Professor Darrell Evans

With the availability of numerous adjuncts or alternatives to learning anatomy other than cadavers (medical imaging, models, body painting, interactive media, virtual reality) and the costs of maintaining cadaver laboratories, it was considered timely to have a mature debate about the need for cadavers in the teaching of undergraduate medicine. This may be particularly pertinent given the exponential growth in medical knowledge in other disciplines, which gives them valid justification for time in already busy medical curricula. In this symposium, the pros and cons of cadaver use in modern medical curricula were debated and audience participation encouraged.

Background: Student failure creates additional economic costs. Knowing the cost of failure helps to frame its economic burden relative to other educational issues, providing an evidence-base to guide priority setting and allocation of resources. The Ingredients Method is a cost-analysis approach which has been previously applied to health professions education research. In this study, the Ingredients Method is introduced, and applied to a case study, investigating the cost of pre-clinical student failure. Methods: The four step Ingredients Method was introduced and applied: (1) identify and specify resource items, (2) measure volume of resources in natural units, (3) assign monetary prices to resource items, and (4) analyze and report costs. Calculations were based on a physiotherapy program at an Australian university. Results: The cost of failure was £5991 per failing student, distributed across students (70%), the government (21%), and the university (8%). If the cost of failure and attrition is distributed among the remaining continuing cohort, the cost per continuing student educated increases from £9923 to £11,391 per semester. Conclusions: The economics of health professions education is complex. Researchers should consider both accuracy and feasibility in their costing approach, toward the goal of better informing cost-conscious decision-making.

ABSTRACT: The conventional lecture has significant limitations in the higher education context, often leading to a passive learning experience for students. This paper reports a process of transforming teaching and learning with active learning strategies in a research-intensive educational context across a faculty of 45 academic staff and more than 1000 students. A phased approach was used, involving nine staff in a pilot phase during which a common vision and principles were developed. In short, our approach was to mandate a move away from didactic lectures to classes that involved students interacting with content, with each other and with instructors in order to attain domain-specific learning outcomes and generic skills. After refinement, an implementation phase commenced within all first-year subjects, involving 12 staff including three from the pilot group. The staff use of active learning methods in classes increased by sixfold and sevenfold in the pilot and implementation phases, respectively. An analysis of implementation phase exam questions indicated that staff increased their use of questions addressing higher order cognitive skills by 51%. Results of a staff survey indicated that this change in practice was caused by the involvement of staff in the active learning approach. Fifty-six percent of staff respondents indicated that they had maintained constructive alignment as they introduced active learning. After the pilot, only three out of nine staff agreed that they understood what makes for an effective active learning exercise. This rose to seven out of nine staff at the completion of the implementation phase. The development of a common approach with explicit vision and principles and the evaluation and refinement of active learning were effective elements of our transformational change management strategy. Future efforts will focus on ensuring that all staff have the time, skills and pedagogical understanding required to embed constructively aligned active learning within the approach.

Background: Active learning strategies were used to shift student attitudes and behaviours about learning and teaching in a research intensive Faculty of Pharmacy and Pharmaceutical Sciences at a large Australian University. Principles and active learning strategies were developed and tested in discrete content sections during the pilot phase, and then implemented for all students in first and second year units the following two years. Method: The impact of the approach on student perceptions of active learning, attendance in face-to-face classes and performance in exams were evaluated. Results: The majority of students perceived that active learning improved their understanding of content, developed skills in critical thinking and communication, and corrected misconceptions. Nevertheless, 53% of students felt they ¿learnt better¿ in traditional lectures than with active learning during the pilot phase. After strategies to improve student understanding of the generic skill benefit of active learning were implemented, this proportion fell to 34% in year one of implementation and 15% in year two. Students who reported that they ¿learnt better in traditional lectures¿ valued clear content presentation, whilst students who disagreed with this statement valued communication and critical thinking skills development and problem solving. Student attendance was 73% higher in active learning units than untransformed units during the implementation phase. Conclusion: The use of a coordinated and strategic approach to implement active learning led to positive changes in student attitudes to their learning and associated behaviours.

