Plastination.
Admin cost included.
Flight Ticket to Chicago to attend the Bluenotes $1827 Direct route & Economy
conference class
Accommodation in Chicago close to conference $731 For 7days
venue
Bluenotes Conference Registration Fee $731 One person
Ground transport, Food & miscellaneous $731 For 7 days
expense
Publication expenses $731 1 publication
Total $10745
References:
1. MK Anand and TC Singel. A comparative study of learning with “anatomage” virtual
dissection table versus traditional dissection method in neuroanatomy, Indian Journal of
Clinical Anatomy and Physiology, 2017;4(2):177-180
2. Baratz G. Evaluating the Anatomage Table Compared to Cadaveric Dissection as a
Learning Modality for Gross Anatomy. Med Sci Educ. 2019 26;29(2):499-506.
3. Chandrasekaran R, et al., A Validated Instrument Measuring Students' Perceptions on
Plastinated and Three-Dimensional Printed Anatomy Tools. Anat Sci Educ. 2021 Oct 25.
Bluenotes Community Research Grant Proposal – RLS 13 Dec 2021 7
Research Proposal on Anatomage Table
Start of Block: Default Question Block
Page Break
Page 1 of 5
Hello! This is a survey seeking your opinions on the usage of Anatomage table, using prosected
cadaveric specimens / using cadaveric plastinated specimens and actual cadaveric dissection!
Please take your time to carefully consider your answers. Once again, thank you for putting in
your time and effort into the study. It is greatly appreciated!
Page 2 of 5
Q1 for each
statement below, Neither
please give a rating Strongly disagree Strongly
disagree (2) Agree (4)
according to the disagree (1) nor agree agree (5)
extent you agree with (3)
the statement.
I am able to
understand the
concepts better while
o o o o o
learning to use the
Anatomage Table, as
compared to
prosection/dissection.
(1)
While using the
Anatomage Table, I
can see myself
performing an o o o o o
operation (2)
During the
prosection/dissection
sessions, I can see
myself performing an o o o o o
operation (3)
Using the Anatomage
table, I am able to
effectively remember
and visualize, without
any assistance
whatsoever, about
o o o o o
the anatomy covered
in the session (4)
Both the
prosection/dissection
and the Anatomage
o o o o o
Table are equally
effective in helping
me capture the
anatomical concepts
(5)
I am excited to return
o o o o o
for the next session
using the Anatomage
table (6)
Page 3 of 5
Using the
prosection/dissection,
I am able to
effectively remember
and visualize, without
any assistance, o o o o o
about the anatomy
covered in the
session (7)
I am excited to return
o o o o o
for the next
prosection/dissection
session (8)
Q2 Which learning method do you think is more effective for your understanding of the anatomy
tested in the study? why?
o Anatomage table (1) ________________________________________________
o Prosection/dissection (2) ________________________________________________
Q3 Which method of learning do you prefer? Why?
o Anatomage (1) ________________________________________________
o Prosection/dissection (2) ________________________________________________
Q4 Which method of learning is more enjoyable? Why so?
o Anatomage (1) ________________________________________________
o Prosection/dissection (2) ________________________________________________
Page 4 of 5
Q5 Please use this space to provide any additional comments. It can be related to the study, the
use of the Anatomage table and the experience of learning from prosected cadaveric specimens
or actual cadaveric dissection or cadaveric plastinated specimens.
________________________________________________________________
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