Research Report

Surgical Clinical Correlates in Anatomy: Design and

Implementation of a First-Year Medical School Program
Lisa M. Haubert,1 Kenneth Jones,2 Susan D. Moffatt-Bruce1*
1
Department of Surgery, Division of Cardiothoracic Surgery, The Ohio State University Medical Center,
Columbus, Ohio
2
Department of Anatomy, The Ohio State University Medical Center, Columbus, Ohio

Medical students state the need for a clinically oriented anatomy class so to maximize
their learning experience. We hypothesize that the first-year medical students, who take
the Surgical Clinical Correlates in Anatomy program, will perform better than their
peers in their anatomy course, their surgical clerkships and ultimately choose surgical
residencies. We designed and recently implemented this program for first-year medical
students. It consisted of General Surgical Knowledge, Orthopedic Surgery, Plastic Sur-
gery, Urology, Cardiothoracic Surgery, General Surgery, Vascular Surgery, and Ear,
Nose, and Throat (ENT) sessions. Each session had defined learning objectives and
interactive cadaveric operations performed by faculty members and students. The pro-
gram was elective and had 25 participants randomly chosen. An evaluative question-
naire was completed before and after the program. Comparative analysis of the ques-
tionnaires, first-year anatomy examination results, clinical surgical rotation scores, and
residency match results will be completed. The positive opinions of surgeons increased
for all medical students from the pre-evaluation to the post-evaluation, and there was a
greater increase in positive opinions for our participants. Our participants also had the
highest average overall for all combined anatomy examinations. A need exists among
medical students to develop a clinically correlated anatomy program that will maximize
their learning experience, improve their performance and allow them to make
more informed career choices. The recent implementation of this Surgical Clinical
Correlates in Anatomy program fulfills this need. Anat Sci Educ 2:265–272, 2009. © 2009
American Association of Anatomists.

Key words: gross anatomy; surgical education; residents as teachers; clinical correlations;
medical curriculum; clinical integration

INTRODUCTION or being completely removed (Cottam, 1999; Fitzgerald et al.,

There have been many changes to the curriculum of medical
schools with anatomy often having a reduced time allotment
*Correspondence to: Dr. Susan D. Moffatt-Bruce, The Ohio State
University Medical Center, Division of Cardiothoracic Surgery,
Department of Surgery, Columbus, Ohio 43210, USA.
E-mail: susan.moffatt-bruce@osumc.edu
Received 26 July 2009; Revised 20 August 2009; Accepted 21 August
2009.
Published online 17 September 2009 in Wiley InterScience (www.
interscience.wiley.com). DOI 10.1002/ase.108
© 2009 American Association of Anatomists
2008). The Ohio State University College of Medicine is no
exception in that their first-year medical school anatomy
course was recently downsized from 12 to 10 weeks. Further-
more, the field of anatomy has seen a significant decline in
interested and qualified teachers (Seyfer et al., 2007). A sur-
vey from 2002 demonstrated that more than 80% of the
department chairs responsible for teaching anatomy antici-
pated that they would have great or moderate difficulty
recruiting qualified faculty to teach gross anatomy
(McCuskey et al., 2005).
To compound problems, the AAMC Graduation Ques-
tionnaire suggested a decreasing interest for fourth-year
medical students in general surgery from 1978 to 2001
(AAMC, 2009). Additionally, the match results show a grad-
ual trend of more general surgery positions being filled by

