Blake Tim, Marais Debbi, Hassell Andrew B, Stevenson Kay, Paskins Zoe
Rheumatology Department, The Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK.
Education and Research Team, Warwick Medical School, University of Warwick, Coventry, UK.
Musculoskeletal Care. 2017 Dec;15(4):405-412. doi: 10.1002/msc.1188. Epub 2017 Mar 20.
The rheumatologist relies heavily on clinical skills to diagnose diverse conditions, something that is correlated with one's knowledge of clinical anatomy. More recently, rheumatology has offered further career flexibility with opportunities to develop skills such as joint injection and musculoskeletal (MSK) ultrasound, both of which require a sound understanding of anatomy. Currently, there are no formal strategies to support competency-based anatomy learning in rheumatology in the UK. This study aimed to evaluate an innovative applied anatomy course utilizing cadaveric material, targeted at clinicians practising in rheumatology and MSK medicine.
A new course was developed for rheumatologists, rheumatology trainees and allied health professionals practising rheumatology and MSK medicine, with the principal focus being on applied MSK anatomy. A questionnaire was given to course attendees and a mixed methods approach of evaluation used. Descriptive statistical data analysis was performed.
The course received overall positive feedback and statistically significant improvements in levels of confidence in anatomy (mean 52.35-83.53, p < 0.0001), injections (mean 57.65-81.18, p < 0.0001), examination of the upper limb (mean 60.59-76.47, p < 0.0001) and examination of the lower limb (mean 58.24-77.65, p < 0.0001). Course attendees also favoured a peer-assisted and multidisciplinary learning approach.
This study lends support for the use of cadaveric material in the teaching of postgraduate anatomy to rheumatologists. It has demonstrated a continual need for hands-on and interactive anatomy training in an ever-advancing digital world. To be successful, cadaveric learning should not be viewed in a purely 'pre-clinical' setting, but instead integrated with postgraduate learning.
风湿病学家在很大程度上依赖临床技能来诊断各种病症，这与个人的临床解剖学知识相关。最近，风湿病学提供了更多的职业灵活性，有机会发展诸如关节注射和肌肉骨骼（MSK）超声等技能，而这两者都需要对解剖学有充分的理解。目前，在英国没有正式的策略来支持基于能力的风湿病学解剖学学习。本研究旨在评估一门针对从事风湿病学和肌肉骨骼医学的临床医生的、利用尸体材料的创新应用解剖学课程。
为风湿病学家、风湿病学实习生以及从事风湿病学和肌肉骨骼医学的专职医疗人员开发了一门新课程，主要侧重于应用肌肉骨骼解剖学。向课程参与者发放了一份问卷，并采用混合方法进行评估。进行了描述性统计数据分析。
该课程获得了总体积极反馈，在解剖学信心水平（平均从52.35提高到83.53，p < 0.0001）、注射信心水平（平均从57.65提高到81.18，p < 0.0001）、上肢检查信心水平（平均从60.59提高到76.47，p < 0.0001）和下肢检查信心水平（平均从58.24提高到77.65，p < 0.0001）方面有统计学上的显著提高。课程参与者也倾向于同伴辅助和多学科学习方法。
本研究支持在向风湿病学家进行研究生解剖学教学中使用尸体材料。它表明在不断发展的数字世界中，对实践和互动式解剖学培训的持续需求。要取得成功，尸体学习不应仅在纯粹的“临床前”环境中看待，而应与研究生学习相结合。
