Medical Students’ Perception and Attitude towards Embryology Course in Khartoum State Universities, Sudan -2023

Medical Students’ Perception and Attitude towards Embryology Course in Khartoum State Universities, Sudan -2023 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Medical Students’ Perception and Attitude towards Embryology Course in Khartoum State Universities, Sudan -2023 Mohammed Maher Abdallah Awadelkareem, Abubakr Muhammed, Mustafa Sabir Abakar Awad, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4277486/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Embryology teaching is challenging; it is important to determine how students think about it to develop the best teaching strategies. This study was conducted to assess Sudanese medical students’ perception towards embryology course. Materials and methods: A descriptive cross-sectional survey conducted in medical schools at Khartoum state, Sudan. The study included all the medical students who have completed the embryology course within their faculty curricula. Data was collected using a pretested structured questionnaire. The collected data were cleaned using Microsoft excel 2016 and analyzed using SPSS V28, the results are presented in terms of tables and figures. Results: The study included 385 participants with a mean age of 22.3 ± 2 years, females were 273 (71%), and they were from public governmental universities 264 (68.6%). Medical students perceived that integrating embryology and gross anatomy courses in the first and second years are better than teaching each discipline alone 225(58.5%), and they preferred problem-based learning 244(63.4%), and virtual reality for teaching embryology 307(79.7%). Only 22 (5.7%) of them reported that they would pursue embryology as a career due to absence of role model 248 (64.4%), followed by lack of future specialization 238 (61.8%), lack of promotion chances 194 (49.6%), difficulty of the subject 171 (44.4%), and the slow financial growth 110 (28.6%). Conclusion: The study found that medical students preferred problem based learning and use of technology to enhance the learning experience. While they showed positive attitude towards embryology course, only few considered it as a future career. Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Anatomy has been a pillar of medical education, regardless of nation, race, or medical school system. By studying gross anatomy, medical students gain a "first impression" of the human body's structure, which is the foundation for understanding pathologic and clinical problems ( 1 ). Although the importance of anatomy instruction for both undergraduate and graduate students remain uncontested, there is currently a lively debate regarding the methods of anatomy instruction and teaching approaches ( 2 ). Human anatomy is divided into various branches to make the process of learning and understanding easy and effective. It includes gross anatomy, living anatomy, embryology, histology, surface anatomy, and clinical anatomy ( 3 ). Embryology is a branch of developmental biology concerned with the study of life before birth ( 4 ). This is the study of the origin and development of the human from oocyte fertilization to the end of the eighth week of pregnancy, and by extension, any stage of prenatal development ( 5 ). It is frequently included in medical school curricula as part of the basic sciences taught in the first and second years of undergraduate education, and it is frequently included in the anatomy course. Embryology is an essential component of undergraduate education because it enables students to better manage and comprehend clinical cases ( 6 ). In addition to understanding the developmental origins of the diverse anatomy of the human body, knowledge of embryology is essential for a number of medical specialties, including pediatrics, general surgery, craniofacial surgery, obstetrics, and gynecology, due to its coverage of a number of clinical subjects, such as the basis of gametogenesis and fertilization, cleft palate, congenital anomalies, and the effect of intrauterine events, such as congenital infection, on the development of the fetus ( 7 ). One of the most important steps in learning such a basic subject is selecting an appropriate teaching method that can encourage active learning, improve motivation in classrooms, and accordingly promote the learning process. Generally, lectures are the most common method of academic education. In spite of the profuse information conveyed to a large audience in a short time, this method does not seem to be appropriate for teaching a variety of educational contents ( 8 ). Embryology has traditionally been taught in a manner similar to that of gross anatomy, relying primarily on textbooks and lectures, along with two-dimensional images, models, and, in some cases, preserved human embryos. Due to modifications to the medical curriculum, the amount of time students has access to learning resources has decreased. The majority of embryology courses are taught as part of a combined curriculum, and there appears to be a trend toward less lab work during course delivery ( 9 ). Education in embryology has profited immensely from growing virtual reality technologies in recent years. Technology gives the three-dimensional (3D) orientation of the structure concerned and therefore would be able to help students better understand the subject, especially embryology, which students usually find difficult to understand. In recent years, teaching has been revolutionized with the adoption of new teaching methods—learning methods with PowerPoint lectures, etc.—but demonstrating videos and animations along with traditional lectures is not a frequently used method. The videos and animations give them an exact idea of how organ development actually happens, helping them to have a better concept when they begin their clinical postings ( 10 ). The perceptions of medical students are essential to the design of an anatomy curriculum that satisfies the requirements for safe medical practice in the context of constantly evolving diagnostic and therapeutic modalities. Students are almost never involved in the creation or revision of curricula. In order to modify the curriculum in a way that facilitates the learning process, it is crucial to obtain the students' input and determine the most effective method of instruction ( 11 ). Taking into consideration the importance of student’s feedback about their own curriculum. This study aims to evaluate the medical Students’ perception and attitude towards embryology course. Research Methods Study design/setting: This was a descriptive cross-sectional institutional based study, conducted in different faculties of medicine in Khartoum state, Sudan including both governmental and private medical schools. The study took place in the period from March 2023 to December 2023. The study population All medical students at medical faculties in Khartoum state, who has completed the embryology course are included. All medical students who agreed participate were included and we excluded those who hasn’t yet completed the embryology course, and those who refuses to participate. Sample size and Sample technique: The sample size was determined by using a formula: (n = (Z α/2 ) 2 p (1-p)/ d 2 ) for estimating a single population proportion. Considering a 95% Confidence Interval (CI) (Z α/2 =1.96), 5% margin of error (d), and the sample proportion (p) of 50%, generated a minimum sample size of 385 for the study. Sampling technique was convenient non-probability sampling method. Data collection tools and instrument: Data was collected using a pretested, structured, self-administered questionnaire. The questionnaire was obtained from related literature. It includes socio-demographic variables, students’ attitudes toward embryology courses, students’ interests and career choices, and students’ perceptions of the integration of embryology and teratology courses. All viewpoints were rated using a positive Likert scale, with responses ranging from “strongly disagree” to “strongly agree”. Following data collection, the data was reviewed for errors and completeness to ensure data quality. Data management and Analysis: Data was cleaned and entered into Microsoft excel 2016 data sheet and was analyzed using SPSS version 28 software. Categorical data was represented in the form of frequencies and proportions. Microsoft Excel and word were used to obtain various types of graphs such as bar diagram. Data was represented after analysis in form of tables, figures and narrative illustration. Ethical considerations: Ethical approval from the research board committee at National University – Sudan (NUSU) was obtained. A signed consent from the administration was distributed for each university involved in the Study, after being approved from NUSU Ethical approval committee. An informed consent was obtained from each participant after explaining the purpose of the study. Results Demographic characteristics The study included 385 medical students from different universities in Khartoum state, Sudan. The mean age of study participants was 22.3 ± 2 years, majority of them were females 273 (71%), and they were from public governmental universities 264 (68.6%) ( Table 1 ). Perception of embryology teaching Medical students perceived that integrating embryology and gross anatomy courses in the first and second years are better than teaching each discipline alone 225(58.5%), and they preferred problem-based learning that combine embryology and gross anatomy 244(63.4%), they also thick that, virtual reality is more effective than images in the book for teaching embryology 307(79.7%), while half of them thought that It is more successful to teach embryology using adopted embryos 194(50.4%), and they preferred limiting embryology lab material in the first year to what needs to be compared with typical teratologic disorders 219 (56.9%) ( Table 2 ). Positive attitude towards embryology course Regarding medical students’ attitude towards embryology course, they showed positive attitude towards embryology in some areas as they disagreed that embryology requires little understanding 204(53%), and they agreed that embryology terminologies provide the foundation of medicine 211(54.8%), and they perceived embryology as a vital tool in medical practice 228(59.2%). Medical students also disagreed that embryology has no significance in contemporary medicine 212(55.1%), or is waste of time in the basic medical years 273(71%). They also think that every doctor must have a sound understanding of embryology 228(74.8%), and they disagreed that the principles of medicine are not founded on embryological knowledge 170(44.2%), and that medical students should concentrate on clinical practice rather than learning embryology 139(36.1%) ( Table 3 ). Negative attitude towards embryology course However, nearly half of them, were uncertain whether embryology is most clinically relevant for all basic sciences or not 171(44.4%). On the other hand some negative thoughts about embryology teaching were existent; almost half of medical students think that embryology needs to be modernized to be considered useful in medicine 191(49.6%), they also agreed that embryology is important only in some medical fields 169(44%), found it possible that a reasonable diagnosis could be reached without embryology 137(35.6). medical students also think that, existence of medicine is not possible without sound knowledge of embryology. 208(54%), most medical diseases do not require a great understanding of embryology 168(43.6%), and satisfactory medical practice requires only limited knowledge of embryology 163(42.3%) ( Table 3 ). Embryology as a future career Nearly half of medical students were interested in embryology course 186 (48.3%) (Fig. 1), however, only 22 (5.7%) of them reported that they would pursue embryology as a career (Fig. 2), and only 51 (13.2%) would recommend it for juniors as a career (Fig. 3). The most common reason reported by medical students for not joining the embryology field was absence of role model 248 (64.4%), followed by lack of future specialization 238 (61.8%), lack of promotion chances 194 (49.6%), difficulty of the subject 171 (44.4%), and the slow financial growth 110 (28.6%) (Fig. 4). Over half of them think that embryology teaching encourages students to join the field 214 (56%) (Fig. 5), and majority of them think that integrated curriculum will increase the interest of medical students in the embryology course 322 (84%) (Fig. 6). Table (1) Demographic Characteristics of medical students under study. Mean ± SD Age 22.3 ± 2 Gender Frequency Percentage Male 112 29% Female 273 71% University Frequency Percentage Governmental 264 68.6% Private 121 31.4% Table (2) Medical students’ perception toward teaching methodology of Embryology. Improving Methods SD + D Neutral SA + A Integrating embryology and gross anatomy courses in the first and second years are better than teaching each discipline alone. 71(18.5%) 89(23%) 225(58.5%) I prefer problem-based learning that combine embryology and gross anatomy. 59(15.3%) 82(21.3%) 244(63.4%) Virtual reality is more effective than images in the book for teaching embryology. 15(3.9%) 63(16.4%) 307(79.7%) It is more successful to teach embryology using adopted embryos 113(29.4%) 78(20.3%) 194(50.4%) It is preferable to limit embryology lab material in the first year to what needs to be compared with typical teratologic disorders. 45(14%) 112(29.1%) 219(56.9%) Table (3) Medical students’ attitude towards Embryology course Variables SD + D Neutral SA + A Embryology requires little understanding. 204(53%) 88(22.9%) 93(24.2%) Embryology terminologies provide the foundation of medicine. 59(15.3%) 115(29.9%) 211(54.8%) Embryology is a vital tool in medical practice. 49(12.7%) 108(28.1%) 228(59.2%) Embryology is important only in some medical fields. 131 (34%) 85(22%) 169(44%) Embryology has no significance in contemporary medicine. 212(55.1%) 80(20.8%) 93(24.2%) Embryology is waste of time in the basic medical years. 273(71%) 25(6.5%) 87(22.5%) Embryology needs to be modernized to be considered useful in Medicine. 84(21.8%) 110(28.6%) 191(49.6%) Every doctor must have a sound understanding of embryology. 43(11.2%) 54(14%) 228(74.8%) It is impossible to do a reasonable diagnosis without embryology. 137(35.6) 137(35.6%) 111(28.8%) Existence of medicine is not possible without sound knowledge of embryology. 50(13%) 127(33%) 208(54%) The principles of medicine are not founded on embryological knowledge. 170(44.2%) 102(26.5%) 113(29.4) Most medical diseases do not require a great understanding of embryology. 121(31.4%) 96(24.9%) 168(43.6%) Embryology is most clinically relevant for all basic sciences. 