Feasibility of a Collaborative Pelvic Anatomy Lab for Gynecology Residents and the Effects on Confidence and Medical Knowledge

Abstract Body : Introduction & Objective
Knowledge of pelvic anatomy is exceedingly important in gynecologic surgery, yet recent surveys have shown that gross anatomy education is typically not included in residency programs. Including donor-based anatomy education after medical school has been shown to improves surgical skills and anatomy comprehension. However, gross anatomy education can be costly, with time-consuming dissections and resource-intensive facilitation. The feasibility of developing a pelvic anatomy course in a collaboration between gynecology and anatomy faculty of the Anschutz Medical Campus was examined. The objective of the course was to provide high-fidelity, case-based training using whole body donors to fill a crucial gap in residency education.

Materials & Methods
A one-day course was designed that included six stations that each comprised prosected pelvic anatomy performed by second year Doctor of Physical Therapy (DPT) students for their clinical anatomy course. Each station had a clinician facilitator that reviewed gynecologic cases using presentation slides on a computer. The following topics were included: vascular anatomy, genitourinary injury, gastrointestinal injury, simple hysterectomy, adnexal structures, and ureteric anatomy. Department of Gynecology residents and acting interns were invited to participate and attendees received and pre- and post-course surveys to quantify satisfaction with the course, confidence levels, and improvement in medical knowledge.

Results
Six donors were selected from a pool of nine that were dissected by the DPT students immediately prior to the course. A two-hour block of time was secured in the anatomy lab and six clinical faculty facilitators were recruited. Attendees were divided into groups of 4-5 and spent 20 minutes at each station reviewing cases demonstrated on a donor by clinical faculty. A total of 25 residents and acting interns attended the course, ranging from first to fourth year of training. Nineteen participants completed the pre-course survey (76% completion rate), while 14 participants completed the post-course survey (56% completion rate). Of those responses, 93% were somewhat or very satisfied with the course. Twenty-one percent (21%) of participants reported improvement in overall confidence in pelvic anatomy. Participants reported an average improvement of 1.6 points between medical knowledge questions on pre- and post-course surveys.

Conclusion
Delivery of a donor-based pelvic anatomy lab was feasible through collaboration between a clinical and anatomy faculty delivering curricula that included donor dissections performed by health profession students. Such courses can result in improved confidence and medical knowledge in pelvic anatomy and surgical skills, presumably through the cognitive practice of transferring mastery in anatomic knowledge to medical contexts (i.e., Knowledge Transfer Theory).

Significance & Implication
This work presents an example of a collaboration between foundational science and clinical faculty on the same academic campus. These results are important to consider for clinical faculty that identify gaps in residency education.