INTRODUCTORY REMARKS REGARDING HUMAN GROSS ANATOMY
Welcome to Human Gross Anatomy! In this course you will explore anatomy in the lab directly and actively so you can build your own knowledge of human anatomy. Many students consider the chance to directly explore human anatomy a watershed moment in their medical education. We have a staff of nine faculty (all with advanced degrees in anatomy-related fields) along with one graduate student and one thrid year medical student teaching assistant who will work with you in lecture and lab. All the members of the Gross Anatomy Teaching Team are available to you. Remember that although most of us are active researchers, we will make the time to talk or meet with you or meet with you. Gross Anatomy is our priority when the course is in session.
RESOURCES FOR LECTURE AND LAB
Our web page for this course is a critical source of information (http://www.duke.edu/web/anatomy/) and it contains: (1) course information, (2) table assignments, (3) faculty information, (4) detailed reading list, (5) cross-sectional images, (6) video resources, (7) terminology references, and (8) links to other courses. All of these will be valuable to you.
Each student must purchase: Gray’s Anatomy for Students by Drake et al., 2nd or 3rd edition.
Each lab team must purchase: Grant’s Atlas of Anatomy by A.M.R. Augur and Dailey, 13th or 14th edition.
*Any recent edition of the textbooks is fine. We have listed the most recent versions.
Langman's Medical Embryology, 13th ed. by T.W. Sadler (2015). Lippincott Williams & Wilkins.
LECTURES AND TEAM-BASED EXERCISES
GA Lectures: There are 23 lecture slots in this course held in the Learning Hall 2050. You can find the topics of these lectures and team-based exercises (TBE) listed on Bluedocs and the Online Dissector. Most of those slots are dedicated to didactic-style lectures (~50 min total), but some of those will be taught in concert with a clinician (~80 min total). Lecture notes and sometimes short tutorials will be posted before the lectures. To be prepared for lecture, you will need to read these materials and the textbook.
EB Lectures: There are also eight lectures or TBE’s devoted specifically to embryology. Embryology is part of the Gross Anatomy component of the Normal Body, and Dr. Matthew Velkey primarily delivers these lectures. These lectures are very important in developing an understanding of anatomy that can form a useful basis for clinical practice. Questions about embryology will be included on all GA exams.
Team-based Exercises: Five Gross Anatomy and two Embryology lecture slots will be dedicated to a TBE style using group assessments, team applications, or group-learning with osteological material. TBE attendance is mandatory. In most cases, the TBEs will be in the Learning Hall in your anatomy table groups.
HUMAN GROSS ANATOMY LABORATORY
Labs: There are 27 labs in this course, which are primarily held in DS 042 PZ. You will be assigned as a team, to a single cadaver. You will also be organized into sections in the lab, with each section containing two faculty and one graduate student TA. Your team will be responsible for dissecting the cadaver following the Online Dissector.
You must wear long pants and closed-toe shoes. Shorts and sandals are unacceptable. We have a video about lab procedure: https://web.duke.edu/anatomy/Lab01/Lab1.html. Tools for dissection are available at the bookstore. You will need to buy one dissecting kit. An additional kit has been donated to each table from students in previous years (available in the lab along with a few extra tools).
Lab Talks: During some labs, half of your team will attend a short 20-minute “lab talk” in a small lecture room near the lab (DS 101A). The same lecture will then be repeated to the other half of your group. On those days you will be notified of when those lectures occur. They will generally happen at 3 pm and 4 pm. The room for these talks is small and can get noisy easily. Please be respectful to your fellow students and all presenters by arriving on time and refraining from talking.
ONLINE DISSECTION MANUAL AND PREPARATION FOR DISSECTION
To guide your dissections, you will follow an online dissection manual: https://web.duke.edu/anatomy/. The dissection manual consists of the following: (1) objectives and goals, (2) procedures, (3) functional context, (4) clinical context, (5) dissection hints, (6) relevant images, (7) clinical correlates, and (8) surface anatomy. Sometimes there are optional dissections, but these should be read and studied for exams. If time permits, you should take the opportunity to carry them out on your cadaver. Also, there are many options to look at radiological images and cross sectional anatomy, both of which are an important component of Gross Anatomy and appear in lecture and practical exams.
Before coming to the laboratory, read the relevant sections in your textbook and in the dissection manual. Study the drawings in your atlas of the region to be dissected. Read any specific pre-lab material provided. Make sure that you understand the general developmental history of the structures in this region, and of the way in which blood supply and innervation reach them. This is really about making connections between anatomical parts that must work together and connecting that to what you are learning in other parts of this course. In short, you need to come as prepared as possible to lab.
Dissection Captains: All students will read the dissector prior to attending lab and must be prepared to perform the day’s dissection. However, in the interest of fostering teamwork and leadership skills, as well as streamlining the dissections, each cadaver team will designate a daily “Dissection Captain.”