88(22.9%) 171(44.4%) 126(32.7%) For satisfactory medical practice only limited knowledge of embryology is required. 111(28.8%) 111(28.8%) 163(42.3%) Medical students should concentrate on clinical practice rather than learning embryology. 139(36.1%) 128(33.2%) 118(30.6%) Figure (1) Interest in embryology among medical students Figure (2) Embryology as career choice among medical student. Figure (3) Encouraging juniors to pursue Embryology as career among medical students. Figure (4) Reasons for not joining the embryology field Figure (5) Opinion on whether teaching embryology would encourage students to join the field Figure (6) Opinion on embryology curriculum integration Discussion Teaching embryology aims to increase students’ understanding and long-term retention. The main goal of this course is to instruct students on identifying and understanding the typical and atypical progressions during the embryonic and fetal stages of human development. Students must complete this initial requirement in order to gain knowledge about aberrant organ anatomy and function in later years of study or during clinical training. Moreover, their capacity to incorporate knowledge acquired in fundamental and clinical medical courses will rely on their ability to accurately and analytically recognize and manage diverse conditions in their forthcoming medical profession. To achieve this goal, this study assessed the students' perceptions of embryology courses among Sudanese medical students. Compared to Sume et al.'s (2022) study in Ethiopia ( 14 ), which included 246 students, our study included 385 undergraduate students who successfully completed the embryology course. A larger sample size allows for a more comprehensive understanding of the perceptions of Sudanese medical students towards embryology courses. Additionally, including a diverse range of students from different backgrounds and academic abilities would provide a more representative perspective on the effectiveness and relevance of the course in preparing future doctors. Students expressed a preference for the integration of embryology and gross anatomy courses, problem-based learning, and the use of technology to enhance their learning experience. Osman et al. (2014) found that the integrated curriculum in embryology was more satisfactory for students ( 17 ). Momeni et al. (2014) on the other hand found that problem-based learning (PBL) improves students' concentration, comprehension, and level of learning, supporting the notion PBL has a greater focus on the student ( 12 ). In addition, Chaudhary et al. (2018) discovered that most students demonstrated that integrating 3D movies and animations with conventional lectures aided in resolving uncertainty and misconceptions related to the subject matter while also enhancing the topic's level of engagement ( 10 ). The majority of students in this study had a favorable attitude towards embryology and recognized that it as an essential instrument in the field of medicine. This is similar to recent studies conducted by Sume et al. (2022) in Ethiopia ( 14 ), Waseem et al. (2021) in Pakistan ( 13 ), and Zaletel et al. (2016) in Serbia ( 18 ). All of these studies found that medical students recognizes and value the significance of embryology. However, we found that the students perceives the current embryology teaching methods to be conventional and in need of modernization, they also expressed the belief that a significant understanding of embryology is not necessary for most medical conditions, indicating a limited comprehension of the clinical significance of embryology. Although approximately half of the study participants expressed an interest in embryology, only a small minority had aspirations to pursue it as a future career. This can be attributed to various factors, such as the absence of a role model, limited opportunities for specialization and advancement, the challenging nature of the field, and the slow financial progression. These findings are unsurprising, given the numerous obstacles that deter students from pursuing a career in embryology. It is therefore expected that only a small number of students would be interested in this field. This finding aligns with the results published by Sume et al. (2022) in Ethiopia ( 14 ). The findings of this study have important implications for curriculum development in medical education. By understanding students' preferences and areas for improvement in embryology courses, educators can design curricula that better meet the needs and expectations of students. However, the study was not free of limitations. One limitation of this study is that it relied on the self-reported perceptions of the students, which may be subject to bias or inaccuracies. Conclusion The study provides valuable insights into the perceptions of Sudanese medical students towards embryology courses. Sudanese medical students showed positive attitude towards embryology, however, few of them considered it as a future career option, due to the absence of a role model, limited opportunities for specialization and advancement, the challenging nature of the field, and the slow financial progression. The findings of the study highlights the importance of integrating different teaching methods and technologies to enhance the learning experience. Recommendations Our recommendations for incorporating problem-based learning and technology into the embryology curriculum align well with current educational trends and student preferences. Problem-based learning encourages active engagement and critical thinking, while technology can enhance visualization and understanding of complex concepts. Highlighting the practical relevance of embryology through research on its clinical applications is crucial for motivating students and fostering a deeper appreciation for the subject. Investigating how embryology knowledge directly impacts medical practice can help bridge the gap between theory and application. Longitudinal studies tracking students' retention of embryology knowledge and its impact on their academic and clinical performance provide valuable insights into the effectiveness of the curriculum. Continuous evaluation allows educators to refine teaching methods and content to better meet the needs of future medical professionals. By emphasizing the clinical relevance and conducting further research on embryology's applications, educators can enhance student engagement and prepare them more effectively for medical practice. Declarations Consent for Publication: Not Applicable Availability of Data and Materials: The dataset used and analyzed during the current study available from the corresponding author on reasonable request. References Mavridis IN. A powerful way of teaching anatomy. Surgical and Radiologic Anatomy. 2013 May;35(4):365–6. Schofield KA. Anatomy education in occupational therapy curricula: Perspectives of practitioners in the United States. 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17:00:57","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4277486/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4277486/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55535645,"identity":"1ff35aa7-b290-4d0a-82e5-4d1df2d54b4e","added_by":"auto","created_at":"2024-04-29 16:25:29","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":10832,"visible":true,"origin":"","legend":"\u003cp\u003eInterest in embryology among medical students\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4277486/v1/d45e068bc8f08359a44d0074.png"},{"id":55535657,"identity":"560de0be-64ee-46ce-a21b-cb34f9985c37","added_by":"auto","created_at":"2024-04-29 16:25:32","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":8665,"visible":true,"origin":"","legend":"\u003cp\u003eEmbryology as career choice among medical student.