The coronavirus disease 2019 (COVID-19) pandemic has fundamentally reshaped the landscape of anatomy education, offering invaluable insights that can guide the future of anatomy education. As we transition into a post-pandemic era, it is crucial to integrate the lessons learned to create a more resilient, flexible, and effective educational environment. The World Health Organization declared COVID-19 a pandemic in March 2020, leading to global disruptions in education systems [1]. Consequently, social distancing measures prompted an abrupt shift from traditional in-person classes to online teaching and learning strategies, which significantly transformed anatomy pedagogy [2]. This global disruption has emphasized the importance of the concepts of BANI (brittleness, anxiety, nonlinearity, incomprehensibility), indicating the need for prompt action in equipping anatomy education with a future-ready and future-proof curriculum. Given the nature of anatomy education, which typically requires hands-on learning experiences, anatomy educators need to design teaching and learning strategies that can accommodate both face-to-face and online learning.

Nevertheless, during the COVID-19 era, the students were hindered from participating in face-to-face learning and hands-on anatomy practical sessions that utilized cadaveric dissection, anatomical models, prosected specimens, and histological slides. To accommodate the restrictions, there was an increased reliance on technologyenhanced tools and internet services, such as teleconference software, web-based learning platforms and digital learning tools [3]. It was argued that full adaptation to online learning had posed challenges to educators as the transition was sudden and required extensive preparation, which eventually led to increased workloads within tight time constraints [4]. Many anatomy educators were not familiar with digital content but were expected to be proficient with new online teaching tools. They were also expected to explore innovative ways to effectively engage students in the virtual learning environment. Meanwhile, students faced difficulties in adapting to this new mode of learning, with issues ranging from technical challenges to a lack of personal interaction affecting their overall learning experience and engagement [5].

In this context of global adaptation, the teaching and learning of anatomy at Universiti Sains Malaysia (USM) underwent a significant transformation from conventional face-to-face lectures and practical classes to a blend of synchronous and asynchronous online sessions. This shift was facilitated by the extensive use of digital learning tools to enhance student engagement. At USM, lectures and practical sessions were delivered synchronously using the teleconferencing platform Cisco Webex (Cisco Systems Inc., San Jose, USA) which provided features such as whiteboard, screen sharing, and breakout rooms. During these synchronous classes, interactive online quizzes were integrated using tools like Mentimeter, Kahoot, and Quizizz. For gross anatomy practical classes, synchronous or recorded demonstrations of anatomical structures were conducted using plastic models and supplemented with the Complete Anatomy application, which offers interactive three-dimensional (3D) anatomical structures. Histological practical sessions utilized virtual histological slides, and the Google Jamboard application (Google LLC, Mountain View, USA) was employed to facilitate small group collaboration during practical sessions [6].

This profound shift, driven by the COVID-19 pandemic, had a considerable impact on anatomy education at USM, underscoring the challenges and adjustments necessary for effective online learning. All learning materials, including lecture notes, pre-recorded and live sessions, and assessments, were made available on the E-learn @ USM portal, which uses the Moodle platform (https://elearning.usm.my/). The E-learn portal proved to be a user-friendly and cost-efficient solution, enabling students to access course materials efficiently during virtual learning. Despite these advancements, the effectiveness of online learning remains debated, with some advocating for the irreplaceable value of in-person interactions [7]. The pandemic, however, highlighted the urgent need for adaptable and well-supported online educational environments to meet students’ learning needs [8]. In response, a mixed-method study was conducted to evaluate preclinical medical students’ perceptions of the anatomy education environment at USM during the pandemic [9]. These experiences not only reshaped students’ learning but also presented significant challenges to lecturers and institutions, emphasizing the necessity for effective strategies in both online and in-person educational settings. Consequently, this paper aims to reflect on the challenges and lessons learned in anatomy education from the USM experience during one of the most challenging periods in recent history. Ultimately, this transformative journey has not only strengthened our anatomy education system but has also paved the way for more resilient and adaptive educational practices in the future.

