This project was born after a particularly difficult dissection day with IUSM medical students. The students struggled to identify and understand the 3-D nature of the perineum. The cadaver dissection of this area is hard and the models we had available were not ideal for demonstrating the layering of the perineum. Working with Dr. Polly Husmann, I designed an activity to emphasize the 3-D nature of the perineum, specifically focused on the content within the IUSM curriculum. Studetns completed this activity and we later compared their performance on relevant test questions versus their colleagues at other IUSM center, who did not complete the activity.

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This research can be found here: https://link.springer.com/article/10.1007/s40670-019-00782-6

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Instructions for this activity have been published on LifeSciTRC and can be found here:

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Build-A-Pelvis-Female Instructions:

https://www.lifescitrc.org/resource.cfm?submissionID=11126

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Build-A-Pelvis-Male Instructions:

https://www.lifescitrc.org/resource.cfm?submissionID=11124

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This activity has been adapted by others. Their experience is described below and are unedited:

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From Dee Silverthorn, Ph.D., Distinguished Teaching Professor of Physiology, Dell Medical School

I first encountered Theo’s “build-a-pelvis” activity in a workshop at the annual meeting of the Human Anatomy & Physiology Society. I am not an anatomist but had been on the lookout for hands-on activities that we could incorporate into our interactive large group teaching at Dell Medical School.  I took the instructions, which Theo generously shared, back to Austin and with the help of some talented undergraduates, we ordered plastic male and female pelvises (to standardize the size) and re-worked the templates to fit.  We made a few changes and additions, then created kits that could be handed out to students working in groups.

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We first used the build-a-pelvis kits in fall 2018. The students had seen the pelvic anatomy in prosected cadavers the previous week, so they had studied the anatomical arrangement prior to the activity.  In our interactive auditorium, which has tables for small group work, we put the students into groups of 5 with a plastic pelvis, instructions, and various components pre-cut to size.  We alternated male and female tables, and at the end of the session, one student stayed at his/her original table to explain while the other 4 students swapped to see the arrangement in the opposite sex. During the activity several instructors circulated to help when students had questions.

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Student reaction during the session was overwhelmingly positive. Several students commented about how what they had observed in the cadavers now made much more sense. Being able to layer the different components into the pelvis helped clarify the three-dimensional relationships in a way that was not possible with prosected cadavers.

 

From Brian Miller, Ph.D., Distinguished Teaching Professor of Anatomy, Dell Medical School

My experience of teaching human gross anatomy for more than thirty years has led me to realize that the 3-dimensional relationships of the bones, neurovascular elements, muscles and viscera located in and around the pelvis and perineum are some of the most difficult concepts for health science students to grasp.   The anatomy in this region is complicated by the presence of numerous boney features, ligaments, foramina, and viscera together with two distinct diaphragms – the pelvic diaphragm and the urogenital diaphragm.  Understanding the relationships of these diaphragms to each other and to the clinically important neurovascular elements, muscles and viscera associated with these structures is a challenge to virtually every student in a traditional gross anatomy course.

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 In the Build-a-Pelvis activity, student teams, using realistic models of pelvic bones, are tasked to construct and accurately position several of the above anatomical elements until they are able to clearly see how these various components are related to each other in the 3-dimensional spaces of the pelvis and perineum.  Since we have been using the Build-a-Pelvis activity, I can confidently say that our first-year medical students have a much firmer grasp of the clinically relevant anatomy in this region.  They certainly have a much clearer idea of the relationships of the regional diaphragms to each other and to the neurovascular elements - such as the pudendal nerves, arteries and veins - that take a convoluted course around and through various pelvic and perineal spaces.  Consequently, these activities help crystalize the student’s knowledge of this complex and critically important region and, importantly, allow them to readily compare and contrast male and female pelvic anatomy.

 

Reports from our students both during and after this initiative have indicated that they genuinely appreciate this activity.  In our formal course evaluations, one student wrote the following:  “I enjoyed the "build-a-pelvis" activity and found it very helpful.”  Another student indicated that the Build-a-Pelvis activity “helped my understanding of unique, hard to grasp concepts.”  We have found that such attitudes are common among the majority of our students.  Accordingly, we will continue to dedicate time in our large group sessions to this informative and very useful activity.

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