Gross Anatomy Teaching for Medical Undergraduates Through Computer-Based Simulation: Introduction and Evaluation of Effectiveness.

Background Cadaveric teaching has been the gold standard for gross anatomy instruction through the ages and across the geographic spectrum, but with issues of availability faced in many medical schools, there is a need to look for other options. Digital tools like virtual dissectors that simulate the cadaver have been around for some years now, but their acceptability to the teachers and students and effectiveness need to be validated in the settings where applied. Aim To evaluate the acceptability, feasibility and effectiveness of using computer-based simulation tools for teaching gross anatomy via online mode to undergraduate medical students. Methodology A prospective crossover randomized controlled study was conducted online on 200 (120 males (60%) and 80 females (40%), Year 1 medical undergraduates (mean age males: 19.67 years and females: 19.52 years), wherein two broad topics of head and neck region were taught by didactic lectures delivered online via Zoom. Dissection videos were prepared for both cadaveric and computer-based simulation teaching. Groups were divided by random allocation and pre- and post-tests and feedback surveys were conducted online. Results A significant increase from pre- to post-test scores was found in both cadaveric and computer-based simulation techniques. However, more change was found in the computer technique as its t-value was more than the cadaveric technique. The feedback from the students was that the computer-based simulation teaching method gave them a good insight into 3D understanding of the human body, increased understanding of relations of body structures and capacity to grasp surface anatomy. Conclusion The study concluded that teaching gross anatomy through computer-based simulation techniques is acceptable to both the students and faculty. The study also concluded that it is an effective and feasible method that can be used to complement cadaveric teaching to revisit areas already dissected and for quick revision.

Professional Identity Formation of Medical Educators: A Thematic Analysis of Enabling Factors and Competencies Needed.

Context: Process of identity formation in any profession is a unique journey and is influenced by many internal and external factors. The factors which enable the development of professional identity of medical educators have been sparsely studied. Aim: The aim of this study was to identify the factors which influence the professional identity formation (PIF) of medical educators and the competencies needed to develop such identity, through their self-reflection. Materials and Methods: A descriptive exploratory study was designed and executed through self-administered Google Forms having open-ended questions. Themes were generated and concept map was designed. Results: Internal zeal, mentoring, networking, self-directed learning, supportive workplace environment, and recognition at the workplace were some of the subthemes generated as influencing factors enabling PIF as a medical educator. Some of the competencies reported were subject knowledge, leadership skills, self-directed learning, and ability to carry out educational scholarship projects. Conclusion: The study elucidates various factors influencing PIF of medical educators, as reflected by medical educators themselves. Institutional policies can be framed accordingly to facilitate the process of PIF of medical educators.

Morphology of Intra-articular Structures and Histology of Menisci of Knee Joint.

INTRODUCTION: Menisci and cruciate ligaments are intra-articular structures of knee, and injury to these structures is common. Morphometric data gained in the study will help in analyzing the variations among humans and correlating it with the possibility, location, and type of injuries as well as better interpretation of structures during magnetic resonance imaging and arthroscopy which will further help in reconstructive surgeries of knee. MATERIALS AND METHODS: Width and thickness of the medial menisci (MM), lateral menisci (LM), and maximum length and width of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were taken on twenty knees. Histological examination of menisci was done. RESULTS: Width of MM was 0.601-0.700 cm at anterior horn (AH) in 45% of cases, 1.000-1.500 cm at posterior horn (PH) in 60% of cases, and 1.000-1.500 cm at body in 30% of cases. Thickness of MM at AH (45%) and PH (40%) was 0.401-0.500 cm and at body (35%) was 0.501-0.600 cm. Width of LM at AH (35%) was 0.801-0.900 cm, at PH (45%) was 0.901-1.000 cm, and at body (35%) was 1.000-1.500 cm. Thickness of LM at AH (45%) was 0.301-0.400 cm, at PH (50%) was 0.401-0.500 cm, and at body (40%) was 0.601-0.700 cm. Length of ACL in maximum percentage of specimens (55%) was 3.01-3.50 cm. Width of ACL in 25% specimens were 0.801-0.900 cm and in another 25% specimens were 1.001-1.500 cm. Length of PCL in maximum percentage of specimens ( 50 %) was 3.51-4.00 cm. Width of PCL in 80 % of specimens was 1.001-1.500 cm. Histological examination of menisci showed fibrocartilage (outer two-thirds) and hyaline cartilage (inner one-third). Orientation of fibers was circumferential with intermingled radial fibers. Fibroblasts, chondrocytes, and unclassified cells were arranged as single, paired, or in rows along the direction of fibers except in hyalinized part. Blood vessels were present toward the peripheral part. CONCLUSIONS: The maximum width of MM was at PH and for LM it was at the body. Maximum thickness was at the body for MM as well as LM. Width of PCL was more as compared to ACL.

