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John C McLachlan

Publications and source records attributed to John C McLachlan.

12 recordsLinked to original sources
PubMed2006

Anatomy teaching: ghosts of the past, present and future.

INTRODUCTION: Anatomy teaching has perhaps the longest history of any component of formalised medical education. In this article we briefly consider the history of dissection, but also review the neglected topic of the history of the use of living anatomy. CURRENT DEBATES: The current debates about the advantages and disadvantages of cadavers, prosection versus dissection, and the use of living anatomy and radiology instead of cadavers are discussed. THE FUTURE: Future prospects are considered, along with some of the factors that might inhibit change.

Anatomy↗
PubMed2005

"Over my dead body?": the influence of demographics on students' willingness to participate in peer physical examination.

This study aims to explore quantitatively and qualitatively students' attitudes towards peer physical examination (PPE) and the influence of demographics on students' willingness to participate in PPE. A total of 296 first-year medical students from two consecutive cohorts at the Peninsula Medical School, UK completed the EFS questionnaire. Quantitative data from the questionnaire were analysed using univariate (i.e. Mann-Whitney and chi-squared tests) and multivariate statistics (i.e. stepwise multiple regression) and qualitative data were analysed using theme analysis. At least 92% of Peninsula Medical School students were willing to examine all 11 body parts (except breast and inguinal regions) of peers of same and opposite gender. Qualitative data support this by highlighting students' positive attitudes towards PPE. PPE was more acceptable within rather than across gender and students generally felt more comfortable examining their peers than being examined by peers. Qualitative data outline the range of student concerns with PPE. Significant relationships existed between students' attitudes towards PPE and various variables: gender, age and religious faith. The findings demonstrate that students may show a greater willingness to participate in PPE than previously thought. Further research is required to explore more fully the barriers to PPE.

Age Factors↗
PubMed2005

Assessment of progress tests.

BACKGROUND: Progress testing is a form of longitudinal examination which, in principle, samples at regular intervals from the complete domain of knowledge considered a requirement for medical students on completion of the undergraduate programme. Over the course of the programme students improve their scores on the test, enabling them, as well as staff, to monitor their progress. AIM: We aimed to review methods which have been used to assess the results of individual tests, and to make recommendations on best practice. DISCUSSION: In assessing progress tests, there are a variety of choices that must be made. These include whether the test is norm- or criterion-referenced; whether marking is negative or "number-right"; whether the grades are reported on a continuous or a discontinuous scale, and whether the grades are weighted towards the most recent observations, or the entire set of grades is used to determine the final grade. Grade boundary setting in the context of progress tests is also considered, using a mathematical model to predict the consequences of different approaches. The relationships between boundary setting, progression and remediation rules are considered. CONCLUSIONS: We concluded that norm referencing is preferable to criterion referencing, negative marking preferable to number-right marking, a discontinuous scale preferable to a continuous scale and that grades should be weighted to favour the most recent outcomes, although there should still be a degree of persistence (earlier grades should not disappear all together). Grade boundaries should be established with regard to rules on remediation and progression.

Clinical Competence↗
PubMed2005

Ethical permission for the publication of routinely collected data.

BACKGROUND: Data collected from undergraduate medical students for routine purposes on a non-consented basis, but subsequently perceived as being potentially valuable for research purposes, lie in an ethical grey area. Currently, such data appear to be used routinely without explicit consideration of ethical considerations. AIMS: This paper proposes a consistent framework that would permit the use of such data. It also provides an advance on current practice with regard to ethical considerations around the absence of consent. DISCUSSION: We argue that students should be informed of generic possible uses of such data and given the opportunity to opt out, that researchers should be able to analyse such data retrospectively, but should then seek ethical permission for publication, and that an ethics committee should determine if ethical practices have been upheld before giving permission for any study incorporating such data to be submitted for publication. FUTURE DIRECTIONS: It is hoped that these proposals will stimulate debate, and that the results of such debate will inform practice in medical schools and medical education publishing.

Confidentiality↗
PubMed2004

Teaching anatomy without cadavers.

