Anonymous body or first patient? A status report and needs assessment regarding the personalization of donors in dissection courses in German,Austrian, and Swiss Medical Schools

Many Anglo‐American universities have undertaken a paradigm shift in how the dissection of human material is approached, such that students are encouraged to learn about the lives of body donors, and to respectfully “personalize” them as human beings, rather than treating the specimens as anonymous cadavers. For the purposes of this study, this provision of limited personal information regarding the life of a body donor will be referred to as “personalization” of body donors. At this time, it is unknown whether this paradigm shift in the personalization of body donors can be translated into the German‐speaking world. A shift from donor anonymity to donor personalization could strengthen students' perception of the donor as a “first patient,” and thereby reinforce their ability to empathize with their future patients. Therefore, this study aimed to collect data about the current status of donation practices at German‐speaking anatomy departments (n = 44) and to describe the opinions of anatomy departments, students (n = 366), and donors (n = 227) about possible donor personalization in medical education. Anatomy departments in Germany, Austria, and Switzerland were invited to participate in an online questionnaire. One‐tenth of registered donors at Ulm University were randomly selected and received a questionnaire (20 items, yes‐no questions) by mail. Students at the University of Ulm were also surveyed at the end of the dissection course (31 items, six‐point Likert‐scale). The majority of students were interested in receiving additional information about their donors (78.1%). A majority of donors also supported the anonymous disclosure of information about their medical history (92.5%). However, this information is only available in about 28% of the departments surveyed and is communicated to the students only irregularly. Overall, 78% of anatomy departments were not in favor of undertaking donor personalization. The results appear to reflect traditional attitudes among anatomy departments. However, since students clearly preferred receiving additional donor information, and most donors expressed a willingness to provide this information, one could argue that a change in attitudes is necessary. To do so, official recommendations for a limited, anonymous personalization of donated cadaveric specimens might be necessary. Anat Sci Educ 11: 282–293. © 2017 American Association of Anatomists.     

Anatomy education in a changing medical curriculum in India: Medical student feedback on duration and emphasis of gross anatomy teaching

Authors report here a survey of medical student feedback on the effectiveness of two different anatomy curricula at Christian Medical College, Vellore, India. Undergraduate medical students seeking the Bachelor in Medicine and Bachelor in Surgery (M.B.B.S.) degrees were divided into two groups by the duration of their respective anatomy curriculum. Group 1 students had completed a longer, 18‐month curriculum whereas Group 2 counterparts followed a shorter, 12‐month curriculum. Students' responses to a questionnaire were studied. Analysis of feedback from Groups 1 and 2 contrasted the effectiveness of the two anatomy curricula. The coverage of gross anatomy was rated adequate or more than adequate by 98% of Group 1 and 91% of Group 2. A desire for greater emphasis on gross anatomy teaching was expressed by 24% of Group 1 and 50% of Group 2 (P = 0.000). Two‐thirds of all students felt that the one‐year program was not adequate, and 90% of Group 1 and 74% of Group 2 felt that clinically oriented anatomy teaching required more emphasis. Dissection was helpful or very helpful for 94% of Group 1 and 88% of Group 2. This study suggests that a better understanding of gross anatomy was gained from a course of longer duration (18 months with 915 contact hr vs. 12 months with 671 contact hr). Students who completed the longer anatomy course had greater appreciation of the need for clinically oriented anatomy teaching and dissection. Anat Sci Educ 2:179–183, 2009. © 2009 American Association of Anatomists.     

