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Keywords:

  • education;
  • medical curriculum;
  • survey;
  • neuroscience;
  • anatomy;
  • embryology;
  • histology;
  • microscope;
  • teaching

Abstract

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

Directors of courses in the basic anatomical sciences in allopathic and osteopathic medical schools in the United States were surveyed regarding the present composition of their courses. Results indicate the majority of gross anatomy courses are in the range of 126 to 200 total course hours, and that laboratory dissection is a key component of these courses. The majority of microscopic anatomy courses are in the range of 61 to 100 total course hours, generally divided equally between lecture and laboratory components. Additionally, despite the availability of computer technology, microscopes are still used in the vast majority of microscopic anatomy courses. The majority of neuroscience courses are in the range of 71 to 90 total course hours, with most of these hours devoted to lectures. Embryology is usually taught in conjunction with gross anatomy, although some schools present it with the microscopic anatomy course or as a separate course. Most embryology courses are in the range of 6 to 20 total course hours, with only a few having a laboratory component. Anat Rec (New Anat) 269:118–122, 2002. © 2002 Wiley-Liss, Inc.


INTRODUCTION

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

Many allopathic and osteopathic medical schools in the United States have found it necessary to change their approach to medical education in recent years. One stimulus for this change is based on significant increases in the knowledge base related to the practice of medicine. These changes include dramatic advances in cell and molecular biology that have increased our understanding of basic physiological processes and the use of this information in the development of better pharmaceuticals for the treatment of disease, improved medical imaging procedures that have changed how diseases are identified and treated, and technological advances in surgery and in the development of medical devices that have led to improved management of diseases. Another stimulus for changes in medical education is based on the belief that different educational approaches might be more appropriate when educating a physician (Drake, 1998; Giffin and Drake, 2000). These new approaches include a decreased number of large group lectures, an increased number of small group activities, more problem solving approaches, fewer scheduled activities, and the increased use of computer technology in the classroom.

Many medical schools in the United States have found it necessary to change their approach to medical education in recent years.

With these factors in mind, many medical schools have made or are in the process of making major curricular changes. This raises the question of what impact these changes are having on the courses in the medical curriculum related to the anatomical sciences (gross anatomy, microscopic anatomy, neuroscience, and embryology). Are course hours being decreased, lectures being eliminated, laboratory sessions being reduced, and/or special laboratory activities, i.e., cadaver dissection and microscope usage, being eliminated? This type of specific information is not current or readily available, although the literature is filled with relevant anecdotes (e.g., on the subject of cadaver dissection, see Aziz et al., 2002). Some information is available through the American Association of Medical Colleges (AAMC), but their information is not current and was incomplete in several of these areas.

Therefore, a survey was initiated under the auspices of the Educational Affairs Committee of the American Association of Anatomists (AAA) in an attempt to gather complete and current information regarding course hours and laboratory activities. The completed surveys were gathered, and the results are summarized in this report. This information will allow course directors to be better informed as to how the anatomical sciences are being presented in medical curricula across the United States. These data will be maintained as a database by the national office of the AAA (www.anatomy.org) and updated on a regular basis.

THE SURVEY

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

The first task was to compile a list of course directors for the basic courses in the anatomical sciences typically offered as part of a medical school curriculum. To eliminate curricular changes related to educational priorities unique to other countries, the list was restricted to allopathic and osteopathic schools in the United States. A survey was developed and sent to the course directors. The survey requested information on total course hours, the number of lecture hours, the number of laboratory hours, a brief description of the course, and additional questions specific to each discipline (i.e., cadaver use in gross anatomy, the use of microscopes in microscopic anatomy). To obtain as complete a response as possible, numerous notices were sent by means of e-mail at different times of the year, and information about the survey was also distributed by the AAA.

