Cultural practices of the Zulu ethnic group on the body and their influence on body donation

Cultural practices in the African continent have been thought to impact negatively on body donation. Thus, most African countries continue to rely on unclaimed bodies for dissection programs, or bequests from the white population. The latter situation is dominant in South African medical schools. Since South Africa is multi-cultural with nine main ethnic groups of the Black African population, it is important to seek the reasons behind lack of participation in body donation. This report represents a move in this direction with its qualitative study of the cultural practices of the Zulu ethnic group in the province of KwaZulu-Natal from the perspective of a variety of participants, with emphasis on their treatment of the human body after death. Four themes emerged from interviews: (1) Death is not the end; (2) Effect of belief in ancestors; (3) Significance of rituals and customs carried out on human tissue; and (4) Burial as the only method of body disposal. Each of these themes is discussed in relation to the likelihood of body donation being seen by Zulus as an acceptable practice. It is concluded that this is unlikely, on account of the need to preserve the linkage between the physical human body and the spirit of the deceased person, and the perceived ongoing relationship between the spirit of the dead and the living. In view of these conclusions, a number of options are canvassed about the manner in which anatomists in KwaZulu-Natal might obtain bodies for dissection. These possibilities have implications for anatomists working in comparable cultural contexts.

Analysis of Population Representation Among Willed Whole-Body Donors to Facilitate the Construction of a Body Donation Program in China: From the Perspective of Medical Students and Anatomists

The body donation program of Peking Union Medical College was established in May 1999. From May 1999 to December 2017, a total of 5,576 registrants registered and 1,459 donors donated their bodies. Demographic and medical characteristics of the donors were analyzed. The top four causes of death were neoplasms, heart diseases, respiratory diseases, and cerebrovascular diseases. Age at death among donors who died of neoplasms were significantly lower than other causes of death (all p < .05), and the interval between registration and donation among donors who died of neoplasms was significantly shorter than that among donors with other causes (all p < .001). The age of donors when they registered (p < .001) and donated (p < .001) was significantly older than that of general Beijing population. This study may provide a guide for medical colleges or research institutions to establish or enhance their own body donation programs.

"Bedside Anatomy": A Tool to Contextualize Learning and Introduce Surgical Careers

BACKGROUND

Many medical students cite an unwelcoming culture in surgery and perceive surgeons as arrogant or unfriendly. These perceptions have been reported as factors discouraging medical students from applying to surgical residency programs. This highlights an opportunity early in medical education to address these negative stereotypes and create opportunities for positive interactions with surgeons. We hypothesize that positive experiences with surgical residents and introduction to representative surgical cases early in the medical school curriculum can provide a real-world context for learning anatomy and encourage students to consider a surgical career.

METHODS

We developed and implemented a series of structured, one-hour, cadaver-based sessions cofacilitated by anatomists and surgical residents for medical students during their anatomy didactics. Sessions included common surgical cases and focused on critical thinking and problem-solving skills, while offering opportunities to review cadaver anatomy. Students completed a postcourse survey.

RESULTS

Nine sessions were implemented with involvement of eight surgical residents and 185 students; 83 students completed a postcourse survey (response rate of 45%). A majority of students rated the sessions "very helpful" in terms of highlighting the importance of anatomy in medical education (n = 52, 63%) and providing clinical context (n = 59, 71%). 54% (n = 45) indicated interest in a surgical career and 64% (n = 53) agreed that session participation had increased their interest in surgery.

CONCLUSIONS

Overall, students agreed that sessions provided clinical context for their learning and increased interest in a surgical career. Surgical faculty and residents should engage in preclinical medical education to bridge the basic science and clinical years and introduce positive surgical role models early during medical training.

Anders Retzius and the Dental Histologists of the Mid-Nineteenth Century: Their Contribution to Comparative Anatomy, Histology and Anthropology

Anatomy, comparative anatomy and embryology are fundamental to taxonomy and evolutionary biology. In the mid-nineteenth century many anatomists and zoologists made major contributions to more than one of these disciplines and a surprising number of them were also histologists. Historical accounts of discoveries and developments in anatomy, and in particular dental histology, rarely consider broader contributions and have tended to be concerned with establishing historical priority about who discovered or described what first. The period 1830 to 1840 saw new developments in light microscopy that enabled studies of histology, cellular pathology and embryology. It also saw a shift away from older ideas such as Naturphilosophie and vitalism towards a more rigorous experimental approach to scientific investigation. Many scientists with diverse research interests were working in parallel on comparative dental histology and were in many cases largely unaware of each other's work. One researcher, Anders Retzius, travelled widely across Europe, corresponded regularly with his scientific colleagues and, probably unbeknownst to himself in his own lifetime, made a lasting contribution to dental histology. Anders Retzius was a clinician, an anatomist, a comparative anatomist, a histologist and latterly an anthropologist. His life and career spanned the whole of this fast-moving period in the history of anatomy and histology.

