As post‐secondary education migrates online, developing and evaluating new avenues for assessment in anatomy is paramount. Three‐dimensional (3D) visualization technology is one area with the potential to augment or even replace resource‐intensive cadaver use in anatomical education. This manuscript details the development of a smartphone application, entitled “Virtual Reality Bell‐Ringer (VRBR),” capable of displaying monoscopic two‐dimensional (2D) or stereoscopic 3D images with the use of an inexpensive cardboard headset for use in spot examinations. Cadaveric image use, creation, and pinning processes are explained, and the source code is provided. To validate this tool, this paper compares traditional laboratory‐based spot examination assessment stations against those administered using the VRBR application to test anatomical knowledge. Participants (undergraduate, n = 38; graduate, n = 13) completed three spot examinations specific to their level of study, one in each of the modalities (2D, 3D, laboratory) as well as a mental rotation test (MRT), Stereo Fly stereotest, and cybersickness survey. Repeated measures ANCOVA suggested participants performed significantly better on laboratory and 3D stations compared to 2D stations. Moderate to severe cybersickness symptoms were reported by 63% of participants in at least one category while using the VRBR application. Highest reported symptoms included: eye strain, general discomfort, difficulty focusing, and difficulty concentrating. Overall, the VRBR application is a promising tool for its portability, affordability, and accessibility. Due to reported cybersickness and other technical limitations, the use of VRBR as an alternative to cadaveric specimens presents several challenges when testing anatomy knowledge that must be addressed before widespread adoption.

Background Since the seventeenth century, the primary approach to teaching anatomy has involved hands‐on learning using cadaveric specimens. However, the ability to use this long‐standing tradition was curtailed in the 2020‐2021 school year due to the COVID‐19 pandemic. Many institutions closed physical classrooms entirely, launching experiential courses, such as anatomy, into the online space. Hypothesis We hypothesized that Q‐methodology could be used to uncover student perceptions of an introductory anatomy and physiology course that was offered online for the very first time. Methods Q‐methodology, considered the study of subjectivity, is an approach that statistically uncovers groups of individuals with shared perceptions within a larger cohort. Instructors can use Q‐methodology to identify groups of students with shared needs, allowing for more specific and productive course reform. In the current study, Q‐methodology was used as a means of course evaluation in the fall 2020 and winter 2021 semesters. Students were asked to sort 44 opinion‐based statements in a quasi‐normal table based on their level of agreement. By‐person factor analysis of 166 responses revealed three statistically distinct groups of students. Results The three groups were assigned the following monikers: Connected and Contented (CC), Disconnected and Disgruntled (DD), and Interconnected and Collaborative (IC). CC students (n=66) felt generally ambivalent toward course components and were comfortable with the technology skills required to participate in the online course space. DD students (n=50) were deeply unhappy with several elements of the course, including lectures, assignments, and evaluations. These students also felt as if they were teaching themselves. Finally, IC students (n=29) looked favourably upon the tutorial space and the role of teaching assistants. Analysis also revealed that some sentiments were shared across all three groups, including the preference for physical rather than virtual specimens, and the desire for more practice questions from faculty in order to prepare for bellringer exams. Interestingly, cohort opinions did not remain static across both semesters. There was a positive attitude shift as more students felt “Disconnected and Disgruntled” in the fall, and “Connected and Contented” in the winter. Conclusions These findings are useful for anatomy instructors interested in transitioning courses to an online or blended space, particularly in the face of ever evolving public health restrictions. The current study also models the wealth of information that can be uncovered using Q‐methodology ‐ useful for anyone interested in the previously amorphous study of subjectivity.

Introduction Anatomy education traditionally relies on in‐person learning and experiential skill development. However, the ongoing COVID‐19 pandemic has forced many courses to adopt online modes of delivery, and anatomy is no exception. The question now is whether anatomy education has successfully made the transition to the digital space, particularly with respect to the perception of learners. Objective The current study seeks to understand how students view an online, introductory anatomy and physiology course. Traditional methods of course evaluation include Likert scales and open‐ended responses; however, such methods fail to consider both the diversity of learners and the need for course‐specific feedback. Thus, we used the emerging area of Q methodology as a tool for course evaluation. Hypothesis We hypothesize that Q methodology will enable us to uncover student opinions which are specifically relevant to their online course experience. Methods Q methodology can be used to identify groups of learners with shared perceptions, allowing educators to better understand and respond to the needs of students. Studies consist of three phases: survey instrument development, data collection, and analysis/interpretation. First, a list of opinion‐based statements regarding anatomy education are selected. Next, students rank statements based on their level of agreement. Finally, rankings undergo a by‐person factor analysis to categorize students into distinct groups with shared perceptions. Results Data was collected from 106 students at McMaster University. Factor analysis revealed three distinct subgroups within the cohort. Group 1 (n = 45) felt they needed more time on their evaluations and lectures did not cover an appropriate amount of content. Group 2 (n = 30) did not enjoy synchronous tutorials or labs. Group 3 (n = 21) overall was satisfied with course delivery. Certain perceptions were also shared among all three groups. There was a consensus among students that they generally disliked online learning compared to in‐person learning, with particular concern surrounding the use of virtual specimens and bellringer exams. Students, however, appreciated the availability of asynchronous lectures as a mode of online content delivery. Age, sex, program, education history, and anticipated grade were not associated with cohort subgroupings. Conclusion Interestingly, results of this study recognize similar course strengths/limitations noted in in‐person classes (e.g., value of in‐person laboratories and assessment concerns reported elsewhere), but also highlight key areas of strength (asynchronous lectures) and limitation (use of digital resources) specific to the online environment, which will be important considerations for future online offerings. Next steps for the current study include repeating the evaluation in the winter semester to see if opinions are stable across groups of learners and individual students.

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