Capo, Jason

Objective The objective of this study was to introduce musculoskeletal physical examination skills in the gross anatomy course as a teaching tool and to evaluate medical students’ perceptions of this experience. Methods A list of 27 clinical examinations of the upper and lower limbs was generated from published core recommendations for undergraduate medical education. During gross anatomy laboratory sessions, teaching assistants (third year medical students) presented one or two of the clinical skills related to that day’s dissection to groups of 3–4 students at a time. The anatomic relationships tested by the clinical examinations were highlighted. One question on the laboratory examination at the end of the unit was an Objective Structured Clinical Examination (OSCE) station where students were given a clinical scenario and asked to demonstrate a physical examination that they would use in evaluating the patient. Following the upper and lower limb units, the students were given a Likert‐scale survey to evaluate their perceptions of the experience. Results Survey responses indicated that most students felt the physical examination demonstrations improved their understanding of the clinical significance of the related anatomy, increased their interest in and motivation to learn the material, and made the laboratory experience more enjoyable. Conclusions Introducing musculoskeletal physical examination skills in the gross anatomy course can be an effective way to emphasize the clinical significance of the anatomy, thereby enhancing students’ motivation to learn the material.

OBJECTIVE. We investigated the prevalence and types of psychiatric disorders diagnosed by early adulthood among patients who had common forms of strabismus as children. METHODS. The medical records of children (<19 years) who were diagnosed as having esotropia (N = 266) or exotropia (N = 141) while residents of Olmsted County, Minnesota, between January 1, 1985, and December 31, 1994, were reviewed retrospectively for psychiatric disease diagnoses. Each case subject was compared with a randomly selected, individually birth- and gender-matched, control subject from the same population. RESULTS. A mental health disorder was diagnosed for 168 (41.3%) of the 407 patients with a history of childhood strabismus, who were monitored to a mean age of 17.4 years, compared with 125 control subjects (30.7%). Children with exotropia were 3.1 times more likely to develop a psychiatric disorder than were control subjects when monitored to a mean age of 20.3 years. Children with esotropia were no more likely to develop mental illness than were control subjects when monitored for similar periods. Patients with intermittent exotropia also were significantly more likely to have greater numbers of mental health disorders, mental health emergency department visits, and mental health hospitalizations and to have suicidal or homicidal ideation. CONCLUSIONS. Children diagnosed as having strabismus in this population, especially those with exotropia, were at increased risk for developing mental illness by early adulthood. Patients with intermittent exotropia seemed to be particularly prone to developing significant psychiatric diseases by the third decade of life.