Reintroduction of anatomy concepts improves surgical training among OBGYN residents

A multidisciplinary teaching-enabled active learning workshop, along with innovative tools, improves outcomes in knowledge of anatomy, confidence, and learning satisfaction among obstetrics and gynaecology (OBGYN) residents in Singapore, reports a study, which recommends the reintroduction of anatomy concepts during OBGYN residency training to enhance surgical training and patient care.

“There is a need to incorporate formal anatomy courses into surgical-based residency training programmes to address knowledge gaps that residents from different medical specialties may have,” the researchers said. “Revisiting anatomy during residency is valuable not only for improving surgical training but for enriching the existing residency training programme curriculum.”

The workshop, facilitated by anatomists and OBGYN consultants, focused on the clinical and surgical anatomy of the female pelvis using 3D virtual dissections, relevant plastinated specimens, and bony pelvic models that had been developed in-house. The researchers then evaluated the students’ knowledge of anatomy and their perceptions of the subject using pre- and post-tests and a five-point Likert scale, respectively. Finally, they applied a mixed methods analysis.

Forty-two residents participated in the workshop, of which 26 (61.9 percent) completed both pre- and post-tests. Overall, the difference between their performance pre- and post-test was 25.41 percent. A significant difference was noted in the residents’ knowledge of anatomy between the pre- and postworkshop (p<0.05). [Proc Singapore Healthc 2021;30:3-9]

Ten participants provided positive feedback on the workshop content, teaching tools, learning activities, and educators. Their recommendations were as follows: that the workshop be held at least once a year (70 percent) and that it should be done specifically during the first year of residency (90 percent).

“After the workshop, there was a significant improvement in residents’ performance in the anatomy test, affirming a positive outcome in relation to enhancing their knowledge of anatomy,” the researchers noted. “These results concur with those from previous studies, in which residents were exposed to cadaveric dissection, took part in a surgical skills training programme, or were involved in clay modelling of the pelvic structures.” [Obstet Gynecol 2001;97:321-324; Am J Obstet Gynecol 2006;195:1789-1793]

Anatomy learning tools have changed in recent years, with previous studies highlighting the use of interactive tools to improve students’ learning, as well as various cost-effective anatomy models. Of note, the multimodal approach has been found as the most meaningful way to provide a three-dimensional understanding of pelvic anatomy to the residents. [Am J Obstet Gynecol 2006;195:1438-1443; Obstet Gynecol 2017;130:873-877; FASEB J 2015;29(Suppl 1):10.2]

“A formal education in anatomy is less common in residency programmes. It is mostly achieved by self-study, or through instruction delivered by senior trainees or surgeons, the latter being limited by time constraints,” the researchers said. [GHS Proc 2017;2:32-37]

Structured courses, as in the present study, are needed to address the gap in residents’ knowledge of anatomy and to further develop their surgical skills, they added. [BMC Med Educ 2018;18:174; Anat Sci Educ 2011;4:302-304]

“Further studies are needed to explore the longitudinal impact of the workshop in terms of residents’ knowledge, clinical judgement, and competence in the clinical environment,” the researchers said.