Lachman, Nirusha

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

Advanced plastic and craniomaxillofacial reconstruction is a multidisciplinary field, requiring communication and accurate planning among various specialists including oncologic surgeons, plastic surgeons, and radiologists. Complex defects may present in pediatric congenital deformities, after trauma or oncologic surgery. Restoration of form and function require precise planning among the various specialists involved and accurate execution of the surgical plan. Often, considerations for bony and soft tissue requirements make the reconstruction more challenging. Virtual surgical planning using computed tomographic imaging, 3D surface imaging technology and computer‐aided design allow the surgeons to perform virtual surgery and generate templates and cutting guides that allow for the precise and expedient recreation of the plan in the operating room. The author presents cases highlighting various reconstructive requirements where virtual planning was used for advanced plastic and craniomaxillofacial reconstruction to achieve precise reconstruction. Support or Funding Information None

AbstractThe 3D stereoscopic technique consists in providing the illusional perception of depth of a given object using two different images mimicking how the right and left eyes capture the object. Both images are slightly different and when overlapped gives a three‐dimensional (3D) experience. Considering the limitations for establishing surgical laboratories and dissections courses in some educational institutions, techniques such as stereoscopy and photogrammetry seem to play an important role in neuroanatomy and neurosurgical education. The aim of this study was to describe how to combine and set up realistic models acquired with photogrammetry scans in 3D stereoscopic projections. Three donors, one dry skull, embalmed brain and head, were scanned using photogrammetry. The software used for displaying the final realistic 3D models (Blender, Amsterdam, the Netherlands) is a free software and allows stereoscopic projection without compromising the interactivity of each model. By default, the model was exported and immediately displayed as a red cyan 3D mode. The 3D projector used in the manuscript required a side‐by‐side 3D mode which was set up with simple commands on the software. The final stereoscopy projection offered depth perception and a visualization in 360° of each donor; this perception was noted especially when visualizing donors with different cavities and fossae. The combination of 3D techniques is of paramount importance for neuroanatomy education. Stereoscopic projections could provide a valuable tool for neuroanatomy instruction directed at clinical trainees and could be especially useful when access to laboratory‐based learning is limited.

AbstractOutflow tract ventricular arrhythmias are the most common type of idiopathic ventricular arrhythmia. A systematic understanding of the outflow tract anatomy improves procedural efficacy and enables electrophysiologists to anticipate and prevent complications. This review emphasizes the three‐dimensional spatial relationships between the ventricular outflow tracts using seven anatomical principles. In turn, each principle is elaborated on from a clinical perspective relevant for the practicing electrophysiologist. The developmental anatomy of the outflow tracts is also discussed and reinforced with a clinical case.

Introduction: Medical education is trending towards an outcome-based curriculum that prepares medical graduates to excel in a rapidly evolving, team-centred healthcare delivery system. The Mayo Medical School (MMS) has recently redesigned its curriculum to introduce early clinical relevance, optimise course integration, provide flexibility and promote active learning. This study aims to evaluate the role that curricular flexibility plays in students’ perceived learning, satisfaction and performance. Materials and Methods: First-year students completed a 5-point Likert scale survey regarding satisfaction with and perceived learning from various components of the flexible curriculum during 2 different academic blocks. Students’ academic performance was assessed by a National Board of Medical Examiners (NBME) Subject Examination after each block. Results: In comparing student-rated satisfaction and perceived learning from didactics versus other curricular components for Block 3 (Pathology and Immunology) and Block 5 (Gross Anatomy and Radiology), students rated didactics higher in all cases in which there was a statistically significant difference in the ratings. There was a statistically significant positive correlation between the amount learned and satisfaction for all curricular components with the exception of Block 5 independent study. During Block 3, only interest in the subject matter correlated positively with the NBME score, while during Block 5, only time spent in class correlated negatively with the NBME score. Conclusions: Although various components of the flexible curriculum do not appear to affect satisfaction and perceived learning, their potential influence on graduate outcomes, in terms of delivering healthcare providers who are patient-centred, creative thinkers and compassionate leaders should not be discounted. Key words: Curriculum reform, Medical curriculum, Outcomes-based education, Student satisfaction

Introduction: Changes in worldwide healthcare delivery require review of current medical school curricula structure to develop learning outcomes that ensures mastery of knowledge and clinical competency. In the last 3 years, Mayo Medical School implemented outcomes-based curriculum to encompass new graduate outcomes. Materials and Methods: Standard courses were replaced by 6-week clinically-integrated didactic blocks separated by student-self selected academic enrichment activities. Gross and microscopic anatomy was integrated with radiology and genetics respectively. Laboratory components include virtual microscopy and anatomical dissection. Students assigned to teams utilise computer portals to share learning experiences. High-resolution computed tomographic (CT) scans of cadavers prior to dissection were made available for correlative learning between the cadaveric material and radiologic images. Results: Students work in teams on assigned presentations that include histology, cell and molecular biology, genetics and genomic using the Nexus Portal, based on DrupalEd, to share their observations, reflections and dissection findings. Conclusions: New generation of medical students are clearly comfortable utilising web-based programmes that maximise their learning potential of conceptually difficult and labor intensive courses. Team-based learning approach emphasising the use of knowledge-sharing computer portals maximises opportunities for students to master their knowledge and improve cognitive skills to ensure clinical competency. Introduction: Changes in worldwide healthcare delivery require review of current medical school curricula structure to develop learning outcomes that ensures mastery of knowledge and clinical competency. In the last 3 years, Mayo Medical School implemented outcomes-based curriculum to encompass new graduate outcomes. Materials and Methods: Standard courses were replaced by 6-week clinically-integrated didactic blocks separated by student-self selected academic enrichment activities. Gross and microscopic anatomy was integrated with radiology and genetics respectively. Laboratory components include virtual microscopy and anatomical dissection. Students assigned to teams utilise computer portals to share learning experiences. High-resolution computed tomographic (CT) scans of cadavers prior to dissection were made available for correlative learning between the cadaveric material and radiologic images. Results: Students work in teams on assigned presentations that include histology, cell and molecular biology, genetics and genomic using the Nexus Portal, based on DrupalEd, to share their observations, reflections and dissection findings. Conclusions: New generation of medical students are clearly comfortable utilising web-based programmes that maximise their learning potential of conceptually difficult and labor intensive courses. Team-based learning approach emphasising the use of knowledge-sharing computer portals maximises opportunities for students to master their knowledge and improve cognitive skills to ensure clinical competency. Ann Acad Med Singapore 2008;37:998-1001 Key words: Clinical competency, E-learning, Educational strategies, Medical wikis, Outcomesbased curriculum, Team-based learning Key words: Clinical competency, E-learning, Educational strategies, Medical wikis, Outcomesbased curriculum, Team-based learning

