Modern approaches to teaching and learning anatomy

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