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The Yale System is far less rigid and stressful than other approaches to medical education, but that doesn’t mean it’s haphazard. Human Anatomy and Development, for example, is a unique, thoughtfully constructed course using dissection, radiology, and computer activities to solve problems about spatial relationships, structure-function relationships, and the anatomical underpinnings of clinical diagnosis and pathogenesis. The course is fully integrated with an introductory course in radiology–a linkage that is unparalleled in other medical schools and that is enthusiastically praised by graduates. “Our goals are to teach students to think and reason in three dimensions,” says Lawrence Rizzolo, Ph.D., course director and director of medical studies for the Section of Anatomy and Experimental Surgery. “All clinicians need these skills, be they laparoscopic surgeons who look at two-dimensional monitors but move their instruments in a three-dimensional space, or radiologists who look at two-dimensional shadows and stacks of two-dimensional images but see in their mind’s eye a three-dimensional image, or neurologists who examine movements of the hand but ‘see’ injured tissue in the neck. This kind of seeing requires a dynamic, functional understanding of the anatomy, a mental image that can be rotated and sectioned in any plane. Just as language cannot be learned by memorizing lists of words–conversation requires practice using words in context–anatomy cannot be learned by memorizing names of bones. Students have to practice solving anatomy problems in three dimensions.” In fact, anatomy at Yale is even more than training in problem solving. The faculty recognizes that dissection of a cadaver can be an emotional experience as well as an intellectual one, and they use the opportunity to discuss issues of objectivity, individuality, empathy, respect, and self-reflection. Hospital and university chaplains, social workers, and clinicians speak with the students about care for the seriously ill. The course serves as the introduction to a coordinated four-year effort to teach care of the dying patient. Recognizing the cadaver as an individual’s gift to medicine, students begin to learn that they must never lose sight of the whole person. Rizzolo says, “About midway through the year, we encourage students to organize an end-of-year service of gratitude. Preparing this service is another way to promote self-reflection. Through prose, poetry, music, and art, these talented students express their joys, gratitude, self-doubt, anguish, and ethical conflicts. It is both brutal in its honesty and inspiring in its thoughtfulness.” |
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Last modified: Wednesday, 11-Aug-2004 14:59:39 EDT. (PL) |