Anatomical instruction and training for professionalism from the 19th to the 21st centuries

Department of Surgery, Yale University, New Haven, Connecticut, United States
Clinical Anatomy (Impact Factor: 1.33). 07/2006; 19(5):403-14. DOI: 10.1002/ca.20290
Source: PubMed


For most of the 19th century, anatomists in the United States saw the affective, emotional aspects of human dissection as salient ingredients in professional formation. Professionalism (or "character") signified medical integrity and guaranteed correct professional conduct. As gross anatomy came under siege in the late-19th and early-20th centuries, crowded out of medical curricula by the new experimental sciences, medical educators rethought what it was that dissecting a human body stood to give medical students. As they embraced a new understanding of professionalism premised on an allegiance to science, anatomists celebrated the habits of mind and sensibility to scientific investigation that could be acquired at the dissecting table. One consequence was a deliberate distancing of gross anatomy from the "art of medicine," and with it a de facto suppression of attention to the affective components of human dissection. During this period in the opening decades of the 20th century, the norm of silence about the emotional dimensions of dissection was set in place. The confluence of various movements by the 1960s and 1970s both revived attention to the emotional experience of dissection and sparked a renewed discussion about the relationship between the affective components of learning anatomy and the professional formation of future healers. There is a need to balance the tension between the "affective" and "scientific" aspects of anatomy, and by extension the tension between the "art" and "science" of medical practice. One method is to use small-group "learning societies" as a means to cultivate and meld both dimensions of the professional ethic.

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Available from: Lawrence Rizzolo, Apr 07, 2015
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    • "This emotional learning experience was used to encourage learning anatomy in harder way in addition to being a perfect practical tool of learning anatomy [1]. In last three decades of the 20 th century, most of the countries started commemorative functions at the end of the anatomy course by highlighting the significance of a cadaver and the students' attitude toward their cadavers [2]. The first recorded cadaveric dissection was recorded around 300 B.C. "
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    • "The major goals for curriculum reform were set as follows: (1) it must reflect the drawbacks of the traditional curriculum ; (2) the knowledge-both type and content-acquired by this school's medical graduates will improve the quality of the medical profession and better prepare them for the 21st century; and (3) it must contain elements of " professional identity " training (see for details: Swartz, 2006;Warner and Rizzolo, 2006;Pearson and Hoagland, 2010). To achieve these curricular goals, the major guidelines given by the educational committee were: (1) to decrease the number of " big class " lectures and dissections (more learning can occur outside the classroom); (2) to emphasize active self-learning and clinical relevancy; (3) to increase usage of computer technology ; (4) To emphasize radiological anatomy. "
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    • "Training students in behavioral standards , or in acquiring their ''Professional Identity,'' should be as integral a component in the formal curriculum as is delivery of requisite knowledge (Cruess and Cruess, 1997). The anatomy course has been identified as one possible vehicle through which to introduce elements of ''Professional Identity'' training in the early medical curriculum (Poni and Poni, 2006; Lachman and Pawlina, 2006; Pangaro, 2006; Pawlina, 2006; Swartz, 2006; Swick, 2006; Warner and Rizzolo, 2006; Bö ckers et al., 2010; Pearson and Hoagland, 2010). To improve training in professional behaviors accrediting organizations, exemplified within the field of medicine, introduced processes that included assessment of behavioral standards in conjunction with the assessment of knowledge (Gallagher et al., 2003; ACGME, 2005; RCPSC, 2011). "
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