Saturday, January 06, 2007

Australia's anatomy courses for doctors given an F by the students

Largely because of trendy bullsh*t teaching methods

Almost three in four medical students say they are taught too little anatomy during their medical degree - and more than a third don't even think they have been taught enough about how the body works to be a competent doctor when they graduate. A survey of more than 600 medical students also found more than half - 53.7 per cent - thought their knowledge of anatomy was inadequately assessed. And nearly 90 per cent of students agreed that the traditional, guided style of anatomy teaching was "more effective" than the alternatives.

In many medical schools, traditional teaching has been increasingly replaced by a self-directed process where students research topics themselves in groups. The findings - which have already been sent to the federal Government as part of a submission for its current review of medical school curriculums - are likely to reignite a controversy revealed in The Australian earlier this year, after senior doctors warned the state of anatomy teaching in Australia's medical schools was so bad that public safety was at stake.

The survey was conducted by the Australian Medical Students Association, partly in response to the revelations. Federal Education Minister Julie Bishop said the findings would be considered as part of the government review, which is due to report later this year. Ms Bishop called on medical school deans to consider the findings carefully. "If 75 per cent of medical students believe the quality of education they are receiving is wanting in some way, that should be taken seriously by our medical schools," Ms Bishop said. "It reinforces the Government's action in setting up this inquiry in the first place."

The survey found more than half the students also cited pharmacology and radiology alongside anatomy as subjects that were given too little time in courses. Many students also criticised selection interviews, with about a quarter saying they were not objective enough, and the trend to tutors who are not medically qualified.

And while most students were in favour of the modern problem-based learning techniques, the report found there was "significant room for improvement as 25 to 30 per cent of students didn't respond positively" to all questions on the topic.

AMSA president Rob Mitchell, a fifth-year medical student at Monash University, said the survey showed medical education was still of high quality. Overall, 71.3 per cent of surveyed students agreed their course would turn them into competent doctors. "There's a perception, and I emphasise it's a perception, that students don't receive enough anatomy teaching," Mr Mitchell said. But students also valued the newer subjects that had squeezed traditional subjects including anatomy - such as ethics, communication skills, and cultural awareness - and did not want them cut back.

Survey respondent Claire Wise, a fifth-year student at Monash, said she could "echo a lot of students' concerns" on anatomy teaching, which she said needed to be more guided and relevant. "When there's 10 students standing around a cadaver and dissecting a muscle, it's not as clinically relevant as when a doctor sits us down and tells us about a patient with a head injury he had last week, and which arteries were damaged, and we can see an MRI scan," she said. "We can relate it to a patient, and more time needs to be devoted to that."

Barry Oakes, a former associate professor at Monash University and a longstanding critic of the cutbacks to anatomy teaching, said universities had "failed miserably" to compile written benchmarks detailing what medical graduates needed to know.

Paul Gatenby, a member of the Committee of Deans of Australian Medical Schools, agreed time for anatomy and some other subjects had been cut back but said this was inevitable given the "explosion of medical knowledge in the past 50 years". "Is there so little anatomy taught that students are dangerous? I don't accept that at all," Professor Gatenby said.


Anatomy of a crisis: Medical students vent spleen at substandard teaching

(Editorial comment from "The Australian")

Eight months ago, The Australian reported that anatomy training was in many cases so poor that students could make it to the last year of medical school and not be able to visually distinguish between a beating heart and a liver, or correctly identify the location of the prostate gland. So it is not surprising to discover that Australians studying to be doctors are increasingly concerned they are not being taught the fundamentals, according to a survey just released by the Australian Medical Students Association. It does not make for happy reading. A majority of students do not feel their training places enough emphasis on vital subjects such as anatomy and pharmacology. About 30 per cent of students are neutral or pessimistic when asked whether they will leave college well-equipped to become competent doctors. And less than four in 10 respondents agreed that when they finished their medical course they would "know enough anatomy to become a competent doctor".

