Development of an Orthopedic Surgery Anatomy Curricular Model for Fourth Year Medical Students Using a Modified Delphi Method.

OBJECTIVE: The purpose of this study was to develop anatomy-focused learning outcomes that can be used to design a fourth-year elective for students matriculating into orthopedic surgery residencies. DESIGN: A series of proposed learning outcomes (N=72) was developed using the ACGME Orthopedic Milestones 2.0 as a framework. In 2021, these were converted into a survey asking participants to rate the importance of each outcome on a 5-point Likert scale. The modified Delphi Method was used to refine the list of outcomes until group consensus was achieved. The consensus was defined using a conservative 3-tier approach. SETTING: Eighteen academic centers with an associated orthopedic surgery residency. PARTICIPANTS: Twenty-six orthopedic surgeons (ranging from 1 to 42 years in practice). RESULTS: Of the 72 learning outcomes from the first-round survey, 25 met consensus criteria. Of the 62 learning outcomes from the second-round survey, 45 met consensus criteria. All learning outcomes that met consensus criteria after the second-round survey were stratified into low-yield (n = 8), intermediate-yield (n = 34), and high-yield (n = 28) categories. CONCLUSION: Using a modified Delphi Method, this study elicited feedback from experts in the field of orthopedic surgery to develop a framework for a fourth-year elective focused on anatomical concepts important for students applying to residencies in orthopedic surgery. The product of this process affords a great deal of flexibility when utilizing the results of this study in institution-specific curricular development.

Essential anatomy for core clerkships: A clinical perspective.

Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.

Clinical students' reflections on the preclinical anatomy learning experience.

Objectives: Anatomy is a fundamental pillar of medical knowledge that bridges basic medical science knowledge and clinical practice. However, integrated modern medical curricula have reduced the anatomy teaching content, and cadaveric dissection is no longer conducted. Medical graduates who lack anatomy knowledge are anticipated to be inadequately equipped for safe clinical practice. This study was aimed at exploring clinical year students' experiences regarding their anatomy learning during the preclinical phase in Malaysian medical schools. The findings reflect how the students' preclinical anatomy training prepared them for their clinical years of study. Methods: A qualitative phenomenology study using the focus group discussion method was conducted on 30 final-year students from four public universities. Four focus group discussion sessions were conducted, and students' responses were transcribed and converted to electronic formats. The transcripts were analyzed thematically with ATLAS.ti software. Results: The first-cycle coding of the text analysis generated 157 open codes based on the phrases used by the participants. The subsequent coding cycle produced 16 axial codes-groups of open codes with similar features. During the final coding cycle, the content and interrelations between the axial codes were categorized into six codes: (1) preclinical anatomy learning experience, (2) anatomy content and teaching, (3) anatomy-related competency, (4) the importance of anatomy knowledge in clinical practice, (5) the importance of early exposure to applied clinical anatomy, and (6) suggestions for future anatomy education. Conclusions: The six identified themes reflected students' perceptions of their anatomy learning experience, the challenges that they faced during their preclinical years, and their opinions regarding the anatomy knowledge and skills that are functionally relevant during the clinical years. Their responses also echoed the need to improve anatomy teaching and learning, thereby emphasizing the importance of early clinical integration and application.

On the added benefit of virtual anatomy for dissection-based skills.

Technological approaches deploying three-dimensional visualization to integrate virtual anatomy are increasingly used to provide medical students with state-of-the-art teaching. It is unclear to date to which extent virtual anatomy may help replace the dissection course. Medical students of Johannes Kepler University attend both a dissection and a virtual anatomy course. This virtual anatomy course is based on Cinematic Rendering and radiological imaging and teaches anatomy and pathology. This study aims to substantiate student benefits achieved from this merged teaching approach. Following their dissection course, 120 second-year students took part in objective structured practical examinations (OSPE) conducted on human specimens prior to and following a course on Cinematic Rendering virtual anatomy. Likert-based and open-ended surveys were conducted to evaluate student perceptions of both courses and their utility. Virtual anatomy teaching was found to be unrelated to improvements in student's ability to identify anatomical structures in anatomical prosections, yielding only a 1.5% increase in the OSPE score. While the students rated the dissection course as being more important and impactful, the virtual anatomy course helped them display the learning content in a more comprehensible and clinically applicable way. It is likely that Cinematic Rendering-based virtual anatomy affects knowledge gain in domains other than the recognition of anatomical structures in anatomical prosections. These findings underline students' preference for the pedagogic strategy of the dissection course and for blending this classical approach with novel developments like Cinematic Rendering, thus preparing future doctors for their clinical work.