GENERAL COMMENTS ABOUT RESPONSES

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

Available information indicates there are a total of 141 allopathic and osteopathic schools in the United States. The following number of responses were received:

Gross Anatomy

83 (59%)

Microscopic Anatomy

80 (57%)

Neuroscience

84 (60%)

Embryology

69 (49%)

These numbers, although sufficient, were somewhat below expectations. In an attempt to supplement the current survey, data available from the AAMC for the academic years 1999–2000 and 2000–2001 were examined. It was found that, although this additional information provided us with a greater number of schools included in the tabulations, in all cases, the statistical information was not changed significantly. Because of this finding and the fact that the AAMC information was 1 to 2 years old, it was not included in this report, which presents the most current information available regarding courses in the anatomical sciences offered in allopathic and osteopathic schools across the United States.

GROSS ANATOMY

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

The survey questions regarding gross anatomy requested the number of total course hours, the proportion of those hours devoted to lectures and laboratories, and the type of laboratory experience offered, i.e., student dissection, prosections, or both. The distribution of total course hours in gross anatomy is shown in Figure 1. The average number of course hours reported was 167 (n = 83; SD = 39; median = 167). The range of total hours was from 55 to 252. To determine whether the laboratory experience was still a major component of gross anatomy courses, the respondents were asked to supply lecture and laboratory hours. To analyze this information, the number of laboratory hours was divided by the total number of course hours. This information was used to prepare Table 1, which shows the percentage of hours that gross anatomy courses commit to the laboratory experience. This percentage ranged from 34% to 89% of the total hours assigned to the course. As shown in Table 1, in 40% of the gross anatomy courses the laboratory component represented 70% or more of the total course hours. Looking at this from the opposite end, only 16% of the respondents indicated that the laboratory represented less than 50% of their total course hours.

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Figure 1. Distribution of total course hours for gross anatomy. Survey responses describing gross anatomy courses were compiled, and the total number of schools reporting within the ranges of total course hours indicated is shown.

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Table 1. Gross anatomy: percentage of total course hours in laboratory
Lab Hours/Total Hours (%)Number of Schools
0–100
11–200
21–300
31–404
41–509
51–6014
61–7023
71–8025
81–908

The final question in the gross anatomy portion of the survey related to the type of laboratory experience being offered. The majority of courses (61%) reported their students did a complete dissection, whereas nearly all of the remaining courses (38%) offered some combination of student dissection and prosection.

MICROSCOPIC ANATOMY

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

The survey of microscopic anatomy courses focused on the number of total course hours, the proportion of those hours devoted to lectures and laboratories, and whether microscopes were still used in the laboratories. The distribution of total course hours in microscopic anatomy is shown in Figure 2. The average number of course hours reported was 79 (n = 80; SD = 26; median = 79). The range of total hours was from 20 to 160. To further assess the distribution of course hours, the respondents were asked to divide the hours between lectures and laboratories. As shown in Table 2, in more than half of the courses the laboratory component represents more than 50% of the total course hours.

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Figure 2. Distribution of total course hours for microscopic anatomy. Survey responses describing microscopic anatomy courses were compiled, and the total number of schools reporting within the ranges of total course hours indicated is shown.

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Table 2. Microscopic anatomy: Percentage of total course hours in laboratory
Lab Hours/Total Hours (%)Number of Schools
0–102
11–200
21–307
31–409
41–5017
51–6028
61–7011
71–804
81–900
91–1002

The final piece of information requested in the survey of microscopic anatomy courses was whether these courses were still using microscopes in the laboratory. This question was being asked because computer technology has increased the availability and use of digital images both within institutions and over the Internet. We found that only 14% of the microscopic anatomy courses reported they do not use microscopes during their laboratory sessions. This was true despite the fact that many of the institutions using microscopes indicated that they also used some form of digital images as a companion to the microscopes.

NEUROSCIENCE

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

The information requested in the neuroscience survey related to the number of course hours and the proportion of those hours dedicated to laboratory activities. The distribution of the total course hours in neuroscience is shown in Figure 3. The average number of course hours was 96 (n = 84; SD = 37; median = 90). The range of total hours was from 9 to 180. As shown in Table 3, the laboratory component of neuroscience courses ranged from 0% to 85% of the total course hours. Although this range is large, in more than half of the neuroscience courses, the laboratory component was less than 30% of the total course hours. Only 4% of the neuroscience courses offered no laboratory instruction.

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Figure 3. Distribution of total course hours for neuroscience. Survey responses describing microscopic anatomy courses were compiled, and the total number of schools reporting within the ranges of total course hours indicated is shown.