There are many reasons why medical students are not getting the training they want and so vitally need. Among them is a concern expressed by AMSA members that the Howard Government's drive to increase medical school places might ultimately come at a cost to quality. Culturally, too, medical schools have, like so many other institutions, fallen victim to the fashion for dismantling traditional structures without replacing them with anything similarly useful or effective. Thus traditional lectures have been replaced by such supposed innovations as problem-based learning, where instructors (who are often not doctors) are not allowed to tell students what is right and what is wrong, leaving them to work it out for themselves. Hard science must compete with an increasing emphasis on soft topics such as cultural sensitivity. Certainly medicine is about more than just mechanics, and doctors should be trained to deal with patients' minds as well as their bodies. But while humanities courses can be watered down without harming anyone beyond those paying for the degrees, medicine is a serious business. To go down the same soft road in medical faculties is to write a prescription for disaster.


Greenie dam-hatred finally starts to turns off taps

Some Brisbane households may soon not have enough water pressure to run taps after City Hall admitted to progressively turning down the mains pressure under a radical scheme to conserve water. Brisbane City Council water spokeswoman Jane Prentice also said residents would have to personally foot the bill to increase pressure by purchasing a booster pump, at a cost of up to $1000. The pump would also need to be installed by a plumber and electrician.

Those likely to be most affected will be residents of apartment buildings and homes on hillsides and hilltops, along with homeowners whose renovations included the installation of extra upstairs faucets. Cr Prentice said some inner-city areas had been secretly tested and a full roll-out would be completed by mid-year. She said council would notify major industry in coming weeks and homeowners over the next two months. "We will be giving plenty of notice that the pressure is being reduced and homeowners may have to put in booster pumps," she said. [How kind!]

Brisbane's ageing inner-city water pipes leak up to 13 million litres a day. Stopping that would help the municipality hit stringent State Government water-saving guidelines. As The Courier-Mail reported yesterday, the Queensland Water Commission this week slammed councils for having fallen behind their target to save 62 megalitres of water per day by fixing leaks and pressure.

Cr Prentice said water pressure delivered to a property's boundary would not fall below the national standard of 210kPa, or the strength to shoot a column of water 21m into the air at the property's boundary. However, she conceded that it could drop below that mark once inside the boundary. Brisbane properties currently receive over 300kPa. "Some people at the bottom of the hill (currently) get lovely pressure but at the top sometimes you need a pump," Cr Prentice said. "We have found old apartments are unlikely to have the boosters and that water pressure can drop out in an upstairs ensuite for example. "This is particularly evident for those people who have renovated and live on hillsides. But I don't think it will affect many people. Some people might find it is under the 210kPa by the time it gets up the hill or to the top of the house, but it is only the Council's responsibility to deliver national standards and we will do that."


Conservative cartoons rare in Australia

Why do Australia's leading cartoonists favour a left-wing point of view? asks Janet Albrechtsen. She seems to overlook that there are quite a few American conservative cartoons

There is nothing like an end-of-year anthology to collect all the evidence. Each morning during the past year, many of you, like me, will have tucked into your Cornflakes and chuckled at your favourite cartoonist in the morning newspaper. Taken individually, each cartoon took a well-aimed pot shot at a deserving target. But you, like me, probably had a nagging suspicion that something was missing. Then it dawned. All the pot shots seem to come from one side of politics. And all the targets from the other. Is there no such thing as a conservative Australian humorist?

The anthology that inadvertently assembles the evidence is the Best Australian Political Cartoons of 2006 edited by Russ Radcliffe. This collection of witty, occasionally hilarious, sometimes magnificently insightful cartoons sums up the year's events as seen by cartoonists from our major, and sometimes minor, newspapers.

Perhaps the pick of the bunch is by Andrew Weldon in The Big Issue, a newspaper sold on street corners. Weldon depicts John Howard's growing political stature with a handy chart that shows the ever-increasing tendency of cartoonists to draw Howard as a small man - he shrinks every year - only increases his electoral appeal. It's a neat thesis topped off with a plea for cartoonists to start drawing the Prime Minister as a tall man, in the hope that his popularity will then shrink. Funny stuff.