Anatomical Sciences Education NOVEMBER/DECEMBER 2009 Anat Sci Educ 2:265–272 (2009)
international graduates due to lack of interest amongst
American graduates (NRMP, 2009; Schneider, 2009). It is
thought that a lack of exposure to surgeons and surgical
topics in the first two years of medical school may be the
cause of the decreased interest in surgery (Fuller et al.,
2008). This decreased interest in surgery has been attributed
to concerns about lifestyle and hard work environments, as
well as the paucity of role models as surgical educators and
their hesitancy to undertake educational leadership roles
(Polk, 1999). Many surgeons are content to have others edu-
cate medical students, likely due to perceived time and pro-
fessional constraints. To increase medical student interest in
surgery, surgical faculty and residents must become more
involved in medical education (Polk, 1999; Debas et al.,
2005; Fuller et al., 2008).
Unfortunately, surgeons are not routinely sought after as
educators because they often suffer from an unfavorable
image. One study revealed that 34% of third-year medical
students believed surgeons to be ‘‘unapproachable’’ (Ek et al.,
2005). Another study showed that 50% of students believed
that they were considered an inconvenience by attending sur-
geons while on their third-year surgical rotations (De et al.,
2004). However, previous studies have shown that even a
brief intervention by surgeons during the first-year of medical
school can favorably influence students toward surgery
(Kozar et al., 2003; Zaid et al., in press). Positive medical
student operative experience and resident and faculty mentor-
ing interactions with the students have been correlated with
students matching into categorical surgical residency positions
(O’Herrin et al., 2003, 2004; Berman et al., 2008).
These competing circumstances come at a time when it
has been clearly determined that there is an impending sur-
geon shortage as early as 2009 (Debas et al., 2005). This
trend is thought to greatly impact general surgery with the
estimation of a shortage of 1,300 surgeons by 2010. If this
decline continues, it is predicted that there will be a shortage
of 6,000 general surgeons by 2050 (Williams and Ellison,
2008; Peters, 2009). A recent article estimates that the nation
will need 10,000 additional first-year residency slots and 60
new medical schools by 2020 to control the crisis (Jancin,
2007). This increase will place a greater strain on the already
deteriorating anatomical workforce.
It may seem that most of these issues are not related, but
in fact, they are all significantly interconnected. If surgeons
embark on teaching anatomy, this will both help to alleviate
the stress on the anatomy departments and expose medical
students to surgery and surgical subspecialties early in their
careers. This will allow medical students to explore career
options during their first two years of medical school, instead
of waiting until their third-year to have these opportunities.
This in turn has the potential to improve the image of sur-
geons, allow for an increased interest in surgery and create
higher match rates into surgical specialties.
The Ohio State University College of Medicine prides itself
on being one of the leaders in innovation of medical curric-
ula. Medical students, both those that enter surgical and med-
ical specialties, state the need for a practical, surgically orien-
tated anatomy class before their clinical surgical rotations so
that they might maximize their learning experience and be
more informed about residency choices. We have designed
and implemented a program for first-year medical students
that will fulfill this need. As such, we hypothesize that the
first-year medical students, who take the Surgical Clinical
Correlates in Anatomy program, will perform better than
266
their peers in their anatomy course, their surgical clerkships,
and ultimately choose surgical residencies.
EXPERIMENTAL DESIGN
Class Organization
The first-year anatomy course was designed to be taught over
a 10-week period. Therefore, a two-hour time period was
chosen that fit into the anatomy schedule for each of the
eight designated Surgical Clinical Correlates in Anatomy
classes. Each class covered a different surgical topic. There
was approximately one class per week during the ten-week
anatomy course. These classes were held outside the schedule
of the standard anatomy dissections. We were permitted to
use one of the dissection laboratories for all of our classes.
We secured two cadavers for our class and the use of pro-sec-
tions from the Department of Anatomy to supplement the
dissections. A fresh cadaver was also obtained to be used dur-
ing the ENT class. Surgical instruments that were no longer
in use were donated by the Department of Orthopedic Sur-
gery for our cadaver operations. Surgical faculty also supplied
extra instruments and materials to be used during their re-
spective classes. The Department of Anatomy allowed us to
borrow their digital video camera and monitor to use during
each class, which allowed for a close-up image of the surgery
being performed. This allowed all 25 students a close view of
the procedures during the demonstration phase of the class.
The 25 students divided themselves between the two
cadavers. Each student took a turn during the dissections. For
example, one student would make the skin incision, and then
another student would take over and perform the next step in
the procedure. This allowed each student a hands-on experi-
ence for each procedure.
Each class was divided into two parts. For the first part,
each attending surgeon was asked to create a 30 to 45-minute
presentation that included a review of the relevant anatomy,
clinical correlations, pertinent radiologic studies, and an
actual surgical video portraying the surgery the students
would be performing. The attending surgeons were then
asked to perform procedures pertinent to their specialty that
allowed for hands-on experience and accommodate the time
constraints of the class. During these sessions, the students
participated in and performed the procedures on the cadavers
so to fully appreciate the applied surgical anatomy.
Faculty Recruitment and Participation
An attending surgeon for each of the eight classes was chosen
based on merits of previous teaching experience amongst resi-
dents. A letter was drafted inviting these individuals to partic-
ipate as teachers. Each of the selected attending surgeons
accepted the invitation. A meeting was then scheduled to
meet with each of these attending surgeons to discuss expect-
ations for the class. The attending surgeons then submitted
their intended surgical procedure(s), and this information was
shared with the students before the class.
Class Size Determination/Selection
It was determined that 25 of the 211 entering first-year medi-
cal students was the minimum number needed to participate
in Surgical Clinical Correlates in Anatomy for statistical sig-
Haubert et al.
nificance. The power for this study was based on 25 students Table 1.
participating in the Surgical Clinical Correlates in Anatomy
Program and approximately 175 students in the traditional Surgical Clinical Correlates in Anatomy Program Sessions
medical program. The primary goal was to see if participa-
tion in the program increased a student’s performance in their
three anatomy examinations, their three practical examina- Session Procedure(s)
tions, and their third-year medical shelf examination. To
avoid a selection bias, the 25 students in the Surgical Clinical General  Identify and handle common surgical
surgical instruments
Correlates in Anatomy program were randomly selected from
knowledge  Identify assorted sutures and their uses
the 93 volunteers. The mean scores (standard deviation) of
 Learn how to tie knots
prior final anatomy written and practical examinations were  Learn general techniques of wound
88.1 (68.5) and 91.4 (66.9), respectively. There will be a re-approximation
power of 90% to detect at least a 7% increase in both of
these scores. This was based on a two-sided test with an a 5 Plastic  Carpal tunnel release
0.0167 and a common standard deviation using 25 students surgery  Repair of facial fractures
in the surgical correlates program and 175 students with tra-
ditional medical training. The mean scores (standard devia- Cardiothoracic  Thoracotomy with lobectomy
tion) of recent third-year shelf examinations was 72.0 (68.7). surgery  Sternotomy with dissection of heart
There will be a power of 90% to detect at least a 10%
General  Appendectomy
increase in these scores. This power calculation uses the same surgery  Right hemicolectomy
assumptions as above. The a was set to 0.0167 since we will
be testing to see if all three examination scores increase thus Urologic  Nephrectomy
conserving the type I error at 5% due to the multiple testing. surgery  Pelvic floor resuspension
To advertise this new program, a flier was created and
placed in each student’s mailbox during orientation week. It Orthopedic  Tibial osteotomy
was also distributed on the first day of anatomy lecture and a surgery  ACL reconstruction
short presentation about the program was given. Of the first-  ORIF tibial fracture
 Meniscus repair
year medical school class, 93 students volunteered to partici-
pate in Surgical Clinical Correlates in Anatomy. The 25 posi- Vascular  Carotid endarterectomy
tions were filled by randomization of the interested students. surgery  Above and below knee amputation
Anticipating that we would need to follow the 25 students
and compare them with the class as a whole to test our hy- ENT  Radical neck dissection
pothesis, an IRB approval was successfully sought. Consent
was then achieved from all but 13 students of the entire first- This table describes each procedure that was performed for each
year medical school class so that their results could be contin- individual class. Students were given this hand-out prior to start
uously monitored. of the program.

