Modern approaches to teaching and learning anatomy
BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1310 (Published 09 September 2008) Cite this as: BMJ 2008;337:a1310
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The painting by Johann Zoffany which appears with this article, shows
Dr William Hunter teaching anatomy at the Royal Academy.
The copyright holder is the Royal College of Physicians.
Competing interests:
None declared
Competing interests: No competing interests
The Swiss method described by Prof.Jean Fasel has great utilitarian value. It is not the number of hours of teaching, but how inspiring the teacher is, that counts. A good teacher is one that inspires his students to learn more. The methods of teaching used, should facilitate the retentive and integrative functions of the receiving brain. There seems to be a high degree of regulations on the procurement and usage of cadavers, at least locally. I find access to dissected anatomy, for teaching of musculoskeletal medicine to health professionals, especially General Pracitioners an impossible task. Every practicing doctor should be able to have access to dissected cadavers. But this is not easy. Having visited and taught in Asian Medical Schools, I note that the problem is almost universal, though to a far lesser degree in Asian countries.
Competing interests:
None declared
Competing interests: No competing interests
We read with interest Collins' article "Modern approaches to teaching
and learning anatomy." [1] As former anatomy demonstrators at Newcastle
University medical school, we surveyed 231 final-year students with
regards to the teaching and learning of anatomy [2]. Perhaps echoing the
findings from the Australian Medical Students’ Association survey [3], a
significant proportion of respondents (40%) did not feel that the anatomy
they had been taught had adequately prepared them for clinical placements.
60% had encountered problems with their anatomy knowledge in their
clinical years, with free text reponses revealing that more than half of
these were in relation to surgical specialty-based placements.
Collins states that "the undergraduate programme should be principle
based (start with general anatomy) and problem directed (incorporate
clinical anatomy)". Indeed, many of the students we surveyed perceived the
clinical relevance of the subject, with several suggesting that clinical
scenarios could be incorporated into anatomy teaching sessions as a way to
further their understanding of the subject. Postulated solutions included
teaching pelvic anatomy using hysterectomy and hip fracture cases as
examples, or discussions focussing on central line insertion to facilitate
the learning of neck anatomy. Respondents to our questionnaire had
participated in the anatomy course relatively recently, with the added
benefit of a couple of years of clinical experience subsequently; surely
their opinions as to how anatomy teaching should be delivered should hold
as much weight as those of fully-qualified doctors or academics?
Fortunately, student feedback is being heeded in Newcastle, and a
more clinically-orientated approach is being adopted. Some anatomy
practicals are run in parallel with clinical skills sessions, such as
teaching shoulder anatomy and examination in one sitting. Radiological
imaging also has an important role: interactive ultrasound sessions enable
students to visualise neck veins or the brachial plexus in real-time; and
chest radiographs and coronary angiograms are used in conjunction with
prosected specimens to facilitate clinical correlation of important
structures.
Of course, there is considerable variation in the anatomy teaching
delivered by different medical schools, both in terms of methods employed
and the emphasis placed on the subject matter. Dissection is still
performed in some medical schools, whilst some have done away with
cadaveric material entirely [4]. A Scottish study showed a huge
discrepancy in the time spent teaching anatomy between the five medical
schools in Scotland, ranging from 67 to 228 hours (in 2003-4) [5]. Whilst
it will almost certainly never come to pass that a consistent approach to
the teaching and learning of anatomy is adopted by medical schools across
the UK, we would like to echo Collins' sentiments: namely, that further
research is needed to provide backing to teaching methodologies. It is our
belief that the views of students must play a vital role in this process.
1.Collins JP. Modern approaches to teaching and learning anatomy. BMJ
2008;337:665-667,a1310.
2.White RD, Edmonds KM, Spencer JA, Fraser RA, Kachroo N. Attitudes
of final-year medical students and consultant general surgeons to the
teaching and learning of anatomy. Prague: AMEE, 2008.
3.Australian Medical Students’ Association. What makes a success in
medical education? Canberra: AMSA, 2006:1-37.
