A multi-method study to explore perceptions and attitudes towards neuroanatomy in an undergraduate medical curriculum

Abstract

Human anatomy is a core module of the medical curriculum. Anatomy lecturers are expected to teach clinically-relevant content, while utilising interactive and student- centred teaching methods and approaches. This teaching and facilitation must happen in the context of decreased curriculum hours while credits remain mostly unchanged. Therefore, a dire need exists to explore the various teaching modalities currently used in medical education, to improve the teaching and facilitation of anatomy, and more specifically, neuroanatomy.

Neuroanatomy tends to be challenging for students. Their inability to integrate the basic concepts with the clinical environment could lead to the development of a negative attitude or fear towards neuroanatomy (neurophobia). Neuroanatomy provides exceptional opportunities for the integration of basic- and applied concepts, however, the teaching approaches and time allocated to this subject has a large influence on how staff and students perceive neuroanatomy and the teaching thereof.

A multi-method research study was conducted to explore the attitudes of anatomy lecturers, undergraduate- and postgraduate students towards the teaching and learning of neuroanatomy in the medical curriculum. This study further explored the perception of students on the importance of neuroanatomy as it relates to their future careers. The sample constituted four groups: Nineteen neuroanatomy lecturers from various medical schools in South Africa, five postgraduate neuroscience students and 299 undergraduate medical students from the University of Pretoria, as well as two international key-opinion leaders in the field of neuroanatomy education and neurophobia. Various methods were used for data collection which included online questionnaires, focus-group discussions, round-table discussions and semi-structured interviews.

All the neuroanatomy lecturers acknowledged that neuroanatomy is important in their students’ medical training. However, only a few deem it necessary to modernize their teaching approaches to be more suitable for the 21st century student. Information of the medical neuroanatomy curriculum and teaching practices at the institutions were gathered, which was then benchmarked against various international medical schools’ curricula. One-directional didactic lectures and guided dissection are mainly used for undergraduate neuroanatomy teaching. This indicated a need for more innovative, technology-supported teaching methods better suited for the 21st century medical student in South Africa.

Undergraduate medical students preferred lecture notes to other literature types while their most favourite topic was cranial nerves. The postgraduate students shared their undergraduate neuroanatomy experiences and provided constructive feedback and suggestions to undergraduate students and lecturing staff. These students perceive neuroanatomy as an interesting and important subject in their medical degree stating, however, that changes are needed to modernize neuroanatomy and make it more accessible and student-friendly.

The interviews with the experts yielded three themes namely the teaching practices in neuroanatomy, perceived relevance of neuroanatomy within the medical curriculum and the perception of neurophobia. The participants had opposing views on teaching approaches and the relevance of neuroanatomy in the undergraduate medical curriculum. However, they had similar opinions on neurophobia, its impact on the undergraduate medical students and possible preventative measures.

This study highlighted that there is neither a single best teaching method for neuroanatomy, nor does it need to be a modern teaching approach, but rather student- centred. Therefore, by reflecting on our own perceptions, attitudes and teaching approaches for neuroanatomy, and by making the necessary changes, we can help our students overcome this fear for the neurosciences.