H
S
Faculty Information
Course Syllabus
ORTH 3010
Topics: Ocular Motility I
Fall Semester, 2012
4 semester credits
Contact hours: 60 lecture
Mondays 3:15 – 5:00 pm
Tuesdays 3:25 – 5:00 pm
Old Main, 1 st floor, Room 103
Prerequisite: accepted student in Orthoptic major
Name: Lisa P. Rovick, MHSc, CO, COMT
Office location: Minneapolis Campus. Old Main #401
Phone: 651-690-7778 Cell: 612-716-4418
E-mail lprovick@stkate.edu
Office Hours: Mondays 10:00 – 12:30 (beginning October 1); by appointment
Course Description (from catalog)
This course introduces you to ophthalmology, including the role, duties and responsibilities of the orthoptist.
Ethics, professional associations and certification, and patient privacy and confidentiality (HIPAA) will be discussed. You will be introduced to the structure and function of the human visual system including the globe, orbit, ocular adnexa, extraocular muscles, conjunctiva, cornea, iris, pupil, angle structures, ciliary body, crystalline lens, vitreous, retina, optic disc, optic nerve, visual pathway and neuro-anatomy. Binocular vision, vision development and abnormalities such as amblyopia, neurologic control of eye movements and abnormalities will be discussed. You will learn and practice the elements and techniques of a basic sensorimotor evaluation, including evaluation of sensory status and measurement of eye alignment and eye
movements. This course will also include completion of a programmed text in medical terminology.
Course Goals
The overall goals for this course are to provide a knowledge and skill base upon which all of the additional courses in the orthoptic major are built:
Course Goal
1. Describe the structures and functions of the eye and visual pathway.
Liberal Arts Goal
Discipline-Based Competence
2. Describe fundamental concepts of eye movements and binocular vision. Discipline-Based Competence
3. Explain and demonstrate basic skills involved in an ocular and sensorimotor examination.
Discipline-Based Competence
4. Research the published Pediatric Ophthalmology and Orthoptic literature.
Critical and Creative Inquiry

5. Prepare and present findings of the above research to an audience. Effective Communication, Lifelong
Learning
LIBERAL ARTS GOALS
Ocular Motility I (ORTH 3010) advances the attainment of the University’s “Goals of a Liberal Arts Education”, generally, as this course prepares students to explore the nature of critical thinking in Orthoptics. Additionally, the following liberal arts goals are met in this course:
Leadership and
Collaboration
Ethics and
Social Justice
Diversity and
Global
Perspectives
Critical and
Creative
Inquiry
Discipline-
Based
Competence
Effective
Communication
Students collaborate in the preparation of the Evening
Seminar presentations and other group projects during the semester.
During case discussions students are reminded about respectful approach and sensitivity to patients with varying levels of ability.
Cultural differences are addressed in the context of case discussions
-research and discussion of topics that apply to the discipline of
Orthoptics.
-Students learn the underlying pathology of strabismus.
-Selection of appropriate examination techniques in the evaluation of the pathology introduced.
-Presentation at monthly
Evening
Seminars
Lifelong
Learning
Participation in monthly
Evening
Seminar, a continuing education event.

Learning Outcomes
Student Learning Objectives
Upon successful completion of this course, you will be able to:
1.
2.
3.
Instructional
Strategy
Describe the structures and functions of the brain, eye and orbit including:
In the anatomy lab: a.
identify the major structures of the brain b.
identify and trace the structures involved in the visual pathway from the optic nerve c.
identify cranial nerves II, III, IV,
V, VI as they exit the brain stem
Lecture, anatomy lab direct identification, group project
Programmed text, classroom discussion.
Deduce the meaning of a medical term through the understanding of the structure of medical terminology
Discuss the development of vision, the concepts of binocular vision and amblyopia.
Lecture, discussion, simulation
4.
Lecture, discussion, simulation
5.
6.
7.
List the elements and demonstrate proper technique used in the assessment of visual acuity, binocular vision and eye alignment.
Describe the different subspecialties within the field of eye care and the patient populations served by each.
Describe ethical clinical practice, as outlined in the Orthoptic Ethics
Statement.
Summarize, through a PowerPoint presentation, assigned peer reviewed journal articles and select appropriate supporting documentation to support these findings.
Discussion
Discussion, roleplaying
Presentation, lecture, discussion,
Method of Assessment
Weekly quiz, midterm and final examinations. Eye model project.
Weekly quiz, midterm, final examinations.
Weekly quiz, midterm and final examinations.
Weekly quiz, midterm and final examinations, clinical skill checklist.
Weekly quiz.
Midterm and final examinations.
Student peer review

