Although it is not a particularly difficult concept, sometimes students have trouble remembering the different names that the subclavian artery takes on as it passes through the superior mediastinum and base of the neck into the axilla (as the axillary artery) and arm (as the brachial artery), or they don’t quite get that it is the same vessel with three different names.
One thing I do in lecture and lab is to analogize this name change using name changes for streets in town. Fortunately, I work at a university (Benedictine University in Lisle, IL) that is situated on a road (College Road) that changes name to the north (Yackley Avenue) and to the south (Wehrli Road) without changing direction appreciably. Every student has to drive along these roads to get to school. I tell my students that the subclavian artery is like Yackley Avenue, and when it crosses the lateral edge of the first rib (in this analogy, Maple Avenue, see Figure), it changes name to the axillary artery (College Avenue); it changes name again after crossing the inferior margin of the teres major muscle (Hobson Road, see Figure), at which point it becomes the brachial artery (Wehrli Road). I would wager that many (most?) towns in the United States have roads that change names in the same way, so that the analogy could be adapted to local conditions. A particularly good example, in Washington, DC, is Constitution Avenue, which starts as I-66E, changes to US-50E/Constitution Avenue after crossing Roosevelt Bridge, and then turns into Maryland Avenue after crossing 2nd Street NE.
Of course, every semester the students and I question the sanity of anatomists and city planners alike for changing a perfectly good name again and again. I wonder how many students, driving home from my anatomy class, are thinking about the different names for the main artery of the upper limb as they drive along Yackley Avenue/College Road/Wehrli Road?
Robert McCarthy is an assistant professor in the Department of Biological Sciences at Benedictine University in Lisle, IL, where he teaches human anatomy and evolution to undergraduate biology and health science students. Robert is a biological anthropologist who studies the evolution of speech and language, the primate skull, hominin evolution, and human anatomic variation.
In the early 2000s, the HAPS Curriculum and Instruction (C&I) committee embarked on a multi-year project that resulted in the development of HAPS Anatomy & Physiology (A&P) learning outcomes. These learning outcomes were developed for 2-semester human A&P courses, and served as a benchmark for instructors who are currently teaching A&P courses, or as a guide for those individuals developing new A&P courses. These learning outcomes were well received, and many publishers have since adopted or incorporated these outcomes into their own learning materials. In addition, the HAPS Comprehensive A&P exam questions were developed by mapping to these learning outcomes.
Unfortunately, the A&P learning outcomes are not as useful for those of us who teach stand-alone anatomy (or stand-alone physiology) courses. A new set of learning outcomes needed to be developed for each of these stand-alone courses. With that in mind, the HAPS Testing Committee embarked on a multi-year project to create and develop the HAPS Anatomy Learning Outcomes.
Why the HAPS Testing committee and not the C&I committee, you ask? We quickly realized that anatomy-specific learning outcomes needed to be developed by individuals who teach stand-alone anatomy courses – and most of the C&I members did not teach such a course, whereas many members of the HAPS Testing committee did. In addition, the HAPS Testing committee also has the goal of creating a HAPS anatomy-specific comprehensive exam – but before an exam could be created, the learning outcomes needed to be fleshed out.
The process of creating anatomy-specific learning outcomes involved multiple revision cycles involving members of the Testing Committee as well as members of the Anatomy Testing task force (experts charged with the task of developing the HAPS anatomy exam, under the purview of the HAPS Exam Program). We used the HAPS A&P learning outcomes as a template, but ensured the learning outcomes were written with a stand-alone anatomy course in mind. We greatly appreciate the assistance of ADInstruments, as they helped fund several off-site meetings with the task force in order to finalize these learning outcomes. We completed our task in early 2018 and introduce to you all – the HAPS anatomy learning outcomes! Please visit the website to learn more and download the outcomes.
As with the A&P learning outcomes, the HAPS Anatomy learning outcomes are to serve as a guide and benchmark only. We do not expect all anatomy instructors to cover every single learning outcome, they may address the learning outcomes in whatever order they like, and they are welcome to include additional learning outcomes in their own courses.
We hope you find these learning outcomes of use in your anatomy courses! Many thanks to the HAPS testing committee members and the HAPS anatomy exam panel for their hard work in this effort.
Administrators and faculty have questioned the effectiveness of online, hybrid and dual credit sections of a course as opposed to a traditional face to face section. The opinion voiced most often is that the online and dual credit sections cannot begin to equal the learning in a traditional face to face classroom. Indeed, in our era of transparency in education, this question has arisen amongst state and federal education agencies as well as the administrative offices of colleges and universities. Studies have been conducted to compare modalities of delivery effects on student satisfaction, student retention, GPAs, as well as other parameters.
