2015–2024年俄罗斯医科大学人体解剖学教学趋势：基于学术出版物的数据

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BACKGROUND

The post–COVID-19 period has set new tasks for the discipline of Human Anatomy, requiring an in-depth study of the following aspects: anatomical variations; congenital malformations; individual, age-related, sex-specific, and typological features of various anatomical structures. In addition, up-to-date information on microscopic anatomy and modeling of structural-functional relationships in health and disease is needed [1]. Forecasting the development of the discipline is extremely important and should be based on evidence, which will help reduce the risk of errors in assessing trends in educational practice and clarify the role and place of the discipline in the system of comprehensive medical training. This goal requires a detailed analysis of current teaching practices, primarily by reviewing publications devoted to this topic.

This work aimed to assess the specific features of teaching human anatomy in Russian medical universities based on the analysis of Russian scientific publications over the past 10 years.

METHODS

Study Design

This study was based on an analysis of 96 full-text Russian-language articles published between January 2015 and June 2024. The search was conducted in the Russian Science Citation Index (RSCI) database using keywords related to anatomy and education.

Eligibility Criteria

Exclusion criteria: authorship or source affiliation with nonmedical universities or with departments of topographic anatomy or anatomic pathology within medical universities. A total of 96 publications were included in the final analysis.

For each selected publication, combinations of keywords were recorded. Single-occurrence terms and combinations were excluded from further analysis, as their presence may have been occasional and not reflective of trends in the field.

Statistical Analysis

The statistical analysis was conducted using Microsoft Excel spreadsheets. Graphs were plotted using the obtained results. Developmental trends were evaluated by constructing a distance matrix of keywords in Excel, with conceptual proximity defined as co-occurrence within the same publication [2]. Visualization of keyword networks was performed using Gephi 0.10.1 (Université de Technologie de Compiègne, France). Terms with only a single link to human anatomy were excluded. The Force Atlas layout algorithm was applied to construct keyword networks for 2015–2024. In order to assess the changes in the frequency of keywords and combinations, results were calculated separately for 2 intervals: 2015–2019 (59%, 57 publications) and 2020–2024 (41%, 39 publications). The network analysis allowed for the synthesis of data from the reviewed studies.

RESULTS

Primary Results

A total of 438 analyzed keywords and phrases (terms), 1054 paired combinations were analyzed. On average, each publication contained 4.6 terms and 11 combinations. A total of 45 terms and 75 combinations occurred more than once. Table 1 presents the terms that appeared 4 or more times.

 

Table 1. Frequency of keywords in the analyzed publications

Term (keyword or phrase)	Occurrence
	Number of cases			Percentage
	Total	2015–2019	2020–2024	2020–2024
Human anatomy #	60	37	23	38
Higher education	22	12	10	45
Teaching	21	11	10	48
Anatomical specimens #	13	8	5	38
Teaching methods	10	5	5	50
Distance learning	9	4	5	56
International students	9	5	4	44
Innovative learning *	7	1	6	86
Pedagogy *	6	1	5	83
Psychology *	6	1	5	83
Surveying	5	3	2	40
3D anatomy #	4	3	1	25
Dissection #	4	3	1	25
Interactive learning	4	3	1	25
Quality of education	4	2	2	50
Clinical reasoning #	4	3	1	25
Latin terminology #	4	4	0	0
Instructor’s personality #	4	3	1	25
Curriculum #	4	3	1	25
Polymer embalming (plastination)	4	2	2	50
Practice-oriented learning *	4	1	3	75
Problem-based learning	4	2	2	50
Modern approaches to learning	4	2	2	50
Students *	4	1	3	75

Note. * Terms with increased frequency in 2020–2024 (≥75%); # Terms with decreased frequency in 2020–2024 (≤40%).

 

As 2020 became a turning point for all Russian medical universities, and the subsequent changes during and after the COVID-19 period substantially modified the methodology of teaching human anatomy, particularly through the increased use of innovative computer technologies, we further focused on the 2020–2024 interval.

All analyzed terms can be divided into 3 groups. Group 1 includes terms that were more frequently encountered in 2020–2024 (≥75% of occurrences). These terms include innovative learning, pedagogy, psychology, practical method, and students. Based on this trend, it may be expected that the frequency of these terms in publications devoted to teaching human anatomy will continue to increase.

Group 2 includes terms less frequently encountered in 2020–2024 (≤40% of occurrences): Latin terms, 3D anatomy, dissection, interactive learning, clinical reasoning, instructor’s personality, curriculum, human anatomy, and anatomical specimens. The observed trends suggest that, unfortunately, the frequency of this group of terms in publications addressing the educational process in human anatomy is likely to decrease.

Group 3 represents the main body of terms (words and phrases) whose frequency remained relatively stable throughout the study period. The structure of interrelationships among key concepts (words and phrases) is shown in Fig. 1.

