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Jacob J, Paul L, Hedges W, Hutchison P, Cameron E, Matthews D, Whiten S, Driscoll P. Undergraduate radiology teaching in a UK medical school: a systematic evaluation of current practice. Clin Radiol 2016; 71:476-83. [DOI: 10.1016/j.crad.2015.11.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/18/2015] [Accepted: 11/24/2015] [Indexed: 11/26/2022]
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Smith CF, Finn GM, Stewart J, Atkinson MA, Davies DC, Dyball R, Morris J, Ockleford C, Parkin I, Standring S, Whiten S, Wilton J, McHanwell S. The Anatomical Society core regional anatomy syllabus for undergraduate medicine. J Anat 2015; 228:15-23. [PMID: 26612592 DOI: 10.1111/joa.12405] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 11/27/2022] Open
Abstract
The Anatomical Society's core syllabus for anatomy (2003 and later refined in 2007) set out a series of learning outcomes that an individual medical student should achieve on graduation. The core syllabus, with 182 learning outcomes grouped in body regions, referenced in the General Medical Council's Teaching Tomorrow's Doctors, was open to criticism on the grounds that the learning outcomes were generated by a relatively small group of anatomists, albeit some of whom were clinically qualified. We have therefore used a modified Delphi technique to seek a wider consensus. A Delphi panel was constructed involving 'experts' (n = 39). The revised core syllabus of 156 learning outcomes presented here is applicable to all medical programmes and may be used by curriculum planners, teachers and students alike in addressing the perennial question: 'What do I need to know ?'
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Affiliation(s)
- C F Smith
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - G M Finn
- Centre for Education Development, Hull York Medical School, University of York, Heslington, York, UK
| | - J Stewart
- School of Medical Education, Newcastle University, Newcastle upon Tyne, UK
| | - M A Atkinson
- Oral & Maxillofacial Pathology, The School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - D C Davies
- Human Anatomy Unit, Department of Surgery and Cancer, Imperial College London, London, UK
| | - R Dyball
- Clare College, University of Cambridge, Cambridge, UK
| | - J Morris
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - C Ockleford
- Clinical Anatomy Learning Centre, Lancaster University, Lancaster, UK
| | - I Parkin
- School of Medicine, St Andrews, Fife, UK
| | - S Standring
- Department of Anatomy, King's College London, London, UK
| | - S Whiten
- School of Medicine, St Andrews, Fife, UK
| | - J Wilton
- Department of Anatomy, University of Birmingham, Birmingham, UK
| | - S McHanwell
- School of Medical Education, Newcastle University, Newcastle upon Tyne, UK
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Bowness JS, Nicholls K, Kilgour PM, Ferris J, Whiten S, Parkin I, Mooney J, Driscoll P. Finding the fifth intercostal space for chest drain insertion: guidelines and ultrasound. Emerg Med J 2015; 32:951-4. [PMID: 26438727 DOI: 10.1136/emermed-2015-205222] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/16/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVES International guidelines exist for chest drain insertion and recommend identifying the fifth intercostal space or above, around the midaxillary line. In a recent study, applying these guidelines in cadavers risked insertion in the 6th intercostal space or below in 80% of cases. However, there are limitations of cadaveric studies and this investigation uses ultrasound to determine the intercostal space identified when applying these guidelines in healthy adult volunteers. METHODS On each side of the chest wall in 31 volunteers, the position for drain insertion was identified using the European Trauma Course method, Advanced Trauma Life Support (ATLS) method, British Thoracic Society's 'safe triangle' and the 'traditional' method of palpation. Ultrasound imaging was used to determine the relationship of the skin marks with the underlying intercostal spaces. RESULTS Five methods were assessed on 60 sides. In contrast to the cadaveric study, 94% of skin marks lay over a safe intercostal space. However, the range of intercostal spaces found spanned the second to the seventh space. In 44% of women, the inferior boundary of the 'safe triangle' and the ATLS guidelines located the sixth intercostal space or below. CONCLUSIONS Current guidelines often identify a safe site for chest drain insertion, although the same site is not reproducibly found. In addition, women appear to be at risk of subdiaphragmatic drain insertion when the nipple is used to identify the fifth intercostal space. Real-time ultrasonography can be used to confirm the intercostal space during this procedure, although a safe guideline is still needed for circumstances in which ultrasound is not possible.
