The use and effectiveness of interactive progressive drawing in anatomy education

Anatomical relationships are challenging concepts for first‐year medical students. The use of progressive drawing, where an image is created from a blank template, has long been utilized for outlining anatomical relationships and continuity from one region to another, and has shown positive outcomes for student learning. More recently, computerized progressive drawing has been introduced; however, challenges, including issues with visual clarity, have been described. In this study, 17 computerized screencasts of drawings covering neurovasculature of the limbs, abdomen, pelvis, head, and neck were created and provided to first‐year medical students at Morehouse School of Medicine. An animated method for drawing was utilized to increase visual clarity. Surveys were provided to 181 first‐year medical students to collect feedback about these screencasts. Sixty percent (n = 108) of students completed at least one survey. Respondents rated all 17 screencasts with a minimum of 4.7/5 for helpfulness in learning the material for course examinations. A majority of students (77.8%) reported viewing the screencasts more than once on at least one survey, and students reported varying methods for utilizing the screencasts. A majority of students provided positive feedback relating to technical quality. Some significant differences in course performance were seen based on screencast usage. The positive responses from students indicate that this is a useful method in medical education. Anat Sci Educ 11: 445–460. © 2018 American Association of Anatomists.     

The assertive-aggressive distinction and the cross-cultural perspective

Are assertive and aggressive behaviors distinguishable from each other across different cultures? A limited amount of research, reviewed here, indicates that they are. It seems that, across cultures, assertive and aggresive behaviors are identifiable as different constructs and that they vary independently from each other. Other variables that mediate differences on assertiveness between cultures such as individualism versus collectivism and masculinity versus femininity are considered. Finally, recommendations regarding research methodology for the study of assertive behaviors across cultures are presented.     

法律与道德的区别

很多年以前,我开办了一所学校,专门招收来自印第安原始部落的学生,他们从亚利桑那州的各个原始部落来到我位于加利福尼亚奥克兰市的家里。这些学生中有一个名叫纳瓦霍的年轻人,他是最爱学习和思考的。一个周日的晚上,我带他去参加一个聚会。在聚会上,小伙子们对法律和道德的区别展开了激烈的讨论,可是说到最后也没有一个人能     

The anatomy of anatomy: A review for its modernization

Anatomy has historically been a cornerstone in medical education regardless of nation or specialty. Until recently, dissection and didactic lectures were its sole pedagogy. Teaching methodology has been revolutionized with more reliance on models, imaging, simulation, and the Internet to further consolidate and enhance the learning experience. Moreover, modern medical curricula are giving less importance to anatomy education and to the acknowledged value of dissection. Universities have even abandoned dissection completely in favor of user‐friendly multimedia, alternative teaching approaches, and newly defined priorities in clinical practice. Anatomy curriculum is undergoing international reformation but the current framework lacks uniformity among institutions. Optimal learning content can be categorized into the following modalities: (1) dissection/prosection, (2) interactive multimedia, (3) procedural anatomy, (4) surface and clinical anatomy, and (5) imaging. The importance of multimodal teaching, with examples suggested in this article, has been widely recognized and assessed. Nevertheless, there are still ongoing limitations in anatomy teaching. Substantial problems consist of diminished allotted dissection time and the number of qualified anatomy instructors, which will eventually deteriorate the quality of education. Alternative resources and strategies are discussed in an attempt to tackle these genuine concerns. The challenges are to reinstate more effective teaching and learning tools while maintaining the beneficial values of orthodox dissection. The UK has a reputable medical education but its quality could be improved by observing international frameworks. The heavy penalty of not concentrating on sufficient anatomy education will inevitably lead to incompetent anatomists and healthcare professionals, leaving patients to face dire repercussions. Anat Sci Educ 3: 83–93, 2010. © 2010 American Association of Anatomists.     

The Child and the Fairy-Tale

The fairy-tale plays a very important part in the development of a child's speech, his fantasy, his intellectual abilities, his emotions and his personality as a whole.     

The Dishwasher's Child: education and the end of egalitarianism

This paper argues that egalitarianism, in itself and as a basis for educational policy, is unacceptable. Three recent defences of it are examined and rejected. Three anti-egalitarian positions, however, all of which stress sufficiency rather than equality, pass muster. Educational implications are followed through, with reference to mixed ability grouping, selection, equal opportunities in education and conflicting views about the minimum content of a common school curriculum.     

Bringing anatomy to life: Evaluating a novel ultrasound curriculum in the anatomy laboratory

As point-of-care ultrasound (POCUS) invades medical specialties, more students covet earlier ultrasound (US) training programs in medical school. Determining the optimal placement and format in the curriculum remains a challenge. This study uses student perceptions and confidence in interpreting and acquiring images to evaluate the effectiveness of an US curriculum and assesses their performance on US content. A unique US curriculum was incorporated into first-year clinical anatomy at Tufts University School of Medicine (TUSM). Students completed surveys evaluating changes in US confidence and perceptions. Mean ratings on pre- and post-surveys were compared using Mann–Whitney U tests. Performance on US examination questions was evaluated. Two independent evaluators coded narrative responses and NVivo software was used to identify common themes. Two hundred eleven students completed the US curriculum. Students reported higher post-curriculum mean confidence ratings on US comprehension, operation, image acquisition, artifact recognition, and normal image interpretation (P < 0.0001). US reinforced anatomy concepts and clinical correlates (9.56, ±0.97 SD; 9.60, ±1.05). Students disagreed with items stating learning US is too difficult (1.2, ±2.2) and that it interferes with learning anatomy (0.68, ±1.7). Students scored above passing on practical US knowledge questions, supporting survey data, and the relation to learning spatial relationships. Qualitative analysis identified seven major themes and additional subthemes. Limited integration of US breaks barriers in students' perceptions and confidence in performing POCUS. The TUSM US curriculum is a natural marriage of anatomy and POCUS applications, serving as a template for medical schools.     

