Geoffroy P. J. C. Noel

Body painting (BP) is a well‐established active learning strategy in anatomy education that promotes engagement and spatial understanding of surface anatomy. However, it is time‐intensive and may disadvantage students with limited artistic confidence. Temporary tattoos (TT) may offer a faster, standardized alternative. An intensive undergraduate anatomy course included four weekly surface anatomy sessions (face/neck, arm/forearm, hand, leg). Participants were randomly assigned to BP or TT for each session and participated in both modalities twice. Quiz scores and time‐on‐task were recorded after each session. Control scores were derived from regions not associated with either modality. Statistical analyses included Friedman tests and Wilcoxon signed‐rank tests. Per‐participant costs were calculated for both modalities. Learning condition significantly affected quiz performance ( Q (2) = 6.595, p = 0.037). Median scores were 78% [IQR: 72–84] for control regions, 85% [80–89] for BP, and 84% [79–88] for TT. Both BP and TT significantly outperformed control regions (ΔBP, p < 0.0001; ΔTT, p = 0.019). Absolute quiz scores did not differ between BP and TT ( p = 0.657), but TT yielded significantly larger relative gains within‐subjects (ΔTT − ΔBP, p < 0.0001). BP required more time than TT (26.5 vs. 15.0 min; p < 0.0001). Per‐participant costs were comparable (BP: USD$8.92; TT: USD$9.64). Both modalities enhanced surface anatomy learning. TT produced larger relative gains while requiring less time, suggesting a more time‐efficient alternative to BP without compromising learning outcomes.

This study aimed to redefine the precise morphology and relationships of the temporal fasciae using high resolution sectioned images and three dimensional (3D) models. In the temporal region, fascial layers are difficult to distinguish by cadaveric dissection, which has contributed to inconsistent anatomical terminology. Therefore, we undertook this study to investigate and clarify these fasciae. Using the sectioned images with true color and high resolution, fascial, muscular, and vascular structures in the temporal region were traced, segmented, and reconstructed into surface models using MATLAB and Slicer. Maya scripts integrated these models with the sectioned images for 3D visualization. Three fascial layers (the temporoparietal fascia, the superficial layer of the deep temporal fascia, and the deep layer of the deep temporal fascia) were clearly distinguished. The deep temporal fascia presented as a single layer posteriorly but divided into two layers anteriorly. Distinct fat pads were consistently identified between each fascial layer and between the deep fascia and temporal muscle. The courses of the superficial temporal artery and middle temporal vein were precisely visualized. This study provides a clarified, 3D anatomical framework of the temporal fascia, resolving discrepancies in traditional descriptions. High fidelity, artifact free image data offer a reliable basis for safer surgical approaches, flap elevation, filler injections, and regional anesthesia in the temporal region.

The neural crest generates a broad spectrum of cell types that migrate across the body plan to populate multiple tissues¹. However, the relationship between lineages of neural crest derivatives remains unclear, and the extent to which neural crest cells delaminated from the neural tube have specified fates remains debated. Here, leveraging CRISPR barcoding in mice and mosaic variant barcode analysis in humans, we demonstrate robust bilateral progenitor clonal spread of neural crest progenitors along the rostrocaudal axis but limited clonal overlap between sensory and sympathetic lineages. Computational modelling of mosaic variants suggests that most neural crest cells show strong fate restriction before delamination. Real-time imaging of quail embryos further shows a fibroblast-growth-factor-dependent rostrocaudal dispersion of neural crest cells across multiple axial levels. These findings support a model in which neural crest fate bias predominantly emerges within the neural tube, with only a minor subset of delaminated progenitors retaining multipotency to generate both sensory and sympathetic derivatives.

Mixed reality (MR) offers a way to visualize and manipulate complex digital objects in three dimensions, which is particularly beneficial for human anatomy. However, implementing MR effectively requires a deep understanding of its effects on cognitive processes. The purpose of this study was to evaluate cognitive markers of students' engagement and cognitive load while they used MR technology to overlay donor‐specific diagnostic imaging onto the corresponding body donors in a fourth‐year medical elective course. During two separate dissection sessions, each participant ( n = 12) used the imaging on (1) a head‐mounted Microsoft HoloLens and (2) an Apple iPad to examine the underlying anatomy of their body donor before beginning dissection. During each activity, participants wore portable five‐lead electroencephalographic (EEG) devices to collect cognitive processing data. Separate indexes were calculated from those data to quantify engagement (engagement index; EI) and cognitive load (theta‐alpha ratio; TAR), which were compared between HoloLens and iPad usage. Mean EI calculated from EEG data collected while using the HoloLens (0.499 ± 0.038) was significantly higher than the mean EI while using an iPad (0.297 ± 0.037; p = 0.002). Conversely, the mean TAR calculated from EEG data collected while using the HoloLens (1.508 ± 0.047) was significantly lower than that collected while using an iPad (1.813 ± 0.071; p = 0.012). These results indicate that the use of HoloLens to superimpose radiographic images onto a human body donor during dissection is significantly more engaging and requires less cognitive effort than the same task on an iPad.

