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Maffucci P, Park CH, Shirur M, Hyers B, Levine AI, Katz D, Burnett GW, Laitman JT. Human dissection for anesthesiology resident training augments anatomical knowledge and clinical skills. ANATOMICAL SCIENCES EDUCATION 2024; 17:413-421. [PMID: 38124364 DOI: 10.1002/ase.2364] [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: 06/18/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
Anatomy is an essential component of clinical anesthesiology. The use of simulated patients and alternative materials, including embalmed human bodies, have become increasingly common during resident physician training due to the deemphasis on anatomical education during undergraduate medical training. In this report, the need for a more extensive review of relevant anatomy for the practice of anesthesiology was addressed by the design, evaluation, and dissemination of a human dissection course for procedural training of anesthesiology residents. The course utilized "freedom art" embalmed human bodies that allowed trainees to perform ultrasound-based regional and neuraxial techniques followed by detailed dissections of critical anatomy. One hundred and four residents participated in workshops and small group discussions and were evaluated using pre- and post-course assessments. A variety of clinical techniques were performed on the bodies, including regional blocks and neuraxial catheter placement. Insertion of peripheral/neuraxial catheters was successful, with dissections demonstrating the expected placement. Assessment scores improved following the course (pre-course mean 52.7%, standard deviation (σ) 13.1%; post-course mean 72.2%, σ 11.6%; t-test p < 0.0001) and feedback highlighted the usefulness and clinical relevance of course content. The ability to correlate ultrasound imaging with subsequent dissections of the "blocked" area and visualization of dye staining was extremely relevant for spatial understanding of the anatomy relevant for the clinical practice of these techniques. This manuscript demonstrates successful implementation of a comprehensive course for anesthesiology resident physicians to address gaps in undergraduate anatomical education and suggests that broader adoption of dissection courses may be beneficial for training anesthesiologists.
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Affiliation(s)
- Patrick Maffucci
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Chang H Park
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mo Shirur
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin Hyers
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam I Levine
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel Katz
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Garrett W Burnett
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeffrey T Laitman
- Center for Anatomy and Functional Morphology, Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Adkins EN, Barrett E, D'Amato J, Maxwell RA, Kindig M. Learning Pelvic Anatomy and Pathology Through Drawing: An Interactive Session in the Obstetrics and Gynecology Clerkship. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2023; 19:11363. [PMID: 38058493 PMCID: PMC10696139 DOI: 10.15766/mep_2374-8265.11363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/08/2023] [Indexed: 12/08/2023]
Abstract
Introduction Within undergraduate medical education, there is a gap between students' understanding of anatomy and application of that knowledge within surgical specialties. The integration of drawing, in conjunction with traditional learning, has been shown to increase retention and understanding of information. Currently, no educational curriculum integrates drawing to aid in medical students' understanding of surgical pelvic anatomy. We anticipated that the utilization of drawing anatomy in an OB/GYN clerkship would enhance students' ability to explain surgical pelvic anatomy and pelvic pathology. Methods At the beginning of the OB/GYN clerkship, third-year medical students participated in an interactive, 1.5-hour session requiring them to draw pelvic anatomy, present their work, and explain topics related to pelvic surgery and pathology to the other clerkship students. At the end of their clinical rotation, the students were invited to complete a five-item survey to assess long-term retention and understanding of concepts presented in the session. Frequencies and percentages were calculated for all categorical/ordinal variables to describe survey participants and question responses. Results Thirty-seven of 44 respondents (84%) reported that the anatomy interactive session prepared them for the surgical portion of the OB/GYN clinical rotation. Thirty-five respondents (80%) reported that drawing the pelvic structures helped their understanding of pelvic pathology; 33 respondents (75%) reported they had a thorough understanding of pelvic anatomy after taking the OB/GYN anatomy interactive educational session (p < .001). Discussion Our session shows that integrating drawing and anatomy increases students' ability to discuss pelvic pathology and surgical anatomy.
