Center for Excellence in Teaching and Learning, University of Connecticut, Storrs, Connecticut, USA.
Department of Cell Biology and Physiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Anat Sci Educ. 2024 Jul-Aug;17(5):998-1011. doi: 10.1002/ase.2414. Epub 2024 Apr 5.
Many medical schools in the United States have integrated anatomy into an organ-based preclinical curriculum with some schools using anatomy as the cornerstone of their reorganization efforts. Curricular change could affect one or more of the three domains of learning, with the cognitive domain often scrutinized exclusively. A previous study reported the impact of anatomy integration on the affective domain, specifically, student attitudes toward learning anatomy. This mixed methods follow-up study asked if the observed attitudinal changes and lack of effect on student knowledge and confidence persisted using knowledge and confidence surveys, focus groups, internal and national surveys, and United States Medical Licensing Examination performance metrics. Results evidenced the persistence of specific attitudinal differences between cohorts with blocked versus integrated anatomy with no apparent short- or long-term differences in anatomy learning or confidence in this learning. Altered attitudes included lower value placed on working in teams and reflective practices, and less recognition of anatomy's contribution (or less contribution of anatomy learning) to professional identity formation. These attitudinal changes could result in a weaker foundation for building collaborative skills throughout the medical curriculum. A decreased sense of student engagement also followed curricular change, as assessed by data from the American Association of Medical Colleges Year 2 Questionnaire. Overall, results emphasized the necessity of anticipating, monitoring, and if necessary, addressing changes in the affective domain when undertaking curricular change.
许多美国的医学院已经将解剖学纳入以器官为基础的临床前课程中，有些学校将解剖学作为其重组工作的基石。课程的改变可能会影响学习的三个领域中的一个或多个，而认知领域通常是唯一受到严格审查的领域。之前的一项研究报告了解剖学整合对情感领域的影响，特别是学生对学习解剖学的态度。这项混合方法的后续研究通过知识和信心调查、焦点小组、内部和全国调查以及美国医师执照考试成绩指标，询问了观察到的态度变化以及对学生知识和信心的影响是否持续存在。研究结果表明，在解剖学学习或对这种学习的信心方面，没有明显的短期或长期差异，具有阻塞性和整合性解剖学的队列之间存在特定的态度差异。改变的态度包括对团队合作和反思实践的重视程度降低，以及对解剖学对专业身份形成的贡献（或解剖学学习的贡献）的认识减少。这些态度的变化可能会导致整个医学课程中协作技能的基础更加薄弱。学生参与度的下降也紧随课程改革而来，这可以从美国医学院协会第二年问卷的数据中得到评估。总的来说，研究结果强调了在进行课程改革时，需要预测、监测，并在必要时解决情感领域的变化。
