QUE SUELEN EMPLEARSE
1.4 CONCEPTOS GENERALES SOBRE LAS ACTIVIDADES DEPORTIVAS RECREATIVAS.
The fifth major pedagogical concept was that anatomy teachers taught their physiotherapy students to focus on anatomical principles, as a way of coping with the voluminous ‘index knowledge’ of anatomy (please Section 4.5.2.2 from page 104) within the narrow time constraints (please refer to Section 4.3.2 from page 84). The teachers of anatomy for physiotherapy in the USA also faced a high volume of content and insufficient time and responded by teaching “essentials” p.726 (Mattingly & Barnes, 1994). Similar concerns over increasing anatomical content in medical courses against shrinking available teaching time for anatomy have been expressed before (Turney, 2007) and resulted in ‘information overload’ (p.5) (J. Anderson & Graham, 1980). Overloaded medical curricula led to the setting up of shorter anatomical courses for medical courses (Bergman et al., 2011; Drake, Lowrie, & Prewitt, 2002; Heylings, 2002; Leong, 1999; Paalman, 2000; Rizzolo et al., 2006; T. M. Scott, 1993; Terrell, 2006). 70% of medical teachers at an international academic conference reported that teaching time for anatomy was reduced at their last major revisions of their medical curriculums (Pawlina, 2009). An increase in self-study time at home might mitigate the reduction in scheduled teaching time (Bergman et al., 2011). Reduced content and low-density teaching sessions were recommended as a way of dealing with an overloaded curriculum in restricted time allocations (Russell et al., 1984).
Several reasons are responsible for the decline in teaching time for anatomy. The increase in teaching knowledge and teaching time for biomedical science has been at the expense of reducing teaching time for anatomy (Abu-Hijleh, Habbal, Moqattash, & Harris, 1995; Abu- Hijleh, 2010; Paalman, 2000; Rizzolo et al., 2006). The practice of allocating more time for teaching integrated clinical knowledge resulted in less available time for teaching anatomy (Berns et al., 2001). The decline in recognition of the comprehensive coverage philosophy in teaching anatomy, where all the voluminous anatomy content is taught in a time consuming manner, gave rise to knowledge that was too short-lived to be applied to future clinical situations (Rizzolo et al., 2006). The complaints on the decline of the role of anatomy have been driven by anatomy teachers protecting their interests who typically make commentaries in journal papers (Cahill, Leonard, & Marks, 2000; Gogalniceanu et al., 2010; McCuskey et al., 2005; Monkhouse, 1992; Norman, 2000; Older, 2004; Satyapal & Henneberg, 1997; Sugand, Abrahams, & Khurana, 2010). The concerns of anatomy teachers have triggered surveys to confirm their fears of the decline in anatomical teaching time for medical courses (de Bere & Mattick, 2010; Drake et al., 2002; Drake, McBride, Lachman, & Pawlina, 2009; Gartner, 2003; Gogalniceanu, O’Connor, & Raftery, 2009; Heylings, 2002; Willan & Humpherson, 1999b) and for physiotherapy in the USA (Abdur-Rahman, 2007; Armstrong & Rosser, 1996; Latman &
Lanier, 2001; Mattingly & Barnes, 1994; Reimer et al., 2013). The reduction in teaching time for anatomy is unfortunate because cumulative learning is strongly associated with increased time spent learning any given subject (Baddeley et al., 2009).
‘Anatomical principles’ are recurring concepts or phenomenon that can be generalised to many more anatomical situations (Louw et al., 2009). Principles of basic sciences are
advantageous because they last longer in the long-term memory than facts (T. M. Scott, 2000). Two types of anatomical principles emerged from the study: principles of how anatomical structures were arranged and principles on how anatomical structures functioned or lacked function due to impairments. Anatomy teachers can get a better grasp of what these two anatomy principles are by looking at a list of technical anatomical principles compiled by (Louw et al., 2009), which were intended for all health students, including physiotherapy students. I have compiled a list of anatomical principles in APPENDIX 17 on page 249 that I thought would be of interest to the physiotherapy profession. APPENDIX 17 is largely based on anatomical
principles by Louw and his colleagues (Louw et al., 2009) related to the musculoskeletal system and to a lesser extent on anatomical principles described by anatomy teachers in the current thesis.
The idea of teaching general anatomy principles before the more specific anatomical principles is an old one. It is the norm among the more popular anatomy textbooks for physiotherapy students (Cael, 2010; D. B. Jenkins, 2008; Moffat & Mottram, 1979; Palastanga, Field, & Soamas, 2000; Porter, 2008; Singh, 2006) and medical students (Drake et al., 2010; K. Moore et al., 2013; Sinnatamby, 2006; Snell, 1995; Standring, 2008) to start with an introductory first chapter describing general anatomy principles. Anatomy teachers usually give a preliminary threadbare introductory teaching session on the general anatomy principles. More teaching effort and time ought to be set aside for teaching general anatomy principles that lay a more solid foundation for learning anatomy (Louw et al., 2009).
There is more profit in teaching the principles of anatomy than spending more time going through an ‘index knowledge’ of anatomy because concepts are easier to remember (Conway et al., 1991; T. M. Scott, 2000) and are more likely to integrate into existing schema (Bahrick, 1992) and housed in the permastore (Conway et al., 1991) than names. The drive towards learning anatomical principles or concepts is supported by the ‘reconstruction hypothesis’, which indicates that most memories are actually reconstructed during remembering (Bartlett, 1932), although the high retention rate of names challenges that view (Conway et al., 1991). Reconstructing concepts is easier than for verbatim information, such as names, and
resembles problem solving rather than reproducing information (Neisser, 1984). It is doubtful if there are memories for specific experiences at all (Loftus & Loftus, 1980).