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Affiliation(s)
- Elisabeth N. Adkins
- First-Year Resident, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center
| | - Elizabeth Barrett
- Fourth-Year Resident, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
| | - Josette D'Amato
- Assistant Professor, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
| | - Rose A. Maxwell
- Associate Professor and Research Director, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
| | - Marilyn Kindig
- Assistant Professor and Clerkship Director, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
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Koppes DM, Vesseur MAM, Schepens-Franke AN, Kruitwagen RFPM, Notten KJB, Scheele F. Anatomy in the daily practice of the gynecologist, essential or just window dressing? ANATOMICAL SCIENCES EDUCATION 2023; 16:497-503. [PMID: 36448881 DOI: 10.1002/ase.2236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 09/17/2022] [Accepted: 11/26/2022] [Indexed: 05/11/2023]
Abstract
Traditionally, anatomy was one of the basic pillars of medical training. However, due to the expansion of medical science and medical knowledge in general, anatomy teaching has steadily declined and the way anatomy is taught has changed. These changes go hand in hand with growing literature about a perceived and proven lack of anatomical knowledge. While anatomy is important for all doctors, these developments seem to be more worrying for surgical residents. At the same time, little is known about how clinicians use anatomy in daily practice. The primary aim of this study was to increase understanding of the role of anatomy in the daily practice of gynecologists. An explorative qualitative study was performed to answer the question "What is the tangible utility of solid anatomical knowledge in the daily practice of the gynecologist"? Semi-structured interviews with gynecologists and obstetrics and gynecology (ObGyn) residents from Belgium and the Netherlands were held and the responses were analyzed using a phenomenographic inductive coding approach. Anatomical knowledge was important and used for technical skills and non-technical achievements in the daily practice of gynecologists, and three themes were distinguished. Specifically, anatomical knowledge was important and used (1) for daily activities, (2) for the feeling of self-efficacy, and (3) to gain a respected name as a doctor. These findings are discussed in light of (perceived) insufficient anatomical knowledge, and recommendations are made for the postgraduate education of ObGyn doctors.
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Affiliation(s)
- Dorothea M Koppes
- Department of Obstetrics and Gynecology, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
- School for Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Maud A M Vesseur
- Faculty of Medicine, University Maastricht, Maastricht, the Netherlands
| | | | - Rutgerus F P M Kruitwagen
- Department of Obstetrics and Gynecology, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
- School for Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Kim J B Notten
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Fedde Scheele
- Amsterdam Academic Medical Center, Research in Education, Location VUmc, Amsterdam, the Netherlands
- Athena Institute for Trans-Disciplinary Research, The Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Streith L, Cadili L, Wiseman SM. Evolving anatomy education strategies for surgical residents: A scoping review. Am J Surg 2022; 224:681-693. [PMID: 35180995 DOI: 10.1016/j.amjsurg.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Dedicated anatomy educational time in medical schools has decreased significantly, disproportionately affecting surgical residents. In this scoping review, we aim to consolidate existing evidence, describe ongoing research, and highlight future directions for surgical anatomy education. METHODS Two independent investigators searched MEDLINE, EMBASE, and the Cochrane library, for educational interventions targeting anatomy knowledge in surgical residents. English articles until October 28, 2021, were reviewed. RESULTS 1135 abstracts were considered, and 59 (5.2%) included. Agreement on inclusion was excellent (k = 0.90). The majority were single-cohort studies (53%) and prospective cohort studies (17%). The most common disciplines were General Surgery (17%) and Obstetrics and Gynecology (17%). DISCUSSION Cadavers consistently produce positive knowledge gains and are heavily favored by residents. They remain the educational method to which new educational models are compared. New technologies do not yet match cadaver fidelity. Research showing knowledge translation from cadaver labs to patient outcomes remains limited.
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Affiliation(s)
- Lucas Streith
- Department of Surgery, St. Paul's Hospital & University of British Columbia, C303-1081 Burrard Street, Vancouver, Canada
| | - Lina Cadili
- Department of Surgery, St. Paul's Hospital & University of British Columbia, C303-1081 Burrard Street, Vancouver, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, C303-1081 Burrard Street, Vancouver, Canada.
