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A Digital Interview with a Donor Family Member Instills Professionalism in Anatomy Students

A Digital Interview with a Donor Family Member Instills Professionalism in Anatomy Students. Tia R. Milanese, David B. Jones, Terry K. Schiefer, Jeffrey B. Geske, Stephen W. Carmichael, Ph.D., D.Sc., Wojciech Pawlina, M.D. Mayo Clinic College of Medicine. Introduction The Gross Anatomy Course.

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A Digital Interview with a Donor Family Member Instills Professionalism in Anatomy Students

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  1. A Digital Interview with a Donor Family Member Instills Professionalism in Anatomy Students Tia R. Milanese, David B. Jones, Terry K. Schiefer, Jeffrey B. Geske, Stephen W. Carmichael, Ph.D., D.Sc., Wojciech Pawlina, M.D. Mayo Clinic College of Medicine

  2. IntroductionThe Gross Anatomy Course • Dissection forever changes first-year medical students (David, E.M., Annals of Internal Medicine, 1999, vol. 131) • Opportunity for learning • Opportunity for responsibility • Gross anatomy: introduce key concepts into medical school education

  3. IntroductionIssues in Gross Anatomy • Professionalism • Confidentiality • Human dignity • Death and dying • How to deal with one’s emotions (Saylam, C. and Coskunol, H., Surgical and Radiologic Anatomy, 2000, vol. 27)

  4. IntroductionProfessionalism • Professionalism is a competency that needs to be instilled in medical students • Study: 40% of the medical students, house officers, and practicing physicians sampled were unsatisfied with their professionalism training (Barry, D., et al., American Journal of Medicine, 2000, vol. 108)

  5. IntroductionTeaching Methods • Methods to teach professionalism: • Passive • Teach by example • Active • Explicitly teaching through lectures or other teaching aids • Innovative teaching methods • Active teaching believed by many to be necessary. (Steinert, Y., Cruess, S., Cruess, R. and Snell, L., Medical Education, 2005, vol. 39)

  6. IntroductionTeaching Opportunity • A student at Mayo Clinic College of Medicine was in a public setting recounting first day of anatomy • Overheard by “Mrs. X,” a woman whose mother had recently donated her body to the Mayo Clinic Anatomical Bequest Program • Mrs. X concerned by the details of dissection that were recounted in public • Reported her concerns to the medical school

  7. IntroductionTeaching Opportunity • Situation was brought to the class’s attention • All students wrote apology letters to Mrs. X as if they were the offender • Incident used as a teaching tool in practical application of confidentiality (Carmichael, S.W. and Pawlina, W., Academic Medicine, 2004, vol. 79)

  8. IntroductionTeaching Methods • No standard for the inclusion of professionalism in medical education • Much room for innovation in designing appropriate teaching methods (Bryan, R.E., et al., Annals of the Academy of Medicine, Singapore, 2005, vol. 34, pp. 486-91.)

  9. Objective • To clarify for first-year medical students their professional roles in the anatomy lab, specifically, their roles in protecting the confidentiality and considering the humanism of the donors. • Teaching method: Digital interview with a donor family member.

  10. MethodsDigital Interview • Created the video, “The Gift of Knowledge: Teaching the Physicians of Tomorrow Through the Mayo Clinic Anatomical Bequest Program” • Interview between anatomy chair (WP) and Mrs. X • Topics adressed: • the lives of her parents, both donors to the Mayo Clinic Anatomical Bequest Program • their reasons for donation • hopes they had for the medical students who would benefit from their donation • appropriate and inappropriate behavior by medical students in the anatomy lab • Professionalism and how it relates to medical students

  11. MethodsDigital Interview • Overall tone: positive • Emphasis on the donors as teachers of the medical students • Students encouraged to see donation as a gift, privilege, and responsibility

  12. Methods • Gross Anatomy, Day 1: • Anatomy chair (WP) discussed the concept of professionalism • He also detailed the breach of confidentiality that had occurred in the past • Gross Anatomy, Day 2: • Video screening • Request to reflect • Gross Anatomy, Day 3: • Survey (Likert scale, 0=strongly disagree, 10=strongly agree)

  13. MethodsSurvey • 20 statements, 4 categories: • Professionalism and Confidentiality • Humanism in Medicine • Anatomical Bequest Program • Laboratory Experience

  14. ResultsParticipation • Surveys returned by 41/42 students (97.6% participation)

  15. ResultsProfessionalism and Confidentiality 10 = Strongly Agree I feel better equipped to handle my professional role as a medical student in the anatomy lab. 7.7 0 = Strongly Disagree

  16. Results:Professionalism and Confidentiality 10 = Strongly Agree I am more aware of the importance of confidentiality in the anatomy lab. 9.0 0 = Strongly Disagree

  17. Results:Humanity 10 = Strongly Agree I feel more uncomfortable dissecting a human body after learning about the background of two donors. 1.4 0 = Strongly Disagree

