Promoting cultural awareness, professionalism, and communication skills in medicine through anatomy: The Deaf culture session.

The anatomy curriculum is a place where professionalism can be learned and practiced, including training in cultural competence and communication skills for working with diverse populations. One population that has received little attention in terms of medical education are d/Deaf and hard of hearing (d/DHH) patients, although there is much evidence to support health care disparities in this population. Several major contributing factors include differing views of deafness between medical professionals and those who are culturally Deaf, a lack of understanding of Deaf culture and American Sign Language (ASL) by medical professionals, a lack of educational resources in ASL, and poor experiences in health care. To address this need, a Deaf Culture Applied Anatomy session was incorporated into the first-year curriculum at Morehouse School of Medicine while medical students were studying anatomy of the ear and hearing. Panelists, who were culturally Deaf, hard of hearing, and hearing children of deaf adults, shared their experiences in healthcare, including challenges they faced with communication and care. Surveys were provided to students before and after the panel session. Surveys indicated a lack of knowledge prior to this session, while also demonstrating that this 90-min session improved students' understanding of effective communication with future patients and issues related to deafness. Qualitative feedback also suggested that the students found the session to be personally and professionally beneficial. Implementing the Deaf Culture session was an effective means for introducing students to Deaf culture and working with d/DHH patients.

Tracking medical student emotionality in relation to whole body dissection and donation.

INTRODUCTION: For students studying anatomy, dissection of the human body can elicit a wide range of intellectual and emotional responses that are subject to change over the duration of a course. The purpose of this study was to determine how overall emotional responses change over time, if there are differences in responses by gender and previous laboratory exposure, and if these responses impact course performance. METHODS: First-year medical students enrolled in the Human Structure and Function course at the University of Vermont, and in the Organ Systems 1, 2, and 3 courses at Morehouse School of Medicine were given a series of four surveys across the first-year curriculum. Data were gathered regarding age, gender, and previous laboratory exposure. Students were asked to rate their level of 15 positive and negative emotions, and their desire to avoid or approach the laboratory and donors. These responses were translated to three measures: (a) a positive response index (PRI), (b) a negative response index (NRI), and (c) an avoid-approach index (AAI). Responses were followed longitudinally and matched with anatomy practical examination grades. RESULTS: Gender and previous laboratory exposure status were both significantly related to emotional responses at different points throughout the year, and unique patterns of responses across the year emerged within each group. Higher PRI and AAI were positively correlated with some practical examination scores. CONCLUSIONS: Data suggest that gender and previous laboratory exposure status influence emotional responses to dissection, and that these responses may have an effect on course performance.

The Use of Anatomical Dissection Videos in Medical Education.

Dissection videos are commonly utilized in gross anatomy courses; however, the actual usage of such videos, as well as the academic impact of student use of these videos, is largely unknown. Understanding how dissection videos impact learning is important in making curricular decisions. In this study, 22 dissection videos were created to review structures identified in laboratory sessions throughout the Organ Systems 1 (OS1), 2 (OS2), and 3 (OS3) courses. Dissection videos were provided to 201 first-year medical students, and viewing data were recorded. Demographic data for age and gender identity were also collected from students. Overall, there was a significant decrease in total views (P = 0.001), the number of students who pressed play (P < 0.001), and the number of students who viewed ≥ 90% of the total length of videos (P < 0.001) from OS1 to OS3. The total adjusted time spent viewing videos was not significantly different between individual OS courses. There were some instances where significant differences existed in examination performance between those who did and did not view videos, and by time spent viewing videos. There were no significant differences in time spent viewing videos by gender. Together these data suggest that students may utilize dissection videos more at the beginning of a dissection course, although they remain an important resource throughout the year for a subset of students.

Sharing personal information about anatomical body donors: What first-year medical students want to know and how it affects emotional responses to dissection.

