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The Typical Body Segment: An Anatomy Teaching Paradigm Created by Matt Cartmill and Others While Teaching Gross
James D Pampush1,2, Haley Horbaly1,2, Susan E Lad1,3
1Department of Health and Human Performance, High Point University, High Point, North Carolina, USA.
Abstract:
Within allied-health programs, gross anatomy is widely regarded as a foundational and content-dense course challenging instructors and students alike to manage an overwhelming volume of information within an increasingly constrained curriculum. In the late 1960's, the Duke University medical curriculum was redesigned to produce 'scientists-doctors' intensifying the instructional challenges of gross anatomy. In the wake of a series of unsuccessful experiments, comparative anatomists Matt Cartmill and James Shafland were recruited to develop and teach a medical gross anatomy course at Duke. Drawing on comparative anatomy, embryology, and evolutionary theory, Cartmill and colleagues developed a distinctive pedagogical framework organized around an idealized vertebrate metameric Bauplan-the Typical Body Segment (TBS)-with an accompanying textbook: Human Structure. Rather than trying to memorize details about sprawling sets of isolated structures, the TBS approach transforms learning gross anatomy into a series of stories about how evolution and development regionally pattern and differentiate Typical Body Segments into functionally specialized, interconnected modules. This article discusses the circumstances leading to the emergence of Cartmill's course-directorship and the TBS approach to teaching gross anatomy at Duke. We argue that the consistent use of a central homological schema as a starting point for narratives about the complex human form offers many pedagogical advantages, including reduced cognitive load, improved organization of anatomical knowledge, as well as a better grasp on patterns of interaction and variation among parts. Drawing on qualitative data from student course evaluations at High Point University, we further illustrate how this approach appears to shift students' orientation from rote memorization toward a conceptual understanding of anatomy. Finally, we document the diffusion and transformation of the TBS paradigm through faculty lineages, postdoctoral training, and allied health programs, highlighting its enduring influence on contemporary anatomy education. Together, this history and analysis underscore the value of centering evolutionary and developmental narratives in the teaching of human anatomy and documents the major contributions from Cartmill and other gross anatomists who taught with the TBS approach at Duke University.
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