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Chiropractic Journal of Australia : CJA June 2013
Chiropractic Journal of Australia Volume 43 Number 2 June 2013 81 ANATOMY BASED RESEARCH PROJECTS Anatomy can play a signifcant role in teaching about research. Indeed, anatomy education has endured numerous changes in recent years. Traditionally, anatomy was perceived as a dry and difficult subject, burdened with irrelevant detail, where rote learning and endless repetitions were the main modes of acquiring new knowledge. However, anatomy has in recent years transformed into a discipline taught in numerous innovative ways which have positively transformed learning experience and at the same time raised the students’ awareness of anatomy’s applicability and clinical relevance.8,9 Furthermore, anatomy is now seen as a medium in which competencies other than anatomical, such as clinical capabilities, research skills and professionalism, could be effciently introduced and developed.8,10,11 As described in a previous publication,11 at Macquarie University anatomy contributes towards development of research skills for chiropractic students at both undergraduate and postgraduate levels. At the undergraduate level basic concepts of scientifc research are introduced whilst at the postgraduate levels more complex concepts and skills are taught. Anatomy based research projects, outlined in this paper, are examples of anatomy's contribution to research skills development at the postgraduate level. In 2012, two anatomy based projects were carried out by two groups of the fnal year students. The frst project was in clinical anatomy and focused on establishing the correspondence between multifdus muscle atrophy and intervertebral disc degeneration. The students analysed T2- weighted axial MRIs of patients presenting with low back pain. The severity of disc herniation was graded at the L4/ L5 segmental spinal level and related to the total multifdus cross-sectional area and functional muscle cross sectional area. These were measured with the OsiriX – DICOM viewer. This study was, in fact, the frst to formally demonstrate a relationship between multifdus atrophy and severity of disc degeneration. The second project was forensically orientated. Macquarie University has a small osteological collection, which represent a valuable resource in anatomy teaching. Most of the bones from the collection, however, are of unknown provenance as they were donated, mainly by practitioners, at various dates in the past. The students’ task was to make an inventory of the bones and carry out an analysis in which they were to establish the minimal number of individuals, sex, ancestry and the presence of pathologies. They utilised the recently published Osteoware software to record and publish the data. The creation of a database in Osteoware provided a foundation for more specialized research on the collection in the future. Both projects required signifcant revision of relevant anatomy and application of the knowledge of anatomical structure within the clinical and research contexts. They also provided signifcant results and were successfully presented at an international conference in anatomical sciences the same year.12,13 Following the strategy implemented last year, in 2013, several projects focusing on morphological variation in cervical vertebrae are being carried out. Anatomical variations, the importance of which is traditionally undermined in anatomy education,14,15 are potentially of great signifcance in clinical context and need to be investigated thoroughly. CONCLUSIONS Completing a research project in the fnal year of the chiropractic studies is the concluding step in the process of research skills development at Macquarie University. Anatomy based research projects add another educational value to this process – they are an effcient and engaging way to revise anatomy knowledge adopted in the early years of study. Indeed, both research skills and solid knowledge of basic sciences, particularly anatomy, are among the key prerequisites for the development of clinical competencies of a modern chiropractor. REFERENCES 1. World Federation of Chiropractic 2001. Defnition of Chiropractic. http://www.wfc.org/website/WFC/website.nsf/WebPageDefini- tionOfChiropractic? OpenDocument [accessed 9 April 2013] 2. Custers EJFM. Long-term retention of basic science knowledge: a review study. Adv Health Sci Educ 2010;15:109-28. 3. Štrkalj G, Beirman R, Štrkalj M. Teaching anatomy to chiropractic students: experiences from Macquarie University, Sydney. Explore: J Sci Healing 2012;8:141-4. 4. Mather G, editor. Research enhanced learning and teaching: learning through scholarship. Sydney: Macquarie University; 2011. 5. Straus SE, Richardson WS, Glasziou P, Haynes RB. Evidence-based medicine: how to practice and teach EBM. 3rd ed. Edinburgh: Churchill Livingstone; 2005. 6. Haneline MT. Evidence-based chiropractic practice. Boston: Jones and Burtlett Publishers; 2008. 7. Meeker WC, Haldeman S. Chiropractic: a profession at the cross- roads of mainstream and alternative medicine. Ann Intern Med 2002;136:216-27. 8. Louw G, Eizenberg N, Carmichael S. The place of anatomy in medical education: AMEE Guide no 41. Med Teach 2009;31:373–86. 9. Sugand K, Abrahams P, Khurana A. The anatomy of anatomy: a review for its modernization. Anat Sci Educ 2010;3:83–93. 10. Lachman N, Pawlina W. Integrating professionalism in early medi- cal education: the theory and application of refective practice in the anatomy curriculum. Clin Anat 2006;19:456–60. 11. Štrkalj G, Serafn S, Štrkalj M. Using anatomy education to develop the research skills of chiropractic students. In: Giardino AP, and Giardino ER, edsitors. Medical education: global perspectives, challenges and future directions. New York: Nova Science Publishers (in print). 12. Benson T, Court C, French KJ, Saville S, Serafn S, Štrkalj G. MRI investigation of the relationship between lumbar disc degeneration and multifdus atrophy. Clin Anat (in print). 13. Danilovic M, Hussein K, Jamal-Eddine W, Lam D, Matkovic P, Casey M, Serafn S, Štrkalj G. Anthropological analysis of the skeletal col- lection of the chiropractic department of Macquarie University. Clin Anat (in print). 14. Štrkalj G, Spocter MA, Wilkinson AT. Anatomy, medical education and human ancestral variation. Anat Sci Educ 2011;4:362-5. 15. Bergman R. Thoughts on human variation. Clin Anat 2011;24:938-40. ANATOMY BASED RESEARCH PROJECTS GORAN ŠTRKALJ • MARIAN CASEY
CJA March 2013
CJA September 2013