Plate-glass lady keeps her figure

It is a fitting endorsement to the disciplines themselves, and to the astute enthusiasm and eagerness of this generation of students, that new editions of these four texts have become necessary. If the medical profession of the 21st century is to capitalise on the advances of the last, an appreciation of how the human body works must continue to underpin the student's understanding of biomedical science. Similarly, now that the human genome has been mapped, the next generation of molecular biology and genetics graduates needs to benefit from core teaching of anatomy and physiology if they are to make sensible contributions to investigating functional genomics.

Those designing courses should consider recommending any of these four books as their key text to enhance the overall learning experience. Each achieves the high standard of innovative presentation expected from the previous editions. Even colleagues with an inherent suspicion of American texts concede that Gerard Tortora, Frederic Martini, Elaine Marieb and, to a lesser extent, Kenneth Saladin, have established themselves to be the leading global communicators in the field. Their texts far exceed any old-world equivalents. These expert teachers succeed in producing books that students will actually use.

Although the market differs slightly from book to book, all follow an almost identical format. Each begins with a brief introduction including anatomical terminology and definition of structural organisation. A ubiquitous description of the chemical, cellular and tissue levels ensues, before plunging into a systemic approach. Each author predictably begins by peeling off the integumentary system and builds up to a climax with the reproductive system. The concluding chapter in all four texts deals with development (although coverage is quite superficial in one or two). The application of basic science to clinical and health problems is emphasised. Setting the facts in context makes these highly readable and exciting texts an admirable achievement. All have a bank of review questions and critical thinking exercises to reinforce each chapter.

Yet all four texts are more than mere books, and interactive study is certainly the name of the game. The extent of the resource package varies, but all include the obligatory CD-Rom. Saladin in fact has two discs, although I found these more cumbersome to use than the single disc of the other three authors. The pronunciation guide on the Tortora disc is good, as is the slower version on Martini's disc. Marieb and Martini succeed best with their spoken case studies and tutorials. The CD-Rom quizzes are useful self-test exercises and give good feedback (although some additional proof-reading is occasionally necessary - for instance, Tortora has two identical descriptors in question 22 in chapter 24, yet one is deemed correct, the other incorrect). With so many extras and special features, however, the "simple" preface (Martini has an excessive 40 pages) can sometimes take longer to navigate, if one is to gain the full benefit of the complete resource, than would be available for the total number of learning hours of a core course recommending the text.

The Martini deal includes a separate applications manual incorporating an excellent atlas, an embryology summary, surface anatomy, well-dissected specimens and a useful imaging section. (MRIs and X-rays, even if these are printed on grubby paper, are all included). The three other texts have fewer add-ons, although Marieb comes with a high-quality Atlas of the Human Skeleton , but this unfortunately contains only the bare bones. Website access is often available. Martini provides an 18-month subscription to a website companion (it took ages to discover how to obtain my password, and certainly this information could have been more prominently displayed). It does seem a pity, however, that access is surrendered after only a year and a half.

The present reincarnation of all that is good in a text from Tortora and Sandra Grabowski is briefer and more elementary here than in most of their other battery of textbooks (including the excellent Principles in Human Anatomy , which we have recommended for more than a decade in core courses for science, nursing and dental students). This Introduction to the Human Body is just that - an introduction for those without any prior knowledge. At £31.95, it is quite an expensive introduction. It will, however, probably suit health visitors and nurses undertaking a foundation course. The book has the same quality, but frequently smaller, diagrams and photographs as in Tortora's larger tomes (indeed they are often the very same diagrams - how would one survive without the poor unfortunate plate-glass lady featured in fig 1.6?). The "Focus on Wellness" panels are thought provoking, if a little shallow. Personally, I feel the muscular system (chapter eight) and development (chapter 24) sections are the weakest links in this text.

Marieb is in fact extremely good value for money. Again, it is appropriate for nursing students and those from other paramedical professions. From the chapter openings it looks as though it ought to be good for sports scientists, with photos of runners, tennis players, snowboarders and the like. At times, however, its obtuse terminology lets it down - for instance the use of "fibularis" muscles in the text and on diagrams although the more accepted "peroneus" muscles are referred to in the review questions and in the CD-Rom quiz. Icons pointing to "homeostatic imbalance" stress the functional strength of this text, and the "Making connections" and "Closer connections" panels encourage students to think more widely about each topic.

Although the content of Saladin is entirely acceptable for the nursing, therapy and science students for which it is written, its overall visual effect is somewhat less appealing than the other three texts. Even the cover sketch fails to conjure up the excitement of the body in dynamic pose that captures the imagination on the other covers, and the diagrams are less stunning. Unfortunately, the general layout is also less attractive and did not hold my attention to the extent of the other books. Yet, for those who feel comfortable with the style it is a useful book and fulfils its aims, even at a price of £33.99.

The Rolls-Royce of this quartet of texts, to my mind, is Martini. Despite being the most expensive, it represents exceptional value for money. Martini manages a well-integrated anatomical and physiological approach, adopting a bright style with a well-illustrated progression through human form and function. A student could not help but be enthralled by what he or she learns of the body here, whether it is from the book, CD-Rom or website explorations (while their subscription remains valid). The applications manual part of this package would suit medical, dental, nursing and science students alike.

Therefore, in an age when traditional subjects are often deemed outdated and irrelevant, medical educationalists re-evaluating curricula should take note and ring-fence a sufficient grounding in anatomy and physiology, rather than merely paying a cursory glance towards the basic sciences. In doing so, these texts more than adequately supply the core material.

Robert A. Smith is senior lecturer in anatomy, University of Glasgow.