Evaluation of Distance and Face-to-Face Anatomy Education From the Perspective of Students During the COVID-19 Pandemic Period

During the COVID-19 pandemic, a questionnaire was administered to the students who took anatomy courses through distance education in the Faculties of Medicine and Dentistry. Through the questionnaire, the aim was to figure out whether the infrastructure of Firat University was ready and adequate for distance education, how efficient the distance theoretical and practical anatomy classes were, and in what proportions the students would prefer to take face-to-face and distance anatomy classes when the pandemic is over. A questionnaire of 35 questions was applied to 555 students studying at the Medicine and Dentistry Faculties of Firat University. The students widely accepted the opinion that Firat University successfully implemented the distance education system, and distance education offered the opportunity to receive the lessons repeatedly regardless of time and place. In addition, it has been determined as a common opinion that anatomy classes given via distance education were equally beneficial as face-to-face education in terms of duration, content, and efficiency. Despite these advantages, the lack of face-to-face interaction and weak information permanence were reported as the negative aspects of distance education. The students emphasized that applied anatomy classes and especially cadaver studies should be conducted face to face. Anatomy education is quite substantial in the acquisition and development of professional skills. It is considered that distance anatomy education will be inadequate to provide this gain. The high demand for face-to-face practical classes by students also backs this up.Copyright © 2023, Universidad de la Frontera. All rights reserved.

The Importance of Simulation in Vascular Training: A Literature Review

Funding: None. Synopsis: Once a subspecialty of general surgery, vascular surgery has transitioned to an entity with its own training paradigms and board certification. Part of this transition is due to many advances in technology, devices, and techniques. The management of vascular pathology that was at one time relegated to open procedures has now shifted to a field where endovascular options can be performed. These advances come with the concern of training competent vascular surgeons who are already under stringent duty hours restrictions, deal with heightened scrutiny associated with patient safety, and recently have had their operative volumes decreased due to COVID-19-related cancellations and shut downs. Simulation has been offered as a possible means to mitigate these limitations and shift the learning curve to competency. Despite this, little is known regarding the efficacy and best practices of incorporating simulation into vascular training. Method(s): A literature review was performed of English language articles on the EBSCO database without publication date restrictions on vascular surgery simulation. Search terms included vascular surgery simulation, endovascular surgery simulation and vascular education simulation. Additional studies were found by searching reference lists of relevant articles. All study designs were included if they pertained to simulation for open vascular or endovascular procedures. Simulator fidelity, educational efficacy, validity of the simulator, transfer of skill, and cost and time effectiveness were assessed. With endovascular simulation we assessed the amount of handling error, procedure time, fluoroscopy time, and the amount of contrast used. Result(s): Using these methods, twenty-two articles were identified. In regards to simulation used for open procedures in vascular surgery, the analysis showed that the most important factors in determining efficacy were the involvement of expert level (attending) proctors and the use of high fidelity (cadaver) simulators. Other important determinants were the use of trainee-specific models and the employment of specific learning objectives. The use of virtual endovascular simulators in enhancing trainee competence is supported by better quality data in the literature. Specifically measured and proven outcomes are a decrease in catheter handling errors, a reduction in both procedure and fluoroscopy time, and a diminished volume of contrast used. Endovascular simulators also allowed for reliable and consistent assessment of operator performance and showed a good transfer of skill to actual cases. Conclusion(s): Simulation is an important tool for both the assessment and training of vascular residents. The use of expert proctors, appropriate simulators, and well-designed curricula are the keys to success. Further studies connecting simulation training to patient-centered outcomes are still needed to define the true potential of these tools and methods. Institution: Lousiana State University HSC, New Orleans, LACopyright © 2022

Knowledge Practice Gap Among Nurses Towards COVID-19 Patients' Dead Body Care in a Tertiary Care Hospital

