Using Q‐Methodology to Evaluate Student Perceptions of Online Anatomy in the Time of COVID‐19

Abstract

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.

Anatomy beyond the pandemic: A Q‐methodology study exploring student perceptions toward a hybrid curriculum

“…A drawback of virtual anatomy education is the omission of what is known as the “hidden curriculum,” which refers to the teamwork, ethical reasoning, empathy, and respect that is brought upon through interaction with body donors 18,19 . A previous study conducted by our group on a completely virtual Anatomy course revealed students' indifference regarding the privilege of learning from virtual human prosections 8 which directly contrasts with the current study's findings. In fact, all students were in strong agreement that it was a privilege to learn from human prosections, and a slight increase in agreement was noted following the winter semester and more in‐person laboratory experiences, as exemplified by student feedback expressing gratitude toward donors for enhancing their learning (Table 5).…”

“…The first step to a Q‐methodology study is the development of a concourse . The authors developed a comprehensive set of statements related to the anatomy and physiology course sourced from open‐ended student feedback, prior concourses, 8 and the relevant literature. These statements were reviewed and refined with minor edits by a panel of experts including course instructors, administrators, and a Q‐methodology expert for clarity and relevancy across both semesters.…”

“…These studies have yielded mixed results with regard to students' perceptions toward online education with some indicating favorable views based on the convenience of online learning, 2 accessibility of content, 3 and ideal conditions for self‐directed learning 4 ; while others indicating negative views related to the lack of personable interactions in an online curriculum, 5 inability to work with specimens 6 and encounters with technical difficulties 7 . One study used Q‐methodology (a semi‐quantitative qualitative approach) to explore undergraduate student perceptions toward an online curriculum of anatomy and physiology 8,9 . The study revealed three distinct perspectives toward the virtual learning environment: students that were satisfied with the course, students that were unhappy with several course elements, and students that enjoyed interactive course components like tutorials.…”

“…7 One study used Q-methodology (a semi-quantitative qualitative approach) to explore undergraduate student perceptions toward an online curriculum of anatomy and physiology. 8,9 The study revealed three distinct perspectives toward the virtual learning environment: students that were satisfied with the course, students that were unhappy with several course elements, and students that enjoyed interactive course components like tutorials. This study also found that some perspectives were shared amongst all students such as students' preference for physical specimens over virtual ones.…”

“…Student learning preferences across fall and winter terms presented in percentage of Q-sorts. Factor one: no preference for virtual or in-person learning, factor two: prefer in-person learning, factor three: prefer virtual learning (as determined by responses to statements3,8,32,34,40,41).…”