Modern approaches to teaching and learning anatomy

I read Collins’[1] treatment on modern anatomical teaching and
learning with interest. I agree that advances in medical imaging and
surgical technology are an increasingly useful resource for contextual
anatomical teaching. They may even facilitate deep learning. However,
medical students themselves perceive dissection as crucial for deep
learning. In an Australian study on first and second year medical
students, neither pre-dissected specimens, multimedia resources nor
computer-aided learning were preferred to dissection, which was associated
with deep learning.[2]

Suggesting that only surgeons should and could benefit from cadaveric
dissection is not supported by good clinical evidence. Anatomy is a core
building block for the clinical examination of patients. As all doctors,
whatever specialty, are expected to examine patients and make a diagnosis,
it is reasonable to ensure that they are competently trained to do so. Non
-surgical specialties also rely on detailed anatomical training for
everyday practice, for example, emergency physicians and clinical
oncologists. Neurologists and anaesthetists require in addition detailed
neuro-anatomical knowledge for their practice.

Differential anatomy teaching may be particularly inappropriate in
the UK, where service provision for patient care increasingly requires all
junior doctors, whatever their intended specialism, to care for all
acutely unwell patients, whether medical or surgical. Hospital at Night is
a Department of Health (England) initiated project that encourages this
approach for out-of-hours hospital care.[3] Therefore any such changes to
undergraduate curricula regarding anatomy may have propound effects on
patient care, unless they are sympathetic to current and future models of
delivering patient care.

Many studies have shown that medical students do not reliably know
which career path they intend to take when questioned early in their
undergraduate training, and most change their mind during training
anyway.[4] Therefore, it not feasible nor useful to implement Collins’
proposed approach for anatomy teaching and learning.

Reference

[1] Collins JP. Modern approaches to teaching and learning anatomy.
BMJ 2008;337:a1310.

[2] Azer SA, Eizenberg N. Do we need dissection in an integrated
problem-based learning medical course? Perceptions of first- and second-
year students. Surg Radiol Anat. 2007;29(2):173-80.

[3] The Case for Hospital at Night - The Search for Evidence. 2008.
http://www.healthcareworkforce.nhs.uk/resources/nwp_resources/case_for_h...

[4] Compton MT, Frank E, Elon L, Carrera J. Changes in U.S. medical
students' specialty interests over the course of medical school. J Gen
Intern Med. 2008;23(7):1095-100.

Competing interests:
None declared