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1.
Basic and superior reasoning skills are woven into the clinical reasoning process just as they are used to solve any problem. As clinical reasoning is the central competence of medical education, development of these reasoning skills should occur throughout the undergraduate medical curriculum. The authors describe here a method of teaching reasoning skills in a clinical context during a human anatomy course. Anat Sci Educ 3:267–271, 2010. © 2010 American Association of Anatomists.  相似文献   

2.
Clinical skills and medical knowledge enable physicians to overcome the uncertainty of emergent and rare clinical scenarios. Recently, a growing emphasis on evidence-based medicine (EBM) has flooded medical curricula of universities across the globe with guideline-based material, and while it has given teachers and students new tools to improve medical education, clinical reasoning must be reaffirmed in its capacity to provide physicians with the ability to solve unexpected clinical scenarios. Anatomical education in medical school should have two main objectives: to acquire anatomical knowledge and to develop the skill of applying that knowledge in clinical scenarios. The authors present a clinical scenario in which an unexpected and rare complication occurred during a routine elective hip replacement surgery. The general surgeon presiding over the case, also an anatomy professor, solved the problem using clinical reasoning and anatomical knowledge. It was a clear example of how clinical reasoning is key in approaching unprecedented, rare, or unknown complications. The intention of this scenario is to remind colleagues and medical schools that, although EBM is the standard, educators must uphold sound clinical reasoning to best prepare health care providers for their careers.  相似文献   

3.
Clinically integrated curricula in health science education has been shown to promote the development of problem-solving schema and positively impact knowledge acquisition. Despite its’ purported benefits, this type of curricula can impose a high cognitive load, which may negatively impact novice learners’ knowledge acquisition and problem-solving schema development. Introducing explicit clinical reasoning instruction within pre-professional undergraduate basic science courses may limit factors that increase cognitive load, enhance knowledge acquisition, and foster developing clinical problem-solving skills. This study, conducted over the Fall and Spring semesters of the 2018–2019 school year, sought to evaluate whether the implementation of a clinical reasoning instructional intervention within a clinically integrated pre-professional undergraduate general human anatomy course influenced students’ acquisition of anatomical knowledge and development of clinical problem-solving skills. Results of the study were mixed regarding the acquisition of anatomical knowledge. Both the intervention and comparison groups performed similarly on multiple choice examinations of anatomical knowledge. However, the clinical reasoning intervention positively impacted students’ ability to apply clinical reasoning skills to anatomically based clinical case studies. Results from M\mixed between-within subjects analysis of variance comparing scores on Written Clinical Reasoning Assessments revealed a significant interaction between time and group affiliation, with the groups receiving the interventions outperforming the comparison groups: Fall, P < 0.001; Spring, P < 0.001. The results of this study may imply that explicit clinical reasoning instruction within a clinically integrated undergraduate Human Anatomy course could hold potential for fostering students’ early clinical reasoning skills.  相似文献   

4.
Translating basic sciences into a clinical framework has been approached through the implementation of various teaching techniques aimed at using a patient case scenario to facilitate learning. These techniques present students with a specific patient case and lead the students to discuss physiological processes through analysis of provided data supported by independent learning and research. However, no literature exists that describes a reverse teaching methodology in which students are given disease diagnosis and then asked to construct a patient case. This article discusses an explorative learning approach introduced in the gross anatomy course in which students were asked to use clinical skills and reasoning to create a patient case. The online knowledge‐sharing portal utilizing MediaWiki provided a necessary base for students in completing their task. Teams were given 4 weeks to complete their written online project with weekly feedback provided by 3rd year teaching assistants using the Wiki discussion page. A survey was performed to assess competence regarding a patient write up and oral presentation. Skills that the teams acquired through the completion of this project will benefit future patient interactions. This project also emphasized and reinforced the importance of effective communication, leadership, and teamwork. This study shows that a clinical anatomy project that incorporates explorative learning can be an effective way of introducing students to the skills needed for patient write ups and oral presentations. Furthermore this approach to learning allows students to excel during their clinical years and to correlate anatomy to clinical diagnoses. Anat Sci Ed 1:106–110, 2008. © 2008 American Association of Anatomists.  相似文献   

