title: Effectiveness of laparoscopic cadaveric dissection in enhancing resident comprehension of pelvic anatomy.
abstract: BACKGROUND
  Anatomic instruction during preclinical years of medical school has been in decline recently. There is evidence that residents already lose a considerable portion of basic anatomic knowledge in the transition from student to clinician, and this deficit is even more dramatic in residents who start their training with a decreased understanding of anatomy. We questioned whether anatomy could be adequately retaught to new residents as surgical anatomy. In an effort to address this deficiency, we developed a program to teach pelvic anatomy in fresh cadavers using a laparoscopic approach. The purpose of this investigation is to determine if such a program is effective in enhancing residents' pelvic anatomy comprehension.
  
  
  METHODS
  An obstetrics and gynecology residency was divided into intervention (n = 15) and control (n = 13) groups. The intervention was a 4-hour laparoscopic dissection in a fresh cadaver. Outcomes measures included a multiple-choice test, practical exam, faculty evaluation, and satisfaction assessment. The faculty evaluation and satisfaction assessment used a visual analog scale. Univarate and nonparametric analysis were used when appropriate.
  
  
  RESULTS
  Initial test scores (p = 0.32), faculty evaluations (p = 0.25), and satisfaction scores (p = 0.17) were similar. Both groups improved their anatomic knowledge based on test scores (p = 0.004) and faculty evaluations (p < 0.001), and final test scores were not significantly different (p = 0.19). Data measured on a 10-cm visual analog scale suggested higher faculty evaluations in the intervention group (14mm versus 10.3mm, (p = 0.23). Similarly there were higher scores on the cadaver test in the intervention group (65% versus 50%), (p = 0.13). The intervention group was significantly more satisfied with their anatomic training (16.1 mm versus-10.1 mm, p = 0.001).
  
  
  CONCLUSIONS
  This study did not have sufficient power to demonstrate that a single laparoscopic cadaveric dissection improves cognitive measures of anatomic perception, but suggested that it improves spatial perception of anatomy and is perceived by residents to be a valuable educational approach.
authors: Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, MD 21287, USA.
authors: G W
authors: GW
authors: Cundiff
authors: A C
authors: AC
authors: Weidner
authors: A G
authors: AG
authors: Visco
mesh_terms: D000715:Anatomy / Q000193:education*; D001291:Attitude of Health Personnel; D002102:Cadaver; D002983:Clinical Competence / Q000592:standards; D004210:Dissection / Q000379:methods; D004503:Education, Medical, Graduate / Q000379:methods*; D005180:Faculty, Medical; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology; D013513:Obstetric Surgical Procedures / Q000379:methods; D009774:Obstetrics / Q000193:education*; D010388:Pelvis / Q000033:anatomy & histology*; D015397:Program Evaluation