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Bilella A, Eppler E, Link K, Filgueira L. Body painting, ultrasound, clinical examination, and peer-teaching: A student-centered approach to enhance musculoskeletal anatomy learning. ANATOMICAL SCIENCES EDUCATION 2024; 17:157-172. [PMID: 37670412 DOI: 10.1002/ase.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 07/12/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023]
Abstract
The presented course, established 2016 as a compulsory elective for 22nd-year bachelor medical students, aimed to enhance deep learning of upper and lower limb anatomy from a clinical perspective by a maximum of student-centered activities combining hands-on skills training with team-learning. Three cohorts (in total 60 students) participated in this study. Students rotated through body painting, ultrasound, and clinical investigation supervised by faculty or an experienced clinician. Teams of 3-4 students prepared presentations on clinical anatomy and pathological conditions, which by teacher- and peer assessments on average achieved >85% (mean 17.8/20 points ± 1.06). After each activity session, the students reported their learning experience through a reflective diary. Fifty students (83%) evaluated the course by a voluntary anonymous questionnaire combining Likert-type scale and free-text questions to assess, predominantly, perception of course activities and their perceived influence on learning anatomy. Journal reports and questionnaires revealed that the students highly valued the course, and 92% (29 females, 17 males) rated group work satisfying or well-perceived. The highest appreciation achieved ultrasound followed by clinical examination and body painting, which one third proposed to integrate into the regular dissection course. All students recommended the course to their younger peers. This course was feasible to integrate in the pre-existing curriculum. Limiting factors to offer this elective course to more students are availability of clinical teachers, technical equipment, and education rooms. Being student-directed tasks, body painting and reflective diary-writing would be feasible to implement without additional faculty, which we recommend to educators for student engagement activation.
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Affiliation(s)
- Alessandro Bilella
- Anatomy, University of Fribourg, Fribourg, Switzerland
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | | | - Karl Link
- Anatomy, University of Fribourg, Fribourg, Switzerland
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2
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Antipova V, Niedermair JF, Siwetz M, Fellner FA, Löffler S, Manhal S, Ondruschka B, Pietras SM, Poilliot AJ, Pretterklieber ML, Wree A, Hammer N. Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel- and ethanol-glycerin-embalmed tissues. ANATOMICAL SCIENCES EDUCATION 2023; 16:1144-1157. [PMID: 37337999 DOI: 10.1002/ase.2306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 06/21/2023]
Abstract
Anatomical dissection is known to serve as an integral tool in teaching gross anatomy, including postgraduate training. A variety of embalming techniques exist, resulting in different haptic and optical tissue properties. This study aimed to objectify learning outcomes and medical student perceptions related to the use of two widely used embalming techniques, namely Thiel and ethanol-glycerin embalming. Between 2020 and 2022, first- and second-year medical students enrolled in the course on topographic anatomy participated in this study. Objective structured practical examinations were carried out for the head, neck, thorax, abdomen, pelvis, and extremity regions following regional dissection just before the oral examinations began. Six to ten numbered tags were marked in prosections of each region in Thiel- and ethanol-glycerin-embalmed specimens. Following the examinations, the students were surveyed regarding the suitability of the two embalming techniques with respect to preservation, colorfastness, tissue pliability, and the suitability in preparing for their anatomy examinations. Consistently higher scores were achieved for the thoracic and abdominal regions in ethanol-glycerin-embalmed specimens when compared to Thiel. No benefit was found for Thiel-embalmed upper or lower extremities. Tissues embalmed with ethanol-glycerin were rated higher for preservation and suitability to achieve the learning objectives, tissue pliability was rated higher for Thiel-embalmed tissues. Ethanol-glycerin embalming appears to offer certain advantages for undergraduate students in recognizing visceral structures, which may align with students' ideas on tissue suitability for their learning. Consequently, the benefits reported for Thiel embalming for postgraduate study unlikely reflect its suitability for novices.