Providing formative assessment opportunities has been recognised as a significant benefit to student learning. The outcome of any formative assessment should be one that ultimately helps improve student learning through familiarising students with the levels of learning required, informing them about gaps in their learning and providing feedback to guide the direction of learning. This article provides an example of how formative assessments can be developed into a formative assessment journey where a number of different assessments can be offered to students during the course of a module of teaching, thus utilising a spaced-education approach. As well as incorporating the specific drivers of formative assessment, we demonstrate how approaches deemed to be stimulating, interactive and entertaining with the aim of maximising enthusiasm and engagement can be incorporated. We provide an example of a mixed approach to evaluating elements of the assessment journey that focuses student reaction, appraisal of qualitative and quantitative feedback from student questionnaires, focus group analysis and teacher observations. Whilst it is not possible to determine a quantifiable effect of the assessment journey on student learning, usage data and student feedback shows that formative assessment can achieve high engagement and positive response to different assessments. Those assessments incorporating an active learning element and a quiz-based approach appear to be particularly popular. A spaced-education format encourages a building block approach to learning that is continuous in nature rather than focussed on an intense period of study prior to summative examinations. © 2013 Anatomical Society.

For many years art, anatomy and medicine have shared a close relationship, as demonstrated by Leonardo da Vinci's anatomical drawings and Andreas Vesalius' groundbreaking illustrated anatomical textbook from the 16th century. However, in the modern day, can art truly play an important role in medical education? Studies have suggested that art can be utilized to teach observational skills in medical students, a skill that is integral to patient examination but seldom taught directly within medical curricula. This article is a subjective survey that evaluates a student selected component (SSC) that explored the uses of art in medicine and investigates student perception on the relationship between the two. It also investigates whether these medical students believe that art can play a role in medical education, and more specifically whether analyzing art can play a role in developing observational skills in clinicians. An "Art in Medicine" 8-week course was delivered to first year medical students at Brighton and Sussex Medical School. The use of art to improve observational skills was a core theme throughout. Feedback from the students suggests that they believe a strong association between art and medicine exists. It also showed a strong perception that art could play a role in medical education, and more specifically through analyzing art to positively develop clinical observational skills. The results of this subjective study, together with those from research from elsewhere, suggest that an art-based approach to teaching observational skills may be worth serious consideration for inclusion in medical and other healthcare curricula. © 2014 American Association of Anatomists.

Mineralisation of the tendon tissue has been described in various models of injury, ageing and disease. Often resulting in painful and debilitating conditions, the processes underlying this mechanism are poorly understood. To elucidate the progression from healthy tendon to mineralised tendon, an appropriate model is required. In this study, we describe the spontaneous and non-pathological ossification and calcification of tendons of the hindlimb of the domestic chicken (Gallus gallus domesticus). The appearance of the ossified avian tendon has been described previously, although there have been no studies investigating the developmental processes and underlying mechanisms leading to the ossified avian tendon. The tissue and cells from three tendons - the ossifying extensor and flexor digitorum longus tendons and the non-ossifying Achilles tendon - were analysed for markers of ageing and mineralisation using histology, immunohistochemistry, cytochemistry and molecular analysis. Histologically, the adult tissue showed a loss of healthy tendon crimp morphology as well as markers of calcium deposits and mineralisation. The tissue showed a lowered expression of collagens inherent to the tendon extracellular matrix and presented proteins expressed by bone. The cells from the ossified tendons showed a chondrogenic and osteogenic phenotype as well as tenogenic phenotype and expressed the same markers of ossification and calcification as the tissue. A molecular analysis of the gene expression of the cells confirmed these results. Tendon ossification within the ossified avian tendon seems to be the result of an endochondral process driven by its cells, although the roles of the different cell populations have yet to be elucidated. Understanding the role of the tenocyte within this tissue and the process behind tendon ossification may help us prevent or treat ossification that occurs in injured, ageing or diseased tendon. © 2013 Anatomical Society.

