Hołda Mateusz K, Stefura Tomasz, Koziej Mateusz, Skomarovska Oksana, Jasińska Katarzyna A, Sałabun Wojciech, Klimek-Piotrowska Wiesława
Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.
Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
Ann Anat. 2019 Jan;221:48-56. doi: 10.1016/j.aanat.2018.09.004. Epub 2018 Sep 20.
Insufficient anatomical training can put patients' safety at risk. The aim of this study was to assess the proficiency of medical students and physicians in identifying labeled anatomical structures. The second aim of the study was to evaluate factors that can affect this recognition.
An internet-based survey where participants had to correctly identify labeled anatomical structures on cadaveric specimens was designed.
The study group included 1186 participants (58.7% females): 931 medical students and 255 medical graduates from all twelve Polish medical schools. The mean total survey score for the entire study group was 65.6%. Students gained significantly higher results than graduates (total: 67.3% vs. 59.5%, P<0.001); 331 (27.9%) participants did not pass the test (<60). There was a correlation observed between points gained in this survey and grade obtained in the gross anatomy course (P<0.001). Multivariable logistic regression found that participation in cadaver laboratory classes most strongly increases anatomical competencies (OR=5.30, 95%CI=1.20-23.40, P=0.03). Other significant factors boosting anatomical proficiency were membership in students' scientific clubs, being male, and having a high grade (≥80%) in initial gross anatomy course. The time since anatomy course completion was negatively correlated with the total survey score (OR=0.86, 95%CI=0.81-0.92, P<0.001).
Anatomical knowledge of Polish medical students is moderate (<70%) and it significantly decreases with time. Anatomical structure recognition can be up to 25% lower in highly trained physicians when compared to pre-clinical medical students. This trend may be reversed by replacing subject-based anatomy courses with system-based (integrated) curricula at the undergraduate level or introducing short refresher anatomical courses during postgraduate training.
解剖学训练不足会危及患者安全。本研究旨在评估医学生和医生识别标注解剖结构的熟练程度。该研究的第二个目的是评估可能影响这种识别的因素。
设计了一项基于互联网的调查，参与者必须正确识别尸体标本上标注的解剖结构。
研究组包括1186名参与者（58.7%为女性）：来自波兰所有12所医学院校的931名医学生和255名医学毕业生。整个研究组的平均总调查得分是65.6%。学生的成绩显著高于毕业生（总计：67.3%对59.5%，P<0.001）；331名（27.9%）参与者未通过测试（<60分）。在本次调查中获得的分数与大体解剖学课程的成绩之间存在相关性（P<0.001）。多变量逻辑回归发现，参加尸体实验室课程最能提高解剖学能力（OR=5.30，95%CI=1.20-23.40，P=0.03）。提高解剖学熟练程度的其他重要因素包括加入学生科学俱乐部、男性身份以及在初始大体解剖学课程中获得高分（≥80%）。自解剖学课程结束后的时间与总调查得分呈负相关（OR=0.86，95%CI=0.81-0.92，P<0.001）。
波兰医学生的解剖学知识水平中等（<70%），且会随时间显著下降。与临床前医学生相比，训练有素的医生对解剖结构的识别能力可能低25%。在本科阶段用基于系统的（综合）课程取代基于学科的解剖学课程，或在研究生培训期间引入短期解剖学复习课程，可能会扭转这一趋势。