Current status of cadaver sources in Turkey and a wake-up call for Turkish anatomists

Persisting difficulties in body procurement in Turkey led to the acquisition of donated, unclaimed, autopsied, and imported bodies regulated under current legislature. Yet, no study had investigated the extent of the on-going cadaver problem. This study was aimed to outline cadaver sources in anatomy departments and their effectiveness by means of an online survey. Additionally, official websites of each department were investigated regarding any information on body donation. Unclaimed cadavers (84.8%) were the major source for anatomy departments, followed by donated (50%) and imported cadavers (39.1%). Foundation-based medical faculties were more likely to import cadavers (P = 0.008). There was a moderate increase (r_s  = 0.567; P = 0.018) in donation registrations to our department after 2000. The departments in cities with significantly higher City-Based Gross Domestic Product measures (US$9,900 vs. US$16,772, P = 0.041), frequencies for mid- or high-school graduates (30.4% vs. 31.3%, P = 0.041), and frequencies for under- or post-graduates (13.1% vs. 15.8%, P = 0.24) had managed to use donated cadavers. Anatomy departments' major reasons for using unclaimed cadavers were education (45.9%), unclaimed cadavers being the only source (24.3%), and receiving inadequate donations (21.6%). Nine out of seventy-four departments (12.2%) provided information regarding body donation on their websites. Body procurement remains as a serious problem in Turkey and it is apparent that current legislature does not provide a sufficient cadaver inflow. Similarly, anatomy departments' effectiveness in public awareness of body donation and support in the National Body Donation Campaign seems questionable. Anat Sci Educ 11: 155-165. © 2017 American Association of Anatomists.

Maintaining the anonymity of cadavers in medical education: Historic relic or educational and ethical necessity?

Throughout the modern history of anatomical dissection by medical and other health science students, cadavers have been anonymized. This has meant that students have been provided with limited, if any, information on the identities or medical histories of those they are dissecting. While there was little way around this when the bodies were unclaimed, this need not be the case when the bodies have been donated. However, with a few exceptions, no efforts have been made to change this model. Recent attempts to move anatomy teaching in a more humanistic direction, by emphasizing the cadaver as the students' first patient and with the growth of commemoration services following the dissecting process, raise the question of whether cadavers should continue to be anonymized. In laying a basis for discussion of this matter, we outline what appear to be the virtues of anonymity, and the form that alternatives to anonymity might take. The options identified are nonidentification, low information; nonidentification, moderate information; and identification, full information. The virtues and drawbacks of each of these possibilities are assessed by analyzing their value for students, and also for donors and their families. Policy issues raised by alternatives are also considered. This article provides a basis for continued discussion and suggestions for further research in this area. Anat Sci Educ 10: 87-97. © 2016 American Association of Anatomists.

Interactive anatomical and surgical live stream lectures improve students' academic performance in applied clinical anatomy

Tuebingen's Sectio Chirurgica (TSC) is an innovative, interactive, multimedia, and transdisciplinary teaching method designed to complement dissection courses. The Tuebingen's Sectio Chirurgica (TSC) allows clinical anatomy to be taught via interactive live stream surgeries moderated by an anatomist. This method aims to provide an application-oriented approach to teaching anatomy that offers students a deeper learning experience. A cohort study was devised to determine whether students who participated in the TSC were better able to solve clinical application questions than students who did not participate. A total of 365 students participated in the dissection course during the winter term of the 2012/2013 academic year. The final examination contained 40 standard multiple-choice (S-MC) and 20 clinically-applied multiple-choice (CA-MC) items. The CA-MC items referred to clinical cases but could be answered solely using anatomical knowledge. Students who regularly participated in the TSC answered the CA-MC questions significantly better than the control group (75% and 65%, respectively; P < 0.05, Mann-Whitney U test). The groups exhibited no differences on the S-MC questions (85% and 82.5%, respectively; P > 0.05). The CA-MC questions had a slightly higher level of difficulty than the S-MC questions (0.725 and 0.801, respectively; P = 0.083). The discriminatory power of the items was comparable (S-MC median Pearson correlations: 0.321; CA-MC: 0.283). The TSC successfully teaches the clinical application of anatomical knowledge. Students who attended the TSC in addition to the dissection course were able to answer CA-MC questions significantly better than students who did not attend the TSC. Thus, attending the TSC in addition to the dissection course supported students' clinical learning goals. Anat Sci Educ 10: 46-52. © 2016 American Association of Anatomists.