 

Fig. 1. Relationships between keywords: HE, higher education; PC, professional competencies; IT, innovative teaching; DL, distance learning; TM, teaching methods; EP, educational program; DM, dissection methods; PB, polymer embalming; MA, modern approaches to teaching. The terms most frequently encountered in the publications are highlighted in bold; the terms with increasing frequency and their associations are marked in red; those with decreasing frequency and their associations are marked in blue.

 

DISCUSSION

Summary of Primary Results

Our study demonstrated that some substantial changes have occurred in the teaching of human anatomy in recent years. Innovative methods involving computer technologies are replacing classical approaches based on cadaveric anatomical specimens.

Discussion of Primary Results

The changes observed in the teaching of human anatomy after 2020 were partly associated with the coronavirus disease 2019 (COVID-19) pandemic, which is consistent with the findings of other authors [3, 4]. In March 2020, all Russian universities shifted to distance learning because of the epidemiological situation. However, the experience gained in this format has shown that no remote learning platform can fully substitute in-person training. The main reason is the need to work with cadaveric anatomical specimens [1, 5–8]. At the same time, our analysis revealed a decline in the frequency of the term anatomical specimen in the Russian scientific publications since 2015.

Currently, the acquisition, preparation, and storage of anatomical specimens, as well as religious, cultural, and ethical restrictions, have contributed to the decreasing emphasis on traditional approaches to teaching human anatomy [9, 10]. According to Federal Law of the Russian Federation No. 323-FZ On the Fundamentals of Health Protection of Citizens, dated November 21, 2011, the use of human remains for medical, scientific, and educational purposes is permitted only under the following conditions:

• The body is unclaimed or there is notarized lifetime consent.
• The identity of the deceased is established.
• Permission is granted by the authorities that ordered the forensic examination.

In practice, however, full compliance with these requirements is challenging [7, 8]. Nevertheless, according to E.S. Ershova [11], assistant professor at the Department of Human Anatomy, Kursk State Medical University, “there is a revival of the traditional method of cadaveric dissection in anatomy education” [11], which highlights the importance of the systematic scientometric analysis to evaluate the development of human anatomy.

It should also be noted that as interest in cadaveric specimens has declined, the frequency of terms such as innovative technologies, polymer embalming, and plastination has increased.

Our findings also indicate a growing frequency of terms such as pedagogy, psychology, and students in publications. Over the past decade, the practice of surveying students to evaluate their satisfaction with the educational process has made it possible to consider learners’ perceptions of faculty competence and the organization of teaching activities. The analysis of various surveys has revealed psychological difficulties associated with the study of human anatomy [12].

The data from Kursk State Medical University indicate that students may have attention deficit, hyperactivity, dyslexia, and difficulties with correct pronunciation of Latin terms [13]. Additionally, challenges are observed in formulating detailed responses, providing arguments, and reading large volumes of text. During lectures, students often find it difficult to identify the key points [3].

It has been suggested that the ability for abstract logical thinking emerges in students only after the age of 20 years. Therefore, for first-year students, cadaveric anatomical specimens and high-quality visual teaching aids are essential [1, 3]. The preferred standard of contemporary education is textbooks and manuals that present material in the form of the most common and universal patterns [14].

We noted that after 2020, the term anatomical museum has become more common in publications. The use of anatomical museums remains a traditional method of teaching human anatomy in Russian medical universities, as nearly every department of human anatomy maintains such a collection. Authors of nearly all publications mentioning this term emphasize that the most valuable feature of anatomical museums for teaching is the availability of specimens illustrating individual, sex-specific, and typological variations in human anatomy. For instance, the authors from the Russian State Medical University reported that anatomical museum displays are filled with unusual and unique exhibits, including specimens illustrating pathological changes, congenital malformations, and other abnormalities [15]. At the Department of Human Anatomy, Prof V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, the museum houses a collection of specimens illustrating developmental anomalies [16]. The Fundamental Museum of the Department of Normal Anatomy at the Military Medical Academy contains both the specimens representing systematic anatomy and a unique teratological collection of approximately 150 exhibits, including more than 50 rare specimens that illustrate individual anatomical features, age-related changes in various organs, and striking examples of typical pathologic processes [1]. The exhibition hall of the Department of Normal Anatomy at the Military Medical Academy is also popular among medical students and high school students; it presents specimens that comparatively demonstrate normal anatomy, pathologic anatomy, and the effects of harmful habits on the human body.

We assume that in the context of limited access to cadaveric material for teaching, combining the resources of anatomical museums with innovative educational technologies, helping students overcome psychological barriers, may become a breakthrough direction in the development of anatomy education in Russia. To some extent, this is supported by the growing use of the interactive Pirogov anatomical table (Synergy Research and Production Association, Russia), which has been the focus of several recent publications [9, 17].