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Nedimyer JD, Hirumi A, Cendan JC. Rigorous Curricular Innovation: Development, Integration, and Evaluation of Anatomic Clinical Correlations Module. JOURNAL OF SURGICAL EDUCATION 2022; 79:190-197. [PMID: 34518121 DOI: 10.1016/j.jsurg.2021.08.014] [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: 04/29/2021] [Revised: 07/16/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To develop an anatomy clinical correlations module utilizing modern instructional design techniques and theoretically structured student feedback for course improvements. DESIGN A pre-experimental, single group post-test study. Eleven module sessions were structured using the 5-E instructional strategy (engage, explore, explain, elaborate, and evaluate). Learning impact was measured using Keller's ARCS framework (attention, relevance, confidence, and satisfaction) and narrative student feedback was collected to inform case alterations. The course was repeated the following year with the integrated feedback and year-on-year comparisons were drawn. SETTING Single-institution study at the University of Central Florida College of Medicine. PARTICIPANTS Medical students currently enrolled in the first-year anatomy course. RESULTS Year-on-year comparisons for AY18-19 (n = 78) and AY19-20 (n = 118) yielded statistically significant improvements in attention (4.69-4.76, p = 0.01) and relevance (4.54 to 4.75, p ≤ 0.001) with high total combined survey response rates (n = 196/238, 82.4%). Internal consistency was good for attention and strong for the following scales: total scale, relevance, confidence, and satisfaction. Narrative feedback referenced the importance of applied anatomy, clinical context and decision-making, the format of the sessions. CONCLUSIONS We structured a series of anatomic clinical correlations using an evidence-based instructional strategy, assessed its impact, and improved on the course to optimize the motivation to learn anatomy. Systematic use of structured student feedback is important to ensure case difficulty is within the zone of proximal development.
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Affiliation(s)
- Julia D Nedimyer
- University of Central Florida College of Medicine, Department of Medical Education, Orlando, Florida.
| | - Atsusi Hirumi
- University of Central Florida College of Medicine, Department of Medical Education, Orlando, Florida
| | - Juan C Cendan
- University of Central Florida College of Medicine, Department of Medical Education, Orlando, Florida
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Sanguin S, Roman H, Foulon A, Gondry J, Havet E, Klein C. Deep infiltrating endometriosis with sacral plexus involvement: Improving knowledge through human cadaver dissection. J Gynecol Obstet Hum Reprod 2021; 50:102129. [PMID: 33781973 DOI: 10.1016/j.jogoh.2021.102129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/19/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of this study was to assess a human cadaver model of sacral plexus dissection for learning about deep innervation in the female pelvis, and the latter's relationship with deep infiltrating endometriosis. METHODS This was a prospective, observational study. Eight residents in obstetrics and gynecology were tested before and after a lecture on innervation of the female pelvis and a cadaver dissection class. Standardized cadaver dissection was used to identify the sacral nerve roots S2 to S4, superior and inferior hypogastric plexuses, hypogastric nerve, and splanchnic nerves. RESULTS The residents' level of knowledge improved significantly after a one-hour lecture (p = 0.9.10-5) and after a cadaver dissection class (p = 0.6.10-6). The improvement was significantly greater for the dissection class (p = 0.0003). All the pelvic nerve structures were identified in all but one of the cadavers and had similar measurements. A vascular anatomical variant was observed in one case. CONCLUSION A human cadaver model is of value for learning about deep pelvic innervation and the latter's relationship with deep infiltrating endometriosis. The reproducibility and safety of cadaver dissection might improve surgical skills.
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Affiliation(s)
- Sophie Sanguin
- Department of Gynecology and Obstetrics, Amiens University Medical Center, Amiens, F-80054, France
| | - Horace Roman
- Endometriosis Center, Clinique Tivoli-Ducos, F- 33000, Bordeaux, France; Department of Gynecology and Obstetrics, Aarhus University Medical Center, Nordre Ringgade 1, 8000 Aarhus C, Denmark
| | - Arthur Foulon
- Department of Gynecology and Obstetrics, Amiens University Medical Center, Amiens, F-80054, France
| | - Jean Gondry
- Department of Gynecology and Obstetrics, Amiens University Medical Center, Amiens, F-80054, France
| | - Eric Havet
- Anatomy Laboratory, Jules Verne University of Picardie, Amiens, F-80054, France
| | - Céline Klein
- Anatomy Laboratory, Jules Verne University of Picardie, Amiens, F-80054, France; Department of Pediatric Orthopedic Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, F-80054, France.