COVID-19 due to SARS-CoV-2 is a global pandemic that presents a serious challenge from many angles for healthcare professionals. The virus causes a potentially fatal disease that is easily transmitted among patients and caregivers, hence specific dead body care is required for such patients. Our study was conducted to identify knowledge, attitude, and practice regarding COVID-19 dead body care among hospital nursing personnel. A cross sectional survey-based study was performed involving 282 nurses who worked in COVID-19 units during data collection from July 2020 to September 2020. The online structured questionnaire was based on world health organization guidelines, institutional infection control protocols, and course material regarding emerging respiratory diseases including COVID-19. We found that work experience in the COVID-19 unit had a significant impact on knowledge and practice regarding COVID-19 dead body care. Similarly, we observed that training improved the knowledge and practice of nursing personnel regarding dead body care. Good knowledge, attitude, and practice were observed in experienced and trained nurses (p-value <0.005). No significant changes were observed with age, gender, and education qualification. Overall knowledge, attitude, and practice regarding COVID-19 dead body care were moderate to good. Adequate training among nurses should prevent the transmission of disease due to occupational exposure.Copyright © 2023, Science Publications. All rights reserved.

Comparing the emotional experiences of students in similar dissection- and prosection-based medical gross anatomy courses: A mixed-methods study.

The anatomy laboratory can incite strong emotional reactions in students, which can in turn facilitate growth in empathy, care for vulnerable others, and professionalism. Despite this, little is known about the relative emotional impacts of different laboratory modalities. The response to the COVID-19 pandemic created an opportunity to compare the emotional experiences of students in similar courses in which one group of students dissected donors and the other group learned from prosected donors. The courses were otherwise the same in content, length, instructional design, and assessment. Students in the dissection-based (Fall 2019) and prosection-based (Fall 2020) courses completed a previously validated survey that used quantitative and qualitative questions to assess their feelings about the donors and the anatomy laboratory experience. Students in both cohorts reported overall appreciation for having had the experience. Negative themes experienced by both groups included feeling anxiety, worries about depersonalizing donors, and physical discomfort in the laboratory. Students in the dissection course reported stronger connections with the donors and the donors' families but also more frequently felt negative feelings such as disgust, anxiety, and feeling alone. Students in the prosection course reported more consistently positive responses but worried about not using the donors to the fullest extent possible. Regardless of pedagogical design, students have complex emotional experiences in the anatomy laboratory and our results indicate that these feelings may be more intense in the context of dissection. Anatomists should foster educational settings that enable students to learn to process complex or challenging emotions.

Conduct of body donation and cadaveric dissection training during the COVID-19 pandemic: challenges, impacts and mitigation.

The new coronavirus disease 2019 (COVID-19) has had a substantial impact on the Silent Mentor Programme (SMP), a programme in which members of the public may pledge their bodies to be used for medical training and research after their death. This study aimed to explore the conduct of body donations and simulation surgery training during the COVID-19 pandemic from the viewpoints of the committee members of the SMP and the next-of-kin of body donor pledgers. This study utilised a qualitative exploration method to seek an in-depth understanding of this phenomenon. In-depth individual interviews were carried out. Thematic analysis was used to identify patterns of themes. The COVID-19 polymerase chain reaction (RT-PCR) test is compulsory before accepting a body donation, and this resulted in the turning down of several donations. Being a donor is the final wish of pledgers and this turning down led to a negative emotional remorseful feeling in the next-of-kin of pledgers. From the perspective of students, it is feared that the conduct of the programme, particularly the home visit session being held online, has impeded teaching of humanistic values, compassion, and empathy, which is the prime philosophy of the programme. Previous to the pandemic, the programme ceremonies were well-attended, denoting the utmost respect and recognition of the mentors; however, travel restrictions due to the pandemic limiting in-person attendance resulted in ceremonies becoming less impactful. Continuous postponements of cadaveric dissection training also resulted in students missing training opportunities, hence potentially impairing their professional practice and humanistic values in the medical profession. Counselling interventions should be directed at easing the negative psychological impact on the next-of-kin of pledgers. As the COVID-19 pandemic may pose a significant impediment to achieving the educational outcomes of cadaveric dissection training, efforts to make up for these gaps are essential.