Augmented Reality in Otology/Neurotology: A Scoping Review with Implications for Practice and Education.

OBJECTIVE: To determine how augmented reality (AR) has been applied to the field of otology/neurotology, examine trends and gaps in research, and provide an assessment of the future potential of this technology within surgical practice and education. DATA SOURCES: PubMed, EMBASE, and Cochrane Library were assessed from their inceptions through October 2022. A manual bibliography search was also conducted. REVIEW METHODS: A scoping review was conducted and reported according to PRISMA-ScR guidelines. Data from studies describing the application of AR to the field of otology/neurotology were evaluated, according to a priori inclusion/exclusion criteria. Exclusion criteria included non-English language articles, abstracts, letters/commentaries, conference papers, and review articles. RESULTS: Eighteen articles covering a diverse range of AR platforms were included. Publication dates spanned from 2007 to 2022 and the rate of publication increased over this time. Six of 18 studies were case series in human patients although the remaining were proof of concepts in cadaveric/artificial/animal models. The most common application of AR was for surgical navigation (14 of 18 studies). Computed tomography was the most common source of input data. Few studies noted potential applications to surgical training. CONCLUSION: Interest in the application of AR to otology/neurotology is growing based on the number of recent publications that use a broad range of hardware, software, and AR platforms. Large gaps in research such as the need for submillimeter registration error must be addressed prior to adoption in the operating room and for educational purposes. LEVEL OF EVIDENCE: N/A Laryngoscope, 133:1786-1795, 2023.

How human anatomy is being taught in entry-level occupational therapy programs in the United States.

There has been a lack of empirical information regarding anatomy education for occupational therapists (OTs). Insufficient anatomy education can result in underprepared entry-level OTs, who may then produce increased practice errors and reduced patient care. The objective of this study was to investigate how human gross anatomy was taught in entry-level occupational therapy programs throughout the United States and evaluate faculty perspectives on its teaching. A mixed-methods survey was sent to the directors of entry-level occupational therapy programs in the United States. Survey responses were compiled to best represent the current occupational therapy education environment. Ten of sixty-eight participating programs did not teach anatomy as a part of their standard occupational therapy curriculum. Of the programs that featured entry-level occupational therapy anatomy courses, the majority were taught by either a non-clinician anatomist or an OT without specialized anatomy training in a region-based, standalone anatomy course during the first semester. In most programs, anatomy was taught to only occupational therapy students using lecture, models/plastination, and/or prosection. Teaching tools, methods, faculty, and programmatic factors were perceived as contributing to program strengths. The design, resources, and faculty involved in the occupational therapy anatomy course may negatively impact the perceived quality of an occupational therapy anatomy program and its students. Participants identified several consequences of insufficient anatomy preparedness, including academic, clinical reasoning, treatment skills, patient care, and professional identity concerns. Occupational therapy educators may want to be aware of the current climate of occupational therapy anatomy education in the United States when designing entry-level occupational therapy anatomy curricula.

Skeletal muscle coverage in undergraduate courses: a comparison of stand-alone human anatomy and anatomy and physiology (A&P) courses.

