Of mice (dogs, horses, sheep) and men: A novel comparative anatomy dissection course in a United Kingdom university

At the University of Bristol, we established a novel dissection course to complement our anatomy degree. Students enrolled in this undergraduate course are trained as comparative anatomists, with equal time given to both human and veterinary anatomy. Historically, students opted to dissect either human or veterinary donors as part of the course. To fully reflect the comparative nature of the degree, the dissection course was redesigned so students could dissect both human and veterinary specimens as part of the same course. This facilitated a wide‐ranging experience of anatomy, encouraging detailed knowledge of a multitude of species and allowing for multifaceted anatomy graduates to be ready for employment in a wide and competitive job market. Across three iterations of the amended version of the course, median marks ranged from 58.7% to 62.0%, with between 22 and 39 students enrolled. In comparison to the course prior to the introduction of the change, median marks ranged from 59.8% to 62.8%, with between 16 and 24 students enrolled. There was no significant difference between marks before or after the introduction of the concurrently comparative aspect. This paper describes the course, with learning materials and assessments considered, along with some reflection on its value. The course offers benefits to students by widening their perspective on anatomical knowledge and making them more equipped for the job market. It also broadens their understanding of form‐function relationships. However, student feedback implied that having the choice between human or veterinary dissection was preferable, and this may outweigh the perceived benefits of the course.


INTRODUC TI ON
The most effective way for anatomy to be taught continues to be a subject of debate in higher education institutes globally, 1,2 and the use and value of teaching with body donors continues to be questioned. 3Arguments around efficacy, cost, and safety are offered as reasons to abandon this classic style of teaching, but despite this, it remains the preferred method of instruction by many institutions globally, with extensive learning opportunities highlighted beyond the purely anatomical. 4,5As educators, it is our duty to provide the materials needed for students to become familiar with core concepts while presenting appropriate avenues for further lifelong learning.
As such, we must continue to review our practice to ensure anatomy teaching is delivered in a way that is relevant and useful to the twenty-first century anatomist.
At the University of Bristol, our second-year Applied Anatomy BSc students undertake full body dissection as part of their Anatomy by Dissection course.At its inception in 2017, this course offered students the opportunity to undertake either full human or veterinary dissections, with veterinary dissection utilizing a canine donor alongside appropriate large animal specimens where relevant.The option allowed students to follow interests or develop specialties in an area of anatomy that suited them.
The School of Anatomy is uniquely placed in the United Kingdom as being home to both human and veterinary anatomy specialties under the same roof.Medical, dental, veterinary, and science courses all utilize the expertise housed at the school, allowing for multidisciplinary teaching and sharing of detailed anatomical knowledge by dedicated anatomy specialists.Full advantage of this has been adopted as part of the Applied Anatomy BSc, and especially for this course.
During the 2020-2021 academic year, we made significant adaptations to this course.In order to increase the amount of dissection possible during social distancing periods, students were provided with a dissection course interjecting human dissection with relevant veterinary dissections.Specimens of canine, bovine, and equine origin were dissected by students to highlight interesting variations or to demonstrate scientifically relevant topics.The course encouraged students to observe the adaptations acquired by species, to develop their dissection skill set, and to enhance their understanding of both human and veterinary anatomy.
Our justifications for these changes are many, as will be discussed.One justification for these changes is the expectation that teaching anatomical science in this way develops a fundamental understanding of anatomical structure.Where the development of the pentadactyl limb is considered, for example, students are able to see how structures adapt in canine, human, and equine species.Similarly, adaptation of the gut for varied digestion is successfully demonstrated in human, canine, equine, and ruminant gut dissections.

