2. LIVING ANATOMY PROJECT (LAP) Stephanie Pieczenik, MSSM II Carrie Sager, MSSM II Jeffrey T. Laitman, PhD

3. OUR MISSION • To use movement, e.g. yoga and pilates exercises, as a teaching tool to enhance students’ understanding of the material taught in the first-year Gross Anatomy course • To increase students’ physical awareness—including biomechanics, proprioception, and posture —of themselves and others, and; • To infuse a component of physical activity, relaxation, and good health into the medical school environment.

4. PILATES AND YOGA: DEFINED • Pilates • A body-conditioning discipline designed 80 years ago by Joseph H. Pilates • Encompasses hundreds of mat- and equipment-based exercises • Focuses on improving core-strength and overall flexibility • Yoga • An ancient Hindu discipline designed to unify the body and mind • Physical elements challenge strength, flexibility, and balance • Spiritual components include meditation and relaxation exercises

5. In The Beginning … • Fall 2004: A gift to our fellow classmates • Spring 2005: Evaluation and expansion • Fall 2005: Integration with the anatomy • curriculum

6. LAP Class Overview • 2-3 classes offered per anatomy module • 1 hour per class, 1.5 hour per exam review class • Student sign-ups posted before each class; approximately 10-20 students attended each class • Same class format for each class

7. Class Format • Savasana (a yoga pose, also known as “corpse pose”)

8. SAVASANA

9. Class Format (cont’d) • Savasana (a yoga pose, also known as “corpse pose”) • Core Warm-Up

10. CORE WARM-UP

11. Class Format (cont’d) • Savasana (a yoga pose, also known as “corpse pose”) • Core Warm-Up • Palpation of bony landmarks

12. PALPATION

13. Class Format (cont’d) • Savasana (a yoga pose, also known as “corpse pose”) • Core Warm-Up • Palpation of bony landmarks • Yoga and pilates exercises that demonstrate relevant musculoskeletal anatomy

14. DOWNWARD DOG

15. ARM ABDUCTION

16. OUR DEAN OF MEDICAL EDUCATION

17. Class Format (cont’d) • Savasana (a yoga pose, also known as “corpse pose”) • Core Warm-Up • Palpation of bony landmarks • Yoga and pilates exercises that demonstrate relevant musculoskeletal anatomy • Interactive wrap-up sessions and review sheets

18. INTERACTIVE WRAP-UP • What muscle should you use to stabilize properly your scapula during chataranga (a push-up)? • T or F: Loss of function of the long thoracic nerve results in inability to adduct the arm.

19. Class Format (cont’d) • Savasana (a yoga pose, also known as “corpse pose”) • Core Warm-Up • Palpation of bony landmarks • Yoga and pilates exercises that demonstrate relevant musculoskeletal anatomy • Interactive wrap-up sessions and review sheets • Savasana

20. SAVASANA

21. 2004 Evaluations GOALS: • To assess how the LAP impacted medical students’: • Knowledge of anatomy • Exam-related stress levels • Sense of physical awareness • To elicit general feedback about the LAP class METHOD: • 1. Email survey: • Total LAP participants = 57 (students only) • Total survey respondents = 17 attendees, 9 non-attendees • 2. Focus Group • Participants = 5 attendees

22. 2004 Survey Results Did the LAP class help you prepare for the Gross Anatomy final exam? Yes = 1 Maybe = 3 No = 5

23. 2004 Survey Results Did the class lessen the tension of the exam period? Yes = 1 Maybe = 3 No = 5

24. 2004 Survey Results Did you gain physical awareness from the LAP class? Yes = 1 Maybe = 3 No = 5

25. 2004 Survey Results Was the class worth your time? Yes = 1 Maybe = 3 No = 5

26. 2004 Focus Group Results • “I thought it was an innovative idea to teach relevant anatomy, reduce pre-exam tension, and gain an understanding of our body.” • “The class was very relaxing, and I enjoyed it very much.  It's so rare that most of us have an opportunity to just do some deep breathing!  After the class, I felt re-centered and re-focused.”

27. 2005 Evaluations GOALS (same as 2004): • To assess how the LAP impacted medical students’: • Knowledge of anatomy • Exam-related stress levels • Sense of physical awareness • To elicit general feedback about the LAP class ADDITIONS • Demographics • More specific questions assessing efficacy of the LAP class in reaching the goals listed above

28. Challenges We Face • Logistics: scheduling conflicts and space availability • Quantifying the efficacy of the LAP • Acquiring funding for scholarly leave and the purchase of teaching tools

29. Future of the LAP • Integration of the LAP with the curriculum • Further integration with the anatomy curriculum • Intersession selective offered during week-long break from third-year of medical school • ASM II: clinical skills course (musculoskeletal exam)

30. Future of the LAP (cont’d) • Continuation of LAP classes • DVD & manuals • Web-based programs • Instructor training

31. Future of the LAP (cont’d) • Presentation and Feedback • Conferences: • 2005 MSSM Educational Research Day* • 2005 AAMC annual meeting in Washington, DC • 2006 Northeast Group on Educational Affairs annual retreat in Philadelphia, PA** • Workshops • Further research and publishing of results * Blue Ribbon Winner for Innovation ** Innovation in Pre-Clinical Medical Student Education Award; Best Poster Award

32. Acknowledgements • Mount Sinai School of Medicine in NY, NY • Center for Anatomy and Functional Morphology • Dr. Jeffrey T. Laitman, PhD • Pilates on Fifth studio in NY, NY

33. Really, everyone can do it!

34. Questions?

35. 2005 Sample Questions • IMPACT ON PHYSICAL AWARENESS • Did the LAP enhance your physical awareness, defined as: recognition of the physical condition of your body, including posture and any musculoskeletal sensations (eg. kyphosis, tight hips, uneven weight distribution on feet, limited range of joint motion)? • Did the class improve your ability to locate/palpate anatomical structures on your own body? • Do you believe that physical awareness of your body will help you as a clinician?

36. 2005 Sample Questions • IMPACT ON KNOWLEDGE • Did the class(es) increase your factual knowledge of the material (eg, root value of long thoracic nerve)? • Did the class(es) increase your conceptual knowledge of the material (eg, understanding why the right external oblique rotates the torso to the left)? • Did the dissemination of anatomical information in a non-traditional environment improve your ability to learn?

37. 2005 Sample Questions • IMPACT ON RELAXATION AND WELL-BEING • Do you feel that you need a relaxing break during the course of a typical medical school day? • If yes, do you feel that the LAP served this purpose? • Do you think that relaxation and well-being improves your performance as a medical school student?