Teaching/Learning Activities:
Instruction/facilitation methods include lecture, demonstration, skills laboratory sessions, and case-study learning.
Evaluation methods include written examination, writing exercises and assessment of Evening Seminar presentations.
Participation
Includes class and small group discussions
Percentage of final grade
1. Weekly Content quiz
Weekly content quiz (based on material presented and discussed during previous week) 10 pts./quiz
2. Eye Model Group Activity
Students will design and build a working model of a globe, with all extraocular muscles and their respective cranial nerves, suspensory ligaments and other structures involved in the rotation of the globe in the orbit.
3.. Monthly Evening Seminar presentation
-Preparation of presentation (clarity, logical sequence, citations present) 20%
-Demonstrates understanding of material presented 30%
-Clarity of presentation 30%
-Evaluations from audience and peers 20%
4. Midterm and Final Examinations written comprehensive examination at midterm and end of semester
25%
5%
10%
30% per exam
Grading Policies
The final course grade for Ocular Motility I (ORTH 3010) is as follows:
Final Percentage
90 – 100
80 – 89
Final course grade
A
B
70 – 75
60 – 74
< 60
C
D
F
A final percentage of 75 or greater in this course is required for continued enrollment in the orthoptic major.
Exceptions to this rule may be made at the discretion of the program director.
ASSIGNMENTS: All students are expected to turn in assignments by the DUE dates. Every assignment for this class must be completed in order to receive a final grade for the course. It is your responsibility to contact the course instructor in advance of the due date, if you are struggling with an assignment or if you need an extension.
EXCUSED ABSENCES: Make up course requirements (exams, quizzes, projects, etc) must be rescheduled at a mutually convenient time. It is your responsibility to arrange a make-up schedule with the course instructor IN ADVANCE.
UNEXCUSED ABSENCES: make-up course requirements that were missed must be completed by the student within
three (3) school days of their original date. If not completed within this time frame, the total point value of the course requirement is forfeited.
INCOMPLETE GRADES: “A grade of incomplete is given only when unusual circumstances deem it appropriate.
Ordinarily, such circumstances would involve matters that are not wholly within a student’s control, such as illness. If you wish to receive an incomplete grade you must complete a Petition for Incomplete Grade form
(available online http://minerva.stkate.edu/RecOffFrms.nsf/Incomp4?OpenForm )

no later than the last day of the term in which course requirements are due. You must be making satisfactory progress in the course and you must have completed 75% of the course at the time the petition is filed. Incompletes are awarded at the instructor’s discretion. If granted, the normal deadline for completion of work is no more than eight weeks after the last day of classes in the session or sub-session in which the course is offered. The instructor may establish a due date after the normal deadline if you request it and special circumstances warrant it. The instructor will submit an alternate grade that will automatically be recorded if you do not complete the requirements for the course by the deadline. If you complete the course requirements in the time allotted, the instructor must submit the final grade by the deadline. Extensions to the due date originally agreed to by you and your instructor must be approved by the appropriate academic dean.” (Petition for an Incomplete Grade, from St. Catherine University Catalog).
REQUIRED EVALUATION ACTIVITIES
Weekly content and Medical Terminology quizzes
(the lowest scoring quiz in each section will be dropped)
Eye model group activity
Evening Seminar presentations
PERCENTAGE OF GRADE
25%
5%
10%
Midterm examination
Comprehensive final examination
TOTAL
30%
30%
100%
Textbooks and Other Required Materials
REQUIRED:
Medical Terminology… A Programmed Systems Approach 9 th year….we’ll use 9 th
edition revised (there is a new edition out this
edition…less expensive) Authors are Dennerll, Jean Tannis & Davis, Phyllis E. ISBN: 1-
4180-2021-4
JCAHPO/ATPO Pocket Guide order this from the JCAHPO web site. http://www.jcahpo.org/pdfs/Pock_Guide_Order_Form.pdf
Handbook of Pediatric Strabismus and Amblyopia Wright, K., Spiegel, P, & Thompson, L. ed Springer 2006.
ISBN: 0-387-27924-5 e-ISBN: 0-387-27925-4
Fundamentals for Ophthalmic Technical Personnel. Cassin, B. W. B Saunders, 1995. ISBN: 0-7216-4931-9
Binocular Vision And Ocular Motility. vonNoorden, Gunter Available online (you may print your own copy, if you prefer to read on paper) through Cybersight: http://www.cybersight.org/bins/content_page.asp?cid=1-
2193
Purchase from instructor:
Orthoptic Syllabus $100.00
The Orthoptic Basic Science Lecture Series on DVD, with manual $75.00
Basic Clinical & Science Course. Section 5 (Neuro-Ophthalmology). Published by the American Academy of
Ophthalmology ISBN: 978-1-61525-294-7 ~$90.00 (you’ll get this a bit later in the semester)
OPTIONAL:
Management of Strabismus and Amblyopia A Practical Guide second edition. Pratt Johnson, Tillson ISBN: 0-
86577-992-9 (you don’t need to purchase this one, but it’s a good one to have)
Clinical Orthoptics, 2 nd ed. Rowe , Fiona. Blackwell Publishing, 2004 ISBN: 1-4051-1342-1 (this is a required text for the spring semester)

