But the teacher isn’t a med school faculty member. She’s a doctoral candidate in �鶹ԭ��’s physical therapy program participating in an interdisciplinary session designed to better educate future doctors on human anatomy. She is one of three PT graduate students serving as teaching assistants during this year’s Anatomy Lab module.

“It’s a win-win situation,” says Daniel Topping, who directs the College of Medicine’s Anatomy Lab and began the physical-therapists-as-educators program. “Physical therapy students get more intensive anatomy training than our medical students because their profession is very anatomy dependent. They are so knowledgeable and great with the med students that it’s just like having another faculty member. It was an experiment that I think is going really well.”

The College of Medicine’s Anatomy Lab module is unique nationally. Cadavers are considered a student’s first patient. First-year medical students don’t just memorize organs and body systems – they become forensic detectives trying to determine their patient’s cause of death. PT students provide additional expertise, Topping says, because they have spent seven months studying in a cadaver lab compared with 17 weeks for med students.

The PT students — Combs, Akash Bali and Kelly LaMaster — were chosen based on their expertise and teaching experience. They come in every Friday for the four-hour lab, and teach under the supervision of Topping and other core and volunteer faculty.

“We get to open their eyes to what we do and offer them a different perspective on anatomy.” — Kayla Combs, physical therapy doctoral candidate

“What’s really good as physical therapy students, is that we get to open their eyes to what we do and offer them a different perspective on anatomy,” Combs says, “like having them pull on tendons to see what the muscle actually does, actually seeing that it flexes the finger or flexes the toe.”

“And in teaching them, we’re also teaching ourselves,” Combs says. “Our PT labs are purely about identification. For the med students, their lab is much more about investigating and asking questions, as they have to determine the cause of death of their ‘patient’. So it’s been fun to see them question things, whether or not an organ looks normal or not and I learned a lot too from that process.”

The PT students say the collaboration has been an opportunity to “get inside the mind of med students” which will give them a better understanding of the physician’s perspective as far as pathologies, clinical diagnoses and treatment.

“In the future when we need to talk to a physician about a patient we will know where the physicians mind is at or why they made the referral or recommendation,” LaMaster says. “When everyone is on the same page, the better the outcomes are going to be for the patient.”

Medical students enjoy the casual peer-to-peer interaction, which they say helps them learn better.

“Being students themselves, they understand what it is like to learn anatomy for the first time,” says medical student Kevin Boyd. “And so they’re able to sort of communicate a little differently than faculty, and we felt more comfortable asking them questions that we would probably be intimidated to ask faculty.”

“I think interprofessional collaborations such as these will provide a more well-rounded healthcare provider both for physical therapists and medical doctors.” — Patrick Pabian, program director for the Doctor of Physical Therapy program

With the development of �鶹ԭ��’s new Academic Health Science Center (AHSC), which will ultimately bring many �鶹ԭ�� health programs to Lake Nona, Topping says such collaborations are only the beginning of an exciting future for healthcare education.

“Anatomy is a discipline that’s so fundamental to all healthcare professions, speech therapy, physical therapy, nursing, anyone involved in direct patient care, and we have such a great facility here, so it’s just a great place for us to collaborate and to begin partnerships.”

He and other AHSC faculty hope to make such educational partnerships a staple for the new �鶹ԭ�� health sciences center. “It was a very easy decision to make when Dr. Topping approached us with this idea,” says Patrick Pabian, program director for the Doctor of Physical Therapy program. “I think interprofessional collaborations such as these will provide a more well-rounded healthcare provider both for physical therapists and medical doctors. Getting our students working together and becoming familiar with each other as much as possible is paramount because it’s really going to benefit patients in the future.”

“Look how small the esophagus is,” she says, examining her patient’s neck.  “Now I’m definitely going to chew my food a bit more knowing that it’s going down this small pipe into your stomach.”

“It’s definitely going to do wonders for me in helping me be a better nurse.” – Desiree dos Anjos, �鶹ԭ�� nursing student

Her “patient” was a cadaver, a person who had donated their body to help train medical students, and her “clinic” was the �鶹ԭ�� College of Medicine’s Anatomy Lab.  Dos Anjos was one of 10 �鶹ԭ�� College of Nursing students who trained in the lab with thanks to medical students who organized a one-day workshop Nov. 28.

“It’s been absolutely phenomenal,” dos Anjos says of her first experience learning from real humans. “I’ve learned so much, knowing how the different organs look and how they work inside the body instead of just looking at pictures in a textbook. It’s definitely going to do wonders for me in helping me be a better nurse, because I’ll have a fuller understanding of how everything actually works when I’m explaining procedures to my patients.”

