Perception and attitude of pre-clinical medical students towards obese donors: Should obesity sessions be incorporated in gross anatomy labs?

INTRODUCTION: The prevalence of obesity in the United States has grown to over 40% and is a major cause of morbidity and mortality. With the advent of integrated curriculum, many medical schools across the US have incorporated obesity education programs. However, gaps still exist within preclinical medical education including specific training that addresses obesity and long-term studies showing that such training is needed (Butsch et al., 2020). In a medical student's career, dissection labs are a place where students first encounter human bodies in a medical capacity. The donor is a great resource that can help medical students' perception and bias about obesity. During dissection, students navigate through different regions of the body, totally inattentive to the distribution of fat in specific regions such as the vital organs & their clinical implications. To ensure medical students are supported throughout their education about obesity and its impact on health, we at OUWB, through an innovative curriculum initiative incorporated an obesity session using donors and imaging in the endocrine systems clinical integrated lab (CIL).

METHODS: In this study, a survey (pre-session) was developed and sent to medical students to assess students' clinical knowledge and perceptions regarding fat distribution in donors before the endocrine systems anatomy CIL.

RESULTS: Thirty-six medical students responded to the pre-session anatomy of fat survey. Only 11.4% of respondents felt they could "learn and observe a lot from an obese donor," whereas 45.7% felt that obese donors "don't make any difference" to their learning and 28.6% felt that an obese donor "will take a long time to dissect." 85.9% of respondents reported never having discussed the distribution of fat with their lab-mates (Fig.1). In order to assess student knowledge regarding fat distribution in several organs with clinical implications, 36.5% and 27.0% of respondents acknowledged the presence of fat around the heart and kidneys (respectively), less than 10% of students recognized the fat around the lungs, bones, spinal cord, or orbit (Fig. 2). Additionally, only 17.1% of respondents reported routinely looking for the "clinical relevance of fat while identifying structures on the donor."

CONCLUSIONS: Based on our survey results it is clear that many students do not see the utility of learning from obese donors. Furthermore, they seem to be unaware of the need to consider fat distribution through a clinical lens and failed to recognize key organs where fat distribution may have clinical implications. We hope that by incorporating anatomy of fat education using donors and imaging early-on in the curriculum within a lab setting, will make students more attentive and aware of the clinical implications about fat. This will enhance their perceptions of obese patients and be well prepared for the clinical years.

REFERENCES: Butsch WS, Kushner RF, Alford S, Smolarz BG. Low priority of obesity education leads to lack of medical students' preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study. BMC Med Educ. 2020;20(1):23. Published 2020 Jan 28. doi:10.1186/s12909-020-1925-z.