Saphenous donor site neuralgia is a cause of morbidity post-coronary artery bypass surgery. Saphenous nerve damage during harvesting of the great saphenous vein is thought to be responsible. We dissected 37 cadaveric lower limbs from the knee fold to the dorsal venous arches, to study the spatial relations of the saphenous nerve and great saphenous vein to identify its distribution within the leg. Distribution of the saphenous nerve was categorized into Type A, where the nerve traveled inferiorly and split into an anterior and posterior branch during its course between the knee fold and medial malleolus, Type B, where the nerve traveled anterior to the vein with a small caliber branch traveling posteriorly at the proximal end, Type C where two main branches originated at the knee fold, one anterior to and one posterior to the vein. Overall the vein and nerve crossed in 27 out of the 37 cases (73%), occurring between 5 and 29 cm from the malleolus (60% occurred between 16 and 26 cm). In 32 (86%) of cases, the distal part of the nerve and vein were tightly adhered to each other within a common sheath. The length of adherence ranged from 3 to 26 cm with an average of 14 cm. The saphenous nerve is highly vulnerable during harvesting of the great saphenous vein due to its close relationship and crossing branches. Knowledge of the distribution categories of the nerve can help guide the surgeon to avoid damaging nerve branches during harvesting. Clin. Anat. Clin. Anat. 2013. © 2012 Wiley Periodicals, Inc.

In the twenty-first century, communication has become truly global. Advances in technology have opened up a host of ways in which we are able to communicate to retrieve or pass on information and knowledge. In many cases we have moved from a place-based communication approach to one of increasing mobility. With this shift in approach, it is apparent that effective communication skills are perhaps even more important so that we can connect appropriately with diverse audiences. Despite this, relatively little attention has been paid to training our students in different modes of communication and therefore we may not be fully preparing our students to play their part in the global community. Given anatomy's place within many health-care curricula, an ideal avenue is available for anatomists to take the lead in providing communications skills training for students. There are a variety of approaches, some of which are outlined in this article, which can be used to create appropriate opportunities for developing different communication skills and these can be woven into existing practices to ensure courses do not become overburdened. A sustained approach to communication skills training will help equip our students to communicate easily with the many aspects of modern society. Anat Sci Educ 6: 134-137. © 2012 American Association of Anatomists.

The General Medical Council states that United Kingdom graduates must function effectively as educators. There is a growing body of evidence showing that medical students can be includedas teachers within a medical curriculum. Our aim was to design and implement a near-peer-led teaching program in an undergraduate medical curriculum and assess its acceptability among year 1 students. Students received six tutorials focusing on aspects of cardiac, respiratory, and blood physiology. Tutorials ran alongside standard module teaching. Students were taught in groups of ~30 students/group, and an active teaching approach was used in sessions where possible. Using anonymous evaluations, student feedback was collected for the program overall and for each tutorial. The program was voluntary and open to all first-year students, and 94 (of 138) medical students from year 1 at Brighton and Sussex Medical School were recruited to the study. The tutorial program was popular among students and was well attended throughout. Individual tutorial and overall program quantitative and qualitative feedback showed that students found the tutorials very useful in consolidating material taught within the module. Students found the small group and active teaching style ofthe near-peer tutors very useful to facilitating their learning experience. The end-ofmodule written examination scores suggest that the tutorials may have had a positive effect on student outcome compared with previous student attainment. In conclusion, the present study shows that a near-peer tutorial program can be successfully integrated into a teaching curriculum. The feedback demonstrates that year 1 students are both receptive and find the additional teaching of benefit. © 2012 The American Physiological Society.