The workshop was the brainchild of former critical-care-nurse-turned-�鶹ԭ��-medical student Will Pruitt. After getting trained in the during his first year of medical school, Pruitt realized how valuable such a learning experience would have been during his nursing education.

“So much of what I learned during the gross anatomy module would have been tremendously helpful in multiple facets of my nursing practice,” says Pruitt, who is now in his second year of medical school. “So, I wanted to give �鶹ԭ�� nursing students, starting with this small group, a unique learning experience that gives them an opportunity to bridge the gap between what they have learned in nursing textbooks and the actual human body.”

Only a handful of nursing schools utilize cadavers for their students’ learning. While the College of Nursing employs advanced simulation technologies, such as high-fidelity mannequins, virtual or screen-based patients, as well as clinical experience with real patients, cadaver-based learning experiences are not yet part of the curriculum.

“It’s clear from listening to the student interactions that there is much to learn and share between disciplines.” – Joyce Burr, �鶹ԭ�� College of Nursing lecturer

“The most exciting thing for me as an educator was the absolute total engagement and enthusiasm of both the nursing and medical students during this teaching and learning experience,” says Joyce Burr, associate lecturer at the College of Nursing who helped coordinate the event. “It’s clear from listening to the student interactions that there is much to learn and share between disciplines. The medical students are teaching but they are also learning from the nursing students, and it shows that each partner on the team has something valuable to contribute, and the end product is a healthy patient.”

Pruitt worked with three other medical students and Daniel Topping, the Anatomy Lab’s director, to design a workshop curriculum that allowed nurses to see and touch core parts of the anatomy and common pathologies and review common clinical scenarios like hernias and lung damage while peering into the human body. The nurses also flushed central lines, inserted tracheal tubes and used manual resuscitators to inflate balloons as simulated lungs with medical devices donated by the Osceola Regional Medical Center.

“Nurses are at the bedside helping to place and monitor these devices, but they never really get to see what lies beneath the skin,” Pruitt says. “So we want them to get a better understanding of where these devices are traveling and how they work once they are in the body, so it will assist them when putting these devices in, and also be able to picture exactly what happens when a device fails or migrates out of place.”

“Anatomy is fundamental to any discipline involved in direct care of patients, whether nursing, speech therapy, or pharmacology.” – Daniel Topping, �鶹ԭ��’s Anatomy Lab director

Before studying in the lab, nursing students watched a videotape about the experience and the impact of their patient’s gift to medical education. At �鶹ԭ��’s medical school, cadavers are considered the student’s first patient. Medical students talked to their nursing colleagues about honoring and respecting the person’s gift to their training. Pruitt will be analyzing the impact of the experience in a research study, and hopes his results will help make the program a staple for �鶹ԭ�� nursing students.

With the development of �鶹ԭ��’s new Academic Health Science Center, which will ultimately bring many �鶹ԭ�� health programs to Lake Nona and encourage more interprofessional education, research and patient care, Topping says the Anatomy Lab workshop can be a model for future collaborations between healthcare disciplines.

“Anatomy is fundamental to any discipline involved in direct care of patients, whether nursing, speech therapy, or pharmacology. And we have such a wonderful facility and resources here, which makes perfect sense for us to collaborate and begin partnerships,” he says.

“I also feel that our donors would want as many healthcare professionals as possible to benefit from their gift,” he added. “And what better way to do it than through these interprofessional collaborations.”

To view a video version of this story, visit 

On February 5, the students made a presentation called “The Life of Pi” that showed they believed their first patient had died of suffocation that left him brain dead. At the conclusion of their report, Team 9 learned they were right. Pi was a competitive swimmer who drowned while practicing breathing exercises.

Autopsy reports are an annual tradition for first-year �鶹ԭ�� medical students completing their Anatomy Lab module. Unlike most medical schools, �鶹ԭ�� doesn’t tell students their cadaver’s cause of death. Instead students conduct a forensic study of their first patient and use dissection, medical imaging, pathology and research to conclude how and why their patient perished. Students present their autopsy reports to a panel of faculty and only then learn the actual cause of death listed on their patient’s death certificate.

“The very first day I walked in the lab and saw (Pi) I thought I was going to cry,” said Kirsten Hosang, a Team 9 member.  “I was really overwhelmed, because I expected to have somebody older, around my grandparents’ age. All of us were around the same age and so we felt very connected to him.”