The daily Dissection Captain is responsible for: 1) Reading the dissector ahead of lab and coming prepared to perform the dissection; 2) Leading their team through the dissection and delineate tasks; 3) Leading a review of the major structures explored following each dissection; 4) Making sure the dissection instruments are accounted for, organized, and cleaned following each dissection; 5) Making sure the cadaver is wetted and properly stored following each dissection; and 6) Making sure your station is clean, the light is turned off, and you have logged off the computer.
All students will have access to the CT scan images of their team’s cadaver. In continuing to foster teamwork and leadership skills, as well as streamlining the dissections and corresponding radiological images, each team will designate a daily “Radiology Captain.”
The daily Radiology Captain is responsible for: 1) Reviewing the appropriate CT scans (corresponding to the region being dissected) ahead of lab and coming prepared to help the team members identify anatomical structures in the CT images of their own cadaver; 2) Leading their team through using the CT image viewer software and orienting everyone to the corresponding CT images; 3) Leading a review of the major structures explored following each dissection; 4) Making sure the that all of the relevant anatomical structures have been identified to the best of the ability of the captain; 5) Collecting and organizing questions from the team about the CT images or identifying structures to then present to the radiology resident or fellow present during the week. Once a week, radiology residents or fellows will be in the gross anatomy lab to answer questions and help teams understand radiological imaging and the structures they should be able to identify in those images.
Prior to the first dissection, each team will produce a schedule of daily Dissection Captians and Radiology Captains to be approved by the anatomy teaching staff. Dissection Captain and Radiology Captain assignments should be evenly distributed among all the team members. Each team member must take a turn as Dissection Captain and as Radiology Captain prior to any member taking a second turn.
Narrative Assessment: At mid-course and at the end of the course we will provide narrative feedback on your performance in lecture and lab. Your performance as Dissection Captain and as Radiology Captain will be included in the review of your professionalism in these assessments. The narrative feedback is a requirement from accreditation agencies and should help you improve as a team member, which will be important later in medical school, residency, and clinical practice. These written assessments have no effect on your grade and will only be seen by you and the Gross Anatomy faculty.
Lecture Exams: There are four lecture exams. These will be taken via computer (through Examsoft), but students will take the exams in the Trent Semans Center, during the time period specified on Bluedocs. The exams will contain factual and conceptual questions in multiple formats including ordering, labeling, fill-ins, true/false, and multiple choice/multiple correct. The exams will also have “board-style” questions. These exams include embryology questions explicitly and within other questions. Students must get a 60% or greater on any exam to pass. Retake exams, for missing or failure, are given based on the specific written policy that guides students to obtain permission from the advisory Dean and Course Directors to do so. Exams can only be retaken in the case of failure once. Each exam will be worth 12% of the grade. Thus, lecture exams will constitute 48% of the grade for GA. These exams are not explicitly cumulative.
Laboratory Practicals: There are four laboratory practical exams associated with each exam . Lab practicals last for 30 minutes and are held at two separate times in two groups before the lecture exam. You will be assigned to a group for each practical. You will be assigned a time to begin, and a station at which you will start. Arrive at least fifteen minutes early so the practical can start on time. If you are late for the practical, you will lose the points for every question you were not in attendance for, unless you have an excused absence. For each practical exam you will have one minute to identify a structure either directly or by identifying a structure that attaches to another one (i.e,. muscle to a part of a bone). Students must average a 70% or greater on the practicals. Retake exams, for missing or failure, are given based on the specific written policy that guides students to get permission from the advisory Dean and Course Directors to do so. Exams can only be retaken in the case of failure once. The highest possible grade on a retake exam is 70%. Each practical will count for 9% of the grade, for a total of 36% of the GA grade.
There are always questions about exam release and key release. In regards to the former we grade some parts of the exams by hand and usually require a day to do so. If a student has to complete a make-up exam, we sometimes delay release until it has been completed. In regards to key release, we follow the policy established for the Normal Body Course of allowing short-term review of the key after exams. Following the Normal Body Policy we do not provide keys for exams that can be kept or distributed.
Lab Attendance: Lab attendance is mandatory and counts for 6% of your final grade. Students must attend 85% of the labs. More specifically, you can miss 4 labs without an excuse. If you have reached that number and need to miss for illness or emergency please speak to the course directors. If you miss more than 4 labs without excuse you will have 6% deducted from your grade. This rule is designed to make sure you really spend time dissecting and that you do not leave your team short-handed for this enormous task.
Team-based Exercises: Team-based exercises are mandatory and participation in them constitutes 10% of your final grade. Completion of these exercises is the requirement to gain the points. We follow the policy established for the Normal Body Course in which any unexcused absence will result in a score of zero. If the absence is excused ahead of time the TBE scores will be calculated based on the sessions that the student attended. Team-based events aren’t recorded and can’t be completed at a later date. You should only miss these sessions for very serious reasons.