Early Clinical Exposure as a Learning Tool to Teach Neuroanatomy for First Year MBBS Students.

CONTEXT: Early clinical exposure (ECE) is one of the important tools to teach basic science to the MBBS students. It is one form of vertical integration between basic science and clinical subjects. This study is an effort at exploring the use of ECE as a motivational tool toward better learning in neuroanatomy for first year MBBS students. AIM: This study aims to make the students interested and motivated to study neuroanatomy by using ECE as learning tool in neuroanatomy and to make the students enable to retain the knowledge of neuroanatomy more efficiently and correlate the knowledge of neuroanatomy with neuromedicine. SETTINGS AND DESIGN: This study was conducted in collaboration with the Departments of Anatomy, General Medicine and Medical Education Unit in the year 2016. This was cross-sectional study. SUBJECTS AND METHODS: One hundred and fifty students of 1st Professional MBBS were subdivided into two groups. After preliminary classes on brain, brainstem, and spinal cord for both groups, conventional lecture classes were taken for Group A only on upper motor neuron (UMN) and lower motor neuron (LMN) paralysis, and only Group B visited General Medicine ward where HOD, General Medicine showed and examined patients of UMN paralysis and LMN paralysis, elicited different symptoms, and discussed different investigation. It was followed by assessment of all by problem-based multiple choice questions (MCQ) and short answer questions. Then, Group B attended lecture class on different cranial nerve palsy whereas Group A visited medicine ward. It was followed by assessment of both groups by problem-based MCQ and short answer questions. The performance was compared. Then, the feedback of the students on ECE was collected by means of reflection writing followed by administration of questionnaire. Then, the perception of teachers regarding ECE was recorded by focused group discussion. STATISTICAL ANALYSIS USED: Student's t-test was used to compare the performance of both batches. Reflection writing and focus group discussion were analyzed qualitatively. RESULTS: There was a significant difference in Group A (P = 0.019) but no significant difference in Group B (P = 0.679). All the teachers opined that ECE was an efficient method but more time and interdepartmental collaboration were necessary. CONCLUSIONS: Group A improved performance due to ECE but Group B maintained the motivational effect of it. Therefore, ECE can be used as an effective learning tool.

Module for Interns in Medical Ethics: A Developmental Diegesis.

BACKGROUND: Media report is rife with incidences of doctor-patients' conflict, and this partly is due to communication gap and unethical practices being adopted by the doctors. Our regular curriculum fails to impart any training in ethical issues in patient care. Imparting training to students in these soft-skills is the need of the hour. AIM AND OBJECTIVES: To develop a module for interns in medical ethics (MIME) in patient care, validate it and pilot run the module for standardization. METHODOLOGY: After conducting faculty development workshop in curriculum designing and three rounds of Delphi with alumni, a module in medical ethics was developed and peer validated. The questionnaire for pilot run, questionnaire for future use of module delivery and pre- and post-test were also peer validated. The module was delivered to 17 interns as pilot run in the form of 4 days' workshop. After pilot run, the module was standardized to 10 broad topics and 3 days' workshop. The questionnaire for future delivery of module in regular routine was also validated during pilot run. RESULTS: Twenty-five faculty members participated in 1 day faculty development workshop and 59 alumni completed three rounds of Delphi. After peer review by five experts, a module of 11 broad areas was developed and was pilot run on 17 interns. Based on the feedback from pilot run, a standardized, validated 18 h teaching MIME in patient care was developed. CONCLUSION: Pilot study proves that curriculum innovation in the form of medical ethics training to interns; when as undergraduate students, they actively participate in patient care under supervision will go a long way in inculcating soft skills like ethics, compassion and communication in them.

Autopsy as a tool for learning gross anatomy during 1(st) year MBBS.

INTRODUCTION: Embalmed cadavers are the primary tool for teaching anatomy. However, difficulties are encountered due to changed color/texture of organs, hardening of tissues, and smell of formaldehyde. To overcome these difficulties, dissections on a fresh human body were shown to the 1(st) year MBBS students, and their perception was noted. MATERIALS AND METHODS: After taking universal precautionary measures, postmortem dissections were shown to students on voluntary donated bodies in the dissection hall, in addition to the traditional teaching on embalmed cadavers. Feedback was taken from students and faculty regarding the utility of these sessions. RESULTS: Better appreciation of texture, orientation, location, and relations of organs in fresh body, integration of teaching, awareness of the process and laws related to body donations were the outcomes of the study. However, the smell and sight of blood was felt to be nauseating by some students, and some students were worried about the spread of infectious diseases. CONCLUSIONS: Visualizing single fresh body dissection during 1(st) year professional MBBS is recommended either on medicolegal autopsy or on voluntarily-donated bodies.