Background: The development of new technologies has provided medical education with the ability to enhance the student learning experience and meet the needs of changing curricula. Students quickly adapt to using multimedia learning resources, but these need to be well designed, learner-centred and interactive for students to become significantly engaged. Context: One way to ensure that students become committed users and that resources become distinct elements of the learning cycle is to involve students in resource design and production. Such an approach enables resources to accommodate student needs and preferences, but also provides opportunities for them to develop their own teaching and training skills. Innovation: The aim of the medical student research project was to design and produce an electronic resource that was focused on a particular anatomical region. The views of other medical students were used to decide what features were suitable for inclusion and the resulting package contained basic principles and clinical relevance, and used a variety of approaches such as images of cadaveric material, living anatomy movies and quizzes. The completed package was assessed using a survey matrix and found to compare well with commercially available products. Implications: Given the ever-diversifying arena of multimedia instruction and the ability of students to be fully conversant with technology, this project demonstrates that students are ideal participants and creators of multimedia resources. It is hoped that such an approach will help to further develop the skill base of students, but will also provide an avenue of developing packages that are student user friendly, and that are focused towards particular curricula requirements. © 2012 Blackwell Publishing Ltd.

The forelimbs of higher vertebrates are composed of two portions: the appendicular region (stylopod, zeugopod and autopod) and the less prominent proximal girdle elements (scapula and clavicle) that brace the limb to the main trunk axis. We show that the formation of the muscles of the proximal limb occurs through two distinct mechanisms. The more superficial girdle muscles (pectoral and latissimus dorsi) develop by the "In-Out" mechanism whereby migration of myogenic cells from the somites into the limb bud is followed by their extension from the proximal limb bud out onto the thorax. In contrast, the deeper girdle muscles (e.g. rhomboideus profundus and serratus anterior) are induced by the forelimb field which promotes myotomal extension directly from the somites. Tbx5 inactivation demonstrated its requirement for the development of all forelimb elements which include the skeletal elements, proximal and distal muscles as well as the sternum in mammals and the cleithrum of fish. Intriguingly, the formation of the diaphragm musculature is also dependent on the Tbx5 programme. These observations challenge our classical views of the boundary between limb and trunk tissues. We suggest that significant structures located in the body should be considered as components of the forelimb. © 2011 Elsevier Inc.

The value of human bodies for the teaching of anatomy has been recognized since the 16th century. Many medical students are exposed to the process of body donation as human dissection continues to play a fundamental role in many medical courses. The opportunity of dissection not only provides students with an educational approach to learning human structure but also exposes them to the emotions surrounding death and dying and the role of the anatomical donor in their journey. This paper explores the subject of body donation in relation to anatomical examination, the relationship the donor has to the medical student experience and the purpose of thanksgiving services. The paper concludes with a brief description of a study carried out at a UK medical school to seek the views of first and second-year medical students on the purpose, place and value of thanksgiving services.

Although podcasting has been a well used resource format in the last few years as a way of improving the student learning experience, the inclusion of enhanced audiovisual formats such as screencasts has been less used, despite the advantage that they work well for both visual and auditory learners. This study examines the use of and student reaction to a set of screencasts introduced to accompany embryology lectures within a second year module at Brighton and Sussex Medical School. Five mini-lecture screencasts and one review quiz screencast were produced as digital recordings of computer screen output with audio narration and released to students via the managed learning environment (MLE). Analysis of server log information from the MLE showed that the screencasts were accessed by many of the students in the cohort, although the exact numbers were variable depending on the screencast. Students accessed screencasts at different times of the day and over the whole of the access period, although maximum downloads were predictably recorded leading up to the written examination. Quantitative and qualitative feedback demonstrated that most students viewed the screencasts favorably in terms of usefulness to their learning, and end-of-module written examination scores suggest that the screencasts may have had a positive effect on student outcome when compared with previous student attainment. Overall, the development of a series of embryology screencasts to accompany embryology lecture sessions appears to be a useful addition to learning for most students and not simply an innovation that checks the box of "technology engagement. Copyright © 2011 American Association of Anatomists.

