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Background: It is well documented in the medical education literature that students retain minimal anatomy knowledge when transitioning from pre-clinical didactics to clinical application on the wards. In a previous study at our own institution we were able to quantify this knowledge deficit in students on surgical clerkships, specifically surgery and obstetrics and gynecology (OB/GYN). Using our previous data, we designed an integrated, nested clinical teaching model utilizing e-modules to review clinically relevant surgical anatomy during their clinical rotations.

Objective: The goal of this study is to evaluate the impact of a newly designed method of teaching clinically relevant anatomy to medical students on surgical rotations. The surgery curriculum will implement and evaluate the use of interactive e-modules. The OB/GYN curriculum will combine the use of interactive e-modules and hands-on anatomy laboratory sessions.

Methods: Quantitative and qualitative methods were used to assess the retention of students’ anatomical knowledge before and after they completed the nested modules. Using principles of adult learning and instructional design, two educational models were built and nested into the curriculum. The first model consists of e-modules highlighting clinically relevant anatomical topics such as biliary anatomy/cholecystectomy for surgery, and uterine anatomy/hysterectomy for OB/GYN. These modules include an assessment of baseline knowledge, an interactive learning session and post-activity evaluations. The second model, only used in the OB/GYN clerkship, consists of hands-on gross lab sessions reflecting the content of the e-modules, with model building and practice of clinical techniques. We are currently evaluating their effectiveness at our institution by using multiple choice testing and subjective surveys.

Results: Data from the pre-tests continue to show a need to close the anatomical knowledge gap found in third year medical students. Students entering their surgery clerkship answered just 47%, 54%, and 63% of multiple choice questions correctly concerning bone, inguinal, and abdominal anatomy, respectively. The average total score on the surgery clerkship test consisting of questions on a variety of anatomic topics was 62.67%. Average multiple choice scores on the OB/GYN clerkship were similar with students answering 54.5% of questions on varied anatomic topics correctly. Post-intervention scores increased significantly for OB/GYN students, averaging 74.8% of questions correctly answered (p<0.0001).

Conclusions: Although promising, more data needs to be gathered to prove success of our nesting intervention. We also plan to conduct a multi-centered study to further demonstrate that using this nesting technique improves clinically-relevant anatomical knowledge in adult learners.


Presented at: George Washington University Research Days 2014.

Samantha Ahle received the third place award in the George Washington University Research Days 2014 School of Medicine and Health Sciences category.

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This work is licensed under a Creative Commons Attribution 3.0 License.

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