Citations

While fundamental principles of anatomy are well‐established in early medical training, continued retention of anatomical knowledge is dependent on value, importability and relevance to surgical practice. As novel reconstructive strategies emerge, surgeons must account for individual patient factors and comorbidities in predicting patient outcome. Mastery of planning requires precise knowledge of local anatomy and reconstructive techniques, warranting reconnection with prior anatomic knowledge. Finding dedicated time to learn anatomy through self‐guided approach, is often challenging in a busy practice and CPD opportunities become a highly valued resource. In recent years, two mainstream professional dermatology societies have provided a platform for delivery of anatomy based clinical sessions. This study aims to assess value of point of care delivery of relevant anatomy and its role in improving perception of surgical confidence amongst procedural dermatologists in a CPD course. Assessment of core knowledge and knowledge gaps was conducted through the American College of Mohs Surgery (ACMS). Objectives were designed by a team of anatomists and clinicians based on a series of challenging cases. Anatomy sessions were offered at a large general session (>300 participants) and a small group hands‐on flap based session (n=20) Key anatomic teaching points relating to danger zones, safe zones and functional impairment were highlighted. Videos of real‐time dissection using a layered approach of targeted anatomy were created and supplemented with 3D‐printed models. For challenging anatomy encountered during Mohs reconstruction, patient defects were re‐created on the cadaver highlighting pertinent anatomy. Qualitative and quantitative analyses were conducting using course review for general session and confidence rating using Likert scale of anatomy based objectives for small group session. While 60–90 minute general session was sufficient for anatomist‐clinician team to facilitate discussion, participants indicated strong desire for increased session time. Videos and high quality photography were seen as outstanding tools for demonstrating anatomy within surgical field. Participants strongly valued anatomist/clinician partnership and relevance of material to everyday practice. Session review data (n=78) indicated session objectives “improved their ability to provide excellent patient care by helping close practice gaps”( 89.74%), helped “identify practice gaps in knowledge, performance and outcomes” (83.33%) and material presented was relevant to their Mohs and dermatologic practice (100%). Within small group session (n=11), only 18% had access to anatomy facility and material, with 100% agreeing/strongly agreeing that anatomy education was critical to their current practice. Analysis of perceived confidence in anatomic knowledge post course showed significant improvement in confidence in identifying, isolating and visualizing relevant anatomical (p<0.05). Positive impact of collaborative teaching of anatomy outside a mainstream academic setting using targeted point of care delivery through the use of technology (video), products of technology (photography and 3D‐printed material) and patient based clinical discussion to improve physician confidence was demonstrated. In era of authentic learning, anatomists share a responsibility for bringing point‐of‐care content for improved patient care. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Medical professionalism is a multifaceted concept that includes maintenance of knowledge, interpersonal skills, teamwork, privacy and honesty. While non‐technical skills are often under‐emphasized in the medical student learning environment these skills are directly associated with providing professional medical care. There is an increasing trend however, for basic science courses such as Anatomy to introduce medical students early onto the concept of professionalism and highlight the importance of non‐technical skill development to patient care. To reinforce these competencies as well as develop an authentic curriculum for non‐technical skill development, anatomists and internists at Mayo Clinic, College of Medicine aligned objectives within medical school and residency programs. Strategies were designed to evaluate (1) teamwork, (2) communication and (3) self‐reflection. The aim of this presentation is to demonstrate how each of these core competencies can be promoted in both residency and medical student curricula and how trainee and student progress may be measured by educational approaches within their learning environments. Strategies include the use of a team charter, self‐reflection/reflective diaries and communication exercises that target patients and the multidisciplinary health care team. Through educational design (1) trainee and student's ability to acknowledge self‐limitation and develop critical thinking skills appeared to evolve and (2) trainee and student appreciation of the importance of communication skills when interacting with different groups as well as ability to translate medical/anatomical terminology to lay language were evident. In addition, the use of reflection and team charters promoted understanding team dynamics and facilitation of effective teamwork. The current multi‐disciplinary health care environment places strong emphasis on team‐work, confidentiality of protected health information and the role of communication in preventing medical errors and improving patient outcome. Anatomy courses designed on team‐based approaches with use of body donors provide a useful simulated learning environment. Medical students may be assessed through a variety of activities targeting team‐work, communication skills and clinical reasoning at different levels. Use of reflective exercises assessing team interaction, evolution of critical thinking skills and course challenges have found an important place in the evolving anatomy curriculum. Early exposure to these critical skills helps prepare for clinical rotations where milestones for these skills will need to be reached. This presentation will demonstrate the translational approach in synergizing non‐technical skill development between anatomy and residency curricula. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Near‐peer teachers continue to be a significant driving force behind curricular changes that provide anatomy instruction to meet the needs of students in the current learning environment. Near‐peer teaching assistants (TAs) are important contributors in the facilitation of Mayo Clinic School of Medicine, anatomy course. The team‐based design of this course incorporates various approaches to team oriented activities, including introduction to radiology and ultrasound education and whole body dissections. TAs are equally involved in delivery of briefing sessions, prosections, guidance of student dissections, and review sessions. While students acknowledge educational benefits of learning anatomy through dissection, many still experience challenges in effectively using combined classical resources such as dissection manuals, textbooks, atlases, and various computer‐assisted tools. To enhance student competency in dissection as well as to maintain curricular alignment between clinically oriented course content and dissection goals often different than what is presented in dissection manuals or commercially available videos, TAs dissected a cadaver and created short videos. Videos outlined necessary steps for the assigned dissection, identified challenging aspects of dissection procedure, and provided review of clinically relevant anatomic structures. Videos were filmed daily by TAs using commercially available iPads or iPhones and edited using iMovie software. All videos were uploaded to Blackboard curriculum management system the day before dissection and remained accessible to students throughout the course. The objective of this study was to determine medical student satisfaction and utilization of near‐peer created teaching videos for preparation and guidance of laboratory dissection. A total of 28 videos were created that ran from approximately 2 to 13 min in duration. Viewing data for the videos was tracked on the server and a survey was distributed to the students after the final examination (IRB protocol #17‐009090). Response rate was 91% (48 of 53 students responded to the survey). The survey used a five‐point Likert scale in which 1 = strongly disagree and 5 = strongly agree. In general, students found the videos useful in their preparation for laboratory dissection. They agreed that they frequently used the videos to prepare for the assigned dissection (4.74) and they felt that videos improved their efficiency (4.73) and confidence (4.45) in the laboratory. Additionally, 47% of students ranked the videos as their primary resource for dissection preparation. Near‐peer created videos provide an inexpensive and effective alternative to commercially available products. In addition, these videos allow facilitators to relate course specific material with dissection goals, advance self‐directed learning, and help students overcome the challenge of potential cognitive overload from the need to consult too many references within a short timeframe of the dissection laboratory. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Significant increase in literature regarding “residents as teachers” highlights the importance of providing opportunities and implementing guidelines for continuing medical education and professional growth. Structured teaching assistant (TA) experiences are not uncommon. Programs, both nationally and internationally, have implemented and continue to provide established opportunities for under‐ and post‐ graduate students to develop teaching skills. However, due to the nature of undergraduate medical curricula, there is neither sufficient time nor an abundance of opportunity for medical students to develop teaching skills. The TA program at Mayo Clinic incorporates learning through apprenticeship and mentoring during a 7‐week anatomy block. This study explores the impact of the TA experience and the effectiveness of its facilitation by faculty mentors. Structured questionnaires obtained feedback regarding improvement in teaching and communication skills, as well as, experiences in curriculum development and educational research. Preliminary data revealed that teaching opportunities, mentoring from course faculty, and exposure to educational research and curriculum development improved the TA's ability to teach and fostered an increased interest in teaching. Medical student TA's perceive learning through apprenticeship and mentoring as an effective way to learn how to teach. Grant Funding Source : Department of Anatomy