To address this question, Western Iowa Tech Community College Science Department in Sioux City, IA implemented a common assessment requirement for Human Anatomy & Physiology I and II. Initially the A&P common assessment consisted of an in-house exam created by full-time A&P Instructors. When HAPS re-created the comprehensive final exam and piloted A&P I and A&P II versions of the exam in 2014, WITCC students participated in the pilot. WITCC’s choice for separate A&P I and II exams was based on the observation that not all students complete their 2 semesters sequentially. Occasionally students begin their study of Anatomy & Physiology while to complete coursework during their wait to be admitted. Occasionally a student is accepted into their program more quickly than expected resulting in the withdrawal of the student from the second semester to focus more completely on their program specific courses.
WITCC’s results for semesters where all A&P students were tested included traditional face to face classes, hybrid sections where the students are provided an hour of lecture and 2 hours of lab per week, league classes which are dual credit high school students where the high school instructor is also the college instructor, hybrid league classes where there is both a college instructor and a high school instructor, and online students from WITCC only. Below is a graph of all of the data for the modalities demonstrating the comparability of instruction between the modalities. In addition to the scores and test statistics, users of the exams are provided statistics for all of the exams twice a year in June and again in December. These statistics are provided by school type such as 4-year college, 2-year college, technical college, etc. It is helpful to be able to compare my student performance with that of the students in other colleges similar to mine.
In 2014, when I was teaching at a school of nursing, I was asked to develop a Human Anatomy and Physiology course sequence for undergraduates at our university who were interested in pursuing a degree in nursing. Human Anatomy and Physiology was required for admission to our school, and we were interested in attracting more undergraduates from our university. We wanted to make these undergraduates more aware of nursing as a possible career path, particularly bright students who already expressed an interest in science. Additionally, we were seeing that many students who matriculated into our traditional BSN program (to obtain a first bachelor’s degree) either were not well prepared, or seemed to have forgotten a significant portion of their basic science coursework. A colleague and I developed a pilot course that combined Human Anatomy and Physiology II (a common nursing prerequisite course) with Health Assessment (a course that is often offered early in the professional nursing curriculum) into a novel course that we called Physical Assessment: Normal Human Form and Function. Students in this novel course would take the traditional Human Anatomy and Physiology II lecture but would have a separate lab where the Health Assessment skills would be taught. We got approval from our university’s IRB, and also from our School’s curriculum committee. We obtained funding through a small grant from our university’s Center for Faculty Development and Excellence, and funds from the Center for Science Education. Our pilot course launched in the spring of 2016 with 10 students.
Our hypothesis was that students who participated in the pilot offering of this novel course would demonstrate improved learning of the basic anatomy and physiology concepts, as well as better retention of these concepts, than students who did not participate in the innovative pilot course. We used the HAPS standardized exam as a pre-test / post-test to measure students’ improvement from the beginning of the course sequence (August 2015) to the end (May 2016). We found that all students had significantly improved post-test scores on the HAPS exam when compared to the pre-test scores. We did see that participants in our pilot study did outscore non-participants in terms of exam scores, overall course scores and HAPS exam scores. These students appeared to be more satisfied with their overall experience. Further, participants also appeared to have stronger course scores in Pathophysiology, the first science course they encountered as professional nursing students, than non-participants. We noted a correlation between the learning gains on the HAPS exam and scores in Pathophysiology – this may be the first observation of correlation of pre-professional coursework performance with professional performance. Our pilot course experience resulted in a poster presentation at the 2017 annual HAPS meeting in Salt Lake City.
The biggest limitation of our study was the small sample size – our pilot cohort was 10 students. We chose the students in this cohort carefully for this first iteration in an attempt to minimize the potential disruption to their entry and progression through a professional nursing curriculum (ie, we chose students that appeared likely to be successful). Thus, we cannot generalize our results widely to pre-nursing students, and we cannot rule out the possibility that the participants would have out-scored their non-participant counterparts in any case.
There were several challenges specifically associated with the HAPS exam we faced as we developed this course. One challenge was the cost of the HAPS exam – about $10 per student. Since we opted to use the exam as a pre-test / post-test assessment, we needed $20 per student to obtain this data. Funding from the CFDE / Center for Science Education covered the cost of the exams. Another challenge in the use of the HAPS exam was that it is completely online. One required element in administering the exam is a professionally-supported computer lab. Students were not allowed to use their own computers, and there is no compatibility with any “lock-down browser” mechanisms that would prevent students from accessing online resources during the exam. While our school of nursing still had a computer lab, many schools have stopped supporting these in lieu of having students provide their own computers. Some students taking the HAPS exam at the beginning of the academic year expressed their anxiety when viewing their scores, and some dropped the course shortly afterward. Additionally, we did not include an incentive for students to perform to their best ability on either the pre-test or the post-test, which may have indicated that their HAPS exam score was not important.
