Dissecting through the decade: a 10-year cross-sectional analysis of interprofessional experiences in the anatomy lab.

Interprofessional education (IPE) is prioritized as a critical component in preparing pre-licensure health professional students for effective teamwork and collaboration in the workplace to facilitate patient-centered care. Knowledge in anatomy is fundamental for healthcare professionals, making interprofessional anatomy education an attractive intervention for IPE and anatomy learning. Since 2009, the Education Program in Anatomy at McMaster University has offered an intensive 10-week IPE Anatomy Dissection elective to seven health professional programs annually. From 2011, students were invited to complete the Readiness for Interprofessional Scale (RIPLS) and Interprofessional Education Perception Scale (IEPS) before and after the elective. A total of 264 students from 2011 to 2020 completed RIPLS and IEPS. There were significant differences before and after the elective in students' total RIPLS scores and three of the four subscales: teamwork and collaboration, positive professional identity, and roles and responsibilities. Similarly, there were statistical differences in the total IEPS scores and two of three subscales: competency and autonomy and perceived actual cooperation. Statistically significant differences in RIPLS and IEPS total scores across several disciplines were also observed. This study demonstrates the elective's impact in improving students' IPE perceptions and attitudes, likely from the extended learning and exposure opportunity with other disciplines.

Student perceptions of hybrid delivery of interprofessional anatomy-The best of both worlds?

Interprofessional anatomy dissection (IAD) courses increase students' readiness for interprofessional education (IPE) both in-person and online. During the COVID-19 pandemic, virtual environments for anatomy learning were perceived as less effective. Hybrid instruction approaches emerged but have been scarcely evaluated. This study assessed students' experiences with a hybrid IAD course's virtual and in-person components. A hybrid IAD course consisting of virtual and in-person anatomy laboratory-based instruction was offered to 32 students from different health sciences programs. Before and after the full course, students completed the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). After the virtual and the in-person course components, students completed a Q-methodology survey to assess their perceptions of the course. Twenty-eight students (20 females; 24.8 ± 6.3 years old) from different programs (4 Physician Assistant; 2 Midwifery; 3 Speech-Language Pathology; 4 Physiotherapy; 3 Occupational therapy; 4 Nursing; 8 Medicine) participated. The total RIPLS score improved after the 8-week course (Median 84 interquartile range [78-87] vs. 87 [85-90]; p = 0.0145). The Q-methodology identified three factors: IPE & Virtual Enthusiasts, Introspective Learners, and IPE & Virtual Skeptics. Factors represented different levels of students' engagement with the IPE and virtual environment. The transition to in-person resulted in all factors praising the experience. Health science students showed improvements in their readiness for IPE after an 8-week hybrid IAD course. The main differences in the evaluations of the virtual and in-person components were related to engagement and the ability to learn anatomy; no differences were noted between settings regarding engagement in IPE.

Development of the McMaster Embalming Scale (MES) to assess embalming solutions for surgical skills training.

Human cadavers used for surgical training are embalmed using various methods to facilitate tissue storage and longevity while preserving the natural characteristics required to achieve high fidelity functional task alignment. However, there are no standardized means to evaluate the suitability of embalming solutions for this purpose. The McMaster Embalming Scale (MES) was developed to assess the extent to which embalming solutions allow tissues to achieve physical and functional correspondence to clinical contexts. The MES follows a five-point Likert scale format and evaluates the effect of embalming solutions on tissue utility in seven domains. This study aims to determine the reliability and validity of the MES by presenting it to users after performing surgical skills on tissues embalmed using various solutions. A pilot study of the MES was conducted using porcine material. Surgical residents of all levels and faculty were recruited via the Surgical Foundations program at McMaster University. Porcine tissue was unembalmed (fresh- frozen) or embalmed using one of seven solutions identified in the literature. Participants were blinded to the embalming method as they completed four surgical skills on the tissue. After each performance, participants evaluated their experience using the MES. Internal consistency was evaluated using Cronbach's alpha. Domain to total correlations and a g-study were also conducted. Formalin-fixed tissue achieved the lowest average scores, while fresh frozen tissue achieved the highest. Tissues preserved using Surgical Reality Fluid (Trinity Fluids, LLC, Harsens Island, MI) achieved the highest scores among embalmed tissues. The Cronbach's alpha scores varied between 0.85 and 0.92, indicating a random sample of new raters would offer similar ratings using the MES. All domains except odor were positively correlated. The g-study indicated that the MES is able to differentiate between embalming solutions, but an individual rater's preference for certain tissue qualities also contributes to the variance in scores captured. This study evaluated the psychometric characteristics of the MES. Future steps to this investigation include validating the MES on human cadavers.

