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Interprofessional education (IPE) is prioritized as a critical component in preparing pre-licensure health professional students for effective teamwork and collaboration in the workplace to facilitate patient-centered care. Knowledge in anatomy is fundamental for healthcare professionals, making interprofessional anatomy education an attractive intervention for IPE and anatomy learning. Since 2009, the Education Program in Anatomy at McMaster University has offered an intensive 10-week IPE Anatomy Dissection elective to seven health professional programs annually. From 2011, students were invited to complete the Readiness for Interprofessional Scale (RIPLS) and Interprofessional Education Perception Scale (IEPS) before and after the elective. A total of 264 students from 2011 to 2020 completed RIPLS and IEPS. There were significant differences before and after the elective in students' total RIPLS scores and three of the four subscales: teamwork and collaboration, positive professional identity, and roles and responsibilities. Similarly, there were statistical differences in the total IEPS scores and two of three subscales: competency and autonomy and perceived actual cooperation. Statistically significant differences in RIPLS and IEPS total scores across several disciplines were also observed. This study demonstrates the elective's impact in improving students' IPE perceptions and attitudes, likely from the extended learning and exposure opportunity with other disciplines.
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Human cadavers used for surgical training are embalmed using various methods to facilitate tissue storage and longevity while preserving the natural characteristics required to achieve high fidelity functional task alignment. However, there are no standardized means to evaluate the suitability of embalming solutions for this purpose. The McMaster Embalming Scale (MES) was developed to assess the extent to which embalming solutions allow tissues to achieve physical and functional correspondence to clinical contexts. The MES follows a five-point Likert scale format and evaluates the effect of embalming solutions on tissue utility in seven domains. This study aims to determine the reliability and validity of the MES by presenting it to users after performing surgical skills on tissues embalmed using various solutions. A pilot study of the MES was conducted using porcine material. Surgical residents of all levels and faculty were recruited via the Surgical Foundations program at McMaster University. Porcine tissue was unembalmed (fresh- frozen) or embalmed using one of seven solutions identified in the literature. Participants were blinded to the embalming method as they completed four surgical skills on the tissue. After each performance, participants evaluated their experience using the MES. Internal consistency was evaluated using Cronbach's alpha. Domain to total correlations and a g-study were also conducted. Formalin-fixed tissue achieved the lowest average scores, while fresh frozen tissue achieved the highest. Tissues preserved using Surgical Reality Fluid (Trinity Fluids, LLC, Harsens Island, MI) achieved the highest scores among embalmed tissues. The Cronbach's alpha scores varied between 0.85 and 0.92, indicating a random sample of new raters would offer similar ratings using the MES. All domains except odor were positively correlated. The g-study indicated that the MES is able to differentiate between embalming solutions, but an individual rater's preference for certain tissue qualities also contributes to the variance in scores captured. This study evaluated the psychometric characteristics of the MES. Future steps to this investigation include validating the MES on human cadavers.
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Embalsamamento , Formaldeído , Humanos , Animais , Suínos , Embalsamamento/métodos , Projetos Piloto , Reprodutibilidade dos Testes , CadáverRESUMO
OBJECTIVES: The features that contribute to the apparent effectiveness of three-dimensional visualisation technology [3DVT] in teaching anatomy are largely unknown. The aim of this study was to conduct a systematic review and meta-analysis of the role of stereopsis in learning anatomy with 3DVT. METHODS: The review was conducted and reported according to PRISMA Standards. Literature search of English articles was performed using EMBASE, MEDLINE, CINAHL EBSCOhost, ERIC EBSCOhost, Cochrane CENTRAL, Web of Science and Google Scholar databases until November 2019. Study selection, data extraction and study appraisal were performed independently by two authors. Articles were assessed for methodological quality using the Medical Education Research Study Quality Instrument and the Cochrane Collaboration's tool for assessing the risk of bias. For quantitative analysis, studies were grouped based on relative between-intervention differences in instructional methods and type of control conditions. RESULTS: A total of 3934 citations were obtained of which 67 underwent a full-text review. Ultimately, 13 randomised controlled trials were included in the meta-analysis. When interactive, stereoscopic 3D models were compared to interactive, monoscopic 3D models within a single level of instructional design, for example isolating stereopsis as the only true manipulated element in the experimental design, an effect size [ES] of 0.53 (95% confidence interval [CI] 0.26-0.80; P < .00001) was found. In comparison with 2D images within multiple levels of instructional design, an effect size of 0.45 (95% CI 0.10-0.81; P < .002) was found. Stereopsis had no effect on learning when utilised with non-interactive 3D images (ES = -0.87, 95% CI -2.09-0.35; P = .16). CONCLUSION: Stereopsis is an important distinguishing element of 3DVT that has a significant positive effect on acquisition of anatomical knowledge when utilised within an interactive 3D environment. A distinction between stereoscopic and monoscopic 3DVT is essential to make in anatomical education and research.