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Hunter LD, Mosley CF, Quinn MM, Cray JJ, Baker AS, Burgoon JM, Kalmar E, McHugh KM. A Novel Approach to Gross Dissection of the Human Pelvis and Perineum. ANATOMICAL SCIENCES EDUCATION 2020; 13:618-627. [PMID: 31758729 DOI: 10.1002/ase.1932] [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: 10/03/2018] [Revised: 10/10/2019] [Accepted: 11/19/2019] [Indexed: 06/10/2023]
Abstract
Progressive curricular changes in medical education over the past two decades have resulted in the diaspora of gross anatomy content into integrated curricula while significantly reducing total contact hours. Despite the development of a wide range of alternative teaching modalities, gross dissection remains a critical component of medical education. The challenge posed to modern anatomists is how to maximize and integrate the time spent dissecting under the current curricular changes. In this study, an alternative approach to the dissection of the pelvis and perineum is presented in an effort to improve content delivery and student satisfaction. The approach involves removal of the perineum en bloc from the cadaver followed by excision of the pubic symphysis, removal and examination of the bladder and associated structures, examination and bisection of the midline pelvic organs in situ, and midsagittal hemisection of the pelvis for identification of the neurovasculature. Results indicate that this novel dissecting approach increases the number of structures identified by 46% ± 14% over current dissecting methods. Survey results indicate that students were better able to integrate lecture and laboratory concepts, understand the concepts, and successfully identify more structures using the new approach (P < 0.05). The concept of anatomic efficiency is introduced and proposed as a standard quantitative measure of gross dissection proficiency across programs and institutions. These findings provide evidence that innovative solutions to anatomy education can be found that help to maintain critical content and student satisfaction in a modern medical curriculum.
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Affiliation(s)
- Leah D Hunter
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio
| | - Claudia F Mosley
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio
| | - Melissa M Quinn
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio
| | - James J Cray
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio
| | - Anthony S Baker
- Medical Visuals Department, Health Sciences Library, The Ohio State University, Columbus, Ohio
| | - Jennifer M Burgoon
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio
| | - Eileen Kalmar
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio
| | - Kirk M McHugh
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio
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Vallabhajosyula R, Mathur M, Kathirvel R, Madan AI, Kang J, Mogali SR. Getting back to basics: Reintroduction of pelvic anatomy concepts for obstetrics and gynaecology residents. PROCEEDINGS OF SINGAPORE HEALTHCARE 2020. [DOI: 10.1177/2010105820935913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: A sound understanding of pelvic anatomy is essential for training in obstetrics and gynaecology (OBGYN) and for practising in the field post-qualification. There is a growing concern that surgery residents have an inadequate knowledge of anatomy and little confidence in their approach to the subject. Objective: This study aims to explain the use of an anatomy workshop to deliver a unique and self-designed innovative instruction method that employs cutting-edge resources to enhance OBGYN residents’ comprehension of clinical anatomy and to discuss why this approach works. Methodology: The workshop emphasised the clinical and surgical anatomy of the female pelvis using 3-D virtual dissections, relevant plastinated specimens and also bony pelvic models that had been developed in house. Anatomists and OBGYN consultants facilitated the workshop. The students’ knowledge of anatomy and their perceptions of the subject were evaluated by pre- and post-tests and a five-point Likert scale, respectively. A mixed methods analysis was applied. Results: Of the 42 participants, 26 (61.9%) completed both the pre- and post-test. The overall difference (mean percentage) between the pre- and post-test performance was 25.41%. There was a significant difference in the residents’ knowledge of anatomy between the pre- and post-workshop ( p<0.05). Participants ( n=10) provided positive feedback on the workshop content, teaching tools, learning activities and educators. They recommended that the workshop should be held at least once a year (70%), and particularly during the first year of residency (90%). Conclusion: The active learning workshop enabled by multidisciplinary teaching and the innovative tools employed resulted in improved outcomes in knowledge of anatomy, confidence and learning satisfaction. Reintroduction of anatomy concepts during OBGYN residency training is needed to improve surgical training and patient care.
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Affiliation(s)
| | - Manisha Mathur
- Obstetrics & Gynaecology, KK Women’s and Children’s Hospital, Singapore
| | - Rajeswari Kathirvel
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Obstetrics & Gynaecology, KK Women’s and Children’s Hospital, Singapore
| | | | - Julian Kang
- Obstetrics & Gynaecology, KK Women’s and Children’s Hospital, Singapore
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Quiroga-Garza A, Teran-Garza R, Elizondo-Omaña RE, Guzmán-López S. The Use of Clinical Reasoning Skills in the Setting of Uncertainty: A Case of Trial Femoral Head Migration. ANATOMICAL SCIENCES EDUCATION 2020; 13:102-106. [PMID: 30763453 DOI: 10.1002/ase.1869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/26/2019] [Accepted: 02/11/2019] [Indexed: 06/09/2023]
Abstract
Clinical skills and medical knowledge enable physicians to overcome the uncertainty of emergent and rare clinical scenarios. Recently, a growing emphasis on evidence-based medicine (EBM) has flooded medical curricula of universities across the globe with guideline-based material, and while it has given teachers and students new tools to improve medical education, clinical reasoning must be reaffirmed in its capacity to provide physicians with the ability to solve unexpected clinical scenarios. Anatomical education in medical school should have two main objectives: to acquire anatomical knowledge and to develop the skill of applying that knowledge in clinical scenarios. The authors present a clinical scenario in which an unexpected and rare complication occurred during a routine elective hip replacement surgery. The general surgeon presiding over the case, also an anatomy professor, solved the problem using clinical reasoning and anatomical knowledge. It was a clear example of how clinical reasoning is key in approaching unprecedented, rare, or unknown complications. The intention of this scenario is to remind colleagues and medical schools that, although EBM is the standard, educators must uphold sound clinical reasoning to best prepare health care providers for their careers.