Learning Resources
• This is a Desire 2 Learn supported course. Course documents will be uploaded to this portal, which may be accessed at: https://stkate.desire2learn.com/
Your USERNAME and PASSWORD will be the same as in KateWay.
If needed, please call the HELP DESK at 651-690-6204.
• It is your responsibility to check D2L DAILY for messages, updates, assignment folders, websites, and other support material for this course.
ATTENDANCE
St. Catherine University defines attendance as participating in the faculty and student interaction required by the course. Regular attendance is expected of all students. Students are expected to arrive at class on time and stay for the duration of the class. Students, whether present or not, are responsible for in–class content and class assignments (see Assignments section). Absences for any reason will be taken into account in the evaluation of the student’s work.
If you cannot get to class (e.g. illness, car won’t start, relative dies), contact the instructor before class begins. Instructors must be informed about any absence before class or it will be unexcused .
Students who do not attend class on the first day of class will be withdrawn from the course by the
Registrar’s Office. Even if the student does not attend class meetings, the student remains financially responsible for paying tuition for the course, up to the date of formal withdrawal. The deadlines for adding, dropping and withdrawing from a course are found on the Academic Calendar (on Kateway).
ACCOMODATIONS
Saint Catherine University is committed to equal access for all and recognizes that disability is an aspect of diversity. The University’s goal is to create learning environments that are usable, equitable, inclusive and welcoming. If there are aspects of the instruction or design of this course that result in barriers to the learning environment, accurate assessment or your achievement, please contact the Resources for
Disabilities office as soon as possible. Access Consultants can be reached in the O’Neill Center at 651-690-
8160 to discuss academic adjustments or accommodations.

ACADEMIC INTEGRITY POLICY
The mission of St. Catherine University provides for excellence in education through the search for truth and justice. In accordance with the mission, the University expects all students and faculty to uphold the highest standards of academic integrity, and acts of academic dishonesty will not be tolerated. Academic dishonesty includes, but is not limited to, the following examples of conduct:
 violating the academic rights of another student;
 cheating on assignments or exams, including the use of crib notes or other unauthorized materials;
 submitting papers or assignments written by another person (student, commercial agency, etc);
 copying from another student's paper;
 stealing copies of exams or answer sheets;
 conveying test items to other students;
 plagiarizing on papers and other assignments;
 consenting to have one's work used by another student as her/his own;
 falsely reporting information or misrepresenting actions in clinical or classroom laboratories;
 depriving other students of necessary course materials by stealing books, periodicals or other materials from the library, media center, labs, etc.;
 submitting the same paper, or substantially similar papers, to meet the requirements of more than one course without approval of the appropriate instructors;
 interfering in a harmful way with another student's work, such as sabotaging another student's laboratory experiment or entering or deleting data in another student's computer account or
 unlawfully duplicating copyrighted materials.
CONDUCT AND ACADEMIC INTEGRITY PLEDGE
Each student is expected to adhere to all Orthoptic Program Student Policies and Procedures including the following Conduct and Academic Integrity Pledge.
I, _______________________________________________________, pledge to uphold the ideals of
St. Catherine University that learning be pursued in a spirit of excellence, life be lived with a commitment to values of justice and caring, and leadership be carried out appropriately, actively and positively. Having read the Orthoptic Ethics Statement and the Policy on Academic Integrity, I hold myself bound to respect and obey it in all matters of personal conduct and academic integrity.
(Students will be asked to sign this learning contract at the beginning of the Orthoptic Program to indicate their acceptance of these expectations.)
REAFFIRMATION OF CONDUCT AND ACADEMIC INTEGRITY PLEDGE
I re-affirm the St. Catherine University Orthoptic Program Conduct and Academic Integrity Pledge for this evaluation activity.
Student signature ______________________________________________ Date ______________
(This Reaffirmation of Conduct and Academic Integrity Pledge will be included on all exams, tests and written assignments, with the student’s signature and date, indicating their adherence to this pledge.)