Class Composition/Session Matter sion allowed the students to perform a nephrectomy and
learn the basics of pelvic floor resuspension. General Surgery,
Anatomy for the first-year of medical school curriculum con-
the fifth session, allowed the students to perform an appen-
tains three blocks over ten weeks. It was therefore decided
dectomy and a right hemicolectomy, with both hand sewn
that two to four Surgical Clinical Correlates in Anatomy
and stapled anastomoses. The orthopedic session involved
classes per block for a total of eight classes would be a rea-
performing an autograft anterior cruciate ligament recon-
sonable and practical amount for implementation. Each class
struction, a meniscus repair, tibial osteotomies, and an open
was designed to be two hours. Surgical specialties were cho-
reduction internal fixation of a tibial fracture. The vascular
sen to correlate with the anatomy blocks (Table 1). The first
surgery sessions involved the students performing a carotid
block, Upper Extremity and Back, began with a class on gen-
endarterectomy and lower extremity amputations. The ENT
eral surgical knowledge, which was an introduction to sur-
session allowed the students to perform radical neck dissec-
gery and the operating room. Plastic Surgery was the second
tions. These sessions correlated with the dissections the stu-
class to be included in this anatomy block. The second anat-
dents were performing in their regular anatomy lab.
omy block, Thorax, Abdomen, and Lower Extremity, would
The operations all took place on the same two cadavers.
include classes on Cardiothoracic Surgery, General Surgery,
This required the planning of the sessions such that pertinent
Urology, and Orthopedic Surgery. Head and Neck, the third
body parts were still available. For instance, the orthopedic
block, would contain classes on Vascular Surgery and ENT.
sessions took place before the vascular surgery amputations.
In the general surgical knowledge session, the students
took part in an interactive session in order to become familiar
with surgical instruments, different types of sutures, wound Monitoring devices
healing, and how to suture and tie. The class involved sutur-
ing in a variety of ways on the cadavers. In the Plastic Sur- A pre-evaluation and a post-evaluation questionnaire were
gery session, the students performed a carpal tunnel release, created and distributed to the entire first-year medical school
facial fracture repairs and appreciated the LeFort classifica- class. The pre-evaluation included having the students rank
tion system. The third session, Cardiothoracic Surgery, their interest in common medical fields, both medical and
included performing a thoracotomy and lobectomy, a sterno- surgical, identify their opinions of surgeons, and provide infor-
tomy, and dissection of the human heart. The Urologic ses- mation regarding prior anatomy classes, relatives as physicians

