مقاله انگلیسی رایگان در مورد تأثیر تغییرات برنامه درسی در عملکرد دانشجویان – الزویر 2018

INTRODUCTION

Anatomical dissection is considered a fundamental cornerstone of medical education in the United States. From the first formal anatomy course in 1745 at the University of Pennsylvania, cadaver dissection grew immensely popular as an educational tool. The scarce supply created a whole industry of procurement, with medical students turning to grave robbing in the 18th and 19th centuries.1 State legislatures began to enact laws facilitating supply of cadavers to medical schools starting in the 1830s, with laws allowing for unclaimed bodies of people who died in public institutions, hospitals, asylums, and prisons to be used for anatomical dissection.1 In 1968, the National Conference of the Commissioners on Uniform State Laws approved the Uniform Anatomical Gift Act (UAGA), establishing that an individual’s right to donate their body superseded the wishes of any next of kin. Reforms in 1987 standardized the process of body donation in the United States, ensuring that human cadaver dissection is available to teach gross anatomy to medical students. Mastery of anatomy is important to the future career of all physicians. Student performance in this first-year anatomy course, especially in human cadaver dissection, is positively correlated with student outcomes. Contrary to the potential needs of practicing physicians, current changes in curriculum countrywide include decreased hours for anatomy lecture and dissection. While scores on the United States Medical Licensing Examination (USMLE) Step 1 examination have marginally increased over time, concerns have been raised about how well these students are prepared for residency and beyond. Over the 5 years of this study, hours dedicated to teaching anatomy at Tulane University School of Medicine (TUSOM) have consistently decreased, falling from 16 weeks in 2008, 2009, and 2010, to 15 weeks in 2011 and 2012. Hours continued to decrease to 11 weeks in 2013 and 2014, to less than 10 weeks in 2015. This study was conducted to determine the effects of this curriculum change and determine whether the shorter course schedules have been destructive to clinical knowledge. In this article, we discuss data related to anatomy knowledge collected during students’ third-year surgical clerkship at TUSOM. These data represent information from students from the first class of students taught with a changing anatomy curriculum, through 4 subsequent years of progressive reduction in time spent learning anatomy. We looked at the performance of almost 700 students, in six different areas of anatomical knowledge compared to their scores in first-year non-anatomy basic science knowledge and total exam scores during their surgery clerkships.