Utukuri Pallavi S, Lefkowitch Jay H, Erde Steven M, Smithgall Marie, Makkar Jasnit, Weintraub Joshua L, Bernd Paulette
Department of Radiology, Columbia University, Vagelos College of Physicians & Surgeons, New York, NY USA.
Department of Pathology & Cell Biology, Columbia University, Vagelos College of Physicians & Surgeons, 622 West 168th Street, New York, NY 10032 USA.
Med Sci Educ. 2020 Aug 17;30(4):1405-1411. doi: 10.1007/s40670-020-01054-4. eCollection 2020 Dec.
The preparation of student-authored autopsy reports of anatomical donors was added to the Gross Anatomy course to integrate the basic and clinical sciences and determine whether students considered this early clinical exposure to be a valuable experience. All donors were scanned using computerized tomography (CT) and student groups received the scan of their donor and a report written by a radiologist. As students dissected, they took photographs and biopsies of pathological findings that were processed for microscopic evaluation. Following consultation with pathologists and radiologists, each group prepared an autopsy report that proposed a cause of death supported with macroscopic, microscopic, and CT images. Cardiovascular events and cancer were the most common. Autopsy reports were evaluated by the faculty and each student group received feedback with respect to content, accuracy, and completeness and whether faculty agreed with students' proposed cause of death. A majority of students answering an anonymous survey indicated that this exercise was valuable or somewhat valuable, but did not agree that preparation of the autopsy report resulted in their being more engaged during the course. Students agreed or somewhat agreed that the exercise should be repeated next year, that they gained insight into the clinical manifestations of disease, that they were able to interpret the CT scan themselves, that meeting with a pathologist was interesting, and that the time required to prepare the report was adequate. Since autopsy reports prepared by students are feasible and students found it to be a valuable experience, we suggest that medical schools add this to Gross Anatomy courses to introduce clinical material and increase clinical relevance.
将学生撰写的解剖学捐赠者尸检报告纳入大体解剖学课程,以整合基础科学与临床科学,并确定学生是否认为这种早期临床接触是一次宝贵的经历。所有捐赠者均接受了计算机断层扫描(CT),学生小组收到了其捐赠者的扫描结果以及放射科医生撰写的报告。在学生解剖过程中,他们对病理发现进行拍照和活检,并进行处理以进行显微镜评估。在与病理学家和放射科医生协商后,每个小组编写了一份尸检报告,提出了死因,并辅以大体、显微镜和CT图像。心血管事件和癌症是最常见的死因。尸检报告由教师进行评估,每个学生小组都收到了关于内容、准确性、完整性以及教师是否同意学生提出的死因的反馈。大多数回答匿名调查问卷的学生表示,这项活动很有价值或有点价值,但不同意编写尸检报告使他们在课程中更投入。学生们同意或有点同意该活动明年应重复进行,他们对疾病的临床表现有了深入了解,他们能够自己解读CT扫描结果,与病理学家会面很有趣,并且编写报告所需的时间是足够的。由于学生编写的尸检报告是可行的,并且学生们认为这是一次宝贵的经历,我们建议医学院校将其纳入大体解剖学课程,以引入临床资料并提高临床相关性。