In Search of the Core Principles of Human Anatomy

A message from HAPS Central Regional Director, Murray Jensen.
A message from HAPS Central Regional Director, Murray Jensen.

HAPSters spend a lot of time discussing the teaching and learning of anatomy and physiology.  Check out this post from long time HAPSter and Central Regional Director, Murray Jensen.  Murray is trying to generate a bit of controversy about teaching anatomy and long hot lists that we require our students to memorize.  Just how important are all those names and structures?  Look forward to a retort from graduate student Bradley Barger next week.

After 25 years of teaching entry-level anatomy and physiology, I can safely say that I’ve begun to figure a few things out – like the importance of setting high expectations on the first day of class; you have to scare the kids a bit.  All HAPSters know that one.  Another thing I’ve begun to figure out is how to teach human physiology.  This is in large part due to the work of Joel Michael and his group who identified the core principals of physiology  (http://advan.physiology.org/content/33/1/10).    Energy flow, homeostasis, and a few other concepts set the stage for pretty much every topic in physiology.   I use Michael’s core principals to design my course, write curriculum, generate exam questions, etc.  It’s a powerful tool for those of us who teach entry-level physiology. Required Structures ListI also teach basic human anatomy, and after 25 years and a couple thousand students, I can say with confidence that I really don’t know what I’m doing.  I remember vividly the first human A & P course I taught.  Skeletal system .. skull anatomy…hmmm…what structures should be on the hot list?  Ethmoid? Of course. Sphenoid? Obviously.  How about the foramen spinosum?  Should that be on the list? To facilitate the decision process I used Rule One of Teaching – you teach the way you’ve been taught.  In deciding what structures to include on my own hot list, I simply went back to the notes I used as a student, “What did Dr. Ivan Johnson make me learn?” Turns out Dr. Johnson indeed had me learn the foramen spinosum; therefore it must be important, and so it went on my very first hot list for skull anatomy.   Twenty-five years later I still have my students learn the foramen spinosum.  Why?  The best I can do is “because I had to do it!” Blindly following Rule One is not professional.  I would like to do better.  Joel Michael’s core principles greatly improved my ability to teach physiology – his work established an epistemological foundation for physiology education.  Now when a student asks “why do we have to learn about vasopressin?” I can confidently answer that it fits into the bigger picture of how the body works, and vasopressin’s role in the homeostasis of sodium, water, and blood pressure.  Much, much more satisfying than responding, “Well…I had to learn it!” or even worse “Because it will be on the exam.” In the past few years I’ve been pushing my anatomy colleagues for answers.  What should kids learn about anatomy in my entry-level course? What should they learn first?  If a student wants a career in anatomy, what are the themes? What’s at the foundation of a conceptual understanding of human anatomy?  We’ve had some good beginning ideas: orientation, cavities, medical terminology, liquids and solids, layers have promise.  But there is nothing official at this stage – just some good conversations.  And nothing that helps me figure out if I should include the foramen spinosum on the hot list. Identifying the core principles of anatomy is a worthy quest, and HAPS leadership is looking into starting a task force to get things moving.  I’ve been working with Bradley Barger, PhD candidate in Anatomy and Cell Biology at Indiana University, and we’ll be hosting a workshop at San Antonio for others interested in the project. In pondering the task ahead, I think I’ve identified a significant question, but some background is needed first.  Dr. Ernest Rutherford, Nobel Prize winning physicist from way back, has a quote, “All science is either physics or stamp collecting.” I think Rutherford is correct – everything in science boils down to physics.  When teaching human physiology and thinking about Michael’s core principals, I see physics (e.g., diffusion, pumps, gradients, barriers, energy).  If students can comprehend some basic physics, then they can make some good strides toward understanding human physiology. My big question: Is there any physics in anatomy?   At this time I don’t see any physics.  I see terminology, orientation, embryology, and sometimes even design (gasp!) – but I don’t see physics. Disagree?  Disagree strongly? Well…make a list of your own core principles of human anatomy and come to the workshop in San Antonio.  Help me figure out if I should keep the foramen spinosum on my hot list.