Thursday 19th May 2016
Professor John McLachlan, Durham University
Done to death: the use of the living body in anatomy teaching
The preserved cadaver is the canonical text we expect medical students to read anatomy from. It represents a rite of passage, invested with cultural meaning far beyond its information content. But in real clinical contexts, doctors encounter the living body itself.
The project Professor McLachlan described, promotes the iconoclastic view that anatomy learning should be through the living body, using peer examination and living models, medical imaging and art. It can be argued that this both brings benefits and avoids some kinds of harms. The implications of such experiences are wider, however, than across medical teaching, or even across health professional teaching. Many innovative teachers may find themselves in the uncomfortable position of challenging the cultural norms of their subject, and our experiences may illustrate both the pitfalls and rewards of such teaching.
Professor Jim Parle Director of the Physician Associate (PA) programme and Karen Reynolds from the Interactive Studies Unit
Who are the ACEs and what can they do?
Associate Clinical Educators (ACEs) are essentially non-medical people who have been trained in the medical examination systems and know how those examinations should feel ‘on the receiving end’. They are able to support the clinical teaching the students receive and the students get to practice the examinations on them, receiving real time feedback.
The ACEs are also able to layer these skills with simulation and so a scenario can be created where the ACE is able to simulate appropriate signs and the student can examine the ACE as well as take a history. ACEs are also familiar with the ‘errors’ that both patients and students make and can both simulate the former and correct the latter, again using instant feedback e.g. ‘Press a bit harder and you will be able to feel the colon’.
ACEs work in both teaching and assessment, primarily with our PA students. They also work in Year 4 with our MBChB students at the Royal Orthopaedic Hospital, Birmingham. For this work the ACEs received extra training in orthopaedic conditions from Professor Edward Davis. ACES cover all areas of the clinical examination, including neurology, respiratory, cardiovascular and GI examination as well as intimate examinations such as male rectal, female breast, male genitalia. Lastly we have other female ACEs who are Gynaecological Teaching Associates (GTAs) who have been trained by gynaecologist Miss Shirin Irani; they work with both our MBChB Year 3 students and the PA students.
This session explained a little more about the work of the ACEs and how they are trained. They also demonstrate a ‘hands-on’ simulated clinical scenario.