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Stephen W Carmichael

Publications and source records attributed to Stephen W Carmichael.

17 recordsLinked to original sources

Latin and Greek in gross anatomy.

BACKGROUND: Medical students and practitioners learn and use a vocabulary originating almost entirely from classical Latin and Greek languages. Previous generations required Latin or Greek prior to medical school, but the current generation does not have such requirements. Anecdotal evidence suggests that understanding Latin or Greek helps students to learn and practitioners to recall otherwise foreign terminology. This study evaluated students' familiarity with Latin and Greek etymologies before and after a gross anatomy course that incorporated etymologies into its curriculum. METHODS: First-year medical students at Mayo Clinic College of Medicine were taught Latin and Greek etymologies through lectures and handouts during their gross anatomy course. They took a pretest and a posttest before and after the course to assess their understanding of etymologies. In addition, students from all four years of medical school, residents, and staff physicians also took a general etymology quiz to assess their understanding of etymologies. RESULTS: After their gross anatomy course emphasizing etymologies, first-year students scored higher on the posttest than they did on the pretest. First-year students also reported that learning etymologies enhanced anatomy learning, made the experience more enjoyable, and proved to be less difficult than they thought it would be prior to the course. Medical students, residents, and staff physicians scored almost equally on the general etymology quiz and almost equally reported that etymologies enhanced learning and recalling terminology. Medical students, residents, and staff physicians almost equally endorsed incorporating etymologies into medical education. CONCLUSIONS: This study provides novel scientific evidence that a basic understanding of Latin and Greek etymologies enhances performance and comfort when learning and using medical terminology.

Anatomy↗

Anatomic compartments of the foot: a 3-Tesla magnetic resonance imaging study.

There is neither consensus on the number nor agreement on the location of the anatomic compartments of the foot. This project utilized high-resolution magnetic resonance imaging (MRI) to identify foot compartments. The purpose of this study was to devise a new system using 3-Tesla (3T) MRI that assessed the number and location of these compartments. Six feet from healthy volunteers were imaged. From these, 10 compartments were described: (1) medial, (2) calcaneal, (3) lateral, (4) central superficial, (5) central deep (adductor), (6-9) interossei, and (10) skin. The 3T MRI and foot/ankle coil allowed us to assess the number and location of foot compartments.

Compartment Syndromes↗

Transsciatic foramen pedicle VRAM coverage of gluteal defects.

Tumors of the gluteal region are rare. Defects from resection often can be closed primarily. Some patients require local flaps such as a gluteus maximus V-Y advancement flap. Such flaps typically result in some muscle dysfunction. In addition, the use of local irradiated tissue may lead to wound complications and prolonged hospitalization. Avoiding local radiated tissue, such as the gluteal muscles, can be beneficial. We report our experience using a novel route by passage through the transsciatic foramen to transpose a pedicle vertical rectus abdominis myocutaneous flap. This regional option avoids gluteal muscle dysfunction and potential wound complication from irradiated tissue.

Adult↗

Leadership and professionalism curriculum in the Gross Anatomy course.

INTRODUCTION: Today's physicians must demonstrate both professionalism and leadership skills in order to succeed in largely team-based healthcare environments. The purpose of this study was to determine if professionalism attributes, leadership style, and leadership style adaptability are associated with academic performance among first-year students early in their medical curriculum. MATERIALS AND METHODS: Students were divided into 4-member dissection groups for the duration of the Gross and Developmental Anatomy course. Leadership responsibility was randomly assigned to a team member on a rotating basis every 5 weeks. After each 5-week block, student performance was measured by written and practical examinations, and each student assessed their leader's or their own professionalism attributes and leadership style using validated survey instruments. RESULTS: Most students demonstrated either a "selling" only (57%) or "participating" only (30%) leadership style with low to moderate leadership adaptability. "Participating" and "delegating" leadership styles have the highest average group written exam scores (89.4%, P <0.008). "Telling" only or "selling" only leaders have the lowest average group exam scores (83.5%, P <0.001). "Selling" and "participating" leaders have significantly lower average group practical exam scores than other styles (81.5%, P <0.007). Positive associations were observed between the written and practical examination scores and the leader's integrity (P = 0.003, P = 0.002) and responsibility (P <0.001, P = 0.037). CONCLUSIONS: This study demonstrates that various situational leadership styles and aspects of professionalism are associated with written and practical examination scores in the Gross and Developmental Anatomy course. Furthermore, it demonstrates that first-year medical students are in need of leadership skill development.

