The Teaching of Anatomy to Exercise Physiology Students
Tommy Boone, PhD, MPH, FASEP, EPC
Professor and Chair
Director, Exercise Physiology Laboratories
Department of Exercise Physiologists
The College of St. Scholastica
Duluth, MN 55811

 
INCREASINGLY, the teaching of anatomy to exercise physiology students has undergone major changes over the past 4 decades.  Today, only a few academic programs actually teach anatomy.  This is a big difference from decades ago when anatomy was taught as a kinesiology course.  Then, physical education students were expected to know the origins and insertions of the major muscles in the body.  During the 70s and 80s many of these academic programs were re-named to exercise science, kinesiology, or a combination of other [2]. 

In America, the academic landscape, at least by degree title, is a mess.  There are many reasons but one, in particular, is that doctorate exercise physiologists turned a blind eye to the problems at the undergraduate level.  After all, they are "physiologists" and not even "exercise physiologists."  The latter thinking makes no sense at all and yet it is part of the many reasons why the teaching of anatomy to exercise physiology students is a problem throughout the United States.  The problem isn't just that doctorate level exercise physiologists failed to look ahead with a vision for exercise physiology they failed in leading the transition of exercise physiology successfully from physical education into its own existence.

While the impact of sports medicine on exercise physiology has been explored many times in earlier PEPonline articles [2-3], exercise physiologists understand little about how or why students learn anatomy.  To make matters worse, no one is discussing the curricula used to teach anatomy.  No one knows whether there are anatomy courses for exercise physiology students much less if it involves dissection, prosected and plastinated specimens, lectures, tutorials and peer learning, web-based and/or computer-based resources.  The literature on exercise physiology is dominated by sports training and "exercise physiology" studies.  Often there is the general belief that anatomy is little more than recall of facts.  Memorizing facts and reciting the information is one reason for lack of interest in anatomy.  This thinking must change since memorizing, visualizing, and understanding structures of the body represent the language of anatomy.

Seeing the overall picture in anatomy is the goal, not just rote learning.  Similarly, the overall picture of exercise physiology is not just physiology.  For students of exercise physiology to have the confidence they need as healthcare professionals, they need the broader understanding of the human body.  This is also true with the psychophysiology course and other important healthcare courses.  There is little doubt that what constitutes the 21st century exercise physiology curriculum is not what students should be studying.  But, then, generally speaking, exercise physiologists have no way of knowing what is taught, given the lack of objective data by exercise physiology researchers. 

Without the teaching of anatomy, the professional practice of exercise physiology cannot help but fail to be credible.  It becomes increasingly clear that exercise physiologists must get their minds around the following two questions:  First, what is the language of anatomy and how best can it be taught?  Second, why exercise physiologists need to know anatomy as well as physiology?  Clearly, exercise physiologists who want to work with clients who have musculoskeletal problems or, more simply, who want to develop their muscle strength and endurance, need a solid academic background in anatomy.  Whether the content of such a course should be taught as a lecture only course or as a lecture and anatomical dissection course remains to be addressed the profession.

Should the teaching of anatomy not find its roots in cadaver dissection, it will very likely be a mistake.  This thinking is no different from the teaching of exercise physiology concepts without a metabolic cart.  The practice of exercise physiology stretches beyond physiology, that is, if its practitioners are to acquire the skills required to attain a social and moral end – the good of the client.  To achieve this more engaging sense of exercise physiology's role in healthcare will require not only a thorough grounding in exercise physiology but anatomy, too.  Yet, more is required from the anatomy than simple surface anatomy in which the student can assume that it isn't important given the commonly combined status of kinesiology (i.e., applied anatomy) and biomechanics.

The question here, then, is not about physiology in general but in the teaching of anatomy to exercise physiology students.  This makes for vulnerability on the part of the students which can only be corrected by placing a correct amount of interest on anatomy.  But to pursue this thinking requires a vision on part of the profession of exercise physiology.  That vision has been defined by the American Society of Exercise Physiologists [4].  Members of the Board of Directors understand that the students of exercise physiology need a thorough and comprehensive academic preparation to properly care for their clients. In other words, the motive of engaging physiology over other subjects is a matter of personal choice; it has no "absolute dominance" over other important manners (e.g., biomechanics, rehabilitation, nutrition, psychophysiology, spirituality to mention a few) in the practice of exercise physiology. 

