Medical School Course Research Articles

The Visible Human Project.

This paper gives a flavor of Dr. Donald A.B. Lindberg’s view of the expanding role of libraries, his curiosity, and his tolerance for taking educated risks, through the creation and nurturing of National Library of Medicine’s Visible Human Project. That project produced the Visible Man and Visible Woman datasets and a suite of tools for presenting and analyzing those and similar datasets. The results are used in teaching anatomy and other medical school courses and in software from the open-source Insight Tool Kit (ITK) that is included in many if not most volume-reconstructing systems. This story is a bit personal. From the beginning we recognized and understood each other since we were both “boys from Brooklyn”.

Obesity Stigma in Anatomy and Osteopathic Manipulative Medicine

Weight stigmas are discriminatory ideologies targeted towards individuals because of size. Medical students are not immune to bias and prejudiced treatment of patients by physicians is often a result of stigmas.1 Medical students must confront bias so as not to compromise appropriate medical care. Given the holistic approach of osteopathic medicine, osteopathic medical students should be trained on biases and how to best mitigate them. Several studies have focused on overcoming weight stigmas but with marginal success2,3. Weight stigmas arise in several medical school courses including anatomy and osteopathic manipulative medicine (OMM). Data show medical students perceive cadavers with excessive weight as “difficult”, “unhealthy”, and “evoking disgust”.4 Although these studies do provide information regarding weight stigmas in medical schools, the limited focus on osteopathic schools is what garners interest. The purpose of this study is to assess how obesity stigma arises in OMM, a course reliant on surface anatomy.An extensive literature review was conducted for body and weight stigma in OMM, producing no results. Further investigation into body and weight stigmas in OMM will occur through a survey of first and second year osteopathic medical students. A sample of the survey questions: ‐Do you feel BMI is a valid measure for overall health? ‐Do you feel the Osteopathic Manipulative Treatment you perform on an athletic individual would be the same quality and as treatment performed on an overweight individual? ‐Do you have concerns about treating overweight patients with OMM? Analysis of survey results will be available by presentation time.Current results include qualitative observation, and following are some of our resultant data: ‐Faculty members commenting on a student used for an OMM demo as being “fit and athletic” ‐Students expressing concern about difficulty finding anatomical landmarks on an overweight student ‐Observations that the largest student in the class was not chosen quickly as a practice partner Future directions of this study following survey results could lead to curricular changes that address weight stigmas or prevent them to uphold the tenets of osteopathic medicine and its commitment to holistic care and inclusivity. Based on data from the CDC, the average male’s BMI is 26.6 and the average female’s BMI is 26.5; therefore, the average patient physicians treat is overweight. When medical students begin practicing with obesity stigmas, the effective and empathic care of patients is compromised. Something must be done to reverse the stigma and even prevent the stronghold it could occupy in future physicians. Action can be taken in the both the anatomy and OMM labs. Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. obesity reviews, 16(4), 319‐326. Wiese, H. J., et al. (1992). Obesity stigma reduction in medical students. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity, 16. Alberga, A. S., et al. (2016). Weight bias reduction in health professionals: A systematic review. Clinical Obesity, 6. Goss, A. L., et al. (2020). The “difficult” cadaver: weight bias in the gross anatomy lab. Medical education online, 25(1), 1742966.

Trauma-Informed Care in the Classroom: Our Experience with a Content Warning in a Medical School Course.

The online version contains supplementary material available at 10.1007/s40670-022-01559-0.

Implementation of team-based learning (TBL) in a second year medical school course: does prior experience with TBL improve the impact of this pedagogy?