Virtual peer teaching in the gross anatomy lab: a format of peer teaching and learning during the COVID-19 pandemic.

Background: Peer teaching is a powerful educational tool utilized in medical school curricula. Previously, first year medical students taught their peers about the gross anatomical structures they had dissected in the anatomy lab. While this strategy provided an opportunity for students to learn from one another, there were unintended outcomes including difficulty engaging all students. Considering these observations, along with needing to limit student numbers in the lab due to the coronavirus disease 2019 (COVID-19) pandemic, a strategy was developed where students could conduct their anatomy peer teaching in a virtual environment. The goal was to establish an effective and efficient means for students to teach and learn from one another virtually. Methods: Students, working in groups of four, were tasked to: 1) Find and label 4-5 assigned structures on cadaver-based images; 2) Provide a rationale for labeling; 3) Discuss something relevant about the structure; 4) Prepare a 5-minute video presentation of steps 1-3; and 5) Review and provide meaningful feedback on another group's presentation. Student performance on virtual peer teaching assignments was evaluated using a structured rubric and grades were weighted based on two separate faculty assessments.  Student feedback was obtained via discussions with the course director, a semi-structured 1-hour virtual focus interview and from course evaluation data. Results: While students performed well on these assignments, feedback from students indicated several drawbacks such as excess time editing their videos, concerns about the validity of information provided by their peers, and the timing of peer teaching to be non-conducive to learning. Conclusions: Although the students viewed the virtual peer teaching negatively, we were successful in developing a platform in which students participated more equally in peer teaching. Recommendations to those considering this platform include careful consideration of timing of peer teaching activities and faculty feedback as well as technology used.

Practical anatomy online learning among COVID-19 pandemic era: perceptions of 1 st -year MBBS students

Introduction: With the rise of the COVID-19 pandemic, digital learning has been implemented in medical colleges across India to continue the ongoing medical education. Anatomy is the basis of medical science and is best learned through offline classes that allow students to experience the texture of structures and handling of specimens. During this pandemic period, cadaveric dissection was not used to study anatomy. The aim of this study was to learn about students' attitudes regarding virtual teaching and learning in anatomy, as well as the problems they may confront. Material(s) and Method(s): A descriptive cross-sectional study was conducted in the department of anatomy among the 50 1 st -year MBBS students of All India Institute of Medical Sciences, Rajkot in April 2021. Google Forms were used to obtain informed consent from students. Prevalidated questionnaires were given online to the students and responses were noted and descriptive statistical data was derived from the analysis. Result(s): About 37 (74%) respondents found traditional classes are better than online teaching. Majority preferred to attend anatomy practicals offline with safety precautions. About 17 (34%) showed interest in prerecorded videos. About 35 (60%) students faced social isolation as an impact of online learning. Technical issues and distractions were the key problems faced while learning anatomy online. Conclusion(s): Prerecorded videos of the practicals are helpful in teaching anatomy practicals, and can be used in future to ensure an unbroken, continuous, and effective delivery of medical education.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Resilience in Heath Care workers during Disaster situation-Experience from tertiary care hospital during Covid 19 and future lessons

