Medicine is an ever-changing field; but significance of anatomy in clinical practice has stood the test of time(1–4). Anatomical knowledge is a fundamental one has to acquire in order to master clinical arts raging from the basics of physical examination to the extremes of performing complex invasive procedures(3) .
Despite its importance, Clinicians find clerkship students basic anatomy knowledge poor(1, 2, 5). A guest editorial note on the journal of Canadian radiologists’ stated, “Senior medical students completing radiology rotations sometimes struggle to recall the basic elements of first-year anatomy, such as the names of the tarsal bones or the order of the great vessels of the aortic arch” (6). Student’s attribute this to information overload, the need to translate between multiple dimensions and to the lack of clinical correlations in the teaching(7, 8). These learning challenges are aggravated by the tides currently hitting the ‘Anatomy world’. The community has been struggling with scarcity of anatomist, large size of students and Lack of funding for acquiring enough cadavers(3–5, 9).
The ordeals of 21st century anatomy is not limited to these. As a challenge to the centuries old status quo; further advent of new technologies have revolutionized how doctors scrutinize patient’s interior(5, 10). Despite surgeons and few other specialties still getting acquainted to cadaver-like tactile anatomy; radiology has now become the venue majority of the doctors experience it.(5, 12) This has come with its own challenges to the curriculum. The invention of Computer tomography(CT) and magnetic resonance imaging(MRI) has put much emphasis on cross sectional anatomy(11), a topic seldom discussed in classes in the past. Virtual colonoscopy has capitalized intraluminal gastrointestinal landmarks. Echocardiography has transformed the static visualization of the cadaver’s heart into functional dynamic cardiac cycles. These and other inventions have brought radiology to the forefront of medical practice. Clearly, medical imaging has transformed the practice of medicine and surgery.
At the dawn of this Millennia, the perceived deficiency in the young graduates, the challenges in Anatomy teaching plus the mentioned dynamics of development in medicine culminated to global call for a facelift in anatomy curriculum. This resulted in shift from traditional didactic to more clinical oriented problem-based learning(5, 10, 13, 14). Unsurprisingly, one of the landmarks of the new curriculum was emphasis for radiologic anatomy.
The use of radiology as a tool to teach anatomy dates back to 1927(14). But the limited contrast tissue resolution offered by radiographs then [the only available modality] most likely limited its utilization to few topics. Currently CT, MRI and ultrasonography by offering super tissue resolution have made noninvasive glimpse to the brain, thoracoabdominal viscera, vasculature, and developing fetus possible. This has in turn made radiology an interesting tool for teaching medical students gross anatomy (15).
The emphasis to radiologic anatomy via the reengineered anatomy curriculum helped students increase interest in the subject matter (5, 12). It also helped students acquire a thorough understanding of anatomical spatial relationships in multiple plains(16, 17). Improvement in course scores(12, 14) and development of professional competency were also noted(9).
Utilization of radiological images is a favored instructional format by students. Lawrence J Rizzolo etal revealed 80% of students liked the concept of radiologic anatomy (18). Radiology by bridging the gap between anatomy and clinical medicine provides the raison d’etre of the course to the students.(14) In a prospective study, Erkonen et al assessed the effectiveness of using radiologic images in gross anatomy teaching; they concluded, the integration of anatomy instruction with radiologic imaging was an effective approach for teaching students(15, 19).
However, despite best practice guideline recommendations from medical organizations such as the Association of American Medical Colleges, the General Medical Council and the Royal College of Physicians and Surgeons of Canada, the role medical images play in teaching gross anatomy is heterogeneous, its weight varying among and even within countries(20–22).
Ethiopia where this study has taken place has undergone a major transformation in medical education; increasing its public medical schools from 5 to 28 in relatively short duration. Its annual medical school admission also has increased from the hundreds to thousands. Therefore, it is only natural to assume the existence of aforementioned challenges. Here despite many medical schools changing medical curriculum from traditional to competency based integrated modular, no study had been conducted to evaluate the extent of utilizations of radiologic images for teaching anatomy.