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Arthroscopy or ultrasound in undergraduate anatomy education: a randomized cross-over controlled trial.

Knobe M, Carow JB, Ruesseler M, Leu BM, Simon M, Beckers SK, Ghassemi A, Sönmez TT, Pape HC - BMC Med Educ (2012)

Bottom Line: The benefit of the ASK module was limited to the shoulder area (p < 0.001).The final examination (OSCE) showed no significant differences between any of the groups with good overall performances.Although arthroscopy and ultrasound teaching do not have a major effect on learning joint anatomy, they have the potency to raise the interest in surgery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Trauma, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, Aachen 52074, Germany. mknobe@ukaachen.de

ABSTRACT

Background: The exponential growth of image-based diagnostic and minimally invasive interventions requires a detailed three-dimensional anatomical knowledge and increases the demand towards the undergraduate anatomical curriculum. This randomized controlled trial investigates whether musculoskeletal ultrasound (MSUS) or arthroscopic methods can increase the anatomical knowledge uptake.

Methods: Second-year medical students were randomly allocated to three groups. In addition to the compulsory dissection course, the ultrasound group (MSUS) was taught by eight, didactically and professionally trained, experienced student-teachers and the arthroscopy group (ASK) was taught by eight experienced physicians. The control group (CON) acquired the anatomical knowledge only via the dissection course. Exposure (MSUS and ASK) took place in two separate lessons (75 minutes each, shoulder and knee joint) and introduced standard scan planes using a 10-MHz ultrasound system as well as arthroscopy tutorials at a simulator combined with video tutorials. The theoretical anatomic learning outcomes were tested using a multiple-choice questionnaire (MCQ), and after cross-over an objective structured clinical examination (OSCE). Differences in student's perceptions were evaluated using Likert scale-based items.

Results: The ASK-group (n = 70, age 23.4 (20-36) yrs.) performed moderately better in the anatomical MC exam in comparison to the MSUS-group (n = 84, age 24.2 (20-53) yrs.) and the CON-group (n = 88, 22.8 (20-33) yrs.; p = 0.019). After an additional arthroscopy teaching 1% of students failed the MC exam, in contrast to 10% in the MSUS- or CON-group, respectively. The benefit of the ASK module was limited to the shoulder area (p < 0.001). The final examination (OSCE) showed no significant differences between any of the groups with good overall performances. In the evaluation, the students certified the arthroscopic tutorial a greater advantage concerning anatomical skills with higher spatial imagination in comparison to the ultrasound tutorial (p = 0.002; p < 0.001).

Conclusions: The additional implementation of arthroscopy tutorials to the dissection course during the undergraduate anatomy training is profitable and attractive to students with respect to complex joint anatomy. Simultaneous teaching of basic-skills in musculoskeletal ultrasound should be performed by medical experts, but seems to be inferior to the arthroscopic 2D-3D-transformation, and is regarded by students as more difficult to learn. Although arthroscopy and ultrasound teaching do not have a major effect on learning joint anatomy, they have the potency to raise the interest in surgery.

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Related in: MedlinePlus

The flow of participants through each stage of the trial is shown. ASK: arthroscopy, MSUS: musculoskeletal ultrasound, CON: control-group without additional intervention (only cadaver dissection course), OSCE: objective structured clinical examination.
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Figure 1: The flow of participants through each stage of the trial is shown. ASK: arthroscopy, MSUS: musculoskeletal ultrasound, CON: control-group without additional intervention (only cadaver dissection course), OSCE: objective structured clinical examination.

Mentions: Participants were randomly assigned following simple randomization procedures (computerized random numbers) to one of the three trial groups (Figure 1). The CON-group served as control group and received their anatomical knowledge solely through the established dissection course. The MSUS-group received additional ultrasound training in the first week of the dissection course, while the ASK-group received additional arthroscopy training using a simulator. Autonomous self-study was not regulated through the trials’ setting.