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4277486/v1/77cf8ee0c9e0a4653823872d.png"},{"id":55535615,"identity":"76c5042a-e3bb-4aaf-8222-27db48380961","added_by":"auto","created_at":"2024-04-29 16:25:28","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":10488,"visible":true,"origin":"","legend":"\u003cp\u003eEncouraging juniors to pursue Embryology as career among medical students.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4277486/v1/f298625968edcde3484111f2.png"},{"id":55535658,"identity":"b301a22c-5d97-4e1a-9400-147ba8ded834","added_by":"auto","created_at":"2024-04-29 16:25:32","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":14988,"visible":true,"origin":"","legend":"\u003cp\u003eReasons for not joining the embryology field\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-4277486/v1/b4f269bb84df38f5678ab506.png"},{"id":55535643,"identity":"30d82194-a2e8-4f4d-a87e-8ebb9e3c2347","added_by":"auto","created_at":"2024-04-29 16:25:29","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":12004,"visible":true,"origin":"","legend":"\u003cp\u003eOpinion on whether teaching embryology would encourage students to join the field\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-4277486/v1/bdcdb481b7773af3f6b38184.png"},{"id":55535607,"identity":"1ed1d52f-34ed-4ff9-8600-6b25341341e4","added_by":"auto","created_at":"2024-04-29 16:25:26","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":15088,"visible":true,"origin":"","legend":"\u003cp\u003eOpinion on embryology curriculum integration\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-4277486/v1/2267bdd06aaacabd93f1b919.png"},{"id":62089941,"identity":"738a2920-6f8b-4996-8aa7-e810a7430a8c","added_by":"auto","created_at":"2024-08-09 07:28:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":596637,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4277486/v1/40619d4e-a1a6-4877-b020-3451bab9bf41.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Medical Students’ Perception and Attitude towards Embryology Course in Khartoum State Universities, Sudan -2023","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAnatomy has been a pillar of medical education, regardless of nation, race, or medical school system. By studying gross anatomy, medical students gain a \"first impression\" of the human body's structure, which is the foundation for understanding pathologic and clinical problems (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough the importance of anatomy instruction for both undergraduate and graduate students remain uncontested, there is currently a lively debate regarding the methods of anatomy instruction and teaching approaches (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHuman anatomy is divided into various branches to make the process of learning and understanding easy and effective. It includes gross anatomy, living anatomy, embryology, histology, surface anatomy, and clinical anatomy (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEmbryology is a branch of developmental biology concerned with the study of life before birth (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). This is the study of the origin and development of the human from oocyte fertilization to the end of the eighth week of pregnancy, and by extension, any stage of prenatal development (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIt is frequently included in medical school curricula as part of the basic sciences taught in the first and second years of undergraduate education, and it is frequently included in the anatomy course. Embryology is an essential component of undergraduate education because it enables students to better manage and comprehend clinical cases (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn addition to understanding the developmental origins of the diverse anatomy of the human body, knowledge of embryology is essential for a number of medical specialties, including pediatrics, general surgery, craniofacial surgery, obstetrics, and gynecology, due to its coverage of a number of clinical subjects, such as the basis of gametogenesis and fertilization, cleft palate, congenital anomalies, and the effect of intrauterine events, such as congenital infection, on the development of the fetus (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOne of the most important steps in learning such a basic subject is selecting an appropriate teaching method that can encourage active learning, improve motivation in classrooms, and accordingly promote the learning process. Generally, lectures are the most common method of academic education. In spite of the profuse information conveyed to a large audience in a short time, this method does not seem to be appropriate for teaching a variety of educational contents (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEmbryology has traditionally been taught in a manner similar to that of gross anatomy, relying primarily on textbooks and lectures, along with two-dimensional images, models, and, in some cases, preserved human embryos. Due to modifications to the medical curriculum, the amount of time students has access to learning resources has decreased. The majority of embryology courses are taught as part of a combined curriculum, and there appears to be a trend toward less lab work during course delivery (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEducation in embryology has profited immensely from growing virtual reality technologies in recent years. Technology gives the three-dimensional (3D) orientation of the structure concerned and therefore would be able to help students better understand the subject, especially embryology, which students usually find difficult to understand. In recent years, teaching has been revolutionized with the adoption of new teaching methods\u0026mdash;learning methods with PowerPoint lectures, etc.\u0026mdash;but demonstrating videos and animations along with traditional lectures is not a frequently used method. The videos and animations give them an exact idea of how organ development actually happens, helping them to have a better concept when they begin their clinical postings (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe perceptions of medical students are essential to the design of an anatomy curriculum that satisfies the requirements for safe medical practice in the context of constantly evolving diagnostic and therapeutic modalities. Students are almost never involved in the creation or revision of curricula. In order to modify the curriculum in a way that facilitates the learning process, it is crucial to obtain the students' input and determine the most effective method of instruction (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTaking into consideration the importance of student\u0026rsquo;s feedback about their own curriculum. This study aims to evaluate the medical Students\u0026rsquo; perception and attitude towards embryology course.