Learning clinical anatomy

SUMMARY This article places the student at the center of their own learning experience. It draws together research to enable us to put forward a theoretical framework of best practice for student learning of clinical anatomy in a modern medical curricula. Anatomical knowledge involves both propositional knowledge and non-technical knowledge. For knowledge to be gained it must be contextualized and the content matter engaged with in a way that creates meaning for the students. From a neuroanatomical basis, this involves memory processing at a synaptic level within the circuitry of the hippocampus. It is important to recognize learners as individuals with their own personality traits and spatial ability. Both of which have been shown to influence the learning of anatomy. Students can vary the way they go about learning, they may utilize a surface, deep and/or strategic learning approach. It is quite possible that each student’s approach will differ depending on their personal experience. Approach will also vary at different points of their learning journey, because in higher education, students are free to engage in a wide range of learning activities. At some point in the future students may need to relearn or reconfigured their knowledge because the initial route to understanding is superseded by either a greater need or a more sophisticated line of reasoning, for example, knowledge can be challenged via more complex clinical scenarios. Knowledge consolidation is the next stage for students/trainees and this involves embedding the restructured learning and using it in practice. This stage will vary in time depending on the content it may occur during education or many years later. Anatomy learning is a personalized journey for the individuals. However, it is the role of the educators to aid learners in the development of a education framework that makes their learning effective, meaningful and stimulating

The Spring 1985 high precision baseline test of the JPL GPS-based geodetic system

The Spring 1985 High Precision Baseline Test (HPBT) was conducted. The HPBT was designed to meet a number of objectives. Foremost among these was the demonstration of a level of accuracy of 1 to 2:10 to the 7th power, or better, for baselines ranging in length up to several hundred kilometers. These objectives were all met with a high degree of success, with respect to the demonstration of system accuracy in particular. The results from six baselines ranging in length from 70 to 729 km were examined for repeatability and, in the case of three baselines, were compared to results from colocated VLBI systems. Repeatability was found to be 5:10 to the 8th power (RMS) for the north baseline coordinate, independent of baseline length, while for the east coordinate RMS repeatability was found to be larger than this by factors of 2 to 4. The GPS-based results were found to be in agreement with those from colocated VLBI measurements, when corrected for the physical separations of the VLBI and CPG antennas, at the level of 1 to 2:10 to the 7th power in all coordinates, independent of baseline length. The results for baseline repeatability are consistent with the current GPA error budget, but the GPS-VLBI intercomparisons disagree at a somewhat larger level than expected. It is hypothesized that these differences may result from errors in the local survey measurements used to correct for the separations of the GPS and VLBI antenna reference centers

Investigating the impact of remote neuroanatomy education during the COVID-19 pandemic using online examination performance in a National Undergraduate Neuroanatomy Competition

Neuroanatomy is a notoriously challenging subject for medical students to learn. Due to the coronavirus disease-19 (COVID-19) pandemic, anatomical education transitioned to an online format. We assessed student performance in, and attitudes toward, an online neuroanatomy assessment compared to an in-person equivalent, as a marker of the efficacy of remote neuroanatomy education. Participants in the National Undergraduate Neuroanatomy Competition (NUNC) 2021 undertook two online examinations: a neuroanatomically themed multiple-choice question paper and anatomy spotter. Students completed pre- and post-examination questionnaires to gauge their attitudes toward the online competition and prior experience of online anatomical teaching/assessment. To evaluate performance, we compared scores of students who sat the online (2021) and in-person (2017) examinations, using 12 identical neuroradiology questions present in both years. Forty-six percent of NUNC 2021 participants had taken an online anatomy examination in the previous 12?months, but this did not impact examination performance significantly (p?>?0.05). There was no significant difference in examination scores between in-person and online examinations using the 12 neuroradiology questions (p?=?0.69). Fifty percent of participants found the online format less enjoyable, with 63% citing significantly fewer networking opportunities. The online competition was less stressful for 55% of participants. This study provides some evidence to suggest that student performance is not affected when undertaking online examinations and proposes that online neuroanatomy teaching methods, particularly for neuroradiology, may be equally as effective as in-person approaches within this context. Participants perceived online examinations as less stressful but raised concerns surrounding the networking potential and enjoyment of online events.Peer reviewe