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Educação Médica , Aprendizagem , Percepção de Profundidade , Humanos , TecnologiaRESUMO
BACKGROUND: Although several studies (Anat Sci Educ, 8 [6], 525, 2015) have shown that computer-based anatomy programs (three-dimensional visualisation technology [3DVT]) are inferior to ordinary physical models (PMs), the mechanism is not clear. In this study, we explored three mechanisms: haptic feedback, transfer-appropriate processing and stereoscopic vision. METHODS: The test of these hypotheses required nine groups of 20 students: two from a previous study (Anat Sci Educ, 6 [4], 211, 2013) and seven new groups. (i) To explore haptic feedback from physical models, participants in one group were allowed to touch the model during learning; in the other group, they could not; (ii) to test 'transfer-appropriate processing' (TAP), learning ( PM or 3DVT) was crossed with testing (cadaver or two-dimensional display of cadaver); (iii) finally, to examine the role of stereo vision, we tested groups who had the non-dominant eye covered during learning and testing, during learning, or not at all, on both PM and 3DVT. The test was a 15-item short-answer test requiring naming structures on a cadaver pelvis. A list of names was provided. RESULTS: The test of haptic feedback showed a large advantage of the PM over 3DVT regardless of whether or not participants had haptic feedback: 67% correct for the PM with haptic feedback, 69% for PM without haptic feedback, versus 41% for 3DVT (p < 0.0001). In the study of TAP, the PM had an average score of 74% versus 43% for 3DVT (p < 0.0001) regardless of two-dimensional versus three-dimensional test outcome. The third study showed that the large advantage of the PM over 3DVT (28%) with binocular vision nearly disappeared (5%) when the non-dominant eye was covered for both learning and testing. CONCLUSIONS: A physical model is superior to a computer projection, primarily as a consequence of stereoscopic vision with the PM. The results have implications for the use of digital technology in spatial learning.
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Anatomia/educação , Instrução por Computador/métodos , Percepção de Profundidade , Educação Médica/métodos , Avaliação Educacional/métodos , Modelos Anatômicos , Adulto , Currículo , Feminino , Humanos , Masculino , Ontário , Adulto JovemRESUMO
Interprofessional anatomy dissection (IAD) courses increase students' readiness for interprofessional education (IPE) both in-person and online. During the COVID-19 pandemic, virtual environments for anatomy learning were perceived as less effective. Hybrid instruction approaches emerged but have been scarcely evaluated. This study assessed students' experiences with a hybrid IAD course's virtual and in-person components. A hybrid IAD course consisting of virtual and in-person anatomy laboratory-based instruction was offered to 32 students from different health sciences programs. Before and after the full course, students completed the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). After the virtual and the in-person course components, students completed a Q-methodology survey to assess their perceptions of the course. Twenty-eight students (20 females; 24.8 ± 6.3 years old) from different programs (4 Physician Assistant; 2 Midwifery; 3 Speech-Language Pathology; 4 Physiotherapy; 3 Occupational therapy; 4 Nursing; 8 Medicine) participated. The total RIPLS score improved after the 8-week course (Median 84 interquartile range [78-87] vs. 87 [85-90]; p = 0.0145). The Q-methodology identified three factors: IPE & Virtual Enthusiasts, Introspective Learners, and IPE & Virtual Skeptics. Factors represented different levels of students' engagement with the IPE and virtual environment. The transition to in-person resulted in all factors praising the experience. Health science students showed improvements in their readiness for IPE after an 8-week hybrid IAD course. The main differences in the evaluations of the virtual and in-person components were related to engagement and the ability to learn anatomy; no differences were noted between settings regarding engagement in IPE.