\u003c/p\u003e"},{"header":"Research Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design/setting:\u003c/h2\u003e \u003cp\u003eThis was a descriptive cross-sectional institutional based study, conducted in different faculties of medicine in Khartoum state, Sudan including both governmental and private medical schools. The study took place in the period from March 2023 to December 2023.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eThe study population\u003c/h2\u003e \u003cp\u003eAll medical students at medical faculties in Khartoum state, who has completed the embryology course are included. All medical students who agreed participate were included and we excluded those who hasn\u0026rsquo;t yet completed the embryology course, and those who refuses to participate.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSample size and Sample technique:\u003c/h2\u003e \u003cp\u003eThe sample size was determined by using a formula:\u003c/p\u003e \u003cp\u003e(n = (Z\u003csub\u003eα/2\u003c/sub\u003e)\u003csup\u003e2\u003c/sup\u003e p (1-p)/ d\u003csup\u003e2\u003c/sup\u003e) for estimating a single population proportion.\u003c/p\u003e \u003cp\u003eConsidering a 95% Confidence Interval (CI) (Z\u003csub\u003eα/2\u003c/sub\u003e =1.96), 5% margin of error (d), and the sample proportion (p) of 50%, generated a minimum sample size of 385 for the study. Sampling technique was convenient non-probability sampling method.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData collection tools and instrument:\u003c/h2\u003e \u003cp\u003eData was collected using a pretested, structured, self-administered questionnaire. The questionnaire was obtained from related literature. It includes socio-demographic variables, students\u0026rsquo; attitudes toward embryology courses, students\u0026rsquo; interests and career choices, and students\u0026rsquo; perceptions of the integration of embryology and teratology courses. All viewpoints were rated using a positive Likert scale, with responses ranging from \u0026ldquo;strongly disagree\u0026rdquo; to \u0026ldquo;strongly agree\u0026rdquo;. Following data collection, the data was reviewed for errors and completeness to ensure data quality.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData management and Analysis:\u003c/h2\u003e \u003cp\u003eData was cleaned and entered into Microsoft excel 2016 data sheet and was analyzed using SPSS version 28 software. Categorical data was represented in the form of frequencies and proportions. Microsoft Excel and word were used to obtain various types of graphs such as bar diagram. Data was represented after analysis in form of tables, figures and narrative illustration.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations:\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e from the research board committee at National University \u0026ndash; Sudan (NUSU) was obtained. A signed consent from the administration was distributed for each university involved in the Study, after being approved from NUSU Ethical approval committee. An informed consent was obtained from each participant after explaining the purpose of the study.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eDemographic characteristics\u003c/h2\u003e \u003cp\u003eThe study included 385 medical students from different universities in Khartoum state, Sudan. The mean age of study participants was 22.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2 years, majority of them were females 273 (71%), and they were from public governmental universities 264 (68.6%) (\u003cb\u003eTable\u0026nbsp;1\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePerception of embryology teaching\u003c/h2\u003e \u003cp\u003eMedical students perceived that integrating embryology and gross anatomy courses in the first and second years are better than teaching each discipline alone 225(58.5%), and they preferred problem-based learning that combine embryology and gross anatomy 244(63.4%), they also thick that, virtual reality is more effective than images in the book for teaching embryology 307(79.7%), while half of them thought that It is more successful to teach embryology using adopted embryos 194(50.4%), and they preferred limiting embryology lab material in the first year to what needs to be compared with typical teratologic disorders 219 (56.9%) (\u003cb\u003eTable\u0026nbsp;2\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePositive attitude towards embryology course\u003c/h2\u003e \u003cp\u003eRegarding medical students\u0026rsquo; attitude towards embryology course, they showed positive attitude towards embryology in some areas as they disagreed that embryology requires little understanding 204(53%), and they agreed that embryology terminologies provide the foundation of medicine 211(54.8%), and they perceived embryology as a vital tool in medical practice 228(59.2%). Medical students also disagreed that embryology has no significance in contemporary medicine 212(55.1%), or is waste of time in the basic medical years 273(71%). They also think that every doctor must have a sound understanding of embryology 228(74.8%), and they disagreed that the principles of medicine are not founded on embryological knowledge 170(44.2%), and that medical students should concentrate on clinical practice rather than learning embryology 139(36.1%) (\u003cb\u003eTable\u0026nbsp;3\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eNegative attitude towards embryology course\u003c/h2\u003e \u003cp\u003eHowever, nearly half of them, were uncertain whether embryology is most clinically relevant for all basic sciences or not 171(44.4%). On the other hand some negative thoughts about embryology teaching were existent; almost half of medical students think that embryology needs to be modernized to be considered useful in medicine 191(49.6%), they also agreed that embryology is important only in some medical fields 169(44%), found it possible that a reasonable diagnosis could be reached without embryology 137(35.6). medical students also think that, existence of medicine is not possible without sound knowledge of embryology. 208(54%), most medical diseases do not require a great understanding of embryology 168(43.6%), and satisfactory medical practice requires only limited knowledge of embryology 163(42.3%) (\u003cb\u003eTable\u0026nbsp;3\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eEmbryology as a future career\u003c/h2\u003e \u003cp\u003eNearly half of medical students were interested in embryology course 186 (48.3%) (Fig.\u0026nbsp;1), however, only 22 (5.7%) of them reported that they would pursue embryology as a career (Fig.\u0026nbsp;2), and only 51 (13.2%) would recommend it for juniors as a career (Fig.\u0026nbsp;3).\u003c/p\u003e \u003cp\u003eThe most common reason reported by medical students for not joining the embryology field was absence of role model 248 (64.4%), followed by lack of future specialization 238 (61.8%), lack of promotion chances 194 (49.6%), difficulty of the subject 171 (44.4%), and the slow financial growth 110 (28.6%) (Fig.\u0026nbsp;4).\u003c/p\u003e \u003cp\u003eOver half of them think that embryology teaching encourages students to join the field 214 (56%) (Fig.\u0026nbsp;5), and majority of them think that integrated curriculum will increase the interest of medical students in the embryology course 322 (84%) (Fig.\u0026nbsp;6).