BackgroundWe have shown that use of Team-based learning (TBL) in a first-year Infectious Diseases (ID) course improved final examination and course performance. Therefore, we implemented TBL in the second-year Women’s Health (WH) course to improve acquisition of course content. We hypothesized that prior experience with TBL in the first-year of medical school would lead to a strong correlation between TBL performance in the first and second years.MethodsOur study is a retrospective review of student TBL and final examination performance in the ID and WH courses. The ID course has weekly TBL exercises that cover all course material, while the WH course has one TBL that covers a small portion of the course material. Final examination and TBL individual readiness assurance test (iRAT) scores in the ID and WH courses from three classes (n = 226) were obtained with institutional review board approval. Statistical analyses were performed including comparisons of means and correlation studies.ResultsAverage WH iRAT scores were significantly higher than ID iRAT scores (9.19 vs. 7.40,p < 0.01), and iRAT scores in both courses were highly correlated (r = 0.35,p < 0.01). When stratifying students based on WH course performance, in struggling students, iRAT but not final examination scores were higher in the WH course than the ID course (8.73 vs. 7.00,p < 0.01 and 82.45 vs. 80.51,p > 0.05, respectively).ConclusionsOur results suggest that prior experience with TBL improves TBL iRAT scores, especially in struggling students. Prior TBL experience is also associated with consistent iRAT performance between first- and second-year courses in high performing students.

Medical students\u2019 self-evaluation of character, and method of character education

BackgroundAs medical doctors must have a strong sense of ethics, character education is particularly important for them compared with other professions. This follow-up study aimed to establish the foundation for developing a character education program in medical schools by (1) conducting a survey among medical students on the self-assessment of one’s character based on eight qualities (service and sacrifice, empathy and communication, care and respect, honesty and humility, responsibility and calling, collaboration and magnanimity, creativity and positivity, patience and leadership), the perceived importance of character, and satisfaction with character education at medical school, and (2) analyzing the usefulness of learning methods for acquiring character elements. It also aimed at verifying the (3) gender differences in self-evaluation of character elements, and (4) academic-year differences in the survey items.MethodsMedical students’ perceptions were identified through a questionnaire survey among 856 medical students from five South Korean medical schools. The questionnaire comprised items on the achievement level of the character element, importance of character in the medical curriculum, satisfaction with character education in medical schools, and the learning method’s degree of helpfulness. Descriptive statistics, t-test, and one-way ANOVA were used to compare responses.ResultsThe importance of eight-character qualities had high average scores, whereas the average scores for satisfaction with character education and achievement level were comparatively low. For the question on each learning method’s helpfulness in gaining the eight-character qualities, the score of team-based learning activities was the highest, followed by club activities, relationships with peers, role modeling of professors, and course study. Regarding satisfaction with character education, male students gave higher scores than female students, manifesting a statistically significant difference. Regarding the importance of the character element in medical education, statistically significant differences existed based on academic year.ConclusionMedical students’ perceptions of character education varied according to gender and academic year. They regarded character education highly but were unsatisfied with the current character education at medical schools. Thus, diverse character education curricula must be developed and implemented along with extra-curricular character programs. An effective approach to implementing character education can be discovered by verifying the differences in students’ perceptions based on the character education courses in medical schools.

Evaluating Online Learning Strategy and Assessment Methods in the Course of Human Biology for the Preparatory Year Medical Students During COVID-19 Pandemic Lockdown

Since the lockdown caused by the COVID-19 crisis, there has been insufficient reporting regarding the evaluation of students’ performance in biology courses in medical schools. This study is designed to evaluate the online learning strategy by examining its effects on preparatory medical students’ performance. The target population included preparatory year medical students (n = 115) at Fakeeh College for Medical Sciences in Saudi Arabia. The human biology course (15 weeks) was taught using two different teaching strategies due to the lockdown and home-schooling decision. The first eight weeks were conducted on campus and the remaining seven weeks were conducted using online interactive lectures and virtual classrooms via Blackboard platform. The latter is the formal platform used by the college for online teaching. Continuous and final assessment results were used to assess student performance and to evaluate the effects of online learning on students’ knowledge and skills. The results of the final examinations demonstrated a significant increase (p &lt; 0.05) in student performance. The mean of the students’ scores increased by 1.28 in the final examinations compared to the midterm examinations for female students (n = 73). Similarly, there was a significant increase in the male students’ scores in the final examinations. The mean increased by 1.24 in the final compared to the midterm examination for male students (n = 42). Online assessment tools are proved to be successful assessment methods and could provide additional non-traditional methods for students’ performance evaluation. Furthermore, with online learning and assessment, students’ performance is enhanced.

Lessons from designing a medical school course on mortality.

