An evaluation of the effectiveness of teaching anatomy to rheumatologists through combined musculoskeletal sonoanatomy and human cadaveric dissection

Abstract

Objective: Our aim was to evaluate the effectiveness of teaching anatomy through combined musculoskeletal sonoanatomy and human cadaveric dissection for rheumatologists practising musculoskeletal US. Methods: The principal focus was on scanning and then dissecting relevant musculoskeletal structures. Outcomes measured included confidence levels and objective knowledge. A mixed-methods approach of evaluation and descriptive statistical data analysis was performed. Results: The change in confidence ratings by delegates after the teaching event as represented by the mean difference (S.D.) (S.E.M.) for identification of surface anatomy was 1.846 (1.281) (0.355), with Student's paired t ¼ 5.196 and P¼0.000223. The mean difference (S.D.) (S.E.M) for performing IA injections was 1.538 (1.266) (0.351), with Student's paired t ¼ 4.382, P¼0.001, and for recognizing sonoanatomical structures it was 1.769 (1.235) (0.343), with Student's paired t ¼ 5.165 and P¼ 0.000235. There was a significant increase in correct identification of anatomical and sonoanatomical knowledge in the pre- and post-course assessments. Rotator cuff interval region improved from 13 to 73%, P ¼ 0.004; knee tendons insertion sites from 47 to 93%, P ¼ 0.016; and muscles not adjacent to joints from 27 to 93%, P ¼ 0.002. Conclusion: Dissection of joints enabled a three-dimensional relational mind map of the relevant regions of the human body, producing clarity in understanding regional relational topographic anatomy and sonoanatomy. The combination of US and cadaveric dissection improved learners' satisfaction, confidence and knowledge in areas where soft tissue complaints are common, which is likely to lead to accurate early diagnosis and cost-conscious, better overall care.