  18. Results:Humanity 10 = Strongly Agree I have a better sense of the human component of the laboratory experience and medicine in general. 7.8 0 = Strongly Disagree

  19. Results:Humanity 10 = Strongly Agree I have a deeper respect for those who have donated their bodies. 8.8 0 = Strongly Disagree

  20. Results:Humanity 10 = Strongly Agree It was beneficial to hear from a future donor. 8.2 0 = Strongly Disagree

  21. Results:Anatomical Bequest Program 10 = Strongly Agree This video would be beneficial to show to potential donors. 8.4 0 = Strongly Disagree

  22. Results:Laboratory Experience 10 = Strongly Agree Future classes should watch this video. 8.6 0 = Strongly Disagree

  23. Results:Laboratory Experience 10 = Strongly Agree Other medical school students should watch this video. 8.6 0 = Strongly Disagree

  24. DiscussionSummary • Results support our hypothesis that this video has helped clarify the professional roles of first-year medical students

  25. DiscussionLimitations • Some degree of subjectivity inherent in survey • Students from only one institution • Small sample size due to small class size at Mayo Clinic College of Medicine • Usefulness for future donors would need to study the impact of the video on a different population

  26. Conclusion • Hearing from a donor family member can clarify medical students’ professional roles in protecting the confidentiality and humanity of donors. • Sharing information about the lives of donors and their messages to medical students can deepen medical students’ respect for donors. • A video interview with a donor family member may be beneficial to those contemplating body donation • Most first-year medical students agree that future classes of medical students would benefit from watching a video interview with a donor family member.

  27. Acknowledgements • “Mrs. X” for her help in creating the video script and participating in the video • Mayo Clinic College of Medicine Class of 2009 for their enthusiastic participation

  28. Questions?

  29. References • ABIM and ACP-ASIM (2002) Medical professionalism in the new millennium: a physician charter. Annals of Internal Medicine, 136, pp. 243-6. • BARRY, D., CYRAN, E. and ANDERSON, R.J. (2000) Common issues in medical professionalism: room to grow. American Journal of Medicine, 108, pp. 136-42. • BOULWARE, L.E., RATNER, L.E., COOPER, L.A., LAVEIST, T.A. and POWE, N.R. (2004) Whole body donation for medical science: a population-based study. Clinical Anatomy, 17, pp. 570-7. • BRYAN, R.E., KRYCH, A.J., CARMICHAEL S.W., VIGGIANO, T.R. and PAWLINA, W. (2005) Assessing professionalism in early medical education: experience with peer evaluation and self-evaluation in the gross anatomy course. Annals of the Academy of Medicine, Singapore, 34, pp. 486-91. • CARMICHAEL, S.W. and PAWLINA, W. (2004) Loose lips sink ships. Academic Medicine, 79, pp. 1002. • COHN, F. and LIE, D. (2002) Mediating the gap between the white coat ceremony and the ethics and professionalism curriculum. Academic Medicine, 77, pp. 1168. • DAVID, E.M. (1999) On being a doctor. Thoughts from gross anatomy. Annals of Internal Medicine, 131, pp. 974-5. • DAVIS, L., DOMM, J.A., KONIKOFF, M.R. and MILLER, R.A. (1999) Attitudes of first-year medical students toward the confidentiality of computerized patient records. Journal of the American Medical Informatics Association, 6, pp. 53-60. • DICKINSON, G.E., LANCASTER, C.J., WINFIELD, I.C., REECE, E.F. and COLTHORPE, C.A. (1997) Detached concern and death anxiety of first-year medical students: before and after the gross anatomy course. Clinical Anatomy, 10, pp. 201-7. • DONOHOE, M. and DANIELSON, S. (2004) A community-based approach to the medical humanities. Medical Education, 38, pp. 204-17. • ELGER, B.S. and HARDING, T.W. (2005) Avoidable breaches of confidentiality: a study among students of medicine and of law. Medical Education, 39, pp. 333-7. • HILLKIRK, K., TOME, J. and WANDRESS, W. (1989) Integrating reflection into staff development programs. Journal of Staff Development, 10, pp. 54-8. • LYPSON, M.L. and HAUSER, J.M. (2002) Talking medicine: a course in medical humanism--what do third-year medical students think? Academic Medicine, 77, pp. 1169-70. • RIZZOLO, L.J. (2002) Human dissection: an approach to interweaving the traditional and humanistic goals of medical education. Anatomical Record, 269, pp. 242-8. • ROBERTSON, K. (2005) Reflection in professional practice and education. Australian Family Physician, 34, pp. 781-3. • SAYLAM, C. and COSKUNOL, H. (2005) Orientation lesson in anatomy education. Surgical and Radiologic Anatomy, 27, pp. 74-7. • STEINERT, Y., CRUESS, S., CRUESS, R. and SNELL, L. (2005) Faculty development for teaching and evaluating professionalism: from programme design to curriculum change. Medical Education, 39, pp. 127-36.

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