Medical EducationVolume 56, Issue 5 p. 566-566 REALLY GOOD STUFF Lessons from designing a medical school course on mortality Paul W. Horak, Paul W. HorakSearch for more papers by this authorHenry Bair, Corresponding Author Henry Bair hbair@stanford.edu orcid.org/0000-0002-3422-0373 Correspondence Henry Bair, 1704 Oak Creek Drive, Unit 403, Palo Alto, CA 94304, USA. Email: hbair@stanford.eduSearch for more papers by this authorPeter Pompei, Peter PompeiSearch for more papers by this authorMichael A. Gisondi, Michael A. Gisondi orcid.org/0000-0002-6800-3932 Search for more papers by this author Paul W. Horak, Paul W. HorakSearch for more papers by this authorHenry Bair, Corresponding Author Henry Bair hbair@stanford.edu orcid.org/0000-0002-3422-0373 Correspondence Henry Bair, 1704 Oak Creek Drive, Unit 403, Palo Alto, CA 94304, USA. Email: hbair@stanford.eduSearch for more papers by this authorPeter Pompei, Peter PompeiSearch for more papers by this authorMichael A. Gisondi, Michael A. Gisondi orcid.org/0000-0002-6800-3932 Search for more papers by this author First published: 01 March 2022 https://doi.org/10.1111/medu.14767 Paul W. Horak and Henry Bair contributed equally to this work. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume56, Issue5May 2022Pages 566-566 RelatedInformation

Teaching medical statistics to undergraduate medical students: what is taught and what is really useful for a medical professional? A report of the Education Committee of the Italian Society of Medical Statistics and Clinical Epidemiology (SISMEC)

&#x0D; Background: There is a large heterogeneity among the courses of medical statistics in Italian Medical Schools. &#x0D; Aims: (1) To describe issues that are dealt with in the statistics undergraduate medical courses in Italian medical Schools. (2) To investigate which methodological topics are deemed as more useful for the education of undergraduate medical students by clinical teachers. &#x0D; Methods: (1) An online questionnaire, covering the qualifying teaching issues of medical statistics, was sent to all academic biostatisticians, asking what they were teaching to undergraduate medical students. The reference year was 2015-2016. Undergraduate medical courses were the statistical units. (2) A second survey involved teachers of other medical disciplines with institutional roles, asking to score the usefulness for medical education of a number of topics concerning medical statistics, on a 5-point Likert scale. Only descriptive analyses were performed. &#x0D; Results: Fifty-two (96%) case report forms (CRF) were returned from teachers of medical statistics. Most statistical and epidemiological topics were taught except comparison of &gt;2 groups, impact of biases and standardization of rates. Conversely, issues of clinical epidemiology were neglected in about half of degree courses. &#x0D; Thirty-three (31%) CRFs were returned from clinical teachers. The percentage of issues deemed very useful or essential ranged from 57% to 94%, with higher scores for those referring to critical assessment of the literature. &#x0D; Conclusions: More extensive coverage of clinical epidemiology issues is needed to meet the demand of physicians, as responsible consumers of quantitative research. As biostatisticians we should operate to increase the homogeneity of medical statistics teaching in medical undergraduates’ education&#x0D;

The Visible Human Project.

This paper gives a flavor of Dr. Donald A.B. Lindberg's view of the expanding role of libraries, his curiosity, and his tolerance for taking educated risks, through the creation and nurturing of National Library of Medicine's Visible Human Project. That project produced the Visible Man and Visible Woman datasets and a suite of tools for presenting and analyzing those and similar datasets. The results are used in teaching anatomy and other medical school courses and in software from the open-source Insight Tool Kit (ITK) that is included in many if not most volume-reconstructing systems. This story is a bit personal. From the beginning we recognized and understood each other since we were both "boys from Brooklyn".

