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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.

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A Novel Cadaver-Based Educational Program in General Surgery Training

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  1. 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

  2. Anatomy in Surgical Education Knowledge of anatomy/exposure essential Time devoted to anatomy decreasing Interns lack adequate knowledge Cadaveric dissection is irreplaceable

  3. 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

  4. Specific Aims • Describe UCLA Surgery anatomy program • Assess resident attitudes toward program

  5. UCLA Surgery Anatomy Program Conceived by emeritus faculty member

  6. UCLA Surgery Anatomy Program Conceived by emeritus faculty member Rembrandt Harmenszoon van Rijn, The Anatomy Lesson, c 1632

  7. 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

  8. Anatomy Theater

  9. Anatomy Theater

  10. Anatomy Theater

  11. Anatomy Lab

  12. Cadavers • Fresh frozen at -17C to -20C • Stored in special facility • Defrosted prior to use • Ethically donated per patient’s bequest

  13. Anatomy Program Costs Each body approximately $2,500 Donated / without charge: Instruments Faculty time Facilities

  14. UCLA Anatomy Curriculum Core general surgery procedures Junior resident skills sessions Senior resident skills sessions PGY1 dissection program

  15. UCLA Anatomy Curriculum Core general surgery procedures Junior resident skills sessions Senior resident skills sessions PGY1 dissection program

  16. 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

  17. Resident Skills Sessions

  18. Resident Skills Sessions

  19. Resident Skills Sessions

  20. Cadaver Education Survey Response Rate 89% (n = 40)

  21. Cadaver Sessions are a Good Way to Learn Anatomy

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

  23. Cadaver Sessions Increase my Confidence in Doing an Operation

  24. I Would Like to Have More Cadaver Sessions

  25. I Would Spend Free Time in the Cadaver Lab

  26. Trainees Should do an Operation on a Cadaver Before Real Patient

  27. 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

  28. 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

  29. 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

  30. Preferred Session Format • Perform dissection under direct supervision • Self-guided dissection and • review of findings with instructor • Watch instructor perform a dissection

  31. Fresh Cadavers in Surgical Training

  32. Fresh Cadavers in Surgical Training

  33. Fresh Cadavers in Surgical Training

  34. Fresh Cadavers in Surgical Training

  35. Fresh Cadavers in Surgical Training

  36. Fresh Cadavers in Surgical Training

  37. Comparison of Cadaver Types

  38. Future Directions • Continue to expand curriculum • Dedicated facility nearing completion • Program validation using surgical skills • assessment and demonstration of • improved operative performance

  39. 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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