National Survey on Canadian Undergraduate Medical Programs: The Decline of the Anatomical Sciences in Canadian Medical Education.

The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.

Structured, Small-group Hands-on Teaching Sessions Improve Pre-clerk Knowledge and Confidence in Point-of-care Ultrasound Use and Interpretation.

Introduction Many undergraduate medical education (UME) programs have begun adopting point-of-care ultrasound (PoCUS) curricula, reflecting the increasing ubiquity of this technique across medical specialties. The structures of international PoCUS curricula have been extensively studied. However, the efficacy of these curricula to increase knowledge and confidence in PoCUS is less well-studied. We investigated whether a structured, small-group PoCUS teaching session consisting of pre-defined learning objectives, an introductory presentation, and a mandatory hands-on scanning component would increase pre-clerk knowledge of and confidence in PoCUS theory, use, and interpretation. Methods A pre-post study was designed to assess changes in pre-clerk knowledge and confidence in PoCUS theory, use, and interpretation. Pre-clerks were recruited from the Hamilton campus of the Michael G. DeGroote School of Medicine at McMaster University. Pre-clerks were organized into four groups, with an average group size of seven learners. Two preceptors each taught two groups. Sessions included an introductory PowerPoint presentation and one-on-one preceptor-guided practice in identifying abdominal and genitourinary structures using PoCUS. Student responses on pre- and post-intervention surveys were analyzed to identify changes in knowledge and confidence. Student satisfaction with the teaching session was assessed from self-reported levels of agreement with satisfaction statements. The strengths and areas of improvement for the teaching sessions were identified from open-ended survey responses. Results Data from 27 students indicated a significant improvement in knowledge test scores (p < .05), with no significant differences between groups (F(3,23) = 0.64, p = n.s.) or between students with different preceptors (p = n.s.). Students' confidence in PoCUS use and interpretation improved significantly (p < .05 for both), with no significant differences between groups (F(3,23) = 0.70, p = n.s. and F(3,23) = 0.32, p = n.s., respectively) or between students with different preceptors (p = n.s. for both). Improvements in knowledge of and confidence in PoCUS use were significantly correlated (r = .44, p < .05). All of the students agreed that they liked the instruction, content, and structure of the teaching session. The most frequently cited strengths of the teaching sessions were the mandatory individual practice time per student, individualized instruction from and interactions with preceptors, and the small group structure of the sessions. Conclusion This study provides novel evidence that a structured, small-group teaching session featuring a didactic presentation, defined learning objectives, and mandatory hands-on learning can effectively teach introductory PoCUS knowledge and skills to pre-clerks and increase student confidence. Future studies will investigate the retention and application of PoCUS knowledge and skill throughout clerkship and early residency training to determine if this teaching model can facilitate longitudinal PoCUS learning and competency as well as improved diagnostic capabilities as students advance through undergraduate medical training.