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What is anatomy? Implications for anatomy as a discipline and for Clinical Anatomy as a journal.

Anatomy as a discipline is explored against a background of the growth of scientific knowledge and developments within modern universities. The structural overtones of anatomic approaches provide intellectual cohesion for the approaches of complementary disciplines. When anatomy departments function in a transdisciplinary manner, they encompass a range of areas from molecular biology to functional anatomy and biological anthropology. Suggestions are made for a journal, such as Clinical Anatomy, to provide stimulus for the further development of anatomy as a coherent discipline.

Anatomy↗

Integration of clinical problems in teaching gross anatomy: living anatomy, X-ray anatomy, patient presentations, and films depicting clinical problems.

In addition to lectures and the dissection course, four supplements are described to stimulate first-year medical students to learn gross anatomy. All topics are coordinated with the dissection course. The additional options are living anatomy, X-ray anatomy by a roentgenologist, presentation of patients by clinicians, and films on clinical problems. This integrated curriculum of basic and applied anatomy generates a high level of student interest in gross anatomy.

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Adequacy of medical school gross anatomy education as perceived by certain postgraduate residency programs and anatomy course directors.

In light of the many changes that have been made in medical gross anatomy instruction, an attempt was made to determine the adequacy of medical student preparation in gross anatomy upon arrival at a postgraduate residency program and whether the adequacy of preparation had changed in the last 10 years. To address these questions, a survey was mailed to all of the programs in four postgraduate residencies in the United States. This survey requested information about the importance of gross anatomy to the discipline, the adequacy of resident preparation, how today's residents compare to those of 10 years ago, and in what areas they are deficient. Another survey was mailed to all medical school anatomy departments to follow changes in curriculum, teaching methods, curriculum hours, and staffing in gross anatomy. Overall, of the surveys mailed, 79% were returned, 78% from the residency programs, and 81% from the anatomy departments. A majority of the residency programs report that gross anatomy is either extremely important or very important to mastery of their discipline and rank it as the most important basic science. Overall, 57% of the residency program directors felt that residents need a refresher in gross anatomy upon arrival, 29% felt that they were adequately prepared, whereas 14% felt they were seriously lacking. Fifty-six percent of the residency programs indicated that the residents are as prepared as those of 10 years ago, 41% indicated that they are less prepared, and only 4% said that they were better prepared. There were significant differences in the responses between the different residency programs. The residency programs indicated that residents need to arrive more proficient in clinical applications, general knowledge, and cross-sectional applications. Anatomy departments continue to modify their curriculum and teaching methods, decrease the curriculum hours and faculty devoted to gross anatomy, and foresee problems obtaining qualified gross anatomy teachers in the future.

Anatomy↗

The relationship between premedical coursework in gross anatomy and histology and medical school performance in gross anatomy and histology.

Many premedical students enroll in courses whose content will be encountered again during their medical education. Presumably, students believe this practice will lead to improved academic performance in corresponding medical school courses. Therefore, this study was undertaken to determine whether a premedical gross anatomy and/or histology course resulted in increased performance in corresponding medical school courses. A second aim of the study was to examine whether the type of premedical gross anatomy and/or histology course differentially affected medical school performance. A survey that assessed premedical gross anatomy and histology coursework was administered to 440 first-year medical students. The results from this survey showed that students with premedical gross anatomy (n = 236) and/or histology (n = 109) earned significantly more points in the corresponding medical school course than students without the premedical coursework (P < 0.05). Analysis of premedical course types revealed that students who took a gross anatomy course with prosected specimens (n = 35) earned significantly more points that those students without premedical gross anatomy coursework (P < 0.05). The results from this study suggest: 1) premedical gross anatomy and/or histology coursework improves academic performance in corresponding medical school courses, and 2) a premedical gross anatomy course with prosected specimens, a specific type of undergraduate course, significantly improves academic performance in medical gross anatomy.

Adult↗

Anatomy departments and anatomy education: reflections and myths.

This report is based on the basic postulate that if the overall goal of anatomy departments is to function as vigorous academic and scholastic communities welcoming research and innovative thinking, there will be implications for the nature of anatomy teaching. In developing this theme, perceptions about the meaning of the term "anatomy" are explored, as are the repercussions of teaching anatomy entirely within the context of a medical curriculum. There have been a variety of responses to the perceived demise of anatomy, resulting in a discipline that is heterogeneous, both in terms of teaching and research emphases. The options open to university departments are assessed by way of the model of third-wave departments, with their characteristics of excellence, flexibility, planning, networking, and risk-taking. The consequences of this model for anatomy departments include the importance of a research emphasis, a close conceptual link between teaching and research, and a structural base for the research. In view of these consequences, three distinct forms of teaching are recognized: undergraduate teaching to medical and other health science students, undergraduate teaching to science students, and postgraduate teaching. Some of the distinctive features of the two forms of undergraduate teaching are explored. Various central contentions (myths) regarding anatomy departments and anatomy education are rejected.