When academic dishonesty is alleged, the faculty member will immediately discuss with the student the grounds for suspicion and educate the student about the academic integrity policy and the consequences for violating the policy. If the faculty member determines that a violation has occurred, she/he will check with the Academic Affairs Office on her/his campus to inquire if the student has been reported previously for violations of the Academic Integrity Policy. The Academic Affairs Office maintains a database of past offenses; however, these notations do not become a part of a student's permanent academic record unless they are the basis for expulsion from the University. The faculty member will forward a description of the violation, a copy of the evidence, and a proposed sanction to the Academic Affairs Office.
The Associate Dean for Academic Affairs Bonnie LaDuca, as well as the faculty member's department chair or program director, will be available to consult with the faculty member regarding an appropriate sanction, based in part on the severity of the infraction and whether the student had a prior history of such offenses. Faculty-determined sanctions will generally involve a reduced grade or zero credit on the assignment, test, or project or a reduced or failing grade in the course. For very serious offenses, the department chair or program director may impose the penalty of dismissal from the student's academic program. For the most serious offenses, the academic dean or her/his designee may impose the penalty of academic suspension or expulsion from the University.
For a more detailed explanation of the Academic Integrity Policy, consult the online Le Guide: Student Code of Conduct and Community Expectations. Pay particular attention to sections III. Code of Conduct, IV.
Sanctions resulting from Code violations, and VIII. Academic Integrity. Faculty members can find additional guidelines on the Academic Affairs website.

Tentative Class Schedule (subject to change, as needed) Ocular Motility I Fall Semester 2012
Week
Tues,
9/11 topic
Mon, 9/10 Skull, orbits, brain, blood supply
Globe, muscles, nerves, cranial nerves
Homework/readings
Med Term Unit 1 Cassin Chapters 2-3 http://memo.cgu.edu.tw/cgmj/3303/330310.pdf ongoing throughout the semester: Orthoptic Basic Science Series DVD: Ocular Anatomy
Orthoptic Syllabus p. 2-3,10-12
Med term quiz unit 1 vonNoorden Chapter 3,6
Cassin Chapter 1, 6, 10, pg. 307-308
Wright Chapter 2: pp 24-60
Orthoptic Syllabus p. 7-9, 12-14
Mon. 9/17 Eyelid, tears, conj. & cornea
Tues,
9/18
Fixation, Eye movements, Hering,
Sherrington Laws, positions of gaze , axes of rotation (Fick, etc)
Med Term Unit 2 Cassin p. 3-6, 397-399
Med Term quiz unit 2
Orthoptic Syllabus p.3-5
Cassin pg 161-163, 278-279, Chapter 21
Wright Chapter 2: pp 61-67 ongoing throughout the semester: Orthoptic Basic Science Series DVD: Oculomotor Physiology of the Eyes
Syllabus p. 24-26
Mon,
9/24
Tues,
9/25
Tenon’s, episclera, sclera, angle structures, uvea
Visual development, age-appropriate vision testing
Med term unit 3 Cassin p.6-8, 406-418
Syllabus 5-6, 17-18
Med term quiz unit 3
Cassin pg. 157-163
Wright Chapter 1: pp 1-12, Chapter 4 vonNoorden Chapter 14
Article: Dissociation of processing of featural and spatiotemporal information in the infant cortex http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WNP-50G0678-
1&_user=1822421&_coverDate=07%2F05%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&vi ew=c&_acct=C000054564&_version=1&_urlVersion=0&_userid=1822421&md5=4bf825352d72b0bc5171c7ba36e ac689 ongoing throughout the semester: Orthoptic Basic Science Series DVD: Amblyopia