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Anatomia , Estudantes de Ciências da Saúde , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Pandemias , Anatomia/educação , Dissecação/educação , Aprendizagem , Relações Interprofissionais , Atitude do Pessoal de SaúdeRESUMO
As a result of the COVID-19 pandemic, anatomy education was forced to adopt online modes of delivery. Previous research on student views revealed areas of strong preference (asynchronous lectures) and strong dislike (virtual specimens) in online anatomy courses. The current study seeks to compare the views of a single cohort of students experiencing both online and in-person undergraduate introductory anatomy and physiology courses. This comparison can highlight what students consider beneficial to their education and can inform future hybrid course offerings. Q-methodology was used to assess the opinions of students. Students sorted 41 statements on anatomy education in a quasi-normally distributed grid based on their degree of agreement with the statements. The rankings underwent a by-person factor analysis which categorized students with shared perceptions into groups. Data were collected from 246 students in the primarily online fall semester and 191 students in the primarily in-person winter semester. Analysis revealed three distinct factors (groups) in the cohort. Factor one (n = 113 (fall), n = 93 (winter)), was satisfied overall with the course materials and delivery. Factor two (n = 52 (fall), n = 18 (winter)) had a deep dislike of online learning, and factor three (n = 37 (fall), n = 49 (winter)) had a strong preference for online learning. While many students were comfortable in both online and in-person learning environments, this was not the case for all learners. The strengths and weaknesses of each teaching modality suggest the opportunity to explore hybrid learning as an option for future course offerings and specifically highlight valuable aspects to incorporate from each environment.
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Anatomia , COVID-19 , Currículo , Educação a Distância , Humanos , COVID-19/epidemiologia , Anatomia/educação , Educação a Distância/métodos , Feminino , Masculino , Adulto Jovem , Percepção , Pandemias , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Adulto , Educação de Graduação em Medicina/métodosRESUMO
Interprofessional learning improves students' clinical and interprofessional competencies. COVID-19 prevented delivering in-person education and motivated the development of a virtual interprofessional cadaveric dissection (ICD) course. This study reports on the effects of a virtual ICD course compared to a previously delivered in-person course, on students' readiness for, and perceptions about, interprofessional learning. Students attending the ICD course in-person (2019-2020) or virtually (2020-2021) completed the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Students in the virtual course also provided written feedback. Thirty-two (24 women; Median: 24 [Q1-Q3: 22-25] years) and 23 students (18 women; 22 [21-23] years) attended the in-person and virtual courses, respectively. In the virtual cohort, the RIPLS total score (82 [76-87] vs. 85 [78-90]; p = 0.034) and the roles and responsibilities sub-score (11 [9-12] vs. 12 [11-13]; p = 0.001) improved significantly. In the in-person cohort, the roles and responsibilities sub-score improved significantly (12 [10-14] vs. 13 [11-14]; p = 0.017). No significant differences were observed between cohorts (p < 0.05). Themes identified in the qualitative analysis were advantages and positive experiences, competencies acquired, disadvantages and challenges, and preferences and suggestions. In-person and virtual ICD courses seem to have similar effects on students' interprofessional learning. However, students reported preferring the in-person setting for learning anatomy-dissection skills.