4.McLachlan JC, Regan de Bere S. How we teach anatomy without
cadavers. The Clinical Teacher 2004;1 (2): 49-52
5.Pryde FR, Black SM. Scottish Anatomy Departments: Adapting to
Change. SMJ 2006;51(2):16-20
Competing interests:
None declared
Competing interests: No competing interests
Dear Sir
I cannot let the article ‘Modern Approaches to Teaching and Learning
Anatomy’ by Collins (BMJ, 20 September 2008) pass without comment. The
running headline of this paper, namely ‘The view that new doctors have
inadequate knowledge of anatomy is not supported by the evidence’ is
misleading. Nowhere in the paper is there any sound evidence to support
this. The paper summarises teaching methodologies available at the present
time and argues for the use of prosected specimens, life models,
radiological images and telescopic views of the living body. The author
claims that these “maximise learning”. Where is the evidence for this? A
theme running through the article is to dismiss dissection while
supporting other teaching modalities, reserving dissection for those
contemplating a surgical career. Dissection is dismissed as expensive,
time consuming and emotionally disturbing for some students. Perhaps the
latter should not be studying medicine!
A review by Winkelmann 1 is the only article used to argue against
dissection and Collins states that the article found no difference in the
level of anatomical knowledge between those who learned through prosection
and those who dissected cadavers. My interpretation of Winkelmann’s review
differs from that of Collins. Winkelmann states that it is difficult to
interpret and generalise from the results of the reviewed studies. However
“…the review shows a slight advantage for traditional dissection over
prosection. The review challenges the conclusion of many authors that the
replacement of traditional hands-on dissection by learning on prosections
would be without negative effects on learning outcomes. Two papers
mentioned in the review are particularly pertinent. Jones et al 2 using a
large randomised comparison of dissection and prosection demonstrated that
dissecting students performed significantly better when tested on cadavers
but only non-significantly better in US National Board of Examiners MCQ
tests as part of their assessment. Willson et al 3 provided two different
courses to medical students, a traditional dissecting course and a shorter
course with rotating dissection, peer-group teaching and audiovisual
technology. This study was carried out over a three year period. In all
three examined years, the traditional group performed better than the
experimental group although differences were small. Winkelmann 1 goes on
to say “…if even those who try hard to prove its inferiority find
advantage in traditional hands-on dissection this may suggest that there
is a real superiority in this teaching method.” It is therefore
misleading to state that no difference was found in the level of knowledge
of anatomy between those who learned through prosected specimens and those
who dissected cadavers.
It is a pity that no mention was made of the papers by Patel and
Moxham 4 or Moxham and Moxham 5 which showed that dissection is considered
a superior tool by anatomists ( both “traditional” and “modern”) and that
medical students would prefer anatomy taught practically ie by dissection,
prosections and living and radiological anatomy rather than theoretically
by didactic teaching, models and computer-assisted learning
The argument against dissection seems to be that it is expensive and
time consuming. In other words, it would seem that we are fitting
teaching to resources rather than deciding the core knowledge that is
needed and then providing the resources to teach it. The paper also
states that there are dwindling numbers of tutors and reduced teaching
time and therefore a learner- centred approach is necessary. It would
therefore seem that the argument in this paper is that changes in anatomy
teaching are not necessarily being made to improve the knowledge and
learning of the students but to fit in with the reduced facilities which
are available. Surely we owe it to our patients to decide the amount of
anatomy that needs to be taught and then to provide the appropriate
resources to teach it.
I accept that cadaver dissection is only one modality of teaching and
that it should be supported by prosected material, models and radiological
imaging throughout the course. However, it merely seems common sense that
if a student is to work with a human body, then they should find out how
it works by learning on the human body. Ellis 6 has made an extremely
eloquent argument in favour of cadaver dissection based on common sense
and not emotive arguments.
I accept also Collins’ contention that it is the responsibility of
universities to ensure that medical graduates have mastered the
fundamental principles and core knowledge of anatomy necessary to start
medical practice. There are considerable variations in teaching and
assessing basic medical sciences in undergraduate courses in the UK. A
core anatomy syllabus was proposed in 2002 at a symposium on anatomical
education hosted by the Anatomical Society of Great Britain and Ireland.
