Enthusiasm gets anatomy back on table
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.’’
Back to basics: Tessa Ho says beefing up the basics comes from student and doctor comments