The Embryology unit of the Macromolecular Structure and Development of the Human Body Module (MSD) is designed to give first year medical students a foundation in the development of the major organ systems and the important congenital malformations associated with them. The temporal organization of the unit and the use of faculty who teach in the Gross Anatomy unit is intended to help students use their knowledge of development to aid in studying human anatomy.

 

Unit Organization. The Embryology unit is given in the fall semester. There are six major divisions: 1) Fertilization and the Early Stages, 2) Cardiovascular Embryology, 3) Gastrointestinal Embryology, 4) Urogenital Embryology, 5) Development of the Limbs, 6) Development of the Pharyngeal Arches and Face, and 7) Congenital Malformations. To better integrate the Embryology and Anatomy unit material, Embryology will not be given on a fixed time schedule. The number of lectures and conferences per week will vary considerably during the semester. Embryology classes are listed in the Macromolecular Structure and Development course schedule as well. Please bear in mind that Embryology is taught in part by faculty who also teach the Anatomy unit. Students should check the schedule to ascertain what subject is being taught at a particular time.

Examinations and Evaluation of Student Performance.  This pass/fail evaluation will be based primarily on the student's performance on the examinations. There are four examinations in the MSD course: Sept. 21 from 11 a.m. - 2:30 p.m., Oct. 18 from 12:30 - 4:30 p.m., Nov. 12, from 11:30 a.m. - 3:30 p.m., and Dec. 13, 9 - 10 a.m. The first three are combined Gross Anatomy and Embryology exams while the Dec. 13 exam is Embryology only . The Embryology component of the first examination is a quiz covering Fertilization and Early Stage embryology. It will have ~25 questions and a short essay. The second examination, which includes Cardiovascular and Gastrointestinal embryology, will have both standard questions as well as short essay questions. The third examination will have the Hindgut/Urogenital system and Limb embryology and will have a short essay along with standard questions. The fourth examination will cover Face/Pharyngeal Arches and Congenital Malformations and will have standard questions as well as at least one short essay.

On the examinations, standard questions will be in matching and multiple choice format. The examination questions are designed to test the breadth of knowledge and understanding of the student but by necessity, the exams will cover only a subset of the content of the unit. In general questions are not designed to fool or trick the student. However, some of the questions may require a fairly detailed knowledge of the subject matter.

To successfully complete the Macromolecular Structure and Development Course, a student must pass each of the exams. In particular, the Embryology questions on each examination will be compiled and listed as a separate score from the Anatomy questions. Students must have a satisfactory score on the Embryology portion of each examination. This is separate and apart from their score on the Gross Anatomy portions. The unit directors will establish the appropriate criteria for a passing grade for each examination based on the overall class performance and past experience. Student performance on the Anatomy portion of the MSD is not taken into consideration when determining if remedial work in Embryology is required. Quizzes and class participation grades in the small group exercises will also count approximately 3% of the overall unit grade.

            In the event that a student should be deemed not to have met the standard for passing the Embryology unit, he/she will be required, subject to approval by the Dean of Students, to take a make-up examination given on or before January 7, 2004. The make-up exam will cover those portions of the unit that the student needs to make up and will be in short essay format. If the overall performance of the student is weak, even if only a single examination make-up is required, the unit directors may require that the make-up examination cover the entire unit.

            Examinations are not returned to the students. Scores are posted on the bulletin board in the Anatomy lab and group examination review sessions will be scheduled after the exams are graded. These sessions will be scheduled in the late afternoon and allow students to view the examinations and their answer sheets with an instructor present to answer questions.

Textbooks and Study Guides.  Handouts for each topic are provided in the Study Guide. The handouts are in the form of detailed and comprehensive written chapters and are generally a substitute for the corresponding chapters in textbooks. Because color reproductions are so much better than xeroxed black and white figures, drawings or pictures from the textbook are not reproduced in the Study Guide. Instead, the figure numbers are listed in the text. In addition, the web-based version of the Study Guide has the figure links embedded in the text for convenient online use by students. Students are therefore urged to refer to the drawings in the textbook and/or online. Slides from the lectures will be posted on the Embryology web site in most cases.

The recommended textbook is Langmanπs Medical Embryology, 9^th edition, by T.W. Sadler. It is a paperback available in the bookstore. Because of the limited lecture hours in the course, some subtopics will not be covered thoroughly in lecture. Nonetheless, students will be responsible for the basic information in these areas, which will be reviewed prior to the examinations. The topics are covered in the Study Guide and textbook comprehensively, and study questions emphasizing basic knowledge in these topics are included in the Study Guide. Certain Embryology topics will not be covered as part of the Embryology unit and will not appear on examinations.  These include the development of the Nervous System, much of the Skeletal System, and Muscle Tissue. It is anticipated that the student will be introduced to the other topics in later courses like Cell Biology (general principles of development, including growth factor signaling and Hox genes), Histology (Skeletal and Muscle Tissue) and Neuroscience (Brain and Nervous Tissue).