\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTable\u0026nbsp;(1)\u003c/strong\u003e \u003cp\u003eDemographic Characteristics of medical students under study.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e22.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003ePercentage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eFrequency\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003ePercentage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGovernmental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTable\u0026nbsp;(2)\u003c/strong\u003e \u003cp\u003eMedical students\u0026rsquo; perception toward teaching methodology of Embryology.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImproving Methods\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSD\u0026thinsp;+\u0026thinsp;D\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSA\u0026thinsp;+\u0026thinsp;A\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntegrating embryology and gross anatomy courses in the first and second years are better than teaching each discipline alone.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71(18.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89(23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e225(58.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI prefer problem-based learning that combine embryology and gross anatomy.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59(15.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82(21.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e244(63.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVirtual reality is more effective than images in the book for teaching embryology.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15(3.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63(16.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e307(79.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt is more successful to teach embryology using adopted embryos\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113(29.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78(20.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e194(50.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt is preferable to limit embryology lab material in the first year to what needs to be compared with typical teratologic disorders.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45(14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112(29.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e219(56.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTable\u0026nbsp;(3)\u003c/strong\u003e \u003cp\u003eMedical students\u0026rsquo; attitude towards Embryology course\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSD\u0026thinsp;+\u0026thinsp;D\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSA\u0026thinsp;+\u0026thinsp;A\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology requires little understanding.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e204(53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88(22.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93(24.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology terminologies provide the foundation of medicine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59(15.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115(29.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e211(54.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology is a vital tool in medical practice.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49(12.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108(28.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e228(59.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology is important only in some medical fields.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131 (34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85(22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e169(44%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology has no significance in contemporary medicine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e212(55.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80(20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93(24.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology is waste of time in the basic medical years.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e273(71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(6.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87(22.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology needs to be modernized to be considered useful in Medicine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84(21.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110(28.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e191(49.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery doctor must have a sound understanding of embryology.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43(11.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54(14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e228(74.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt is impossible to do a reasonable diagnosis without embryology.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e137(35.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137(35.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e111(28.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExistence of medicine is not possible without sound knowledge of embryology.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50(13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127(33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e208(54%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe principles of medicine are not founded on embryological knowledge.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e170(44.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e102(26.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113(29.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMost medical diseases do not require a great understanding of embryology.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121(31.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(24.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e168(43.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmbryology is most clinically relevant for all basic sciences.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88(22.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e171(44.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e126(32.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFor satisfactory medical practice only limited knowledge of embryology is required.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111(28.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111(28.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e163(42.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical students should concentrate on clinical practice rather than learning embryology.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e139(36.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e128(33.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e118(30.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure (1)\u003c/strong\u003e \u003cp\u003eInterest in embryology among medical students\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure (2)\u003c/strong\u003e \u003cp\u003eEmbryology as career choice among medical student.