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Affiliation(s)
- Alejandro Quiroga-Garza
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Rodrigo Teran-Garza
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - Santos Guzmán-López
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
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Selcuk İ, Tatar I, Huri E. Cadaveric anatomy and dissection in surgical training. Turk J Obstet Gynecol 2019; 16:72-75. [PMID: 31019843 PMCID: PMC6463429 DOI: 10.4274/tjod.galenos.2018.15931] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/24/2018] [Indexed: 12/27/2022] Open
Abstract
Detailed knowledge of anatomy is an essential part of surgical practice. However, there are many drawbacks in anatomy education that make many residents feel inadequate when they start performing surgeries. Cadaveric dissection courses aim to close the gap between the anatomic knowledge and surgical practice. This review focuses on the role of cadaveric dissection on surgical education, and additionally states the panel decision of the Surgical Anatomy and Technologies Association on the proper use of cadavers.
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Affiliation(s)
- İlker Selcuk
- University of Health Sciences, Zekai Tahir Burak Woman's Health Training and Research Hospital, Clinic of Gynecologic Oncology, Ankara, Turkey
| | - Ilkan Tatar
- Hacettepe University Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Emre Huri
- Hacettepe University Faculty of Medicine, Department of Urology, Ankara, Turkey
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Klima S, Hepp P, Löffler S, Cornwall J, Hammer N. A novel phased-concept course for the delivery of anatomy and orthopedics training in medical education. ANATOMICAL SCIENCES EDUCATION 2017; 10:372-382. [PMID: 28002644 DOI: 10.1002/ase.1675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 11/17/2016] [Accepted: 11/19/2016] [Indexed: 06/06/2023]
Abstract
Integration of anatomy and clinical teaching is a theoretical ideal, yet there is a worldwide paucity of such amalgamation. These teaching models provide support for medical trainees, an important element in Germany where orthopedic intern numbers have declined and anecdotal evidence suggests disinterest in orthopedics. The aim of the study was to develop an integrated anatomy-surgical course for undergraduate medical training, assess the model developed, and explore how medical students perceive orthopedics as a career. The course was to deliver medical anatomy and clinical orthopedic training, focusing on interdisciplinary teaching and learning, vertical integration of clinical knowledge and skills, and professional interaction. Survey evaluation of the course and students' perceptions of orthopedic careers was performed, including Likert-type responses rating variables of interest. A phased-concept program of five courses, each optional and under one-week in duration, was developed parallel to the undergraduate medical program. Delivered by anatomists and surgeons, courses included biomechanics, advanced dissection, surgical approaches, casts and implants, and sports medicine. Course data indicate positive support for course format, stimulation of interest, and high clinical relevance. Students are generally interested in surgery, and identify hierarchy, lawsuits, bureaucracy and physical stress as barriers to orthopedic careers. This novel phased-concept successfully delivers combined anatomy and surgery training in a vertically-integrated format while addressing students' clinical and professional skills. The format facilitates an appreciation of potential career options in orthopedics, while fostering professional skills during medical training. Barriers to careers in orthopedics can now be addressed in future courses. Anat Sci Educ 10: 372-382. © 2016 American Association of Anatomists.