Contrast in usage of FCAT‐approved anatomical terminology between members of two anatomy associations in North America

Almost 12 years since the publishing of Terminologia Anatomica (TA) by the Federative Committee on Anatomical Terminology (FCAT), there has yet to be a unified adoption of FCAT‐recommended anatomical terms by North American anatomists. A survey was sent to members of the Human Anatomy & Physiology Society (HAPS) to compare the frequency of FCAT term usage with a previous study involving the American Association of Anatomists (AAA). The HAPS differed from AAA in being composed mostly of biologists (56.5%) who teach anatomy with only 18.3% of respondents having terminal degrees in anatomy. The survey included the same 25 sets of synonymic names for selected gross anatomical structures or related terms used for the AAA survey. Overall results indicate that the FCAT preferred term had the highest frequency of usage in only 40.0% of the survey questions, demonstrating 4% lower compliance than AAA respondents. Compliance with FCAT preferred terms ranged from 92.2% to 1.7% usage. When compared with AAA anatomists, there were reversals in predominant usage between FCAT and non‐FCAT terms for six sets of anatomical structures: HAPS respondents predominantly used non‐FCAT terms for adrenal gland (88.7%), antecubital fossa (57.4%), patellar tendon (65.2%), ligamentum capitis femoris (36.5%), while preferring the FCAT anterior circumflex humeral artery (45.2%) and anterior/posterior preferred over ventral/dorsal (41.7%). Almost 54% of HAPS anatomists were not familiar with the FCAT, nearly 21% higher than the AAA. Anat Sci Educ 3:25–32, 2010. © 2009 American Association of Anatomists.     

Lessons to be learned from the history of anatomical teaching in the United States: The example of the University of Michigan

Although traditional departments of anatomy are vanishing from medical school rosters, anatomical education still remains an important part of the professional training of physicians. It is of some interest to examine whether history can teach us anything about how to reform modern anatomy. Are there lessons to be learned from the history of anatomical teaching in the United States that can help in the formulation of contents and purposes of a new anatomy? This question is explored by a review of US anatomical teaching with special reference to Franklin Paine Mall and the University of Michigan Medical School. An historical perspective reveals that there is a tradition of US anatomical teaching and research that is characterized by a zeal for reform and innovation, scientific endeavor, and active, student‐driven learning. Further, there is a tradition of high standards in anatomical teaching through the teachers' engagement in scientific anatomy and of adaptability to new requirements. These traditional strengths can inform the innovation of modern anatomy in terms of its two duties—its duty to anatomy as a science and its duty toward anatomical education. Anat Sci Educ 3:202–212, 2010 © 2010 American Association of Anatomists.     

Explorable three‐dimensional digital model of the female pelvis,pelvic contents,and perineum for anatomical education

The anatomy of the pelvis is complex, multilayered, and its three‐dimensional organization is conceptually difficult for students to grasp. The aim of this project was to create an explorable and projectable stereoscopic, three‐dimensional (3D) model of the female pelvis and pelvic contents for anatomical education. The model was created using cryosection images obtained from the Visible Human Project, in conjunction with a general‐purpose three‐dimensional segmentation and surface‐rendering program. Anatomical areas of interest were identified and labeled on consecutive images. Each 2D slice was reassembled, forming a three‐dimensional model. The model includes the pelvic girdle, organs of the pelvic cavity, surrounding musculature, the perineum, neurovascular structures, and the peritoneum. Each structure can be controlled separately (e.g. added, subtracted, made transparent) to reveal organization and/or relationships between structures. The model can be manipulated and/or projected stereoscopically to visualize structures and relationships from different angles with excellent spatial perception. Because of its ease of use and versatility, we expect this model may provide a powerful teaching tool for learning in the classroom or in the laboratory. Anat Sci Educ. © 2010 American Association of Anatomists.     

A human dissection training program at Indiana University School of Medicine‐Northwest

As human cadavers are widely used in basic sciences, medical education, and other training and research venues, there is a real need for experts trained in anatomy and dissection. This article describes a program that gives individuals interested in clinical and basic sciences practical experience working with cadavers. Participants are selected through an open application process and attend sessions focused on anatomical terminology, gross anatomy and radiography, and some of the educational applications of human cadavers. Dissection skills are honed during an intensive, two‐day cadaver dissection and orthopedic workshop. Participants communicate the knowledge they gain through table‐side discussions, reflect upon the experience during a memorial service, and submit written program evaluations. Additionally, the dissection and preparation of cadaveric materials accomplished in this course are used in the medical school gross anatomy course during the next academic year. From 2004 through 2008, the annual number of applicants increased from 40 to 167, and the number of participants increased from 25 to 43 per year. Program participants have represented diverse ethnic, educational, and professional backgrounds. Feedback from participants has been remarkably positive, including comments on the large amount of learning that takes place during the sessions, the positive impact the program has had on career choice, and the desire for program expansion. This program, which could be replicated at other institutions, teaches anatomy, prepares cadaveric prosections for teaching and training others, and encourages participants to pursue careers in anatomical and biomedical sciences. Anat Sci Educ 3: 77–82, 2010. © 2010 American Association of Anatomists.     