This was eventually modified and published in 2007 7. This is an excellent
core syllabus and requires adoption in medical schools throughout the
UK.The GMC are responsible for medical education in this country and it is
time that they took a better grasp on the medical curriculum and its
assessment. Why is there not a national assessment of the necessary basic
medical sciences in the United Kingdom? Indeed, there should be a
national qualifying examination in medicine. We would then be reassured
that all doctors are being trained to the same standard.
The question of who is going to teach anatomy is a vexed question.
There are few clinically qualified teachers of anatomy and if it is to be
taught and learned within a context that is clinically meaningful, then,
in addition to career anatomists, it must be taught by clinicians who
know the practical application of it.
I accept Collins’ contention that assessment must focus on tests
that resemble clinical problems and reward integration and application.
However, along with this there is a need for factual recall and facts must
be learned. It is time for the resurgence of the surgeon- anatomist and
whatever the expense, we must move forward in this direction. Anatomical
knowledge is too important to future doctors to leave its teaching to the
educational fashions of the day.
Andrew T Raftery
Surgeon (retired) – Anatomist (active)
Competing interests: Fellow (formerly President), British Association of
Clinical Anatomists.
References:
1. Winkelmann A. Anatomical dissection as a teaching method in medical
school: A review of the evidence. Med Educ 2007;41:15-22.
2. Jones NA, Olafson RP, Sutin J. Evaluation of a gross anatomy programme
without dissection. Acad Med 1978;53:198-205.
3. Willson JT, Tarby TJ, Seale RU, Whitlock DG. The 2-course system
in gross anatomy. J Med Educ 1975;50:788-796.
4. Patel KM, Moxham BJ. Attitudes of professional anatomists to
curricular change. Clin Anat 2006;19:132-141.
5. Moxham BJ, Moxham SA. The relationships between attitudes, course
aims and teaching methods for the teaching of gross anatomy in the medical
curriculum. Eur J Anat 2007;11(Suppl 1):19-30.
6. Ellis H. Teaching in the dissecting room. Clin Anat 2001;14:149-
151.
7. McHanwell S, Atkinson M, Davies DC, Dyball R, Morris J, Ockleford
C, et al. A core syllabus in anatomy - adding common sense to need to
know. Eur J Anat 2007;11:3-18.
Competing interests:
Fellow(formerly President) British Association of Clinical Anatomists
Competing interests: No competing interests
To the Editor –
I read with interest JP Collins’ article (1), and I agree with many
of the points raised, as stated in the Lancet (2). However, Collins’ paper
focuses mainly on formal issues, in particular on the use of new
technology and teaching methods. In my opinion, the most crucial question
to be answered first is not how, but what to teach within the reduced time
available in our days. I am delighted to read that theoretical attempts
have recently been made in this sense (3). Allow me to mention that in
Switzerland, a content-oriented curriculum based on the needs of
progressively specialized clinical practice has been elaborated and
implemented since ten years (4). The policy is intended to present a
pragmatic solution – a proverbial Swiss compromise - to the controversial
issue under consideration. It is characterized by 3 levels of training in
clinical anatomy:
1. 1st – 3rd year of medical studies: Anatomy for general medical
practice. This common trunk of anatomical knowledge is compulsory for all
students (5).
2. 4th – 6th year: Anatomy for future specialists. At this level,
particularly gifted students, after selection, are given the opportunity
to learn more detailed anatomy, specific to the clinical specialty
intended.
3. Postgraduate and continuing education: This training is oriented
to the demands of national examinations for obtaining the title of
recognized specialist. It also implies sponsored workshops in our
dissecting rooms that thus become clinical skills laboratories.
The strategy described, in my view, did not only improve the
knowledge and skills indispensable for general medical practice, and
possibly maintain high standards of anatomical knowledge for surgeons, but
also allowed macroscopic anatomy to regain power within the University by
rising notable external funds from the industry. The main drawback of the
policy, in my experience, is its tendency to jeopardize the training of
future professionals in macroscopic anatomy. This is the reason why we
have maintained intensive cadaver dissection for our residents in anatomy
– and for ourselves.
