ANATOMY AND PROFESSIONALISM IN AN UNDERGRADUATE MEDICAL CURRICULUM

Abstract

Name: Gabrielle Maria Finn

Title of thesis: Anatomy and professionalism in an undergraduate medical curriculum

Higher degree for which submitted: Doctor of Philosophy (PhD)

Year of submission: 2010

This thesis describes two themes within the undergraduate medical curriculum; innovations in anatomy teaching, and the assessment of professionalism. Methodologies from both the quantitative and qualitative paradigms were utilised.

The main findings were:
1) The Virtual Human Dissector™ (VHD) was shown to be equally as effective as cadaveric prosections as a tool for learning cross-sectional anatomy.

2) Body painting was demonstrated as being a highly motivating and engaging exercise for students. Students reported that the bold colours and kinaesthetic nature of body painting promotes retention of knowledge and informed their approach to future patients when painting was coupled with simultaneous peer-physical examination (PPE).

3) Contextual learning and simulation were shown to directly impact upon retention of knowledge through the use of clothing in anatomy education. This highlighted how when implementing simulation small and seemingly trivial details, such as clothing, are important.

4) The Conscientiousness Index (CI) has been demonstrated as an objective and scalar measure of one element of professionalism, conscientiousness. The CI identified students at the positive and negative end of the behavioural spectrum, and this correlated with peer and staff judgements on the professionalism exhibited by students at these extremes of behaviour.

5) Students were able to accurately assess the conscientiousness of their peers, however were unable to self-assess conscientiousness. The reliability of such peer assessments was improved when peers assessed only those in their tutor groups, with whom they had the majority of academic contact, compared to when assessing the entire cohort. This demonstrated the importance of assessor familiarity in assessments.

6) Critical incident reporting, of extremes in professionalism, was shown to promote reflection in students. Critical incident reports, as with the Conscientiousness Index, offers faculty a tool by which outlying students can be identified.

7) Students were unclear about the constituent elements of professionalism and the contexts in which professionalism was relevant. Three contexts were identified; the clinical, the academic (University), and the virtual (online) context. The impact of professionalism assessments and the scrutiny on students has led students to struggle with identity negotiation. This was with respect to their personal and professional identities and the expectations of different stake holders, such as faculty, the media and prospective patients.