5.
Integration of anatomy and clinical teaching is a theoretical ideal, yet there is a worldwide paucity of such amalgamation. These teaching models provide support for medical trainees, an important element in Germany where orthopedic intern numbers have declined and anecdotal evidence suggests disinterest in orthopedics. The aim of the study was to develop an integrated anatomy‐surgical course for undergraduate medical training, assess the model developed, and explore how medical students perceive orthopedics as a career. The course was to deliver medical anatomy and clinical orthopedic training, focusing on interdisciplinary teaching and learning, vertical integration of clinical knowledge and skills, and professional interaction. Survey evaluation of the course and students' perceptions of orthopedic careers was performed, including Likert‐type responses rating variables of interest. A phased‐concept program of five courses, each optional and under one‐week in duration, was developed parallel to the undergraduate medical program. Delivered by anatomists and surgeons, courses included biomechanics, advanced dissection, surgical approaches, casts and implants, and sports medicine. Course data indicate positive support for course format, stimulation of interest, and high clinical relevance. Students are generally interested in surgery, and identify hierarchy, lawsuits, bureaucracy and physical stress as barriers to orthopedic careers. This novel phased‐concept successfully delivers combined anatomy and surgery training in a vertically‐integrated format while addressing students' clinical and professional skills. The format facilitates an appreciation of potential career options in orthopedics, while fostering professional skills during medical training. Barriers to careers in orthopedics can now be addressed in future courses. Anat Sci Educ 10: 372–382. © 2016 American Association of Anatomists.  相似文献   

6.
There is growing demand from accrediting agencies for improved basic science integration into fourth-year medical curricula and inculcation of medical students with teaching skills. The objective of this study was to determine the effectiveness of a fourth-year medical school elective course focused on teaching gross anatomy on anatomical knowledge and teaching confidence. Fourth-year medical student “teacher” participants' gross anatomy knowledge was assessed before and after the course. Students rated their overall perceived anatomy knowledge and teaching skills on a scale from 0 (worst) to 10 (best), and responded to specific knowledge and teaching confidence items using a similar scale. First-year students were surveyed to evaluate the effectiveness of the fourth-year student teaching on their learning. Thirty-two students completed the course. The mean anatomy knowledge pretest score and posttest scores were 43.2 (±22.1) and 74.1 (±18.4), respectively (P < 0.001). The mean perceived anatomy knowledge ratings before and after the course were 6.19 (±1.84) and 7.84 (±1.30), respectively (P < 0.0001) and mean perceived teaching skills ratings before and after the course were 7.94 (±1.24) and 8.53 (±0.95), respectively (P = 0.002). Student feedback highlighted five themes which impacted fourth-year teaching assistant effectiveness, including social/cognitive congruence and improved access to learning opportunities. Together these results suggest that integrating fourth-year medical students in anatomy teaching increases their anatomical knowledge and improves measures of perceived confidence in both teaching and anatomy knowledge. The thematic analysis revealed that this initiative has positive benefits for first-year students.  相似文献   

7.
There is little consensus among programs that train physician assistants (PAs) regarding how much time should be devoted to the study of anatomy, what should be included, or how it should be taught. Similar concerns led us to redesign anatomy for medical students and introduce clinically engaged anatomy, an approach designed in collaboration with clinical faculty. This approach presents anatomy entirely within the context of common clinical cases. This report examines whether clinically engaged anatomy could be adapted to the PA program, where students cover the basic sciences in half the time as medical students. We offered a modified version of clinically engaged anatomy to PA students in which time spent in self-directed learning activities was reduced relative to medical students. We compared their scores on an examination of long-term recall to students who took the previous course. Two classes who took clinically engaged anatomy, scored the same or significantly higher on every portion of the examination (P < 0.05). Students expressed high satisfaction with the course (Likert scale, 4.3-4.8/5 points). Compared to medical students who took clinically engaged anatomy, the data suggest that the tradeoff for reducing the time spent in self-directed learning was reduced skills in applying structure-function relationships and spatial reasoning to clinical problems. The data suggest clinically engaged anatomy can be effective in various educational settings, and can be readily adapted to clinical programs that vary in the depth that anatomy is covered. Nonetheless, careful assessments are needed to determine if the necessary tradeoffs are consistent with the goals of the profession.  相似文献   

