Background: As medical schools seek to standardize ultrasound training and incorporate clinical correlations into the basic science years, we proposed that ultrasonography should have a greater role in the anatomy curriculum.
Objectives: To describe the introduction of ultrasound into the curriculum of a ﬁrst-year medical student anatomy course and evaluate the utility of this introduction.
Methods: First-year medical students attended two ultrasound lectures and three small-group hands-on sessions that focused on selected aspects ofmusculoskeletal, thoracic,abdominal, and neck anatomy. Pre and post surveys were administered to assess student perception of their ability to obtain and interpret ultrasound images and the utility of ultrasound in the anatomy course. Understanding of basic ultrasound techniques and imaging was tested in the practical examinations.
Results: Of the 269 ﬁrst-year medical students who completed the course, 144 students completed both surveys entirely, with a response rate of 53%. Students’interest and self-perceived experience, comfort, and conﬁdence in ultrasound skills signiﬁcantly increased (p under 0.001).
Conclusions: Ultrasound can be effectively incorporated into an anatomy course for ﬁrst-year medical students by utilizing didactics and hands-on exposure.Medical students found the addition of ultrasound training to be valuable, not only in enhancing their understanding of anatomy, but also in increasing their interest and experience in ultrasound imaging.
2014 Elsevier Inc.
All ﬁrst-year medical students were assigned to a small group consisting of 10–12 ﬁrst-year medical students and one senior medical student proctor. Senior medical students, residents, and faculty proctored the ultrasound laboratory sessions that focused on the use of ultrasound to study selected aspects of musculoskeletal anatomy, thoracic and abdominal anatomy, and neck anatomy. First-year medical students received a list of objectives prior to each scanning session and proctors received speciﬁc hands-on training and scanning guidelines prior to each session. Several resident and attending physicians circulated in the laboratory during each session to provide overall guidance.
During ‘‘Block 1 – Musculoskeletal,’’ at which time students were participating in cadaveric extremity dissections, ﬁrst-year medical students viewed a proctor demonstration of ultrasound imaging of the shoulder, wrist, and elbow. Each student was then provided the opportunity to scan one of the three joints during individual scanning timewhile observing others as they imaged the other joints noted above. Focal anatomy during shoulder imaging included the humeral head, the biceps tendon within the bicipital groove, the subscapularis tendon inserting onto the lesser tuberosity of the humerus, and the supraspinatus tendon inserting onto the greater tuberosity of the humerus. Elbow imaging included the biceps brachii tendon, brachial artery, median nerve, and humerus, radius, and ulna in the anticubital fossa. Wrist imaging included the components of the carpal tunnel, as well as the radial artery, radius, and ulna.
During ‘‘Block 2 – Abdomen/Thorax,’’ when students were completing their abdominal cadaveric dissections, ﬁrst-year medical students viewed a proctor demonstration of ultrasound imaging of the liver, great vessels, and kidneys. Each student was then given the opportunity to perform this imaging on a live model with proctor guidance. Speciﬁc liver anatomy included the portal triad, differentiating portal from hepatic veins, hepatic veins draining into the inferior vena cava (IVC), and the effect of deep respiration on liver imaging. Focal kidney imaging included the liver–kidney interface and the psoas muscle.
Abdominal vessel imaging focused on locating the aorta anterior to the vertebral bodies, scanning the aorta distally to image the aortic bifurcation, and proximally to identify the inferior mesenteric artery, the superior mesenteric artery, and the celiac trunk branching from the aorta,and drainage of the IVC into the right atrium.
Finally, during ‘‘Block 3 – Head/Neck,’’ when students were completing cadaveric neck dissections, ﬁrst-yearintroduction of ultrasound into the medical curriculum at this College of Medicine. Beginning in 2006, we introduced a clinical correlation of a case of cholecystitis that included ultrasound imaging as part of the patient work-up. In subsequent years, we added optional hands-on laboratory experience using the device. Students learned to image the extremities, torso, and neck anatomy on a live model as part of a curriculum that paralleled their dissections in the cadaver laboratory. Based on student feedback, ultrasound remained part of the anatomy curriculum as an introductory exposure to ultrasound in medical school.