Purpose ¿ The ability to communicate with society is one of the key skills by which our students can help enhance knowledge and understanding of different subjects within the general population. Unfortunately, up until recently few subject areas have provided tailored training for their students in the art of communicating with different audiences, especially a non-specialist one. This review paper aims to discuss the rationale for incorporating defined communication skills training (CST) into higher education courses, focusing on medicine, other healthcare professions and science. In addition the review aims to identify example methodologies used for the training and assessment of communication skills. Design/methodology/approach ¿ The approach taken for this review has been to: identify and review national, subject specific and individual drivers for why higher education should be including CST in their courses and programmes; evaluate some of the published approaches and innovations used to introduce CST into higher education courses; and finally, assess the factors that curriculum designers should consider when incorporating CST into their programmes or modules. Findings ¿ The review shows that there are a number of important drivers for including CST in higher education curricula, especially training which is directed to communicating with non-specialist audiences. The paper identifies a number of varied approaches for integrating training into existing and emerging HE courses and modules, aimed at developing both oral and written communication skills. Originality/value ¿ The paper demonstrates the need for CST in undergraduate courses and acts as a challenge to others to devise strategies to ensure their students are ready and able to communicate with society in the twenty-first century.

Developmental biology research has used various avian species as model organisms for studying morphogenesis, with the chick embryo being used by the majority of groups. The focus on the chick embryo led Hamburger and Hamilton to develop their definitive staging series nearly 60 years ago and this series is still the mainstay of all laboratories working with avian embryos. The focus on the chick embryo has somewhat overshadowed the importance of another avian embryo that has proved to be equally powerful, the Japanese quail. Since the late 1960s, chimeras have been produced using chick and quail embryos and this technique has revolutionized the approach taken to the investigation of the cellular and molecular interactions that occur during development. Reviews of the literature demonstrate that many research groups are using the quail embryo in a number of established and new ways, and this species has become a primary animal model in developmental biology. Some staging of quail has been performed but this has been incomplete and variations in descriptions, stages and incubation timings mean that comparisons with the chick are not always easily made. There appears to be general agreement that, at the early stages of embryogenesis, there is little developmental difference between chick and quail embryos, although the basis for this has not been established experimentally. The accelerated ontogeny of quail embryos at mid to late stages of development means that registration with the chick is lost. We have therefore developed a definitive developmental stage series for Japanese quail so that differences are fully characterized, misconceptions or assumptions are avoided, and the results of comparative studies are not distorted. © 2009 The Authors. Journal compilation © 2009 Anatomical Society of Great Britain and Ireland.

The development of limb cartilage involves complex signalling pathways allowing the formation of distinct segments of cartilage that are maintained in the fully developed joint. In this study, we investigated the Notch signalling pathway and its role in cartilage development. The differential distribution of the Notch signalling family of receptors and their corresponding ligands in developing avian ( gallus gallus ) cartilage revealed expression of Notch.1, Delta.1, Jagged.1 and Jagged.2 in all limb mesenchyme cells at the early stages of cartilage anlagen development, which were subsequently restricted to the developing cartilage element. Expression of both Notch.1 and Jagged.1 became increasingly restricted to the surface cartilage once joint cavity formation had occurred. Delta.1 and Jagged.1 were restricted to a layer of cells underneath the surface cartilage and were also observed in the hypertrophic chondrocytes, where Notch.1 expression was evident in stage 40-44 limbs. Notch 2, Notch 3 and Notch 4 were not evident in early stage limbs but were present after cavitation, although expression was lost in late stage limbs (stage 40-44). We also demonstrated that inhibition of the Notch pathway leads to altered Notch receptor expression, disrupting cartilage differentiation. From these data it is clear that Notch signalling is a necessary and critical factor in regulating cell fate decisions allowing controlled chondrogenesis, elongation and subsequent maintenance of limb cartilage. © Journal compilation © 2009 Anatomical Society of Great Britain and Ireland.