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure (3)\u003c/strong\u003e \u003cp\u003eEncouraging juniors to pursue Embryology as career among medical students.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure (4)\u003c/strong\u003e \u003cp\u003eReasons for not joining the embryology field\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure (5)\u003c/strong\u003e \u003cp\u003eOpinion on whether teaching embryology would encourage students to join the field\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure (6)\u003c/strong\u003e \u003cp\u003eOpinion on embryology curriculum integration\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eTeaching embryology aims to increase students\u0026rsquo; understanding and long-term retention. The main goal of this course is to instruct students on identifying and understanding the typical and atypical progressions during the embryonic and fetal stages of human development. Students must complete this initial requirement in order to gain knowledge about aberrant organ anatomy and function in later years of study or during clinical training. Moreover, their capacity to incorporate knowledge acquired in fundamental and clinical medical courses will rely on their ability to accurately and analytically recognize and manage diverse conditions in their forthcoming medical profession. To achieve this goal, this study assessed the students' perceptions of embryology courses among Sudanese medical students.\u003c/p\u003e \u003cp\u003eCompared to Sume et al.'s (2022) study in Ethiopia (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), which included 246 students, our study included 385 undergraduate students who successfully completed the embryology course. A larger sample size allows for a more comprehensive understanding of the perceptions of Sudanese medical students towards embryology courses. Additionally, including a diverse range of students from different backgrounds and academic abilities would provide a more representative perspective on the effectiveness and relevance of the course in preparing future doctors.\u003c/p\u003e \u003cp\u003eStudents expressed a preference for the integration of embryology and gross anatomy courses, problem-based learning, and the use of technology to enhance their learning experience. Osman et al. (2014) found that the integrated curriculum in embryology was more satisfactory for students (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Momeni et al. (2014) on the other hand found that problem-based learning (PBL) improves students' concentration, comprehension, and level of learning, supporting the notion PBL has a greater focus on the student (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In addition, Chaudhary et al. (2018) discovered that most students demonstrated that integrating 3D movies and animations with conventional lectures aided in resolving uncertainty and misconceptions related to the subject matter while also enhancing the topic's level of engagement (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe majority of students in this study had a favorable attitude towards embryology and recognized that it as an essential instrument in the field of medicine. This is similar to recent studies conducted by Sume et al. (2022) in Ethiopia (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), Waseem et al. (2021) in Pakistan (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), and Zaletel et al. (2016) in Serbia (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). All of these studies found that medical students recognizes and value the significance of embryology. However, we found that the students perceives the current embryology teaching methods to be conventional and in need of modernization, they also expressed the belief that a significant understanding of embryology is not necessary for most medical conditions, indicating a limited comprehension of the clinical significance of embryology.\u003c/p\u003e \u003cp\u003eAlthough approximately half of the study participants expressed an interest in embryology, only a small minority had aspirations to pursue it as a future career. This can be attributed to various factors, such as the absence of a role model, limited opportunities for specialization and advancement, the challenging nature of the field, and the slow financial progression. These findings are unsurprising, given the numerous obstacles that deter students from pursuing a career in embryology. It is therefore expected that only a small number of students would be interested in this field. This finding aligns with the results published by Sume et al. (2022) in Ethiopia (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe findings of this study have important implications for curriculum development in medical education. By understanding students' preferences and areas for improvement in embryology courses, educators can design curricula that better meet the needs and expectations of students. However, the study was not free of limitations. One limitation of this study is that it relied on the self-reported perceptions of the students, which may be subject to bias or inaccuracies.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study provides valuable insights into the perceptions of Sudanese medical students towards embryology courses. Sudanese medical students showed positive attitude towards embryology, however, few of them considered it as a future career option, due to the absence of a role model, limited opportunities for specialization and advancement, the challenging nature of the field, and the slow financial progression. The findings of the study highlights the importance of integrating different teaching methods and technologies to enhance the learning experience.\u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations\u003c/h2\u003e \u003cp\u003eOur recommendations for incorporating problem-based learning and technology into the embryology curriculum align well with current educational trends and student preferences. Problem-based learning encourages active engagement and critical thinking, while technology can enhance visualization and understanding of complex concepts.\u003c/p\u003e \u003cp\u003eHighlighting the practical relevance of embryology through research on its clinical applications is crucial for motivating students and fostering a deeper appreciation for the subject. Investigating how embryology knowledge directly impacts medical practice can help bridge the gap between theory and application.\u003c/p\u003e \u003cp\u003eLongitudinal studies tracking students' retention of embryology knowledge and its impact on their academic and clinical performance provide valuable insights into the effectiveness of the curriculum. Continuous evaluation allows educators to refine teaching methods and content to better meet the needs of future medical professionals.\u003c/p\u003e \u003cp\u003eBy emphasizing the clinical relevance and conducting further research on embryology's applications, educators can enhance student engagement and prepare them more effectively for medical practice.