Integration of Embryology and Anatomy

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Integration of Embryology and Anatomy

• Keith L. Moore, Ph.D., Chair
• Arthur F. Dalley, Ph.D., Co-chair

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Integration of Embryology and Gross Anatomy

• Arthur F. Dalley, Ph.D.
• Vanderbilt University Medical Center
• Nashville, Tennessee

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Embryology has had a difficult time finding a
stable niche in the medical curriculum

• Most often it is taughtin whole or in partwith
  gross anatomy
  
• Carlson (02)
• . . seems like 1/3 of the time.
• Drake (02)
• 56 of time, entire coverage is within course
• 64 of time, whole or in part within course

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Why integrate with gross anatomy?

• Obvious compatibility with organogenesis
• Study of the developmental stages of an organ or
  system enables a fuller appreciation of the adult
  structure
  
• fuller story makes both more comprehensible, more
  likely to be retained
  
• Provides insight regarding
• normal variation observed during dissection
• developmental anomalies encountered during
  studies or in the clinics
  
• Sense of ownership and responsibility
• Trend is away from stand-alone disciplinary
  courses

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Regardless of placement, embryology has faced an
uphill battle

• Concepts complex, require 3-D imagination
  insight, a mountain of new terminology
  
• Not a major player (one of the big boys)
• Time effort required disproportionate to credit
  hours, representation on exams
  
• Frequently taught by those with a secondary
  interest or passion
  
• Too multi-disciplinary for ideal fit overall

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For Gross Anatomy specifically

• Knowledge of early development is prerequisite to
  organogenesis, but . . .
  
• Early embryology (to the trilaminar stage)
  doesnt correlate well (or at all) with gross
  anatomy
  
• Early embryology is sufficiently complex that
  even simplified coverage requires multiple
  presentations and time to absorb

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Problems with early embryology within the gross
anatomy course

• Covered at the beginning, when students
• must come to grips with the density of the
  medical curriculum and associated activities and
  opportunities
  
• face a considerable learning curve in gross
  anatomy, and often in other simultaneous or
  integrated major courses, such as biochemistry,
  physiology, and/or histology

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Problems with early embryology within the gross
anatomy course

• Because of the lack of correlation, there is a
  tendency to minimize this part of the story.
  However . . .
  
• Simplifying coverage or reducing number or length
  of lectures does not simplify or reduce the
  concepts involved
  
• Only makes them less coherent and provides less
  time for absorption.

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Problems with early embryology within the gross
anatomy course

• Can be reduced to the point where the
  story-line is lost
  
• becomes a litany of dates, terms, and complex
  sequences of 3-dimensional events
  
• In the absence of understanding, rote
  memorization is required
  
• Typically presented via 2-dimensional
  illustrations to students coming from a
  increasing wide variety of backgrounds, many with
  no visual-learning component.

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Problems with early embryology within the gross
anatomy course

• most gross anatomy courses face reduced time in
  the curriculum
  
• pressure on embryology in general--and this
  component in particular--has increased.
  
• For example, at Vanderbilt
• 2006 2007/08
• Gross anatomy 240 hrs ? 176 hrs (?25)
• Embryology 18 hrs ? 13 hrs (?33)
• Early embryo 4 hrs ? 2 hrs (?50)

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Problems with early embryology within the gross
anatomy course

• Consequently, too often students initial
  perceptions of embryology are that it is too
  difficult and irrelevant.
  
• This apparent disconnect, combined with concerns
  about other coursework, taints student attitudes
  toward embryology as a discipline.
  
• Subsequent attempts to integrate organogenesis
  may be received with bias.

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Students new to embryology are like embryos
themselves

• The early period is the most vulnerable.
• Those successfully surviving this period are
  likely to successfully complete gestation

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Possible Solutions?

• Spend more time on early embryology
• Integration may not allow
• Still competing with early challenges of GA
• Have early embryology precede GA
• Delay start (have a pre-session)
• Integrate into preceding curriculum, if any
• Proceed without early embryology?
• Other ideas?