En­thu­si­asm gets anatomy back on ta­ble

The Weekend Australian - Travel - - Resources - Adam Cress­well Health ed­i­tor

DIS­SEC­TION may re­turn to the core cur­ricu­lum at Syd­ney Univer­sity’s med­i­cal school af­ter aca­demics were stunned by the over­whelm­ingly pos­i­tive re­sponse from stu­dents to a vol­un­tary teach­ing ses­sion held over the Christ­mas hol­i­days.

The univer­sity — which this week in­tro­duced a re­vamped med­i­cal cur­ricu­lum, fea­tur­ing greatly in­creased teach­ing time for ba­sic sci­ences such as anatomy — opened its lab­o­ra­to­ries for a se­ries of vol­un­tary, su­per­vised dis­sec­tion classes over the hol­i­day break, with some stu­dents trav­el­ling 90 min­utes each way on pub­lic trans­port so they could take part.

A for­mal eval­u­a­tion of the ses­sions, to­talling a max­i­mum of eight hours per stu­dent, found one par­tic­i­pant had re­turned to Syd­ney a month early so as not to miss the ses­sions. One stu­dent said their ‘‘ only re­gret is that it didn’t hap­pen ear­lier in the med­i­cal de­gree’’, while an­other said it ‘‘ was part of what I had al­ways hoped med­i­cal school would in­clude’’. Yet an­other said sim­ply: ‘‘ Thank you so much — best part of my MBBS de­gree this far’’.

The eval­u­a­tion con­cluded the re­sponse from stu­dents was ‘‘ over­whelm­ingly clear’’.

‘‘ The re­sults sug­gest that wider op­por­tu­ni­ties for anatomy dis­sec­tion for stu­dents are in­di­cated and need fac­ulty sup­port,’’ the eval­u­a­tion doc­u­ment said.

As re­ported in The Aus­tralian this week (Fe­bru­ary 11), Syd­ney is greatly in­creas­ing the teach­ing time for ba­sic sci­ences, in­clud­ing more than dou­bling lec­tures in anatomy from 500 hours to 1200 hours.

As­so­ci­ate Pro­fes­sor Tessa Ho, the univer­sity’s head of med­i­cal ed­u­ca­tion, said the re­sults of the eval­u­a­tion of the dis­sec­tion ses­sions were ‘‘ re­ally over­whelm­ing’’. ‘‘ In 18 years uni teach­ing I have never seen such (pos­i­tive) com­ments,’’ she said.

Asked to re­spond on a five-point scale, rang­ing from ‘‘ strongly agree’’ to ‘‘ strongly dis­agree’’, to the state­ment ‘‘ I very much en­joyed un­der­tak­ing the dis­sec­tion op­tion’’, 100 per cent of stu­dents strongly agreed.

An­other state­ment, that the ses­sions were ‘‘ rel­e­vant to my de­gree/ca­reer’’, also met with 100 per cent strong agree­ment, and 100 per cent ei­ther agreed or strongly agreed that they gained an ap­pre­ci­a­tion of anatomy from the course.

Over 90 per cent agreed or strongly agreed that dis­sec­tion should be part of the core cur­ricu­lum.

Ho says Syd­ney’s cur­ricu­lum re­view last year had noted that stu­dents had lit­tle or no op­por­tu­nity to dis­sect. She said there was a wide­spread view

that ‘‘ it’s im­pos­si­ble to open books, and look at plas­ti­cised struc­tures, or on­line pic­tures, and re­mem­ber the (anatom­i­cal) struc­tures’’.

Un­der the old cur­ricu­lum for the four-year course — the coun­try’s first post­grad­u­ate en­try course when it be­gan 11 years ago — stu­dents were in­stead shown ‘‘ pro­s­ected’’ spec­i­mens al­ready cut up, and which the stu­dents them­selves did not touch but merely ob­served.

John Mitro­fa­nis, ap­pointed last week as Syd­ney Univer­sity’s first pro­fes­sor of anatomy in med­i­cal ed­u­ca­tion, says he will be ‘‘ mak­ing hope­fully a strong case to have this (dis­sec­tion) as part of the core cur­ricu­lum’’ fol­low­ing the suc­cess of the Christ­mas pilot.

‘‘ In view of the over­whelm­ing re­sponse from stu­dents, I think it’s a pretty strong case for it to be part of the core cur­ricu­lum,’’ Mitro­fa­nis said. ‘‘ I have had stu­dents ring up from other univer­si­ties en­quir­ing whether they can do the dis­sec­tion course. It’s been quite bizarre, and ev­ery­body seems to be hov­er­ing (in other univer­si­ties) to see how we go.

‘‘ Once they see how (Syd­ney’s) grad­u­ates come out with a much bet­ter un­der­stand­ing of how the body works and how it’s struc­tured, I re­ally think it will be a change of di­rec­tion for the med­i­cal ed­u­ca­tion sys­tem.’’

Mitro­fa­nis says deans that in the past had cut back on science teach­ing had ‘‘ thought they were be­ing pro­gres­sive’’, but the re­sult in­stead is that ‘‘ you take away the soul of the course’’.

He says he has heard of stu­dents start­ing their or­thopaedic train­ing who ‘‘ weren’t sure how many bones there were in the (lower) leg’’.

‘‘ That’s quite em­bar­rass­ing,’’ he said. ‘‘ I would un­der­stand if they didn’t know about the bones in the foot, be­cause there are lots of them and some are quite ob­scure. But there are only two in the (lower) leg — the tibia and fibia.

‘‘ The beauty of this new cur­ricu­lum is that it’s re-found the im­por­tance of anatomy, and re­found the im­por­tance for stu­dents to have an ap­pre­ci­a­tion of body struc­ture and func­tion.

‘‘ In the com­mu­nity there’s an ex­pec­ta­tion . . . that if you have a heart at­tack your doc­tor can ex­plain to you how your heart pumps blood and where it’s lo­cated. That was some­where along the way.’’

How­ever, Al­lan Carmichael, pres­i­dent of Med­i­cal Deans Aus­tralia and New Zealand, dis­agreed with Mitro­fa­nis’s pre­dic­tion that other univer­si­ties would fol­low Syd­ney’s lead, say­ing Syd­ney’s re­view and sub­se­quent re­forms were spe­cific to its own cir­cum­stances. ‘‘ While other schools will look at their re­view with in­ter­est, I don’t think they will say they will re­spond in the same way.’’

Ho says the re­view’s rec­om­men­da­tions to in­crease ba­sic science train­ing re­flect com­ments from stu­dents and doc­tors.

‘‘ The main is­sue that they raised was that our grad­u­ates felt rel­a­tively un­pre­pared, com­pared to other med­i­cal stu­dent grad­u­ates, for clin­i­cal prac­tice, par­tic­u­larly in re­la­tion to their knowl­edge of ba­sic clin­i­cal sci­ences — ar­eas such as anatomy, phys­i­ol­ogy, phar­ma­col­ogy and pathol­ogy. We are beef­ing up anatomy across the first year — clin­i­cians were feel­ing that stu­dents needed a bit more of this to be clin­i­cally com­pe­tent.’’



Pic­ture: James Croucher

Back to ba­sics: Tessa Ho says beef­ing up the ba­sics comes from stu­dent and doc­tor com­ments

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