The benefits of being a near-peer teacher

Background: Near-peer teaching is used in anatomy education because of its benefits to the learner, teacher and faculty. Despite the range of reports focusing on the learner, the advantages for the teacher, which are thought to include communication skills, subject knowledge and employability, are only beginning to be explored. Method: A questionnaire was distributed to the teachers involved in anatomy near-peer teaching at the University of Southampton and Brighton and Sussex Medical School. This questionnaire was designed using 0-10 rating scales to assess teacher perspectives on their level of knowledge, teaching skills and enjoyment of teaching. Free text responses determined the teachers’ motivation and perceived benefits from the teaching. Results: Twenty-eight questionnaires were gathered (54.9% response rate) including 20 from Southampton and 8 from BSMS. Long term knowledge retention and better understanding of the material were rated 8.1 and 7.9 out of 10 respectively. Eight responses were from currently practising doctors, who rated how much they now use their teaching skills as doctors as 8.9 out of 10. Of the 8 doctors, 7 gained points for their foundation programme applications as a direct result of near-peer teaching. The most common motivator for engaging in teaching was to improve subject matter knowledge and the most common benefit was improved communication skills. Discussion: There are numerous advantages to being a near-peer teacher in medical school, which include knowledge improvement, transferrable professional skills and employability. These initial results support the hypothesised benefits to the teachers and provide a foundation for further longitudinal studies

The discourse of Olympic security 2012 : London 2012

This paper uses a combination of CDA and CL to investigate the discursive realization of the security operation for the 2012 London Olympic Games. Drawing on Didier Bigo’s (2008) conceptualisation of the ‘banopticon’, it address two questions: what distinctive linguistic features are used in documents relating to security for London 2012; and, how is Olympic security realized as a discursive practice in these documents? Findings suggest that the documents indeed realized key banoptic features of the banopticon: exceptionalism, exclusion and prediction, as well as what we call ‘pedagogisation’. Claims were made for the exceptional scale of the Olympic events; predictive technologies were proposed to assess the threat from terrorism; and documentary evidence suggests that access to Olympic venues was being constituted to resemble transit through national boundarie

Population Objects: Interpassive Subjects

While Foucault described population as the object of biopower he did not investigate the practices that make it possible to know population. Rather, he tended to naturalise it as an object on which power can act. However, population is not an object awaiting discovery, but is represented and enacted by specific devices such as censuses and what I call population metrics. The latter enact populations by assembling different categories and measurements of subjects (biographical, biometric and transactional) in myriad ways to identify and measure the performance of populations. I account for both the object and subject by thinking about how devices consist of agencements, that is, specific arrangements of humans and technologies whose mediations and interactions not only enact populations but also produce subjects. I suggest that population metrics render subjects interpassive whereby other beings or objects take up the role and act in place of the subject