Jean HD Fasel, Full Professor of Clinical Anatomy, University Medical
Center, Geneva, Switzerland. jean.fasel@unige.ch
References
1) Collins JP. Modern approaches to teaching and learning anatomy.
BMJ 2008;337:665-667,a1310.
2) Fasel JHD et al. A survival strategy for anatomy. Lancet
2005;365:754.
3) McHanwell S et al. A core syllabus in anatomy – adding common
sense to need to know. Eur J Anat 2007;11:3-18.
4) Fasel JHD et al. A core anatomy program for medical
undergraduates. Acad Med 1998;73:585-586.
5) Fasel J: Teaching of gross anatomy to medical undergraduates:
general practice as a guideline? A synopsis. J Anat 1998;192:305-306.
Competing interests:
None declared
Competing interests: No competing interests
The medical undergraduate curriculum is continually undergoing
transition
with emerging information technology heralding a new dawn in education.
Collins has reported that those responsible for anatomy courses face
daunting challenges. [1] New curriculums must be delivered in an era of
reduced teaching times and a reduction in the number of tutors.
Consideration must also be given to new entry graduates having a degree of
computer literacy that exceeds university faculty members. [2] The
traditional
methods of cadaveric dissection and didactic lecture are being
supplemented
with multimedia, problem based learning and various imaging modalities.
[3]
Additional techniques that have arisen are body, projectors, body
painting,
virtual bodies, 3-D anatomy reconstruction and surgical simulators.
The emergence of problem based learning across the medical curriculum
has
reduced the emphasis on traditional techniques. Problem based learning
promotes the continued participation of the student during the course and
encourages them to actively assimilate information in their own private
study.
Small group tutorials may also highlight the student who is struggling
within
the course and interventions may be made at an early stage to improve
their
performance. This as opposed to conventional methods where the problem
student may only be highlighted following examination performance. Harvard
Medical School has effectively integrated problem-based learning into
their
course in order that students are introduced to clinical anatomical based
problems such as pneumothorax at an early stage. [4]
The Peninsula Medical School have replaced cadaveric dissection with
novel
techniques. They have utilised concepts such as body projection and body
painting. [5] Body projections involve data projectors and Microsoft
Powerpoint to project anatomical images onto the human body surface and
may represent sequential layers of dissection. Body painting involves
painting
internal structures on the body surface using particular reference points.
[6]
Both of these techniques may offer a solution to the increasing financial
burden of a dissection laboratory. However with the implementation of
Medical Modernising Careers in the United Kingdom and reduced
opportunities for postgraduate anatomy demonstrating, there is a danger
that
the potential surgeon may never be exposed to a cadaver in their training.
The National Library of Medicine’s Visible Human Project has ensured
the
development of various anatomical models, which can be further utilised
for
education. Temkin et al describe the use of such a model in the form of
virtual dissection where virtual explorations can be performed in 2D and
3D
views. [7] This virtual body system explorer, using multimedia methods, is
a
feasible approach to enhancing anatomy education. It integrates the
conventional technique of cadaveric navigation whilst emphasising key
structures in an easy visual manner. The virtual dissection method does
not
compromise on detail and hence may please the anatomy traditionalists.
3D reconstructions of the human body are available in various formats
whether on CD-ROM or via a website. Primal Pictures [8] provide such a
reconstruction and enable the user to add and remove structures to allow
views of differing anatomical depths as well as rotation of their models.
Nicholson et al [9] have demonstrated that there is a potential benefit
from
such models but these techniques are entirely dependent on the anatomical
detail to which they have been created.
