LIVING ANATOMY PROJECT (LAP) Stephanie Pieczenik, MSSM II Carrie Sager, MSSM II Jeffrey T. Laitman,...

LIVING ANATOMY PROJECT (LAP)

Stephanie Pieczenik, MSSM II

Carrie Sager, MSSM II

Jeffrey T. Laitman, PhD

OUR MISSION

• To use movement, e.g. yoga and pilates exercises, as a teaching tool to enhance students’ understanding of the material taught in the first-year Gross Anatomy course

• To increase students’ physical awareness—including biomechanics, proprioception, and posture —of themselves and others, and;

• To infuse a component of physical activity, relaxation, and good health into the medical school environment.

PILATES AND YOGA: DEFINED

• Pilates

– A body-conditioning discipline designed 80 years ago by Joseph H. Pilates

– Encompasses hundreds of mat- and equipment-based exercises

– Focuses on improving core-strength and overall flexibility

• Yoga

– An ancient Hindu discipline designed to unify the body and mind

– Physical elements challenge strength, flexibility, and balance– Spiritual components include meditation and relaxation

exercises

In The Beginning …

• Fall 2004: A gift to our fellow classmates

• Spring 2005: Evaluation and expansion

• Fall 2005: Integration with the anatomy

curriculum

LAP Class Overview

• 2-3 classes offered per anatomy module

• 1 hour per class, 1.5 hour per exam review class

• Student sign-ups posted before each class; approximately 10-20 students attended each class

• Same class format for each class

Class Format

• Savasana (a yoga pose, also known as “corpse pose”)

SAVASANA

Class Format (cont’d)

• Savasana (a yoga pose, also known as “corpse pose”)

• Core Warm-Up

CORE WARM-UP

Class Format (cont’d)

• Savasana (a yoga pose, also known as “corpse pose”)

• Core Warm-Up

• Palpation of bony landmarks

PALPATION

Class Format (cont’d)

• Savasana (a yoga pose, also known as “corpse pose”)

• Core Warm-Up

• Palpation of bony landmarks

• Yoga and pilates exercises that demonstrate relevant musculoskeletal anatomy

DOWNWARD DOG

ARM ABDUCTION

OUR DEAN OF MEDICAL EDUCATION

Class Format (cont’d)

• Savasana (a yoga pose, also known as “corpse pose”)

• Core Warm-Up• Palpation of bony landmarks• Yoga and pilates exercises that demonstrate

relevant musculoskeletal anatomy• Interactive wrap-up sessions and review

sheets

INTERACTIVE WRAP-UP

• What muscle should you use to stabilize properly your scapula during chataranga (a push-up)?

• T or F: Loss of function of the long thoracic nerve results in inability to adduct the arm.

Class Format (cont’d)

• Savasana (a yoga pose, also known as “corpse pose”)

• Core Warm-Up• Palpation of bony landmarks• Yoga and pilates exercises that demonstrate

relevant musculoskeletal anatomy• Interactive wrap-up sessions and review sheets• Savasana

SAVASANA

2004 Evaluations

GOALS: • To assess how the LAP impacted medical students’:

– Knowledge of anatomy– Exam-related stress levels– Sense of physical awareness

• To elicit general feedback about the LAP class

METHOD: • 1. Email survey:

– Total LAP participants = 57 (students only)– Total survey respondents = 17 attendees, 9 non-attendees

• 2. Focus Group– Participants = 5 attendees

2004 Survey Results

Did the LAP class help you prepare for the Gross Anatomy final exam?

0 2 4 6 8

1

3

5

Res

po

nse

Number of Respondents

Yes = 1

Maybe = 3

No = 5

2004 Survey Results

Did the class lessen the tension of the exam period?

0 5 10 15

1

3

5

Res

po

nse

Number of Respondents

Yes = 1

Maybe = 3

No = 5

2004 Survey Results

Did you gain physical awareness from the LAP class?

0 2 4 6 8

1

3

5

Res

po

nse

Number of Respondents

Yes = 1

Maybe = 3

No = 5

2004 Survey Results

Was the class worth your time?

0 5 10 15 20

1

3

5

Res

po

nse

Number of Respondents

Yes = 1

Maybe = 3

No = 5

2004 Focus Group Results

• “I thought it was an innovative idea to teach relevant anatomy, reduce pre-exam tension, and gain an understanding of our body.”

• “The class was very relaxing, and I enjoyed it very much.  It's so rare that most of us have an opportunity to just do some deep breathing!  After the class, I felt re-centered and re-focused.”

2005 Evaluations

GOALS (same as 2004):

• To assess how the LAP impacted medical students’:

– Knowledge of anatomy

– Exam-related stress levels

– Sense of physical awareness

• To elicit general feedback about the LAP class

ADDITIONS

• Demographics

• More specific questions assessing efficacy of the LAP class in reaching the goals listed above

Challenges We Face

• Logistics: scheduling conflicts and space availability

• Quantifying the efficacy of the LAP

• Acquiring funding for scholarly leave and the purchase of teaching tools

Future of the LAP

• Integration of the LAP with the curriculum– Further integration with the anatomy

curriculum– Intersession selective offered during week-long

break from third-year of medical school– ASM II: clinical skills course (musculoskeletal

exam)

Future of the LAP (cont’d)

• Continuation of LAP classes– DVD & manuals– Web-based programs– Instructor training

Future of the LAP (cont’d)

• Presentation and Feedback– Conferences:

• 2005 MSSM Educational Research Day*• 2005 AAMC annual meeting in Washington, DC• 2006 Northeast Group on Educational Affairs annual retreat

in Philadelphia, PA**– Workshops– Further research and publishing of results

* Blue Ribbon Winner for Innovation** Innovation in Pre-Clinical Medical Student Education Award;

Best Poster Award

Acknowledgements

• Mount Sinai School of Medicine in NY, NY– Center for Anatomy and Functional

Morphology

• Dr. Jeffrey T. Laitman, PhD

• Pilates on Fifth studio in NY, NY

Really, everyone can do it!

Questions?

2005 Sample Questions

• IMPACT ON PHYSICAL AWARENESS– Did the LAP enhance your physical awareness,

defined as: recognition of the physical condition of your body, including posture and any musculoskeletal sensations (eg. kyphosis, tight hips, uneven weight distribution on feet, limited range of joint motion)?

– Did the class improve your ability to locate/palpate anatomical structures on your own body?

– Do you believe that physical awareness of your body will help you as a clinician?

2005 Sample Questions

• IMPACT ON KNOWLEDGE– Did the class(es) increase your factual knowledge of

the material (eg, root value of long thoracic nerve)?

– Did the class(es) increase your conceptual knowledge of the material (eg, understanding why the right external oblique rotates the torso to the left)?

– Did the dissemination of anatomical information in a non-traditional environment improve your ability to learn?

2005 Sample Questions

• IMPACT ON RELAXATION AND WELL-BEING– Do you feel that you need a relaxing break during the

course of a typical medical school day?• If yes, do you feel that the LAP served this

purpose? – Do you think that relaxation and well-being improves

your performance as a medical school student?