Teaching Radiology/Anatomy to Medical Students: Using Multiple Approaches to Understand 2D/3D Structure of the Heart

Training in medical school now requires students to understand and interpret digital images of body structure. Many of these images (MRI, CT) are serial planar sections of body regions and internal organs. Some organs, such as the heart, have both complex internal organization and non‐orthogonal orientation within the body. As a consequence, interpretation of two dimensional sections of the heart is particularly challenging and difficult to relate to its three dimensional structure. As part of training in Gross Anatomy at the Joan C. Edwards School of Medicine, we have developed new multifaceted approaches to teaching the structure of the heart in both two and three dimensions. The format combines independent learning using downloaded videos with cadaver dissection and study of specimens in the Gross Anatomy laboratory. The material for independent learning is based upon study of a single template, a T1 weighted MRI series of the the thorax taken without contrast medium. The image series, chosen for its high definition of vessels and chambers, was imported to PowerPoint and labeled by a medical student under supervision of our department of Radiology. The independent learning exercise first required viewing a short (20 minute) video that incorporated those images. Each image in the series was correlated with other diagrams and photographs that provided cues for orientation to the structure of the heart in three dimensions. Student feedback to date has indicated that the video provided a valuable tool in understanding of the heart in both two and three dimensions, although repeated viewing of images was often necessary. In addition, students were provided prosected specimens of the heart (in the Gross Anatomy laboratory) that were sectioned in the plain of axial MRI or CT. These specimens were prepared by manually cutting hearts perpendicular to an axis determined by the orientations of the Superior and Inferior Venae Cavae. We also plan to develop methods for students to section the hearts they have removed in the course of their own cadaver dissection. In sum, we present methods for teaching students the structure of the heart that provides understanding of the relationship of its three dimensional structure and its appearance in two dimensional sections. We suggest that the combination of approaches (independent learning, guided laboratory instruction) may be beneficial in the future, particularly as schools undergo curricular revisions/compressions that can lead to reduction in the time available for study of Anatomy.