Piloting an interprofessional virtual cadaveric dissection course: Responding to COVID-19.

Interprofessional learning improves students' clinical and interprofessional competencies. COVID-19 prevented delivering in-person education and motivated the development of a virtual interprofessional cadaveric dissection (ICD) course. This study reports on the effects of a virtual ICD course compared to a previously delivered in-person course, on students' readiness for, and perceptions about, interprofessional learning. Students attending the ICD course in-person (2019-2020) or virtually (2020-2021) completed the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Students in the virtual course also provided written feedback. Thirty-two (24 women; Median: 24 [Q1-Q3: 22-25] years) and 23 students (18 women; 22 [21-23] years) attended the in-person and virtual courses, respectively. In the virtual cohort, the RIPLS total score (82 [76-87] vs. 85 [78-90]; p = 0.034) and the roles and responsibilities sub-score (11 [9-12] vs. 12 [11-13]; p = 0.001) improved significantly. In the in-person cohort, the roles and responsibilities sub-score improved significantly (12 [10-14] vs. 13 [11-14]; p = 0.017). No significant differences were observed between cohorts (p < 0.05). Themes identified in the qualitative analysis were advantages and positive experiences, competencies acquired, disadvantages and challenges, and preferences and suggestions. In-person and virtual ICD courses seem to have similar effects on students' interprofessional learning. However, students reported preferring the in-person setting for learning anatomy-dissection skills.

Using Q-methodology to determine students' perceptions of interprofessional anatomy education.

Interprofessional education (IPE) prepares healthcare students for collaboration in their future careers. The purpose of this study was to determine which aspects of the IPE Program in Anatomy at McMaster University contributed to the development of healthcare student's interprofessional skills. Q-methodology was used to identify the students' common viewpoints of the IPE experience. A total of 26/28 (93%) of students in the course from the medical, nursing, midwifery, physician assistant, occupational therapy, and physiotherapy programs participated in this study. Students were asked to sort a Q-sample of 43 statements about the IPE dissection course derived from previous qualitative studies of the program. Using the centroid factor extraction and varimax rotation, three salient factors (groups) emerged, namely: (1) Anatomy IPE Enthusiasts, (2) Practical IPE Advocates, and (3) Skeptical IPE Anatomists. The Anatomy IPE Enthusiasts believed that students from different disciplines brought unique anatomical knowledge and each group member guided others through difficult material. The Practical IPE Advocates expressed that they would be stronger advocates for interprofessional teams in the future because of the course. The Skeptical IPE Anatomists strongly disagreed that learning with students from different disciplines helped them gain an understanding of their roles in the context of other healthcare professionals and felt that there was little benefit from the IPE program compared to other non-interprofessional programs. These findings about student attitudes are critical to drive an evidence-based evolution of the IPE dissection course, since students' perceptions can have a profound influence on interprofessional collaboration in the workplace.

Three-dimensional micro CT derived morphology of the condylus mandibulae in older adults: implications for clinical dentistry / Micro tomografía computarizada tridimensional derivada de la morfología del cóndilo de la mandíbula en adultos mayores: implicaciones para la odontología clínica

