Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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Tomorrow's Doctors, published by the General Medical Council of the UK in December 1993, has prompted far-reaching changes to medical education in Britain. We draw attention to some inconsistencies in the document and to those aspects of it that we maintain are undesirable. We question the emphasis in Tomorrow's Doctors on change in view of the unchanging nature of the structure and function of the human body. ⋯ In the face of experts being unable to agree on or to define scientific method, we wonder if consideration of this is appropriate in an undergraduate medical course, and we doubt that ethics and criticism are rightly placed in the undergraduate curriculum. The drawbacks of systems-based teaching are considered in the light of the disease process, and we draw attention to the lack of evidence for the document's condemnation of departmental structures and its uncritical espousal of integration. Finally, we consider some of the ways in which these changes have affected anatomy.
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In light of the many changes that have been made in medical gross anatomy instruction, an attempt was made to determine the adequacy of medical student preparation in gross anatomy upon arrival at a postgraduate residency program and whether the adequacy of preparation had changed in the last 10 years. To address these questions, a survey was mailed to all of the programs in four postgraduate residencies in the United States. This survey requested information about the importance of gross anatomy to the discipline, the adequacy of resident preparation, how today's residents compare to those of 10 years ago, and in what areas they are deficient. ⋯ There were significant differences in the responses between the different residency programs. The residency programs indicated that residents need to arrive more proficient in clinical applications, general knowledge, and cross-sectional applications. Anatomy departments continue to modify their curriculum and teaching methods, decrease the curriculum hours and faculty devoted to gross anatomy, and foresee problems obtaining qualified gross anatomy teachers in the future.
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Anatomy atlases are unlike other knowledge sources in the health sciences in that they communicate knowledge through annotated images without the support of narrative text. An analysis of the knowledge component represented by images and the history of anatomy atlases suggest some distinctions that should be made between atlas and textbook illustrations. ⋯ The objective of such a model is to support anatomical reasoning and thereby replace memorization of anatomical facts. Criteria are suggested for selecting anatomy texts and atlases that complement one another, and the advantages and disadvantages of hard copy and computer-based anatomy atlases are considered.
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Comparative Study
Morphological study of two human facial muscles: orbicularis oculi and corrugator supercilii.
Human facial muscles are unique in that they do not cross joints and they function either to open and close the apertures of the face or to tug the skin into intricate movements producing facial expressions. Compared to other skeletal muscles of the body, little is known about the microscopic architecture and organization of facial muscles. It was hypothesized that facial muscles with different roles would possess differences in their cellular organization and morphology that would reflect their unique function. ⋯ The oo muscle fibers were small, rounded, and 89% of them were of the fast-twitch (Type II) variety. The muscle fibers in the cs were larger, polygonal, and only 49% of them were of the fast-twitch variety. The capillary index of the cs was 2.4 times that of the oo.
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This paper by the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) is a sequel to one published earlier, A Clinical Anatomy Curriculum for the Medical Student of the 21st Century (Clin. Anat. 9:71-99). ⋯ The present paper describes several of these invasive procedures in detail to demonstrate 1) that gross anatomy forms the foundation for their safe, efficient, and effective performance and 2) that such a foundation in gross anatomy is delineated in our previously published curricular document. Furthermore, the AACA Educational Affairs Committee hopes this paper will serve as a valuable resource for incorporating these and other invasive procedures into a clinical anatomy curriculum for students of medicine.