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Table 3. Neuroscience: percentage of total course hours in laboratory
Lab Hours/Total Hours (%)Number of Schools
0–109
11–2021
21–3018
31–4021
41–509
51–602
61–702
71–801
81–901

EMBRYOLOGY

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

The major questions regarding embryology focused on the number of total course hours and whether or not the course was taught in conjunction with another anatomy course. The distribution of total course hours in embryology is shown in Figure 4. The average number of course hours was 16 (n = 69; SD = 11; median = 14). The range of total hours was from 3 to 65. By far, the majority of institutions reported that their entire embryology component was lecture format only. Only 13% indicated there was a laboratory component to the embryology, and most of these reported four or fewer total hours of laboratory.

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Figure 4. Distribution of total course hours for embryology. Survey responses describing embryology courses were compiled, and the total number of schools reporting within the ranges of total course hours indicated is shown.

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As to whether embryology was taught as a separate course, only 19% replied that it was. The majority of respondents indicated that embryology was taught in conjunction with other basic science courses. Of these, 56% teach embryology in conjunction with gross anatomy, whereas 23% teach embryology in conjunction with gross anatomy and one or more other courses. Only 11% teach embryology in conjunction with histology, whereas another 11% teach embryology in conjunction with courses such as human structure and function or in a problem based learning format. Thus, 64% of all the schools reporting indicated they are teaching embryology in conjunction with some portion of gross anatomy.

CONCLUSIONS

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

The most obvious conclusion to be drawn from the data compiled for this survey is the incredible variation in the range of total course hours. The range for gross anatomy is 55 to 252 hours, for microscopic anatomy 20 to 160 hours, for neuroscience is 9 to 180 hours, and for embryology 3 to 65. This finding suggests that total course hours are a function of institutional curricular design and that no institution has identified a magical number of hours that are necessary when presenting material in a specific course. However, even though this wide variation exists, there are several common themes within each course. First, the majority of total course hours in gross anatomy are still spent in a laboratory experience using a cadaver. Second, almost all microscopic anatomy courses are using microscopes in the laboratory. Third, the majority of course hours in neuroscience courses are lecture format. Fourth, most embryology courses are primarily lecture format and are integrated into some aspect of a gross anatomy course.

We encourage administrators and directors of anatomical science courses in medical schools to consult this survey and future updates on the AAA Web site when re-evaluating their curricula. Additionally, other articles published recently outline novel approaches to the teaching of gross anatomy (Reidenberg and Laitman, 2002), microscopic anatomy and histology (Heidger et al., 2002a,b), neuroscience (Haines et al., 2002), embryology (Carlson, 2002), and undergraduate anatomy (Miller et al., 2002). These articles may provide useful points for discussion of the future of anatomical science education in allopathic and osteopathic medical schools worldwide.

Acknowledgements

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

We thank all of the respondents to the survey for their willingness to share information on their course structure with the community at large. We also thank Ms. Andrea Pendleton, Executive Director of the AAA, for her assistance and that of her office in this project.

LITERATURE CITED

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

Biographical Information

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. THE SURVEY
  5. GENERAL COMMENTS ABOUT RESPONSES
  6. GROSS ANATOMY
  7. MICROSCOPIC ANATOMY
  8. NEUROSCIENCE
  9. EMBRYOLOGY
  10. CONCLUSIONS
  11. Acknowledgements
  12. LITERATURE CITED
  13. Biographical Information

Dr. Drake is Professor and Vice Chairman in the Department of Cell Biology, Neurobiology, and Anatomy at the University of Cincinnati College of Medicine (UCCM) and Director of the gross anatomy course. He is currently Chair of the Educational Affairs Committee of the American Association of Anatomists. Dr. Lowrie is an Assistant Professor in the Department of Cell Biology, Neurobiology, and Anatomy at UCCM. He participates in the gross anatomy, microscopic anatomy, and brain and behavior 1 courses. Dr. Prewitt is an Assistant Professor in the Department of Cell Biology, Neurobiology, and Anatomy at UCCM. She participates in the gross anatomy and brain and behavior 1 courses.