Anatomy studies begin with focus on respect
Each September, first year students in the Queen’s Undergraduate Medical program quietly begin their studies in anatomy with a service acknowledging the donation of bodies that will be used in the lab assignments.
This year the short service will be held on Tuesday, September 5 at 3 p.m. in room 032 of the Medical Building, following the introduction to the Human Structure & Function course.
The course co-directors, Les MacKenzie, Stephen Pang, and Allan Baer will be joined by Queen’s Chaplain Kate Johnson to lead the program.
The session emphasizes respect and professionalism. “This is the first approach to professionalism,” MacKenzie explained in an interview. “The purpose of the donations is for this study and we have to respect that.”
“Respect not just for the bodies that have been donated, but for the families who have donated them,” he added.
Queen’s is one of a decreasing number of medical schools that still uses human cadavers in anatomy courses. According to a 2016 article in National Geographic, “half of Canadian medical schools have cut back on using cadavers, relying instead on new technology to make teaching basic anatomy more efficient.”
While there is definitely a place for technology, MacKenzie acknowledged, there’s also a strong argument for using donated human bodies. He pointed out, for example, that the many variations of “normal” are not experienced if everyone is using the same computer simulated program. It’s a privilege to have this learning experience, MacKenzie noted, and the students recognize this.
The emphasis on respect is tied to one of the objectives from the Queen’s UGME Competency Framework (Professional 1.1a) which notes students will “Identify honesty, integrity, commitment, dependability, compassion, respect, confidentiality and altruism in clinical practice and apply these concepts in learning, medical and professional encounters.” For the Human Structure and Function course, this is further annotated to explain that students will: “Consistently demonstrate compassion and respect for those who have donated their bodies to the medical school for use by students studying anatomy.”
“I truly believe the point does get across,” MacKenzie said. “Our medical students really get the message, there’s no horseplay. We have zero tolerance of misbehaving.”
Queen’s Chaplain Kate Johnson, who has led the opening service in recent years, takes the opportunity to emphasize the students’ own humanity and to remind them to keep in touch with it.
“Historically, medical students were at risk of a ‘super human’ culture of medicine,” Johnson said. “Now, with technological advances, there’s the danger of taking the humanity out of medicine. The anatomy lab is one place to keep the humanity.”
Johnson also reminds students they are starting on a pathway to a position of trust.
“You’re not just technically excellent, but your professional conduct is to be worthy of trust,” she noted at last year’s service. “It’s appropriate then that this part of your education starts with the bodies of people whose last wish was to entrust their physical remains to you in order that you can be fully trained in your profession,” she said. “Even more, their surviving family members have made what is often a huge decision to trust you by following through on their deceased loved ones’ wishes.
Tuesday’s service is open to all members of the Queen’s community. “It would be great if it was standing room only,” MacKenzie said.
Each spring features a more formal, graveside burial service at the Queen’s University plot at Cataraqui Cemetery which is attended by family, friends, and members of the Queen’s community. Details on this service will be available in the spring.
For more on the Human Body Donor Program at Queen’s see A body of medical knowledge in the Queen’s Alumni Review 2017 Issue 2
For information on procedures to donate, see the Queen’s Department of Biomedical and Molecular Sciences Human Body Donor Program web page.
Reducing the Burden of Concussions Through Education
By Chris Griffiths
The Concussion Education, Safety and Awareness Program (CESAP) seeks to reach a broad audience on the prevention, identification and management of concussion injuries. According to the Centre for Disease Control, 65% of all concussions occur in those aged 5-18, and concussions make up 13.2% of high school sports injuries (CDC, 2015). As high school populations are at increased risk of injury, it is important that they are properly educated on the risks they incur by participating in sport, and how to best minimize these dangers. However, a study in Florida examining high school football players, a sport at the highest risk of injury, found that only 1 in 4 received proper concussion education (Cournoyer & Tripp, 2014). As 20% of those injured eventually develop long-term sequelae of concussion, such as depression and anxiety disorders, it is important that schools develop supportive environments for those injured (Hudak et al., 2011). Increased awareness has been demonstrated to increase the likelihood students will adhere to management and prevention strategies, and increase the level of compassion received from their peers (Taylor & Sanner, 2016).
