The repair-workshop theory: Supervising Anatomical Research

Anatomical research remains constrained in Africa and the development of relevant anatomical leadership strategies is crucial to unlocking the anatomical research  potential. The importation of leadership strategies from developed countries may not be relevant in Africa because of peculiar social, political, funding, academic and research contexts. Ambiguous leadership, characterised by unclear goals, is poorly understood and is said to be irrational and driven by pure chance. The current paper describes how ambiguous leadership unfolded within the supervision of BSc  Intercalated Anatomy research projects at the University of Zimbabwe, which had an incredibly high degree of unclear goals, using grounded theory research  methodology. The analysis of the results produced a rational and normative ambiguous leadership theory model called the ‘Repair-Workshop-Theory’, which had two types of goals: the initially unclear Year-Goals and the always clear Day-to-Day-Goals. The clarity of the Year-Goals progressed from being vague initially to being very clear at the end of the research projects, as the Year-Goals were being ‘discovered’, while Day-to-Day-Goals were permanently clear and were the basis of day-to-day rational decisions. The normative principle of ‘discovering’ Year-Goals allows goals to emerge from the interests of the students, staff and contextual  constraints and has significant implications for managing unclear research goals in African anatomy departments.Key words: anatomy, Africa, ambiguous leadership, unclear goals, garbage can  theor

An analysis of the pedagogical concepts used by anatomy teachers to facilitate the teaching and learning of anatomy to physiotherapy undergraduates in the United Kingdom: A constructivist grounded theory study

Anatomy is a challenging subject to learn because it is voluminous, requires three-dimensional cognitive skills and is easily forgotten. Furthermore, anatomy is facing diminishing teaching attention and time. There is a scarcity of literature offering pedagogical guidance for teaching anatomy for physiotherapy in the UK, despite anatomical knowledge underpinning an ever widening scope of physiotherapy. The study provides a pedagogical theory and guidance on how anatomy for physiotherapy undergraduates could be taught more effectively in the UK. The research design generated data through in-depth semi-structured interviews with eight anatomy teachers for physiotherapy from an identified sample of 50 participants in the UK who taught anatomy modules and were registered physiotherapists. The combined interview transcripts generated 72,292 words of data that were analysed using coding techniques of grounded theory. Chronologically, the study found that anatomy teachers explicitly taught anatomy during the 1st year, largely through practical anatomy tutorials. During the 2nd and 3rd years, clinical physiotherapy lecturers implicitly revised anatomy during their teaching sessions, while student placement supervisors implicitly reinforced anatomical knowledge and skills during hospital placements. Conceptually, five pedagogical concepts emerged that are supported by literature for medical education and were explained using the Four-Component-Instructional-Design framework derived from the Cognitive-Load theory. The anatomy-teachers-for-physiotherapy used a spirally arranged curriculum, extensive use of visual anatomical imagery, promoted kinaesthetic anatomical skills, applied anatomical knowledge and skills to physiotherapy situations and used anatomical principles for metacognitive strategies. The study deviated from the Cognitive-Load theory in three ways. The long-term memories of physiotherapy students had limited capacities that stored temporary anatomical information, instead of having unlimited capacities for permanent information. The teachers used haptic learning that is ignored by the Cognitive-Load theory. Recommendations were made on how anatomical teaching could be improved and are addressed to Anatomy Theme-Leads, anatomy-teachers-for-physiotherapy and the Chartered Society of Physiotherapy

Pedagogical principles used by anatomy teachers to facilitate the teaching and learning of anatomy to physiotherapy undergraduates in the United Kingdom

The teaching of anatomy for physiotherapy differs from other health professions, and yet there is lack of guidance for the best practice in the literature, especially within the United Kingdom (UK). The present study aimed to provide the most effective pedagogical guidance for teaching a typical anatomy curriculum for a three-year BSc Physiotherapy degree program within the UK. The research design used a constructivist grounded theory where semi-structured interviews were conducted with eight registered physiotherapists teaching anatomy to undergraduate physiotherapy students within the UK. The study generated 72,292 words of qualitative data that were thematically analyzed using Saldaña's coding techniques until data saturation was reached. The results had three main components: a pedagogical backdrop composed of five pedagogical issues, pedagogical approaches with its three sub-components and pedagogical timings of phases of when anatomical teaching was conducted across the three undergraduate physiotherapy degree programs. The cognitive load theory (CLT) best explained the results through five main pedagogical principles: spiral curriculum strategies, visual anatomical imagery, kinesthetic anatomical skills, strategies for teaching clinical physiotherapy anatomy, and using anatomical principles for metacognition. The study proposes a new modified version of CLT which acknowledges that newly acquired knowledge is fragile in novice learners, who have limited long-term memory capacities, and subsequently require regular revisitations, and also acknowledges kinesthetic input and germane cognitive load metacognition strategies. The study recommends appointing anatomy theme leads to take responsibility for the spiral curriculum approach across the 3 years and to introduce explicit anatomy teaching during the later clinical years