This post comes from Dr. Ann Massey, PhD, Senior Lecturer for the Department of Cellular Biology at The University of Georgia.
From the founding of the Human Anatomy and Physiology Society (HAPS) as an organization in 1989, there has been a general agreement that many of our students find the study of Human Anatomy and Physiology to be difficult. For some there is the difficulty in the sheer volume of new words to process and for most there is also a difficulty in conceptualizing the body as a set of integrated organ systems with interdependent processes necessary to sustain the life of the whole person. Partially to counteract grade inflation pressures on individual campuses, partially to justify requests for baseline prerequisite courses, and partially just for our own reference, there has been an ongoing desire for more “objective’ ways to know how well our students are doing. Out of this impulse the “HAPS Comprehensive Exam” was born in first draft around 1992 and piloted in June of 1993. I have great familiarity with the exam as I took over scoring the exam from Chris Farrell (Trivecca Nazerene University) and did all the central scoring of paper and pencil exams from the summer of 2007 through the spring of 2015, when the paper and pencil version was discontinued.
The exam has undergone several major revisions through time and has migrated from the original mail order, self-scored, paper and pencil form to a secure on-line testing environment. The HAPS Exam Program continues to write new questions and refine the scoring algorithm. Some questions (up to 20 per administration) are being tested for validity and reliability before being permanently added into the master question database. The exam has costs associated with the maintenance of the database, validation of new questions, test administration, and data analysis of the results. Consequently the exam is offered on a per-test fee basis to faculty and administrators at accredited institutions of higher education.
The HAPS exam is now a secure 100+ item test correlated to the HAPS Learning Outcomes for Undergraduate Anatomy and Physiology. It is currently the only validated means for obtaining comparison data across textbooks and publishers to help benchmark the performance of your students against the performance of other A&P students across the North American continent.
There are now several versions of the exam including the combined exam and subsets for A&P I only and A&P II only. Neither the complete exams nor the individual items contained in the exams are, or have ever claimed to be, perfect or without flaws. The HAPS exam is not an exhaustive examination of everything that your students actually know or even theoretically should know. The HAPS exam is not a substitute for a final exam targeted to your student population and your particular course. The HAPS exam score by itself in isolation is not a total representation of your students’ learning or the quality of your course(s). But in this era of assessment and accountability the HAPS Exam remains the only nationally normed and somewhat standardized examination over the content and concepts of Human Anatomy and Physiology.
What makes the HAPS Exam valuable?
The HAPS exam data is very useful in accreditation reports to validate efficacy of curriculum changes that have been made or to provide leverage to support requests for proposed changes. Sequentially administered test results over several years is a potentially powerful data source for answering the question, “How do you know it works?” Although administrators often find this the most compelling reason to justify the annual expense of the exam, I have found, personally, that the ability to gain perspective on my students’ performance to be of even more value.
I have found that the HAPS exam gives us at the St. Louis College of Pharmacy the opportunity to step back away from our local concerns and get a bit of perspective on how our students are actually doing. They may not be mastering the nervous system in the way we would like, but guess what? Turns out that many students across North America are struggling with that system. This doesn’t mean that we give up or quit trying. It just means that we have a more realistic sense of the challenge we are facing – not just at our school but across all of HAPS. If we are all having difficult in getting our students to deeply engage with a particular topic or system, I know I can go to the HAPS listserv (I still call it that) and ask around for what others are doing to address the issues we are facing. It is very empowering to know that neither I, nor my colleagues, nor my students as a group, are necessarily failing, even when I can see room for improvement in my students’ development of meaningful understanding of A&P. Perspective taking can be very powerful.
And if my/our students do particularly well in one area compared to the normed average? Well then I/we have the perfect topic/technique/workshop to share at the next HAPS annual meeting, or an article for HAPS Ed, or other publication! I can feel especially confident in offering my thoughts, suggestions and materials to others because I have evidence that what I and my colleagues are doing is helping our students meet not only our expectations, but allowing achievement at or above the national norm.
The more schools and students who participate, the more meaningful the results become. If you have not done so before, think about the HAPS exam this year.
Two years of planning, many discussions, and revisions of the program’s agenda and it finally happened!
On May 29, 2017, a wonderful group of CCBC (Community College of Baltimore County) biology students and faculty left for an exciting 10-day adventure, dubbed Human Anatomy in Poland. The human anatomy and education parts of the program included a visit to the Anatomy Museum at the Jagiellonian University Medical College in Krakow (the oldest university in Poland), the Criminal and Forensic Medicine Museum at the Wrocław Medical University, the unforgettable experience of visiting and attending a workshop at the world-famous Plastinarium in Guben, and student-interactive activities at the Public Higher Medical Professional School in Opole.