Anatomy, Cross-Sectional↗

Reciprocal peer teaching: students teaching students in the gross anatomy laboratory.

Three common instructional strategies used to teach gross anatomy are lecture, discovery or inquiry-based learning, and cooperative learning. One form of cooperative learning, called reciprocal peer teaching (RPT), illustrates circumstances where students alternate roles as teacher and student. By assuming the responsibility of teaching their peers, students not only improve their understanding of course content, but also develop communication skills, teamwork, leadership, confidence and respect for peers that are vital to developing professionalism early in their medical careers. Traditionally in our Anatomy department, students dissect the entire body using a standard dissection manual. More non-traditionally, however, we have increased cooperative learning in the dissection laboratory by involving students in a series of supplementary RPT activities. During these exercises, 10% of the class practiced their demonstration with course instructors until the students felt prepared to demonstrate the exercise to their classmates. We designed one peer demonstration emphasizing three to six teaching objectives for most of the 40 dissection units. This resulted in a compendium of peer demonstrations for implementation throughout the course. The multitude of diverse exercises permitted each student many opportunities to teach their peers. A debriefing questionnaire was administered at the end of the course demonstrating that 100% of students agreed the RPT experience increased their understanding of the topics they taught and 97% agreed it increased their retention of information they taught to their peers. In addition, 92% agreed that RPT improved their communication skills, which can be applied beyond anatomy to their careers as future physicians.

Anatomy↗

The importance of anatomy in health professions education and the shortage of qualified educators.

The current shortage of faculty qualified to teach anatomy in U.S. medical schools is reversible. Sufficient numbers of individuals are in the pipeline to provide a future cadre of well-trained faculty members educating students in gross anatomy. The challenge is to realign departmental, institutional, and federal training grant priorities and resources, creating incentives for graduate students, postdoctoral fellows, and faculty members to stay the course and become the teachers needed to educate the next generation of health professionals. These strategies include (but are not limited to) team-teaching gross anatomy, thereby distributing the time commitments of a laboratory-based course more widely within a department; funds made available from the administration of medical schools to allow postdoctoral fellows to participate in teaching and providing compensation for the research activities; using "mission-based budgeting" to specifically compensate for faculty teaching time; and, finally, re-instituting federally funded training grants that solved this same teaching crisis in the not-too-distant past.

Anatomy↗

Effect of lithotomy positions on strain of the obturator and lateral femoral cutaneous nerves.

The purpose of this study was to determine if various lithotomy positions increase strain on the obturator and lateral femoral cutaneous nerves in fresh adult cadavers. A static load cell was used to record strain changes of the obturator and lateral femoral cutaneous nerves in the pelvis and anterior thigh when the lower limbs were placed in three sets of positions of varying hip abduction and flexion. The means of the strain measurements, which were measured in grams in all positioning angles were compared to the baseline 0 degrees measurements. Analysis of variance was calculated for the differences. Flexion of the hip did not increase strain on either nerve. Abduction to 30 degrees or 45 degrees increased strain by more than 30 g on the obturator nerve (P < 0.05) but not the lateral femoral cutaneous nerve. The addition of 45 degrees or more of flexion to abduction negated the strain increase on the obturator nerves seen with abduction alone. Nerve strain >30 g has been associated consistently with nerve dysfunction, disrupting axonal transmission, and causing structural neural damage. Our findings suggest that concomitant hip flexion should be used when placing anesthetized patients in a lithotomy position that includes abduction of the lower limbs to >30 degrees to decrease the risk for perioperative neuropathy of the obturator nerve.

Aged↗

Help of third-year medical students decreases first-year medical students' negative psychological reactions on the first day of gross anatomy dissection.