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Affiliation(s)
- Veronica Antipova
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Julian F Niedermair
- Central Radiology Institute, Johannes Kepler University Hospital, Linz, Austria
| | - Martin Siwetz
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Franz A Fellner
- Central Radiology Institute, Johannes Kepler University Hospital, Linz, Austria
- Division of Virtual Morphology, Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Sabine Löffler
- Department of Anatomy, University of Leipzig, Leipzig, Germany
| | - Simone Manhal
- Office of the Vice-Rector for Studies and Teaching, Medical University of Graz, Graz, Austria
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra M Pietras
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | | | - Michael L Pretterklieber
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Andreas Wree
- Institute of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology Dresden, Dresden, Germany
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McNeill K, Reyes N, Choe S, Peterson D, Bryant D, Sonnadara RR. A History of Musculoskeletal Medicine and Its Place and Progress in Undergraduate Medical Education. MEDICAL SCIENCE EDUCATOR 2023; 33:777-790. [PMID: 37501799 PMCID: PMC10368607 DOI: 10.1007/s40670-023-01782-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 07/29/2023]
Abstract
Musculoskeletal diseases are responsible for some of the most prevalent conditions affecting population health in the world. Despite the prevalence of these conditions, musculoskeletal medicine has a fraught history within the world of undergraduate medical education. We review the origins of musculoskeletal medicine, its evolution in undergraduate medical education, and progress that has been made over the last decade as a result of global initiatives such as the Bone and Joint Decade. Understanding the history of musculoskeletal medicine is essential to contextualizing the problems that exist today and creating comprehensive solutions to fill the gaps that persist in musculoskeletal curricula.
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Affiliation(s)
- Kestrel McNeill
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
| | - Natasha Reyes
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
| | - Stella Choe
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
| | - Devin Peterson
- Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
| | - Dianne Bryant
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
- Department of Surgery, Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| | - Ranil R. Sonnadara
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
- Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
- Department of Surgery, University of Toronto, 27 King’s College Cir, Toronto, ON M5S 1A1 Canada
- Compute Ontario, Toronto, ON Canada
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Ivarson J, Hermansson A, Meister B, Zeberg H, Bolander Laksov K, Ekström W. Transfer of anatomy during surgical clerkships: an exploratory study of a student-staff partnership. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:221-229. [PMID: 36049218 PMCID: PMC9905002 DOI: 10.5116/ijme.62eb.850a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This qualitative study aims to explore how fourth-year medical students on the surgery course perceived a clinical anatomy workshop organised by near-peer student teachers in partnership with faculty. METHODS Forty-seven medical students participated in a workshop on clinical anatomy in the dissection laboratory. A voluntary response sampling method was used. The students' perceptions of the workshop were explored through a thematic content analysis of transcribed, semi-structured group interviews and written comments. RESULTS A majority of the students had not revisited the dissection laboratory since their second year, and all students described the workshop as a unique opportunity to vertically integrate anatomical knowledge. Four main themes were identified as most valuable for the students' learning experience, namely that the workshop 1) was taught by knowledgeable and friendly near-peer tutors (NPTs), 2) consisted of highly relevant anatomical content, 3) offered a hands-on experience of cadavers in the dissection laboratory, and 4) was taught in a focused session in the middle of the surgery course. CONCLUSIONS This study shows how hands-on workshops in clinical anatomy, developed in student-staff partnerships and taught by NPTs, can enable senior medical students to recall and vertically integrate anatomical knowledge during surgical clerkships. The results have implications for curriculum design, giving voice to senior students' wishes for spaced repetition and vertical integration of pre-clinical anatomy knowledge during their clinical training. Moreover, this study may inspire other students and faculty to develop similar near-peer teaching activities through student-staff partnerships.