Anatomy is recognized to play a central role in the education and training of clinicians, healthcare professionals, and scientists. However, in recent years, the perceived decline in popularity of anatomy has led to a deficiency in the numbers of new anatomy educators. The tide is now turning with anatomy once again taking its rightful place in a wide of variety of disciplines, and therefore it is imperative that a new generation of anatomists is in place to meet this need. In response, the Anatomical Society of Great Britain and Ireland has made the training of the next set of anatomists, one of its strategic priorities, and in collaboration with the American Association of Anatomists has developed a dedicated Training Program. The overall aim of the Program is to provide trainees with the necessary knowledge, understanding, aptitudes, and attitudes in appropriate detail, sufficient to enable them to teach and examine Anatomy with full competence at the undergraduate and postgraduate level. The Program offers opportunities to consolidate knowledge and deepen understanding of anatomy, improve skills in teaching and communication with students, and be competent in preparing teaching materials and assessment modalities. The Program uses a distance-learning approach with an incorporated Residential School and is particularly aimed at those undertaking a career in the biosciences. Early indications suggest that initiatives such as the development of this Training Program will help deliver the next generation of anatomists and ensure that anatomy continues to play a fundamental role in the education of clinicians, healthcare professionals, and scientists. © 2009 American Association of Anatomists.

Peer teaching has been recognized as a valuable and effective approach for learning and has been incorporated into medical, dental, and healthcare courses using a variety of approaches. The success of peer teaching is thought to be related to the ability of peer tutors and tutees to communicate more effectively, thereby improving the learning environment. Near-peer teaching involves more experienced students acting as tutors who are ideally placed to pass on their knowledge and experience. The advantage of using near-peer teachers is the opportunity for the teacher to reinforce and expand their own learning and develop essential teaching skills. This study describes the design and implementation of a program for fourth year medical students to teach anatomy to first- and second-year medical students and evaluates the perceptions of the near-peer teachers on the usefulness of the program, particularly in relation to their own learning. Feedback from participants suggests that the program fulfills its aims of providing an effective environment for developing deeper learning in anatomy through teaching. Participants recognize that the program also equips them with more advanced teaching skills that will be required as they move nearer toward taking on supervisory and teaching duties. The program has also provided the school with an additional valuable and appropriate resource for teaching anatomy to first- and second-year students, who themselves view the inclusion of near-peer teachers as a positive element in their learning. © 2009 American Association of Anatomists.

Skeletal muscles have a characteristic proportion and distribution of fiber types, a pattern which is set up early in development. It is becoming clear that different mechanisms produce this pattern during early and late stages of myogenesis. In addition, there are significant differences between the formation of muscles in head and those found in rest of the body. Early fiber type differentiation is dependent upon an interplay between patterning systems which include the Wnt and Hox gene families and different myoblast populations. During later stages, innervation, hormones, and functional demand increasingly act to determine fiber type, but individual muscles still retain an intrinsic commitment to form particular fiber types. Head muscle is the only muscle not derived from the somites and follows a different development pathway which leads to the formation of particular fiber types not found elsewhere. This review discusses the formation of fiber types in both head and other muscles using results from both chick and mammalian systems. © 2002 Elsevier Science (USA).