The assistance of third-year medical students (MS3) may be an easy, inexpensive, educational method to decrease physical and emotional stress among first-year medical students (MS1) on the first day of gross anatomy dissection. In the academic years 2000-2001 and 2001-2002, a questionnaire on the emotional and physical reactions on the first day of dissection was distributed to 84 MS1 at Mayo Medical School (Rochester, MN); 74 (88%) responded. Student perceptions were assessed on a 5-point Likert scale. The 42 second-year medical students (MS2) whose first academic year was 1999-2000 were used as a control group, because they had not had assistance from MS3. MS2 completed the same questionnaire (59% response rate). Data were collected from MS1 on the day of their first gross anatomy dissection. The most frequent reactions were headache, disgust, grief or sadness, and feeling light-headed. Significant differences (alpha < 0.05) were found with use of the chi(2) test to compare the emotional and physical reactions of MS1 and MS2. MS1 had significantly fewer physical reactions (64% vs. 88%), reporting lower levels of anxiety (23% vs. 48%), headache (14% vs. 36%), disgust (9% vs. 20%), feeling light-headed (11% vs. 24%), and reaction to the smell of the cadaver and laboratory (8% vs. 52%). MS1 commented that having MS3 at the dissection table was extremely helpful. They relied less on their peers and felt they learned more efficiently about the dissection techniques and anatomical structures. Using MS3 as assistants is one method to reduce fear and anxiety on the first day of gross anatomy dissection.

Adult↗

Tongue engorgement with prolonged use of the esophageal-tracheal Combitube.

We report a case of massive tongue engorgement associated with placement of an esophageal-tracheal twin-lumen airway device (Combitube) in a morbidly obese patient. Approximately 4 hours after atraumatic placement of the Combitube, tongue swelling occurred. An emergency tracheostomy was needed for airway management before removal of the Combitube. Ischemia-reperfusion injury or compression of glossal blood vessels, specifically lingual veins, was the most likely cause for the patient's tongue engorgement. An exhaustive search for other causes revealed nothing. Prolonged use of the Combitube may incur greater risk of airway complications such as tongue engorgement.

Adult↗

Outcomes of the gross and developmental anatomy teaching assistant experience.

During the first-year Gross and Developmental Anatomy Course at Mayo Medical School, third-year medical students volunteer as teaching assistants (TAs). Their responsibilities include preparing for dissection, instructing students during dissection, writing examination questions, and giving a lecture. To evaluate the academic and professional impact of this experience on former TAs, a survey instrument was developed, and was sent to former TAs from the past 17 years. Seventy-two percent of the surveys were returned. Most respondents (84%) indicated that the TA experience was beneficial during their third-year surgical rotation. Over 60% identified benefits during Neurology, Obstetrics and Gynecology, and Internal Medicine rotations. The majority (62%) indicated they regularly use the knowledge gained from the TA experience. Communication was the most highly ranked area of skill development, with 86% of respondents indicating gains in lecture effectiveness and 97% in one-on-one teaching. Among respondents, 32% entered surgical or radiological fields, roughly paralleling the non-TA medical student population. All respondents indicated that they would repeat the experience and recommend it to other medical students. Although benefits for long-term career development have not yet been established, the Gross and Developmental Anatomy TA experience had perceived short-term benefits with respect to clinical rotations and teaching skill development.

Adult↗

Localization of caveolin 1 in aortic valve endothelial cells using antigen retrieval.

Ultrastructural analysis of aortic valve endothelial cells subjected to growth arrest revealed many vesicles defined as caveolae by the localization of caveolin. Translocation of caveolin after exposure to oxidized LDL suggests that the localization of caveolin may be a valuable tool to study models of early atherogenesis. In this study, several antigen retrieval protocols were tested in osmium-fixed and Spurr-embedded cells to determine the optimal method of antigen retrieval in our model system. SDS produced the most consistent labeling pattern. A quantitative evaluation revealed that SDS significantly increased the labeling density in Spurr-embedded cells. The labeling pattern appeared as clusters of gold particles, 15-40 nm in diameter, that were associated with membranes of a similar size which may represent the neck region of the caveolae.

Animals↗