The mixed-method study conducted by Ahmad Hisham [9] highlighted several significant challenges in anatomy education at USM during the pandemic, offering critical reflections for post-pandemic improvements. These reflections are based on the qualitative data gathered using a phenomenology research design. Thematic analysis was performed by using the ATLAS.ti software (https://atlasti.com/) to analyze an open-ended feedback question, distributed via Google Forms (Google LLC). The feedback explored students’ experiences and challenges in learning anatomy during COVID-19.

One primary challenge was the difficulties students faced in effectively visualizing anatomical structures through online platforms, especially those with low visuospatial abilities. Without tactile experiences and kinesthetic learning opportunities provided by physical models and specimens in traditional in-person classes, students struggled to construct 3D mental images of these structures. The absence of hands-on manipulation made it challenging for students to comprehend spatial relationships, appreciate anatomical textures and accurately perceive the relative sizes and positions of the structures. The study emphasized that sensory feedback is crucial for creating lasting mental maps of anatomical features, particularly benefiting kinesthetic learners who grasp concepts more effectively through physical interaction [9].

The transition to online classes also resulted in decreased face-to-face interaction, which forced students to rely more on self-directed learning without immediate guidance from lecturers. Novice learners, who depended on real-time feedback and clarification of doubts to understand complex anatomical concepts, found this shift particularly challenging. The lack of face-to-face interaction hindered collaborative learning experiences through group discussions, which are essential for gaining a deeper understanding of anatomical concepts from diverse perspectives. These discussions enhance critical thinking and problem-solving skills, and their absence left students feeling disconnected and uncertain about their understanding of anatomical structures. Additionally, impaired motivation and emotional well-being were significant challenges in learning anatomy during the pandemic. The online learning environment was less conducive compared to in-person classes, as students often had to deal with distractions from their home environments. The absence of non-verbal communication cues from lecturers, such as facial expressions and hand gestures, made the virtual class less engaging. Consequently, students found it challenging to focus and experienced increased feelings of isolation, anxiety, and boredom, which negatively affected their mental health and learning effectiveness.

The COVID-19 lockdown also posed significant technical and accessibility problems for students. The closure of the anatomy museum necessitated a shift of all resources to online platforms, which primarily affected students in rural areas and those from underprivileged backgrounds. Poor internet connectivity and limited computer access restricted their ability to utilize essential resources, including specific software that requires stable and fast internet. The abrupt transition to online learning presented challenges for both students and lecturers as many encountered difficulties with digital literacy and lacked the necessary technological skills to navigate the online environment.

Reflecting on these post-pandemic experiences, we have systematically addressed the identified challenges, resulting in the transformation and enhancement of anatomy education. By implementing pedagogical strategies and establishing robust support systems, we have effectively bridged the gaps between online and in-person educational settings, thus ensuring a reliable, resilient, and adaptive anatomy education system for the future.

The COVID-19 pandemic has played a crucial role in reshaping the landscape of anatomy education at USM. One of the lessons learned from this experience is the critical importance of a multimodal teaching approach in anatomy instruction for flexibility and adaptability. Therefore, it is imperative to implement hybrid learning by integrating robust digital learning tools with in-person instruction. There are four transformative strategies for anatomy education at USM: (1) empowering blended learning, (2) developing and utilizing technologyenhanced tools, (3) embodying student-centered learning during anatomy practical sessions, and (4) incorporating formative assessment during teaching.

The COVID-19 pandemic has emphasized the importance of adopting innovative strategies in medical education, extending beyond anatomy. For example, in fields like dentistry and nursing where hands-on learning is essential, blended learning provides flexibility and accessibility that allows students to integrate theoretical lessons with in-person practical sessions [13]. Additionally, the adoption of technology-enhanced tools, such as augmented reality and virtual simulations can provide immersive learning experiences that extend beyond conventional classroom settings [14]. Emphasizing studentcentered learning promotes independent and critical thinking, which is essential in clinical areas like medicine, gynecology and surgery [15]. Furthermore, the implementation of formative assessments offers continuous feedback, supporting the development of effective study skills [16]. Thus, enhancing academic performance in subjects requiring theoretical knowledge and practical application. Therefore, these strategies not only enhance anatomy education but also offer a comprehensive and robust framework for improving education across various medical disciplines in the post-pandemic era.