Gross Anatomy Review for Anesthesiology Residents on the Acute Pain Service: How Basic Science Training Could Improve Knowledge and Confidence
Authors: Cale Andrew Stephen , Hendrickse Adrian , Lyman Matthew , Royer Danielle 
Published: June 2021

INTRODUCTION

The Anesthesiology Acute Pain Service (APS) manages peri‐operative pain using ultrasound‐guided peripheral nerve blocks (PNB). PNB success is dependent on detailed anatomical knowledge, which residents may not have formally reviewed in years. GOALS. This study describes and evaluates a novel strategy for improving residency education using an instructor‐led Cadaver Review session that provides anatomical context to APS residents.

METHODS

The curriculum for a monthly, small group, two‐hour Cadaver Review was developed to reintroduce the anatomy relevant to the most common PNBs on the APS. In each Review, an anatomist reviewed the origin, function, and key relationships of major peripheral nerves, while an APS attending integrated the anatomy with PNB methods and cases. Strategies were used to encourage active, hands‐on learning. An IRB‐exempt survey was distributed post‐Review to all participants (March – November 2017, N = 31). Likert responses (5 = strongly agree) were analyzed to evaluate the impact of the Review on the residents' confidence with anatomy (7 items) and perceptions (4 items). For a subgroup of residents (N = 8), change in pre‐/post‐test confidence and perception ratings were also compared using an unpaired t‐test.

RESULTS

94% of participants completed post‐Review surveys and 100% completed pre‐/post‐test surveys. Mean time since their last anatomy course was 6.9 years. After the Review, 89% of participants felt more confident in their knowledge of nerve origins (mean = 4.3), 86% reported greater confidence in cutaneous innervation (mean = 4.2), and 88% noted an increase in confidence with both muscle innervation (mean = 4.1) and key relationships (mean = 4.3). Participants also felt more confident identifying anatomy on illustrations (83%, mean = 4.2), cadavers (90%, mean = 4.3), and ultrasound (86%, mean = 4.2). 93% of participants found the Review accessible (mean = 4.7) and 95% would recommend it (mean = 4.5). Participants believed their reinforced knowledge would also improve future clinical (88%, mean = 4.4) and board exam (85%, mean = 4.3) performance. Residents in the preliminary pre‐test/post‐test subgroup showed significant increases (p ≤ 0.05) in their self‐reported confidence with the anatomy knowledge and identification items, suggesting that the Review had a positive impact on residents' education. Belief that the Review would improve future clinical and board exam performance also increased (meanPre = 4.1 vs meanPost = 4.9; meanPre = 4.3 vs meanPost = 4.9 respectively), although not significantly.

CONCLUSIONS

The Review improved anesthesiology residents' confidence with anatomy by integrating basic science and residency training, and was highly valued. Further study is needed to discern the impact of the Review on residents' anatomical knowledge and clinical outcomes. Similar basic sciences adjuncts may also benefit residents from other specialties.

This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.