Anecdotal data suggest great variation in breadth and depth of skeletal muscle coverage between undergraduate human anatomy (HA) and anatomy and physiology (A&P) courses. This manuscript is the second in a series (Reynolds A, Goodwin M, O'Loughlin VD. Adv Physiol Educ 46: 309-318, 2022. doi:https://doi.org/10.1152/advan.00084.2021) that methodically assesses skeletal muscle content coverage across undergraduate HA and A&P courses. The authors developed an online skeletal muscle coverage survey and collected 342 responses worldwide, 156 from instructors of HA courses and 186 from A&P course instructors. Demographic results showed that HA courses are primarily taught at 4-year baccalaureate institutions, have relatively larger class sizes, and are more likely to use human (vs. animal) prosections or dissections. In contrast, A&P courses are primarily taught at community colleges, have relatively smaller class sizes, and are more likely to use animal (vs. human) dissections. HA courses tend to require their students to learn all skeletal muscle aspects (i.e., identification, action, attachments, innervation), whereas A&P courses tend to focus on muscle identification or action only. The proportions of courses that require identification of large, superficial skeletal muscles are similar between the two course types. However, HA courses are more likely to require their students to identify deeper and smaller muscles, including more distal appendicular muscles and pelvic muscles. These differences likely are due, in part, to the more anatomical focus of HA courses and the slightly different student populations between these courses. These findings provide much-needed information about muscular system coverage between HA and A&P courses and may guide instructor discussions about curricula.

General trends in skeletal muscle coverage in undergraduate human anatomy and anatomy and physiology courses.

There is a widely variable breadth of coverage of skeletal muscle content across both undergraduate human anatomy and undergraduate anatomy and physiology (A&P) courses. In response to the need for a more global understanding of the content taught in undergraduate anatomy courses, we developed an online survey (administered through Qualtrics) where both human anatomy and A&P faculty could report skeletal muscle coverage in their courses. The survey also collected comparative demographic institutional data such as the type of institution (community college vs. 4 year), course format, and geographic location of the undergraduate institution. Skeletal muscles surveyed included those listed and described in a typical undergraduate human anatomy text (McKinley MP, O'Loughlin VD, Pennefather O. Human Anatomy (5th ed.), 2017, p. 960). The data indicated some interesting instructional trends regarding muscular system coverage. First, both the "identification" and "action" of specific muscles are taught at a higher frequency than the teaching of either "attachments or innervation." Innervation of specific skeletal muscles is the least taught concept. In each body region, certain muscles were taught with higher frequency than others. This research shows there is a global trend in teaching identification of specific skeletal muscles within each body region and often this is accompanied by teaching actions of said muscles. These general instructional trends may increase our understanding of the anatomical and physiological education our undergraduate students are receiving and will lead to further critical conversations about content development and curriculum.

Does an Audiovisual Dissection Manual Improve Medical Students' Learning in the Gross Anatomy Dissection Course?

The gross anatomy dissection course is considered to be one of the most important subjects in medical school. Advancing technology facilitates the production of e-learning material that can improve the learning of topographic anatomy during the course. The purpose of this study was to examine a locally produced audiovisual dissection manual's effects on performance in dissection, formal knowledge gained, motivation, emotions, learning behavior, and learning efficiency of the medical students. The results, combined with the total effort put into the production of the manual, should support decisions on further implementation of this kind of audiovisual e-learning resource into the university's curriculum. First-year medical students (n = 279) were randomly divided into three groups for two weeks within the regular dissection course hours during the dissection of the anterior and posterior triangles of the neck. Two groups received an audiovisual dissection manual (n = 96) or an improved written manual (n = 94) as an intervention, the control group (n = 89) received the standard dissection manual. After dissection, each student filled out tests and surveys and their dissections were evaluated. The audiovisual dissection manual did not have any significant positive effects on the examined parameters. The effects of the audiovisual dissection manual on the medical students' learning experience, as observed in this study, did not support further curriculum implementation of this kind of e-learning resource. This study can serve as an orientation for further evaluation and design of e-learning resources for the gross anatomy dissection course.

Survey of Gross Anatomy Education in China: The Past and the Present.

Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990-1999, 2000-2009, and 2010-2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000-2009 to 36.10 ± 47.26 in 2010-2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990-1999 to 14.22 ± 5.0 in 2010-2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000-2009 to 1:33.2 in 2010-2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.

Anatomical Sciences in Chiropractic Education: A Survey of Chiropractic Programs in Australia.