Compassion training (CT) has been used in medical education to enhance patient care and decrease provider burnout. A growing number of institutions incorporate humanistic practices into anatomy classes; however, there is no report of CT ever being incorporated. The authors hypothesized that implementing CT during a pre-clinical anatomy course, a program called Compassionatomy, would help students to identify with body donors, practice compassion contemplative exercises during and outside of anatomy labs, and maintain high empathy levels throughout the academic year. All first-year medical students at UC San Diego enrolled in 2022/2023 experienced Compassionatomy, which included combinations of CT during the 7 most emotionally challenging dissections. Longitudinal study participants (n = 36) completed 20 session evaluations—after each of 7 sessions with and 13 sessions without CT. Students’ connection with the body donor, assessed by the Inclusion of Other in Self scale, increased over the year (p < 0.001) with more connection after CT than non-CT sessions (p = 0.048). This increase was associated with higher self-rated positive emotional valence (p = 0.03) but not arousal (p = 0.56). In-session engagement with compassion practices increased over time (p = 0.04). More engagement in contemplative practices outside anatomy was reported in the weeks following CT than non-CT sessions (p = 0.02). Empathy levels, assessed by the Jefferson Scale of Empathy (JSE), remained high across the year (p = 0.22) and did not differ between students in the cohort receiving Compassionatomy and the previous year’s cohort who had not experienced Compassionatomy (p = 0.15). Results suggest that incorporation of CT into anatomy labs has benefits for enhancing connection with the body donor, the students’ “first patient.”

The acquisition of craniofacial and airway nerve block (ANB) skills is hindered by the complex anatomy involved, reliance on landmark-guided techniques, and the absence of simulation-based training tools. Augmented reality offers a promising platform for procedural training by providing real-time visual feedback, yet its potential to improve accuracy in ANBs has not been evaluated. This exploratory study assessed the feasibility of AR guidance for improving nerve block performance among anesthesiology faculty and residents. 20 participants performed infraorbital, inferior alveolar, superior laryngeal, and glossopharyngeal nerve blocks with and without AR guidance using volumetric Digital Imaging and Communications in Medicine (DICOM) reconstructions superimposed on body donor heads via Hololens headset, from Microsoft Corporation and SurgicalAR software from Medivis. AR guidance included a localizer instrument for real-time tracking of a physical needle along a premapped virtual needle path. Performance was assessed by dissection-based accuracy (proximity of methylene blue to the nerve) and procedure time. Overall clinical acceptability was similar between AR and non-AR conditions (65.0% vs 55.0%, McNemar’s p=0.754). There were no differences in performance when stratified by level of training (McNemar p=0.219 for residents; McNemar p=0.625 for faculty). However, AR significantly increased procedure time (overall 49.9±8.4 vs 14.5±2.6 s, Wilcoxon p<0.001) and time increases were consistent across training levels (faculty: +34.9 s, p=0.016; residents: +36.0 s, p=0.062). Additionally, there was no difference in nerve block success or procedure length between an overlay mode with the DICOM superimposed onto the body donor and a detached mode with the DICOM floating above or next to the body donor. In this small, exploratory study, AR did not significantly impact the rates of clinically acceptable nerve blocks when performed by faculty or resident anesthesiologists; however, AR significantly increased the amount of time required to perform the procedures. This proof-of-concept study successfully demonstrated the feasibility of using AR to learn and/or perform various craniofacial and ANBs using commercially available technology.

Objectives: This study aims to quantitatively assess the baseline level of self-perceived cultural competency preparedness and skillfulness among medical and health professions students from 21 universities around the world utilizing a previously validated and standardized testing tool. Design: Cross-sectional study. Setting: The International Collaboration and Exchange Program (ICEP), a global exchange initiative for junior medical and health professions students spanning 21 universities across four continents. Participants: A total of 753 students from the 2021 and 2022 ICEP cohorts. Main Outcome Measures: Students self-evaluated their cultural competency skills on a 5-point Likert-type scale encompassing different areas of competency. Multiple linear regression was performed to identify contributors to cultural competency levels. Results: Upon rating how skillful they are at interacting with culturally diverse patients, North American students reported the highest scores with a mean of 3.22, while Australian students showed the lowest score of 2.82. When analyzing students’ stages of study, those in clinical years of medical schools scored the highest at 3.29. Significant variations were observed in the cultural competency self-rating scores among students based on their respective regions ( p  < .005) and program types/stages ( p < .05). Notably, students in their clinical years of school consistently rated themselves higher compared to their preclinical counterparts ( p < .05). Furthermore, students from Europe displayed elevated self-ratings compared to the other regions ( p < .005). Conclusions: Though these participants represent a highly motivated subgroup of students, potentially limiting result generalizability, the findings emphasize that regional differences exist. Given the multifaceted nature of cultural competency, the results suggest that factors such as educational stage, age, and region may influence students’ perceived competency levels.

The neural crest generates numerous cell types, but conflicting results leave developmental origins unresolved. Here using somatic mosaic variants as cellular barcodes, we infer embryonic clonal dynamics of trunk neural crest, focusing on the sensory and sympathetic ganglia. From three independent adult neurotypical human donors, we identified 1,278 mosaic variants using deep whole-genome sequencing, then profiled allelic fractions in 187 anatomically dissected ganglia. We found a massive rostrocaudal spread of progenitor clones specific to sensory or sympathetic ganglia, which unlike in the brain, showed robust bilateral distributions. Computational modeling suggested neural crest progenitor fate specification preceded delamination from neural tube. Single-cell multiomic analysis suggested both neurons and glia contributed to the rostrocaudal clonal organization. CRISPR barcoding in mice and live imaging in quail embryos confirmed these clonal dynamics across multiple somite levels. Our findings reveal an evolutionarily conserved clonal spread of cells populating peripheral neural ganglia. Highlights - Genetic mosaicism and real-time imaging reveal trunk neural crest cellular dynamics. - DRG or SG cells from different axial levels are more lineage-related than from the same level. - Cell fate specification of trunk neural crest progenitors occurs before neural tube delamination. - These aspects of clonal organization are evolutionarily conserved across mammals and avians.