ME THODOLOGY
During the academic year 2020-2021, as a result of the global COVID-19 pandemic, significant changes were made to higher education delivery globally. 6Practical, in-person teaching was especially impacted, and social distancing guidelines brought about by the pandemic meant it was no longer possible for all students to be present around a donor simultaneously.
We adapted with secure, two-way live streaming of our dissections, facilitated by ceiling-mounted cameras. 7A reduced number of students from each dissection group (2-3 students per group, of a group of 7 students) entered the dissection room on a rota to continue to engage with the practical element of the course while respecting social distancing regulations.Those not scheduled to attend in person attended via a live-streamed Zoom call. 8This stream was not recorded at any point to respect cadaver consent and ensure the security of the session.The dissectors streamed their work from the dissection room, with one member dissecting, another narrating and ensuring visibility of the dissection, while the third researched and answered questions posed by those at home.The home group provided feedback, generated discussion, and conducted further research.
The discrepancy between the student numbers in the human and the vet dissection streams meant that those choosing to undertake veterinary dissection would have received twice as many practical experiences as those dissecting human donors due to the smaller cohort size.The serendipitous decision was made to introduce the multi-species dissection route that was initially planned, with all students dissecting both human and veterinary specimens.The nature of the change complemented the wider course and was perceived as being advantageous to the students.While initially driven by restrictions in the 2020-2021 academic year, the changes described here are not limited to pandemic-related changes and were planned changes for the course that were accelerated by the pandemic.

Course structure
The course runs the full length of the academic year, and allows for eighteen, three-hour dissection sessions.The sessions run on a once-weekly basis and aim to cover the following intended learning focused on a specific aspect of regional anatomy.Table 1 outlines the focus of each dissection session, where they fit in the academic year as well as how sessions relate to other academic events in the year.This distribution of sessions allowed for 10 human-focused dissections, 6 canine-focused dissections, and 2 dissections of large animal material.These were aligned so that similar body regions were grouped, allowing comparisons between body regions to be made more easily.Sessions were explicitly designed to focus on a single species per week to ensure exclusive use of the dissection room, ensuring no mixing between human and nonhuman materials.
The introductory session in week 1 invites all students into the dissection room to familiarize with tool use, dissection technique, and regulations surrounding human tissue use.Weeks 6, 12, and 16 are allocated as "Wellbeing Weeks."These weeks are intentionally free of teaching in every Applied Anatomy BSc course, and can be used by students for whatever purpose they consider as most needed.Typically, this includes catching up with material, TA B L E 1 Outline of session titles for each of the dissection sessions.To ensure appropriate use of donated tissue, there was never cross over between human and animal tissue at any point.As outlined in Table 1, human and veterinary dissections took place on separate weeks, with human and animal tissue never sharing a dissection room.
Students were provided with a pair of dissection guides: one for Teaching Block 1 and another for Teaching Block 2. The dissection guides were bespoke to the course presented in this study, and was written by subject specialists from the School of Anatomy.The guides were instructional in nature, with interspersed questions designed to guide student research or prompt further thinking about a structure or region.
Each section of the guide had an Intended Learning Outcomes section, a Surface Anatomy section and a Clinical Applications section to allow for the application of the anatomy.

Assessment
Assessment in anatomy comes with several challenges.Retention of anatomical content might be assessed through a multiple-choice question or a spotter test, though these assessment styles often examine the lower levels of Bloom's taxonomy 9 and typically align best with earlier stages of higher education.As a Level I/5 course, students on this course are expected to demonstrate higher cognitive skills, and the skills they develop in this course complement those required for their final year.As such, research and critical evaluation skills are encouraged.
We attempt to assess this course with inclusive assessment types to ensure all learners are accommodated and that assessment is appropriate and constructive to students' future careers.Table 2 outlines the assessment required for this course.

Essays
Students were set essay titles relating to the body region being dissected in that teaching block; there was one essay set at the start of the first teaching block, due at its end, and another set at the start of the second teaching block, due at its end.The essays were limited to 2000 words and were marked according to the University of Bristol 21 marks scale (Appendix 1), assessing an ability to cover and evaluate the literature, apply criticality, and develop an original argument with polished scientific writing.

Dissection guide
This was a novel assessment designed to encourage students to apply their knowledge of anatomy in combination with their applied knowledge of dissection techniques.
Students were given a scenario and were required to design a dissection guide that was specific to that scenario.The scenario was designed to encourage students beyond published dissection guides to apply their research skills and their knowledge.A limit of 1500 words was given, representing the more truncated nature of the writing in this task, with bullet points used frequently.The guides were marked according to the University of Bristol 21 marks scale, assessing the student's ability to identify potential challenges to their dissection, develop a workable guide, and acknowledge the changes to the anatomy as a result of the pathology and the surgery.