Declining Student Performance and Satisfaction following Back-to-Back Scheduling of Foundational Science Exams: Experience at a Large US Osteopathic Medical School

Examinations are a significant source of academic stress, particularly in the demanding environment of medical education. In order to reduce the burden of anxiety, burnout and depression among students, medical schools aim at reducing academic stress by exploring alternatives to frequent, high-stakes assessment schedules. The bundling of examinations into integrated block assessments has emerged as a successful strategy to reach this goal, as the resulting reduction in examination days can provide uninterrupted periods of study time that allows for a deeper understanding of material as well as an opportunity for students to take wellness breaks between exams. The present study examines the outcomes of a natural experiment on back-to-back exam scheduling in two related medical school courses post hoc. The outcomes of the scheduling change on the academic performance and satisfaction of examinees were analyzed with a mixed-methods approach. The data show that the transition from a spaced-out to a back-to-back exam schedule was accompanied by a drop in academic performance and student satisfaction with the curricular schedule. The data presented suggest that without proper curricular integration, the block scheduling of exams has negative effects on learning outcomes and student satisfaction.

Does medical school cause depression or do medical students already begin their studies depressed? A longitudinal study over the first semester about depression and influencing factors.

In the past, medical students have been found to be at increased risk for depressive symptoms compared to the general population. This study addresses the question, whether medical students already show these elevated depression scores at the beginning of medical school or whether it is the studies of medicine that leads to symptoms of depression. In the winter semester 2018/2019, 148 medical students at a middle-sized German university answered a questionnaire during the first (T0) and last week (T1) of their first semester that examined various risk and resilience factors for initial depressive symptoms and their course. The severity of symptoms was assessed with the Beck´s Depression Inventory II (BDI-II). A subscale of the NEO-FFI was used to investigate the personality factor neuroticism. Over the study period, the percentage of students suffering from at least mild depressive symptoms increased from 16.3% in the first week of their studies (T0) to 21.4% at the end of the first semester (T1). The use of drugs or medication, loneliness, mental overload, performance pressure and financial burden show the strongest influence on the development of depressive symptoms. Concerning surveyed resilience factors, in particular emotional support, physical workout and sufficient time for social contact appear to be protective. The more risk factors are concentrated on an individual, the higher its increase of depressive symptoms. The opposite is prevailing for the investigated resilience factors. Except for the use of drugs or medication, no other criterion than the BDI-II value at T0 was able to predict the BDI-II score at T1. This underlines that especially the interplay of factors is decisive. The findings of this study could indicate a worsening tendency of the BDI-II score in the further course of medical school. Ultimately, we emphasize the importance of offering preventive measures to medical students as early as possible.

Os desafios para o ensino de emergências de psiquiatria em desastres e conflitos armados

Abstract: Introduction: The Mozambican population has been recurrently affected by traumatic situations due to natural (cyclones, droughts, floods) or man-made (armed conflicts) catastrophes, which can lead to the development of mental disorders that, if not identified and treated, result in severe sequelae and cause chronicity. Objectives: To promote a reflection on the inclusion of emergency psychiatric topics in natural disasters and armed conflicts in the disciplines or modules of psychiatry in undergraduate medical school courses in Mozambique. Methods: Narrative literature review carried out between April and June 2021, focusing on the research of articles and documents published on the virtual platforms Research4life, PubMed, Hifa-PT, Google Scholar and that address the topics of natural disasters and armed conflicts and the teaching of these topics to medical students in the discipline of psychiatry. Results: The inclusion of psychiatric emergencies in situations of natural disasters and armed conflicts in the medical course can provide general practitioners who work in primary health care with knowledge and skills to recognize and act in psychiatric emergencies caused by natural disasters and armed conflicts, taking into account the fact that the country currently has few doctors specialized in psychiatry. Final considerations: The adequacy of the organization and assistance in psychiatric emergencies to the population exposed to natural disasters and armed conflicts contributes to the resilience and protection of the mental health of the communities. In this article, we reflect on the challenge of incorporating the topics of psychiatric emergencies caused by exposure to natural disasters and armed conflicts as a contribution to improving the skills of general practitioners in responding to the pressing mental health demands of this vulnerable population.