8.
In modern curricula, the early integration of anatomy and clinical skills education at undergraduate level is seen as important. However, the direct relationship between medical students' competence in anatomy, and their clinical proficiency during early undergraduate years, has scarcely been studied. In this study, the marks for anatomy and clinical skills of three consecutive cohorts of medical students (n = 538 in total) during their first two years were correlated. The anatomy competence was measured using a new marker, the Anatomy Competence Score (ACS) which was calculated with equal contributions from theory knowledge and its practical and clinical application. Proficiency in clinical skills was determined by OSCE performance marks for stations which examined physical examination and practical procedural skills. The possible compounding effect of students' general academic ability was investigated by using the overall performance mark for each student based on their performance in all subjects over the first two years of the medical curriculum. We found that the correlation between anatomy and clinical skills marks was weak to moderate. However, this correlation was virtually nullified once the effect of academic ability was accounted for. Although these findings suggest that anatomy education does not compliment early clinical education, the lack of complexity of clinical problems used in clinical skills assessments (OSCEs) during the early stages may well be the primary contributing factor to this finding.  相似文献   

9.
Commonly used technical anatomy and physiology (A&P) terms are predominantly rooted in Latin and Greek vocabulary, so it is commonly inferred that a solid grounding in Latin and Greek roots of medical terminology will improve student learning in anatomy and related disciplines. This study examines the association of etymological knowledge of A&P terms and A&P course performance among 446 undergraduates in their first semester of the study of human gross anatomy and physiology, with a more detailed analysis of the characteristics of 52 students who filled out surveys about their prior knowledge and experiences related to medicine or anatomy. In both data sets, there was only a weak positive correlation between the performance on a quiz of Latin and Greek medical terms and the students' performance on regular assignments. The presumption that familiarity with Latin and Greek word roots has a strong influence on successful learning of anatomy is not supported by these data. Future research should address whether or not there are particular skills associated with using etymological knowledge in improving A&P course performance.  相似文献   

10.
For many years art, anatomy and medicine have shared a close relationship, as demonstrated by Leonardo da Vinci's anatomical drawings and Andreas Vesalius' groundbreaking illustrated anatomical textbook from the 16th century. However, in the modern day, can art truly play an important role in medical education? Studies have suggested that art can be utilized to teach observational skills in medical students, a skill that is integral to patient examination but seldom taught directly within medical curricula. This article is a subjective survey that evaluates a student selected component (SSC) that explored the uses of art in medicine and investigates student perception on the relationship between the two. It also investigates whether these medical students believe that art can play a role in medical education, and more specifically whether analyzing art can play a role in developing observational skills in clinicians. An “Art in Medicine” 8‐week course was delivered to first year medical students at Brighton and Sussex Medical School. The use of art to improve observational skills was a core theme throughout. Feedback from the students suggests that they believe a strong association between art and medicine exists. It also showed a strong perception that art could play a role in medical education, and more specifically through analyzing art to positively develop clinical observational skills. The results of this subjective study, together with those from research from elsewhere, suggest that an art‐based approach to teaching observational skills may be worth serious consideration for inclusion in medical and other healthcare curricula. Anat Sci Educ 7: 370–378. © 2014 American Association of Anatomists.  相似文献   

