The Initial Impact of the Anatomical Society Gross Anatomy Core Syllabus for Medicine in the United Kingdom: Student and Teacher Perspectives

"Pet things" and "penny drops"-Factors influencing clinicians' teaching of pelvic anatomy

Pelvic anatomy is considered challenging to teach and learn, partly because its complexity can make it difficult to conceptualize. Educational researchers recognize the value of a spiraling curriculum to develop clinically orientated anatomy knowledge for health professionals, but most studies have focused on the preclinical years. It is unclear how the complexities of pelvic anatomy are taught in the clinical setting by clinician educators. Understanding pelvic anatomy teaching from the perspectives of clinician educators is important because of their critical role in supporting medical students to become knowledgeable, safe practitioners. This study sought to examine factors that influence clinician educators' teaching of pelvic anatomy to medical students during clinical placement. Using established qualitative research methods, this exploratory study used semi-structured interviews with 10 participants from obstetrics/gynecology (n = 4) and urology (n = 6) in Australia. Interviews were transcribed, and data were analyzed using a reflexive thematic analysis framework. Two overarching factors were identified as influencing clinician educators' teaching: (1) how they defined the scope of knowledge, and (2) pedagogical understanding. Scope of knowledge was underpinned by patient safety considerations and guided by past experience and student aspirations. Pedagogical understanding also relied on experience and encompassed multiple teaching strategies, including approaches informed by sensitivities surrounding pelvic anatomy. Multiple factors influence how clinician educators define the scope of pelvic anatomy knowledge required of medical students. Clinician educators' awareness of syllabus and teaching approaches can enable them to support students to attain threshold concepts such as three-dimensional spatial relationships and sociocultural sensitivities associated with pelvic anatomy.

Establishing a veterinary anatomy core syllabus through a modified Delphi process

Anatomy forms a key component of veterinary curricula, but, in the context of an evolving profession, curricula are adapting and changing accordingly. There is a lack of guidance for educators regarding the levels of anatomical knowledge required for a graduate to be considered safe or competent. A formal review of veterinary anatomy learning outcomes (LOs) is therefore timely to support curriculum development in this rapidly evolving field. This study aimed to create a set of LOs which reflect the recommended core requirements for a new graduate veterinarian. A consensus approach using a modified Delphi method was used. The Delphi panel consisted of 23 experienced and active veterinary anatomy educators from veterinary schools within the UK and Ireland. The process had four stages: (1) Research team review, pre-screening and modification of a list of existing LOs (adapted from the Core Regional Anatomy Syllabus) which then formed the initial set of outcomes sent for review; (2) Delphi Round 1; (3) Delphi Round 2; (4) Post-Delphi final screening and review. Qualitative data outlining the rationale for modification and rejection of LOs were analysed via content analysis. 167 LOs were initially presented to the Delphi panel in Round 1. 64 of those were accepted, 79 recommended for modification and 23 rejected. 122 LOs were presented to the Delphi panel in Round 2. Of these, 86 outcomes were accepted, 10 modified and 26 rejected. 160 LOs were ultimately accepted and form the Veterinary Anatomy Core Syllabus. Key themes arising from analysis include the removal of unnecessary detail and increased focus on the relevance of competencies required of a new veterinary graduate. The syllabus presented may be used by curriculum planners, teachers and students within veterinary education worldwide.

Anatomy education for medical students in the United Kingdom and Republic of Ireland in 2019: A 20-year follow-up

Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's "Tomorrow's Doctors." The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full-time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part-time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system-based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub-disciplines.

An Approach to Determining, Delivering and Assessing Essential Course Content in a Medical Human Anatomy Course

INTRODUCTION

Learning objectives typically indicate subject matter judged to be important or that represents essential material to be learned during a course. We report here on our efforts to identify essential course content and determine our effectiveness teaching and assessing this content in our preclinical human anatomy course.