The Case for a True Task-Based Curriculum for Medical Spanish Courses

Issue For decades, professional healthcare schools have invested considerable time and resources into the development and implementation of medical Spanish courses. However, most (if not all) of these courses and programs were developed without significant input from experts in the fields of applied linguistics and second language acquisition (SLA). This resulted in programs and courses which differ in every conceivable way, most notably in course objectives, course content, and assessment measures. Despite multiple calls by applied linguists over the years, there has never been a systematic evaluation of medical Spanish programs through the lens of applied linguistics. The literature to date also demonstrates a near-complete absence of collaboration between medical school faculty, applied linguists, and language teachers, furthering the divide between what is now well-documented in the applied linguistics and SLA literature and the reported classroom practices in the medical Spanish context. Evidence This article begins by contextualizing the development of medical Spanish courses under a backdrop of a critical need for multilingual medical professionals to better address documented healthcare disparities for Low English Proficiency (LEP) Spanish speakers, a steadily growing population in the United States. Then, the article introduces Task-Based Language Teaching (TBLT) as an opportunity for unprecedented collaboration between healthcare practitioners, medical Spanish course instructors, and applied linguists to improve medical Spanish curricular offerings. It goes on to identify specific opportunities for collaboration between medical Spanish professionals (instructors, course designers, program administrators) and applied linguists by highlighting three major areas for further development in the medical Spanish context. This collaboration would result in a pedagogical framework strongly rooted in applied linguistics research findings with direct, measurable impacts on both L2 Spanish learners in medical Spanish courses and the patients they will serve. Implications Based on identified opportunities for curricular and programmatic improvement in published medical Spanish course reports, this article provides a rationale for TBLT as well as an overview of the process of TBLT course development. This detailed overview of TBLT course development with specific reference to the medical Spanish context presents an argument for the adoption of TBLT as an evidence-based and pedagogically viable alternative to current course offerings in medical Spanish programs. This article aims to identify a clear path forward to enable medical school program administrators and course and curriculum designers to take concrete steps to align courses with current best practices in second language pedagogy in order to optimize Spanish learning outcomes for their programs’ specific students.

Virtual medical student dermatologic surgery workshop increases confidence in suturing and skin biopsy skills in the era of COVID-19

Background: During the COVID-19 pandemic, many pre-clinical medical school courses were conducted virtually. In order to increase exposure to basic procedures in the remote learning setting, our group developed a virtual dermatologic surgery workshop.&#x0D; Objective: To evaluate whether a virtual dermatologic surgery workshop increases medical student confidence in their ability to perform suturing and skin biopsies.&#x0D; Methods: All 147 second-year medical students at the University of Pittsburgh watched 70 minutes of pre-recorded lectures that introduced suturing, skin biopsies, and other dermatologic procedures. Each student was provided with a suturing kit to remotely practice the following skills: simple interrupted suture, simple running suture, horizontal mattress suture, vertical mattress suture, running subcuticular suture, shave biopsy, and punch biopsy. Pre- and post-workshop surveys were distributed to the students and paired using a randomized de-identified number.&#x0D; Results: 117 (80%) students completed the pre-survey and 71 (48%) completed the post-survey. 61 (41%) responses were paired. The average baseline level of confidence ranged from 1.0 on a 10-point scale for subcuticular running suture to 2.4 for simple interrupted suture. The average level of confidence increased after the workshop for each skill, ranging from 3.7 for subcuticular running suture to 8.0 for instrument tie. In the paired responses, the average level of confidence increased significantly for each skill by an average of 5.5 points (SD=1.1, p&lt;.001).&#x0D; Conclusions: A virtual, asynchronous dermatologic surgery workshop significantly increases medical student confidence in their ability to perform suturing and skin biopsies.

We need to teach human rights in medical schools

There are protocols of the questioning of a young military physician in the Israeli Defense Forces, who performed a vaginal examination on a Palestinian woman under arrest, against the latter’s expressed will and without a medical indication. In support of the WMA guidelines on including human rights courses in medical schools, we call on medical schools to integrate a human rights perspective and introduce sufficient material on human rights, prisoners’ rights and medical ethics to help physicians like her make the right decisions in challenging situations such as the one described.