Quick dissection of the segmental bronchi

Knowledge of the three‐dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde‐fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the bronchopulmonary segments. Anat Sci Educ 2010. © 2010 American Association of Anatomists.     

Design and development of a new facility for teaching and research in clinical anatomy

This article discusses factors in the design, commissioning, project management, and intellectual property protection of developments within a new clinical anatomy facility in the United Kingdom. The project was aimed at creating cost‐effective facilities that would address widespread concerns over anatomy teaching, and support other activities central to the university mission–namely research and community interaction. The new facilities comprise an engaging learning environment and were designed to support a range of pedagogies appropriate to the needs of healthcare professionals at different stages of their careers. Specific innovations include integrated workstations each comprising of a dissection table, with removable top sections, an overhead operating light, and ceiling‐mounted camera. The tables incorporate waterproof touch‐screen monitors to display images from the camera, an endoscope or a database of images, videos, and tutorials. The screens work independently so that instructors can run different teaching sessions simultaneously and students can progress at different speeds to suit themselves. Further, database access is provided from within an integrated anatomy and pathology museum and display units dedicated to the correlation of cross‐sectional anatomy with medical imaging. A new functional neuroanatomy modeling system, called the BrainTower®, has been developed to aid integration of anatomy with physiology and clinical neurology. Many aspects of the new facility are reproduced within a Mobile Teaching Unit, which can be driven to hospitals, colleges, and schools to provide appropriate work‐based education and community interaction. Anat Sci Ed 2:34–40, 2009. © 2009 American Association of Anatomists.     

A novel approach to the dissection of the human knee

The knee is one of the most frequently injured joints of the human body with injuries affecting the general population and the athletic population of many age groups. Dissection procedures for the knee joint typically do not allow unobstructed visualization of the anterior cruciate or posterior cruciate ligaments without sacrificing the collateral ligaments. In many cases, the relationships of the intraarticular structures are lost as dissection systematically removes superficial structures to gain access to deeper structures. The authors present an alternative technique for dissection of the human knee joint that allows maximal visualization of intraarticular structures such as the cruciate ligaments and menisci with minimal disturbance to the tibial and fibular collateral ligaments, thus preserving the relationships of the ligamentous and intraarticular structures. Anat Sci Ed 2:41–46, 2009. © 2009 American Association of Anatomists.     

Does Confucianism allow for body donation?

Confucianism has been widely perceived as a major moral and cultural obstacle to the donation of bodies for anatomical purposes. The rationale for this is the Confucian stress on xiao (filial piety), whereby individuals' bodies are to be intact at death. In the view of many, the result is a prohibition on the donation of bodies to anatomy departments for the purpose of dissection. The role of dissection throughout the development of anatomy within a Confucian context is traced, and in contemporary China the establishment of donation programs and the appearance of memorial monuments is noted. In reassessing Confucian attitudes, the stress laid on a particular interpretation of filial piety is questioned, and an attempt is made to balance this with the Confucian emphasis on a moral duty to those outside one's immediate family. The authors argue that the fundamental Confucian norm ren (humaneness or benevolence) allows for body donation as people have a moral duty to help others. Moreover, the other central Confucian value, li (rites), offers important insights on how body donation should be performed as a communal activity, particularly the necessity of developing ethically and culturally appropriate rituals for body donation. In seeking to learn from this from a Western perspective, it is contended that in all societies the voluntary donation of bodies is a deeply human activity that is to reflect the characteristics of the community within which it takes place. This is in large part because it has educational and personal repercussions for students. Anat Sci Educ 11: 525–531. © 2018 American Association of Anatomists.