This anatomy focused experience was intermingled with touring the cities of Wroclaw, Opole, Krakow and Warsaw. The participants learned about Polish history, culture, and architecture by visiting many sites registered on the UNESCO World Cultural and Natural Heritage List, including the Centennial Hall in Wroclaw, the Old Town in Krakow, the Nazi German concentration camp Auschwitz-Birkenau, the Salt Mine in Wieliczka, and the Historic Centre in Warsaw.
Description of the study abroad program would not be complete without adding that the participants were enthralled with Polish food, enjoying all varieties of pierogi (commonly confused with “pierogis”). Some are even still experiencing “lody (ice cream) withdrawal”. I was asked on multiple occasions throughout the study abroad by the participants whether the program will be repeated; I share this enthusiasm and hope it isn’t the last of its kind!
Ewa Gorski is a biology professor at the Community College of Baltimore County in Maryland where she has been teaching human anatomy & physiology and physiological pathology courses for about twenty years. The majority of her students are preparing for careers in nursing and mortuary science. Ewa has been HAPS member since 2002.
This post describes Quelly Shaive’s anatomy program in Manaus, Brazil.
Anatomy for Medicine is a class which emphasizes the application of anatomy knowledge within a clinical anatomy model. The approach of Anatomy for Medicine is topographic, where we explore each segment, structure or organ in great detail . This course is divided into 2 parts: Anatomy I and II. This course consists of teaching the anatomy itself as well as pertinent clinical correlations to facilitate student learning and to prepare them for further clinical and surgical education. Students are responsible for presenting seminars where they demonstrate their understanding of anatomy within a clinical case format.
The aims of Human Anatomy I (given in the first period) and Human Anatomy II (given in the second period) are to know the main aspects of regional anatomy and the relationships with the clinical diagnosis of major diseases that affect humans. Students also have guidance on anatomical dissection practices and the technical notion of invasive procedures, both diagnostic and therapeutic.
Our topographical approach focuses on the regional division of the human body and incorporates in its discussions the medical/surgical importance and applied anatomical knowledge. This provides students of medicine good learning conditions to study the subjects that are prerequisite: Medical Propedeutics, Neuropsicoimunologia and Operative Technique and Experimental Surgery.
We have 8 teachers and we count on the help of Teacher’s Assistants, who are selected through written test. These Teacher’s Assistants give us support in practical classes, help students in extra class schedules, organize symposiums and events in anatomy and perform the anatomoclinical sessions. The Teacher’s Assistants also participate in events outside the state of Amazonas, such as Brazilian Medical Education Congress.
The Federal University of Amazonas (UFAM) offers the discipline of Anatomy for various courses in the health area, which is offered according to the needs of each course as shown in the table below:
Degree in Sciences: Chemistry and Biology
Anatomy and Physiology
Fundamentals of Human Anatomy
Natural Sciences, Physical Education, Biological Sciences and Psychology
Fundamentals of Human Anatomy
Fundamentals of Human Anatomy
Functional Anatomy Neuroanatomy
It is noteworthy that these subjects offered by UFAM are not exactly the same for all federal universities in Brazil; however, there is equivalence of the nomenclature, workload and content approach. The Ministry of Education and Culture (MEC) is the institution which determines accreditation and coordination for all public and private universities.
Some studies published in Brazil show that anatomical teaching in our country began on 18 February 1808 by Decision No Régia. 2, D. João VI, the Bahia School of Surgery, was formed in Salvador, and over the years, other medical schools were opened in Brazil until today.
The Anatomy courses are divided into theoretical and practical classes. For lectures, we make use of Power Point and whiteboard. The classes are held in laboratories with real human specimens without using any advanced technology, such as 3D Dissection Tables. The human cadaver parts used for dissection are preserved in formaldehyde, alcohol and glycerine. When anatomical variations are found they are cataloged and published in appropriate journals.
The importance of the use of cadaver dissection is appreciated for providing a faithful model of the future student reality. UFAM has adopted these practices to help students of anatomy, favoring the development of teamwork, respect for the body, familiarization with the body, application of practical skills, integration of theory and practice and preparation for clinical work
To improve my performance in class, I participated for the first time in the 30th HAPS Annual Conference in May 2016 in Atlanta, Georgia. As a member of HAPS, I receive messages daily about novelties in anatomy, clinical discussions of best books tips, applications, websites and videos that is of great value to improve my knowledge in the area. I have a long way to go in higher education, and I know I can count on the support of HAPS and my fellow members to improve my teaching of one of the oldest arts in the world: Anatomy.
Quelly Shiave is a professor of anatomy at the Federal University of Amazonas (UFAM) in Manaus, Brazil.