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Anatomia , COVID-19 , Estudantes de Ciências da Saúde , Humanos , Feminino , Relações Interprofissionais , Anatomia/educação , Comportamento Cooperativo , Atitude do Pessoal de Saúde , CadáverRESUMO
Given the decline of cadavers as anatomy teaching tools, immersive virtual reality (VR) technology has gained popularity as a potential alternative. To better understand how to maximize the educational potential of VR, this scoping review aimed to identify potential determinants of learning anatomy in an immersive VR environment. A literature search yielded 4523 studies, 25 of which were included after screening. Six common factors were derived from secondary outcomes in these papers: cognitive load, cybersickness, student perceptions, stereopsis, spatial understanding, and interactivity. Further objective research investigating the impact of these factors on anatomy examination performance is required. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01701-y.
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Three-dimensional (3D) scanning and printing technology has allowed for the production of anatomical replicas at virtually any size. But what size optimizes the educational potential of 3D printing models? This study systematically investigates the effect of model size on nominal anatomy learning. The study population of 380 undergraduate students, without prior anatomical knowledge, were randomized to learn from two of four bone models (either vertebra and pelvic bone [os coxae], or scapula and sphenoid bone), each model 3D printed at 50%, 100%, 200%, and either 300% or 400% of normal size. Participants were then tested on nominal anatomy recall on the respective bone specimens. Mental rotation ability and working memory were also assessed, and opinions regarding learning with the various models were solicited. The diameter of the rotational bounding sphere for the object ("longest diameter") had a small, but significant effect on test score (F(2,707) = 17.15, p < 0.05, R2 = 0.046). Participants who studied from models with a longest diameter greater than 10 cm scored significantly better than those who used models less than 10 cm, with the exception of the scapula model, on which performance was equivalent across all sizes. These results suggest that models with a longest diameter beyond 10 cm are unlikely to incur a greater size-related benefit in learning nominal anatomy. Qualitative feedback suggests that there also appear to be inherent features of bones besides longest diameter that facilitate learning.
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Anatomia , Avaliação Educacional , Humanos , Anatomia/educação , Modelos Anatômicos , Currículo , EstudantesRESUMO
An Objective Structured Practical Examination (OSPE) is an effective and robust, but resource-intensive, means of evaluating anatomical knowledge. Since most OSPEs employ short answer or fill-in-the-blank style questions, the format requires many people familiar with the content to mark the examinations. However, the increasing prevalence of online delivery for anatomy and physiology courses could result in students losing the OSPE practice that they would receive in face-to-face learning sessions. The purpose of this study was to test the accuracy of Decision Trees (DTs) in marking OSPE questions as a first step to creating an intelligent, online OSPE tutoring system. The study used the results of the winter 2020 semester final OSPE from McMaster University's anatomy and physiology course in the Faculty of Health Sciences (HTHSCI 2FF3/2LL3/1D06) as the data set. Ninety percent of the data set was used in a 10-fold validation algorithm to train a DT for each of the 54 questions. Each DT was comprised of unique words that appeared in correct, student-written answers. The remaining 10% of the data set was marked by the generated DTs. When the answers marked by the DT were compared to the answers marked by staff and faculty, the DT achieved an average accuracy of 94.49% across all 54 questions. This suggests that machine learning algorithms such as DTs are a highly effective option for OSPE grading and are suitable for the development of an intelligent, online OSPE tutoring system.
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The COVID-19 pandemic forced many universities and colleges to rapidly adopt online course delivery. As with any new foray, realizing the optimal aspects of a course to change became incredibly important for course instructors. In this study, we used a particularly sensitive method, i.e. Q-methodology, to evaluate changes based on students' perceptions from fall 2020 to winter 2021. Q-methodology is commonly used to uncover shared values, opinions, and preferences. Using Q-methodology, students participating in both semesters of an undergraduate anatomy and physiology course were surveyed in fall 2020 and winter 2021. The Q-sample included 44 statements. Data from fall 2020 were treated as the baseline and changes in students' perceptions from 2020 to 2021 were assessed. In total, 31 students completed both fall 2020 and winter 2021 course evaluations. Three salient factors emerged from the fall 2020 evaluation: Overtaxed students, Solo Achievers, and In-Person Learners. At the baseline, students were concerned mostly about the delivery of the course, then the winter 2021 evaluation showed how they were adjusting to online learning. The longitudinal Q-study proved to be robust in identifying changes in perceptions. These granular findings indicate how students might differ in viewing and evaluating online courses. This methodology can be used in redesigning and restructuring different components of an online course in higher education settings.