A comparative study of community medicine and public health curriculum at medical schools in Iran and North America

Background: Community medicine and public health are the core subjects in medical education. One of the main competencies of general physicians in the national curriculum is having knowledge and skills in health promotion and disease prevention in the health system. Any curriculum revision in community medicine departments needs to incorporate the evidence and use pioneer countries’ experiences in this issue. This study aims to compare community medicine and public health courses in medical schools between Iran and selected universities in North America. Methods: The elements of a community medicine curriculum for medical students were compared in a descriptive-comparative study using the Bereday model. These elements included objectives and competencies, educational strategies, teaching and learning methods, assessment, and educational fields in a community medicine curriculum in Iran and in selected universities in North America. A literature search was conducted in CINAHL, SCOPUS, MEDLINE, Web of Science, EBSCO, and on university websites. Results: Essential aspects of community-based strategies among community medicine and public health curriculum of general medicine in universities in Canada and the United States included a longitudinal approach, training in urban and rural primary care centers, teaching by family physicians and health center staff, a spiral curriculum, focus on social determinants of health, taking of social and cultural histories and social prescriptions, learning teamwork, and using LIC (Longitudinal Integrated Curriculum). Conclusion: The objective of community medicine and public health curriculum in selected North American universities was to prepare general practitioners who work in Level 2 and 3 hospitals and to improve their skills to provide high-quality services to the community. Some of the successful points in the selected universities that could be replicated in Iranian faculties of medicine included using integration strategy, a spiral curriculum, and an LIC approach.

Stability and Differences in Empathy Between Men and Women Medical Students: a Panel Design Study.

Empathy is central to the physician-patient relationship, and affects clinical outcomes. There is uncertainty about the stability of empathy in medical students over the course of medical school, as well as differences in empathy between men and women. A panel study design was used to follow first year through fourth year medical students (MS1-4) during the 2018-2019 school year. Empathy was measured using the interpersonal reactivity index (IRI), a self-report scale that separates empathy into a cognitive perspective taking (PT) and affective empathic concern (EC) component. A total of 631 (359 women and 272 men) from 970 students (65% response rate) responded to a baseline survey, and a total of 536 students (300 women and 236 men) from 970 students (55% response rate) responded to surveys throughout the year. At baseline, women had significantly higher EC scores than men (p < 0.0001), with no significant PT difference between men and women (p > 0.05). These differences were stable for all MS cohorts. Women had self-reported higher affective empathy (EC component) than men, while there were no differences in cognitive empathy (PT component). We discuss these data in the context of defining gender vs. sex, socialized gender stereotypes, and implications for future research.

Medical Student Experience and Outcomes, as Well as Preceptor Experience, with Rapid Conversion of a Preclinical Medical School Course to a Remote-Based Learning Format in the Setting of the COVID-19 Pandemic

ObjectivesTo assess student outcomes and experiences, as well as preceptor experiences, after emergently converting a preclinical medical school renal course to a remote setting during the COVID-19 pandemic.MethodsFirst-year medical student examination scores and responses to Likert-scale questions on end-of-course evaluations from the 2018–2019 (traditional) and 2019–2020 (remote) academic years were compared. Free-text responses from students and preceptors were analyzed using a qualitative summative approach to extract major themes in perceptions of remote learning.ResultsMean student scores on course examinations did not significantly differ between the traditional and remote settings (p = 0.23 and 0.84 respectively). Quantitative analysis of student evaluations revealed no significant difference across all items in mean Likert-scale responses. Student and preceptor free-text responses identified course leader engagement and responsiveness as essential to the success of remote-based learning. Optimal group size and online etiquette are areas that require attention.ConclusionsDespite rapid conversion of a preclinical medical school renal course to a remote-based format in the setting of the COVID-19 pandemic, student scores and evaluations remain positive and largely unchanged.

A Great Conversation With Dr. James Corbett

A Great Conversation With Dr. James Corbett

Newborn anatomy.

Newborn anatomy, despite being distinctly different than adult anatomy, does not constitute a major component of a typical medical school course in gross anatomy. Accordingly, there is a perception that other than the well-known late 20th-century atlas and small textbook by Edmund Crelin on newborn anatomy, there is almost no information available for anatomists and clinicians to refer to on normal infant anatomy. This perception, as verbalized by Crelin in his books, is not correct. There is an amazing wealth of accurate descriptive and pictorial information on infant anatomy available from late 19th- and early 20th-century sources. One of these sources is a comprehensive 200-page chapter on pediatric anatomy by Richard Scammon that was published in 1923 and that is freely available. Because of some inconsistencies and inaccuracies we have identified in the Crelin works, we suggest that any anatomist or clinician who wishes to learn and teach about infant anatomy refer to Scammon's chapter before using any text or image from the Crelin books.