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConsent for Publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset used and analyzed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003e\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMavridis IN. A powerful way of teaching anatomy. Surgical and Radiologic Anatomy. 2013 May;35(4):365\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eSchofield KA. Anatomy education in occupational therapy curricula: Perspectives of practitioners in the United States. Anat Sci Educ. 2018 May 1;11(3):243\u0026ndash;53. \u003c/li\u003e\n\u003cli\u003eBranches of Human Anatomy - Gross, Surface, Clinical \u0026amp; Other - Anatomy Notes.. Available from: https://anatomynotes.org/branches-of-human-anatomy-gross-surface-clinical-other/\u003c/li\u003e\n\u003cli\u003eMoxham BJ, Brichova H, Emmanouil-Nikoloussi E, Chirculescu AR. Embryology and Teratology in the Curricula of Healthcare Courses ANATOMICAL EDUCATION. Vol. 21, J. Anat. 2017. Available from: https://eurjanat.com/data/pdf/eja.160436bm.pdf\u003c/li\u003e\n\u003cli\u003eMeyer AW. Essays on the History of Embryology. Cal West Med. 1932 Oct;37(4):243\u0026ndash;6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18742279\u003c/li\u003e\n\u003cli\u003eAlfalah SFM, Muhaidat N, Elfalah M, Falah O, Falah JF. Investigating Learners\u0026rsquo; Attitudes Toward Virtual Reality Learning Environments in Embryology Education. Mod Appl Sci. 2019;13(1). Available from: https://www.researchgate.net/profile/Orwa-Falah/publication/329540715_Investigating_Learners\u0026rsquo;_Attitudes_Toward_Virtual_Reality_Learning_Environments_in_Embryology_Education/links/5f510d94299bf13a319c8d2b/Investigating-Learners-Attitudes-Toward-Virtual-Reality-Learning-Environments-in-Embryology-Education.pdf\u003c/li\u003e\n\u003cli\u003eScott KM, Charles AR, Holland AJA. Clinical embryology teaching: Is it relevant anymore? ANZ J Surg. 2013 Oct;83(10):709\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eJuhi A. Students approach towards problem based learning over traditional learning method. journal of Medical Science And clinical Research [Internet]. 2019 Mar 18 [cited 2024 Feb 4];7(3). Available from: http://jmscr.igmpublication.org/v7-i3/125%20jmscr.pdf\u003c/li\u003e\n\u003cli\u003ePatel KM, Moxham BJ. The relationships between learning outcomes and methods of teaching anatomy as perceived by professional anatomists. Clinical Anatomy. 2008;21(2):182\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eChaudhary P, Arora K, Dhir S. Combining traditional embryology lectures with technology and perception of students toward it. CHRISMED Journal of Health and Research. 2018;5(4):290. Available from: http://www.cjhr.org/text.asp?2018/5/4/290/245455\u003c/li\u003e\n\u003cli\u003eSbayeh A, Qaedi Choo MA, Quane KA, Finucane P, McGrath D, O\u0026rsquo;Flynn S, et al. Relevance of anatomy to medical education and clinical practice: perspectives of medical students, clinicians, and educators. Perspect Med Educ. 2016 Dec 1;5(6):338\u0026ndash;46. \u003c/li\u003e\n\u003cli\u003eMomeni S, Abdolmaleki M, Zarezadeh Y, Rezaie MJ. Effects of problem based learning approach on medical students\u0026rsquo; learning, satisfaction and engagement in embryology course. Future of Medical Education Journal. 2014 Mar 1;4(1):27\u0026ndash;31. \u003c/li\u003e\n\u003cli\u003eWaseem N, Iqbal K, Anwar N, Rehman I, Kundi H, Qamar A. Medical students\u0026rsquo; attitudes towards the clinical importance of embryology. J Pak Med Assoc. 2021 Apr 1;71(4):1167\u0026ndash;70. \u003c/li\u003e\n\u003cli\u003eSume BW. Medical Students\u0026rsquo; Attitude and Perception Towards Embryology Course at Debre Markos University, Ethiopia. Adv Med Educ Pract. 2022;13:789\u0026ndash;96. \u003c/li\u003e\n\u003cli\u003eMahdi M, Kermanian F, Iravani S, Moghadam N, Shayan S. COMPARING LECTURE AND PROBLEM-BASED LEARNING METHODS IN TEACHING LIMB ANATOMY TO FIRST YEAR MEDICAL STUDENTS. Iranian Journal of Medical Education. 2008; \u003c/li\u003e\n\u003cli\u003eDemetri L, Donnelley CA, MacKechnie MC, Toogood P. Comparison of Case-Based Learning and Traditional Lectures in an Orthopedic Residency Anatomy Course. J Surg Educ. 2021 Mar 1;78(2):679\u0026ndash;85. \u003c/li\u003e\n\u003cli\u003eOsman M, Adnan A, Kutty MK, Al-Naggar RA, Lumpur. K. Evaluation of Laboratory Medicine Teaching and Learning by Medical Students in Hybrid Integrated Curriculum. Data from Public Malaysian University. 2014. \u003c/li\u003e\n\u003cli\u003eZaletel I, Marić G, Gazibara T, Rakočević J, Labudović Borović M, Pu\u0026scaron;ka\u0026scaron; N, et al. Relevance and attitudes toward histology and embryology course through the eyes of freshmen and senior medical students: Experience from Serbia. Annals of Anatomy. 2016 Nov 1;208:217\u0026ndash;21. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4277486/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4277486/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eEmbryology teaching is challenging; it is important to determine how students think about it to develop the best teaching strategies. This study was conducted to assess Sudanese medical students\u0026rsquo; perception towards embryology course.\u003c/p\u003e\u003ch2\u003eMaterials and methods:\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional survey conducted in medical schools at Khartoum state, Sudan. The study included all the medical students who have completed the embryology course within their faculty curricula. Data was collected using a pretested structured questionnaire. The collected data were cleaned using Microsoft excel 2016 and analyzed using SPSS V28, the results are presented in terms of tables and figures.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThe study included 385 participants with a mean age of 22.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2 years, females were 273 (71%), and they were from public governmental universities 264 (68.6%). Medical students perceived that integrating embryology and gross anatomy courses in the first and second years are better than teaching each discipline alone 225(58.5%), and they preferred problem-based learning 244(63.4%), and virtual reality for teaching embryology 307(79.7%). Only 22 (5.7%) of them reported that they would pursue embryology as a career due to absence of role model 248 (64.4%), followed by lack of future specialization 238 (61.8%), lack of promotion chances 194 (49.6%), difficulty of the subject 171 (44.4%), and the slow financial growth 110 (28.6%).\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eThe study found that medical students preferred problem based learning and use of technology to enhance the learning experience. While they showed positive attitude towards embryology course, only few considered it as a future career.\u003c/p\u003e","manuscriptTitle":"Medical Students’ Perception and Attitude towards Embryology Course in Khartoum State Universities, Sudan -2023","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-29 16:25:14","doi":"10.21203/rs.3.rs-4277486/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ce91391c-06fa-4c4d-8459-6fdf18476c7a","owner":[],"postedDate":"April 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-09T07:20:28+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-29 16:25:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4277486","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4277486","identity":"rs-4277486","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}