Anatomical Sciences Education NOVEMBER/DECEMBER 2009 267

Table 2.
Pre-evaluation Questionnaire for Surgical Clinical Correlates in Anatomy

Mailbox Number: _______

1- h Participant in Surgical Clinical Correlates in Anatomy h Non-participant in Surgical Clinical Correlates in Anatomy

2a- If you did not participate in the class, please comment on why you did not choose to participate.

2b- If you chose to participate in the class, please comment on why you chose to participate.

3a- Please rank your interest in the following specialties:

Family Medicine h Very Interested h Interested h Neutral h Not Interested

Surgery h Very Interested h Interested h Neutral h Not Interested

OB/GYN h Very Interested h Interested h Neutral h Not Interested

Internal Medicine h Very Interested h Interested h Neutral h Not Interested

Anesthesia h Very Interested h Interested h Neutral h Not Interested

Radiology h Very Interested h Interested h Neutral h Not Interested

Dermatology h Very Interested h Interested h Neutral h Not Interested

Ophthalmology h Very Interested h Interested h Neutral h Not Interested

Other ____________ h Very Interested h Interested h Neutral h Not Interested

4- If you chose to participate in the class, please comment on what you want to achieve by taking this class.

5- Do you feel that participation in this class will affect your exam results? If so, how?

6- Have you taken an anatomy class prior to medical school? If so, please state at which level of education and for how long.

7- Have you ever observed or participated in an operation?

8- Are any of your family members physicians? If so, which specialties?

9- What is your opinion of surgeons (check all that apply):

h friendly h approachable h good teachers h unapproachable h reserved h do not take time to teach h rushed h busy
h good listener h not team players h arrogant h cold h compassionate h inconsiderate

10- The course objectives are clear to me.

h True h False

11- Please list goals you have for this course.