A proposed anatomy syllabus for entry‐level physiotherapists in the United Kingdom: A modified Delphi methodology by physiotherapists who teach anatomy

The ever-increasing scope of physiotherapy practice is raising questions on what anatomical knowledge and skills ought to be taught within qualifying physiotherapy degree programmes in the United Kingdom (UK). The aim of the study was to create core anatomical knowledge and skills learning objectives to inform knowledge and skills for entry-level physiotherapists in the UK. A two phased modified Delphi methodology created a consensual anatomy curriculum. A Research-Team-Expert-Panel of four physiotherapists who teach anatomy proposed Anatomy Learning Objectives (Anat-LOs) and accompanying clinical rationales relevant for newly qualified entry-level physiotherapists. A Teacher-Expert-Panel of nine physiotherapists who taught anatomy to physiotherapy students in the UK reviewed Anat-LOs in two consecutive Delphi Rounds, and rated and commented on each Anat-LO. After each Delphi Round, the Research-Team-Expert-Panel reviewed the ratings and comments from the Teacher-Expert-Panel and banked Anat-LOs that passed the 85% acceptance threshold. There were 182 banked Anat-LOs that spanned all eight areas: Introductory Concepts, Principles and Basic Histology; Head and Neck; Thorax; Abdomen, Pelvis and Perineum; Upper Limb; Lower Limb; Spine; and Neuroanatomy regions/systems. The Anat-LOs develop both anatomical knowledge and key anatomical skills, such as palpation and conducting manual tests on model patients. A first ever core anatomy curriculum for entry-level physiotherapists has been created for entry-level physiotherapists, typically Band-5 NHS physiotherapists, and takes an integrated learning approach. The anatomy curriculum brings clarity to students, teachers, clinical supervisors and future employers on the expected anatomical standards for entry-level physiotherapists

Frequency of Agenesis Palmaris Longus through Clinical Examination - An East African Study

INTRODUCTION: The Palmaris longus, one of the most variable muscles in the body both flexes the wrist and tenses the palmar fascia. It is used by surgeons as a source of tendon graft and racial differences in its variation have been documented. We sought to determine the frequency of the absence of the Palmaris longus in an East African population. METHODS: A prospective study was conducted using ten common clinical tests among patients and students in a large teaching hospital in East Africa to determine the presence of a Palmaris longus. RESULTS: The overall rate of absence was 4.4% with unilateral absence at 3.3% and bilateral absence at 1.1%. The overall difference between males and females was not statistically significant (p = 0.605). Participants were more likely to have absence in their non dominant hand. DISCUSSION: Our findings though in contrast to many studies worldwide, it concurs with most studies done in the African setting. These differences may be due to the higher levels of manual labour and the more use of the right hand in these activities. The frequency of the absence of Palmaris longus in East Africa has been determined. Surgeons should acquaint themselves with prevalence in their areas of practice

A mental hook for learning the three-dimensional anatomy of the sphenoid bone: an angelic resemblance

The sphenoid bone seems to resemble a biblical angel. The angel had six wings, and used two to cover the eyes (lesser wings with optic canal representing the eyes), two to fly (greater wings), and two (broad lateral pterygoid plates) to cover the feet (medial pterygoid plates with hamulus). This illustration may help surgical trainees to conceptualise and understand the clinical implications of this wide-ranging bone

A convenient three dimensional model to teach the arterial supply of the brainstem

An easier approach of teaching the three dimensional nature of arteries of the brainstem is being proposed and aids the understanding of clinical vascular conditions of the brain. Various regions of a standing student appear to represent different parts of the brainstem: head (midbrain), trunk (pons), thigh (medulla oblongata), leg (spinal cord), satchel (cerebellum) and plastic box (fourth ventricle). The vertebral arteries travel proximal to the spinal cord and medulla oblongata and unite at the position of the belt buckle to form the basilar artery. The basilar artery runs superiorly and finally bifurcates laterally at the neck of the student, to form the posterior cerebral artery. The teaching aid is simple, convenient and depicts 19 arteries of brainstem and circle of Willis