Mon, 10/1 Lens, vitreous, retina, color vision, optic nerve
Med term unit 4 Cassin Chapter 5, p.397, 424-426
Syllabus p. 6-7, 12
Tues,
10/2
Tues
10/9
Tropia/phoria. Basic types of strabismus
(includes Dissociated strabismus)
Mon, 10/8 Clinical Discussion
Visual pathway, visual fields, pathology
Med term quiz unit 4
Med term unit 5
Evening seminar prep. Med term quiz unit 5
Cassin Chapter 20
Wright Chapter 3: pp. 84-94
Syllabus
Cassin Chapter 7, 16
Syllabus ongoing throughout semester: Orthoptic Basic Science DVD: Neuro Anatomy
Evening seminar prep. and practice
Mon,
10/15
Mon.
10/15
Tue,
10/16
Clinical Discussion
Cover tests, corneal reflex tests
(Hirschberg/Krimsky)
Recording results
Med term unit 6 Cassin Chapter 20
Wright Chapter 5:pp. 143-160
Syllabus
Evening Seminar 6:30-8:00 pm
AMBLYOPIA (anatomy & physiology of amblyopia, types of amblyopia, traditional/historical treatment, treatment recommendations from ATS studies, looking to the future; clinical pearls)
Review
MIDTERM
EXAM
No med term quiz. Review: 3-4 pm
Midterm Exam: 4-5 pm
Two part examination: Part 1: Ocular A&P, terminology through unit 6 (30 points)
Part II: Ocular Motility topics

Mon,
10/22
Tues,
10/23
Mon,
10/29
Clinical
Discussion
Neuroanatomy intro (circle of
Willis, cranial nerve pathways, chiasm)
Med Term unit 7
Med term quiz unit 7 Sensory fusion, motor fusion,
Panum’s area, monofixation, retinal correspondence
Clinical
Discussion
More
Neuroanatomy
Cerebellum
Med term unit 8
Tues,
10/30
Fusional amplitudes, accommodative amplitudes,
Near reflex
Mon, 11/5 Clinical
Discussion
Pons and cranial nerve nuclei
EYE MODEL
DUE
Med term quiz unit 8
Med term unit 9
BCSC Neuro Ophth. Pg 20, 27-37,
50-55, Chapter 11
Cassin Chapter 6, 8, 10
CASSIN pg. 278-282
Wright Chapter 3: pp. 70-83, Chapter 6: pp 174-188
Basic Science Series DVD: Abnormal Binocular Physiology of the Eyes
BCSC Neuro Ophth pg 48-49, 52
Cassin Chapter 8
Cassin pg 15, 139-145, 170, 194-195, 282-287
Wright pp. 90-100 vonNoorden
Cassin Chapter 10
BCSC pg. 51-62

Tues,
11/6
Mon
11/12
Tues,
11/13
Mon,
11/19
Tues
11/20
Mon
11/26
Diplopia: monocular, binocular
Diplopia vs confusion
NO LECTURE
Med term quiz unit 9 BCSC Chapter 8
Wright pp. 174-178, 188-204
NO LECTURE
Clinical
Discussions
Introduction to paralytic and supranuclear disorders (neuro ophthalmic disorders)
Med term unit 10
Evening Seminar
Prep
Med term quiz unit 10
Med term unit 11, 12 Cadaver lab session
Clinical
Discussion
Pupil function, includes pupil
NO LECTURE (make up = Evening Seminar)
Please go to assigned clinic
NO LECTURE (make up = Evening Seminar)
Please go to assigned clinic
Cassin Chapter 9
BCSC pp. 37-41, Chapter 7
Wright pp. 423-440
Evening Seminar Prep
Meet in St. Paul
Neuro anatomy review
Ocular and orbital anatomy dissection (guided)
Video: http://www.medicalvideos.us/play.php?vid=87

Mon.
11/26
Tues,
11/27 pathway
Pupil disorders, testing
Mon, 12/3 Clinical
Discussion
Torticollis: ocular and nonocular
Non-organic
(Functional) vision loss
Med term quiz unit 11,
12
Med term unit
13, 14
Syllabus p. 17-18
Evening Seminar 6:30-8:00pm VISION SCREENING DEBATE
Olivia McKinley, Laura Olson, Rhea Curtis screening vs. comprehensive eye exam
Dimitra Triantafilou, Emily Dockendorf, Trish Walsh photoscreening vs. critical line testing
BCSC Neuro-Ophthalmology (Section 5) Chapter 15 starting page 169.
Watch YouTube videos on Horner’s, APD, Adies, normal pupil testing, neutral density filters for grading APD
Cassin Chapter 22
BCSC Chapter 13, pg 247
Tues.
12/4
Spectacle problems related to strabismus, prism correction
Med term quiz 13, 14 Cassin pp. 286-287
Mon.
12/10
Tues,
12/11
Final Exam review
Med term unit 15 + review
Evening Seminar
Prep
Med term quiz unit 15
Date TBD FINAL EXAM
(written)
Review
Evening Seminar prep
Final exam review session, if time
2 parts: Ocular A&P + Terminology 1 hour
Ocular Motility 1 hour

