The impact of curricular change on medical students' knowledge of anatomy.

BACKGROUND: In recent years, following the publication of Tomorrow's Doctors, the undergraduate medical curriculum in most UK medical schools has undergone major revision. This has resulted in a significant reduction in the time allocated to the teaching of the basic medical sciences, including anatomy. However, it is not clear what impact these changes have had on medical students' knowledge of surface anatomy. AIM: This study aimed to assess the impact of these curricular changes on medical students' knowledge of surface anatomy. SETTING: Medical student intakes for 1995-98 at the Queen's University of Belfast, UK. METHODS: The students were invited to complete a simple examination paper testing their knowledge of surface anatomy. Results from the student intake of 1995, which undertook a traditional, 'old' curriculum, were compared with those from the student intakes of 1996-98, which undertook a new, 'systems-based' curriculum. To enhance linear response and enable the use of linear models for analysis, all data were adjusted using probit transformations of the proportion (percentage) of correct answers for each item and each year group. RESULTS: The student intake of 1995 (old curriculum) were more likely to score higher than the students who undertook the new, systems-based curriculum. CONCLUSION: The introduction of the new, systems-based course has had a negative impact on medical students' knowledge of surface anatomy.

Anatomy 1999-2000: the curriculum, who teaches it and how?

AIM: To review the impact of Tomorrow's Doctors on anatomical teaching in the UK and Ireland. To establish in particular whether a consensus has emerged on: (a) the duration and format of teaching, and (b) the impact on staffing and on the four main anatomical disciplines of gross anatomy, histology, embryology and neuroanatomy. METHOD AND RESULTS: A postal survey of 28 anatomy departments was carried out. This yielded a response rate of 75%. Twelve departments used systems-based curricula, five used problem-based curricula, and four used a traditional regional format. There were variable levels of integration between the anatomical disciplines and subjects outside anatomy. Dissection taught over the first 2 years was retained in 76% of the courses, frequently supplemented with demonstrations, with an average of 2 hours of practical work for every hour of lecture. Staff/student ratios varied with the type of curriculum: dissection room teaching and problem-based curricula were associated with higher numbers of either full or part-time clinically qualified teachers. Teaching was supported by a high proportion of part-time clinically qualified staff, giving an overall average staff/student ratio of 19.8 in a dissection class. CONCLUSIONS: There is considerable variation in duration and staffing of anatomy teaching, according to the type of curriculum. This suggests there may well be substantial variation in the level, content and depth of anatomical curricula across the country, and that this should be quantified.