Human anatomy knowledge is a core requirement for all health care clinicians. There is a paucity of information relating to anatomy content and delivery in Australian chiropractic programs. The aim of this study was to describe anatomy teaching in Australian chiropractic programs, utilizing a survey which was distributed to all four programs, requesting information on: anatomy program structure, delivery methods, assessment, teaching resources, and academic staff profile at their institution. The survey was undertaken in 2016 and documented practices in that academic year. All four institutions responded. There was a reported difference in the teaching hours, content, delivery and assessment of anatomy utilized in Australian chiropractic programs. Anatomy was compulsory at all four institutions with the mean total of 214 (SD ± 100.2) teaching hours. Teaching was undertaken by permanent ongoing (30%) and sessional academic staff, and student to teacher ratio varied from 15:1 to 12:1. A variety of teaching resources were utilized, including human tissue access, either as prosected cadavers or plastinated body parts. The results of this survey confirm that anatomy has an established place in chiropractic education programs in Australia and while curricular variations exist, all programs had similar course design, delivery, and assessment methods. This study confirmed the provision of a strong foundation in topographical anatomy and neuroanatomy, while other anatomical sciences, such as histology and embryology were not consistently delivered. Formalization of a core anatomy curriculum together with competency standards is needed to assist program evaluation and development, and for accreditation purposes.

The Benefits of an Augmented Reality Magic Mirror System for Integrated Radiology Teaching in Gross Anatomy.

Early exposure to radiological cross-section images during introductory anatomy and dissection courses increases students' understanding of both anatomy and radiology. Novel technologies such as augmented reality (AR) offer unique advantages for an interactive and hands-on integration with the student at the center of the learning experience. In this article, the benefits of a previously proposed AR Magic Mirror system are compared to the Anatomage, a virtual dissection table as a system for combined anatomy and radiology teaching during a two-semester gross anatomy course with 749 first-year medical students, as well as a follow-up elective course with 72 students. During the former, students worked with both systems in dedicated tutorial sessions which accompanied the anatomy lectures and provided survey-based feedback. In the elective course, participants were assigned to three groups and underwent a self-directed learning session using either Anatomage, Magic Mirror, or traditional radiology atlases. A pre- and posttest design with multiple choice questions revealed significant improvements in test scores between the two tests for both the Magic Mirror and the group using radiology atlases, while no significant differences in test scores were recorded for the Anatomage group. Furthermore, especially students with low mental rotation test (MRT) scores benefited from the Magic Mirror and Anatomage and achieved significantly higher posttest scores compared to students with a low MRT score in the theory group. Overall, the results provide supporting evidence that the Magic Mirror system achieves comparable results in terms of learning outcome to established anatomy learning tools such as Anatomage and radiology atlases.

A Quantitative Analysis of Four Undergraduate Human Anatomy Laboratory Curricula: Approaches, Identified Structures, Concepts, and Thematic Emphases.

Human anatomy is a foundational course thatserves diverse pre-professional health care majors. However, limited information is available on the teaching approaches, content, and thematic emphases of this course at the undergraduate level when compared with that of medical and other graduate schools. Herein, we document and quantitatively evaluate the laboratory curriculum of four undergraduate human anatomy courses in the USA. For each course, we assess the total number of structures (terms requiring identification during an exam), concepts (terms requiring an explanation), and clinical applications. To facilitate further assessments, we also compare the content distribution of each course with that recommended by the American Association of Clinical Anatomists (AACA). Two courses followed a regional approach emphasizing the use of human cadavers, while the other two followed a system-based approach and used plastic models and non-human cadaveric materials (e.g., cats and sheep). The total amount of information presented to students differed significantly among curricula. The majority of terms (65-88%) taught to students referred to the identification of anatomical structures whereas clinical applications were rare (< 1.3%). Courses using a regional approach expected students to learn as much as twice the number of terms than those following a system-based approach. Functions, innervations, origins, and insertions of muscles are only included in the curriculum of the courses following a regional approach. The proportion of terms devoted to each anatomical module in all curricula was significantly different from each other, as well as from that of AACA recommendation. We discuss these differences in the curriculum, the challenges and limitations inherent with each teaching approach, as well as in the teaching materials used among the curricula. These quantitative analyses aim to provide insightful information about the structure of the undergraduate human anatomy laboratory curriculum and may prove useful when redesigning a course.

Gross anatomy education for South African undergraduate physiotherapy students.

