An Innovative Technique in Anatomy Pedagogy: The Flexagon as a Model of Gastrulation in Embryology

Keywords

Embryology; Pedagogy; Gastrulation; Morphogenesis; Tensegrity.

Introduction

"It is not birth, marriage, or death, but gastrulation, which is truly the most important time in your life."

Lewis Wolpert (1986)

Research confirms that anatomy is considered to be the corner stone subject within the medical curriculum and in clinical procedures to ensure safe medical practice by surgeons, doctors and a wide diverse range of medical specialists [1-3]. Anatomists would agree that understanding embryology is essential for gaining a comprehensive understanding of anatomy and teratology [4]. Alarmingly, the overall continuing decline in anatomy and embryology hours in medical schools is well documented [5]. Teaching anatomy is an innate challenge and anatomy educators view embryology as notoriously hard to teach and to learn while the challenging subject matter can become even more difficult with the reduction in emphasis as a subject.Medical students have fewer hours to learn anatomy, and many see little point in learning embryology other than to pass exam questions [6]. The authors address this unfortunate decline in interest in embryology using a novel learning technique aimedat making the concept more accessible while inspiring greater interest in embryology as a fascinating subject that serves to illuminate anatomical knowledge as part of long-term clinical professionalism and medical related competencies [7].

Knowledge of anatomy has been identified as critical within the operating room [1].

The result is a multi-dimensional folded paper embryo that anatomists can interact with and use to reinforce the process of invagination/ enfolding during gastrulation (Fig 1). The origami action of folding the paper reinforces the concept of morphological constraints arising from internal mechanical circumstances of biologic geometry and force transmission [8]. Research has shown that by introducing a 3-Dimensional aspect to both the visual and kinaesthtic learning a greatervisuospatial appreciation is gained supporting a broader understanding of anatomy and embryology [9]. A lessor known and under-appreciated role of gastrulation is the establishment of a tensegrity based architecture informing emerging organ formation and a multidimensional, biomolecular chiral based body-plan predicated upon a north-south (cranial/ caudal) axis with dorsal/ventral and selective right and left symmetry [10]. The 3D hexaflexagon,representing a multi-dimensional, folded, paper embryo (Fig 1) is offered as the ideal teaching tool to support anatomy educators when explaining the mechanical forces of morphogenesis and embryological development.

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Figure 1:

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Figure 1 (a, b, c, d, e). From a single piece of paper students are instructed in the folding technique that results in a 3D hexaflexagon representing a multi-dimensional, folded, paper embryo. The activity, while being fun, is informative providing both a kinaesthetic and visual experience of several important processes including invagination, blastula folding and 3-dimentionality.

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Figure 2:

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Figure 2. Adding colours to the constructed hexaflexagon allows for a more pronounced visual experience.

Conclusion

As medical and clinical training pathways evolve student learning needs and their educational preferences need also to evolve.

The aim of this paper is to propose that a greater understanding of the stages of embryonic folding can be achieved through folding one’s own origami flexagon, or 3D hexaflexagon (aka “kaleidocycle”) (Fig 2).A better understanding of embryology in the wider context of anatomy will better serve the medical student. Anatomy educators are crutial members of all medial teaching faculties ensuring under-graduate and post-graduate medical students gain an anatomically accurate and detailed education required to operate in a patient focused safe, appropriate and effective manner. We trust that our proposal will help anatomy educators move one step closer in achieving that goal.