Every student in the first-year medical school class was given this questionnaire before they started their anatomy block and before the
start of the Surgical Clinical Correlates program. All of the questionnaires were returned for evaluation.

and why they were interested in participating in Surgical Clini-
cal Correlates in Anatomy (Table 2). The post-evaluation
included the same questions as the pre-evaluation with addi-
tional questions allowing the students to rank the program, the
surgeons, and the material in the classes (Table 3). The collec-
tion rate of the pre- and post-evaluation was 100%. We had
planned to compare the results to determine if there was a
change in opinion of surgeons and interest in surgery. Ulti-
mately, we will compare the third-year surgery clerkship exami-
nations and residency matches as we follow these students
throughout their medical school career. IRB approval was
obtained to follow the entire first-year medical school class
through-out the four years and to use the data collected in a
comparative analysis. The data was stored on a secured Excel
spreadsheet (Microsoft Corp. Redmond, WA) in which the stu-
dents were recognized only by a code known to the primary in-
vestigator. IRB approval has also obtained to follow and collect
data from the future incoming first-year medical school classes.

268 Haubert et al.

Table 3.
Post-evaluation Questionnaire for Surgical Clinical Correlates in Anatomy

Mailbox Number: _______

1- h Participant in Surgical Clinical Correlates in Anatomy h Non-participant in Surgical Clinical Correlates in Anatomy

2a- If you did not participate in the class, please comment as to whether or not you think you should have participated in this class.

2b- If you chose to participate in the class, please comment on whether or not you would recommend this class to another student.

3a- Please rank your interest in the following specialties:

Family Medicine h Very Interested h Interested h Neutral h Not Interested

Surgery h Very Interested h Interested h Neutral h Not Interested

OB/GYN h Very Interested h Interested h Neutral h Not Interested

Internal Medicine h Very Interested h Interested h Neutral h Not Interested

Anesthesia h Very Interested h Interested h Neutral h Not Interested

Radiology h Very Interested h Interested h Neutral h Not Interested

Dermatology h Very Interested h Interested h Neutral h Not Interested

Ophthalmology h Very Interested h Interested h Neutral h Not Interested

Other ____________ h Very Interested h Interested h Neutral h Not Interested

4- If you chose to participate in the class, please comment on whether or not you achieved your goals by taking this class.

5- Do you feel that participation in this class affected your grades? If so, how?

6- Have you taken an anatomy class prior to medical school? If so, please state during at which level of education and for how long.

7- Have you ever observed or participated in an operation?

8- Are any of your family members physicians? If so, which specialties?

9- What is your opinion of surgeons (check all that apply):

h friendly h approachable h good teachers h unapproachable h reserved h do not take time to teach h rushed h busy
h good listener h not team players h arrogant h cold h compassionate h inconsiderate

10- The course objectives were clear to me.

h True h False

11- Do you think the length of the classes were appropriate?

12- Do you think there were too many classes, not enough classes, or the right amount of classes?

13- Was the video section of each class educational? Please comment on likes and dislikes of the videos.

14- Was the dissection component of each class educational? Please list specific likes and dislikes of each dissection.

15- Please rank each surgeon on a scale of 1 to 5 with 1 being poor, 2 being below average, 3 being average, 4 being above average,
and 5 being exceptional. Please list specific comments about each attending surgeon:

A- General Surgical Knowledge: h1 h2 h3 h4 h5

B- Orthopedic Surgery: h1 h2 h3 h4 h5

C- Cardiothoracic Surgery: h1 h2 h3 h4 h5

(Continued)