Academic Medical Centers↗

The painted Amsterdam anatomy lessons: anatomy performances in dissecting rooms?

The Anatomy Lesson of Dr. Nicolaes Tulp, painted by Rembrandt in 1632, has recently been fully restored. From 02-10-98 to 10-01-99 this painting and some other Amsterdam painted anatomy lessons were exhibited in the Mauritshuis in The Hague, with the title "Rembrandt under the scalpel". The unique Tulp painting is one of those portraits painted in the tradition of the famous group portraits which flourished in 17th-century Holland, a predominantly urban, middle-class society where the main patrons of the arts were the leading citizens of the various towns. Moreover, it is a portrait in the tradition of the anatomy lessons especially painted for the Guild of Surgeons for their Guild Room. Nine such lessons have been painted for the guild and are still to be found in Dutch museums (Mauritshuis and Amsterdam Historical Museum). The anatomy lesson of Prof. Andreas Bonn, dated 1792, as well as some group portraits of the leading persons of the guild also play an important role in the Amsterdam group portraits. In 1925 the Amsterdam anatomist Louis Bolk commissioned Martin Monnickendam to paint another anatomy lesson. The restoration of the painting of Dr. Tulp has provided new information concerning the original composition of Rembrandt and the later additions. However, from an anatomical point of view, it is doubtful whether the Amsterdam anatomy lessons depict a real contemporary anatomical demonstration. They provide, together with archival sources, reliable information about the praelectores anatomiae and the leading persons of the guild, but fail to give much information about the dissecting room, the anatomy theatre or the procedure. The anatomical demonstration procedures of the guild are discussed in relation to the painted anatomy lessons.

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A clinical anatomy curriculum for the medical student of the 21st century: developmental anatomy.

An understanding of human developmental anatomy provides a fundamental framework for the accurate diagnosis and proper treatment of patients with congenital clinical entities, a significant population of any medical practice. Therefore, the regard afforded the study of developmental anatomy in the medical curriculum deserves thoughtful attention. In an effort to provide guidance in designing an undergraduate medical curriculum that properly addresses developmental anatomy, the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) developed this clinical anatomy curriculum in developmental anatomy. It outlines the subject matter and principles that will not only allow the physician to recognize and treat congenital diseases, but will also provide a solid basis for the incorporation of future discoveries, particularly in the rapidly evolving field of molecular developmental anatomy. The AACA seeks to ensure that all medical students receive thorough training in developmental anatomy and that each student, regardless of the institution attended, will be exposed to a curriculum that will provide the necessary competence and confidence for the effective practice of medicine in the 21st century.

Anatomy↗

Computer-based sessions in radiological anatomy: one year's experience in clinical anatomy.

In the last curricular review (1995/96) radiological anatomy was introduced as an innovation in the program of the course of clinical anatomy of the Medical School. Since computer-based media are known to facilitate the understanding of the human body, computer technology was selected in the academic year of 1997/98 as an elective educational tool to teach radiological anatomy. CD-ROMs were introduced as additional instructional resources in 1997/98. This technology aimed to provide educational support to the program, namely, to the sessions of radiological anatomy in each section of the course: head, neck, thorax, abdomen, pelvis and perineum. A questionnaire was designed to evaluate the opinion of the students enrolled in this course, focusing on the teaching sessions of radiological anatomy. Of 152 students, 135 (88.8%) returned the questionnaire. To describe the relationship between the value of this technology and several aspects of its organisation and adequacy, the Spearman rank correlation coefficient was used; canonical correlation was used for the various practical sessions. The comments of students were very positive emphasising the quality of the media, organisation of the course, immediate feedback, degree of interactivity and simplicity of use; they suggested a larger facility for the computers and acquisition of more programs and hardware. The positive evaluation of the use of the CD-ROMs in clinical anatomy allows us to foresee the formal integration of these instructional tools in the whole course, and not to restrict its use to specific units within the course.

Anatomy↗

What is anatomy for? Considerations on the body as a whole and whole anatomy.