The study describes and evaluates the current version of our introduction of ultrasound into the anatomy course of ﬁrst-year medical students. Currently, students receiveinstruction on basic elements of ultrasound imaging, on how to use the ultrasound device, and how to obtain ultrasound images of targeted areas of musculoskeletal, trunk, and neck anatomy, all in parallel with their dissections.
The objectives of this study were 1) to demonstrate the utility of incorporating ultrasound into preclinical medical students’ anatomy education; and 2) to determine if ultrasound imaging enhances ﬁrst-year medical students’understanding of anatomy.
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Color Atlas of Ultrasound Anatomy(Block)296p,2004 CAUA.pdf
Review of Gross AnatomyPansky)681p,1996 RGAP.pdf
To our knowledge, this study is novel because the impact of ultrasound with cross sectional anatomy images and line diagrams for teaching anatomy of upper and lower limbs has not been reported. It has shown that this can be a useful adjunct in teaching anatomy to medical students. Anatomy teaching using ultrasound in Phase 1 (year 1 and year 2) medical curriculum can act as bridging tool to integrate anatomy learning and clinical practice by helping the students to apply anatomical knowledge to interpret normal ultrasound images and to be more prepared when they encounter abnormalities during their clinical years of medicine and as clinicians in their future practice. It can also increase the students’awareness of the importance of anatomy knowledge in clinical practice.
The utilization of bedside ultrasound by an increasing number of medical specialties has created the need for more ultrasound exposure and teaching in medical school. Although there is a widespread support for more vertical integration of ultrasound teaching throughout the undergraduate curriculum, little is known about whether the quality of ultrasound teaching differs if performed by anatomists or clinicians. The purpose of this study is to compare medical students' evaluation of ultrasound anatomy teaching by clinicians and anatomists. Hands-on interactive ultrasound sessions were scheduled as part of the gross anatomy course following principles of adult learning and instructional design. Seven teachers (three anatomists and four clinicians) taught in each session. Before each session, anatomists were trained in ultrasound by clinicians. Students were divided into groups, rotated teachers between sessions, and completed evaluations. Results indicated students perceived the two groups as comparable for all factors except for knowledge organization and the helpfulness of ultrasound for understanding anatomy (P < 0.001). However, results from unpaired samples t-tests demonstrated a nonstatistically significant difference between the groups within each session for both questions. Moreover, students' test performance for both groups was similar. This study demonstrated that anatomists can teach living anatomy using ultrasound with minimal training as well as clinicians, and encourage the teaching of living anatomy by anatomists in human anatomy courses using ultrasound. Repeating this study at a multicenter level is currently being considered to further validate our conclusion. Anat Sci Educ 7: 340-349. © 2013 American Association of Anatomists.
© 2013 American Association of Anatomists.
ĐỀ CƯƠNG HỌC VÀ DẠY GIẢI PHẪU HỌC BẰNG SIÊU ÂM
1/CƠ XƯƠNG KHỚP=11 X2=22 TIẾT
2/ TIÊU HÓA-GAN MẬT-THẬN=6X2=12 TIẾT
3/ SINH DỤC-NÔI TIẾT=3X2=6 TIẾT
4/ĐẦU MẶT CỔ -NÃO=8X 2=16 TIẾT
5/ TIM – PHỔI= 4X2 = 8 TIẾT
TỔNG CÔNG =64 TIẾT
TÀI LIỆU THAM KHẢO:
GIÁO TRÌNH GPH TIẾNG VIÊT XIN SỬ DỤNG: GIÁO TRÌNH GIẢI PHẪU HỌC, LÊ ĐÌNH VẤN.
GIÁO TRÌNH GPH TIẾNG ANH: HUMAN ANATOMY, A Synoptic Approach, NICOLAS JAMES MIZERES, 1981.
GIÁO TRÌNH THỰC TẬP GPH XIN SỬ DỤNG SÁCH DIAGNOSTIC
SURGICAL IMAGING ANATOMY_ULTRASOUND, AHUJA, 2007 VÀ COLOR ATLAS of ULTRASOUND ANATOMY, BLOCK,
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