Background: The number of soft-tissue filler injections performed in the United States is constantly increasing and reflects the high demand for enhanced facial and body attractiveness. The objective of the present study was to measure the viscoelastic properties of soft-tissue fillers when subjected to different testing frequencies. The range of tested frequencies represents clinically different facial areas with more [lips (high frequency)] or less [zygomatic arch (low frequency)] soft-tissue movement. Methods: A total of 35 randomly selected hyaluronic acid–based dermal filler products were tested in an independent laboratory for their values of G′, G″, tan δ, and G* at angular frequencies between 0.1 and 100 radian/second. Results: The results of the objective analyses revealed that the viscoelastic properties of all tested products changed between 0.1 and 100 radian/second angular frequency. Changes in G′ ranged from 48.5 to 3116 percent, representing an increase in their initial elastic modulus, whereas changes in G″ ranged from −53.3 percent (i.e., decrease in G″) to 7741 percent (i.e., increase in G″), indicating both an increase and a decrease in their fluidity, respectively. Conclusions: The increase in G′ would indicate the transition from a “softer” to a “harder” filler, and the observed decrease in G″ would indicate an increase in the filler’s “fluidity.” Changes in the frequency of applied shear forces such as those occurring in the medial versus the lateral face will influence the aesthetic outcome of soft-tissue filler injections.

Focus on residents' role in teaching and learning has become a topic of increasing interest underscored by the responsibility that physicians in training are given as facilitators of medical student rotations, supervisors of peers and patient educators. Studies demonstrate that more developed teaching skills are predictive of increased knowledge base and improved clinical skill. As a coveted competency, development of teaching skill has become an established milestone in residency programs and a requirement by regulatory agencies (ACGME, LCME) that training institutions provide more opportunities for formal Resident‐as‐Teacher programs (RAT). In keeping with the authentic learning curriculum, the Student‐as‐Teacher (SAT) program in the Department of Anatomy, Mayo Clinic offers a structured and formal near‐peer teaching opportunity to third year medical students for advancing teaching skills. The program selects an average of 5–6 applicants to participate in teaching a 7‐week Anatomy block for first year medical students in an apprenticeship‐based model that emphasizes (1) Teamwork, (2) Leadership, (3) Lifelong learning, (4) Communication, (5) Core Knowledge, and (6) Teaching Skills/Professional development through individualized mentoring, structured debriefing, and reflective diaries. The purpose of this study is to assess the effectiveness of the apprenticeship model by measuring changes in the targeted competencies in the context of teaching practice. Teaching assistants (TAs) were asked to reflect and evaluate their pre‐ and post‐teaching experience in SAT program on a visual analog scale (VAS). All 5 TAs voluntarily responded to the survey. De‐identified VAS ratings were converted into numerical data from 1 to 100. Most reported increase in perception was in the area of non‐technical skills development: providing feedback (59.7; P = 0.0009); understanding expectations and teaching skills required in medical education (39.7; P = 0.002); and understanding teamwork in teaching role (33.1; P = 0.025). Additionally, TAs appreciated increased acquisition of technical skills: knowledge in anatomy, embryology and radiology (31.4; P = 007). Thematic analysis of responses generated a list of themes which included “appreciation for learning of non‐technical skills” and “skills in providing feedback”. The role of basic science educators is extended through facilitation of future physician required competencies in early medical education. While improvement of anatomical knowledge is an obvious benefit to medical students, improvement of non‐technical skills is reinforced by opportunity of the near‐peer teaching experience. In a teaching role, non‐technical skills supported through the art of “learning by doing” provides senior medical students with an authentic experience and ability to turn the intangible into the tangible. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Professionalism is a core competency of gross anatomy and general medical school curricula requiring students to develop the skills of giving and receiving peer feedback. Our study evaluated the effectiveness of delivering feedback in a group setting compared to delivering it individually. The first year class of Mayo medical students (n=50) enrolled in gross anatomy (in dissection teams of 3 or 4) completed weekly anonymous peer‐evaluations of their team regarding multiple aspects of professionalism (integrity, responsibility, compassion, and peer respect). Professionalism scores were calculated using the quantitative values from these surveys. Students were also asked to comment on strengths and areas for improvement for each student. At the mid‐point of the course, peer comments and professionalism scores were shared with students in debriefing sessions, either individually or as a team. Preliminary analysis of pre‐ and post‐intervention professionalism scores indicates that students receiving feedback in a group setting are more likely to demonstrate higher scores on subsequent evaluations. Our findings suggest that providing feedback to first‐year medical students in a group setting is more beneficial for group dynamics and may improve professional attitudes and behaviors. This work was supported by the Mayo Clinic Department of Anatomy. Grant Funding Source None