Anatomy programs that incorporate dissection of donated human tissue often hold ceremonies of gratitude and reflection for body donors. The content of these ceremonies often include learners’ reflections on mortality, respect, altruism, and personal growth told through various humanities modalities. The task of planning is usually faculty‐ and student‐led with participation from other health care students. Objective information on current memorial ceremonies for body donors in anatomy programs in the United States appears to be lacking. The number of programs in the United States that currently plan these ceremonies and information on trends in programs undertaking such remain unknown. Anatomy program directors throughout the United States were issued a brief, voluntary, thirteen‐item questionnaire on memorial ceremonies held at each institution. Qualitative data regarding the number of anatomy programs which hold their own memorial ceremonies, the content of such ceremonies, how they are planned, level of confidentiality maintained, and the types of participants who attend these events will be presented. This information may serve as a guide to institutions considering initiating a ceremony of their own. Grant Funding Source : Department of Anatomy

Anatomy learned by active exploration in the dissection laboratory has been shown to be beneficial in improving anatomic knowledge, promoting self‐reflection, teamwork, and professionalism. Decreased dissection time may affect the quality of dissection and ultimately retention of gross anatomy knowledge. This could translate to lower student performance in the anatomy course. The purpose of this study was to determine whether evaluating the quality of students’ dissection has an effect on practical examinations performance, mid and end‐course evaluations. Quality of dissections for each team enrolled in a gross anatomy course at Mayo Medical School was evaluated bi‐weekly. Each member of the dissection team received the same score which was calculated towards 5% of their final grade. Dissections were evaluated using a five‐point rubric that incorporates measures for determining whether students had met laboratory learning objectives. Assessment of anatomic knowledge was based on laboratory practical exam scores recorded at intervals throughout the course and achievements on daily audience response system quizzes. Increase in quality of dissection was associated with improvement in practical exams. Teams that received lower dissection scores had lower scores on practical exams. Our results imply that students who achieve daily dissection goals, perform better on the practical examinations. Grant Funding Source : Department of Anatomy

