|Year : 2020 | Volume
| Issue : 2 | Page : 63-65
Perceptions and attitudes of medical students toward the use of digital surgical operative video in lecture – A better anatomical understanding
Medora C Dsouza Dias1, Rajesh T Patil2
1 Assistant Professor, Department of Anatomy, Goa Medical College, Bambolim, Goa, India
2 Associate Professor, Department of Surgery, Goa Medical College, Bambolim, Goa, India
|Date of Submission||03-Feb-2020|
|Date of Decision||12-Mar-2020|
|Date of Acceptance||02-May-2020|
|Date of Web Publication||10-Sep-2020|
Medora C Dsouza Dias
Villa A – 17, Sapana Harmony, Gogol, Fatorda, Margao - 403 602, Goa
Source of Support: None, Conflict of Interest: None
Background and Aims: There are numerous variations in the branching of the internal iliac artery (IIA), which are important during any pelvic surgery. An aberrant/accessory obturator vessel is the most common source of hemorrhage during pelvic surgery and to prevent this, one needs to have a good knowledge of pelvic vascular anatomy. Our aim was to enhance the learning process of the branching pattern of the IIA in MBBS students in order for them to better understand the concept of aberrant/accessory obturator artery (OA) and corona mortis (CM). Materials and Methods: First-year MBBS students after completing their routine dissection of branches of the IIA, were shown a video of laparoscopic femoral hernia reduction surgery and their feedback was taken. Results: Nearly 95.82% of the students agreed that they observed and understood aberrant OA, 99.16% of the students agreed that they observed and understood accessory OA, 98.33% of the students agreed that they observed and understood the CM concept, and 100% of the students felt that more such videos should be incorporated and discussed in future interactive lecture teaching. Conclusion: This study incorporates the levels of competency as per AET-COM teaching module in the knowledge domain, i.e., “Knows” and “Knows-How.” This study proves that learning anatomy can be made more interesting for and be better conceptualized, visualized, and understood by students by incorporation of relevant surgical/clinical video clips during conventional teaching.
Keywords: Aberrant obturator artery, corona mortis, laparoscopic hernia surgery, lecture
|How to cite this article:|
Dsouza Dias MC, Patil RT. Perceptions and attitudes of medical students toward the use of digital surgical operative video in lecture – A better anatomical understanding. Natl J Clin Anat 2020;9:63-5
|How to cite this URL:|
Dsouza Dias MC, Patil RT. Perceptions and attitudes of medical students toward the use of digital surgical operative video in lecture – A better anatomical understanding. Natl J Clin Anat [serial online] 2020 [cited 2020 Nov 28];9:63-5. Available from: http://www.njca.info/text.asp?2020/9/2/63/294750
| Introduction|| |
First-year MBBS students routinely dissect out branches of the internal iliac artery (IIA) in the human cadaver and usually find obturator artery (OA) arising from the anterior division of IIA. OA can also originate from the common iliac, inferior epigastric, gluteal, internal pudendal, or external iliac arteries. An aberrant/accessory OA is often a common source of hemorrhage during pelvic surgery and when anastomotic, it is called “corona mortis” (CM).,,
Trying to teach human anatomy, only by dissecting cadavers, may not prepare students in a clinical setting, so we need to use a method incorporating a three-dimensional concept by supplementing dissection and lectures with e-learning.,
With the aim of enhancing learning, we tested the importance of incorporating a video of a laparoscopic procedure during a conventional lecture in teaching anatomy of the accessory/aberrant OA and the CM concept to first-year MBBS students of Goa Medical College.
| Materials and Methods|| |
First-year MBBS students upon completion of their routine cadaveric dissection for branches of IIA, took part in this study which was carried out in February 2018 after obtaining approval of the Ethics Committee of Goa Medical College. A short video clip of a laparoscopic femoral hernia reduction surgery was shown to supplement the understanding of the branching pattern of IIA, with emphasis on abnormal/aberrant OA and the CM concept. The video presentation, which lasted approximately 10 min, was preceded by an introduction to laparoscopic surgery after which the surgeon explained and demonstrated the gross anatomy of this region. The video also showed the in situ disposition of the abdomino-pelvic organs and was paused as required at intervals while the structures encountered were explained in order, hence giving the students time to observe, understand, and correlate all of the major structures such as the parietal peritoneum, Coopers' ligament, and contents of the femoral hernia and its proximity to the aberrant OA.