METHODS AND MATERIALS

Using a consensus driven approach, we identified anatomical structures, relationships and functional concepts judged to represent essential material in our unit on the thorax that students were expected to be familiar with. We then determined performance on specific examination questions that focused directly on the essential material.

RESULTS

Thirty-seven of forty-eight students (77%) correctly answered all 34 of 51 questions that directly focused on content we defined as essential. The remaining eleven students answered the majority of these questions correctly. The overall mean score was 86% (range 61%-98%).

CONCLUSION

Our review of student performance on the End of Block thorax examination confirmed our belief that we were successful in helping students learn material we defined as essential. We found the process described here to be helpful in defining essential content and for helping focus and improve medical education and learning assessment based on that material. We believe the idea of defining essential content that can be efficiently taught and effectively learned within a proscribed period of time is an important and necessary objective. We believe the approach used here might be successfully utilized in other programs in efforts aimed at quality improvement. This article is protected by copyright. All rights reserved.

Why is Anatomy Difficult to Learn? The Implications for Undergraduate Medical Curricula

The impact of the medical curricular reform on anatomy education has been inconclusive. A pervasive perception is that graduates do not possess a sufficient level of anatomical knowledge for safe medical practice; however, the reason is less well-studied. This qualitative study investigated the perceived challenges in learning anatomy, possible explanations, and ways to overcome these challenges. Unlike previous work, it explored the perceptions of multiple stakeholders in anatomy learning. Semi-structured interviews were conducted and the transcripts were analyzed by a grounded theory approach. Three main themes emerged from the data: (1) visualization of structures, (2) body of information, and (3) issues with curriculum design. The decreasing time spent in anatomy laboratories forced students to rely on alternative resources to learn anatomy but they lacked the opportunities to apply to human specimens, which impeded the "near" transfer of learning. The lack of clinical integration failed to facilitate the "far" transfer of learning. Learners also struggled to cope with the large amount of surface knowledge, which was pre-requisite to successful deep and transfer of learning. It was theorized that the perceived decline in anatomical knowledge was derived from this combination of insufficient surface knowledge and impeded "near" transfer resulting in impeded deep and "far" transfer of learning. Moving forward, anatomy learning should still be cadaveric-based coupled with complementary technological innovations that demonstrate "hidden" structures. A constant review of anatomical disciplinary knowledge with incremental integration of clinical contexts should also be adopted in medical curricula which could promote deep and far transfer of learning.

What Use is Anatomy in First Opinion Small Animal Veterinary Practice? A Qualitative Study

Despite the uncontested importance of anatomy as one of the foundational aspects of undergraduate veterinary programs, there is still limited information available as to what anatomy knowledge is most important for the graduate veterinarian in their daily clinical work. The aim of this study was therefore to gain a deeper understanding of the role that anatomy plays in first opinion small animal veterinary practice. Using ethnographic methodologies, the authors aimed to collect rich qualitative data to answer the question "How do first opinion veterinarians use anatomy knowledge in their day-to-day clinical practice?" Detailed observations and semi-structured interviews were conducted with five veterinarians working within a single small animal first opinion practice in the United Kingdom. Thematic analysis was undertaken, identifying five main themes: Importance; Uncertainty; Continuous learning; Comparative and dynamic anatomy; and Communication and language. Anatomy was found to be interwoven within all aspects of clinical practice; however, veterinarians were uncertain in their anatomy knowledge. This impacted their confidence and how they carried out their work. Veterinarians described continually learning and refreshing their anatomy knowledge in order to effectively undertake their role, highlighting the importance of teaching information literacy skills within anatomy curricula. An interrelationship between anatomy use, psychomotor, and professional skills was also highlighted. Based on these findings, recommendations were made for veterinary anatomy curriculum development. This study provides an in-depth view within a single site small animal general practice setting: further work is required to assess the transferability of these findings to other areas of veterinary practice.

COVID-19 and anatomy: Stimulus and initial response

The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world.