Improving Anatomical Knowledge Through Nested Interactive Modules on the Obstetrics and Gynecology Clinical Clerkship

Abstract

BACKGROUND: Deficits in retention of anatomy knowledge from the preclinical years to clinical application on the wards have been well-documented in medical education literature. OBJECTIVE: This study aims to determine if interactive clinically-oriented basic anatomy modules nested longitudinally in the curriculum increase anatomy knowledge in medical students on the obstetrics and gynecology clinical clerkship. METHODS: A 20-question multiple-choice examination was administered to 143 consenting third-year medical students at the beginning and end of each obstetrics and gynecology rotation at a large, urban medical school. Students participated in a 2-hour hands-on skills laboratory with preparatory e-modules linking basic anatomy to clinical application during each rotation. Topics included perineal muscle anatomy (obstetric laceration repair), anterior abdominal wall anatomy (cesarean delivery), vulvovaginal and uterine anatomy (intrauterine device insertion), and pelvic organ, vasculature, and neural anatomy (hysterectomy). Data were analyzed using a univariate analysis of variance with post-hoc t tests. RESULTS: Mean anatomy knowledge scores improved significantly after nesting of interactive modules, increasing from 57% to 69% (P<.001). Knowledge retention was the lowest in the topics of embryology (45%), uterine anatomy (47%), pelvic vasculature (46%), and fallopian tube anatomy (54%). Mean postrotation scores for uterine, vasculature, and fallopian tube anatomy increased significantly to 78% (P<.001), 72% (P<.001) and 71% (P<.001) respectively. CONCLUSIONS: Medical students' baseline anatomical knowledge before entering the obstetrics and gynecology clerkship is poor. Nesting anatomical science into the clinical curriculum through preparatory e-modules and hands-on anatomy laboratory sessions may improve pelvic anatomy knowledge. These data may be used to increase longitudinal integration of the various disciplines across the undergraduate medical curriculum.