title: Are medical students being taught anatomy in a way that best prepares them to be a physician?
abstract: Reasoning in a clinical context is an attribute of medical expertise. Clinical reasoning in medical school can be encouraged by teaching basic science with a clinical emphasis. The aim of this study was to investigate whether anatomy is being taught in a way that facilitates the development of clinical reasoning. Two multiple-choice tests on thoracic anatomy were developed using a modified Delphi approach with groups of four clinical consultants and four teachers, respectively, expressing their opinions about knowledge relevant to thoracic anatomy. Validity was assessed by administering the tests to clinical consultants, anatomy teachers, and pre-course medical students. Post-course medical students took both tests to explore the focus of the course, i.e., whether it facilitated clinical reasoning. The pre-course students scored significantly lower than the teachers and post-course students on both tests and lower than the consultants on the consultants' test (P < 0.001 for all comparisons). The teachers significantly outperformed the consultants (P = 0.03 on the consultants' test, P < 0.001 on the teachers' test) and the medical students (P < 0.001 on both tests). The post-course students scored significantly lower on the consultants' test (P = 0.001) and significantly higher on the teachers' test (P = 0.02) than the consultants. This study demonstrates poor performances by medical students on a test containing clinically relevant anatomy, implying that the teaching they have received has not encouraged clinical reasoning.
authors.affiliation: Center for Clinical Education, Center for HR, the Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Mona
authors.initials: M
authors.lastname: Meral Savran
authors.affiliation: Institute of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Tranum-Jensen
authors.affiliation: Department of Pulmonology, Gentofte Hospital, University of Copenhagen and the Capital Region of Denmark, Hellerup, Denmark.
authors.forename: Paul
authors.initials: P
authors.lastname: Frost Clementsen
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Hastrup Svendsen
authors.affiliation: Department of Cardio-Thoracic Surgery, Rigshospitalet, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Holst Pedersen
authors.affiliation: Institute of Biomedicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Seier Poulsen
authors.affiliation: Department of Cardio-Thoracic Surgery, Rigshospitalet, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Arendrup
authors.affiliation: Center for Clinical Education, Center for HR, the Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Konge
mesh_terms: D000715:Anatomy / Q000193:education*; D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods*; D006801:Humans; D013663:Teaching / Q000379:methods*; D013909:Thorax / Q000033:anatomy & histology
keywords: anatomy teaching; clinical reasoning; medical students;  anatomy teachers