But the gaping hole is that one side of politics gets off almost entirely scot-free. Of the 186 cartoons, the few that mock Labor do so from the Left, attacking former Opposition leader Kim Beazley over his Australian values-for-visas policy (admittedly a dopey idea). We are treated to images of him in a scratching, clawing punch-up with Howard as the two leaders apparently fight for the same xenophobic moral low-ground over national identity. There's another one with the same leaders belting out their own dog whistle politics via a trumpet. Funny, huh?

While both cop it from the cartoonists over Australian values, when it comes to other issues, the poison pen of the cartoonists in this collection is aimed only in one direction - to the Right. The top picks of the year on anti-terrorism laws, for example, have Australia literally going to the dogs with the PM and Attorney-General Philip Ruddock suckling a fierce "terror" Rottweiler. Bill Leak's sedition edition of The Australian is blank with a chuffed PM remarking that there is "nothing to worry about in the paper today". Too bad that the average punter apparently supports these laws by a wide margin.

Similarly, the top 14 pick of industrial relations cartoons all veer in the same direction. It's fair enough that The Age's Matt Davidson has Howard, the sculptor, chipping away at a statue emblazoned with "Workers' Rights". And that The Sydney Morning Herald's Alan Moir has Howard and a group of raping, pillaging Viking employers behind a cannon blasting employees to smithereens. And so on.

But where is the lampooning of Labor's fraudulent IR campaign, its symbiotic relationship with the unions or the irony that the so-called progressives now want to drag 21st-century workers back to the 1950s nine-to-five salaryman paradigm? On Iraq, no mention of Labor's white flag cut and run policy. Instead, we get a Left-Wing Garage Sale from The Age's John Spooner where "everything must go" - secular humanism, free speech, feminism, democracy and science. Labor's farcical leadership problems get a passing stab but what of its retarded policy on uranium mining and its agonies over teacher standards? Where are the digs at Labor's new-found recognition that passive welfare hurts? And so on.

And the Greens demonstrate even more powerful layers of Teflon. With nutters on the Left of the calibre of Bob Brown, you might think it rich pickings for our cartoonists. But Green hyperbole and inner-city populism gets a free kick every time. It seems the further to the Left you travel, the more untouched the terrain when it comes to our cartoonists.

It is possible that the fault lies with the anthologist. Maybe Radcliffe is simply a hopelessly irredeemable old leftie whose funny bone only works when struck from one side. And true it is that a conservative government in Canberra will inevitably mean anti-conservative japes are more topical and easier to make. But does that explain why apparently only one side of politics does lampoonable things?

No. Sadly the best explanation is likely to be the obvious one. There are no conservative funny men, or women, in Australia. Or at least none that our publishers and broadcasters will air. Sure, there used to be at least the token right-wing humourist. But even those guys - such as Tim Blair, former columnist at The Bulletin and now opinion editor at The Daily Telegraph and The Australian's Imre Salusinszky - have moved on to bigger and better things. Indeed, with this cartoon anthology slotting snugly into those shelves of your local bookstore, groaning under the weight of the latest diatribes against the nasty conservatives, you kind of get the feeling that Australian publishers can't find any right-wingers at all, funny or not.

But back to our best cartoons of 2006. To borrow from Julius Sumner Miller, why is this so? Can it really be the case that more than 52 per cent of voters who elected the Coalition Government don't enjoy cartoons, or that cartoonists can't find something that might appeal to them. The editorial stance of newspapers is at most only a partial explanation - although no one seriously expects The Age to poke fun at their secular gods on the Left.

Nor is this some wacky conspiracy where, in the dead of night, scruffy cartoonists sit around planning how to join forces to shift the country on their pet issues. Cartoonists, no doubt, sincerely believe in their causes. The explanation lies not in some cartoonists' conspiracy, but in the cartoonist's cast of mind. There is a natural leftist habitat for the cartooning kind.

So I'll leave you with a larger but somewhat cheeky hypothesis. Left-wing politics is essentially an emotional, instinctive utopian kind of world peopled by romantics and dreamers. Conservatism is, on the other hand, more rational, analytical and pragmatic. That is why creative types tend to come from the Left. Right-wingers, by contrast, have real jobs.


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