A questionnaire was distributed to the students who gave their valuable feedback on this video presentation as a method of enhancing the learning of abnormal/aberrant OA and the concept of CM. The questionnaire included a 5-point Likert scale which was provided for registering the students' understanding of the concept of CM. The students were also provided space for any additional comments on the presentation itself.
| Results|| |
Totally, 130 first-year MBBS students took part in this study, out of which 120 (92.3%) students filled the feedback forms. After being shown the video clip of the surgical procedure, the observations among students were recorded, as shown in [Table 1].
|Table 1: Observations of student feedback of video clip viewing as an adjunct to lecture teaching|
Click here to view
Nearly 100% of the students felt that more such videos should be incorporated and discussed in interactive lecture teaching. Most of the additional comments were about interest and insight generated, creating a clearer path to the visualization of anatomical structures.
One particular student related the fact that until the day the video was shown, he was attending anatomy lectures for attendance only (out of compulsion for fulfilling mandatory required minimum attendance) and after attending the video presentation, he felt that this lecture was really interesting and worthwhile and he was glad he had attended this lecture.
The responses of the students to the video presentation are summarized in a bar diagram in [Figure 1].
|Figure 1: Student responses to video clip viewing as an adjunct to lecture teaching. Oa: Obturator artery; cm: Corona mortis|
Click here to view
| Discussion|| |
The conventional method of teaching anatomy through cadavers, helps preclinical medical students to understand the relationships of structures to each other, but does not give them a clear concept of their appearance in the living; they get to appreciate this only when they begin their surgical clinics.
Both students and staff were in favor of cadaveric teaching being supplemented by surgical videos.,, In fact, Biasutto et al. in their study had seen better scores among the group of students who learned by interacting between dissection and using various digital learning resources.
In the present study, by exposing the students to the surgical video clip, they have been able to appreciate the clinical relevance of human anatomy learned in the first-year MBBS course. Applying this anatomical knowledge in clinical postings might be easier if such clinical videos are incorporated during initial anatomical teaching itself, as it highlights the relevant living anatomy.
This study incorporates the levels of competency (Anatomy (AN) 48.3; 15.4) as per the Attitudes Ethics and Communication (AET-COM) teaching module in the knowledge domain, i.e., K = knows the branching pattern of the IIA and the concept of aberrant/accessory OA and CM. The KH = knows-how level of competency is also activated wherein the student can understand, analyze, and discuss the CM concept in relation to aberrant/accessory obturator versus a normal OA and its implications in laparoscopic femoral hernia reduction surgery.
The 21st-century undergraduate medical curriculum has moved forward from a more passive, didactic, and a too detailed course, toward more clinically relevant methods of teaching, such as incorporating relevant laparoscopic video clips into the preclinical anatomy course. Fitzpatrick et al. reported some medical schools that use laparoscopic training using embalmed cadavers, but other authors retort that this use is restricted to surgical residents to revise their basics in human anatomy and for developing their laparoscopic surgical skills.,,,,,
Our students' written feedback highly supported the use of laparoscopic surgery recordings during didactic lecture teaching, and most of them appreciated the great efforts spent to give them a “key-hole view” into the abdominal cavity of a living subject. Many students opined that they would like to see more such videos during their anatomy course as it would help them to visualize and hence appreciate living human anatomy better.
According to Older, teaching anatomy is in a downward spiral, hence we need to improvise our teaching methods to encourage and facilitate learning in students. Laparoscopic surgeries can be recorded and used in emphasizing the three-dimensional relationship of organs in the living patient, which will allow the preclinical MBBS students to apply relevant human anatomy learned during their preclinical course later in their clinical practice and also helps them take decisions regarding their future field of specialization.
| Conclusion|| |
Anatomy education has undergone enormous transformation in the last decade. Traditional topographic anatomy taught by the system of didactic lectures with cadaveric dissection has been supplemented by various other interactive teaching methods such as problem-solving, models, learning strategies, and digital teaching tools.
The positive responses of the students in this study prove that anatomy topics and dissections can be made more interesting for and better conceptualized, visualized, and understood by incorporation of surgical/clinical video clips during didactic lecture teaching.
The authors would like to thank Mr. Vishvesh V. Naik I/C Computer Graphics and Multimedia Section, Goa Medical College, Bambolim, Goa, for his valuable support and expertise in computer graphics including video and multimedia lecture presentation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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