Surgical simulation is incorporating itself as a prerequisite for the
training of
the novice surgeon. Simulators such as the LapMentorTM enable a trainee to
perform a complete laparoscopic cholecystectomy whilst displaying the
virtual anatomy within this body region. Whilst this technique has obvious
benefits for the surgical trainee the anatomy is lacking in detail. These
programmes are designed with the presumption that anatomical knowledge
of that particular region exists and not designed for the novice anatomy
student. Hariri et al [10] demonstrated that there was no objective
benefit of
learning shoulder anatomy from a simulator than from an anatomy atlas
although students rated the simulator as a more effective learning tool.
Increasing emphasis on detail may render this technique amenable to the
further education of students.
There is no standardised, universal anatomy undergraduate curriculum.
Anatomy education must be prioritised to ensure that students gain a basic
knowledge of the underlying concepts whilst being able to recall this
information with ease. More detailed anatomy should be taught using
methods, which enhance an understanding of spatial relationships between
structures thus eliminating the rote learning, which is commonplace at
this
level. Whilst the debate regarding conventional methods, such as cadaveric
dissection, continues novel techniques using multimedia technology should
be embraced enabling the student to maximise their learning potential.
References
1. Collins JP. Modern Approaches to teaching and learning anatomy.
BMJ
2008; 337: a1310
2. Ward J, Gordon J, Field MJ, Lehmann HP. Communication and
information
technology in medical education. The Lancet 2001; 357:792-796
3. Mitchell BS, Stephens CR. Teaching anatomy as a multimedia
experience.
Medical education 2004; 38: 911-912
4. Yiou R, Goodenough D. Applying problem-based learning to the
teaching
of anatomy: the example of Harvard Medical School. Surgical and
Radiologic
Anatomy 2006; 28: 189-194
5. McLachlan JC, Regan de Bere S. How we teach anatomy without
cadavers.
The Clinical Teacher 2004;1 (2): 49-52
6. Temkin B, Acosta E, Malvankar A, Vaidyanath S. An Interactive
Three-
Dimensional Virtual Body Structures System for Anatomical Training Over
the
Internet. Clinical Anatomy 2006; 19: 267-274
7.Opp den Akker J, Bohnen W, Oudgeest W, Hillen B. Giving colour to a
new
curriculum: bodypaint as a tool in medical education. Clinical Anatomy
2002;
15: 356-362
8. Nicholson RT, Chalk C, Funnell RJ, Daniel SJ. Can virtual reality
improve
anatomy education? A randomized controlled study of a computer-generated
three-dimensional anatomical ear model. Medical Education 2006; 40 (11):
1081-1087
9. URL: www.primalpictures.com (last accessed 16-09-2008)
10 . Hariri S, Rawn C, Srivastava S, Youngblood P, Ladd A. Evaluation
of a
surgical simulator for learning clinical anatomy. Medical Education 2004;
38:
896-902
Competing interests:
None declared
Competing interests: No competing interests
Dear Editor,
Medical defence claims referred to by Collins (1) represent just one
of the strands of evidence for the decline in anatomical knowledge. Other
studies support this contention (2-3). A recent survey in Auckland found
that 40% of senior medical students judged their knowledge of anatomy as
inadequate for safe clinical practice (4). We strongly support the move
away from rote learning of a large body of factual anatomy with no obvious
clinical relevance, but it is imperative that today’s doctors are equipped
with a working knowledge of anatomy appropriate for safe everyday clinical
practice.
Collins makes several excellent points about the teaching and
learning of anatomy. However, he may not be aware that progressive anatomy
departments have already embraced most of the reforms he discusses.
At the University of Otago, our undergraduate medical students are
taught clinically orientated anatomy within a curriculum centred around
early clinical contact. Anatomy is taught in parallel to clinical cases,
clinical skills (including surface anatomy), and radiology. We have
increasingly adopted innovative methods of teaching. This year alone, a
highly successful body painting session and an abdominal anatomy
ultrasound demonstration were introduced. Most anatomy is taught in
practical classes with the aid of targeted dissections, prosections
(plastinated and ‘wet’ specimens), museum models, cross-sectional slices,
and radiological images. The few lectures on anatomy focus on concepts,
difficult areas and clinical application. Students have access to a wide
range of multi-media resources for independent study. An active clinical
anatomy research programme fosters and underpins a culture of research-
informed teaching.