Aims and objective: To present a series of 5 cases of Stress Related Disorders in HCWs during the covid second wave where they bounced back and recovered fully, returned to work Methodology: Reporting 5 different cases of psychological trauma in healthcare workers working in the peak of covid pandemic as frontline workers -02 doctors, 02 Nurses, and 01 health assistant who reported symptoms of vague nature arising out of stress during handling of Covid 19 pts. All of them had clear cut psychological symptoms arising in close temporal relation to experiencing the trauma of handling covid patients and the agony and disaster that befell us during the covid second wave from April to Aug 2021. None of them had any past history of psychiatric illness or genetic loading of significance. None of them had any other significant live stressor in personal life or h/o drug abuse. Thus underlying the life threatening nature of Covid exposure as a healthcare worker and it's psychological implications. All of them were referred for vague symptoms like irritable mood, not able to function as before, physical symptoms of headache, marital discord etc. The exposure ranged from personal handling of serious covid patients to handling dead bodies in the mortuary to managing relatives of dying patients. No preventive distressing mechanism was available to them, the need of which is the learning from this study. Also, the remarkable recovery and resumption of functioning and return to duty shown by these frontline healthcare covid warriors with minimal support from the environment is a lesson in bouncing back from psychological trauma, a concept recognized as resilience. The Resilient HCWs ascribed their bouncing back to peer and organizational support during crisis, a sense of duty to care and psychoeducation as their driving force to early recovery, among other things Results: High index of suspicion, early intervention, empathetic handling, psycho education, behavioral modifications and cognitive counseling with a short course of anxiolytics and antitidepressants in few, helped all of them improve completely with return to almost normal functioning. Conclusion(s): The Covid experience has been a life threatening experience for HCWs involved in treatment of serious covid patients during covid pandemic esp the second wave. It has been a never before experienced reality, completely overwhelming and traumatogenic enough to cause psychological decompensation in some of them. For the few diagnosed, there would be many undiagnosed HCWs. The focus should be on high index of suspicion for stress related psychological trauma in HCWs and it's mitigation through early detection and support for complete recovery. The importance of systemic, family and peer support is emphasized.

Impact of modified teaching strategies used in a gross anatomy course on the academic performance of dental students during the COVID-19 pandemic.

INTRODUCTION: Modified teaching strategies (MTS), asynchronous online teaching and smaller dissection groups, were applied to a gross anatomy course for dental students in the National Taiwan University in April 2020 in response to the COVID-19 pandemic. This study aimed to investigate the effects and perceptions of MTS on dental students. MATERIALS AND METHODS: Scores for anatomy examinations for 2018-2019 (without MTS) and 2019-2020 (with MTS) cohorts were compared to explore the effect on academic performance. Moreover, questionnaire from the 2019-2020 cohort was analysed to determine dental students' perceptions about MTS. RESULTS: The lecture performance in the final examination of the second semester for the 2019-2020 cohort was significantly higher than that of the first semester (pre-COVID-19) and that for the 2018-2019 cohort. However, the laboratory performance in the midterm examination of the second semester for the 2019-2020 cohort was significantly lower than that for the 2018-2019 cohort and showed no difference in the final examination of the first semester. The questionnaires revealed that the majority of students displayed positive attitudes towards MTS and agreed with the importance of peer discussion during laboratory dissection. CONCLUSIONS: Asynchronous online learning for anatomy lecture may be beneficial for dental students; however, a smaller dissection group accompanied by reduced peer discussion may temporarily exert negative effects on their laboratory performance at the beginning of the application. Furthermore, more dental students exhibited positive perceptions towards smaller dissection groups. These findings could illuminate the learning condition of dental students in anatomy education.

Outcomes of keratolimbal allograft from ABO compatible donors for severe bilateral limbal stem cell deficiency.

PURPOSE: To report outcomes of keratolimbal allograft (KLAL) compatible for both human leukocyte (HLA) and/or blood type using oral prednisone, mycophenolate, and tacrolimus, with basiliximab if panel reactive antibodies (PRA) are present. Intravenous immunoglobulin (IVIG) was used post-operatively if donor-specific anti-HLA antibodies (DSA) were present. METHODS: Retrospective interventional series of consecutive patients with KLAL for limbal stem cell deficiency (LSCD) from HLA and/or blood type compatible deceased donors with a minimum follow-up time of 12 months. Main outcome measures were ocular surface stability, visual acuity and systemic immunosuppression (SI) adverse events. RESULTS: Eight eyes of eight patients with mean age of 48.6 ±â€¯10.1 years (range 34-65 years) were included. Mean follow-up time was 37.3 ±â€¯22.7 months (range 12-71 months) following KLAL; four (50%) had combined LR-CLAL surgery. The etiologies of LSCD were Stevens-Johnson Syndrome (n = 4/8), aniridia (n = 2/8), chemical injury (n = 1/8) and atopic eye disease (n = 1/8). All patients had PRA present and received basiliximab infusions. 5/8 patients received IVIG based on DSA identified pre-operatively. At last follow-up, 7 eyes (87.5%) had a stable ocular surface; 1 eye (12.5%) developed failure and had keratoprosthesis implantation. There was a significant improvement in visual acuity from 1.65 ±â€¯0.48 to 0.68 ±â€¯0.34 logMAR (p = 0.01). SI was tolerated well with minimal adverse events. CONCLUSIONS: Preliminary outcomes of KLAL with ABO compatible tissue using the Cincinnati protocol, preoperative basiliximab (when PRA present) and post-operative IVIG (when DSA present) are encouraging. This protocol may allow for utilization of deceased donor tissue with results approximating those of living donor tissue transplanted for severe bilateral LSCD.