Torture and the UK’s “war on asylum”: medical power and the culture of disbelief

When the now ‘iconic’ images of shackled, humiliated and dehumanised detainees in the Abu Ghraib prison complex in Iraq were broadcast globally, in the mid-2000s, the relationship between medical power and torture in the “war on terror” was also thrust sharply into focus. Graphic images of coalition troops photographing and posing in front of hooded, naked prisoners forced into a “human pyramid”, and of people made to wear animal collars, indicated a regime in which degradation had a defining role. The photograph of a soldier gloating over the corpse of a man who had died as a result of torture was just one picture of a network of interrogation camps in which detention by coalition forces could be fatal. Yet if there were any expectations that the presence of medical personnel may have checked this violence, these were shattered by the fact that clinicians – in some cases at least – were integral to its practice. «It is now beyond doubt that Armed Forces physicians, psychologists, and medics were active and passive partners in the systematic neglect and abuse of war on terror prisoners», wrote Steven Miles in 2009 (Miles 2009, X). And as he continued, this involved providing interrogators «with medical information to use in setting the nature and degree of physical and psychological abuse during interrogations». It involved monitoring «interrogations to devise ways to break prisoners down or to keep them alive». It involved pathologists holding back death certificates and autopsy reports in order to minimise the number of fatalities or cover up torture-related deaths as deaths by natural causes (Ibid). Procedures including «cramped confinement, dietary manipulation, sleep deprivation, and waterboarding» were among the practices that were «at times (…) legally sanctioned due to medical supervision» in the context of the “war on terror”, according to Hoffman (2011, 1535). He continued to suggest that doctors are not just important to «modern torture methods», they are «irreplaceable». In this context, the “war on terror” is no aberration. As the revolutionary psychoanalyst and philosopher Frantz Fanon documented in 1959, for example, certain medical practitioners had an integral role in the military occupation of Algeria, and «There are, for instance, psychiatrists … known to numerous prisoners», he suggested, «who have given electric shock treatments to the accused and have questioned them during the waking phase, which is characterized by a certain confusion, a relaxation of resistance, a disappearance of the person's defences.» (Fanon 1959/1965, 138). Indeed, in his analysis of the Algerian revolution, he discussed how resistance to and struggles over the meanings of medical power were integral to the revolution itself. However, while the role of medical power in the practice of torture has been subjected to sustained critique in the context of the “war on terror”, what follows examines the relationship between medical power and torture in the context of what has been depicted – metaphorically – as another (although to some extents related) “war”: the “war” on asylum. According to the UNHCR (2017, 3), between 5 and 35 per cent of those asylum seekers who have been granted refugee status have survived torture. And focusing on the UK as a case study, this chapter examines the institutional and legal structures prohibiting torture and inhuman and degrading treatment, particularly as they apply to those subject to immigration control in this context. But further, it also examines the ideological and political conditions within which claims by those seeking asylum that they have been subjected to torture prior to arrival can be (and have been) ignored, downplayed and denied. It examines how medical expertise has frequently been undermined in the asylum process when this expertise is utilised to add weight to asylum seekers’ claims to have experienced torture. It examines how there have been attempts to narrow the definition of torture in ways which exclude people from the protections to which torture survivors are entitled. But it also explores the ways in which segments of the medical profession have been complicit in riding roughshod over existing safeguards to prevent further harm to those who have experienced torture, thus potentially compounding its effects. In particular, it examines claims that in certain contexts clinicians have administered dangerous “care” in order to ensure the removal of people from the UK, despite them claiming that they – or their family members – face serious harm and persecution on arrival as a result of this. In a historical discussion of medical involvement in torture, Giovanni Maio (2001, 1609) has noted that from its earliest incarnations one of the features of torture has been its use as an «oppressive instrument used in the preservation of power». Furthermore, whilst methods of torture have certainly «developed», and continue to do so, he argues, this «function» of torture is «especially relevant today». This chapter argues that the (mis)treatment of those in the UK who say they have been tortured, preserves and is bound up with a particular manifestation of state power: the aims, rationale and dictates of immigration control. Its claims are perhaps much more mundane than the forms of direct medical complicity in torture alluded to above. But they are nonetheless important. For it is argued that the acts of omission and commission documented in this chapter expose the tensions between the rights of certain “categories” of migrants to be afforded adequate clinical care on the one hand, and the goals and aims of immigration control itself on the other. This poses profound questions about the functions of clinical care and the ethical duties, responsibilities and obligations of clinicians, it is suggested. But as this chapter also crucially explores, this is a form of power that many within the medical profession have historically challenged, and continue to do so