Aziz M Ashraf, McKenzie James C, Wilson James S, Cowie Robert J, Ayeni Sylvanus A, Dunn Barbara K
Department of Anatomy, Howard University, College of Medicine, Washington, DC 20059, USA.
Anat Rec. 2002 Feb 15;269(1):20-32. doi: 10.1002/ar.10046.
Major national and international critiques of the medical curriculum in the 1980s noted the following significant flaws: (1) over-reliance on learning by rote memory, (2) insufficient exercise in analysis and synthesis/conceptualization, and (3) failure to connect the basic and clinical aspects of training. It was argued that the invention of computers and related imaging techniques called to question the traditional instruction based on the faculty-centered didactic lecture. In the ensuing reform, which adopted case-based, small group, problem-based learning, time allotted to anatomical instruction was severely truncated. Many programs replaced dissection with prosections and computer-based learning. We argue that cadaver dissection is still necessary for (1) establishing the primacy of the patient, (2) apprehension of the multidimensional body, (3) touch-mediated perception of the cadaver/patient, (4) anatomical variability, (5) learning the basic language of medicine, (6) competence in diagnostic imaging, (7) cadaver/patient-centered computer-assisted learning, (8) peer group learning, (9) training for the medical specialties. Cadaver-based anatomical education is a prerequisite of optimal training for the use of biomedical informatics. When connected to dissection, medical informatics can expedite and enhance preparation for a patient-based medical profession. Actual dissection is equally necessary for acquisition of scientific skills and for a communicative, moral, ethical, and humanistic approach to patient care. Anat Rec (New Anat) 269:20-32, 2002.
20世纪80年代,国内和国际上对医学课程的主要批评指出了以下重大缺陷:(1)过度依赖死记硬背式学习;(2)分析与综合/概念化练习不足;(3)未能将基础培训与临床培训相结合。有人认为,计算机及相关成像技术的发明对基于教师主导的讲授式传统教学提出了质疑。在随后采用基于案例的小组问题式学习的改革中,分配给解剖学教学的时间被大幅削减。许多课程用尸体标本演示和基于计算机的学习取代了解剖。我们认为尸体解剖对于以下方面仍然是必要的:(1)确立患者的首要地位;(2)理解身体的多维性;(3)通过触摸感知尸体/患者;(4)解剖变异;(5)学习医学基础语言;(6)具备诊断成像能力;(7)以尸体/患者为中心的计算机辅助学习;(8)小组学习;(9)医学专业培训。基于尸体的解剖学教育是优化生物医学信息学使用培训的前提条件。当与解剖相结合时,医学信息学可以加快并加强以患者为基础的医学职业准备。实际解剖对于获得科学技能以及对患者护理采取沟通、道德、伦理和人文方法同样必要。《解剖学记录(新解剖学)》269:20 - 32,2002年。