We have retained cadaveric dissection which is extremely popular with
most medical and dental students (5). It offers much more than three-
dimensional haptic anatomy. It encourages teamwork, dialogue using medical
language, ethical consideration, knowledge of human variation, and an
introduction to common pathology. It may be emotionally disturbing for a
few but so are various other aspects of medicine; learning to cope with
emotional upset in a supportive framework is an important part of becoming
a doctor. We agree that there is no firm scientific evidence for the
superiority of dissection, but the statement that “dissecting cadavers is
beneficial only in specialties requiring more detailed anatomy” is equally
unsubstantiated.
We agree that learning anatomy is best achieved by sequential
learning and we are currently attempting to vertically integrate anatomy
teaching into the more senior years of undergraduate medical training. We
applaud the move of the Colleges of Surgery toward establishing a syllabus
of generic anatomy with the addition of more detailed anatomy for sub-
specialty trainees but assessments of trainees must be aligned with this
as a matter of urgency. It is no longer acceptable to test surgical
trainees by questioning their ability to remember irrelevant anatomical
minutiae.
Mark D Stringer, Professor of Anatomy
mark.stringer@anatomy.otago.ac.nz
Helen D Nicholson, Dean, Otago School of Medical Sciences, University
of Otago, Dunedin, New Zealand
References
1. Collins JP. Modern approaches to teaching and learning anatomy. BMJ
2008;337:a1310
2. McKeown PP, Heylings DJ, Stevenson M, McKelvey KJ, Nixon JR, McCluskey
DR. The impact of curricular change on medical students’ knowledge of
anatomy. Med Educ 2003;37:954-961
3. Turney BW. Anatomy in a modern medical curriculum. Ann Roy Coll Surg
Engl 2007;89:104-107
4. Insull P, Blyth P. Basic science confidence in senior medical students
from the University of Auckland, New Zealand: results of the 2005 Senior
Students Survey. NZ Medical Journal 2006; 119: U2364.
5. Snelling J, Sahai A, Ellis H. Attitudes of medical and dental students
to dissection. Clin Anat 2003; 16: 165-72
Competing interests:
None declared
Competing interests: No competing interests
Is anatomy teaching in crisis? Collins thinks not. (1) In discussing
the anatomy curriculum he considers it vital to identify which aspects of
anatomy every newly qualified doctor should know and refers to a new core
syllabus in anatomy for all doctors, developed on behalf of the Anatomical
Society of Great Britain and Ireland, which attempts to set the standard
required for safe and effective clinical practice. (2) Surprisingly, of
the six named authors of this core syllabus only one is actually a medical
graduate. The others are science graduates, one of whom also has a
veterinary qualification. Perhaps there are other medical graduates in the
“et al” of the relevant reference. If so, it would have been more
appropriate had they been named, simply to counter the impression that non
-medical graduates have become the experts in determining the content of
the anatomy curriculum.
John McLean - Former Senior Lecturer in Anatomy, Manchester
University
1 Collins J. Modern approaches to teaching and learning anatomy. BMJ
2008; 337; 665-667.
2 McHanwell S, Atkinson M, Davies DC, Dyball R, Morris J, Ockleford
C, et al. A core syllabus in anatomy-adding common sense to need to know.
Eur J Anat 2007; 11; 3-18.
There are no competing interests.
Competing interests:
None declared
Competing interests: No competing interests
Having just qualified as a doctor from Cardiff University and
currently undertaking a surgical rotation, I am grateful that I attended a
University where dissection is a preserved component of the curriculum! As
with most medical skills, nothing beats “on the job” experience. Any
number of role play resuscitations or breaking bad news workshops can
replace actually experiencing it on the wards. The same applies to
learning anatomy and is why I feel dissection should remain a fundamental
part of undergraduate training. The argument that modern models and
computer programmes are superior to dissecting a body is like saying that
a surgeon can complete all their training on models before having a go on
a real patient after qualifying. Anatomy is a generic skill that underpins
almost every aspect of medicine in some way.
