McBain Kimberly, Azimov Brandon, O'Brien Jeremy, Noël Geoffroy P J C, Ventura Nicole M
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Department of Diagnostic Radiology, McGill University, Montreal, Quebec, Canada.
BMC Med Educ. 2020 Oct 23;20(1):384. doi: 10.1186/s12909-020-02300-4.
Medical faculties are currently embracing a modernistic approach to anatomical education that integrates diagnostic imaging largely through post-mortem computed tomography scanning of body donors. Post-mortem imaging, however, poses a multitude of challenges. The purpose of this study was to assess the implementation of pre-mortem donor-specific diagnostic imaging on student learning and dissection experience in addition to understanding the potential impact on students' preparation for clinical practice.
Students in a fourth-year medicine elective course were divided into groups; group 1 received pre-mortem donor-specific diagnostic imaging, while group 2 received pathology-specific diagnostic imaging, a collection of images relating to the type(s) of pathologies the donors exhibited, though not specific to the donors themselves. Both groups also received a donor-specific case vignette. A convergent, parallel mixed methods design was employed. This included integrating data from group responses to a study participant survey and students' academic assessment scores analyzed quantitatively through statistical analyses with data from focus group sessions investigating the psychosocial aspects of the student dissection experience and perceptions of the imaging use in the course analyzed qualitatively.
As compared to students receiving pathology-specific diagnostic imaging, the quantitative results demonstrated that students receiving pre-mortem donor-specific diagnostic imaging more positively supported the relevancy of diagnostic imaging to their understanding of anatomy, valued the integration for future practice, and suggested an earlier integration within their medical curriculum. Qualitatively, two main themes were observed: the influence of diagnostic imaging integration on dissection experience and on professional mindset. Although both student groups received imaging corresponding to their body donor, consideration towards the humanistic nature of the body donor as a patient with a history was limited to student feedback from the donor- specific diagnostic imaging group.
Overall the integration of pre-mortem donor-specific diagnostic imaging into anatomical dissection provided students with practical skill development, an enhanced dissection experience, and reinforced personal qualities critical for future practice.
医学院校目前正采用一种现代化的解剖学教学方法,主要通过对遗体捐赠者进行死后计算机断层扫描来整合诊断成像。然而,死后成像带来了诸多挑战。本研究的目的是评估生前针对捐赠者的特定诊断成像在学生学习和解剖体验方面的实施情况,此外还要了解其对学生临床实践准备的潜在影响。
医学四年级选修课程的学生被分成小组;第1组接受生前针对捐赠者的特定诊断成像,而第2组接受针对病理学的特定诊断成像,即与捐赠者所表现出的病理学类型相关的一组图像,但并非针对捐赠者本人。两组学生还都收到了一份针对捐赠者的病例摘要。采用了一种收敛性、平行混合方法设计。这包括整合来自小组对研究参与者调查的回应数据,以及通过统计分析对学生学业评估分数进行定量分析的数据,同时对焦点小组会议的数据进行定性分析,这些数据调查了学生解剖体验的心理社会方面以及对课程中成像使用的看法。
与接受针对病理学的特定诊断成像的学生相比,定量结果表明,接受生前针对捐赠者的特定诊断成像的学生更积极地支持诊断成像与他们对解剖学理解的相关性,重视其对未来实践的整合,并建议在医学课程中更早地进行整合。在定性方面,观察到两个主要主题:诊断成像整合对解剖体验和专业思维模式的影响。尽管两个学生小组都收到了与他们的遗体捐赠者相对应的成像,但将遗体捐赠者作为有病史患者的人文性质的考量仅限于来自针对捐赠者的特定诊断成像小组的学生反馈。
总体而言,将生前针对捐赠者的特定诊断成像整合到解剖学中,为学生提供了实践技能发展、增强的解剖体验,并强化了对未来实践至关重要的个人素质。