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COVID-19 , Estudantes de Medicina , Humanos , Pandemias , COVID-19/epidemiologia , Inquéritos e Questionários , AtitudeRESUMO
Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.
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Anatomia , Estágio Clínico , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Estados Unidos , Criança , Anatomia/educação , Currículo , Inquéritos e QuestionáriosRESUMO
Interprofessional education (IPE) prepares healthcare students for collaboration in their future careers. The purpose of this study was to determine which aspects of the IPE Program in Anatomy at McMaster University contributed to the development of healthcare student's interprofessional skills. Q-methodology was used to identify the students' common viewpoints of the IPE experience. A total of 26/28 (93%) of students in the course from the medical, nursing, midwifery, physician assistant, occupational therapy, and physiotherapy programs participated in this study. Students were asked to sort a Q-sample of 43 statements about the IPE dissection course derived from previous qualitative studies of the program. Using the centroid factor extraction and varimax rotation, three salient factors (groups) emerged, namely: (1) Anatomy IPE Enthusiasts, (2) Practical IPE Advocates, and (3) Skeptical IPE Anatomists. The Anatomy IPE Enthusiasts believed that students from different disciplines brought unique anatomical knowledge and each group member guided others through difficult material. The Practical IPE Advocates expressed that they would be stronger advocates for interprofessional teams in the future because of the course. The Skeptical IPE Anatomists strongly disagreed that learning with students from different disciplines helped them gain an understanding of their roles in the context of other healthcare professionals and felt that there was little benefit from the IPE program compared to other non-interprofessional programs. These findings about student attitudes are critical to drive an evidence-based evolution of the IPE dissection course, since students' perceptions can have a profound influence on interprofessional collaboration in the workplace.
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Anatomia , Estudantes de Ciências da Saúde , Anatomia/educação , Atitude do Pessoal de Saúde , Humanos , Educação Interprofissional , Relações InterprofissionaisRESUMO
INTRODUCTION: Recent systematic reviews highlighted increasing use of cadaveric models in the surgical training, but reports on the characteristics of the models and their impact on training are lacking, as well as standardized recommendations on how to ensure the quality of surgical studies. The aim of our survey was to provide an easy guideline that would improve the quality of the studies involving cadavers for surgical training and research. METHODS: After accurate literature review regarding surgical training on cadaveric models, a draft of the CACTUS guidelines involving 10 different items was drawn. Afterwards, the items were improved by questionnaire uploaded and spread to the experts in the field via Google form. The guideline was then reviewed following participants feedback, ergo, items that scored between 7 and 9 on nine-score Likert scale by 70% of respondents, and between 1 and 3 by fewer than 15% of respondents, were included in the proposed guideline, while items that scored between 1 and 3 by 70% of respondents, and between 7 and 9 by 15% or more of respondents were not. The process proceeded with Delphi rounds until the agreement for all items was unanimous. RESULTS: In total, 42 participants agreed to participate and 30 (71.4%) of them completed the Delphi survey. Unanimous agreement was almost always immediate concerning approval and ethical use of cadaver and providing brief outcome statement in terms of satisfaction in the use of the cadaver model through a short questionnaire. Other items were subjected to the minor adjustments. CONCLUSION: 'CACTUS' is a consensus-based guideline in the area of surgical training, simulation and anatomical studies and we believe that it will provide a useful guide to those writing manuscripts involving human cadavers.