The Uppsala anatomist Ivar Sandström and the parathyroid gland

The discovery of the parathyroid gland by the Uppsala anatomist Ivar Sandström (Figure 1) is often called the last anatomical discovery. That remarkable discovery was made in 1877 at the Anatomical Department in Uppsala. At that time Sandström was a young medical student, who had worked as an assistant at the department since 1873. His discovery was published in Upsala Läkareförenings Förhandlingar, in 1880 (1). His publication was in Swedish, and the paper was entitled ‘On a New Gland in Man and Several Animals’. The article comprised 30 pages, and in the introduction Sandström writes: Almost three years ago I found on the thyroid gland of a dog a small organ, hardly as big as a hemp seed, which was enclosed in the same connective tissue as the thyroid, but could be distinguished therefrom by the light colour

Can anatomists teach living anatomy using ultrasound as a teaching tool?

The utilization of bedside ultrasound by an increasing number of medical specialties has created the need for more ultrasound exposure and teaching in medical school. Although there is a widespread support for more vertical integration of ultrasound teaching throughout the undergraduate curriculum, little is known about whether the quality of ultrasound teaching differs if performed by anatomists or clinicians. The purpose of this study is to compare medical students' evaluation of ultrasound anatomy teaching by clinicians and anatomists. Hands-on interactive ultrasound sessions were scheduled as part of the gross anatomy course following principles of adult learning and instructional design. Seven teachers (three anatomists and four clinicians) taught in each session. Before each session, anatomists were trained in ultrasound by clinicians. Students were divided into groups, rotated teachers between sessions, and completed evaluations. Results indicated students perceived the two groups as comparable for all factors except for knowledge organization and the helpfulness of ultrasound for understanding anatomy (P < 0.001). However, results from unpaired samples t-tests demonstrated a nonstatistically significant difference between the groups within each session for both questions. Moreover, students' test performance for both groups was similar. This study demonstrated that anatomists can teach living anatomy using ultrasound with minimal training as well as clinicians, and encourage the teaching of living anatomy by anatomists in human anatomy courses using ultrasound. Repeating this study at a multicenter level is currently being considered to further validate our conclusion.

Orthopedic resident anatomy review course: a collaboration between anatomists and orthopedic surgeons

A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months for all of its residents. The primary purpose of the course is to renew competencies in basic science disciplines so that incoming residents more quickly reach a level of functional proficiency and to afford senior residents a platform to teach their junior colleagues. Before 2005, this course was conducted with minimal participation from anyone outside of the Department of Orthopaedics. Many of the residents voiced concerns that the educational benefits were not proportionate to the time invested. To improve the teaching of orthopedic-related anatomy, an educational collaboration between the Departments of Neurobiology and Anatomy and Orthopaedics was established in 2004 and continues to the present time. The major objectives of refining the course pedagogy, developing a Course Manual and Dissection Guide, and evaluating the results by administering a course survey questionnaire are described in this article. Implementation of all facets of the revised course has resulted in better participation by orthopedic faculty and more favorable reviews by the participating residents. Based on current levels of interest and positive comments from course participants, the Anatomy and Orthopedic faculty course directors plan to continue to develop course materials and pedagogy.

[Final report of the working group for the future planning of the Japanese Association of Anatomists]

The working group for the future planning of the Japanese Association of Anatomists (JAA) has been working to address the issues that were consulted from the president of JAA since October 2009. After making the interim report in March 2010, a public hearing for general members of the JAA was held and a final report was submitted to the President in January 2011. The report contains the analysis of the current situation, the directions in which we should proceed, and recommendations of concrete actions that JAA should take for each issue. The issues discussed were as follows: 1. Future prospects of anatomy and morphological sciences. How can we maintain the specialties of morphological and anatomical sciences in the rapidly advancing field of life sciences and develop collaborations with other fields? 2. Improvement of the JAA academic meetings. How can we increase JAA members and young participants in the academic meetings of the JAA? 3. Fostering the next generation of young researchers. How can we increase young researchers graduated from the schools of Medicine or Dentistry? 4. Future prospects of education of gross anatomy. Prospects of education in gross anatomy and the body donation registration system in relation with some new cadaver-related movements.

[THE ANATOMISTS AND THE RESURRECTIONISTS IN GREAT BRITAIN. II. MURDER FOR ANATOMY]

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