MedEdPORTAL (Nov 2009)
Chest Tube Placement in Gross Anatomy Lab
Abstract
Abstract Introduction In the first of a series of teaching modules incorporating the knowledge of gross anatomy into various clinical procedures, first-year medical students were taught how to place a chest tube in their cadavers while learning about and dissecting the pectoral region, thoracic wall cavity, in a human anatomy course. Methods Each cadaver group of three to five students had a preceptor assigned. Equipment included scalpels, as well as donated expired chest tubes and Kelly clamps. Prior to the lab session, students received an introduction/description of the module with goals/objectives and were required to watch a video narrated by a faculty member showing a second-year medical student performing the procedure on a cadaver. Students were also given a one-page handout showing the landmarks, equipment needed, indications, and complications for tube thoracostomy. Following the session, evaluations were submitted by the medical students. Results Feedback from faculty and students indicated that we had met and exceeded our educational objectives. Students felt that the procedure was “relevant,” liked the “stress free” environment featuring early clinical experience with supervision in small groups, and looked forward to more such experiences during the course. They enjoyed practicing the procedure on a cadaver before doing so on a live patient, noting that the experience would help boost their confidence they could do the procedure later without hurting the patient. Faculty felt that the students were motivated by the session and sought out more educational resources related to the procedure. Discussion The trend for medical education is to integrate basic science, clinical science, and research in a curriculum that fosters an active learning environment. Medical education is a lifelong continuum that requires self-directed learning. By introducing clinical science early on, enthusiasm for learning is stimulated, and the experience gives students some of the skills required for critical thinking. Using an organ-based model helps students to better understand the relevance of a solid basic science foundation in clinical application. It also creates an effective teaching tool that allows basic science faculty and clinical science faculty to collaborate. This course model is a relatively inexpensive yet very effective teaching method that will enhance the training of medical students and future house officers. It can be easily reproduced and addresses areas of the core competencies required of accredited U.S. residency training programs set by the Accreditation Council for Graduate Medical Education.
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