Medical student participation in surface anatomy classes

Abstract

Surface anatomy is an integral part of medical education and enables medical students to learn skills for future medical practice. In the past decade, there has been a decline in the teaching of anatomy in the medical curriculum, and this study seeks to assess the attitudes of medical students to participation in surface anatomy classes. Consequently, all first year medical students at the Guy's, King's and St Thomas's Medical School, London, were asked to fill in an anonymous questionnaire at the end of their last surface anatomy session of the year. A total of 290 medical students completed the questionnaires, resulting in an 81.6% response rate. The students had a mean age of 19.6 years (range 18-32) and 104 (35.9%) of them were male. Seventy-six students (26.2%) were subjects in surface anatomy tutorials (60.5% male). Students generally volunteered because no one else did. Of the volunteers, 38.2% would rather not have been subjects, because of embarrassment, inability to make notes, or to see clearly the material being taught. Female medical students from ethnic minority groups were especially reluctant to volunteer to be subjects. Single-sex classes improved the volunteer rate to some extent, but not dramatically. Students appreciate the importance of surface anatomy to cadaveric study and to future clinical practice. Computer models, lectures, and videos are complementary but cannot be a substitute for peer group models, artists' models being the only alternative.

The anatomy of anatomy: A review for its modernization

“…Simultaneously, there is an opportunity to study the musculoskeletal system (Pabst, 2002;McLachlan and Patten, 2006), which is often understated in curricula. Whereas multimedia may compliment the learning process, nothing could substitute the practical experience gained within peer-groups (Aggarwal et al, 2006) and familiarizing oneself with living anatomy in a safe environment before handling patients. In fact, compared to students on the new systems-based course influenced by GMC's Tomorrow's Doctors (GMC, 2009), McKeown et al (2003) discovered that students on the ''old curriculum'' attained a greater knowledge of surface anatomy.…”

“…In addition, this exercise creates a more comfortable and non-judgmental environment for students to volunteer as models in surface anatomy classes which has been a long-standing issue due to factors such as embarrassment, especially among female participants from ethnic minorities (Aggarwal et al, 2006). Consequently, males are usually expected to or are many times compelled to volunteer because no one else will.…”

“…Consequently, males are usually expected to or are many times compelled to volunteer because no one else will. However, Aggarwal et al (2006) commented that single sex anatomy classes did not result in a substantial increase in volunteering rates. Gender segregation, particularly in anatomy, should be discouraged since clinical practice requires a balance between comfort and professionalism to interact with both genders as vulnerable patients.…”

Evidence‐based surface anatomy

“…For all clinicians undertaking a physical examination, whether generalist or specialist, surface anatomy has not yet been usurped by technology (Verghese and Horwitz, 2009). For medical students, surface anatomy and living anatomy help to contextualize cadaveric topographical anatomy and provide important bridges between lab and clinic (Boon et al, 2002;Aggarwal et al, 2006;Ganguly and Chan, 2008). The subject is of more than academic interest.…”

“…Assuming that surface anatomy, hopefully evidence-based, is not consigned to the long grass, when and how it should be taught? Novel pedagogic approaches, such as using body painting or drawing on a ''translucent cadaver'' (laminated photographs of full body digital X-rays), appear to engage students in the process of knowledge acquisition (Op Den Akker et al, 2002;Aggarwal et al, 2006;McMenamin, 2008;Finn and McLachlan, 2010;Finn et al, 2011), but do not necessarily aid the subsequent implementation of that knowledge in the clinic (Kotzé et al, 2012). This resonates with my experience that the surface anatomical knowledge of some recent medical graduates and surgical trainees often bears a striking resemblance to the childhood guessing game of ''pin the tail on the donkey.''…”