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?