Temporomandibular disorder (TMD) is a multi-etiologic disability, accompanied by a wide range of symptoms, requiring a variety of therapies, with TMJ reconstruction considered the most severe. TMJ surgery is associated with many morbidities and limitations, especially in the elderly. Previous studies have determined the shape and dimensions of the Condylus mandibulae in children and adults, but a range of measurements in the elderly population has yet to be created. This study aims to establish a range of measurements and the morphology of the Condylus mandibulae in an older population using micro CT. 14 cadaveric Condylus mandibulaes (8 male, 6 female; average age, 83±8.6) were scanned with microCT and measured using Amira 4.1.1 modeling software. The anteroposterior length (LAP), mediolateral width (WML) and height (H) of each Condylus mandibulae was measured from 5 equidistant slices in the coronal, sagittal and axial planes. Additionally, each Condylus mandibulae was measured at its greatest anteroposterior length, mediolateral width and height using digital callipers on the cadaveric specimen. This study is the first to accurately describe the morphology of the Condylus mandibulae in an elderly population. The length and width measurements of digital calliper (10.51 ± 0.87; 18.33 ± 2.35) and corresponding micro-CT (11.46 ± 1.60; 17.62 ± 2.05) both showed high consistency and reliability. Our findings lay the foundation for the creation of an off-the-shelf Condylus mandibulae prosthesis or anatomically shaped Condylus mandibulae scaffold for elderly patients.

El trastorno temporomandibular (TTM) es una discapacidad multi-etiológica, acompañada por una amplia gama de síntomas, que requieren una variedad de terapias, entre las cuales la reconstrucción de la articulación temporomandibular (ATM) es considerada una de las terapias más graves. La cirugía de la ATM se asocia con muchas morbilidades y limitaciones, especialmente en adultos mayores. Estudios previos han determinado la forma y las dimensiones del cóndilo de la mandíbula en niños y adultos, no obstante aún no se han identificado estas mediciones en una población de adultos mayores. Este estudio tiene como objetivo establecer un rango de mediciones y la morfología del cóndilo de la mandíbula en una población de adultos mayores mediante microtomografía computarizada (microCT). Se escanearon, con microCT, 14 mandíbulas cadavéricas (8 hombres, 6 mujeres; edad promedio: 83 ± 8,6 años), y se realizaron mediciones utilizando el software de modelado Amira 4.1.1. De cada cóndilo de la mandíbula se midió: longitud anteroposterior (LAP), ancho mediolateral (AML) y altura (A), a partir de 5 cortes equidistantes en los planos coronal, sagital y axial. Además, también se utilizaron calibradores digitales para realizar estas mismas mediciones. Este estudio es el primero en describir con precisión la morfología del cóndilo de la mandíbula en una población de adultos mayores. Las medidas de longitud y anchura del calibrador digital (10,51 ± 0,87; 18,33 ± 2,35) y el micro-CT correspondiente (11,46 ± 1,60; 17,62 ± 2,05) mostraron una alta consistencia y confiabilidad. Nuestros hallazgos sientan las bases para la creación de una prótesis de cóndilo de la mandíbula o un andamio condilar de forma anatómica para pacientes de edad avanzada.

Dissecting through Barriers: A Follow-up Study on the Long-Term Effects of Interprofessional Education in a Dissection Course with Healthcare Professional Students.

Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists.

Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students.

Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions.

Acute exercise increases adiponectin levels in abdominally obese men.

Objective. To examine the effect of acute and short-term (~1 week) aerobic exercise training on plasma adiponectin levels in inactive, abdominally obese men. Materials and Methods. Inactive and abdominally obese men (n = 38, waist circumference ≥102 cm) recruited from Kingston, Canada were randomly allocated to perform three bouts of aerobic treadmill exercise at either low (50% VO(2) peak) or high (75% VO(2) peak) intensity during a 1-week period. Blood samples were taken before and after the first exercise session and 24-72 hours following the completion of the final exercise session. Results. Adiponectin levels were elevated immediately following an acute bout of exercise at both high and low intensities (High: 5.79 ± 0.42 versus 5.05 ± 0.41 ug/mL; Low: 5.24 ± 0.44 versus 4.37 ± 0.44 ug/mL, P < 0.05) and remained elevated following 30 minutes of rest. In comparison to baseline, adiponectin levels were also elevated 24-72 hours following the final exercise session (High: 5.47 ± 0.48 versus 4.88 ± 0.48 ug/mL; Low: 5.18 ± 0.49 versus 4.47 ± 0.49 ug/mL, P < 0.05). Conclusion. Both acute and short-term aerobic exercise result in a significant increase in plasma adiponectin levels in inactive, abdominally obese men independent of intensity.