This past fall, a group of medical and graduate students teamed up to work on reducing the burden of concussion in our community. Two second year medical students, Logan Seaman and Chris Griffiths, began working with MSc Neurosciences candidate, Allen Champagne, to develop a free education program for high school students and athletes. With the advice of physicians at Queen’s University, namely Dr Mike O’Connor, Dr Fraser Saunders and Dr Andrea Winthrop, and endless support from the Centre of Neurosciences Studies, CESAP developed a classroom session focused on the biomechanics, symptoms, and management of concussions. With help from students at the School of Rehabilitation Therapy and their faculty, we have put emphasis on the many healthcare professionals who can help in injury rehabilitation around Kingston.
What we believe sets CESAP apart, however, is our behaviour modification and prevention arm. CESAP runs clinics for youth football teams with classroom sessions followed by on field drills led by Queen’s football players to teach proper tackling technique. The drills were developed based on research at the University of New Hampshire, showing that equipmentless drills that focus on fundamentals, or “heads up tackling”, reduced the number of head impacts by 4.4 per game in collegiate athletes (Swartz et al, 2016). CESAP has committed to expanding these principles to other sports, with drills developed for soccer and hockey.
CESAP’s classroom sessions are modified specially for each target audience. While some sections are shortened for particular groups, the structure of each talk is the same. We begin by introducing basic neuroanatomy, localizing different areas of the brain to their function. For senior high school classes, we go into greater depth into axonal structure, and show different imaging modalities such as MRI and Diffusion Tensor Imaging. Emphasizing that concussion is a functional injury, we explain how injury can occur and the symptoms that are caused. The goal is that students can identify unusual behaviour in themselves or their teammates, and encourage them to make a safe choice by removing themselves from play if necessary. We outline red flags or concerning symptomatic developments, and equip students with questions to ask their peers if they suspect injury.
Unfortunately, the reality is that injury does happen. With help from physicians, occupational therapists and physiotherapists in the field, we have compiled the best resources for management plans in concussion rehabilitation. Parents are provided with information on all of the health care professionals in the area who they can consult, and youth are educated on what to expect in their recovery. Perhaps the most powerful part of our program, however, are the testimonies offered by concussed athletes on our team, such as former Queen’s Football player Jesse Topley. The stories our athletes give make the effects of concussion a reality, as we hope to foster supportive environments around concussions in the community. By outlining the difficulties that follow injury, we hope that athletes understand they have the power to prevent severe sequelae by playing it safe in their recovery. We hope that athletes and youth are able to identify the injury in themselves and take it seriously, and reverse the “warrior culture” that exists in sports that encourages young athletes to play through any injury.
Since the middle of January at program launch, CESAP has presented to over 1,100 students, athletes, parents and coaches in Kingston, Sherbrooke, Quebec City, and across the GTA. Our program hopes to continue to expand into the Limestone District School Board, with regular classes in grade 9 PHE and senior biology classes. In athletics, we are advocating for more education of coaches, referees and trainers in leagues in the Kingston area.
With help from our colleagues at the Centre for Neurosciences, and in partnership with students in the School of Rehabilitation Therapy, we hope that CESAP can continue to grow across Canada. Our dream is to make CESAP, and programs like it, standard education for high school students and athletes. Through increased education, we believe that youth, parents and coaches can make safer decisions regarding head injury and reduce the burden of concussion and its chronic effects on society at large.
If you are interested in booking CESAP for an education session, please contact us at firstname.lastname@example.org. We will accept any audience and are happy to tailor a presentation to your needs! Please follow us on Twitter @cesap100 to learn more about our sessions and concussions in the news.
Centres for Disease Control and Prevention. “Online Concussion Training for Health Care Providers.” Centers for Disease Control and Prevention. N.p., 4 May 2015. Web. 31 Mar. 2016.
Cournoyer, Janie, and Brady L. Tripp. “Concussion knowledge in high school football players.”Journal of athletic training 5 (2014): 654-658
Hudak, A., Warner, M., Marquez de la Plata, C., Moore, C., Harper, C., & Diaz-Arrastia, R. Brain morphometry changes and depressive symptoms after traumatic brain injury. Psychiatry Research, 191(3), 160–165 (2011).
Swartz, E. E., Broglio, S. P., Cook, S. B., Cantu, R. C., Ferrara, M. S., Guskiewicz, K. M., & Myers, J. L. (2015). Early Results of a Helmetless-Tackling Intervention to Decrease Head Impacts in Football Players. Journal of Athletic Training, 50(12), 1219–1222. http://doi.org/10.4085/1062-6050-51.1.06
Taylor, M. E., & Sanner, J. E. (2015). “The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms: A Systematic Review of the Literature.”The Journal of school nursing : the official publication of the National Association of School Nurses. PubMed. Web.