Is cadaveric dissection essential in medical education? A qualitative survey comparing pre-and post-COVID-19 anatomy courses.

CONTEXT: With the surge of the novel coronavirus (SARS-CoV-2 [COVID-19]), the modality of teaching anatomy has shifted from in-person cadaveric dissection to virtual lessons for incoming first-year medical students. As a result, we aim to assess the impact that this curriculum change has on student perspectives. OBJECTIVES: This study aims to understand the relative effect of a virtual anatomy course implemented during the pandemic (2019-2020) on the confidence, skills, and perspectives of first-year medical students compared to medical students who had traditional in-person anatomy at Rowan University School of Osteopathic Medicine (Rowan SOM) in Stratford, New Jersey. METHODS: The authors developed a 14-question survey to target gross anatomy students of the Classes of 2023 and 2024 at Rowan SOM. The Class of 2024 had a virtual anatomy lab compared to the Class of 2023, who had an in-person anatomy lab in their first year of medical school. The responses were analyzed to understand the difference between a hands-on cadaver lab and a virtual anatomy lab utilizing SPSS. RESULTS: The survey was administered to approximately 400 people, from which we received 149 responses (37.3%). Among all responses, 36.2% (n=54) belonged to the Class of 2023 who encountered hands-on cadaver experience, whereas 63.8% (n=95) belonged to the Class of 2024 who gained virtual anatomy lab experience. An independent t-test statistical analysis was utilized. Under the confidence domain, when students were asked about the understanding of trauma after their respective anatomy labs, 64.0% of the Class of 2023 (n=50) showed significantly higher confidence with p<0.001, compared to 15.4% for the Class of 2024 (n=78). Under the skills domain, the Class of 2023 (n=50) felt more comfortable with ultrasound (64.0%), identifying all of the pertinent anatomical structures and their respective locations on imaging (72.0%), and identifying the pathology (90.0%) with respective p values of <0.001, <0.001, and 0.004. Only 36.9% of Class of 2024 respondents shared similar comfort with ultrasound (n=84), 30.9% identifying pertinent anatomical structures (n=84) and 65.4% in identifying pathology (n=84). Under the attitude domain, the Class of 2023 (n=50) had more respect toward the human body with their hands-on cadaver experience (88.0%) than the Class of 2024 (n=89, 33.3%). CONCLUSIONS: Based on current results, it can be established that medical students who had in-person cadaveric dissection had a favorable attitude toward their anatomy course compared to students who had virtual anatomy during the COVID-19 pandemic.

Who really needs a Metaverse in anatomy education? A review with preliminary survey results.