BACKGROUND: Anatomy learning is generally seen as essential to medicine, and exposure to cadavers is generally seen as essential to anatomy learning around the world. Few voices dissenting from these propositions can be identified. AIMS: This paper aims to consider arguments relating to the use of cadavers in anatomy teaching, and to describe the rationale behind the decision of a new UK medical school not to use cadaveric material. DISCUSSION: First, the background to use of cadavers in anatomy learning is explored, and some general educational principles are explored. Next, arguments for the use of human cadaveric material are summarised. Then, possible arguments against use of cadavers, including educational principles as well as costs, hazards and practicality, are considered. These are much less well explored in the existing literature. Next, the rationale behind the decision of a new UK medical school not to use cadaveric material is indicated, and the programme of anatomy teaching to be employed in the absence of the use of human remains is described. Curriculum design and development, and evaluation procedures, are briefly described. Issues surrounding pathology training by autopsy, and postgraduate training in surgical anatomy, are not addressed in this paper. FUTURE DIRECTIONS: Evidence relating to the effect on medical learning by students not exposed to cadavers is scant, and plainly opportunities will now arise through our programme to gather such evidence. We anticipate that this discussion paper will contribute to an ongoing debate, in which virtually all previous papers on this topic have concluded that use of cadavers is essential to medical learning.

Anatomy↗
PubMed2004

Exploring medical students' attitudes towards peer physical examination.

With opportunities for dissection and examination of sick patients decreasing, the role of peer physical examination (PPE) is increasing. This study explores students' attitudes towards PPE and the relationship between attitudes and demographics. A total of 129 first-year medical students from the Peninsula Medical School completed the Examining Fellow Students (EFS) questionnaire. At least 97% of students were comfortable participating in PPE of all body parts except breast and inguinal regions. Over 20% of students were unwilling to participate in PPE of the breast and inguinal regions. Students were more comfortable with PPE within gender than across gender. Females were more likely to be uncomfortable with PPE. Further research with larger sample sizes is required to determine whether attitudes are related to age and religious faith.

Adolescent↗
PubMed2003

Hot male: can sex in humans be modified by temperature?

Sex determination in many animals has an environmental component, particularly through temperature. In this article, it is argued that some evidence may by seen for this in humans, and it is proposed that the influence of temperature on sex determination may be a reason for the placing of testicles outside the body cavity in most male mammals.

Biological Evolution↗
PubMed2003

Using models to enhance the intellectual content of learning in developmental biology.

Models have been particularly useful in developmental biology over the last 30 years. At first, underlying control mechanisms were poorly understood, but over time a wealth of detailed information became available to provide an increasingly detailed knowledge of underlying mechanisms, at levels from genes through cells to organs, organisms and populations. Models are also of great value in teaching developmental biology, as they allow students to explore phenomena hard to perceive directly because of their scale, accessibility, expense or other considerations. A model may allow students to "experiment" in ways which would be impractical in real life, as well as give them a deep understanding of competing hypotheses of development. Lastly, students can be challenged to produce models of their own, whereas only rarely are they able to carry out original experiments. I discuss two main kinds of models and their uses in generating, testing and expounding hypotheses and point out dangers in the use of models in education. Models may draw upon and reflect the consensus paradigm in the field: a researcher may be able to appreciate that models are interim conditional statements of probability and use them to generate new knowledge. A student may be less able to do so and may fail to appreciate where new knowledge will come from. And unlike physics, biology is stochastic and contingent and can never be entirely deduced from first principles, implying that models can never be as perfect in any biological field as they can be in some other fields.

Developmental Biology↗
PubMed2002

Testing learning theories: the NUL hypothesis.

INTRODUCTION: In the spirit of Scrooge and the Grinch, I describe the nasty unpalatable learning (NUL) hypothesis as a new theory of learning. This is an exercise to explore how difficult it would be to develop a new learning theory by reversing the social and altruistic tenets of most existing learning theories. THE NUL HYPOTHESIS: The NUL hypothesis has four propositions. These are: (1) the value of rote learning; (2) the usefulness of authority figures in teaching within a clear hierarchy; (3) the use of fear in teaching, and (4) the value of internal consistency without any necessary connection to the outside world. CONCLUSIONS: The NUL hypothesis may promote reflection not only on the construction of learning theories, but also on the design of critical experiments. It also seems to imply that efficiency may be a better measure of learning success than effectiveness.

Education, Medical↗