No abstract

The lumbar puncture (LP) procedure is a diagnostic procedure that is performed to identify the root cause behind symptoms which can often be caused by various diseases or infections. Currently, medical students will either perform LPs directly on live patients with only theoretical knowledge of the procedure, or they will first be trained using unrealistic models that give a poor representation of the procedure. Traumatic taps (poorly performed LPs) were found to occur in approximately 15% of adult patients, and 35% in children. To reduce these complications, it is necessary that medical students receive the best training possible, which can be made possible through utilizing advanced design and manufacturing technologies. The training mannequin should be flexible, have realistic tissue force resistance, and be reconfigurable for different body types, and age groups. A parametric CAD model is developed that can be modified to represent key structural dimensions from infant to adults, force testing is conducted on a cadaver to determine the puncture forces, and more realistic ‘tissue’ materials are derived via experimentation as the existing training models have noticeably different resistance characteristics. The individual elements for a new training mannequin solution have been determined. Additive manufacturing processes can readily fabricate the vertebrae and pelvis elements, as well as the specialty molds. A final model assembly, and field testing, needs to be performed.

Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight “core” clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1–4 Likert‐type scale (1 = not important, 4 = essential). Non‐parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence‐base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.

A hand sewed, wearable, teaching tool which displays the contents of the abdomen with the peritoneal folds. This model demonstrates a 3D appreciation of abdominal organs with their peritoneal folds. Materials used are cloth of various textures, cushion filling material and bicycle tubing. Students are able to visualize, feel and appreciate the peritoneal fold and their relationships to supplement what they see in the anatomy laboratory. The few advantages of this model are as follows: A 20 minute substitute in the laboratory for a 2 hour lecture. One model can be used to show as little or great detail of the contents of the abdomen. The faculty and students found this model self explanatory and explicit.

Appendicular mucoceles are rare clinical findings characterized by dilation and distention of the appendicular lumen by the accumulation of mucus. Their discovery is often incidental from abdominal imaging or more commonly as a secondary surgical finding. In this case study we report the first known recorded case of a cadaveric mucocele appendix discovered during routine dissection of the gastrointestinal system. The recorded cause of death for the 86-year-old female patient was congestive heart failure. We compared the gross anatomy and histology of this enormous appendix with another cadaveric appendix. A pathology report identified the appendicular mucocele as a mucinous cystadenoma.