11.
One of the strong trends in medical education today is the integration of the humanities into the basic medical curriculum. The anatomy program is an obvious choice for using the humanities to develop professionalism and ethical values. They can also be used to develop close observational skills. Many medical schools have developed formal art observation training in conjunction with nearby art museums to enhance the visual diagnostic skills of their medical students. We report here on an art and anatomy workshop that paired medical and art students who did drawing exercises from plastinated anatomical specimens and the animated face to hone observational skills. Each member of the pair brought a different perspective and expertise to the work that allowed each to be a mentor to the other. The workshop had three sessions: the first involved drawings of plastinated specimens that allowed an intimate experience with authentic human material; the second involved drawings of the human face; and the third included examination of anatomical texts of important anatomist-artists, a lecture on contemporary artists whose work involves anatomy, and a film demonstrating the facial muscles. We propose workshops such as these will help students increase their ability to detect details. This will assist the medical student in developing diagnostic skills for identifying disease and the art student in using the human body as subject. We further propose that these programs will help students develop humanistic sensitivities and provide an outlet for expression of the emotional aspects of dealing with disease and mortality.  相似文献   

12.
Rapid changes in medical knowledge are forcing continuous adaptation of the basic science courses in medical schools. This article discusses a three‐year experience developing a new Computed Tomography (CT)‐based anatomy curriculum at the Sackler School of Medicine, Tel Aviv University, including describing the motivations and reasoning for the new curriculum, the CT‐based learning system itself, practical examples of visual dissections, and student assessments of the new curriculum. At the heart of this new curriculum is the emphasis on studying anatomy by navigating inside the bodies of various living individuals utilizing a CT viewer. To assess the students’ experience with the new CT‐based learning method, an anonymous questionnaire was administered at the end of the course for three consecutive academic years: 2008/2009, 2009/2010, 2010/2011. Based upon the results, modifications were made to the curriculum in the summers of 2009 and 2010. Results showed that: (1) during these three years the number of students extensively using the CT system quadrupled (from 11% to 46%); (2) students' satisfaction from radiologists involvement increased by 150%; and (3) student appreciation of the CT‐based learning method significantly increased (from 13% to 68%). It was concluded that discouraging results (mainly negative feedback from students) during the first years and a priori opposition from the teaching staff should not weaken efforts to develop new teaching methods in the field of anatomy. Incorporating a new curriculum requires time and patience. Student and staff satisfaction, along with utilization of the new system, will increase with the improvement of impeding factors. Anat Sci Educ 6: 332–341. © 2013 American Association of Anatomists.  相似文献   

13.
Medical schools are increasingly looking to case-based formats such as problem-based learning (PBL) for their medical students. However, the effects of PBL have not been adequately assessed for an informed decision. An approach to assessment should consider not just the knowledge outcomes expected of all students, but should be tailored to the theoretical goals of PBL: clinical reasoning, integration of scientific and clinical knowledge, and lifelong learning skills. This means that problem-solving processes as well as products need to be measured. In addition, cognitive measures associated with expert performance can be used to assess the extent to which PBL affects the development of expertise. In this study, students taking an elective in PBL were compared with students taking other electives on a realistic pathophysiological explanation task. The problem-solving protocols were examined for coherence, use of science concepts, strategy use, and self-directed learning. The results indicate that cognitive measures can be used to distinguish students who have participated in PBL from their counterparts in terms of knowledge, reasoning, and learning strategies. This suggests that such measures may play a meaningful role in assessment of student learning.  相似文献   

