Saturday, October 26, 2013

Rite of Passage

We’ve survived.

The first anatomy exam is over.

*insert sigh of relief here*

As I wrote about previously, Loyola just changed up their anatomy curriculum. Most of the changes, at least in my opinion, are for the better. The one change that we were all nervous about, though, was the switch from in-lab anatomy practical exams (where you wander around in the anatomy lab and try to identify labeled structures on cadavers) to online practical exams (where the instructor takes a picture of the labeled structure, and you have to figure out what in the world you are looking at). 
From Anatomy at the Bleeding Edge

Intuitively, it seems like an in-lab practical would be the better course. With anatomy, it’s often helpful to be able to orient yourself to the region of the body you are in and look at a labeled structure from several different angles while you are figuring out what it is. With a picture, on the other hand, we were afraid that we wouldn’t really be able to orient ourselves or see the structure clearly. Looking at pictures of a cadaver can be an entirely different experience than seeing one in the flesh (I know, that was too easy…). In fact, having done a couple of online practical exams as practice before the test, I know all too well that badly-taken pictures can be downright frustrating.

Despite all of that, the general consensus among the students – and I agree – was that the instructors did a great job in creating the online practical. All of the pictures were of good quality, structures were pretty clearly labeled, and they did a good job of orienting us to the region by showing us where exactly in the body we were and making an effort to clearly show neighboring structures.

There was also the benefit of being able to take your time while trying to identify a structure. I took anatomy in undergrad (and subsequently forgot everything…but ah well), and we had in-lab practical exams. These generally consisted of a large mass of students wandering somewhat aimlessly around a locked-down laboratory with a sheet of paper, a clipboard, and a pen. While it is helpful to be able to look at a given structure from multiple angles, at the same time you did feel somewhat rushed by the bolus of students coming down the line behind you. With the online practical exams, however, you could stare at that darn picture however long you pleased, thank you very much. So that was nice.

I was pretty happy with the results of the exam. The class as a whole did pretty well, actually. Anki really shines in anatomy, particularly the image occlusion feature, which allows you to screen-capture a picture from your computer, cover labels, and quiz yourself using Anki’s spaced-repetition algorithm. Since anatomy is all about visual recognition/spatial thinking, Anki is perfect for this subject. It’s much better than staring at a picture in a textbook until you think you have it, only to forget it a week later.

As far as studying for the test – and anatomy in general – goes, I really didn’t spend much time in lab. I generally attended lecture, which I found to be helpful, and then came home and made Anki cards for what we learned that day from lecture slides, Thieme’s Atlas of Anatomy (which has some beautiful pictures), our online dissector (which has a lot of the Thieme pictures), or one of the Lippincott Concise Illustrated Anatomy books (which comes with an access code for on online version of the book on a great e-book platform – awesome for making cards). Also, before or shortly after starting a new region of the body, I tried to watch the relevant Acland’s Anatomy videos – these videos are beautiful prosections of very well-preserved cadavers (which are much more helpful, in my opinion, for understanding what the structures actually look like than studying from a dried-up cadaver).

Those are my primary study sources. I may occasionally glance through BRS Gross Anatomy or play around with this awesome (and free) 3D anatomy visualization website – one of the reasons it’s so great is that you can actually dissect away certain structures, which is awesome for getting a handle on three-dimensional relationships of otherwise hard-to-visualize structures.

One of the many things I like about Anki is that, in the days leading up to the test, I wasn’t spending time learning stuff. I already knew (or at least had seen) the structures we needed to know, because I had been reviewing them according to the spaced repetition algorithm on a daily basis. Instead, I was able to spend time doing the relevant written and practical exams on the University of Michigan Medical School’s website, which is an incredible (and, once again, free!) resource. It really helped tie certain concepts together in clinical scenarios, while at the same time giving me a rough idea of what the online practical format would be like (although, some of the pictures were rather frustratingly unclear…). I did make an effort to do a passive once-over my lecture notes, just to have one last integrated exposure to all of the material and also to review anything that I hadn’t deemed worthy of “Anki-fying.” Finally, I also reviewed any relevant sections of Rohen's Color Atlas of Anatomy to get an idea of what the beautiful illustrated pictures in Thieme and Lippincott actually look like in “real life.”

It was only the day before the test that I actually went down into the lab, which marks the second time I’ve been down there since anatomy started a few weeks ago (the first time was the dedication ceremony for the cadavers). While it can be enlightening to see first-hand what certain structures look like and how they interact with other structures, what you’re looking at in lab is not the best representation of what things look like in real life (Acland’s videos do a much better job, I think). Nevertheless, the anatomy lab is somewhat a rite of passage for medical students, and besides, these are the cadavers that most of the pictures for the practical are coming from. I spent maybe three or four hours in lab, reviewing stuff with other students as we quizzed each other. Some fourth years are also participating in the course as part of a fourth-year anatomy elective and also gave some great mini-reviews. Finally, we have what our professor calls “Magic Pens” (no idea what they are actually called) that are essentially electronic pens with speakers in them. You can tag a body part with a special tag, and the pen will read the tag and play back a recording of whatever the professor wanted to record about that body part. These were helpful for solo-review, since it can otherwise be frustrating trying to pick out various muscles, arteries, and nerves out of something that, a few weeks into the course, looks less like a human being and more like road kill.

One of the biggest challenges of anatomy is figuring out a study routine that works well for you. Each student will learn differently. Another one of the big challenges is sorting through the mountain of information presented to you, organizing it in a way that makes sense, and memorizing it. I feel like the tools above help me do that, and it seems to have paid off. I’ll continue using these resources for the next test, and hopefully things will continue to go ok. We shall see. Meanwhile, my dissection rotation is coming up – I get to do the thorax and abdomen, which should be interesting.

We start on Halloween – fitting, I suppose.

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