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Affiliation(s)
- J S Bowness
- School of Medicine, University of St Andrews, St Andrews, UK
| | - K Nicholls
- School of Medicine, Barts and The London, London, UK
| | - P M Kilgour
- Paediatric Emergency Department, Royal Manchester Children's Hospital, Manchester, UK
| | - J Ferris
- Department of Emergency Medicine, Ninewells Hospital, Dundee, UK
| | - S Whiten
- School of Medicine, University of St Andrews, St Andrews, UK
| | - I Parkin
- School of Medicine, University of St Andrews, St Andrews, UK
| | - J Mooney
- School of Medicine, University of Manchester, Manchester, UK
| | - P Driscoll
- School of Medicine, University of St Andrews, St Andrews, UK
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Bowness J, Kilgour PM, Whiten S, Parkin I, Mooney J, Driscoll P. Guidelines for chest drain insertion may not prevent damage to abdominal viscera. Emerg Med J 2014; 32:620-5. [DOI: 10.1136/emermed-2014-203689] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 11/08/2014] [Indexed: 11/04/2022]
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Bowness J, Kilgour P, Whiten S, Parkin I, Mooney J, Driscoll P. Guidelines for chest drain insertion do not protect relevant anatomical structures. Crit Care 2013. [PMCID: PMC3642740 DOI: 10.1186/cc12231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Elson DW, Whiten S, Hillman SJ, Johnson RJ, Lo SS, Robb JE. The conjoint junction of the triceps surae: Implications for gastrocnemius tendon lengthening. Clin Anat 2007; 20:924-8. [PMID: 17879312 DOI: 10.1002/ca.20544] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Forty embalmed cadaver lower limbs were dissected to identify the morphology of the conjoint junction of the tendons of gastrocnemius and soleus and the location of the gastrocnemius tendon relative to bony landmarks. Five patterns of conjoint junction morphology were found: transverse (25%), oblique passing distally and medially (45%), oblique passing distally and laterally (5%) and arcuate as an inverted U (17.5%) and a U-shape (7.5%). Left-right asymmetry of the junction was observed in 31.6% of 19 paired cadaver legs. On the medial side of the calf the gastrocnemius tendon could be located between 38 and 46% of the proportion of the distance between the upper border of the calcaneus and the fibular head. Corresponding values for the midline and lateral side of the calf were 45-58% and 48-51%. The location of the gastrocnemius tendon relative to bony landmarks may help to guide incision planning for open or endoscopic division of the tendon.
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Affiliation(s)
- D W Elson
- Bute Medical School, University of St. Andrews, St. Andrews, Scotland, United Kingdom
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Smith MJL, Perrett DI, Jones BC, Cornwell RE, Moore FR, Feinberg DR, Boothroyd LG, Durrani SJ, Stirrat MR, Whiten S, Pitman RM, Hillier SG. Facial appearance is a cue to oestrogen levels in women. Proc Biol Sci 2006; 273:135-40. [PMID: 16555779 PMCID: PMC1560017 DOI: 10.1098/rspb.2005.3296] [Citation(s) in RCA: 247] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Although many accounts of facial attractiveness propose that femininity in women's faces indicates high levels of oestrogen, there is little empirical evidence in support of this assumption. Here, we used assays for urinary metabolites of oestrogen (oestrone-3-glucuronide, E1G) and progesterone (pregnanediol-3-glucuronide, P3G) to investigate the relationship between circulating gonadal hormones and ratings of the femininity, attractiveness and apparent health of women's faces. Positive correlations were observed between late follicular oestrogen and ratings of femininity, attractiveness and health. Positive correlations of luteal progesterone and health and attractiveness ratings were marginally significant. Ratings of facial attributions did not relate to hormone levels for women wearing make-up when photographed. There was no effect of sex of rater on the relationships between oestrogen and ratings of facial appearance. These findings demonstrate that female facial appearance holds detectable cues to reproductive health that are considered attractive by other people.