Among educators who teach in the human anatomy laboratory, there has been lively debate about sharing information about anatomical donors. One consideration in this debate is concern about the emotional effect of personalizing donors on the students. The purpose of this study was to evaluate student responses to being exposed to donor information (DI). Three cohorts of first-year medical students (n = 284) were surveyed at four time points throughout the year. Surveys queried students about positive and negative responses to working in the laboratory, wanting to know specific DI, and if knowing this DI would/did affect their responses to working with donors. Analyses examined the relationships between desire to know DI and indices of the following: positive response index (PRI), negative response index (NRI), avoid-approach index (AAI), and compassion-respect index. Across all surveys, a majority of respondents wanted to know some form of DI. At all time points, a majority of respondents felt that knowing all types of DI would increase their positive responses to working with donors. A greater PRI and AAI tended to be associated with wanting to know more personal DI (e.g., names and personal histories). A greater NRI tended to be associated with anticipating that learning personal DI would increase their negative responses before entering the laboratory, which did not persist after dissection began. These data suggest that for a majority of students, knowing personal DI increases their positive response and does not elicit negative responses to dissection or working with anatomical donors. Clin. Anat. 32:1019-1032, 2019. © 2019 Wiley Periodicals, Inc.

The use and effectiveness of interactive progressive drawing in anatomy education.

Anatomical relationships are challenging concepts for first-year medical students. The use of progressive drawing, where an image is created from a blank template, has long been utilized for outlining anatomical relationships and continuity from one region to another, and has shown positive outcomes for student learning. More recently, computerized progressive drawing has been introduced; however, challenges, including issues with visual clarity, have been described. In this study, 17 computerized screencasts of drawings covering neurovasculature of the limbs, abdomen, pelvis, head, and neck were created and provided to first-year medical students at Morehouse School of Medicine. An animated method for drawing was utilized to increase visual clarity. Surveys were provided to 181 first-year medical students to collect feedback about these screencasts. Sixty percent (n = 108) of students completed at least one survey. Respondents rated all 17 screencasts with a minimum of 4.7/5 for helpfulness in learning the material for course examinations. A majority of students (77.8%) reported viewing the screencasts more than once on at least one survey, and students reported varying methods for utilizing the screencasts. A majority of students provided positive feedback relating to technical quality. Some significant differences in course performance were seen based on screencast usage. The positive responses from students indicate that this is a useful method in medical education. Anat Sci Educ 11: 445-460. © 2018 American Association of Anatomists.

Hippocampal subregions are differentially affected in the progression to Alzheimer's disease.

Atrophy within the hippocampus (HP) as measured by magnetic resonance imaging (MRI) is a promising biomarker for the progression to Alzheimer's disease (AD). Subregions of the HP along the longitudinal axis have been found to demonstrate unique function, as well as undergo differential changes in the progression to AD. Little is known of relationships between such HP subregions and other potential biomarkers, such as neuropsychological (NP), genetic, and cerebral spinal fluid (CSF) beta amyloid and tau measures. The purpose of this study was to subdivide the hippocampus to determine how the head, body, and tail were affected in normal control, mild cognitively impaired, and AD subjects, and investigate relationships with HP subregions and other potential biomarkers. MRI scans of 120 participants of the Alzheimer's Disease Neuroimaging Initiative were processed using FreeSurfer, and the HP was subdivided using 3D Slicer. Each subregion was compared among groups, and correlations were used to determine relationships with NP, genetic, and CSF measures. Results suggest that HP subregions are undergoing differential atrophy in AD, and demonstrate unique relationships with NP and CSF data. Discriminant function analyses revealed that these regions, when combined with NP and CSF measures, were able to classify by diagnostic group, and classify MCI subjects who would and would not progress to AD within 12 months.

Subregions of the inferior parietal lobule are affected in the progression to Alzheimer's disease.

Changes in several regions within the brain have been associated with progression from healthy aging to Alzheimer's disease (AD), including the hippocampus, entorhinal cortex, and the inferior parietal lobule (IPL). In this study, the IPL was divided into three subregions: the gyrus, the banks of the sulcus, and the fundus to determine if these regions are independent of medial temporal regions in the progression of AD. Participants of the Alzheimer's disease Neuroimaging Initiative (Alzheimer's disease Neuroimaging initiative (ADNI); n = 54) underwent a structural magnetic resonance imaging (MRI) scan and neuropsychological examination, and were categorized as normal controls, mild cognitively impaired (MCI), or AD. FreeSurfer was initially used to identify the boundaries of the IPL. Each subregion was then manually traced based on FreeSurfer curvature intensities. Multivariate analyses of variance were used to compare groups. Results suggest that changes in thickness of the banks of the inferior parietal lobule are occurring early in the progression from normal to MCI, followed by changes in the gyrus and fundus, and these measures are related to neuropsychological performance.