Eight faculties in South Africa offer undergraduate physiotherapy training with gross anatomy included as a basis for clinical practice. Little information exists about anatomy education for this student body. A 42-question peer-reviewed survey was distributed to physiotherapy gross anatomy course coordinators in all the eight faculties. Seven coordinators from six (75%) of the universities responded. Two respondents' data from the same university were pooled. Collected data show that staff qualifications and experience varied widely and high to average staff to student ratios exist between faculties. Direct anatomy teaching duration was 12.3 (SD ±5.2) weeks per semester. Total number of weeks in courses per faculty was 27.6 (SD ±5.7) varying widely between institutions. Calculable direct contact anatomy hours ranged between 100 and 308 with a mean of 207.6 (SD ±78.1). Direct contact hours in lectures averaged 3.9 (SD ±1.6) per week and the average direct contact hours in practical sessions were 3.5 (SD ±1.8) per week. Dissection, prosection, plastinated models, surface anatomy, and e-learning were available across faculties. Ancillary modalities such as vertical integration and inter-professional learning were in use. All faculties had multiple-choice questions, spot tests, and short examination questions. Half had viva-voce examinations and one had additional long questions assessment. Students evaluated teaching performance in five faculties. Four faculties were reviewing anatomy programs to consider implementing changes to anatomy curriculum or pedagogy. The findings highlighted disparity between programs and also identified the need for specific guidelines to develop a unified South African gross anatomy course for physiotherapy students.

Evaluation of an innovative hands-on anatomy-centered ultrasound curriculum to supplement graduate gross anatomy education.

Ultrasound (US) can enhance anatomy education, yet is incorporated into few non-medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non-medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy-centered ultrasound (ACUS) curriculum were recruited. Mean Likert ratings on pre- and post-course surveys (100% response rates) were compared to evaluate the effectiveness of the ACUS curriculum in developing US confidence, and gauge its impact on views of US. Post-course, students reported significantly higher (P < 0.001) mean confidence ratings in five US skills (pre-course versus post-course mean): obtaining scans (3.13 ±1.04 versus 4.03 ±0.78), optimizing images (2.78 ±1.07 versus 3.75 ±0.92), recognizing artifacts (2.94 ±0.95 versus 3.97 ±0.69), distinguishing tissue types (2.88 ±0.98 versus 4.09 ±0.69), and identifying structures (2.97 ±0.86 versus 4.03 ±0.59), demonstrating the success of the ACUS curriculum in students with limited prior experience. Views on the value of US to anatomy education and to students' future careers remained positive after the course. End-of-semester quiz performance (91% response rate) provided data on educational outcomes. The average score was 79%, with a 90% average on questions about distinguishing tissues/artifacts, demonstrating positive learning outcomes and retention. The anatomy-centered ultrasound curriculum significantly increased confidence with and knowledge of US among non-medical anatomy students with limited prior training. Non-medical students greatly value the contributions that US makes to anatomy education and to their future careers. It is feasible to enhance anatomy education outside of medical training by incorporating US. Anat Sci Educ 10: 348-362. © 2016 American Association of Anatomists.

Posterior approach to kidney dissection: An old surgical approach for integrated medical curricula.

Integrated medical curricular changes are altering the historical regional anatomy approach to abdominal dissection. The renal system is linked physiologically and biochemically to the cardiovascular and respiratory systems; yet, anatomists often approach the urinary system as part of the abdomen and pelvic regions. As part of an integrated curriculum, the renal system must be covered relatively quickly after the thorax in the cadaver laboratory, often without the opportunity to fully appreciate the rest of the abdominal contents. This article provides dissection instructions that follow one of the historical surgical approaches for nephrectomy, including preservation of the posterior abdominal wall neurovasclature. Dissection procedures were developed for first-year medical students, intending this posterior approach to the kidneys to be their first introduction to the renal system. It has been successfully implemented with the first-year medical students at the University of New England, College of Osteopathic Medicine. Utilizing this posterior approach to the kidney enabled the study of the anatomy of the kidneys, suprarenal glands, and renal vessels, as well as the muscles of the lumbar spine, while maintaining the integrity of the anterior abdominal wall and peritoneal cavity for future gastrointestinal and reproductive system-based dissections.