Mon.
12/17
J-term
Evening Seminar 6:30-8:00 pm
Evidence-based orthoptic practice
Speakers: Olivia McKinley, Trish Walsh Cochrane studies of X(T)
Rhea Curtis, Dimitra Triantafilou
January 2-31,
2013
Emily Dockendorf, Laura Olson: Cochrane studies of amblyopia therapy
Happy New Year!
Report to your clinic. Please contact your assigned clinic and make arrangements for the first day
Anatomy Lab
Students in the course will have the opportunity to have a session in the anatomy lab after studying the structures of the brain in the classroom and in text and diagrams
Prior to attendance in the anatomy lab, students will complete training in the required protocol and other lab procedures
Consent and protocol forms are below. The link to the orientation video is http://mediamill.cla.umn.edu/mediamill/embed/18412

With regards to anatomy lab participation at St. Catherine University, students, faculty and staff are required to follow these policies.
1. No cell phones and/or cameras are allowed in the laboratory. Videotaping or photographing the human anatomical material is strictly prohibited without the prior consent of St. Catherine University’s anatomy lab director and the Anatomy Bequest Program Proposal Review Committee at the University of Minnesota, including but not limited to any images which will published or distributed.
2. Students, faculty and staff shall track all loaned human anatomical material by keeping the donor’s acquisition number tag with the donor at all times during the loan. If the tag becomes disassociated from the donor, the course instructor should be contacted immediately, who then will notify the St. Catherine University anatomy lab director. All tissue removed from the donor during dissection must be retained, identified with the donor’s acquisition number, tracking during the loan and returned at the completion of the loan.
3. Anatomical material must not be removed from the dissecting laboratory.
4. Only registered students, teaching assistants and faculty/staff members can access the human donors and/or anatomical material. Visitors and guests are not allowed unless a written request for access is granted by the St. Catherine University anatomy lab director.
5. Both conversational and written language relating to the donor and donor dissection by human anatomy lab students, faculty and staff should be respectful and discrete. Any information about the donor including the donor’s demographical, social or medical history is confidential and students, faculty and staff are not allowed to disclose this information.
6. The use of the Internet in general, and social media sites in particular, including, but not limited to,
Facebook, MySpace, Twitter, etc., by students, faculty and staff as a venue for discussing any aspect of the donor or donor dissection is strictly prohibited.
7. Doctor of Physical Therapy Program and Physician Assistant program students: Any student who wishes to access the lab after standard business hours is required to have at least one other student in the same academic program present with them at all times in the anatomy lab.
8. Non-compliance with the above policies may result in a student being immediately expelled from the course with a failing grade. Students, faculty and staff who are not in compliance with these policies may be referred for further disciplinary actions such as a conduct review hearing, and/or criminal charges, as applicable.
January 2013

Each St. Catherine University student utilizing the Human Anatomy Lab is required to view the following orientation video and then print off and sign the disclosure form and return it to their faculty member PRIOR to accessing the
Human Anatomy Lab for the first time. http://mediamill.cla.umn.edu/mediamill/embed/18412
The opportunity to review and dissect the human body is a privilege afforded to only a limited number of individuals. It carries with it an important responsibility for treating the person who has given his/her own body to advance your education and research with utmost respect and dignity.
It is important that each individual appreciate the opportunity afforded and observe the policies outlined in the
Anatomy Bequest Program Human Anatomy Access Orientation. These policies have been set up to promote respect for the donor and success for you in the laboratory. Failure to adhere to these rules may result in your eviction from the Anatomy lab.
In order to have access to the human anatomical materials provided by the Anatomy Bequest Program, I verify that I have taken part in a Human Anatomy Access Orientation session either in person or by video.
I understand that my access to the human anatomical materials is a privilege, and all donations have been made by consenting individuals and/or families to better aid in anatomy education and research.
I understand that it is my responsibility to adhere to the policies of the Anatomy Bequest Program and additional laboratory policies outlined in the course syllabus or proposal form.
I understand that failure to comply with the established rules and policies regarding human anatomical materials may result in my eviction from the anatomy lab.
I also verify that to the best of my knowledge I do not know any Anatomy Bequest Program whole body donors who have died within the last two years.
If a donor is known, please leave this box unchecked, and fill
_____________________________________________
This disclosure form is to be signed, dated, and returned to the course/lab instructor for filing.
Print Name Date
Sign Name