Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio.
Medical Visuals Department, Health Sciences Library, The Ohio State University, Columbus, Ohio.
Anat Sci Educ. 2020 Sep;13(5):618-627. doi: 10.1002/ase.1932. Epub 2019 Dec 19.
Progressive curricular changes in medical education over the past two decades have resulted in the diaspora of gross anatomy content into integrated curricula while significantly reducing total contact hours. Despite the development of a wide range of alternative teaching modalities, gross dissection remains a critical component of medical education. The challenge posed to modern anatomists is how to maximize and integrate the time spent dissecting under the current curricular changes. In this study, an alternative approach to the dissection of the pelvis and perineum is presented in an effort to improve content delivery and student satisfaction. The approach involves removal of the perineum en bloc from the cadaver followed by excision of the pubic symphysis, removal and examination of the bladder and associated structures, examination and bisection of the midline pelvic organs in situ, and midsagittal hemisection of the pelvis for identification of the neurovasculature. Results indicate that this novel dissecting approach increases the number of structures identified by 46% ± 14% over current dissecting methods. Survey results indicate that students were better able to integrate lecture and laboratory concepts, understand the concepts, and successfully identify more structures using the new approach (P < 0.05). The concept of anatomic efficiency is introduced and proposed as a standard quantitative measure of gross dissection proficiency across programs and institutions. These findings provide evidence that innovative solutions to anatomy education can be found that help to maintain critical content and student satisfaction in a modern medical curriculum.
在过去的二十年中，医学教育中的课程不断变化，导致大体解剖学的内容分散到综合课程中，同时总接触时间显著减少。尽管已经开发出了多种替代教学模式，但大体解剖仍然是医学教育的重要组成部分。现代解剖学家面临的挑战是如何在当前课程变化下最大限度地利用和整合解剖时间。在这项研究中，提出了一种替代的骨盆和会阴解剖方法，以努力提高内容传递和学生满意度。该方法包括从尸体上整块切除会阴，然后切除耻骨联合，取出并检查膀胱和相关结构，原位检查和横断中线盆骨器官，并对骨盆进行矢状中部分割以识别神经血管。结果表明，这种新的解剖方法使识别的结构数量比当前的解剖方法增加了 46%±14%。调查结果表明，学生能够更好地整合讲座和实验室概念，理解概念，并使用新方法成功识别更多结构（P<0.05）。引入了解剖学效率的概念，并提议将其作为衡量各计划和机构大体解剖熟练程度的标准定量指标。这些发现表明，可以找到创新的解剖学教育解决方案，有助于在现代医学课程中保持关键内容和学生满意度。
