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Osteopathic Clinical Anatomy Orientation: “The Immersion”. 2 August 2010. Handout download: Blackboard or http://www.oucom.ohiou.edu/ dbms-witmer/anatomy_immersion.htm. Lawrence M. Witmer, PhD Professor of Anatomy Dept of Biomedical Sciences College of Osteopathic Medicine

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slide1

Osteopathic Clinical Anatomy Orientation:

“The Immersion”

2 August 2010

Handout download: Blackboard or

http://www.oucom.ohiou.edu/

dbms-witmer/anatomy_immersion.htm

Lawrence M. Witmer, PhD

Professor of Anatomy

Dept of Biomedical Sciences

College of Osteopathic Medicine

Ohio University

Athens, Ohio 45701

witmerL@ohio.edu

from Vesalius,

De Humani Corporis Fabrica

(1543)

slide2

Features of the Immersion

• Starts early, first medical school experience

• “Immersion”—highly focused, few other activities

• Four days per week (Mon-Tues-Thurs-Fri)

• Three hours of lab per day, balance of time is largely for reading and other preparation

• OMM is the other major player in the Immersion

• Also, Evidence-Based Medicine…an introduction

• Brings all students together prior to PCC & CPC start

• Frontloads musculoskeletal anatomy (back & limbs)

• Has a strong clinical emphasis

slide3

Justification for the Immersion

• Gross anatomy is the foundation and language of medicine—particularly Osteopathic Manipulative Medicine (OMM)

• Provide that foundation prior to beginning the rest of your training

• Quickly bring all students up to the same level

• Better prepare all our students for OMM training

• Provide a clinical focus & orientation at the outset

• Starting the process of clinical thinking & problem solving

slide4

What Is Clinical Anatomy?

Systemic

Anatomy

Regional

Anatomy

Clinical

Anatomy

head &

neck

Carpal tunnel syndrome

• paresthesia

• thenar wasting

• hand weakness

arterial

system

thorax

upper

limb

abdomen

& pelvis

median

nerve

lower

limb

(from M&D COA5 2006)

slide5

Why Emphasize Clinical Anatomy?

• Medical school is for training physicians, not anatomists

• Promotes critical thinking and clinical problem- solving using anatomical knowledge

• Enhances ability to learn and retain anatomy

• Retention is better if learning is done in the context in which it will be ultimately used

• “Seeing the forest [clinical application] for the trees [anatomical structures]”

• “Reciprocal illumination”

• Need anatomy to understand clinical practice

• Need clinical correlations to understand anatomy

slide6

Anatomy of the Immersion: Webpage

Available on Blackboard or

http://www.oucom.ohiou.edu/dbms-witmer/anatomy_immersion.htm

slide7

Anatomy of the Immersion: “Blue Coats”

J. Eastman, PhD

Professor

R. Staron, PhD

Assoc. Professor

L. Witmer, PhD

Professor

Course Coordinator

M. K. Eastman, MS

Instructor

S. Schumm

Grad TA

Amanda Kocoloski,

MSIV

DFM Fellow

Amy Johnson,

MSIV

OMM Fellow

William Porter

Grad TA

Jillian Davis

Grad TA

Amy Martiny

Grad TA

Jason Bourke

Grad TA

slide8

Anatomy of the Immersion: Assistants

2nd Year OUCOM medical students

• tutoring, prosections, practical exams

Stephanie DeAngelis,

OMSII

OUCOM TA

Maricor Docena,

OMSII

OUCOM TA

Travis Dugger,

OMSII

OUCOM TA

Lindsey Williams,

OMSII

OUCOM TA

slide9

Anatomy of the Immersion: The Lab

A

B

A

B

A

B

A

B

A

B

A

B

B

A

B

A

B

B

A

B

A

B

A

A

• 28 tables, 4 or 5 students/table

• Sections A & B, alternate AM/PM slot weekly

• Teams do their own dissections. Division of labor: cutters, readers, …

• Dissect BOTH sides of cadaver

• Come to lab at off times to finish up

• Attendance in lab is mandatory

slide10

Anatomy of the Immersion: The Lab

How?

• Fingerprint scanner

• Swipe your finger at the beginning

& end of lab

Mandatory Attendance

Why?

• Material is central to your training

• Responsibility to your dissecting team

• Honoring the gift of a willed body

Stay for the whole lab

• Work on dissection

• If dissection is completed, work with other resources

(e.g., other cadavers, bones, x-rays, cross-sections, etc.)

slide12

Anatomy of the Immersion:

Clinical Themes & Question of the Day

Witmer

Fellow

Clinical Themes

• Posted at the beginning of lab

• Provide clinical correlations

• For your reference; instructors may or may not discuss

• Available online prior to lab

A

A

A

A

A

A

A

A

A

A

A

A

Question of the Day (QOD)

• Short clinical vignette

• Table team explores the QOD

• Witmer & Fellows will discuss QOD with pairs of tables

A

A

slide13

Anatomy of the Immersion: Books

• Relevant pages to read are on the schedule. Pages in Moore’s COA 5th ed. are on schedule PDF

• Moore’s Clinical “Blue Boxes” are key (but you won’t understand them without reading what’s between!)

• Dissector & Atlas must be at each table!

• Read dissector prior to coming to lab

slide14

Anatomy of the Immersion: Assessment

1. Required weekly self-assessment quizzes

online on Blackboard

2. Required weekly self-assessment lab practical exams

3. Inspection of results of Blackboard quizzes & practicals by faculty

4. Formal assessment in the Fall when relevant in PCC (Content Exams) & in CPC (MS Block)

5. The problems presented to you by your patients will continuously test your anatomical knowledge and its clinical application

slide15

Cadavers & Body Donation

• Role of the cadaver: 3D anatomy, variation, “diagnosis” of pathology, etc.

• Significance of the cadaver

• A profound experience

• Directly see & handle structures you’ll later have to imagine

• Opportunity and privilege to work on an actual human

• Potentially uncomfortable feelings

• Death: Illness, end-of-life, dying, corporeal remains

• A very different kind of intimacy

• Overcoming societal taboos

• Sadness: clear evidence of their humanity

• Body donation

• Conscious, often family decision to donate

• The ultimate gift

• Honoring that gift

• Respect, professionalism

• USE the gift: prepare for lab, don’t miss lab,

study & learn from all the cadavers

• Great book! — Body of Work, by C. Montross, MD