14.
Understanding the relevance of basic science knowledge in the determination of patient assessment, diagnosis, and treatment is critical to good medical practice. One method often used to direct students in the fundamental process of integrating basic science and clinical information is problem‐based learning (PBL). The faculty facilitated small group discussion format traditionally used for PBL is a significant challenge for faculty and facilities with a large class. To provide inductive learning to a large class early in the preclerkship curriculum, a series of online, case‐based tutorials was created using the method of inquiry‐based learning. The tutorial paradigm is designed to challenge students through a guided inquiry process in which clinical skills and basic science information are seamlessly joined. The psychosocial dimension of patient care is added to the documented case presentation of the tutorials in the form of patient/physician history taking and physical examination videos. These videos augment the written case with additional information providing the student with visual exposure in methods of patient communication and appropriate professional patient/physician interactions that address competencies of patient care, communication, and professionalism. The tutorials were made available via learning management system course sites. The study tracked usage of the tutorials by 270 first‐year medical students. Anat Sci Educ 2:238–243, 2009. © 2009 American Association of Anatomists.  相似文献   

15.
Abstract

Higher education student selection has significant societal, institutional and individual impacts. Thousands of applicants apply only for nursing, one of the major higher education disciplines. As the nursing profession is characterised by cognitive requirements, higher education institutions assess the learning skills of nursing applicants. However, there has been no comprehensive analysis of learning skills assessment for nursing student selection. The purpose of this scoping review was to describe the assessment of learning skills in undergraduate nursing student selection. Five databases were systematically searched, and 24 studies published between 2006 and 2016 were included. Learning skills were most commonly assessed using standardised tests in the areas of language and communication, reasoning, mathematics and natural sciences. Overall scores of onsite selection methods were found to best predict future academic performance. The results indicate that higher education institutions may benefit from comprehensive assessment of learning skills in their selection processes. This assessment should focus on a wider range of cognitive aptitudes, including reasoning skills. This review focussed on nursing education, but the results may benefit other higher education disciplines due to the generic nature of learning skills and similar cognitive requirements of higher education studies. The results support the development of more comprehensive and valid methods for assessing learning skills.  相似文献   

16.
The Radboud University Medical Center has a problem‐based, learner‐oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students’ decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving. In a longitudinal cohort, the retention of anatomical knowledge gained during the first year of medical school among second‐year medical students was assessed. In May 2011, 346 medical students applied for the second‐year gastro‐intestinal (GI) tract course. The students were asked to participate in a reexamination of a selection of anatomical questions of an examination from October 2009. The examination consisted of a clinical anatomy case scenario and two computed tomography (CT) images of thorax and abdomen in an extended matching format. A total of 165 students were included for analysis. In 2011, students scored significantly lower for the anatomy examination compared to 2009 with a decline in overall examination score of 14.7% (±11.7%). Decrease in knowledge was higher in the radiological questions, compared to the clinical anatomy cases 17.5% (±13.6%) vs. 7.9% (±10.0%), respectively, d = 5.17. In both years, male students scored slightly better compared to female students, and decline of knowledge seems somewhat lower in male students (13.1% (±11.1%) vs. 15.5% (±12.0%), respectively), d = ?0.21. Anatomical knowledge in the problem‐oriented horizontal and vertical integrated medical curriculum, declined by approximately 15% 1.5 year after the initial anatomy course. The loss of knowledge in the present study is relative small compared to previous studies. Anat Sci Educ 10: 242–248. © 2016 American Association of Anatomists.  相似文献   

17.
Anatomical education has been undergoing reforms in line with the demands of medical profession. The aim of the present study is to assess the impact of a traditional method like cadaveric dissection in teaching/learning anatomy at present times when medical schools are inclining towards student‐centered, integrated, clinical application models. The article undertakes a review of literature and analyzes the observations made therein reflecting on the relevance of cadaveric dissection in anatomical education of 21st century. Despite the advent of modern technology and evolved teaching methods, dissection continues to remain a cornerstone of anatomy curriculum. Medical professionals of all levels believe that dissection enables learning anatomy with relevant clinical correlates. Moreover dissection helps to build discipline independent skills which are essential requirements of modern health care setup. It has been supplemented by other teaching/learning methods due to limited availability of cadavers in some countries. However, in the developing world due to good access to cadavers, dissection based teaching is central to anatomy education till date. Its utility is also reflected in the perception of students who are of the opinion that dissection provides them with a foundation critical to development of clinical skills. Researchers have even suggested that time has come to reinstate dissection as the core method of teaching gross anatomy to ensure safe medical practice. Nevertheless, as dissection alone cannot provide uniform learning experience hence needs to be complemented with other innovative learning methods in the future education model of anatomy. Anat Sci Educ 10: 286–299. © 2016 American Association of Anatomists.  相似文献   

