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Published in FASEB Journal: https://faseb.onlinelibrary.wiley.com/doi/10.1096/fasebj.2022.36.S1.R3644
Decline of gross anatomy in medical education. I. Independent learning and need for assessment of effects of curricular change on medical practice
First published: 13 May 2022, https://doi.org/10.1096/fasebj.2022.36.S1.R3644
NSF CRCNS Grant 2113028
Abstract
The importance of Gross Anatomy in medical education has declined in recent years as the result of curricular reforms at many schools. The goals of our ongoing observational study are 1) to adapt Anatomy instruction to the compression of content and reduction in duration of anatomy instruction, 2) to evaluate the effectiveness of pedagogical methods in conveying information essential to understanding body structure and 3) to attempt to reduce student stress. Our approach to pedagogical reorganization is to base anatomy instruction upon core clinical conditions. These conditions were not presented as clinical problems, as many students had limited prior training in medical terminology, but focused upon clinical symptoms, allowing for direct correlation of structure and function. Overall methodology has been multi-modal. Content was significantly reduced: for example, knowledge of muscle muscle origins and insertions is no longer required, only muscle actions and innervations. Performance has been evaluated using a long-term data base of student scores on written and regional practical examinations. Results of written examinations were relatively constant during the period prior to the introduction of curricular changes but practical examinations could show large anomalous variability in some years (including data utilized in a previously published study of the effects of independent learning). To increase the accuracy of assessment we have developed a set of questions that were asked repetitively in successive years on written examinations. Current data on exam performance (including repeat questions) indicate that the pedagogical changes were effective during the initial period of curricular change and a survey of students indicated that these changes effectively decreased stress. However, performance in Head and Neck anatomy declined in 2020-2021 as curricular compression and increased reliance upon independent learning has intensified. We are currently assessing whether the decline was associated with the curricular change or the unique circumstances associated with the recent viral pandemic. We also discuss the need for assessment of the effects of these changes on medical practice. The results to date suggest that training in gross anatomy can be modified to a compressed duration but do not support reliance upon independent learning as a pedagogical method.