The evolution in undergraduate medical school curricula has significantly impacted anatomy education. This study investigated the perceived role of clinical anatomy and evaluated perceptions of medical students' ability to apply anatomical knowledge in the clinic. The aim of this study was to develop a framework to enhance anatomical educational initiatives. Unlike previous work, multiple stakeholders (clinicians, medical students, and academic anatomists) in anatomy education were evaluated. Participants completed an eleven-point Likert scale survey written by the investigators. Responses from both clinical educators and medical students at Penn State Milton S. Hershey Medical Center and College of Medicine suggest that medical students are perceived as ill-prepared to transfer anatomy to the clinic. Although some areas of patient management differ in relevancy to anatomical education, there are areas of clinical care which were uniformly ranked as relying heavily on anatomical knowledge (imaging and diagnostic studies, physical examination, and arrival at correct diagnosis) by a variety of clinical specialists. Our results suggest a need for advanced anatomy courses to be taught coincidental with medical students' clinical education. Development of these courses would optimally rely on input from both clinicians and academic anatomists, as both cohorts rated clinical anatomy similarly (P ≥ 0.05). Additionally, we hypothesize that preclinical students' application of anatomy would be enhanced if clinical context was derived from areas of clinical care which rely heavily on anatomy, whereas courses designed for advanced medical students will benefit from anatomical context focused on specialty specific aspects of clinical care identified in this study.

Background. This pilot study assessed the levels of patient emotional distress and impact on clinic throughput time.Methods. From April through August 2012, 149 breast cancer patients at the Penn State Hershey Breast Center were screened with the emotions thermometer (ET), a patient-rated visual 0-10 scale that measures distress, anxiety, depression, anger, burden, and need for help. Also, patients indicated their most pressing cancer-related concerns. Clinic visit time was computed and compared with a control group. Results. Using a previously validated cut point C4 for any thermometer, we found emotional difficulty in the following proportions: distress 22 %, anxiety 28 %, depression 18 %, anger 14 %, burden 16 %, and need for help 10 %; 35 % scored above the cut point on at least 1 thermometer. We found higher levels of distress in all domains associated with younger age at diagnosis. More extensive surgery (bilateral mastectomy vs unilateral mastectomy vs. lumpectomy) was correlated with higher levels of psychosocial distress. Most often cited concerns, experienced by [20 %, included eating/weight, worry about cancer, sleep problems, fatigue, anxiety, and pain. Mean clinic visit time for evaluable patients screened using the ET (n = 109) was 43.9 min (SD 18.6), compared with 42.6 min (SD 16.2) for the control group (n = 50).Conclusions. Utilizing the ET, more than one-third of women screened met criteria for psychological distress. Younger age at diagnosis and more extensive surgery were risk factors. The ET is a simple validated screening tool that identifies patients in need of further psychological evaluation without impacting clinic throughput time.Breast cancer is the most common non-skin cancer among women, with as many as 1 in 8 women diagnosed in their lifetime. 1 It is second only to lung cancer as the leading cause of death due to cancer among women. Nonetheless, diagnostics and therapeutics for breast cancer-similar to many kinds of cancer-have seen continuing improvements, leading to subsequent improvements in prognosis. Although improved prognosis often equals longer life, it does not necessarily equal improved morbidity. Therefore, there has been increasing recognition of the importance of quality of life. 2 The importance of addressing psychological distress in women with breast cancer has clearly been established. [3][4][5] In fact, the American College of Surgeons Commission on Cancer has mandated that cancer centers implement screening programs for psychosocial distress as a new criterion for accreditation. 6 Yet, barriers to care remain, including underrecognition of the need for psychological care as well as possible inciting factors. Because most conventional scales developed to detect distress and depression are too long for routine use in clinical settings, simple verbal and visual-analog measures have been developed of which the distress thermometer (DT) is perhaps the most well known. [7][8][9][10] Although a significant advance in distress screening, the DT falls short in its ability...

No abstract