In anatomy today, construction of the body is devoid of the water element, and the framework of the discipline is sectionalized (segmented, specialized, and divided), so that the body is not described in an integrated, harmonious manner. In this paper, the present authors selected the body, body water, and skin as objects of contemplation and deliberated on the history, significance, and resuscitation of anatomy. (1) Living things are dependent on water, and water is a vital component of the body. Therefore, greater consideration should be given to the presence of body water in morphological description of the body. (2) Since anatomy is sectionalized, understanding of the body is dwarfed and distorted. Whole anatomy, which described the body as a whole is the ideal style. (3) The body as a whole should always be placed in the center of anatomy. This should be the ultimate form of teaching anatomy.

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Anatomy and ethics: an exploration of some ethical dimensions of contemporary anatomy.

Anatomy and ethics have traditionally been viewed as inhabiting different conceptual worlds on the assumption that the practice of anatomy is ethically neutral. This assumption is challenged by critiquing the nature of anatomy and by demonstrating that ethical issues pervade anatomical study. This should come as no surprise since anatomy deals with the structure of the human body, and it is the human body and human tissues that are central to bioethical questions concerning human life in both health and disease, at its beginning and end and in research and clinical practice. Furthermore, many issues of interest to anatomists, such as the mechanisms of organ and fetal tissue transplantation, the neurological bases of aging and dementia, and definitions of brain death, are best tackled by venturing into questions usually dealt with in a clinical context. By the same token, a number of clinical issues can be approached helpfully from starting points provided by anatomy, although they too have ethical dimensions. To illustrate the close interrelationship between anatomical and ethical issues, two topic areas are discussed: research on archeological human remains and the notion of the pre-embryo.

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Survey of gross anatomy, microscopic anatomy, neuroscience, and embryology courses in medical school curricula in the United States.

Directors of courses in the basic anatomical sciences in allopathic and osteopathic medical schools in the United States were surveyed regarding the present composition of their courses. Results indicate the majority of gross anatomy courses are in the range of 126 to 200 total course hours, and that laboratory dissection is a key component of these courses. The majority of microscopic anatomy courses are in the range of 61 to 100 total course hours, generally divided equally between lecture and laboratory components. Additionally, despite the availability of computer technology, microscopes are still used in the vast majority of microscopic anatomy courses. The majority of neuroscience courses are in the range of 71 to 90 total course hours, with most of these hours devoted to lectures. Embryology is usually taught in conjunction with gross anatomy, although some schools present it with the microscopic anatomy course or as a separate course. Most embryology courses are in the range of 6 to 20 total course hours, with only a few having a laboratory component.

Anatomy↗

His and hers: male and female anatomy in anatomy texts for U.S. medical students, 1890-1989.

Much recent work on gender has emphasized how ideas of male and female differences underlie cultural assumptions about appropriate social relations, behavior, institutions and knowledge. This study focuses on the specific ways that anatomy texts for medical students in the United States have presented male and female anatomy between 1890 and 1989, using both numerical data and analysis of textual examples from 31 texts. Despite public debates about gender representation, anatomy texts have generally remained consistent in how 'the' human body has been depicted in this century. In illustrations, vocabulary and syntax, these texts primarily depict male anatomy as the norm or standard against which female structures are compared. Modern texts thus continue long-standing historical conventions in which male anatomy provides the basic model for 'the' human body.

Anatomy↗

A clinical anatomy curriculum for the medical student of the 21st century: gross anatomy.

Human anatomy forms the foundation for clinical medicine; thus its place in the medical school curriculum deserves careful attention. In an attempt to provide guidance to decision-makers involved in clinical anatomy curriculum development at the medical school level, the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) developed this document, which defines the contours of a gross anatomy curriculum leading to the M.D. or D.O. degree. The main body of the document sets forth the anatomical concepts as well as the subject matter a student should master prior to graduation from medical school. The AACA seeks to ensure that all medical students receive thorough training in clinical anatomy and that each student, regardless of the institution attended, will be exposed to a curriculum that will provide a fundamental level of competence required for the practice of medicine.

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Clinical anatomy research in a research-driven anatomy department.

Clinical anatomy is too often viewed as a discipline that reiterates the wisdom of the past, characterized more by description of what is known than by active investigation and critical analysis of hypotheses and ideas. Various misconceptions follow from an acceptance of this premise: the teaching of clinical anatomists is textbook based, there is no clinical anatomy research worthy of the name, and any research that does exist fails to utilize modern technology and does not stand comparison with serious biomedical research as found in cell and molecular biology. The aim of this paper is to challenge each of these contentions by reference to ongoing clinical research studies within this department. It is argued that all teaching (including that of clinical anatomy) should be research-informed and that the discipline of clinical anatomy should have at its base a vigorous research ethos driven by clinically related problems. In interacting with physicians, the role of the clinical anatomist should be to promulgate a questioning scientific spirit, with its willingness to test and challenge accepted anatomic dicta.

Anatomy↗