Anatomical Sciences Education NOVEMBER/DECEMBER 2009 269

Table 3.
(Continued)
D- Cardiothoracic Surgery: h1
E- General Surgery: h1
F- Urologic Surgery: h1
G- Vascular Surgery: h1
H- ENT: h1
I- Plastic Surgery: h1
16- Do you think the number of students in the class was appropriate?
17- Do you think the classes were well-organized?
18- I enjoyed participating in this program.
h Strongly Agree h Agree h Neutral
Every student in the first-year medical school class was given this questionnaire after their final examination in anatomy. All of the
questionnaires were returned for evaluation.
In the future, as the students are followed, descriptive sta-
tistics will be used to compare student demographics between
the students in the Surgical Clinical Correlates in Anatomy
program and those in traditional medical school course. A
two-sample t-test will be used to compare the third-year shelf
examinations between the groups as well as their residency
match. These test scores may be regressed on the groups and
adjusted by student demographics. All analyses will be car-
ried out using Statistical Package for the Social Sciences
(SPSS) software, version17.0 (SPSS, Chicago, IL).
RESULTS
Student Grades After Implementation of the
Surgical Clinical Correlates Program
We divided the first-year medical school class into three
groups prior to evaluating their anatomy examination results.
The first group consisted of the 25 participants of Surgical
Clinical Correlates in Anatomy, the second group included
the students that were not selected but had volunteered for
the program, and the third consisted of the remainder of the
first-year class. Our 25 participants had the highest average,
87.69%, for all combined anatomy examinations. The second
group was next with an average of 86.90% and the third
group was last with an average of 85.94%. There was a
trend for our participants doing better than the rest of the
first-year class, so we performed an ANOVA comparing
scores by group while controlling for total MCAT score.
Total MCAT score was used to control for the possibility of
preexisting differences in academic aptitude across the three
groups. The ANOVA showed that there was no significant
difference between the three groups (P 5 0.388) (Fig. 1). As
we were using groups of different sizes, we tested the
data for heterogeneity of variance and found that it was not
significant.
270
h2 h3 h4 h5
h2 h3 h4 h5
h2 h3 h4 h5
h2 h3 h4 h5
h2 h3 h4 h5
h2 h3 h4 h5
h Disagree h Strongly Disagree
Opinions of Students after the Implementation
of the Surgical Clinical Correlates Program
The post-evaluation questionnaire included specific questions
regarding opinions that may have changed due to participa-
tion in the Surgical Clinical Correlates in Anatomy Program.
Thirteen of the 25 participants felt that the program had in
fact improved their anatomy grades. Twenty-four students
felt the program was helpful and would recommend it to
others. Twenty-three students thought that the class should
be continued. Twenty-two students felt that the classes were
well-organized, while only three thought that they were not
well-organized. Importantly, the opinion of surgeons from
before the program to after the program improved based on
a variety of descriptors (Fig. 2). Overall, the positive opinion
of surgeons increased for all students in the entire medical
school class from pre- to post-evaluations (P < 0.003, t-test).
There was a greater increase in positive opinions for partici-
pants in Surgical Clinical Correlates program (P < 0.008,
ANOVA).
DISCUSSION
The Surgical Clinical Correlates in Anatomy program was
successfully implemented at the OSU College of Medicine.
Many challenges were met and obstacles had to be overcome.
First, it was exceptionally difficult to schedule the sessions
with the attending surgeons due to time constraints. There
were several times when organizational meetings were can-
celled at the last minute due to patient emergencies. Schedul-
ing attending surgeons for their sessions into available medi-
cal student time slots was exceptionally complicated. Each
attending surgeon had clinical responsibilities that had to be
worked around. Plus, we had to fit the classes into the first-
year medical school curriculum. Two classes had to be
Haubert et al.