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Affiliation(s)
- Josefin Ivarson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - André Hermansson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Björn Meister
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hugo Zeberg
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Klara Bolander Laksov
- Centre for Psychiatry Research, Department of Clinical Neuroscience, CAP Research Centre, Karolinska Institutet, Sweden
| | - Wilhelmina Ekström
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Criado-Álvarez JJ, Mohedano-Moriano A, Aceituno-Gómez J, Romo-Barrientos C, Monforte Perez D, Saiz-Sanchez D, Flores-Cuadrado A, Martín-Conty JL, Martín-Rodriguez F, González-González J, Viñuela A, Polonio-Lopez B. The Importance of Optional Practical Anatomy Courses for Undergraduate Speech Therapy Students. ANATOMICAL SCIENCES EDUCATION 2022; 15:187-197. [PMID: 33794066 DOI: 10.1002/ase.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/21/2021] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Abstract
An in-depth understanding of the anatomy discipline is essential for the work of healthcare professionals. In recent decades, the content and time of teaching anatomy have decreased in all health science degrees. The aim of this study was to look for alternatives for compensating the reduction of the teaching of anatomy by supplementing students with a practical training course and to know evaluations of the course given by students enrolled in the degree in Speech Therapy and its impact on their academic results. All students (100%) positively evaluated having acquired skills and attitudes for their future professional life. The majority of the students (95.8%) believed that their knowledge was acceptable; 97.2% of the students thought they would have the possibility to apply their acquired anatomical knowledge as professionals; 98.5% were satisfied with the voluntary course; and finally, the percentage of students that passed the "Anatomophysiology of language and voice organs" course increased from previous academic years. Optional (theoretical/practical) undergraduate courses can be used in parallel to overcome the devaluation of anatomical studies in new curricula. The optional undergraduate anatomy course in the Speech Therapy program has been positively evaluated because it stimulated students' motivation and appealed to their interest in anatomy. Students considered that these courses would help them in their training and they could put what they had learned into practice in their future professions. However, very little evidence for the impact of optional practical courses exists, yet it could be an efficient method to increase anatomical knowledge.
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Affiliation(s)
- Juan José Criado-Álvarez
- Institute of Health Sciences, Ministry of Health, Talavera de la Reina, Toledo, Spain
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Alicia Mohedano-Moriano
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Javier Aceituno-Gómez
- Integrated Care Management at Talavera de la Reina, Castilla-La Mancha Health Services, Talavera de la Reina, Toledo, Spain
- School of Physiotherapy, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Carmen Romo-Barrientos
- Mental Health Service, Hospital Universitary "Nuestra Señora del Prado," Talavera de La Reina, Toledo, Spain
| | - Diana Monforte Perez
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Daniel Saiz-Sanchez
- Department of Health Sciences, School of Medicine, University of Castilla-La Mancha, Ciudad Real, Spain
- Regional Centre for Biomedical Research, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Alicia Flores-Cuadrado
- Department of Health Sciences, School of Medicine, University of Castilla-La Mancha, Ciudad Real, Spain
- Regional Centre for Biomedical Research, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Jose Luis Martín-Conty
- Department of Nursing, Physiotherapy and Occupational Therapy, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Francisco Martín-Rodriguez
- Department of Medicine, Dermatology and Toxicology, School of Medicine, University of Valladolid, Valladolid, Spain
| | - Jaime González-González
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Integrated Care Management at Talavera de la Reina, Castilla-La Mancha Health Services, Talavera de la Reina, Toledo, Spain
| | - Antonio Viñuela
- Department of Nursing, Physiotherapy and Occupational Therapy, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Begoña Polonio-Lopez
- Department of Nursing, Physiotherapy and Occupational Therapy, School of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
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Crosado B, Löffler S, Ondruschka B, Zhang M, Zwirner J, Hammer N. Phenoxyethanol-Based Embalming for Anatomy Teaching: An 18 Years' Experience with Crosado Embalming at the University of Otago in New Zealand. ANATOMICAL SCIENCES EDUCATION 2020; 13:778-793. [PMID: 31758863 PMCID: PMC7687111 DOI: 10.1002/ase.1933] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 10/28/2019] [Accepted: 11/19/2019] [Indexed: 05/08/2023]
Abstract
Embalming fixatives such as formaldehyde and phenol have been associated with occupational health hazards. While anatomists aim at replacing these chemicals, this seems presently unfeasible in particular for formaldehyde. Furthermore, fixation protocols usually require well-equipped facilities with highly experienced staff to achieve good fixation results in spite of only a minimal use of formaldehyde. Combining these aspects, a technique robust enough to be carried out by morticians is presented, resulting in durable tissues with minimal formaldehyde use. An embalming protocol involving phenoxyethanol was established, using concentrations of 7 and 1.5 Vol% of phenoxyethanol in the fixative and the conservation fluid, respectively. Visual, haptic, histological, and biomechanical properties and their perceived potential to positively influence student learning outcomes were compared to standard embalming techniques. The phenoxyethanol technique provides esthetic, durable, and odorless tissues. Bleaching is less pronounced compared to ethanol- or formaldehyde-based protocols. The tissues remain pliable following the phenoxyethanol-based embalming and can be used for biomechanical experiments to some extent. Phenoxyethanol-fixed tissues are well suited for undergraduate teaching with perceived positive learning outcomes and partly for postgraduate training. Phenoxyethanol tissues provide the option to obtain well-preserved histology samples, similar to those derived from formaldehyde. The provided protocol helps replace the use of phenol and formaldehyde for conservation purposes and minimizes the use of formaldehyde for the initial injection fixation. Phenoxyethanol-based embalming forms an effective alternative to standard embalming techniques for human cadavers. It is simple to use, allowing fixation procedures to be carried out in less sophisticated facilities with non-anatomy staff.
