Essential Anatomy in Undergraduate Medical Curricula: Orthopedics and Obstetrics and Gynecology

BACKGROUND The application of modern learning theory, the transition to integrated curricula, a desire for distributed learning across the medical education continuum, and decreased instructional hours has led to significant changes in teaching anatomy in undergraduate medial curricula. In response, some anatomists are attempting to refine what they cover (from a “fire hose” to a “garden hose”). In doing so, several important questions should be asked: “what anatomy is essential” and “for which group of learners?” If the goal is to provide foundational anatomical knowledge for the “generalist”, then an obvious question is “what is a generalist?” Another approach is to provide “what all medical students need,” but this seems concept seems elusive and poorly defined. Alternatively, if anatomical curricula are to be fine‐tuned for students choosing different medical specialties, the question of what is essential should be parsed by specific residencies. This presentation reports the responses to the question of “what anatomy is essential” from residents at William Beaumont Hospital in Royal Oak, MI. METHODS The survey tool for this study, based on learning objectives published by The Anatomical Society (Smith et al., J Anat 228:15–23, 2016), presented anatomical structures in a regional context. For each structure (regional anatomical), participants were asked to base their responses on their clinical experience and address two questions: (1) an assessment of its clinical importance (scaled responses: 1–not important, 2–useful, 3–important, 4–essential), and (2) whether they knew it when needed (scaled responses: 1–not at all to 4–completely). Responses were voluntary and anonymous, and no incentives were offered. Designated residents from each program administered the surveys. RESULTS Residents in seven programs participated, but significant numbers of responses were received only from Orthopedics (n=21; 44%) and Obstetrics & Gynecology (n=13; 27%). Responses to clinical importance were grouped as “not essential” if less than 50% of scaled responses were 1 or 2; likewise, a structure was considered “essential” if greater than 50% of scaled responses were 3 or 4. Statistical analyses are ongoing and results will be presented and full summaries of outcomes will be available. CONCLUSIONS A key element of this research is that the outcomes are based on responses from residents, who not only use the anatomy in a clinical setting, but are also near‐peers of medical students. This are important considerations when considering the distinction between the oft used measure for curricular success of passing USMLE Step 1 versus success in clinical experiences (clerkships) and for treating patients. A follow‐up study is underway to examine responses from residents in non‐surgical fields (internal medicine and family practice). Ultimately, this data should provide an evidence base from which curricular change with respect to anatomy may be better informed in creating courses (learning experiences) that are effective in the time available, that leave students with useful knowledge, and that allow students to acquire anatomical knowledge that is essential for their chosen field of medicine.