The cadavers are people who have willed their bodies to science to help train medical students. �鶹ԭ�� is one of three locations in Florida where people can make such a donation. This year’s first patients included a 24-year-old with cystic fibrosis who died of respiratory failure, an 81-year-old truck driver who showed signs of asbestos exposure, and a network engineer whose entire stomach was removed during his battle with cancer.

In their presentations, students thanked their patients for their generosity and being “silent teachers” who gave the future doctors lessons in anatomy, disease, dignity and death.

Team 18 had a 67-year-old teacher who was wearing hot pink nail polish when she passed away from lung cancer.

“She was a teacher in life and a teacher in death and we are very grateful to have been her last class of students,” one group member said.

Teams 11 and 17 received awards based on the quality of their presentation and the accuracy of their work. Winning teams will have their names engraved on a plaque in the Anatomy Lab and share a cash prize donated by Dr. Hariharier Subramanian, assistant professor of surgery at the College of Medicine.

Team 11’s patient was an 89-year-old nurse who suffered from Type 1 diabetes. She had developed diabetic ketoacidosis before her death.

“I remember we were all so timid doing the dissections the first couple weeks,” said student Zach Helm. “But the fact that our patient was a nurse, we felt like she really wanted us to learn so much from her and we did.”

In their presentation, Helm and the team told the story of the events leading up to the nurse’s death, beginning with her diagnosis of diabetes at a young age and now the disease gradually affected her body.

“Putting together the story was really a great experience,” Helm said. “We had to connect things in the right way in order for it to make sense; put the puzzle pieces together to find the right answer. And that’s what being a physician is about – asking the right questions and finding the right answers.”

That’s the goal of the Anatomy Lab module, said Dr. Deborah German, vice president for medical affairs and dean of the medical school.

“Anatomy is typically a memory-based course, but ours is a course in curiosity,” she said at the awards ceremony. “This course teaches you to think, learn and discover and this gives you an advantage when you become doctors.”

On Monday, the students will participate in a traditional “Send-Off Ceremony,” in which they pay tribute to their first patients.  Some who donate their bodies want them returned to their family for burial. The others are cremated and their ashes scattered in the Gulf of Mexico.

The winning teams are:

Team 11: Elle Crouse, Matthew Moench, David Heaner, Tryphina Mikhail, Zachary Helm, Yasmen Elsawaf

Team 17:  Eric Mason, Meena Kanhai, Amanda Cox, Jonathan Keyes, Nicholas Andrews, Ruhi Vasavada

“Growing up, I saw how that sort of technology changed his life as well our whole family and made it possible for him to live like a normal person,” Sleppy said. “So I want to use my engineering skills toward the medical field to be able to impact other people’s lives the way it impacted my family.”

Sleppy is among 15 �鶹ԭ�� engineering students who are getting to know the inner workings of one of the most intricately designs machines – the human body.

Thanks to a partnership between �鶹ԭ��’s College of Engineering and Computer Science and the College of Medicine, the first cohort of students in �鶹ԭ��’s new biomedical engineering (BME) master’s program are receiving a tactile introduction to the human anatomy.

The master’s program trains young engineers to design medical devices for implant within or on the body, such as heart pumps, pacemakers, and prosthetics. Most of the students have not had any real exposure to anatomy. So the College of Medicine’s Mechanics of Biostructures class is designed to give them a better understanding of the body’s structures.

College of Medicine faculty members Drs. Mohtashem Samsam and Robert Steward lecture the students on basic anatomy. Then the students have seven four-hour lab sessions with Dr. Daniel Topping, assistant professor of family medicine and anatomy. In the lab, the future biomedical engineers examine the musculoskeletal structure of cadavers – persons who have donated their bodies to help train medical students.

“We take them through various body systems including the lungs and chest cavity, spine and back, and the upper and lower extremities,” explained Topping. “The lab runs concurrently with the anatomy class for our first-year medical students and so the students are not required to do dissections as much of the work has already been done by the medical students. But they are able to touch and feel and we pay special attention to cadavers that are found to have medical devices or prosthetics. We’ve had donors with breast implants, hip replacements and a pacemaker.”

“It really humanizes the experiences when you’re seeing the body intact and as a whole system rather than just parts,” said student Katherine McGrane. “We learn so much from physically seeing and touching these innermost components that we’re used to seeing only in drawings. This give us a lot more insight on how we will go forward and design better medical implants and treatments.”