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Affiliation(s)
| | - Sabine Löffler
- Department of AnatomyUniversity of LeipzigLeipzigGermany
| | | | - Ming Zhang
- Department of AnatomyUniversity of OtagoDunedinNew Zealand
| | - Johann Zwirner
- Department of AnatomyUniversity of OtagoDunedinNew Zealand
| | - Niels Hammer
- Department of Clinical and Macroscopic AnatomyMedical University of GrazGrazAustria
- Department of Trauma, Orthopedic and Plastic SurgeryUniversity Hospital of LeipzigLeipzigGermany
- Fraunhofer Institute for Machine Tools and Forming TechnologyDresdenGermany
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Klima S, Cornwall J, Kieser D, Hammer N. The utility and benefit of a newly established postgraduate training course in surgical exposures for orthopedic and trauma surgery. Arch Orthop Trauma Surg 2019; 139:1673-1680. [PMID: 31041521 DOI: 10.1007/s00402-019-03189-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Limited data exist on specialty surgical cadaver courses for graduates, their skill gain, and whether the course contents are transferable to other surgical disciplines. AIM We present the details on the establishment of a specialist trauma and orthopedics approach course, and explore educational and career outcomes from this program. METHODS A 3-day surgical approach course was developed, including a dissection program utilizing Thiel embalmed cadavers. The course was accredited with the local orthopedics association. Participants were assessed by survey on acquired surgical knowledge, skill, decision-making, confidence, and on self-development and effect on career. RESULTS Thirty-one participants successfully completed the courses over 3 years. Increases in surgical skill, knowledge, surgical decision-making and confidence were reported. Skills and confidence also positively impacted on other surgical disciplines. Courses rated highly for learning outcomes; comments highlighted usefulness, applicability, and practicing opportunities, while also impacting positively on career opportunities. CONCLUSION Surgical courses have shown being useful for the acquisition of skills, knowledge, confidence and decision-making, with a positive impact on confidence and decision-making. This information is relevant to future participants, benefactors, surgical programs, and tertiary institutions who want to establish specialist surgical courses.
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Affiliation(s)
- Stefan Klima
- Department of Anatomy, University of Otago, Lindo Ferguson Building, 270 Great King St, Dunedin, 9016, New Zealand.,Department of Trauma, Orthopedic and Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany.,Orthopedicus Clinics, Leipzig, Germany
| | - Jon Cornwall
- Center for Early Learning in Medicine, University of Otago, Dunedin, New Zealand
| | - David Kieser
- Department of Orthopedic Surgery and MSM, Christchurch Hospital, Christchurch, New Zealand
| | - Niels Hammer
- Department of Anatomy, University of Otago, Lindo Ferguson Building, 270 Great King St, Dunedin, 9016, New Zealand. .,Department of Trauma, Orthopedic and Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany. .,Medical Division, Fraunhofer Institute for Machine Tools and Forming Technology, Dresden, Germany.
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Zwirner J, Scholze M, Ondruschka B, Hammer N. Tissue biomechanics of the human head are altered by Thiel embalming, restricting its use for biomechanical validation. Clin Anat 2019; 32:903-913. [DOI: 10.1002/ca.23409] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/13/2019] [Accepted: 05/16/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Johann Zwirner
- Department of Anatomy University of Otago Dunedin New Zealand
| | - Mario Scholze
- Institute of Materials Science and Engineering Chemnitz University of Technology Chemnitz Germany
| | | | - Niels Hammer
- Department of Anatomy University of Otago Dunedin New Zealand
- Department of Orthopedic and Trauma Surgery University of Leipzig Germany
- Fraunhofer IWU Dresden Germany
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