Anatomical knowledge is too important to future exercise physiologists to not teach it correctly.  It is akin to building a home.  If the foundation is of poor quality, then no matter well built other aspects of the home may be, it will only be a poor product.  Even worse, it is a heart ache for many students because they do not have the anatomy foundation from which to build on.  Frankly, there isn't any longer the erosion of the teaching of anatomy in undergraduate exercise physiology and/or related programs of study.  It simply does not exist with any intensity at all.  For certain, there are only a few graduate programs in exercise physiology that students actually dissect cadavers.

Why anatomy isn't being taught by exercise physiologists is rather obvious on one hand.  There are simply not enough doctorate prepared exercise physiologists who know anatomy. In fact, among the few who might teach anatomy, they do not have an expertise in anatomy as one would normally find in other comparisons. This should be corrected, but the likelihood of doing so is not very high.  As a result, the structure of the human body is going to get less and less emphasis during the next several decades.  Eventually, one might expect that anatomy will not be taught at all to exercise physiology students.  And, just think, exercise physiologists who are called upon to develop weight lifting programs and/or identify specific exercises to deal with various musculoskeletal problems will not have the anatomy background to do so safely. 

The problem of integrating "kinesiology" (i.e., anatomy) with biomechanics or some other course is hugely problematic.  There is no way anatomy can be learned without a thorough and engaging period of time for proper study, reflection, lectures, and hands-on laboratory experiences.  This point is without question 100% exactly what the typical exercise physiologist would conclude if exercise physiology, as a course per se, was being considered similarly that anatomy has been.  Frankly, a year of anatomy, especially in an anatomy laboratory, would be much better for an academic exercise physiologist than a year of molecular biology or even a year of biochemistry.  Yet, increasingly, this is the case whereby biochemistry is viewed more important than cadaver dissection. 

The answer is not the occasional turning to an atlas of anatomy.  It is hardly enough to warrant a comprehensive understanding of the human structure.  Students need to engage the muscles just as they are required to engage other hands-on experiences, particularly that of physiology, biomechanics, and exercise testing.  Each area involves processing information, teamwork among the students and instructors, and oral discussion before their peers regarding what they know or do not know.  Content across the courses must be emphasized in an integrated fashion to avoid fragmentation and other related weaknesses.  Professionalism must also be a big part of the anatomy course and all other courses and, therefore, not simply reduced to discussion or lecture in one course.

In sum, the laboratory approach to learning anatomy, especially via cadaver dissection, is the only rational way to truly absorb and learn anatomy.  Dissecting and "personalizing learning" for the future practice of exercise physiology increases the prospect of professional success as healthcare professionals.  But, first, there must be an anatomy course in the accredited curriculum for exercise physiologists.  Second, there must be exercise physiology teachers who know anatomy and who especially know how to teach the dissection of cadavers.  Third, exercise physiologists must distance themselves from the traditionally narrowed interest of "physiology only" that accompanied the optimism of a half century of exercise physiology.  

 References

1.  Kelly, J.E. (1997). "Virtue-Based Ethics" – A Unifying Moral Framework for the Physician-Patient Relationship." Chapter 4: 49-74. Editor: Samuel M. Natale. The Developing Professional: Maintaining Values in "Practical" Training. Kelly quotes from William W. Fortenbaugh's commentary on selections from the Eudemian Ethics (1229b21-26, 1230a31). "Aristotle's Conception of Moral Virtue and Its Perceptive Role," Transactions and Proceedings of the American Philosophical Association 95 (1964), p. 78, cited in Robert Sokolowski. 1992, Pictures, Quotations, and Distinctions: Fourteen Essays In Phenomenology. Notre Dame Indiana: University of Notre Dame, pp. 277-291.

2.  Boone, T. (2001). Anatomy: The Forgotten Piece of the Beginning. Professionalization of Exercise Physiologyonline. 4:6 [Online]. http://faculty.css.edu/tboone2/asep/ANATOMYandExercisePhysiologists.html

3.  Boone, T. (2003). Why Teach Anatomy. Professionalization of Exercise Physiologyonline. 6:3 [Online]. http://faculty.css.edu/tboone2/asep/WhyTeachAnatomy.html

4.  American Society of Exercise Physiologists. (2007). ASEP Vision. [Online]. http://www.asep.org/organization