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Affiliation(s)
- Stefan Klima
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany
| | - Pierre Hepp
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany
| | - Sabine Löffler
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Jon Cornwall
- Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand
| | - Niels Hammer
- Department of Anatomy, University of Otago, Dunedin, New Zealand
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13
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Teaching surgical exposures to undergraduate medical students: an integration concept for anatomical and surgical education. Arch Orthop Trauma Surg 2015; 135:795-803. [PMID: 25896822 DOI: 10.1007/s00402-015-2217-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Indexed: 02/09/2023]
Abstract
BACKGROUND Decreasing numbers of students are interested in starting a surgical career, posing substantial challenges to patient care in the next years. The anatomy course is one of the key subjects in medical training, especially in surgical disciplines. Innovative teaching concepts that integrate surgically relevant anatomy and manual dexterity might help boost student interest in surgery. METHODS A preclinical workshop entitled "Surgical exposures" was developed. A team of anatomists and surgeons introduced the surgical exposures, demonstrating the procedures on Thiel-fixed body donors. Following this introduction, students practiced the exposures in an operating room-like manner. A six-point Likert scale was used to evaluate the workshop and to compare it to the first-year dissection course. RESULTS The overall evaluation result for the surgical exposures was excellent, proving to be a significantly better result when compared to the first-year dissection course. The students were more satisfied with the teaching time invested by the peers and regarded the workshop as clinically highly relevant. Furthermore, they felt that questions were addressed better and that the overall atmosphere was better than in the gross anatomy course. Subject to criticism was the course size and practicing time in both cases. DISCUSSION The surgical exposures workshop provides preclinical students with clinically relevant anatomy and manual dexterity. It may positively influence the decision to follow a surgical career. This course, however, requires extensive teaching resources. The given concept may help implement practical medical skills in the preclinical curriculum, strengthening the professional identity of surgeons and anatomists.
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Dilandro AC, Chappell TM, Panchani PN, Kozlowski PB, Tubbs RS, Khan KH, D'Antoni AV. A chemical application method with underwater dissection to improve anatomic identification of cadaveric foot and ankle structures in podiatric education. J Am Podiatr Med Assoc 2014; 103:387-93. [PMID: 24072367 DOI: 10.7547/1030387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Many cadaver-based anatomy courses and surgical workshops use prosections to help podiatry students and residents learn clinically relevant anatomy. The quality of these prosections is variable and dependent upon the methods used to prepare them. These methods have not been adequately described in the literature, and few studies describe the use of chemicals to prepare prosections of the cadaveric foot and ankle. Recognizing the need for better teaching prosections in podiatric education, we developed a chemical application method with underwater dissection to better preserve anatomic structures of the cadaveric foot and ankle. METHODS We used inexpensive chemicals before, during, and after each step, which ultimately resulted in high-quality prosections that improved identification of anatomic structures relevant to the practice of podiatric medicine. RESULTS Careful preservation of clinically important nerves, vessels, muscles, ligaments, and joints was achieved with these prosections. CONCLUSIONS Although this method required additional preparation time, the resultant prosections have been repeatedly used for several years to facilitate learning among podiatry students and residents, and they have held up well. This method can be used by educators to teach podiatry students throughout their medical training and even into residency.
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Affiliation(s)
- Anthony C Dilandro
- Division of Pre-clinical Sciences, New York College of Podiatric Medicine, New York, NY
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Ullah SM, Bodrogi A, Cristea O, Johnson M, McAlister VC. Learning surgically oriented anatomy in a student-run extracurricular club: an education through recreation initiative. ANATOMICAL SCIENCES EDUCATION 2012; 5:165-170. [PMID: 22434649 DOI: 10.1002/ase.1273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 02/05/2012] [Accepted: 02/20/2012] [Indexed: 05/31/2023]
Abstract
Didactic and laboratory anatomical education have seen significant reductions in the medical school curriculum due, in part, to the current shift from basic science to more clinically based teaching in North American medical schools. In order to increase medical student exposure to anatomy, with clinical applicability, a student-run initiative called surgically oriented anatomy prosectors (SOAP) club was created within the extracurricular program at the Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada. SOAP invites surgeons and residents from various surgical specialties to demonstrate, on a cadaver, a surgical procedure of their choosing. During the demonstration, the anatomy, as it relates to the surgical procedure, is discussed. The students then break into smaller groups to examine the relevant anatomy on the cadavers, during which time the discussion is broadened. The group continues the conversation in a social environment with refreshments. SOAP is one of the most popular extracurricular clubs with 65% of first and second year medical students registered as members. The high demand for SOAP, along with the positive participant feedback, may be due to its utilization of the principle of education through recreation, which seeks to provide opportunities for learning seamlessly throughout all facets of life. It also demonstrates the desire, amongst certain medical students, to learn applied anatomy, particularly within a surgical context.
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Affiliation(s)
- Shahnoor M Ullah
- Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
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