Figure 1.
Cumulative anatomy examination results for the first-year medical students.
The first-year anatomy examinations, both practical and written, were com-
pared between the participants in the Surgical Clinical Correlates Program, the
volunteers that were not selected due to space limitations and the remainder of
the class that did not show any interest in the program. The 25 program par-
ticipants had the highest average, 87.69%, for all combined anatomy examina-
tions. The second group was next with an average of 86.90% and the third
group was last with an average of 85.94%. The ANOVA showed that there
was no significant difference between the three groups (P 5 0.388). As we
were using groups of different sizes, we tested the data for heterogeneity of var-
iance and found that it was not significant.
rescheduled or started late due to conflicts or clinical respon-
sibilities.
We encountered difficulty in determining how to best
advertise the Surgical Clinical Correlates in Anatomy pro-
gram to the incoming first-year medical students. A flier was
created to promote the program, but we were not able to
share the information with the medical students prior to the
first day of anatomy class. Fliers were placed in the medical
students’ mailboxes and the program was introduced during
the first anatomy class. An e-mail was also distributed to all
of the first-year medical students the weekend prior to the
first day of class. Because of the late presentation of informa-
tion, some students did not receive the flier because they did
not check their e-mail, mailboxes or show-up to class. We
have since gained permission to send out the advertisement
flier to the incoming first-year medical students with the ori-
entation packet mailed to the students many months prior to
starting classes.
Difficulties were also encountered during the student vol-
unteer process. Several students either e-mailed after the
deadline or e-mailed the wrong person prior to the deadline.
These students did not get included in the randomized lottery,
but served as another study group comprising those students
interested, but not chosen. One student that was selected to
participate in the program offered his position to a friend
that had not met the time deadline but this was interceded.
None of the students chosen withdrew from the program.
Anatomical Sciences Education NOVEMBER/DECEMBER 2009
With respect to the actual cadaver operations, we have
discovered many improvements that can be made for future
years. For instance, the students had a difficult time all hav-
ing an opportunity to dissect the human heart during the Car-
diothoracic Surgery class. We, therefore, plan to have cow
hearts available for each student to dissect and appreciate
next year. The room used this year was too small for 25 stu-
dents, two cadavers and faculty. Therefore, we will use a
larger room for the cadaver section next year and have a
small area where the students can sit down during the video
portion of the class. We are also going to increase the number
of faculty per session; each class will have two attending sur-
geons and a fellow or senior resident. This will allow more
surgeon time per student for hands-on participation.
Overall, we felt that the evaluation questionnaire helped
us to assess our strengths and weaknesses in the implementa-
tion of this program for the first time. The students in general
felt that the program, which involved an extra time commit-
ment, was worthwhile and should be offered to future stu-
dents. Additionally, the majority of the students felt that it
covered the correct subject matter and that it was generally
well-organized. This is in light of the fact that this year, the
first-year anatomy examination results did not differ between
those in the program, those that volunteered but were not
chosen and those that had not expressed an interest. These
equivocal results in examination scores may reflect the change
in the curriculum this year and a new examination. Our
results from the program next year, which will be the second
year of the new curriculum, are therefore anxiously awaited.
Last, the impression of surgeons statistically improved after
the implementation of this program. This was most promi-
nent amongst those that had participated in the program.
This was not only statistically impressive but also a reality, in
that the overall participation of the surgical faculty and the
interaction with the medical students has palpably improved
Figure 2.
Opinions of surgeons before and after participation in surgical clinical corre-
lates in anatomy. Importantly, the opinion of surgeons from before the pro-
gram to after the program improved based on a variety of descriptors, includ-
ing being friendly, good teachers, approachable, busy, arrogant, rushed, and
compassionate. Overall, the positive opinion of surgeons increased for all stu-
dents in the entire medical school class from pre- to post-evaluations (P <
0.003, t-test). There was a greater increase in positive opinions for participants
in surgical clinical correlates program (P < 0.008, ANOVA).
271
at OSU to the point that students are now approaching surgi-
cal faculty on a routine basis to shadow and seek mentorship.
Caution must be taken however, in that with only one year
of participation, this positive trend will continue. It would be
anticipated, however, that with continuation of this program,
this positive trend would persevere.
The design and implementation of Surgical Clinical Corre-
lates in Anatomy was perceived as a success. We were able to
fully integrate the program into the first-year medical school
curriculum and the program is set to continue next year. We
will ultimately analyze the data after the third-year examina-
tions and the residency match thereby fully testing our hy-
pothesis that the Surgical Clinical Correlates in Anatomy pro-
gram results in better performance in anatomy, surgical clerk-
ships, and matching to surgical residencies.
NOTES ON CONTRIBUTORS
LISA HAUBERT, M.D., is a general surgery resident at the
Ohio State University Medical Center, Columbus, Ohio. She
was involved in the initiation of this program, and the work
is part of her anatomy thesis for Master of Science degree.
KENNETH JONES, Ph.D., is a professor of anatomy at
the Ohio State University Medical Center, Columbus, Ohio.
He is the Director of Anatomy and teaches anatomy, histol-
ogy and embryology to medical and dental students.
SUSAN MOFFATT-BRUCE, M.D., Ph.D., is an assistant
professor in the Department of Surgery, Division of Cardio-
thoracic Surgery at the Ohio State University Medical Center,
Columbus, Ohio. She teaches and mentors medical students,
residents, and fellows. She is a Faculty Scholar at OSU and
has an active transplant immunology research laboratory,
which is funded by a Clinical and Translational Science
Award (CTSA) KL2 Career Development Award.
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