美国:天真的特立独行

美国,这个世界上国土面积第三大的国家,去年(2017年7月4日)刚刚度过它的第241个生日.与有着5000年历史文化的中国和一个建筑动辄有几百上千年历史的欧洲国家相比,美国是一个年轻的国家. 也许因为年轻,以及它在如此短的时间内变得非常强大,且一直处于富足状态,所以,在美国长大的人,总带着一些“不谙世事”的天真和浪漫,像蜜罐里长大而不知忧愁的维尼熊.也正是因为年轻,美国人特别勤奋,似乎有着用不完的精力和无穷的创造力.     

The place of surface anatomy in the medical literature and undergraduate anatomy textbooks

The aims of this review were to examine the place of surface anatomy in the medical literature, particularly the methods and approaches used in teaching surface and living anatomy and assess commonly used anatomy textbooks in regard to their surface anatomy contents. PubMed and MEDLINE databases were searched using the following keywords “surface anatomy,” “living anatomy,” “teaching surface anatomy,” “bony landmarks,” “peer examination” and “dermatomes”. The percentage of pages covering surface anatomy in each textbook was calculated as well as the number of images covering surface anatomy. Clarity, quality and adequacy of surface anatomy contents was also examined. The search identified 22 research papers addressing methods used in teaching surface anatomy, 31 papers that can help in the improvement of surface anatomy curriculum, and 12 anatomy textbooks . These teaching methods included: body painting, peer volunteer surface anatomy, use of a living anatomy model, real time ultrasound, virtual (visible) human dissector (VHD), full body digital x‐ray of cadavers (Lodox^® Statscan^® images) combined with palpating landmarks on peers and the cadaver, as well as the use of collaborative, contextual and self‐directed learning. Nineteen of these studies were published in the period from 2006 to 2013. The 31 papers covered evidence‐based and clinically‐applied surface anatomy. The percentage of surface anatomy in textbooks' contents ranged from 0 to 6.2 with an average of 3.4%. The number of medical illustrations on surface anatomy varied from 0 to 135. In conclusion, although there has been a progressive increase in publications addressing methods used in teaching surface anatomy over the last six to seven years, most anatomy textbooks do not provide students with adequate information about surface anatomy. Only three textbooks provided a solid explanation and foundation of understanding surface anatomy. Anat Sci Educ 6: 415–432. © 2013 American Association of Anatomists.     

The Playing Learning Child: Towards a pedagogy of early childhood

From children's own perspective, play and learning are not always separate in practices during early years. The purpose of this article is, first, to scrutinise the background and character of early years education in terms of play and learning. Second, to elaborate the findings of several years of research about children's learning in preschool related to the curriculum of early years education and, finally, to propose a sustainable pedagogy for the future, which does not separate play from learning but draws upon the similarities in character in order to promote creativity in future generations. Introducing the notions of act and object of learning and play (by act we mean how children play and learn and with the object we mean what children play and learn) we will chisel out an alternative early childhood education approach, here called developmental pedagogy, based on recent research in the field of play and learning, but also related to earlier approaches to early education.     

Child abuse: The role of a consultant psychiatrist in a specialist institution

This paper is based on the experience of a consultant psychiatrist in a child abuse agency. Working with abusing families produces high levels of anxiety in the staff and conflicts over role are particularly strongly felt. These processes, as they affected the consultant psychiatrist and a staff group, were used to try to understand the anxiety and conflicts of the client families. The split between consultant and psychiatrist, between caregiver and authority figure, between parent and child, had to be acknowledged and accepted before the staff could work more effectively. Abusing families benefit from the range of skills offered by a multidisciplinary team. But the stresses for individual staff members working with these emotional, damaged, demanding, difficult families, can at times appear to be increased by the multidisciplinary team with its diversity of views. In the light of experience so far, it seems that work on the conflicts and anxiety needs to be part of a continuing process of staff development. Some of the difficulties for the consultant psychiatrist in such an institution are also discussed.     

Listening and questioning: the apophatic/cataphatic distinction revisited

In an earlier article I drew a distinction between two general types of listening. In one the listener brings pre-determined categories to bear in extracting useful information from the speaker’s utterance. In the other the listener suspends such categories to hear as much as possible in the utterance. This distinction has been challenged by Sophie Haroutunian-Gordon. This article responds to her critique.

The anatomy competence score: a new marker for anatomical ability

The assessment of students' ability in gross anatomy is a complex process as it involves the measurement of multiple facets. In this work, the authors developed and introduced the Anatomy Competence Score (ACS), which incorporates the three domains of anatomy teaching and assessment namely: theoretical knowledge, practical 3D application of the knowledge, and clinical or bedside application of knowledge on patients. Equal contributions from these tripartite domains were used to synthesize the ACS. The theory knowledge was assessed using MCQs and short answer questions while the knowledge of practical 3D application was assessed using an Objective Structured Practical Examination (OSPE). The clinical or bedside application of anatomy knowledge was assessed by an Objective Structured Clinical Examination (OSCE). In this correlation study, the authors examined the interdomain correlations of the summative marks for the three contributing domains of the ACS, in order to examine the rationality of this new marker. Three cohorts of medical students (n = 538) at St. George's, University of London (SGUL) Medical School in the United Kingdom were included and analyzed. The results demonstrated that the correlations between the three domains were significantly low or moderate. The three domains probably represent unique knowledge and abilities. Therefore, it would appear that the average of the domains scores (the ACS) provide a comprehensive picture of a student's ability in anatomy.