Educational Research

The international community of medical educators struggles with how to decompress an overcrowded curriculum. The questions have become what to teach, when to teach it and how to teach it in less time. The problem is especially acute for anatomy. Even though the classical anatomy course is a large component of medical school, residency programs believe their residents come ill-prepared. Further, the pool of qualified instructors is shrinking.

To address these issues of content, efficiency and instructors, I investigated what students need, how they learn and how instructors teach. I call the resulting method “Clinically-Engaged Anatomy”. Clinically-engaged anatomy engages students in professional behaviors to learn the anatomy that prepares them for clerkships. Students learn how to draw inferences from skillful observation to form testable hypotheses, test them and teach others about the process. The coursework requires students to develop the teamwork skills that characterize modern medical practice. The clinical cases that drive the curriculum are cases commonly encountered in Yale affiliated hospitals. Students study the anatomy that underlies the patient’s history, physical exam, imaging studies and medical or surgical resolution.The cadaver becomes a simulated patient whereby anatomy is explored by performing surgical procedures.

This approach fosters integration of anatomy with clinical training and has attracted large numbers of clinic faculty to participate. Despite a 30% reduction in course hours, we demonstrated that students recall more when they enter clerkships. Clinically-engaged anatomy merges advanced web resources with laboratory dissection. My “Anatomy Clinic” website attracts more than 17,000 non-Yale page viewings per year from around the world and is used in Great Britain for their “Basic Training Programme for Anatomy Professionals”. The anesthesiology and otolaryngology residency training programs adapted these methods to their laboratory sessions. Therefore, clinically engaged anatomy has identified important anatomy to teach, conveys that knowledge effectively in less time, and attracts a large number of faculty who would not participate in the old course.

Current research asks how the new Medical School Curriculum impacts student outcomes in the new anatomy course. All of the basic science courses were integrated with the aim to shortened courses by reducing redundancy, leveraging integration to teach more efficiently, and using innovation. Ongoing projects focus on the effectiveness of new innovations and whether integration has achieved its goals.

A second project investigates how clinical students incorporate interactive computer activities into their daily work and how that information might guide curricular development.