Integration of medical imaging including ultrasound into a new clinical anatomy curriculum.

In 2008 a new clinical anatomy curriculum with integrated medical imaging component was introduced into the University of Sydney Medical Program. Medical imaging used for teaching the new curriculum included normal radiography, MRI, CT scans, and ultrasound imaging. These techniques were incorporated into teaching over the first two years of the program as a part of anatomy practical sessions, in addition to dedicated lectures and tutorials given by imaging specialists. Surveys were conducted between 2009 and 2012 to evaluate the student acceptance of the integration. Students were asked to rate individual activities as well as provide open-ended comments. The number of students who responded to the surveys varied from 40% to 98%. Over 90% of the respondents were satisfied with the overall quality of teaching in the anatomy units. In summary, 48% to 63% of the responding students thought that the specialist imaging lectures helped them learn effectively; 72% to 77% of students thought that the cross-sectional practical sessions helped them to better understand the imaging modalities of CT, MRI, and ultrasound; 76% to 80% of students considered hands-on ultrasound session to be useful in understanding the application of ultrasound in abdominal imaging. The results also revealed key similarities and differences in student perceptions of the new integrated curriculum for students with both a high and low prior exposure to anatomy. Further evaluation will aid in refining the integrated medical imaging program and providing its future direction.

Factors influencing student performance on the carpal bone test as a preliminary evaluation of anatomical knowledge retention.

It has been demonstrated that a positive correlation exists between clinical knowledge and retained concepts in basic sciences. Studies have demonstrated a modest attrition of anatomy knowledge over time, which may be influenced by students' perceived importance of the basic sciences and the learning styles adopted. The aims of this study were to: (1) conduct a cross-sectional evaluation of the retention of anatomical knowledge in preclinical (second-year) and clinical (fifth-year) chiropractic students at Murdoch University; and (2) examine students' perceptions of factors that may influence their anatomy knowledge retention. Second- and fifth-year chiropractic students at Murdoch University were invited to participate in the study. Ninety-one students voluntarily participated. The Carpal Bone Test, previously utilized to determine the retention of anatomical knowledge, was utilized to determine the extent to which participants retained gross anatomy knowledge. Participants also completed a questionnaire specifically designed to identify the factors that may have influenced their retention of gross anatomy knowledge. A two-sided Pearson chi-square test of association was used to ascertain statistically significant differences in carpal bone retention and students' responses between the two cohorts. Seventy percent of the fifth-year (clinical) chiropractic students correctly identified all eight carpal bones compared to only six percent of second-year chiropractic students. The majority of participants in both cohorts believed that gross anatomy knowledge is of clinical importance. The use of mnemonics and the clinical application of anatomy knowledge were identified as factors that significantly influenced participants' gross anatomy knowledge retention within this study.

An approach toward the development of core syllabuses for the anatomical sciences.

There is increasingly a call for clinical relevance in the teaching of the biomedical sciences within all health care programs. This presupposes that there is an understanding of what is "core" material within the curriculum. To date, the anatomical sciences have been poorly served by the development of core syllabuses, although there have been commendable attempts to define a core syllabus for gross anatomy in medicine and for some medical specialties. The International Federation of Associations of Anatomists and the European Federation for Experimental Morphology aim to formulate, on an international basis, core syllabuses for all branches of the anatomical sciences. This is being undertaken at the initial stage using Delphi Panels consisting of a team of anatomists, scientists, and clinicians who evaluate syllabus content and accord each element/topic "essential," "important," "acceptable," or "not required" status. Their initial conjectures, published on the International Federation of Associations of Anatomists' website, provide merely a framework to enable anatomical (and other cognate learned) societies and individual anatomists, clinicians, and students to comment upon the syllabuses. This article presents the concepts and methodological approaches underlying the hybrid Delphi process employed. Preliminary findings relating to the development of a neuroanatomy core syllabus are provided to illustrate the methods initially employed by a Delphi Panel. The approach is novel in that it is international in scope, is conceptually democratic, and is developmentally fluid in terms of availability for amendment. The aim is to set internationally recognized standards and thus to provide guidelines concerning anatomical knowledge when engaged in course development.