The term Metaverse ("meta" defined as beyond, transcendence or virtuality, and "verse" meaning universe or world) denotes a "virtual reality space" for anatomy teaching. To ascertain how many anatomists are familiar or are using this adjunct in teaching, we conducted a short survey at the 2022 annual meeting of the American Association of Clinical Anatomists (AACA). Interestingly, only six respondents (9.4%) had used a Metaverse for teaching anatomy. Moreover, the vast majority of attendees were anatomy educators or basic science faculty, but not practicing physicians/surgeons or other actively practicing health care professionals; a group where this technology has been used much more commonly. The present manuscript was authored by anatomy educators, practicing physicians and other actively practicing health care professionals with backgrounds in diverse medical fields, that is, anatomists, medical doctors, physician assistants, dentists, occupational therapists, physical therapists, chiropractors, veterinarians, and medical students. Many of these authors have used or have been exposed to a Metaverse in the clinical realm. Therefore, the aim of the paper is to better understand those who are knowledgeable of a Metaverse and its use in anatomy education, and to provide ways forward for using such technology in this discipline.

Safe management of COVID-19 dead bodies in sub-Saharan Africa: could families be allowed to bury their dead?.

Sub-Saharan African countries have been hit by the Coronavirus 2019 pandemic (COVID-19) since March 2020. Besides the resulting health and economic disasters is the psycho-socio-cultural problem related with the management of corpses of people dead from the disease, which might hinder the implementation of the response strategy. In Cameroon for instance, the current corpse management policy is very disputed. In fact, although they were recently made more flexible, the restrictions applied to burials still ban any transfer of dead bodies between cities. In light of the African cultural considerations of dead persons, the disputes observed between the families and the health personnel, the legislation and the available scientific evidence, this article analyses the risks and benefits of allowing families to bury their relatives. It thereafter suggests solutions that reconcile dignity (by allowing families to bury their dead relatives in their homes) and safety (by ensuring a sealed handling and the surveillance by a judiciary police officer). Applying these solutions could improve the population's trust towards the health system, and positively contribute to COVID-19 case prevention, identification and management. Copyright © 2020, African Field Epidemiology Network. All rights reserved.

Exploring the Suitability of Using Virtual Reality and Augmented Reality for Anatomy Training

Research on alternative ways to provide anatomy learning and training has increased over the past few years, especially since the COVID-19 pandemic. Virtual reality (VR) and augmented reality (AR) represent two promising alternatives in this regard. For this reason, in this work, we analyze the suitability of applying VR and AR for anatomy training, comparing an optical-based AR setup and a semi-immersive setup based on a VR table, using the same anatomy training software and the same interaction system. The AR-based setup uses a Magic Leap One, whereas the VR table is configured through the use of stereoscopic TV displays and a motion-capture system. This experiment builds on a previous one (Vergel et al., 2020) on which we have improved the AR-based setup and increased the complexity of one of the two tasks. The goal of this new experiment is to confirm whether the changes made in the setups modify the previous conclusions. Our hypothesis is that the improved AR-based setup will be more suitable, for anatomy training, than the VR-based setup. For this reason, we conducted an experimental research with 45 participants, comparing the use of an anatomy training software. Objective and subjective data were collected. The results show that the AR-based setup is the preferred choice. The differences in measurable performance were small but also favorable to the AR setup. In addition, participants provided better subjective ratings for the AR-based setup, confirming our initial hypothesis. Nevertheless, both setups offer a similar overall performance and provide excellent results in the subjective measures, with both systems approaching the highest possible values. IEEE

A CASE OF LONG-TERM TOLERANCE AFTER KIDNEY TRANSPLANTATION.