Reflection
There were two assessments that applied reflective practice in this version of the course.The first relating to the dissection guide creation task, the second relating to the course more widely.
For the first, students were required to write a two-part reflection: first, to reflect upon the dissection guide writing assessment, considering, for example, their approach, the methods used, or their impression of the task.The second part of this assessment required them to reflect on the dissection session that corresponds to this guide.They were encouraged to consider, for example, how successful the guide that they wrote would have been, how they approached the dissection session, and how successful the dissection session was.
For the second reflection assessment, students were required to reflect upon the course as a whole and were given guidance to consider reflecting on several individual dissection sessions, or to reflect more broadly on the course as a whole, including the process of dissection, what they might have learnt from dissecting and their donor(s) or the challenges they faced.
There was no wordcount given for the reflective assessments, and students were encouraged to reflect thoroughly, having received guidance around reflective practice and an introduction to various methods of reflection. 10,11They were assessed on their evidence of learning, changed practices, and showing effective metacognition.

Donor presentation
As a dissection group, students were required to produce a short, 10-minute presentation on any variations or pathologies identified in their donors.These presentations were made in front of an audience of peers, anatomy academics, and a pair of assessors.Students were encouraged to consider both human and veterinary donors, potentially drawing comparisons between the anatomy or outlining significant differences in the anatomy.
Presentations were marked according to content, verbal and visual delivery, and the structure of the talk.

RE SULTS
Figure 1 shows the average course mark from students enrolled on this course over the last 5 academic years.The results indicate that there was no statistically significant difference between any of the years (One-way ANOVA, p = 0.179), importantly indicating no decrease in performance following amendment to the course.
Prior to this intervention, marks ranged from 44.3% to 75.0%, with an average mark of 58.7%, while the new course design presented marks ranging from 14.4% to 69.6% with an average mark of 55.3%.
There has generally been an increase in registrations on this course, initially reflecting the infancy of the degree and gradual student recruitment onto the course, though the numbers in 2022/23 reflect an exceptional increase as a response to the Covid-19 pandemic. 12This increase was seen nationally across both courses and institutions.
Student feedback on the course has been highly positive.
Students responded positively to the guide and the opportunity to can be firmly attributed to the Greeks. 13Notable examples of early comparative anatomy practitioners include Galen, with his work on pigs and monkeys drawing similarities (though often erroneously) to human anatomy in a way that we could now recognize as comparative. 14An important distinction is made here when considering our definition of comparative anatomy: comparative anatomy requires the application of anatomy across species, including humans to identify similarities and learn collaboratively from diverse specialties. 15r intention was driven by multiple aims, both educational and beyond.In short, we hoped to enable students to benefit from a thriving One Health approach to medical research, 15,16 to become multiskilled and hence succeed in a challenging career market, but also to benefit from multidisciplinary learning.We believed this method afforded a pedagogic advantage that our unique setting could take advantage of.
As we begin to emerge from the Covid-19 pandemic, we can consider the growing importance of "One Health" as a field of study and the important opportunities this type of thinking brings.
One Health is broadly defined as a practice that brings together human, veterinary, and environmental health sciences in order to understand disease in a holistic sense through interaction between animals, humans, and the environment. 15,16Comparative anatomy, with its complete approach to the subject, can be considered aligned to "One Health" and could offer valuable opportunities.Beyond simply looking at veterinary or human pathology or training human or veterinary anatomists, a comparative approach enables graduates on this course to fully participate in "One Health" practices.
We believe the Applied Anatomy BSc course at the University of Bristol is unique in delivering high-level anatomical content across species without bias toward either human or veterinary science.
Though there are anatomy courses globally that touch on comparative elements (considering the anatomical aspects of evolution or zoology, for example), few look at detailed anatomy to the extent demonstrated in this course.
Publication on the teaching of comparative anatomy is also notably scarce, and this makes establishing a new course based on published best practice challenging but especially exciting.While publications make mention of comparative anatomy in evolutionary terms or related to specific regions, [17][18][19][20] there is no available evidence of the educational benefit of teaching anatomy in this way.
Despite this, we maintain that the educational benefits of approaching dissection in this way are multiple and are excited by the opportunities available.
Interdisciplinary education involves a student engaging with multiple subjects with the goal of developing cross-disciplinary knowledge, 21 and this concept can be applied effectively to this delivery method.Ultimately, students on this course must bring together similar (though different) knowledge bases from their separate human anatomy and veterinary anatomy studies.In doing so, students are able to apply their existing knowledge base to an unfamiliar problem, for example, recognizing species-specific variations or adaptations or identifying unknown structures using their prior knowledge of other species.
A study by Wilson et al., investigated the scarcity of anatomy educators available in higher education institutes in both the United States and Canada and the European Union. 22The authors found that most departmental leaders worried that they would experience between "moderate" and "great" difficulty in hiring anatomy educators in gross anatomy, histology, and embryology over the next five years.A significant limitation of this study appears to be the lack of comparative or veterinary focus.Participants were not scrutinized for their species specialty, for which we suspect the discrepancy between human and veterinary anatomists will be even more stark.The goal of any undergraduate degree should be to prepare graduates for a relevant career, and we hope that the novelty of this course wills allow for this.These graduates, with their intricate knowledge of a range of species, bring with them valuable knowledge of the anatomy of model species.With large animals frequently used for translational health care research, [23][24][25][26][27] these graduates are uniquely placed to appreciate the anatomical complexities across species to make reasoned, well-supported analyses.
As part of this new intervention, students rely on knowledge both from their human and their veterinary anatomical studies.
Interdisciplinary work is a popular idea both in higher education and in industry globally, allowing key ideas from multiple themes to be brought together to facilitate problem solving and idea generation. 28,29Interdisciplinary approaches to research were established in response to the ever-increasing complexity of problems researchers face, 30 though there is no reason similar approaches cannot be adopted in education.
A key challenge for this course has been highlighted by students entering the course with a fixed interest in a particular field and the impact this has on their involvement with the comparative course.
While students enrolled in the Applied Anatomy BSc are required to pass both human and veterinary anatomy courses, there are still students with a strong preference for either human or veterinary anatomy.It is well described that positive student motivation and engagement are associated with student success, 31,32 while the inverse is also well described. 33Additionally, approaches to student choice have seen positive results in the sector, especially around student choice in assessment. 34While it is fair to respect student choice, and this is especially important from an inclusivity or diversification perspective, doing so also allows for more diversification of the curriculum and hence more enjoyment within the course. 35It is therefore likely that by restricting choice, this course loses some element of this.

