Workshop in clinical anatomy for residents in gynecology and obstetrics

Abstract

A workshop in the clinical anatomy of the female pelvic viscera has been part of the training program for the first year residents in Gynecology and Obstetrics at the University of Padova since the 1999-2000 academic year. The purpose of the workshop is to offer a direct experience of practical anatomy despite a shortage of cadavers. It is designed for six residents who work in three teams on three specimens. The anatomical specimens are unembalmed, unfixed, female pelvic visceral blocs that are harvested from the cadavers 24 hr after death. They are stored at -12 degrees C and removed from the freezer 12 hr before the workshop. The workshop is 3 hr in length and has two parts: one on theory and one practical. In the theoretical section (30 min), the teacher presents the topographical anatomy of the specimens and the residents analyze a clinically oriented worksheet. In the practical section (2 hr), the residents identify viscera, vessels, and nerves through inspection and palpation, and then a step-by-step dissection is carried out. In the last section (30 min), the workshop includes presentations on the three specimens that illustrate anatomical variability and assess knowledge of topographical anatomy. For many residents, this is the first practical experience of the anatomy of the female pelvic viscera because the anatomical courses for medical students do not include direct dissection by students. The unfixed viscera preserves the natural characteristics of the different tissues that exhibit the aspects of living organs, such as color, softness, and pliability, enhancing the knowledge of anatomy. The worksheet is structured as a guide to the anatomical basis of physical examination through inspection and palpation of the viscera. It also introduces the residents to the surgical anatomy of the female pelvis through a brief and selective dissection focused on the relationship between the different regional systems.

A comparison of embalming fluids for use in surgical workshops

“…A large number of studies use fresh, unembalmed cadavers (Milsom et al, 1994;Cundiff et al, 2001;Macchi et al, 2003;Supe et al, 2005;Levine et al, 2006). Fresh or fresh frozen cadavers initially ''exhibit lifelike color, softness, and pliability'' (Macchi et al, 2003).…”

Body parts removed during surgery: A useful training source

“…Dissection is extremely useful in a variety of ways: it aids understanding of the three-dimensional organization of the human body (Moore, 1998;Marks, 2000;Granger, 2004;Lachman and Pawlina, 2006;Collins, 2008), implies a haptic (tactile) appreciation of the body (Mutyala and Cahill, 1996;Aziz et al, 2002;Turney, 2007), introduces the concept and demonstration of anatomical variability (Willan and Humpherson, 1999;Macchi et al, 2003a), develops practical skills (Newell, 1995;Moore, 1998;Ellis, 2001;McLachlan et al, 2004), promotes teamwork (Pawlina and Lachman, 2004;McLachlan and Patten, 2006), introduces students to the physician-patient relationship (Coulehan et al, 1995;Aziz et al, 2002), reinforces familiarization with and respect for the human body (Lempp, 2005), and establishes the concepts of humane care and understanding of the phenomena of death and of dying (Tchernig et al, 2000;Rizzolo, 2002;Canby and Bush, 2010). In our project, the resident/surgeon was involved in the various steps of the donation procedure, from collection of informed consent forms to dissection of body parts.…”

“…Dissection of the human body is considered essential in the unique ethical and technical formation of future physicians and surgeons, both in undergraduate and postgraduate medical education (Aziz and McKenzie, 1999;Macchi et al, 2003aMacchi et al, , 2007aAzer and Eizenberg, 2007;Collins, 2008;Korf et al, 2008;Talarico, 2010). In addition to aiding the exploration of the structures and functions of the human body, dissection is also critical to the psychosocial training of physicians (Dyer and Thorndike, 2000;Gregory and Cole, 2002;Rizzolo, 2002).…”

“…Anatomy is taught at the School of Medicine at the University of Padova using both traditional (lectures, textbooks, and atlases) and technological (computer-aided learning and multimedia) resources, which are also integrated with practical laboratory exercises (on plastic models and plastinated specimens) and radiological anatomy sessions (utilizing X-rays, CTs, MRIs, and ultrasound images; Macchi et al, 2003b). The Department of Human Anatomy and Physiology of the University of Padova is actively involved in the promotion of whole body and body parts donations for teaching and research (De Caro et al, 2009) and has developed dissection courses for medical students and residents (Macchi et al, 2003a(Macchi et al, ,b, 2007.…”

Promotion of body donation and use of cadavers in anatomical education at the University of Padova

“…We were also directly involved in the spread of information about principles and procedures of donation of the body through mass media and dedicated meetings, with particular attention to the ethical aspects. In the past few years, we have developed dissection courses for medical students and residents in order to transfer the unique ethical and technical educational value of dissection to future physicians and surgeons (Macchi et al, 2003a(Macchi et al, , 2003b(Macchi et al, , 2007.…”