The praxis and research of human anatomy through autoethnography.

Abstract

This thesis is in manuscript format, as per the guidelines of the College of Health Sciences of the University of KwaZulu Natal. It comprises five manuscripts that have been submitted to accredited journals for publication (one manuscript is currently in press and the others are awaiting final status after revisions were completed). The use of autoethnography as an approach is an emerging transformative field of study within the Health Sciences at Higher Education institutions and is a move away from the key traditional positivist models of research in the domain of anatomical education. This study with praxis and research at the nucleus, aimed to investigate the following: (i) challenges experienced in the teaching and learning of human anatomy; (ii) the views and perceptions of fellow colleagues regarding research in the domain of clinically applied anatomy and how this has impacted on their teaching practices; (iii) the opinions of senior anatomy instructors regarding the state of anatomical knowledge at their respective institutions; (iv) student attitudes and experiences regarding human cadaveric dissection through an analysis of their journal-reflective writings; and (v) the use of mobile devices by learners at a selected medical school. Each of these aims stated above were achieved through the articles which comprised the manuscript of this study. In the first manuscript, Bits, bytes and bones: An Autoethnographic Account of Challenges in Anatomy Education: Perceptions Emanating from a Selected South African University I describe the methodological approach of autoethnography, specifically as it applies to reflection and memory work, and describe how this style enabled me to interrogate the current challenges and dilemmas underpinning the research, teaching and learning practices within this discipline. This was done through the use of an exclusive autoethnographic approach which is a qualitative method of research that seeks to describe and examine personal experience to comprehend cultural practice. The autoethnographic study highlighted challenges experienced, and these included the shortage of cadaveric material for teaching and research, the subsequent implementation of medical software applications, deficiencies in the curriculum and the teaching of anatomy by scientist anatomists. The second manuscript was entitled Communities of Practice: a new methodology in anatomical research and teaching. In this the notion of collaborative autoethnography as a research method is introduced. In this approach, researchers worked in tandem with me to gather autobiographical material to analyse and understand their data collectively with each contributing to an understanding of the sociocultural phenomena.

This type of research allowed for in-depth learning about the self and others and fostered collaboration among researchers in this field of applied anatomy. The use of semi-structured interviews with coauthors (n=10) on co-written papers formed the essential method used in generating this article. The collaborative autoethnographic study revealed four important themes namely: the value of research collaboration; the impact of human anatomical variations; the association with medical and non-medical collaborators; and teaching practice emanating from collaborative research. In manuscript 3, Views of South African Academic Instructors regarding the Scholarship of Teaching and Learning in Anatomy Education, a reflective design is presented and it is understood that reflecting on teaching is commonly referred to as an essential practice for personal and professional development. Open-ended questionnaires were distributed to senior anatomy faculty based at the eight national medical schools in South Africa. The emerging argument in this paper is that educational research into the scholarship of teaching and learning anatomy includes engaging in discipline-specific literature on teaching, reflecting on individual pedagogical methods and communicating these findings to peers. In medical education, reflection has been considered to be a core skill in professional ability. Faculty teaching anatomy highlighted several challenges such as time constraints within the medical curriculum, the lack of cadavers to reinforce knowledge and lack of appropriately qualified staff in the delivery of the subject. The anatomy laboratory is an ideal setting for faculty/student interaction and provides important occasions to investigate active learning and reflection on anatomical knowledge. This forms the basis of the Manuscript 4, Reflective Journals: Unmasking student perceptions of anatomical education, in which seventy-five journals from medical and allied Health Science students were collected and analysed. Through the use of journal-reflective writing as a technique, student attitudes and experiences of human cadaveric dissection of anatomy were analysed. Student reflective journals highlighted the following themes which included (a) Dissecting room stressors, (b) Educational value of dissection , (c) Appreciation, Gratitude, Respect & Curiosity for the cadaver , (d) Positive and negative sentiments expressed in the dissecting room , (e) Benefit of alternate teaching modalities, (f) Spirituality/Religious Beliefs, (g) Shared humanity and emotional bonds, (h) Acknowledgement of human anatomical variations, (i) Beauty and complexity of the human body, and (j) Psychological detachment . For the final manuscript which forms this compilation, Anytime, Anywhere’: Tablet technology in Medical education, a questionnaire comprising both open and closed- ended questions was analysed from 179 (60 male; 119 female) second year medical students registered for the Anatomy course to establish the use of mobile devices by learners at a selected medical school. The themes that emerged from m-learning included students’ ideas on mobile device engagement, and propositions related to the advantages and challenges affecting use of mobile devices. The use of autoethnography as a research approach can be considered dissident, and an ‘anatomical turn’ in the praxis and research in the domain of anatomical education. This study highlights relevant contributions to the research, praxis (teaching and learning) of human anatomy through views of all significant role players – students, researchers and educators. The conceptual framework which was abstracted from the articles and the thesis in its entirety, offers significant understandings regarding the praxis and research of human anatomy within the context of educational theory.