FUTURE DIREC TIONS
In the forthcoming academic year, we will be returning the element of choice to students on this course.While the design and implementation were pedagogically sound, and we remain optimistic about the design, student feedback has shown students favoring an element of choice for this course, and it affecting their overall enjoyment of the course.In response to this feedback, we have restored the choice element but will maintain the alignment of the course, with comparative dissection of analogous body regions happening simultaneously.Students in the forthcoming year will be required to share their practice and findings and discuss variations as a result of species adaptation, thus not losing the valuable lessons learned from the now separate course, all the while upholding appropriate ethical practices as part of this precious learning modality.

CON CLUS ION
We made a considerable change in the delivery of our dissection course in order to allow students to dissect a range of species.
While in part a solution to ensure students still received practical delivery during the pandemic, this was an aim for the course preceding Covid-19, and was not a reaction to the pandemic.While the course ran during restrictions, fortunately many benefits remained when restrictions were eased and became an ongoing change to the Applied Anatomy BSc curriculum.
Through comparative anatomy dissection, students dissected human and domestic species (dog, horse, sheep), and in doing so, applied their anatomy knowledge beyond a single donor, or a single species, to develop a wider understanding of form-function relationships.We found that the new course had no net change to student mark outcomes, but we strongly believe that it has the potential to strengthen anatomical knowledge.
As with other new courses, there remained some teething problems with the new course, including respecting student choice and student motivation, but on the whole, the course has performed well.In future years, we will be adopting a further modification of this course, with students selecting their specialties, while dissecting simultaneously, allowing collaboration and further enhancing the interdisciplinary learning showcased here.

ACK N OWLED G M ENTS
We wish to acknowledge the donation of both human and animal tissue that made this course possible.Our donors' generous gifts are appreciated by all staff and students involved with this course, and our gratitude extends both to the donors, and also to their families for sacrifices that may have been made to allow for this donation.
Dr Hettie Thomas was involved in the initial consultations for the course.