            Students often ask if they may use other textbooks. The Developing Human (now in its 7^th edition) by Moore and Persaud is also a textbook that students find helpful. Human Embryology, by William Larsen, is an excellent book with very detailed and accurate information. Students may use this book. These books will be put on reserve in the Medical Library for use as a reference and students are encouraged to examine the drawings, especially if they feel those in Sadler are inadequate. Human Embryology & Developmental Biology, a textbook by B. Carlson, was not popular among the students in the past and is not recommended. In addition, other books will be placed on reserve are for optional additional reading. These include Gilbert, S.F., Developmental Biology and Speroff, L., Glass, R.H., and Kase, N.G. Clinical Gynecologic Endocrinology and Infertility.

            Students may wish to test their knowledge of Embryology in preparation for the examinations. The web site has a series of self-tests on each topic. In addition, the Study Guide and Review Manual of Human Embryology by Moore & Persaud, available in the bookstore, is highly recommended. Other guides, such as the Embryology Board Review Series may also be of some benefit.

Case Discussions/Small Group Teaching.  Embryology is primarily taught in lecture-conference format. In addition to the small group exercises scheduled for the Early Stages, we will have two case studies, one in the Cardiovascular section, and one on Genital development. The cases will be presented in class as problem-solving exercises and some materials will be distributed to aid in the understanding of the cases and their implications. The rest of the information in the cases will be disclosed in the conferences themselves. Students are encouraged to work with their fellow students in studying the case background material. It is essential that students come to the discussions well prepared, having read the handouts and familiarized themselves with the chapters in the textbook. To encourage adequate preparation, brief quizzes may be given at the beginning of the small group exercises. However, students will be given advance notice if a quiz is to be given. Class participation grades will also be given in some of the small group sessions.

This year most of the cases or small group exercises will be given over two days, with half the class each day. We ask students who have their sessions first not to diminish the experience by sharing detailed information with those whose sections are later that day or the following day.

Review Sessions and Study Questions.  In order to promote student participation in pre-examination discussions and review sessions, a series of Study Questions/Problem Solving Exercises has been prepared for each topic in the unit. These questions will serve as the basis for the Early Stages discussion on Sept. 13/14 and the scheduled pre-exam reviews on Oct. 14/15, Nov. 8/9, and Dec. 9/10. Students are urged to come to the sessions prepared to answer the questions and discuss any difficulties they may have with the subject matter. In addition, three informal optional review sessions have been added to help students who may need additional support throughout the semester. The review sessions have been schedule for Sept. 8 (early stages), Oct. 7/8 (cardiovascular), and Oct. 27 (urogenital).

The study questions are designed to help students test their knowledge of material and to prepare for exams. Drs. Rindler and Ort will be happy to assist students in answering the study questions. This can be done by e-mail or in person. However, students are not to take advantage of faculty assistance to avoid having to make an effort to answer the study questions on their own.

Computer Programs/Library Materials.  Computer programs are available in several relevant areas and are helpful for learning embryology.   Students have found that the Basic Embryology Resource Program (BERP) developed at Univ. of Pennsylvania is very helpful, particularly for the Early Stages and other parts of the course. The program consists of several modules, some animated, and primarily serve as a visual aid of overall development as well as several of the organ systems. The modules were each developed independently and thus vary greatly in scope and detail. This program is available on the Macintosh computers in the 2nd Floor Coles seminar rooms and CDπs are available on reserve in the library as well. The web site also has other useful visual materials and links to sources of information, such as Clinical Human Embryology. The Simbryo animations that come with the textbook are brightly colored and somewhat useful for embryonic folding (check Fertilization and GI) and GI system development.  However, they do lack detail.

            In addition, in conjunction with the Academic Computing Program here at NYUMC, under the direc­tion of Dr. Martin Nachbar, we have developed computer-assisted, case-based learning programs for both Cardiovascular System and Gastrointestinal System Embryology with special emphasis on clinical diagnosis. Many students liked these programs in the past. They are worthwhile but do require a significant time commitment to complete. Students are urged to try them out and then decide how much time to devote to these programs. They are available through the Embryology web site. If you are using a remote computer, you will need to download Shockwave to run these programs. Links have been set up from the module sites to help you find and download the program through Netscape Navigator. There are also programs on heart development on the Embryology website which you are welcome to use.

            Self-test multiple-choice questions are also available on each topic on the web site. These student-generated questions are useful for review purposes. They cover most topics, but are by no means completely comprehensive. Often the questions are more difficult than those on the exams.

 

Office Hours.  There are no formal office hours but the course directors are happy to meet with students or answer questions by e-mail. Please contact Dr. Rindler or Dr. Ort to set up a convenient time to meet. Students are also encouraged to contact individual lecturers in specific topics in the unit, especially those teaching Anatomy, to ask questions about course material in their areas. In addition, please feel free to contact the course directors concerning any general problems that arise.