The exposure to dissection also provides an invaluable experience for
the fresh faced medical student regarding death and mortality. I agree
with the calls for clinicians to provide a continuum of education but it
is far easier for clinicians and students to put this teaching into
context of the student has the building blocks of anatomy provided by
dissection. Surely the argument that you do not always have a clean
dissection and that sometimes is difficult to identify structures merely
adds to the importance of dissection. In real life it is not always plain
sailing when trying to identify nerves to preserve or arteries to tie!
Addressing the shortage of bodies donated for dissection is another
issue that must be addressed and I feel that glamour, heat stopping shows
recently screened on certain TV channels did nothing to help this cause.
Many viewers will have seen the medical profession as being disrespectful
and distasteful for making a circus show of a very serious procedure.
During my time as a student at Cardiff we were expected to carry out
weekly dissections in addition to completing a portfolio, which also
guided us through each session with structured dissections to be
completed. This taught us how to expand our learning, how to research and
identify areas of weakness as well a integrating our knowledge into
practical problems.
The argument that the process of dissection is “emotionally
disturbing” is rather weak. Having been part of several resuscitation
attempts I feel that is a disturbing event but it is part of my job and I
have to deal with it. Dissection is actually a good way for students to
assess if medicine is for them and many of the ones who drip ou of medial
school do so in the first few weeks, having realised that the concept of
death and flesh os not for them! While dissection is held up as being
costly, surely the cost of training a doctor who would not be capable of
practicing would be far greater?
I do however agree that far more should be done to integrate imaging
into modern day anatomy teaching. I have already lost count of the number
of radiology request s I have written in my first few weeks, and with
modern day doctors relying more and more on imaging to aid diagnosis, we
should integrate radiology into the curriculum far more in order to
understand the concept behind the investigations we are requesting!
I hope dissection survives the modern age of medical education, even
if it is alongside computer programme and plastic pro-sections. Variety is
the spice of loife and that is something that 30 dissection tables in
medical schools provides!
Competing interests:
None declared
Competing interests: No competing interests
Tailoring Anatomy Learning for the Individual
Throughout my time at medical school I have received and sought out numerous ways of learning anatomy. These include through telescopic computer programs that enabled me to gain a three dimensional appreciation of human anatomy as well as cadaveric dissection and textbook reading.
I am a firm believer in dissection as the best tool for learning anatomy. However I am a firm proponent of structured dissection sessions rather than random and unskilled exploration. If the junior medical students of today are guided in their learning, they gain a much firmer grasp of the topic. However high quality applications and software programs offer a far more convenient and user friendly method of learning anatomy, however it is debateable as to how representative they are to real living human anatomy, which is often highly varied. Video tutorials of dissections sessions therefore seem to combine the best of skilled dissection with usability e.g. Acland’s video Atlas.
There are some elements of anatomy that you simply must go away and read up on e.g. the smaller arterial branches and lymph nodes that are often dissected out or obliterated during the embalming process.
Teaching anatomy is also an excellent method of learning the topic thoroughly, and often enables you to see the same topic through different perspectives. I certainly feel that explaining a topic to someone else enables you to establish your own level of understanding.
Drawing anatomical structures is also an underappreciated way of learning anatomy and it is sadly becoming a lost art. I feel that drawing diagrams to simplify often complex anatomical relationships is crucial on certain occasions e.g. learning the sacral plexus for the first time! Finding each branch of the sacral plexus would be almost impossible in an embalmed specimen, so images would help with this topic.
Every individual varies in how they learn anatomy best. Some students learn best through reading about the topic, some are great visual learners and require diagrams and images. I believe that students who perform the best are the most enthusiastic i.e. they give the most time to revision and reading around the core curriculum which enables them to think laterally during a written exam or viva voce.
In conclusion therefore, I believe students should be given a variety of options for learning anatomy, and that academic staff should trust them to learn it via the resource that suits them best. Student input is crucial to curriculum design, as they are best placed to comment on the quality of a teaching approach or technique.
Competing interests: No competing interests