R E FE R E N C E S
The course is offered as a second year (Level I/5),20 credit point course to Applied Anatomy BSc students at the School of Anatomy, University of Bristol.These students progress from their first year with knowledge of anatomy, physiology, and neuroscience, having engaged with two physiology courses, two neuroscience courses, and two anatomical science courses.Their second year allows further expansion of their anatomical knowledge, with two human anatomy courses, two veterinary anatomy courses, and a single imaging course that explores imaging in anatomical study (Visualizing Anatomy through Imaging).The year is completed by the comparative anatomy dissection course.During its inception, the Anatomy by Dissection course offered students the choice to dissect either human donors or a canine donor, with the long-term aim of encouraging multi-species dissection as part of the course.Market research during program design showed that students enrolled in this course were keenly interested in the structure of the body.These were students passionate about biology and the way form-function relationships developed in nature, but they did not see the same opportunities to study anatomy in human and veterinary species elsewhere.These students also wanted to dissect; hence, the dissection course became a compulsory element of the degree.The comparative nature of the second year suited a dissection course that considered multiple species.The choice of what species to dissect was made by students toward the end of their first year, and typically, this decision was guided by students' personal preferences and career aspirations.Human dissection was largely favored by students.During the academic year 2018-2019, 14 students chose to dissect a human donor, with 2 choosing canine dissection, and in 2019-2020, 20 students chose to dissect a human donor, with 3 students choosing to dissect a canine donor.

outcomes: 1 .
Demonstrate a knowledge and understanding of the body, particularly the anatomy underlying common clinical problems and procedures it may have undergone 2. Identify, palpate, and demonstrate surface markings and anatomical features 3. Recognize and investigate evidence of surgical procedures 4. Identify, examine, and research pathologies encountered 5. Recognize common anatomical variations and understand the significance of these 6.Discuss the anatomical bases for clinical examination and clinical procedures 7. Recognize the ethical and legal considerations of bequeathal program/procurement of tissue within a dissection-based course Each 3-hour practical session is solely dissection based and taking time away or engaging with part time employment or work experience.This week is reserved across all School of Anatomy courses as a means of encouraging student well-being and learner agency.Learning materialsHuman donors were sourced through the University of Bristol's Body Bequest program.All donors consented during life, as necessitated by the Human Tissue Act 2004, to their bodies being used for anatomical dissection for teaching and research purposes.Prior to donation, donors are made aware of the purposes for body donation and how their bodies may be used while at the department.Canine body donors were sourced through the University of Bristol's Pet Memorial Education Programme.This program allows animal owners to donate their animal's bodies on death for use in anatomical education.Owners donate the bodies alongside any medical history pertinent for anatomical study.Large animal specimens (equine, bovine) were sourced from an abattoir as surplus material from the food or animal product industries.Throughout their use, all tissues were handled ethically and in an appropriate manner.Students additionally received seminars on the importance of ethical treatment of the body in a dissection led course.

5 F I G U R E 1
dissect.They were also complimentary of staff, and appreciated the freedom to apply what they learn elsewhere on their course to a donor body.When asked what was exciting about the course, one student commented "applying what we have learnt in lectures to a human body/canine specimen."However, some comments emerged in 2022-2023 and to a lesser extent in 2021-2022 relating to the intervention described in this manuscript.When asked what was challenging, one student responded "Having to do both animal and human anatomy.The cross over can sometimes be confusing as the anatomy [sic] if different," while another wrote "I think we should be able to [sic] chose between human or animal dissection.This would also allow for there to be more time to go more in depth with pathologies."DISCUSS ION This paper describes the design and outcomes of a novel comparative anatomy dissection course.Comparative anatomy, the study of anatomy across species, can be evidenced as far back as Ancient Greece, with natural philosophers considering both human and veterinary anatomy simultaneously.Aristotle has been described as the first systematic comparative anatomist, and while Babylonians and Egyptians openly dissected both humans and animals, dissection for furthering understanding and knowledge TA B L E 2 Outline of assessments for the comparative dissection course.Median course score.Illustration of median course score over 5 years of the course running.Black bars indicate years where students selected their dissection, while gray bars indicate years where the course ran comparatively.Error bars indicate standard deviation.Label numbers indicate number of students present in each cohort.