Harper, Caitlin J.

While small group learning and team‐based learning (TBL) have become widely accepted modalities in medical education, surprisingly little is known about how medical students interact between and within their learning teams and how dissection teams themselves interact with faculty or teaching assistants (TAs). This study sought to examine: (1) interactions between faculty/TAs and student teams; and (2) student table‐to‐table interactions taking place in the anatomy didactic block at Mayo Medical School. In addition, interactions between students in the same student team and overall team dynamics were examined by faculty. The purpose of this study is to understand dissection group dynamics and how these sets of interactions relate to student academic performance . The amount of time faculty/TAs spent with a group during each teaching session was recorded by students at the end of each session. The number of team‐to‐team interactions were also recorded. These values were then compared to student examination performance. Results from this study indicated that the individual time faculty/TAs spend with teams and the number of table‐to‐table interactions appeared to have no correlation with overall team academic performance. However, faculty assessment of interactions within student teams and overall team dynamics appears to be an accurate predictor of the team's overall academic performance, where groups with well‐defined leadership roles and strong cooperation between team members performed higher than those where this was not present . Support or Funding Information Mayo Clinic College of Medicine Department of Anatomy

ABSTRACTIntroduction: Needle electromyography (EMG) of the diaphragm carries the potential risk of pneumothorax. Knowing the approximate depth of the diaphragm should increase the test's safety and accuracy. Methods: Distances from the skin to the diaphragm and from the outer surface of the rib to the diaphragm were measured using B mode ultrasound in 150 normal subjects. Results: When measured at the lower intercostal spaces, diaphragm depth varied between 0.78 and 4.91 cm beneath the skin surface and between 0.25 and 1.48 cm below the outer surface of the rib. Using linear regression modeling, body mass index (BMI) could be used to predict diaphragm depth from the skin to within an average of 1.15 mm. Conclusions: Diaphragm depth from the skin can vary by more than 4 cm. When image guidance is not available to enhance accuracy and safety of diaphragm EMG, it is possible to reliably predict the depth of the diaphragm based on BMI. Muscle Nerve 49: 666–668, 2014

Introduction : Real time ultrasound imaging of the diaphragm is an under‐used tool in the evaluation of patients with unexplained dyspnea or respiratory failure. Methods : We measured diaphragm thickness and the change in thickness that occurs with maximal inspiration in 150 normal subjects, with results stratified for age, gender, body mass index, and smoking history. Results : The lower limit of normal diaphragm thickness at end expiration or functional residual capacity is 0.15 cm, and an increase of at least 20% in diaphragm thickness from functional residual capacity to total lung capacity is normal. A side to side difference in thickness at end expiration of > 0.33 cm is abnormal. Diaphragm thickness and contractility are minimally affected by age, gender, body habitus, or smoking history. Conclusions : This study confirms previous findings in much smaller groups of normal controls for quantitative ultrasound of the diaphragm and provides data that can be applied widely to the general population. Muscle Nerve 47: 884–889, 2013