Zill Lab Research

ISSUES IN MEDICAL EDUCATION

This web page is intended as a forum for presenting new ideas about medical education. In my view, the major development in education of physicians in the basic sciences in the last 25 years is a large increase in the volume of material that is being taught. However, the overall duration of basic science education has remained the same during this period in most medical schools. This has produced an environment in which teaching and learning have become increasingly stressful and retention of knowledge has decreased. New approaches to the education of physicians are, therefore, not merely desirable but essential.

This page contains links to manuscripts and articles on the teaching of Anatomy in medical school that can be downloaded. However, this page also includes links to other web sites and articles about diverse issues related to medical and graduate education. Articles are also planned on the balance of Teaching and Research (Why faculty need to do both) and the system of Tenure in Medical Schools. Overall, the goals of this page are 1) to raise new ideas and 2) provide data for students and educators.

Original Article

1) In manuscript: 'How is gross anatomy taught in medical school: a consensus on the minimum duration for learning and retention' - This article is a quantitative examination of Gross Anatomy courses in medical schools in the United States based upon data from the AAMC (American Association of Medical Colleges). Download draft version as MS doc file

Opening paragraphs of article: Knowledge of the structure of the human body that is taught in courses in Gross Anatomy has been and remains fundamental to the practice of medicine (Blake 1980; McCuskey et al. 2005). Despite recent advances in cell and molecular biology, most medical diagnoses and treatments require a physician to evaluate a patient's condition by physical examination or interpretation of images of body structure (Sloane et al. 2002). The rapid growth of imaging technology has introduced new techniques and brought those images to the computers of doctors' offices (Miles 2005; Walker 2005; Keppke and Miller 2005). Interpretation of images obtained from ultrasound, MRI or CAT requires detailed training in the anatomical sciences and is no longer limited to specialists (Yip 2003; May 2005). Courses in Gross Anatomy are often the major or sole vehicle for medical students to learn basic radiology and the interpretation of images of body structure (Miles 2005; Gunderman and Wilson 2005). In addition, many curricula combine the subject material of Gross Anatomy and Human Embryology, due to the close relationship between human structure and development (Carlson, 2002). Thus, many Gross Anatomy courses present a broad foundation of knowledge in structure, imaging and development; for medical students, these courses traditionally serve as an introduction to the language of medicine.

However, the recent advances in other disciplines, such as cell and molecular biology, have produced a large increase in the volume of material covered in basic science training in medical education (McCuskey et al. 2005). The curricula of medical schools have been adjusted to allow more time for those subjects. Some schools have sought to integrate training in Anatomy with other disciplines in Organ Systems or multi-disciplinary approaches (Evans and Watt 2005). A few schools have been reported to compress the teaching of Gross Anatomy into a short, single block at the start of medical training. However, to our knowledge, there have been no comprehensive, contemporary reports on how Gross Anatomy is incorporated in the organization of medical school curricula.

(References are cited in full in draft version)

Data Files

1) Curriculum 2006 - A file we have compiled containing the curricula of all medical schools in the United States from data filed with the AAMC (American Association of Medical Colleges). The courses that are taught are indicated in block diagrams for each year and we have marked courses in Gross Anatomy. The file is 141 pages of diverse approaches with common educational goals. Download as pdf file

Important References

1) Shortage of Anatomists - McCuskey RS, Carmichael SW and Kirch DG (2005) The Importance of Anatomy in Health Professions Education and the Shortage of Qualified Educators. Academic Medicine 80: 349-351. This article documents and analyzes the current status of teaching of Gross Anatomy. In contrast to other disciplines, there is both an immediate and growing shortage of trained anatomists in the US. This situation offers real opportunities for graduate students and post-doctoral fellows to obtain faculty positions by being trained in Gross Anatomy. Download at http://www.academicmedicine.org/cgi/content/full/80/4/349

2) Effects of Course Compression on Retention - Dempster, FN (1988). The spacing effect: A case study in the failure to apply the results of psychological research. American Psychologist 43:627-634. This article documents the 'spacing effect'. It is well known that retention of information decreases dramatically when the duration of courses is decreased, even when the number of hours and amount of data remain the same. This is strong evidence that teaching in short intensive blocks produces short term memory but not learning and retention. Download at http://content.apa.org/journals/amp/43/8 (subscription required)

3) Students learn more than just science in Gross Anatomy - Dyer GSM and Thorndike ME (2000) Quidne Mortui Vivos Docent? The Evolving Purpose of Human Dissection in Medical Education. Academic Medicine 75: 969-979. The title of this article means what do the dead teach the living? The Gross Anatomy laboratory has served important roles in medical education that have been largely unrecognized: teaching students to directly confront human death and to appreciate commitment to humanity in the meaningful gifts that humans give in donation of their bodies. These experiences will be lost if Gross Anatomy is taught without a laboratory. Download at http://www.academicmedicine.org/cgi/content/full/75/10/969