Caveolin is the principal component and critical structural and functional element of caveolae, omega-shaped plasmalemmal invaginations, which have been implicated in a wide range of cellular processes in several different tissues. In the present study, we have investigated both the spatial and temporal expression of caveolin proteins during chondrogenesis in the avian tibiotarsus at days 10-20 of embryonic development. By using semiquantitative Western blotting, we found that caveolin-1 was clearly expressed in developing avian cartilage. The positive expression of caveolin-1 in cartilage showed an upward trend of accumulation temporally, with the highest levels of expression at 20 days of development. By using immunocytochemistry, we detected all three caveolin proteins in the cells of the outer fibrous articular surface, although caveolin-1 demonstrated the strongest and most consistent reactivity. In all cases, however, immunoreactivity appeared to be concentrated in cells facing the articular cavity. In the epiphyseal cartilage, immunocytochemistry revealed that caveolin-1 was present in the majority of chondrocytes within all layers of the cartilage and at all stages examined. A discrete, intense band of caveolin-1 immunoreactivity was apparent within the layer of flattened cells immediately underlying the proliferating rounded chondrocytes and suggests that caveolin-1 might be involved in regulating the progression of cells through these gradually maturing cell layers. In contrast to the results for caveolin-1, in the case of caveolin-2 and -3, chondrocytes were devoid of immunoreactivity in all regions of the epiphyseal cartilage. Overall, this study demonstrates that caveolin-1, -2, and -3 are expressed during chondrogenesis in the developing avian limb, although the patterns of expression are restricted both spatially and temporally throughout the differentiating cell layers of the cartilage. The results suggest that caveolin proteins might play a differentiation-dependent role during avian chondrogenesis. © 2002 Wiley-Liss, Inc.

Fusion of mononucleated myoblasts into parallel arrays of mutinucleated myotubes is an essential step in skeletal myogenesis. The formation of such a highly ordered structure requires myoblasts to come together, orient and align in the correct location prior to fusion. We report here that fetal and neonatal myoblasts can use topographical features as strong guidance cues in vitro. Myoblasts were cultured on multiple grooved substrata of varying dimensions, and the axial orientations of individual cells were recorded. Both fetal and neonatal myoblasts aligned parallel with the direction of deep grooves (2.3-6.0 µm), which is correlated well with the location of myoblasts in similar sized grooves during secondary myogenesis. Fetal myoblasts also responded to shallower grooves (0.04-0.14 µm) by aligning parallel or perpendicular to the direction of the grooves, indicating the ability of these cells to respond to fine elements normally encountered within the developing muscle architecture. In contrast, neonatal myoblasts failed to respond to shallow grooves, adding to the suggestion that fetal and neonatal myoblasts may represent separate populations of myoblasts. Overall, the results demonstrate that myoblasts respond to large and small features of the physical topography in vitro and indicate that structural elements in the microenvironment of the muscle may play a critical role in myoblast spatial organization during myogenesis.

We have previously shown that articular cartilage grows by apposition from cells occupying the upper zones of the tissue (surface and transitional). Using the South American opposum as a model system, we showed that cells associated with the articular surface were immunopositive for PCNA, IGF I and II together with 3 isoforms of TGFß. Further, by repeated intra-articular injection of the thymidine analogue bromo-deoxyuridine and subsequent immunodetection, we showed initial incorporation into the transitional zone cells followed by incorporation into the flattened cells of the articular surface indicating that these cells were in extended cycle compared with transitional zone cells. Using 7-day bovine articular cartilage, we have isolated articular surface chondrocytes by scalpel dissection followed by sequential enzyme digestion. Isolated chondrocytes (4,000/ml) were then subjected to a differential adhesion assay on fibronectin coated dishes that is preferentially expressed in the articular surface. We found that cells that had high affinity for the ligand (20 min attachment time) represented 10% of the initial population compared with 4 % that adhered in the following 20 min and the remaining 75+% that adhered after 40 min. FACS analysis showed that the initial 10% cohort with high affinity for fibronectin had significantly elevated levels of a5ß1 integrins (fibronectin receptor) than the remaining two cohorts. In addition, it was found that the high affinity cohort had a 400% higher colony forming efficiency than the lower affinity cohorts. Taken together, these data suggest that there is a sub-population of cells that reside in the articular surface that show classical features of a progenitor/stem cell that has been described in other tissues.