Integrating Anatomical Education into a Residency Curriculum of a Surgical Specialty

Anatomy is a cornerstone of modern medical education yet there is a continuing trend toward decreasing the time devoted to cadaveric dissection during medical school. Has the decrease in its use negatively impacted student's anatomical foundation? This is an especially relevant question for postgraduate education in surgical specialties, where an understanding of the pertinent anatomy is vital. Medical students entering residency training in obstetrics and gynecology often do not have an adequate understanding of pelvic anatomy. In fact, the recent growth in professional development courses employing cadaveric dissections is a testament to practicing gynaecologists recognition of inadequate teaching of pelvic anatomy. Designing a program to address this knowledge deficit is a worthwhile aim, especially if it includes elements that will maximize the utility of anatomical knowledge in surgical practice. Learners need a three‐dimensional understanding of pelvic anatomy that is transferable to pelvic surgery. Such a program should have clinical correlations, and develop production sets that are foundational to gynaecologic procedures. Lastly, repetition is essential to knowledge retention. A multimodality approach to teaching surgical anatomy is the most practical means to achieve these pedagogical goals. Clay modeling is a three‐dimensional technique that serves as an adjunct to lectures to refresh anatomy knowledge in residents entering an Obstetrics and Gynaecology program. The objective of the clay‐modeling session is to allow residents to conceptualize and build the anatomic structures of the pelvis in 3 dimensions using pre‐cut clay structures and a bony pelvis. While the lectures and supplementary teaching methods, are useful to build on the foundation provided by the clay‐modeling lab, the value of cadaveric dissection cannot be overstated. For Gynaecology, both vaginal and laparoscopic cadaver labs should be included, and can be achieved in sequence on the same cadaver. Repetition is the key to sustaining long‐term learning. Perhaps the best way to achieve this is by creating a clinical learning environment that highlights the importance of anatomical considerations and creates opportunities for cognitive reinforcement. Ultimately, the most important approach is to define it as a core competency required for advancement, and to develop discriminating means to test for it. As postgraduate accreditation bodies increasingly adopt competency‐based curricula, the need for valid methods of assessing anatomical competency becomes more pressing.