No abstract

Feelings of burnout in professional students have been associated with additional psychological morbidities and decreased academic achievement. Due to the large volume of content that medical students need to learn during gross anatomy courses, it is possible that anatomical self-efficacy may be a contributing factor to feelings of burnout. Anatomical self-efficacy is defined as a student’s judgment of their ability to execute tasks related to learning anatomy and perform course activities (e.g., dissection). First-year medical students were invited to provide basic demographic information at the beginning of the semester and to complete the Oldenburg Burnout Inventory-student version (OLBI-SS) and the Anatomical Self-Efficacy Instrument (ASEI); at the beginning, middle, and end of the semester, they were enrolled in gross anatomy. Typical descriptive statistics for the demographic information were conducted, as well as, correlational analyses assessing if the information had a relationship with either anatomical self-efficacy or burnout. Female students were more burnt out than male students. Repeated measures ANOVA revealed that students’ feelings of burnout significantly increased from the beginning of the semester to the midpoint and the end of the semester ( p < 0.05). Linear regression demonstrated a predictive relationship between anatomical self-efficacy and burnout ( p < 0.05) at all three measurement points in which lower self-efficacy was predictive of increased feelings of burnout.

Previous research has shown that medical students perform better on first order laboratory practical questions than they do on second order questions. First order questions are defined as requiring the student to only identify a tagged structure. Second order questions ask the student to apply some information about the tagged structure rather than to only identify the structure (i.e. “What is the innervation of the tagged structure?”). This study followed up on the previous research by examining item statistics of first and second order questions to determine individual item quality. Statistics of interest were item difficulty and discrimination index. Item difficulty was defined as the percentage of students getting a particular item correct, so the higher the percentage, the easier the item. Discrimination index (DI) was defined as the difference in percent correct between higher and lower performing students on a particular item. Quality questions typically have a moderate difficulty of approximately 80% correct and a DI of greater than .30. The expectation was that second order questions would continue to show increased difficulty but have a higher DI and potentially be of higher quality than first order questions. The laboratory practical studied was a traditional steeplechase‐style examination where students had a single question at approximately 60 stations. Students had one minute at each station and could not return to any station during or after the examination. During setup, the instructors purposely set about 20% of the items to be second order questions. Responses were analyzed for question difficulty and DI, which was the difference in performance on an item between the top 27% of the class and the bottom 27%. One hundred and seventy two students took the 57‐question examination. There were 13 second order questions (22.8%). The examination average score was 75.04 ± 12.6% and the average DI was .293 ± .14. First order questions averaged 76.18% correct with a DI of .31 while second order questions averaged 72.81% and had a DI of .25. Only one (7.7%) of the second order questions had a difficulty between 75–85% and a DI above .30 while seven (15.9%) of the first order questions achieved these statistics. A post hoc analysis of the 596 total errors made on the thirteen second order questions was also conducted. Examining each of the wrong responses revealed that approximately ten percent of the errors were due to the students giving the first order identification rather than the second order information that was being sought. Initial results indicate that second order questions did not perform better than first order questions in a laboratory practical setting based on traditional item statistics. Instructors need to be aware that these types of assessment questions may not be good indicators of a student’s foundational knowledge as well as their ability to apply that knowledge beyond straight forward identification of anatomical structures. Further investigation should be done to see if these statist...

Feelings of burnout in professional students have been associated with additional psychological morbidities and decreased academic achievement. Due to the large quantity of content that professional students need to learn during gross anatomy courses, in an increasingly condensed time frame, it is possible that participation in gross anatomy may be a contributing factor to feelings of burnout. There are currently no studies linking participation in gross anatomy courses and feelings of burnout in professional students. Therefore, this IRB approved study (protocol #2019‐0178) is seeking to determine if such an association exists. Both first year medical (n=172) and dental (n=40) students are invited to provide basic demographic information at the beginning of the semester and to complete the Oldenburg Burnout Inventory‐Student Version (OLBI‐S) and the Anatomical Self‐Efficacy Scale (ASES) at the beginning, middle and end of the semester they are enrolled in gross anatomy. Anatomical self‐efficacy is defined as a student’s judgement of their ability to execute anatomical tasks. Our hypothesis is that students with lower levels of anatomical self‐efficacy will experience higher levels of burnout. To anonymously track each students’ progression through the semester, students are provided a prompt at each measurement point, that generates a unique identification code. Data collection for the medical students is ongoing and statistical analyses will be conducted at the end of the fall 2019 semester. Data collection for the dental students will occur during the spring 2020 semester. Typical descriptive statistics of the medical and dental student cohorts will be produced. Within‐subjects ANOVA will allow for comparison of scores on both the self‐efficacy and burnout scales to identify whether there are significant changes within a group during a single semester. Between‐groups ANOVA will allow for comparison of self‐efficacy and burnout scores between medical and dental students. Hierarchical linear regression will be conducted to determine the predictive nature between independent variables (anatomical self‐efficacy, demographic variables), and the dependent variable (burnout).

Dissection of the human brain is an important part of health professional education in the neuroscience curriculum. Therefore, it is critical that adequate protocols are utilized to preserve structures when removing brains from cadavers. Previous studies have looked at approaches to extracting the brain and associated structures from the cranial cavity which would best preserve these delicate structures. However, these methods require both extensive dissection experience and more time than suitable for routine use. The aim of this study was to determine the technique for brain removal that minimized the time required for the procedure while preserving key structures for future educational purposes. The time and ease for three aspects of brain extraction were assessed: removal of the calvaria, subsequent removal of the brain, and transection of the brainstem. Six dissectors (two faculty, four senior graduate students) with prior experience performed the removals. Each tested three calvaria‐removal approaches – circumferential only, circumferential plus a median cut, and circumferential plus a coronal cut. They also tested three approaches to brainstem transection—superiorly through the foramen magnum, inferiorly below C1 vertebra, or inferiorly after removal of an occipital wedge. The time for each procedure was recorded, and its ease was evaluated on a 5 point scale (1 easiest and 5 hardest). The combination of calvaria and brainstem approaches and the order of completion were randomized across dissectors and the 3 brains extracted by each. At the completion of brain removal, all brains were evaluated by two neuroscience course directors for utility in educational contexts. The evaluators rated structures on a list compiled from the laboratory handouts in the medical neuroscience course. Preliminary examination of the data suggests that removal of the calvaria using only the circumferential cut or using an additional coronal cut took about the same length of time, whereas performing circumferential and median cuts took somewhat longer. However, the ease of removal was greater when either the additional median or coronal cut was employed. Transecting the brainstem took less than a minute if performed through the foramen magnum or below C1, but it took substantially longer if the occipital wedge cut was executed. The ease of transection was greatest when performed below C1, and least when the occipital wedge was removed. There was no clear difference in overall quality of the brains removed by the various techniques. While there may be advantages to one or the other of the techniques for preservation of specific structures, it appears that all approaches tested were equivalent in yielding brains that could be used for educational purposes.