18.
Background: Scientific excellence is one of the most fundamental underpinnings of medical education and its relevance is unquestionable. To be involved in research activities enhances students' critical thinking and problem-solving capacities, which are mandatory competences for new achievements in patient care and consequently to the improvement of clinical practice. Purposes: This work aimed to study the relevance given by Portuguese medical students to a core of scientific skills, and their judgment about their own ability to execute those skills. Methods: A cross-sectional study was conducted on students attending the first, fourth and sixth years of medical course in the same period. An assessment istrument, exploring the importance given by Portuguese medical students to scientific skills in high school, to clinical practice and to their own ability to execute them, was designed, adapted and applied specifically to this study. Results: Students' perceptions were associated with gender, academic year, previous participation in research activities, positive and negative attitudes toward science, research integration into the curriculum and motivation to undertake research. The viewpoint of medical students about the relevance of scientific skills overall, and the ability to execute them, was independently associated with motivation to be enrolled in research. Conclusions: These findings have meaningful implications in medical education regarding the inclusion of a structural research program in the medical curriculum. Students should be aware that clinical practice would greatly benefit from the enrollment in research activities. By developing a solid scientific literacy future physicians will be able to apply new knowledge in patient care.  相似文献   

19.
The first four levels of Bloom's taxonomy were used to create quiz questions designed to assess student learning of the gross anatomy, histology, and physiology of the gastrointestinal (GI) system. Information on GI histology and physiology was presented to separate samples of medical, dental, and podiatry students in computer based tutorials where the information from the two disciplines was presented either separately or in an integrated fashion. All students were taught GI gross anatomy prior to this study by course faculty as part of the required curriculum of their respective program. Student responses to the quiz questions were analyzed to assess both the validity of Bloom's cumulative hierarchy and the effectiveness of an integrated curriculum. No statistically significant differences were found between quiz scores from students who received the integrated tutorial and from those who received the separate tutorials. Multiple regression analyses provided partial support for a cumulative hierarchy where scores on the lower levels of Bloom's taxonomy predicted scores on higher levels. Notably, in the majority of regression analyses, the comprehension score was the key foundational predictor for application and analysis scores. This study supports the suggestion that educators increase the number of comprehension level questions, even at the expense of knowledge level questions, in course assessments both to evaluate lower order cognitive skills and also as a predictor of success on questions requiring application and analysis levels of the higher order cognitive skills of Bloom's taxonomy. Anat Sci Educ 11: 433–444. © 2018 American Association of Anatomists.  相似文献   

20.
Innovations in undergraduate medical education, such as integration of disciplines and problem based learning, have given rise to concerns about students' knowledge of anatomy. This article originated from several studies investigating the knowledge of anatomy of students at the eight Dutch medical schools. The studies showed that undergraduate students uniformly perceived deficiencies in their anatomical knowledge when they started clinical training regardless of their school's didactic approach. A study assessing students' actual knowledge of clinical anatomy revealed no relationship between students' knowledge and the school's didactic approach. Test failure rates based on absolute standards set by different groups of experts were indicative of unsatisfactory levels of anatomical knowledge, although standards differed markedly between the groups of experts. Good test performance by students seems to be related to total teaching time for anatomy, teaching in clinical context, and revisiting anatomy topics in the course of the curriculum. These factors appeared to outweigh the effects of disciplinary integration orwhether the curriculum was problem‐based or traditional. Anat Sci Ed 2008. © 2008 American Association of Anatomists.  相似文献   

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