Reviewer: Robert M. Klein, PhD (University of Kansas Medical Center)
Description: This is a careful and systematic update of one of the classic medical embryology books for healthcare professions students, doctoral students in biology and biomedical sciences, and healthcare professionals. The approach is thorough, if not encyclopedic, with coverage from gametogenesis through parturition. The improvements in this edition build on the visionary approach taken by the book's originator and founding author, William J. Larsen. These changes are so complete as to represent a new book for medical embryology which combines new knowledge in developmental biology, genetics, reproductive biology, and a variety of medical disciplines with classic embryology.
Purpose: This edition is intended to integrate new findings in developmental biology, molecular biology, and genetics with classical embryology and relate developmental content to medical practice and new findings in the research lab. The book exceeds its intended goal. The use of a standard format with "In the Research Lab," "In the Clinic" and "Clinical Tasters" sections is combined with well written text and beautiful illustrations to form an outstanding book.
Audience: The audience is first year medical students. The "In the Clinic" and "Clinical Taster" sections are outstanding examples of the clinical approach that is required in the teaching of embryology in the 21st century. The incorporation of the "In the Research Lab" sections provides a link to research, and in particular translation research, with a future vision for medical research and practice as investigators learn more about the mechanisms underlying normal development and alterations in the normal pattern that result in congenital dysmorphologies. The problem is that the length and detail of the book may preclude its use in most undergraduate medical curricula. On the other hand, it should be a standard text on the shelves of physicians, medical school faculty, and other health professionals whose practices deal with human development and its consequences. It would be ideal for MD/PhD students, PhD students in an integrated biomedical curriculum, and/or in an honors curriculum for medical students.
Features: The fourth edition contains all the components of an outstanding embryology text: clearly written text, outstanding illustrations, a focus on clinical aspects of human embryology, and integration of classical embryology with other basic and clinical science disciplines. Improvements include an introduction which helps students understand the importance of embryology as a foundation to medical practice. The basic language of human development is provided and its terminology defined, including the trimesters of pregnancy, phases of embryological development, the three critical periods of development (egg, embryo and fetus), the timing of human development (weeks 1-8), and body axes and embryological coordinates. The section "Want to Learn More" could be used as an introduction to the medical literature for all undergraduate medical curricula. It fits in well with the aims of medical educators to develop lifelong learners and student-centered curricula with the ultimate goal of training and educating a generation of medical practitioners who use and practice evidence-based medicine. The "Want to Learn More" section formulates ground rules for access to the electronic literature and compares and contrasts the strength of evidence from different sources: PubMed, search engines such as Google, and appropriate websites and databases. Other advances include a clear format with better integration of developmental content. Use of text headers, color-coded chapter markers, and reorganized content will facilitate student use. Each chapter begins with a clear, concise, focused summary, and the outstanding additions of "In the Research Lab," "In the Clinic," and "Clinical Tasters" sections, each with a clear-cut format and purpose. Several new chapters are also helpful in providing improved organization. Any embryology book depends on the quality of its illustrations, diagrams, and photographs and this edition has many additions and revisions of the artwork. An online glossary and access to Student Consult is provided with the purchase of the book. The suggested readings section of each chapter focuses on a list of review articles and classic papers.
Assessment: There is a solid group of medical embryology books and one outstanding developmental biology book (Gilbert's Developmental Biology, 8th edition (Sinauer Associates, 2006) on the market. Two of the embryology books are available as unabridged and abridged editions. One of those sets, composed of The Developing Human: Clinically Oriented Embryology, 8th edition, and Before We Are Born: Essentials of Embryology and Birth Defects, 7th edition (both Elsevier, 2008) by Moore and Persaud, presents classical embryology with a clinical focus and tidbits of underlying cellular and molecular mechanisms. The second, Langman's Medical Embryology, 10th edition (Lippincott Williams & Wilkins, 2006), and Langman's Essential Medical Embryology (Lippincott Williams & Wilkins, 2005), by Sadler, are abbreviated books that focus on critical concepts and are very popular with medical students. Often, first year students find these the right length for the time they can dedicate to the study of embryology, but ultimately too abbreviated, and they struggle with the condensation of the content. The third is Larsen's Human Embryology. There are few criticisms that can be leveled at this work. The authors and over 40 content experts have incorporated both clinical and research aspects of human development with developmental and molecular biology, genetics, and classical embryology to compile a beautiful book. The access to Student Consult facilitates the use of the book in electronic curricula for a generation of learners who relish use of online resources. A new series of detailed and outstanding 3-D animations have been professionally developed for use with this book and are posted on the Student Consult site. My only suggestion is that the authors should consider discussing the use of blogs and Wikipedia in their section on use of the medical and lay literature. The problem with this book is neither the fault of the authors nor the publisher and is not unique to medical embryology; it is the reality of medical education. The analogy often used for the medical curriculum is that students are trying to take a sip of water from a high pressure fire hose. The time for teaching embryology has been drastically reduced in most curricula. Students purchase few textbooks and do not learn to use them as reference sources. The authors have developed an outstanding encyclopedia of human embryology integrated with research and clinical medicine. It is an excellent reference source for students, but is too large and probably cannot be used as a standard text for studying embryology in most curricula. On the other hand, it should be a standard text on the shelf of pediatricians, obstetricians, neonatologists, radiologists, pathologists, and other health professionals who deal with human development and the outcomes of human developmental processes. It would be ideal for MD/PhD students, PhD students in an integrated biomedical curriculum, and in an honors curriculum for medical students.