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Affiliation(s)
- M J Law Smith
- School of Psychology, University of St Andrews, St Andrews, Fife KY16 9JP, UK.
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Elson D, Whiten S. Re: Spielmann P M, Oliver C W. The carpal bones: a basic test of medical students' and junior doctors knowledge of anatomy. Surgeon 2006; 4:125; author reply 125. [PMID: 16623177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Azhar A, Whiten S, Cochrane L, Abboud R, Wigderowitz C. Scapholunate ligament in carpal kinematics: An anatomical study. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)85043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jones BC, Perrett DI, Little AC, Boothroyd L, Cornwell RE, Feinberg DR, Tiddeman BP, Whiten S, Pitman RM, Hillier SG, Burt DM, Stirrat MR, Law Smith MJ, Moore FR. Menstrual cycle, pregnancy and oral contraceptive use alter attraction to apparent health in faces. Proc Biol Sci 2005; 272:347-54. [PMID: 15734688 PMCID: PMC1634990 DOI: 10.1098/rspb.2004.2962] [Citation(s) in RCA: 168] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Previous studies demonstrating changes in women's face preferences have emphasized increased attraction to cues to possible indirect benefits (e.g. heritable immunity to infection) that coincides with periods of high fertility (e.g. the late follicular phase of the menstrual cycle). By contrast, here we show that when choosing between composite faces with raised or lowered apparent health, women's preferences for faces that are perceived as healthy are (i) stronger during the luteal phase of the menstrual cycle than during the late follicular, fertile phase, (ii) stronger in pregnant women than in non-pregnant women and (iii) stronger in women using oral contraceptives than in women with natural menstrual cycles. Change in preference for male faces was greater for short- than long-term relationships. These findings indicate raised progesterone level is associated with increased attraction to facial cues associated with possible direct benefits (e.g. low risk of infection) and suggest that women's face preferences are influenced by adaptations that compensate for weakened immune system responses during pregnancy and reduce the risk of infection disrupting foetal development.
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Affiliation(s)
- B C Jones
- School of Psychology, University of St Andrews, St Mary's College, South Street, St Andrews, Fife KY16 9JP, UK.
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Abstract
AIM The study's first aim was to assess the emotional impact of cadaver dissection on first year medical students using the newly developed Appraisal of Life Events Scale (ALE). Its secondary aim was to evaluate the validity of the ALE by comparing it with the Impact of Events Scale (IOE). SETTING Division of Biomedical Sciences, School of Biology, University of St. Andrews. SUBJECTS AND METHOD Appraisal of Life Events and Impact of Events data were obtained from 114 UK medical students 4 weeks after their first cadaver dissecting class. Main outcome measures referred to the ALE and IOE scales. RESULTS The students rated the experience as largely positive, registering significantly higher scores on the ALE challenge factor than on ALE threat or ALE loss. Significant correlations between ALE threat and loss scores and IOE intrusions and avoidance scores were noted. CONCLUSION The results indicate that medical students do not report their first exposure to cadaver dissection as an aversive experience. Instead, as the ALE results confirm, they found it to be a positive and challenging life event. The ALE appears to be a useful instrument in assessing positive and negative emotional reactions to significant life events.
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Affiliation(s)
- R E O'Carroll
- School of Psychology, University of St. Andrews, UK.
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Abstract
Despite the fact that development of the human embryo heart is of considerable clinical importance, there is still disagreement over the process and the timing of events. It is likely that some of the conflicting accounts may have arisen from difficulties in describing and visualising 3-dimensional structures from 2-dimensional sections. To help overcome this problem and to improve our understanding of the development of the heart, we have devised techniques for the production of interactive 3D models reconstructed from serial histological sections of human embryos. Our method uses commercial software designed for the creation of 3D models and virtual reality environments. The ability to construct interactive visual images which both illustrate and communicate complex 3D information contributes to our understanding of the complex developmental changes occurring in embryogenesis.
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Affiliation(s)
- S Whiten
- School of Biomedical Sciences, University of St Andrews, Fife, UK.
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