We present a case of long-term organ functioning (ca.10 years) after allografting of a cadaveric kidney without usage of immunosuppressing drugs. In 2005, a patient suffering from a hypertensive form of chronic glomerulonephritis, have received an allogeneic graft of cadaveric kidney compatible for AB0 system, HLA antigens (A19, B07, DR04), and negative results of cross-match test. The graft function was immediately restored, with normalization of creatinine levels achieved 4-5 days after surgery. Immunosuppression with cyclosporine, solumedrol, cellcept, metypred and simulect was performed in the hospital. Pulse therapy with solumedrol was performed on the day +20 due to the development of initial rejection signs. The postoperative period proceeded without infectious complications. The patient was discharged being recommended to take cyclosporine, Cell-Sept and Metypred. Within a year after transplantation, the patient claimed for pain in the hip joint, and, therefore, metypred was completely canceled. Subsequently, the Cellcept was replaced with a Mayfortic. In 2007, the signs of coxarthrosis were revealed at computed tomography, followed by aseptic necrosis of the the right femur head. Deforming osteoarthritis of the right hip joint was detected, and the hip replacement surgery was suggested. In 2010, due to risk of side effects from ongoing immunosuppressive therapy, e.g., joint damage, the Mayfortic was canceled. In 2012, being in fear of original Sandimmun Neoral replacement by a generic drug, the patient completely refused cyclosporine therapy. In 2021, the endoprosthetics of the right hip joint was performed, and the surgical wound healed initially. Since 2012, the patient has not completely taken immunosuppressive therapy. Over this time period, the patient has never been admitted to the hospital for impaired functioning of the organ graft. Meanwhile, he monitored his graft function on regular basis undergoing biochemical analyses, clinical examination, ultrasound studies of the graft and made regular visits to the outpatient department. In 2021, a week after hip replacement, there was a slight increase in serum creatinine, followed by further increase to 230 mmol/L in 2021, and to 310 mmol/L in March 2022. In February 2022, the patient suffered mild respiratory infection (confirmed COVID-19). In March 2022, the first clinical signs of increasing nephropathy appeared, i.e., swelling of both lower extremities, with leukocytes in urine upon routine analysis, increased blood flow resistance in the main artery of the transplant shown by ultrasound study. Due to worsening of the patient's condition, he resumed taking the prescribed immunosuppressants. Copyright © 2022, SPb RAACI.

In jars: The integration of historical anatomical and pathological potted specimens in undergraduate education.

INTRODUCTION: Across the UK, many anatomy departments possess historical potted wet cadaveric specimen collections, such as organs preserved in fluid-filled jars. Although considered obsolete by some for anatomical education, there is immense potential for their utilisation in teaching, particularly in institutes that have limited access to cadavers or have had body donation rates impacted by the Covid-19 pandemic. Another benefit of historical potted cadaveric specimens is that severe pathology, often not seen today, can be observed by the student. MATERIAL AND METHODS: The aim of this study was to understand students' opinions and attitudes towards the use of historical anatomical and pathological potted wet specimen collections in undergraduate science teaching. Following their integration into the anatomy program of a Clinical Sciences degree, seventy-seven undergraduate students completed a five-point Likert questionnaire on their perspective for the integration of the historical potted specimens in anatomical education. This study was approved by the Research Ethics committee at the University of Bradford RESULTS: The study demonstrated that 90 % of students found the collection useful in teaching, 92 % would like to see the collection used more in teaching, and 76 % of students found that the collection encouraged them to consider medical ethics and the donor. CONCLUSIONS: In conclusion, the survey findings suggest that further utilisation of historical potted wet specimen collections would be useful in the teaching of anatomy and that these collections could potentially encourage conversations on post-mortem bodily integrity, ethics, and organ donation.

Impact of a Cadaver Lab and Video Content-Based Curriculum on Emergency Physician and Advanced Practice Provider Performance Confidence and Clinical Utilization of Ultrasound-Guided Knee and Ankle Arthrocentesis

