A novel cadaver based educational program in general surgery training
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A Novel Cadaver-Based Educational Program in General Surgery Training. Catherine E. Lewis, MD Warwick J. Peacock, MD, Areti Tillou, MD, O. Joe Hines, MD Jonathan R. Hiatt, MD Department of Surgery David Geffen School of Medicine at UCLA. Anatomy in Surgical Education.

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A Novel Cadaver-Based Educational Program in General Surgery Training

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A novel cadaver based educational program in general surgery training

A Novel Cadaver-Based Educational Program in General Surgery Training

Catherine E. Lewis, MD

Warwick J. Peacock, MD,

Areti Tillou, MD,

O. Joe Hines, MD

Jonathan R. Hiatt, MD

Department of Surgery

David Geffen School of Medicine at UCLA


Anatomy in surgical education

Anatomy in Surgical Education

Knowledge of anatomy/exposure essential

Time devoted to anatomy decreasing

Interns lack adequate knowledge

Cadaveric dissection is irreplaceable


Cadaver based education

Cadaver-Based Education

  • Ideal model for surgical skills training

  • Support basic and complex operations

  • Superior to other models / simulators

  • - Realistic

  • - Provides haptic feedback

  • - Representative surgical anatomy


Specific aims

Specific Aims

  • Describe UCLA Surgery anatomy program

  • Assess resident attitudes toward program


Ucla surgery anatomy program

UCLA Surgery Anatomy Program

Conceived by emeritus faculty member


Ucla surgery anatomy program1

UCLA Surgery Anatomy Program

Conceived by emeritus faculty member

Rembrandt Harmenszoon van Rijn,

The Anatomy Lesson, c 1632


Ucla surgery anatomy program2

UCLA Surgery Anatomy Program

  • Conceived by emeritus faculty member

  • Utilizes fresh-frozen cadavers

  • Provides education, skills and research for

  • undergraduates, graduates & postgraduates

  • Implemented for general surgery residents as

  • component of core education conferences


Anatomy theater

Anatomy Theater


Anatomy theater1

Anatomy Theater


Anatomy theater2

Anatomy Theater


Anatomy lab

Anatomy Lab


Cadavers

Cadavers

  • Fresh frozen at -17C to -20C

  • Stored in special facility

  • Defrosted prior to use

  • Ethically donated per patient’s bequest


Anatomy program costs

Anatomy Program Costs

Each body approximately $2,500

Donated / without charge:

Instruments

Faculty time

Facilities


Ucla anatomy curriculum

UCLA Anatomy Curriculum

Core general surgery procedures

Junior resident skills sessions

Senior resident skills sessions

PGY1 dissection program


Ucla anatomy curriculum1

UCLA Anatomy Curriculum

Core general surgery procedures

Junior resident skills sessions

Senior resident skills sessions

PGY1 dissection program


Core general surgery procedures

Core General Surgery Procedures

  • Lecture on relevant surgical anatomy

  • Demonstration on fresh cadaver

  • Resident performance of procedures:

  • Groin herniorrhaphyThoracic outlet

  • Liver harvestPancreatectomy

  • ThyroidectomyGastrectomy

  • Abdominal aortic aneurysmectomy


Resident skills sessions

Resident Skills Sessions


Resident skills sessions1

Resident Skills Sessions


Resident skills sessions2

Resident Skills Sessions


A novel cadaver based educational program in general surgery training

Cadaver Education Survey

Response Rate 89% (n = 40)


Cadaver sessions are a good way to learn anatomy

Cadaver Sessions are a Good Way to Learn Anatomy


Cadaver sessions are a good way to learn steps of an operation

Cadaver Sessions are a Good Way to Learn Steps of an Operation


Cadaver sessions increase my confidence in doing an operation

Cadaver Sessions Increase my Confidence in Doing an Operation


I would like to have more cadaver sessions

I Would Like to Have More Cadaver Sessions


I would spend free time in the cadaver lab

I Would Spend Free Time in the Cadaver Lab


Trainees should do an operation on a cadaver before real patient

Trainees Should do an Operation on a Cadaver Before Real Patient


Comparison of learning modalities

Comparison of Learning Modalities

Learn

Anatomy

Cadaver

Textbooks

Simulators

Websites

Animate labs

Lectures

Increase

Confidence

Cadaver

Simulators

Textbooks

Websites

Animate labs

Lectures

Learn Steps

of Operation

Cadaver

Simulators

Animate labs

Websites

Textbooks

Lectures


Comparison of learning modalities1

Comparison of Learning Modalities

Learn

Anatomy

Cadaver

Textbooks

Simulators

Websites

Animate labs

Lectures

Increase

Confidence

Cadaver

Simulators

Textbooks

Websites

Animate labs

Lectures

Learn Steps

of Operation

Cadaver

Simulators

Animate labs

Websites

Textbooks

Lectures


Comparison of learning modalities2

Comparison of Learning Modalities

Learn

Anatomy

Cadaver

Textbooks

Simulators

Websites

Animate labs

Lectures

Increase

Confidence

Cadaver

Simulators

Textbooks

Websites

Animate labs

Lectures

Learn Steps

of Operation

Cadaver

Simulators

Animate labs

Websites

Textbooks

Lectures


Preferred session format

Preferred Session Format

  • Perform dissection under direct supervision

  • Self-guided dissection and

  • review of findings with instructor

  • Watch instructor perform a dissection


Fresh cadavers in surgical training

Fresh Cadavers in Surgical Training


Fresh cadavers in surgical training1

Fresh Cadavers in Surgical Training


Fresh cadavers in surgical training2

Fresh Cadavers in Surgical Training


Fresh cadavers in surgical training3

Fresh Cadavers in Surgical Training


Fresh cadavers in surgical training4

Fresh Cadavers in Surgical Training


Fresh cadavers in surgical training5

Fresh Cadavers in Surgical Training


Comparison of cadaver types

Comparison of Cadaver Types


Future directions

Future Directions

  • Continue to expand curriculum

  • Dedicated facility nearing completion

  • Program validation using surgical skills

  • assessment and demonstration of

  • improved operative performance


Summary cadaver based education

Summary: Cadaver-Based Education

  • Efficient and effective educational tool

  • Useful in teaching anatomy, surgical skills,

  • complex open & laparoscopic procedures

  • Increase confidence in performing operations

  • Positive perception by residents

  • More effective than other learning modalities


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