126 - The Menstrual Cycle: Comparing and Contrasting the Linear and Circular Model Through the Lens of Medical Illustration

Poster Board Number: 126
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Co-authors:

Robert Hage, MD, PhD, DLO, MBA - Chair, Medical Humanities and History of Medicine, St. George's University; Anamaria Gluschitz - Hamburg University of Applied Sciences

Abstract Body : Introduction/ Objectives
The menstrual cycle is often depicted as a linear model. With the use of menstrual cycle tracking apps, circular representations of part of the menstrual cycle have become popular. This allows users to get familiar with its cyclical nature. This project contrasts the linear and circular models through the lens of medical illustration in respect to their educational advantages in medical education.

Materials/ Methods
Tracking apps and medical literature were reviewed for depiction methods. Additionally a Google image search was performed, to include amongst others popular media visualisations accessible to the public.

Results
Circular illustrations and graphs showed primarily the following aspects of the menstrual cycle: 1) The phases; 2) The hormonal changes; 3) The follicular changes; 4) The progression of time from day 1 to day 28. However, no illustrations were found for a circular depiction of changes occurring in the endometrium.

Linear calendar models were found in all period tracking apps, while some additionally used circular models. Circular illustrations were also primarily seen in patient education material, but have not been found in medical educational context.

Conclusion
A linear model resonates with the use of a calendar. A circular model is instinctive when considering its cyclical nature. Both linear and circular models have their advantages in different educational contexts. The choice between them depends on the specific teaching and educational goals.

Linear Model advantages:
1. Sequential Understanding: Often used to represent the menstrual cycle as a series of events that occur in a chronological order to understand the sequence of hormonal changes and physiological processes.

2. Clarity: Provides a clear and straightforward representation of how the cycle progresses over time.

Circular Model advantages:
1. Cyclical Nature: Consistent with the cyclical nature of the menstrual cycle. It visually emphasises that the cycle repeats itself (key component).

2. Connection to Real-life Experience: Experiencing multitude of menstrual cycles over the course of life.

Significance/Implication
In medical education, using both models at different stages of instruction may offer a comprehensive and balanced approach to grasp the complexities of the menstrual cycle. Therefore, depictions of the cyclical nature of all aspects of the menstrual cycle should be made available for medical educators to use. A novel cyclical illustration has been created that considers all aspects of the menstrual cycle in a single image, including changes in the endometrium. It has been implemented into the material of an obstetrics lecture for second year medical students. Surveying the effectiveness of the illustration is the next step.