Manghani Mona, Cheung Peter P, Mogali Sreenivasulu Reddy, Prakash Ashutosh, Chew Li-Ching
Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital.
Lee Kong Chian School of Medicine, Nanyang Technological University.
Rheumatol Adv Pract. 2020 May 3;4(1):rkaa010. doi: 10.1093/rap/rkaa010. eCollection 2020.
Our aim was to evaluate the effectiveness of teaching anatomy through combined musculoskeletal sonoanatomy and human cadaveric dissection for rheumatologists practising musculoskeletal US.
The principal focus was on scanning and then dissecting relevant musculoskeletal structures. Outcomes measured included confidence levels and objective knowledge. A mixed-methods approach of evaluation and descriptive statistical data analysis was performed.
The change in confidence ratings by delegates after the teaching event as represented by the mean difference (s.d.) (s.e.m.) for identification of surface anatomy was 1.846 (1.281) (0.355), with Student's paired = 5.196 and =0.000223. The mean difference (s.d.) (s.e.m) for performing IA injections was 1.538 (1.266) (0.351), with Student's paired = 4.382, =0.001, and for recognizing sonoanatomical structures it was 1.769 (1.235) (0.343), with Student's paired = 5.165 and = 0.000235. There was a significant increase in correct identification of anatomical and sonoanatomical knowledge in the pre- and post-course assessments. Rotator cuff interval region improved from 13 to 73%, = 0.004; knee tendons insertion sites from 47 to 93%, = 0.016; and muscles not adjacent to joints from 27 to 93%, = 0.002.
Dissection of joints enabled a three-dimensional relational mind map of the relevant regions of the human body, producing clarity in understanding regional relational topographic anatomy and sonoanatomy. The combination of US and cadaveric dissection improved learners' satisfaction, confidence and knowledge in areas where soft tissue complaints are common, which is likely to lead to accurate early diagnosis and cost-conscious, better overall care.
我们的目的是评估通过肌肉骨骼超声解剖学与人体尸体解剖相结合的方式,对从事肌肉骨骼超声检查的风湿病学家进行解剖学教学的效果。
主要重点是扫描并随后解剖相关的肌肉骨骼结构。测量的结果包括信心水平和客观知识。采用了评估的混合方法和描述性统计数据分析。
教学活动后代表们信心评级的变化,以识别表面解剖结构的平均差值(标准差)(标准误)表示为1.846(1.281)(0.355),学生配对t = 5.196,P = 0.000223。进行关节内注射的平均差值(标准差)(标准误)为1.538(1.266)(0.351),学生配对t = 4.382,P = 0.001,识别超声解剖结构的平均差值为1.769(1.235)(0.343),学生配对t = 5.165,P = 0.000235。在课程前和课程后的评估中,解剖学和超声解剖学知识的正确识别有显著增加。肩袖间隙区域从13%提高到73%,P = 0.004;膝关节肌腱附着部位从47%提高到93%,P = 0.016;与关节不相邻的肌肉从27%提高到93%,P = 0.002。
关节解剖能够形成人体相关区域的三维关系思维导图,使对区域关系地形解剖学和超声解剖学的理解更加清晰。超声检查与尸体解剖相结合提高了学习者在软组织疾病常见领域的满意度、信心和知识水平,这可能会导致准确的早期诊断以及注重成本效益的更好的整体护理。