Effective communication of medical information by doctors to patients has been found to be positively related to patient satisfaction. In the United States ACGME requires doctors in training to meet the competency of effective communication across many socioeconomic and cultural backgrounds. One of the main contributors to ineffective patient communication is inaccurate perception by the doctor about the extent of a patient's medical knowledge. This study seeks to elucidate medical student perceptions of patients’ knowledge of anatomy based on patient age, sex, occupation, education level and race. It also seeks to understand which of these matter most in guiding students’ assumptions. Patients were asked to complete a questionnaire, created in collaboration with the Mayo Clinic Patient Education Center, which included a multiple choice anatomy quiz and demographic information. First year medical students who had just completed their gross anatomy course were given the same anatomy quiz and a survey that included the demographic profiles of the patients. They were then asked to predict how well the patients scored. Student perceptions of patient knowledge were compared to the actual scores. Pending the results of this study, we anticipate that medical students will over‐estimate patients’ anatomical knowledge. This project was funded by the Department of Anatomy, Mayo Clinic, Rochester, MN.

Emotional intelligence (EI), the ability to perceive and respond to emotions, has been shown to increase academic achievement and team performance. Studies to support this association exist largely in the business world, but its impact in medical education is relatively unexplored. The purpose of this study was to determine whether emotional intelligence correlates with individual or team academic performance in the anatomy course. This study hypothesizes that individuals or teams with higher emotional intelligence will score higher in the course and that team‐based learning will increase emotional intelligence scores. Medical students were asked to complete the Self‐report Emotions Intelligence Test (SSEIT) at the beginning and the end of the 7‐ week anatomy course. Average EI scores for each team were compared to final course grades as well as cumulative daily quiz grades. Individual EI scores were also compared to individual grades, and change in EI scores over the course was assessed. Preliminary analysis of initial EI scores vs. averaged quiz scores at the midpoint of the course does not appear to show significant correlations. Final results, to be analyzed at the end of the course, may hold stronger predictive value in determining association between EI and team performance. This research is supported by the Department of Anatomy at the Mayo Clinic, Rochester, MN. Grant Funding Source : Department of Anatomy, Mayo Clinic

For several years, medical schools in the United States have been urged to integrate public health and population science into their curricula. The first‐year Gross Anatomy course at Mayo Clinic serves as a teaching platform for many non‐technical skills that include professionalism, patient communication and near‐peer teaching that aim to meet core ACGME requirements. As part of the standard Gross Anatomy curriculum, students are assessed on a laboratory based learning activity referred to as a “bedside presentation,” where each small group is assigned a clinical condition and asked to present a hypothetical case as it relates to the anatomy and radiology on their cadaver. The objective of this study is to assess whether first‐year medical students’ knowledge of global health disparities and national population health improved after a longitudinal curriculum revision that combined public health concepts with the bedside presentation. Students first learned to examine a major cause of morbidity and/or mortality on a global/population level following which each team was asked to present a hypothetical patient (relating to their assigned cadaver) with an acute condition associated with the disease or behavior that they had researched earlier. Teams focused on associated anatomic and radiographic findings and used full‐body CT scans and corresponding anatomic parts to illustrate the effects of the disease. Pre‐course data indicate that students have a 50% understanding of population health trends. We anticipate that first‐year medical students will have an improved awareness of public health problems globally and in the United States after completing this activity in Gross Anatomy.

The increasing dependence on radiologic diagnostic modalities in clinical practice has necessitated innovative teaching methods that introduce radiology into early medical curriculum. At Mayo Medical School cadaveric CT images are integrated into the first year gross anatomy course. Using post‐preservation, non‐contrast full body CT scans of their cadavers, medical students are able to correlate radiologic images to their dissection specimen. The AquariusNET thin client software used to view the images provides students numerous options for image manipulation including standard and oblique sagittal and coronal images and three‐dimensional renderings. Students are requested to record interesting findings from the imaging studies as part of an autopsy report. They are also provided with daily radiology learning objectives that require them to visualize specific anatomic structures. At the end of the course, students were comfortable accessing the cadaver CT data, correlating gross and CT anatomy and appreciating relationships of anatomic structures. They enjoyed interactions with radiology faculty and were more prepared to evaluate radiologic examinations. Grant Funding Source : Department of Anatomy