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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?