Study Objectives: The diagnosis of septic arthritis cannot be ruled out without performing an arthrocentesis. Delay in diagnosis leads to potentially irreversible joint damage and patient mortality. It is essential for emergency physicians (EPs) and advanced practice providers (APPs) to perform this procedure. Ultrasound guidance during arthrocentesis has been shown to reduce procedural pain scores and improve first-pass success rates compared to a landmark-guided approach. However, many providers trained when ultrasound was not readily available and feel uncomfortable recognizing a joint effusion on ultrasound. The study objective was to assess the impact of a hands-on cadaver lab arthrocentesis training on emergency medicine provider confidence in performing knee and ankle ultrasound-guided arthrocentesis and subsequent utilization in clinical practice. Method(s): EPs and APPs from a large academic, quaternary-care hospital prospectively enrolled in a 2-hour cadaver lab ultrasound-guided arthrocentesis training intervention. Didactic video content was created and distributed prior to cadaver lab training. The cadaver knee and ankle joint capsules were pre-injected with saline to create realistic effusions. Participant confidence performing and interpreting US-guided arthrocentesis was assessed pre- and post-cadaver lab via electronic survey based on a 0-10 scale (0=not confident at all, 10=extremely confident). Ultrasound-guided knee and ankle arthrocentesis utilization in clinical practice was compared before and after the cadaver lab which was held on October 4, 2021. The pre- intervention comparison time frame was January 1, 2019-December 31, 2019 to avoid changes in ED visits and practice associated with the COVID-19 pandemic. The post-intervention comparison time frame was October 5, 2021 through April 4, 2022. Median confidence scores with interquartile ranges (IQR) and monthly rates of ultrasound-guided arthrocentesis were calculated and presented with 95% confidence intervals. Result(s): A total of 28 emergency providers participated in the ultrasound-guided arthrocentesis cadaver lab (17 EPs, 10 APPs, 1 unknown) and 28 (100%) completed both pre- and post-intervention surveys. Sixty-one percent (17/28) of participants had greater than 5 years of post-training clinical practice. The median (IQR) confidence rating was 7.5 (IQR 5.0-9.0) pre-intervention and 8.0 (IQR 6.0-9.8) post-intervention (p=.153) for performance of ultrasound-guided knee arthrocentesis and was 2.5 (IQR 1.0-4.3) pre-intervention and 7.0 (IQR 6.0-8.8) post-intervention (p<.001) for performance of ultrasound-guided ankle arthrocentesis. Ultrasound-guided knee arthrocentesis utilization increased from a monthly average of 2.3 (95% CI 1.5-3.3) pre-intervention to 6.3 (95% CI 4.5-8.6) post-intervention, rate ratio 2.74 (95% CI 1.64 - 4.63), p<.001. Ultrasound-guided ankle arthrocentesis utilization increased from a monthly average of 0.8 (95% CI 0.4-1.5) pre-intervention to 2.5 (95% CI 1.4-4.1) post-intervention, rate ratio 3.02 (95% CI 1.27 - 7.53), p=.009. Conclusion(s): Our data demonstrate that a cadaver-based educational intervention increased EP and APP confidence in performing ultrasound-guided ankle arthrocentesis and increased ultrasound-guided ankle and knee arthrocentesis utilization in clinical practice. Further studies are needed to determine if this resulted in a meaningful reduction in time to diagnosis and ED length of stay. No, authors do not have interests to disclose Copyright © 2022

Tunisians peoples dealing with death in COVID-19 pandemic: Lived experiences of grief

Introduction: As Dame Cecily Saunders said, "How people die remains in the memory of those who live on." For Muslim people, funerals and burial procedures are crucial moments that help them come to terms with the loss of a loved one. The COVID-19 pandemic has disrupted usual experiences of grief since funerals and burials are held without the presence of family. Approaches to support grief are needed to be adapted to these particular circumstances. Objective(s): Describe the lived experiences of grief of the Muslim Tunisian family for patients who died due to COVID -19. Method(s): This was a qualitative study with a phenomenological approach. Data of patients who died due to COVID -19 were collected. One family member or more of each deceased was contacted. Semi directive interview was conducted to help participants to describe the lived experience. Result(s): 30 persons participated in this study. The reactions of participants towards death were crying, being sad, and being choked. The reactions of grief were influenced by several factors. These included: the circumstances of the deceased, relationship with him, the hospitalization in an intensive care unit, doctors' expectation, and the average length of stay in hospitals before the death. Islamic religious beliefs influenced the way family experienced grief, mainly toward the management of the dead body and the imposed funeral protocol. Conclusion(s): This study describes the devastating impact of COVID-19 toward lived experiences of grief of Muslim Tunisian. In light of these results, grief therapies should be adapted and evaluated in this population.