Program director and �鶹ԭ�� engineering professor, Dr. Alain Kassab said the collaboration provides an indispensable experience for the future biomedical engineers.

“For students that are working on cardiovascular flow, for example, it’s the first time they have seen what an aorta looks like in terms of the structure, the lumen and the actual geometry of these vessels,” he said. “So this will make them better modelers and better at providing solutions for medical problems.”

Kassab said he is motivated by the feedback he has received from faculty and students involved in the joint program. “There are a lot of BME programs that don’t offer such an opportunity and we think that we’ve got something that’s very unique,” Dr. Kassab said. “This collaboration between the College of Medicine and the College of Engineering certainly builds bridges and we are looking forward to expanding this relationship in terms of pedagogical developments and research.”

The paramedics from Casselberry’s two fire stations spent four days in the �鶹ԭ�� College of Medicine’s state-of-the-art Anatomy Lab and learned from faculty and fourth-year medical students who had aced the Anatomy module. “This gives us a sense of human anatomy from the inside, which is something we don’t see,” said Meredith Walker, the Fire Department’s Quality Assurance Officer who is a paramedic and helped organize the training.

The first responders have a range of experience, from nine months to 26 years, and had been trained with mannequins, models, books and movies. The medical school’s lessons came thanks to people who had willed their bodies to science, a gift that was discussed with reverence before class began.  Then, clad in protective gowns, boots and gloves, the first responders saw how pacemakers are attached to diseased hearts. They felt the lungs of patients who had suffered from cancer and emphysema. They saw how calcium builds up in the arteries. And they practiced getting blood samples from bone – a process used with injured children whose veins are too tiny to pierce.

“This was a great opportunity to get hands-on practice,” said firefighter-paramedic Diane Meadows, who is also a registered nurse. “We deal with emergency situations in the field, and have very limited opportunities to get extra training with real cadavers. In my 20 years, this is the first real exposure that has been so beneficial.”

Paramedics brought to the lab the tools they use in the field so they could see how treatment impacts internal organs. They witnessed how intubation actually fills the lungs with air and how pumping air too quickly – which can happen in a high adrenaline emergency – causes the lungs to inflate too much.

Walker initiated the learning partnership, reaching out to �鶹ԭ�� after learning about its lab and willed body program on medical school web site. Working together, the Fire Department and the College of Medicine arranged the cadavers, set up the learning stations and the curriculum. “We approached the college, and they were very open to the idea,” said Casselberry Fire Department Battalion Chief Theresa Krebs. “We’ve felt that eagerness to do the partnership from our first meeting on.”

Casselberry’s Fire Department responds to about 4,500 calls a year in the small Seminole County community. Of those, 70 percent of those are emergency medical calls. The first responders said seeing human anatomy and impact of disease from the inside will help them provide better care to patients during an emergency. And the learning experience was also an eye-opener for medical educators and students. They learned about real-life trauma injuries and the challenges to make lifesaving decisions quickly with only the tools at hand.

“This experience has made me a better teacher,” said Dr. Andrew Payer, professor of anatomy at the College of Medicine who runs the Anatomy Lab. “In this partnership, we both benefit. The paramedics have more confidence in their knowledge of human anatomy. They have a deeper understanding of how their actions impact the body. These first responders are helping people in trouble. And who knows? Maybe someday, one of them may be helping one of my family members.”

To view a video version of this story, please visit

The LCME is the nationally recognized accrediting authority for medical degree education programs in the U.S. and Canada. An LCME survey team visited the college in February and evaluated its progress in meeting 132 standards. Those standards include requirements for classroom and clinical training, educational resources, faculty and budgeting. Full accreditation will not be determined until 2013, when the school’s charter class is in the fourth year of the program.

“I am delighted with the LCME’s decision and am especially proud of the College of Medicine team – our faculty, students, staff and community partners — who are responsible for our extraordinary success,” said Dr. Deborah German, vice president for medical affairs and founding dean of the college. “While we are still very young, we are on track to becoming the nation’s premier 21st century college of medicine.”

The college has 100 students and will enroll its third class of 80 students in August. The charter class recently began its clerkships at area hospitals and clinics.

The medical school, which admitted its first class in 2009, has already gained a reputation for innovation. The school’s new medical education building houses a state-of-the-art anatomy lab and digitally enhanced classrooms. It has drawn visitors from around the world looking for ways to integrate technology into their educational and health facilities back home.