The uniqueness of the interactive anatomical table lies in its ability to simulate the structural organization of male and female bodies at different levels. In addition, the virtual environment allows simulating surgical approaches used in operative procedures, as well as analyzing the imaging data from computed tomography and magnetic resonance imaging, which are of great significance for applied anatomy education. The interactive table increases student engagement and enables learners to model their own approaches to studying the material [17].

To further enhance visualization in teaching, the Department of Normal Anatomy at the Military Medical Academy, in collaboration with RedFab (Russia), has begun developing original 3D models using 3D printing technologies. These models are based on digital processing of cadaveric specimens and classical teaching aids, as well as the creation of virtual anatomical models employing augmented reality and VR technologies [18].

It should be emphasized that despite the growing use of innovative technologies, the demonstration of anatomical variation in educational and fundamental museums remains a classical method for studying individual differences in organs as well as anomalies and congenital malformations.

According to Nikolenko [19], there is a need to “synchronize” traditional instruction with modern educational technologies, including the use of new visual and teaching tools, ranging from standard smartphones to advanced devices. However, it is important to note that even the most advanced interactive technologies cannot replace cadaveric dissection, which remains an essential component of high-quality medical education [1, 20].

CONCLUSION

Over the past decade, the teaching of human anatomy in Russian medical universities has shifted its focus away from the use of cadaveric specimens, mandatory dissection of human body regions, and the mastery of Latin terminology, toward the adoption of innovative educational technologies.

The authors firmly believe that traditional methods of anatomy teaching, including the obligatory use of cadaveric specimens and dissection, must be revitalized, as these practices distinguished the Russian anatomical school and ensured the training of highly qualified physicians. The preparation of anatomical specimens also enriched the collections of anatomical museums, which display rare exhibits illustrating typical and variant anatomy, congenital anomalies, and developmental defects.

At the same time, the integration of modern educational technologies, such as interactive anatomical tables and various digital and multimedia formats, into the teaching of human anatomy will undoubtedly enhance student motivation and foster the development of clinical reasoning skills.

ADDITIONAL INFORMATION

Author contributions: I.V. Gaivoronsky: conceptualization, data curation, writing—review & editing; V.V. Krishtop: conceptualization, data curation, writing—original draft; G.I. Nichiporuk: data analysis, writing—original draft; M.G. Gaivoronskaya: writing—original draft, writing—review & editing; A.A. Semenov: investigation, writing—original draft; P.S. Paschenko: investigation, writing—original draft. All the authors approved the version of the manuscript to be published and agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding sources: No funding.

Disclosure of interests: The authors have no relationships, activities, or interests for the last three years related to for-profit or not-for-profit third parties whose interests may be affected by the content of the article.

Data availability: All data obtained in the present study are presented in the article.

Generative artificial intelligence: No generative artificial intelligence technologies were used in the creation of this article.

Review and peer review: This work was submitted to the journal on an unsolicited basis and reviewed through the standard procedure. The review process involved two external peer reviewers, a member of the editorial board, and the journal's scientific editor.

作者简介

Ivan V. Gaivoronsky

Kirov Military Medical Academy; Saint Petersburg State University

Email: i.v.gaivoronsky@mail.ru
ORCID iD: 0000-0002-6836-5650
SPIN 代码: 1898-3355

Dr. Sci. (Medicine), Professor

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Vladimir V. Kryshtop

Kirov Military Medical Academy

Email: chrishtop@mail.ru
ORCID iD: 0000-0002-9267-5800
SPIN 代码: 3734-5479

Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Gennady I. Nichiporuk

Military Medical Academy named after S.M. Kirov; Saint Petersburg State University

Email: nichiporuki120@mail.ru
ORCID iD: 0000-0001-5569-7325
SPIN 代码: 3532-1203

Cand. Sci. (Medicine), Assistant Professor

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Maria G. Gaivoronskaya

Almazov National Medical Research Centre; Saint Petersburg State University

编辑信件的主要联系方式.
Email: solnushko12@mail.ru
ORCID iD: 0000-0003-4992-9702
SPIN 代码: 2357-5440

Dr. Sci. (Medicine), Assistant Professor

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Alexey A. Semenov

Kirov Military Medical Academy; Saint Petersburg State University

Email: semfeodosia82@mail.ru
ORCID iD: 0000-0002-1977-7536
SPIN 代码: 1147-3072

Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Pavel S. Pashchenko

Kirov Military Medical Academy

Email: pashchenkops@mail.ru
ORCID iD: 0000-0003-2711-7711
SPIN 代码: 1035-3261

Dr. Sci. (Medicine), Professor

俄罗斯联邦, Saint Petersburg

参考

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