The Unintentional Effects on Body Donation Programs of a Competency-Based Curriculum in Postgraduate Medical Education

As medical programs place increasing importance on competency-based training and surgical simulations for residents, anatomy laboratories, and body donation programs find themselves in a position of adapting to changing demands. To better assess the demand for “life-like” cadaveric specimens and evaluate the possible impacts that competency-based medical education could have upon the body donation program of McGill University, Canada, the authors tracked, over the course of the last 10 years, the number of soft-embalmed specimens, along with the number of teaching sessions and the residents enrolled in competency-based programs that are using cadaveric material. The results reveal that the number of soft-embalmed specimens used within residency training increased from 5 in 2009 to 35 in 2019, representing an increase from 6% of bodies to 36.5% of the total number of body donors embalmed in this institution. Correspondingly, the number of annual teaching sessions for residents increased from 19 in 2012 to 116 in 2019. These increases in teaching are correlated with increasing number of residents enrolled in competency-based programs over the last 3 years (Pearson r ranging from 0.9705 to 0.9903, and R² ranging from 0.9418 to 0.9808). Those results suggest that the new skill-centered curricula which require residents to perform specific tasks within realistic settings, exhibit a growing demand for “life-like” cadaveric specimens. Institutions’ body donation programs must, therefore, adapt to those greater need for cadaveric specimens, which presents many challenges, ranging from the logistical to the ethical.     

The Grand Challenges Discourse: Transforming Identity Work in Science and Science Policy

This article analyzes the concept of “grand challenges” as part of a shift in how scientists and policymakers frame and communicate their respective agendas. The history of the grand challenges discourse helps to understand how identity work in science and science policy has been transformed in recent decades. Furthermore, the question is raised whether this discourse is only an indicator, or also a factor in this transformation. Building on conceptual history and historical semantics, the two parts of the article reconstruct two discursive shifts. First, the observation that in scientific communication references to “problems” are increasingly substituted by references to “challenges” indicates a broader cultural trend of how attitudes towards what is problematic have shifted in the last decades. Second, as the grand challenges discourse is rooted in the sphere of sports and competition, it introduces a specific new set of societal values and practices into the spheres of science and technology. The article concludes that this process can be characterized as the sportification of science, which contributes to self-mobilization and, ultimately, to self-optimization of the participating scientists, engineers, and policymakers.