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Técnica Delphi , Cadáver , Consenso , HumanosRESUMO
STUDY DESIGN: This is an anatomic study using cadaveric material. OBJECTIVE: To provide anatomic descriptions of the normal lumbar sublaminar ridge in the lateral recess and its potential to impact on the exiting nerve root there, with implications to surgical technique in lumbar spinal stenosis. SUMMARY OF BACKGROUND DATA: The lateral extent of the sublaminar ridge-the bony, superior insertion site of the ligamenta flava-and its topological relationship to the nerve root are not described in the literature. In the setting of degenerative lumbar stenosis this structure can hypertrophy and impinge the nerve root within the lateral recess even after excision of the corresponding ligamentum flavum. Failure to address this may contribute to failed lateral recess decompression. METHODS: Fifteen lumbar vertebrae, not obviously degenerated, were resected en bloc from three fixed adult human cadavers and then transected through the pedicles, leaving the posterior column and neural elements intact and articulated. The shape of the sublaminar ridge in the lateral recess and its relationship to the exiting nerve root were carefully examined. RESULTS: The exiting nerve root consistently crosses the sublami- nar ridge immediately inferior to the mid-pedicle, lateral to the subarticular gutter, and on the medial aspect of the true intervertebral foramen. A hypertrophic ridge can compress the exiting root by elevating the nerve root superiorly against the bony underside of the pedicle or displacing it anteriorly against the disc or vertebral body. CONCLUSION: The sublaminar ridge in the lateral recess may contribute to degenerative lumbar stenosis. Comprehensive appreciation of this anatomy may facilitate thorough lateral recess decompression.Level of Evidence: 4.
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Estenose Espinal , Adulto , Cadáver , Descompressão Cirúrgica , Humanos , Vértebras Lombares/cirurgia , Região Lombossacral/cirurgia , Estenose Espinal/cirurgiaRESUMO
The novelty of three-dimensional visualization technology (3DVT), such as virtual reality (VR), has captured the interest of many educational institutions. This study's objectives were to (1) assess how VR and physical models impact anatomy learning, (2) determine the effect of visuospatial ability on anatomy learning from VR and physical models, and (3) evaluate the impact of a VR familiarization phase on learning. This within-subjects, crossover study recruited 78 undergraduate students who studied anatomical structures at both physical and VR models and were tested on their knowledge immediately and 48 hours after learning. There were no significant differences in test scores between the two modalities on both testing days. After grouping participants on visuospatial ability, low visuospatial ability learners performed significantly worse on anatomy knowledge tests compared to their high visuospatial ability counterparts when learning from VR immediately (P = 0.001, d = 1.515) and over the long-term (P = 0.003, d = 1.279). In contrast, both low and high visuospatial ability groups performed similarly well when learning from the physical model and tested immediately after learning (P = 0.067) and over the long-term (P = 0.107). These results differ from current literature which indicates that learners with low visuospatial ability are aided by 3DVT. Familiarizing participants with VR before the learning phase had no impact on learning (P = 0.967). This study demonstrated that VR may be detrimental to low visuospatial ability students, whereas physical models may allow all students, regardless of their visuospatial abilities, to learn similarly well.
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Anatomia , Treinamento por Simulação , Realidade Virtual , Anatomia/educação , Estudos Cross-Over , Dissecação , HumanosRESUMO
The bone marrow aspirate and biopsy procedure are fundamental to the diagnosis of many hematologic pathologies. We describe a hands-on, anatomy-based workshop that allows learners to practice bone marrow procedures on cadavers. Notably, participants learned how to perform sternal aspirates: a procedure rarely performed in real-life practice. Learners valued the experience and described increased comfort with the procedure after the workshop. This workshop provides a valuable opportunity for trainees to learn a procedural skill in a safe, high fidelity environment. Given its hands-on nature, residency training programs could also adapt it for direct observation and trainee assessment.
La ponction et la biopsie de la moelle osseuse sont d'une importance capitale pour le diagnostic de nombreuses pathologies hématologiques. Nous décrivons un atelier pratique, axé sur l'anatomie, qui permet aux apprenants de faire des prélèvements de moelle osseuse sur des cadavres. Les participants ont notamment appris à effectuer des ponctions sternales, une intervention qui est plutôt rare dans la pratique réelle. Ils indiquent avoir apprécié l'atelier, grâce auquel ils ont pris confiance pour pratiquer la technique. L'atelier est une occasion précieuse pour les apprenants d'acquérir une habileté technique dans un environnement sûr et haute fidélité. Étant donné son caractère pratique, les programmes de résidence pourraient aussi l'adapter dans un contexte d'observation directe et d'évaluation.