This week, an international audiovisual conference at the Orange County Convention Center will feature those high-tech learning environments and participants will tour the medical school.

But technology alone doesn’t make a premier medical school. Community service is another keystone of the college. In April, the college received the Paul R. Wright Award from the American Medical Student Association in recognition of the students’ volunteerism and leadership as future healthcare leaders. And today the college will host 30 high school seniors who are part of Florida Area Health Education Center, a program dedicated to recruiting and educating them about caring for the state’s growing medically needy population.

The three students said participants at the geriatrics conference were eager to learn how a new medical school brought innovation to its curriculum. “As a new college of medicine, we have the ability to make change a lot faster,” Christina said. “Older medical schools said this was something they would never be able to do. They were asking a lot of questions about how Anatomy Lab was set up as a medical mystery — we don’t know what our first patients died of but have to discover that through the 17 weeks. The other schools were saying, ‘Why didn’t we think of that?'”

The College of Medicine presentation was one of five top geriatric education projects that conference organizers chose to be presented.

While at the conference, the �鶹ԭ�� team shared information about the new medical school and the students, who have formed a Geriatric Interest Group (GIG), learned ways to encourage others to be interested in geriatric medicine.

Malgorzata and Reid said they became interested in geriatric care in part from their volunteer efforts with local hospice organizations. “I loved to listen to their stories,” Malgorzata said of the hospice patients. “They always had such words of wisdom to share.”

In a send-off ceremony that is a medical school tradition at the end of Anatomy Lab, the 60 M-1 students lit candles, presented white roses and spoke about the “precious souls” who had not only taught them science, but also important lessons about life, death and giving back.

At first, “we were frightened to meet you,” said M-1 Omar Shakeel as he described the four-month Anatomy Lab. “Then you began to teach us. You had the answers to our questions. We are grateful for the lessons we will have for the rest of our lives and will be used to save others one day.”

In opening the ceremony, Class of 2014 President Robert Palmer asked classmates to “remember the sacrifice these patients made for us.” M-1 Social Chair Christina Hsu read a tribute written by a Connecticut medical school professor whose mother donated her body to science. The professor had mixed feelings about the donation but realized that her mother’s decision illustrated her love of education and science and her belief that a single person can make a difference. “Study me hard,” the writer said her mother would tell young medical students.

Faculty members compared the send-off ceremony to how they had left Anatomy Lab years ago. There was no chance to reflect, no closure, no chance to express gratitude for the patient’s dedicated gift to helping others. Dr. Jim Sanders, who spoke for Anatomy Professor Andrew Payer, told of a young man dying of a brain tumor who donated his body to Dr. Payer’s medical school lab in Galveston, Texas. Dr. Payer talks frequently about the terminally ill young man and the message he wanted Dr. Payer to give to his medical students: “Tell them I’m a good guy and I hope they learn a lot from me.”

Dr. Richard Peppler, associate dean for faculty and academic affairs, asked the medical students to remember that the donors were “fathers, mothers, sisters, brothers, aunts and uncles. Celebrate what they have contributed to your education.”

As a permanent tribute to the donors, the Class of 2014 will place a brick in the future piazza at the College of Medicine. The brick will be inscribed with these words:  “Beyond flesh, you are woven into the fabric of our future. Beyond words, your spirit is threaded through our lives.”

M-1 students say they hope the pumpkin carving will become a yearly tradition at the college and were even joined by a little white puppy named Jack, who belongs to M-1 Samantha Ulmer.

Top carver awards are open to debate, but the general consensus is that the M-1s mostly likely to become surgeons based on their pumpkin-carving abilities are Pouya Ameli and Omar Shakeel. “They tried very hard to carve an anatomical heart into the pumpkin,” Stacie said. “Let’s see if those skills translate to the Anatomy Lab.”

The art is displayed outside the College of Medicine’s new state-of-the-art anatomy lab.

Jimenez began studying anatomy after suffering serious injuries in a car accident. She took human dissection courses at the University of South Florida and became certified in kinesthetic anatomy, massage therapy and personal training. “I believe the body is a spiritual thing and during dissection you see that the skeleton is a map of the body. It reflects the life and the injuries of the person. I couldn’t imagine a more appropriate place for my artwork to be than the College of Medicine’s Anatomy Lab,” she said.

Andrew Payer, professor of anatomy at the College of Medicine, welcomed the artwork at the lab he helped design. “I think the donation is awesome,” Payer said. “It’s a blend of anatomy with art. And medicine is certainly a mixture of science and art.”