Anatomical principles in the current study were aimed at creating metacognitive schemata that helped the students to benchmark anatomical knowledge. Benchmarking cognition helped the students to self-regulate their primary cognition. In this thesis, primary cognition will be defined as the cognition that causes the intrinsic load (explained in Section 2.3.2.4.3.2
on page 32) and the secondary cognition being the metacognition of the primary cognition. Metacognition is a higher order self-supervision of the primary cognitive task and helps a student to best strategise the solving of a cognition problem, oversee the understanding of a learning task and how well the task is successfully completed (Schnotz & Kürschner, 2007). The two benchmarking metacognition anatomical schema encouraged among the physiotherapy students by the anatomy teachers were schema for generic organisation of anatomical structures and predicting functional abilities (or lack of function due to impairment) of anatomical structures on patients. The two types of anatomical schema could play three different roles: benchmarking cognitive results, answering specific questions with no answers and synthesising forgotten information.
The anatomy teachers taught schema of the generic organisation of anatomical structures that were rules on how the anatomical structures were arranged in the human body and the same rules could be applied to many more places in the body. The other type of benchmarking schemata predicted the functional abilities (or lack of) of anatomical structures on patients. The results of primary cognition could be compared with the benchmarking schemata of generic anatomical organisation or schemata predicting functional outcome, and the differences used to self-regulate their primary cognitions. If there was a difference, metacognition could redirect the cognition system to re-start the analysis of the primary cognition again to see if there was a processing error or try and account for the difference. If there is a suitable explanation of the difference, the schema information in the long-term could be altered to accommodate the difference.
Secondly, the more general schema are usually recruited when a student lacks specific schema to answer specific questions (Neisser, 1984; Renkl et al., 2004), and both the schema on the generic organisation and functional abilities could play that role. Teaching general anatomical principles was thought to arm the students with the “necessary intellectual tools” p.377 on how to find specific anatomical information better (Louw et al., 2009). Thirdly, the same generic benchmarking and functional schema predicting information could also potentially play another metacognitive role of reconstructing the forgotten schema required to solve
anatomical problems being addressed by the primary cognition. A significant portion of the anatomical knowledge was stored temporarily in the long-term memory and forgetting was considered normal by the anatomy teachers. The metacognition process could realise that some information needed to solve a particular anatomical problem is missing, and then redirects the cognition machinery using available generic anatomical schema to rebuild or reconstruct missing or forgotten schema, before going back to solve the primary cognition problem. Although a specific portion of the ‘index anatomical knowledge’ could help rebuild the missing schema, generic benchmarking and functional predicting schema have a more universal application, are more potent and makes them more likely to be frequently used, just as how (Louw et al., 2009) described a more generalisable role of anatomical principles. The concept of more universal generic schemata is what the founder of the Cognitive-Load theory described when he said that the generic schema on trees can be applied on “potentially infinite variety of objects called trees” pp 296, in contrast to schema on one particular tree (Sweller, 1994). The generic anatomical schema are similar to generisable problem solving schema used for solving geometry problems (Koedinger & Anderson, 1990) and word-based problems (Low & Over, 1990) in that they can be applied across a wider spectrum of problems.
At a theoretical level, the use of anatomical principles for benchmarking could be explained using the germane load of the Cognitive-Load theory. The germane load is at a metacognitive level and is the cognitive load due to the student cognitively managing the intrinsic cognitive load, where students undergo a secondary higher level thinking about their primary thinking or cognition (Schnotz & Kürschner, 2007). Up until 1994, the consensus among Cognitive-Load theory scholars was that lowering the cognitive load was an essential educational target for promoting effective learning (Paas & Merriënboer, 1994a). They discovered that an increase in a new ‘good’ cognitive load actually enhanced future learning by improving cognitive schemata and was called the germane cognitive load (Sweller et al., 1998). Teachers were encouraged to increase the germane cognitive load as much as possible to below the maximal capacity of the working memory (Ayres & Sweller, 2005).
Some types of germane cognition are more efficient than others in generating the same metacognition schemata. Therefore, teachers are encouraged to minimise the germane cognitive load by using more efficient germane cognition, so as to free up cognitive resources for the intrinsic cognitive load or for additional germane loads. The anatomy teachers
minimised the germane load by providing information that would make it easier to compile schema that would help to identify anatomical patterns and to be able to predict function. The ultimate aim of the germane cognitive load is to create very useful schema. Some schema requires many years of experience to create, for example chess grandmasters took about ten
years to create complex schema that novice chess players did not have (Amidzic et al., 2001; Chase & Simon, 1973). The eight anatomy teachers who participated in the study had more extensive anatomical experiences of typically over ten years. The teachers had time to make succinct and highly efficient schema that students could not make on their own during their short undergraduate time. Thus the anatomy teachers helped to make the learning of the students more efficient and quicker.
Explicit encouragement of using metacognition strategies ought to be encouraged more (Cutting & Saks, 2012) and should extend to the explicit motivation of students on the use of generic anatomy principles. Metacognition can be facilitated by making the teachers and students think aloud when they are thinking through problems or making decisions in classrooms (Cutting & Saks, 2012), as was done in teasing apart the role of basic sciences during the clinical reasoning of clinicians through ‘thinking aloud’ methodologies (Boshuizen & Schmidt, 1990; Patel & Groen, 1986).