Arthroscopy or ultrasound in undergraduate anatomy education: a randomized cross-over controlled trial.

Knobe M, Carow JB, Ruesseler M, Leu BM, Simon M, Beckers SK, Ghassemi A, Sönmez TT, Pape HC - BMC Med Educ (2012)

The flow of participants through each stage of the trial is shown. ASK: arthroscopy, MSUS: musculoskeletal ultrasound, CON: control-group without additional intervention (only cadaver dissection course), OSCE: objective structured clinical examination.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473305&req=5

Figure 1: The flow of participants through each stage of the trial is shown. ASK: arthroscopy, MSUS: musculoskeletal ultrasound, CON: control-group without additional intervention (only cadaver dissection course), OSCE: objective structured clinical examination.
Mentions: Participants were randomly assigned following simple randomization procedures (computerized random numbers) to one of the three trial groups (Figure 1). The CON-group served as control group and received their anatomical knowledge solely through the established dissection course. The MSUS-group received additional ultrasound training in the first week of the dissection course, while the ASK-group received additional arthroscopy training using a simulator. Autonomous self-study was not regulated through the trials’ setting.

Bottom Line: The benefit of the ASK module was limited to the shoulder area (p < 0.001).The final examination (OSCE) showed no significant differences between any of the groups with good overall performances.Although arthroscopy and ultrasound teaching do not have a major effect on learning joint anatomy, they have the potency to raise the interest in surgery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Trauma, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, Aachen 52074, Germany. mknobe@ukaachen.de

ABSTRACT

Background: The exponential growth of image-based diagnostic and minimally invasive interventions requires a detailed three-dimensional anatomical knowledge and increases the demand towards the undergraduate anatomical curriculum. This randomized controlled trial investigates whether musculoskeletal ultrasound (MSUS) or arthroscopic methods can increase the anatomical knowledge uptake.

Methods: Second-year medical students were randomly allocated to three groups. In addition to the compulsory dissection course, the ultrasound group (MSUS) was taught by eight, didactically and professionally trained, experienced student-teachers and the arthroscopy group (ASK) was taught by eight experienced physicians. The control group (CON) acquired the anatomical knowledge only via the dissection course. Exposure (MSUS and ASK) took place in two separate lessons (75 minutes each, shoulder and knee joint) and introduced standard scan planes using a 10-MHz ultrasound system as well as arthroscopy tutorials at a simulator combined with video tutorials. The theoretical anatomic learning outcomes were tested using a multiple-choice questionnaire (MCQ), and after cross-over an objective structured clinical examination (OSCE). Differences in student's perceptions were evaluated using Likert scale-based items.

Results: The ASK-group (n = 70, age 23.4 (20-36) yrs.) performed moderately better in the anatomical MC exam in comparison to the MSUS-group (n = 84, age 24.2 (20-53) yrs.) and the CON-group (n = 88, 22.8 (20-33) yrs.; p = 0.019). After an additional arthroscopy teaching 1% of students failed the MC exam, in contrast to 10% in the MSUS- or CON-group, respectively. The benefit of the ASK module was limited to the shoulder area (p < 0.001). The final examination (OSCE) showed no significant differences between any of the groups with good overall performances. In the evaluation, the students certified the arthroscopic tutorial a greater advantage concerning anatomical skills with higher spatial imagination in comparison to the ultrasound tutorial (p = 0.002; p < 0.001).

Conclusions: The additional implementation of arthroscopy tutorials to the dissection course during the undergraduate anatomy training is profitable and attractive to students with respect to complex joint anatomy. Simultaneous teaching of basic-skills in musculoskeletal ultrasound should be performed by medical experts, but seems to be inferior to the arthroscopic 2D-3D-transformation, and is regarded by students as more difficult to learn. Although arthroscopy and ultrasound teaching do not have a major effect on learning joint anatomy, they have the potency to raise the interest in surgery.

Show MeSH
Related in: MedlinePlus