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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 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 Knowledge of anatomy/exposure essential Time devoted to anatomy decreasing Interns lack adequate knowledge Cadaveric dissection is irreplaceable
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 • Describe UCLA Surgery anatomy program • Assess resident attitudes toward program
UCLA Surgery Anatomy Program Conceived by emeritus faculty member
UCLA Surgery Anatomy Program Conceived by emeritus faculty member Rembrandt Harmenszoon van Rijn, The Anatomy Lesson, c 1632
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
Cadavers • Fresh frozen at -17C to -20C • Stored in special facility • Defrosted prior to use • Ethically donated per patient’s bequest
Anatomy Program Costs Each body approximately $2,500 Donated / without charge: Instruments Faculty time Facilities
UCLA Anatomy Curriculum Core general surgery procedures Junior resident skills sessions Senior resident skills sessions PGY1 dissection program
UCLA Anatomy Curriculum Core general surgery procedures Junior resident skills sessions Senior resident skills sessions PGY1 dissection program
Core General Surgery Procedures • Lecture on relevant surgical anatomy • Demonstration on fresh cadaver • Resident performance of procedures: • Groin herniorrhaphy Thoracic outlet • Liver harvest Pancreatectomy • Thyroidectomy Gastrectomy • Abdominal aortic aneurysmectomy
Cadaver Education Survey Response Rate 89% (n = 40)
Cadaver Sessions are a Good Way to Learn Steps of an Operation
Cadaver Sessions Increase my Confidence in Doing an Operation
Trainees Should do an Operation on a Cadaver Before Real Patient
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 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 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 • Perform dissection under direct supervision • Self-guided dissection and • review of findings with instructor • Watch instructor perform a dissection
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 • 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