Rethinking Anatomy: Clinical Syndromes as the Basis for Teaching Basic Science in Gross Anatomy
Authors: Zill Sasha 
Published: June 2021

Goal

The goal of this study was to develop new and effective approaches to providing first year medical students with knowledge of Gross Anatomy. A core of clinical conditions that have been taught in second‐year courses (Diseases and Therapeutics) at the Joan C. Edwards School of Medicine and previously tested in USMLE Step One Board Examinations provided the pedagogical basis for re‐organization of teaching of Gross Anatomy.

Background

Knowledge of body structure and the basic terminology of medicine taught in Gross Anatomy is fundamental to cognizant clinical practice. As widely documented, study of Gross Anatomy in medical education has increasingly been compressed or conveyed solely through independent study. This is particularly disadvantageous and stressful for students with limited prior training in the anatomical sciences as it requires simultaneous acquisition of the vocabulary and ‘grammar’ (anatomical consequences) of medicine.

Methods

Teaching of Gross Anatomy was modified and evaluated by use of a data base consisting of questions that have been asked repetitively (or with minor modification) on computer based written examinations over an extended (minimum five year) period and by regional practical exams. The basic pedagogical change was to reorganize instruction of anatomy in the areas of Head and Neck and Lower Extremity within the context of clinical syndromes and conditions. This core of knowledge was stressed and reiterated but was also extended to include training sufficient to allow for laboratory dissections and study of prosections and radiographic images. However, some content was reduced: students were required to learn only muscle actions and innervations, not their origins and insertions (although identification of individual muscles was still required on practical examinations). Instruction in each region culminated in small group laboratory sessions and review discussions. Data on specific questions were analyzed from ExamSoft in Excel and Sigmastat.

Results

Student performance has consistently increased during the period in which a clinical focus was established. Mean scores on written examination questions in both Head and Neck and Lower Extremity have improved after the changes in pedagogy. We are currently analyzing individual repeat questions to examine whether similar differences occurred in different question types (Clinical Vignette, Clinical Procedure, Basic Science). In addition, point biserial data indicate that these tests may also be useful in identifying students needing assistance in learning.

Conclusions

These results suggest that training in Gross Anatomy can be effectively maintained by reorganizing subject material in the context of clinical syndromes and conditions. Our approach has also entailed a reduction in memorization but utilizes independent learning in study of prosections and immediate application in laboratory dissections. Furthermore, the format we have adopted should facilitate review of Gross Anatomy in study for the USMLE Step One Board examinations. Those examinations no longer extensively or directly test expertise in Gross Anatomy but still require attaining knowledge of body structure essential in the practice of medicine.

Support or Funding Information

WVCTSI grant U54GM104942

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.