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As post-secondary education migrates online, developing and evaluating new avenues for assessment in anatomy is paramount. Three-dimensional (3D) visualization technology is one area with the potential to augment or even replace resource-intensive cadaver use in anatomical education. This manuscript details the development of a smartphone application, entitled "Virtual Reality Bell-Ringer (VRBR)," capable of displaying monoscopic two-dimensional (2D) or stereoscopic 3D images with the use of an inexpensive cardboard headset for use in spot examinations. Cadaveric image use, creation, and pinning processes are explained, and the source code is provided. To validate this tool, this paper compares traditional laboratory-based spot examination assessment stations against those administered using the VRBR application to test anatomical knowledge. Participants (undergraduate, n = 38; graduate, n = 13) completed three spot examinations specific to their level of study, one in each of the modalities (2D, 3D, laboratory) as well as a mental rotation test (MRT), Stereo Fly stereotest, and cybersickness survey. Repeated measures ANCOVA suggested participants performed significantly better on laboratory and 3D stations compared to 2D stations. Moderate to severe cybersickness symptoms were reported by 63% of participants in at least one category while using the VRBR application. Highest reported symptoms included: eye strain, general discomfort, difficulty focusing, and difficulty concentrating. Overall, the VRBR application is a promising tool for its portability, affordability, and accessibility. Due to reported cybersickness and other technical limitations, the use of VRBR as an alternative to cadaveric specimens presents several challenges when testing anatomy knowledge that must be addressed before widespread adoption.
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Anatomia , Realidade Virtual , Anatomia/educação , Cadáver , Humanos , Imageamento Tridimensional , SoftwareRESUMO
OBJECTIVE: The purpose of this study was to evaluate the ability of ultrasound to identify and characterize the anterior oblique ligament of the thumb in cadavers and asymptomatic volunteers. SUBJECTS AND METHODS: The anterior oblique ligaments of four cadaveric hands were imaged with a high-resolution transducer. The ligaments were then injected with 0.1% methylene blue using ultrasound guidance. To confirm identification of the ligament, the base of the thumb was immediately dissected, revealing the exact location of the dye. The bilateral ligaments in 40 asymptomatic adult volunteers were imaged. RESULTS: Surgical dissection confirmed injection of methylene blue into all cadaveric ligaments. The proximal attachment of the anterior oblique ligament was well defined in all the hands, and the distal attachment was well defined in 94% of the hands. The mean thickness of the anterior oblique ligament at the metacarpal attachment (0.7 mm), midportion (0.98 mm), and trapezial attachment (0.65 mm) did not differ significantly with respect to sex, right and left side, or hand dominance and was weakly correlated with weight, height, body mass index, and age. The length of the ligament was statistically significantly different between the dominant (10.6 mm) and nondominant (9.6 mm) hands. The volar metacarpal translation with palmar abduction stress did not differ significantly between the dominant (0.7 mm) and nondominant (0.8 mm) hands. There was no association between the degree of translation and the biologic characteristics (weight, height, body mass index, and age). CONCLUSION: High-resolution ultrasound can be used to identify and measure the thickness of the anterior oblique ligament. Dynamic ultrasound imaging can depict volar translation of the metacarpal, which may facilitate diagnosis of ligamentous injury.
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Ligamentos Articulares/diagnóstico por imagem , Ossos Metacarpais/diagnóstico por imagem , Trapézio/diagnóstico por imagem , Adulto , Cadáver , Feminino , Humanos , Ligamentos Articulares/anatomia & histologia , Imageamento por Ressonância Magnética , Masculino , Ossos Metacarpais/anatomia & histologia , Azul de Metileno , Estatísticas não Paramétricas , Transdutores , Trapézio/anatomia & histologia , UltrassonografiaRESUMO
The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.