ePoster
Abstract Title | Musculoskeletal ultrasound module increases medical students' knowledge of gross anatomy

Authors

  1. Catherine Brandon
  2. Patricia Mullan
  3. David Jamadar

Theme

Basic Sciences and Clinical Integration

INSTITUTION

University of Michigan, Dept of Radiology
University of Michigan, Dept of Medical Education
University of Michigan, Dept of Radiology

Background

Medical school curricula currently provide less time for gross anatomy and limited and late exposure to ultrasound. Ultrasound is a highly sensitive and convenient tool for clinical evaluation of the musculoskeletal system (Fornage, 2000; Wright and Bell, 2008). Using ultrasound to teach gross musculoskeletal anatomy permits observation of in vivo motion during real-time imaging and could potentially improved students’ understanding of three dimensional and dynamic anatomic relationships. Radiologists involved in education recognize the complementary need to support anatomic teaching and to promote successful partnerships between radiology and anatomy departments (Marker et al., 2010; Tam, 2010;  Zumwalt et al., 2010; Bohl et al., 2011).  The study evaluated the feasibility and impact of an introductory module on musculoskeletal ultrasound imaging to supplement existing gross anatomy teaching to first year medical students.

Summary of Work

A one-hour module was developed collaboratively between senior radiology and anatomy faculty for students who had completed the existing gross anatomy instruction on upper extremity anatomy including dissection. The module included terminology, basic physics, and scanning techniques. To introduce the dynamic relationships of upper extremity anatomy, a real-time ultrasound demonstration on a volunteer’s arm emphasizing ultrasound’s anatomic and dynamic capabilities lasted for 35 minutes. The module concluded with a presentation about the appearance of selected upper extremity musculoskeletal pathologies. To help the students synthesize material learned in the demonstration with their limited clinical experiences, the cases focused on well-defined tumors and classic tendon ruptures such as the distal biceps tendon.   Evaluation of the module’s impact included pre- and post- assessment of students’ knowledge on five items about clinical ultrasound scanning, as well eliciting students’ perception of the module’s impact.  Participation was voluntary and anonymous.

Summary of Results

One hundred ten students (65%) participated. Students demonstrated an increase in basic knowledge of ultrasound as the mean percent correct score on the knowledge examination increased from 60% on the pre-test to 84% on the post-test, a statistically significant difference (p<.01). They indicated the module was most useful in learning anatomic function (72%) and enhancing their appreciation of gross anatomy (65%) but were less convinced of their own ability to use ultrasound as a tool for learning (49%) or to understand specific structures (39%). 

Table: Students' evaulation of the ultrasound module on a scale that ranged 1 to 5, with higher numbers indication more favorable ratings. N=109    Very useful = rating of 4 or 5

 

  % of students rating the module as "very useful"
Ultrasound lecture and/or demonstration in understanding how structures move in relationship to each other                    72%
Ultrasound lecture and/or demonstration in appreciation of gross anatomy                    65%
Ultrasound as a tool in learning gross anatomy                    49%
Ultrasound lecture and/or demonstration in understanding of specific anatomical stuctures or regions                    39%
Conclusion

Collins (2004) commented that in the field of radiology, medical students, as adult learners, are goal oriented, learning more efficiently when the relevance of the educational objective is obvious. Teaching methods emphasizing anatomy’s clinical application are likely to improve students’ appreciation and acquisition of important anatomical concepts (Collins, 2004; Bohl et al., 2011).  Ultrasound as an imaging modality applied in both anatomical and patient care fields can demonstrate how clinical and functional knowledge rests on anatomical concepts (Bohl et al., 2011). Students need to be guided in their goals and priorities when approaching the study of clinical imaging especially early in their careers. Anatomic and radiology educators both learned to stress surface landmarks to encourage student “hands-on” use of ultrasound. This study confirmed the feasibility and acceptability of an ultrasound teaching module to enhance first year medical students’ interest in anatomy.

Take-home Messages
Acknowledgement

Additional faculty involved in this study included Dr. Lawrence Kruhns, Department of Radiology, University of Michigan, and Dr. John Zeller, Department of Medical Education Division of Anatomical Sciences, Department of Emergency Medicine, Department of Orthopaedic Surgery, University of Michigan. Also thanks to the faculty, staff and first year gross anatomy medial students of the University of Michigan who all so kindly participated and encouraged our work on this project.

References

 

Bohl M, Francois W, Gest T. 2011. Self-guided clinical cases for medical students based on postmortem CT scans of cadavers. Clin Anat 24:655-663.

Collins J. 2004. Education techniques for lifelong learning: Principles of adult learning. RadioGraphics 24:1483-1489.

Fornage BD.  2000.  The case for ultrasound of muscles and tendons. Semin Musculoskelet Radiol 4:375-391.

Marker D, Bansal A, Juluru K, Magid D. 2010. Developing a radiology-based teaching approach for gross anatomy in the digital era. Acad Radiol 17: 1057-1065.

Tam M. 2010. Building virtual models by post processing radiology images: a guide for anatomy faculty. Ant Sci Educ 3:261-266.

Wright S, Bell A.  2008. Enhancement of undergraduate rheumatology teaching through the use of musculoskeletal ultrasound. Rheumatology 47:1564-1566.

Zumwalt A, Lufler R, Monteiro J, Shaffer K. 2010. Building the body: active learning laboratories that emphasize practical aspects of anatomy and integration with radiology. Anat Sci Educ 3:134-140.

Background
Summary of Work
Summary of Results
Conclusion
Take-home Messages
Acknowledgement
References
Send ePoster Link
Comments
Date: 2013-09-06 18:39:58
I value the article.Really looking forward to read more. messi trikot 2010 kinder http://messi-trikot.asktorihartman.com