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Böckers A, Schurr L, Schön M, Scholl T, Böckers TM, Steinestel K, Arndt A. Predictive molecular pathology after prolonged fixation: A study on tissue from anatomical body donors. Exp Mol Pathol 2024; 137:104899. [PMID: 38761540 DOI: 10.1016/j.yexmp.2024.104899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/19/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
Histopathological assessment of tissue samples after prolonged formalin fixation has been described previously, but currently there is only limited knowledge regarding the feasibility of molecular pathology on such tissue. In this pilot study, we tested routine molecular pathology methods (DNA isolation, DNA pyrosequencing/next-generation sequencing, DNA methylation analysis, RT-PCR, clonality analysis and fluorescence in situ hybridization) on tissue samples from 11 tumor entities as well as non-neoplastic brain tissue from 43 body donors during the gross anatomy course at Ulm University (winter semester 2019/20 and 2020/21). The mean post mortem interval until fixation was 2.5 ± 1.6 days (range, 1-6 days). Fixation was performed with aqueous formaldehyde solution (formalin, 1.5-2%). The mean storage time of body donors was 12.8 ± 5.6 months (range, 7-25 months). While most diagnostic methods were successful, samples showed significant variability in DNA quality and evaluability. DNA pyrosequencing as well as next-generation sequencing was successful in all investigated samples. Methylation analyses were partially not successful in some extend due to limited intact DNA yield for these analyses. Taken together, the use of prolonged formalin-fixed tissue samples from body donors offers new avenues in research and education, as these samples could be used for morpho-molecular studies and the establishment of biobanks, especially for tissue types that cannot be preserved and studied in vivo. Pathological ward rounds, sample collection, and histopathological and molecular workup have been integrated in the gross anatomy course in Ulm as an integral part of the curriculum, linking anatomy and pathology and providing medical students early insight into the broad field of (molecular) pathology.
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Affiliation(s)
- Anja Böckers
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Leon Schurr
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Michael Schön
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Tatjana Scholl
- Institute of Pathology and Molecular Pathology, Federal Army Hospital, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - Tobias M Böckers
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Konrad Steinestel
- Institute of Pathology and Molecular Pathology, Federal Army Hospital, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - Annette Arndt
- Institute of Pathology and Molecular Pathology, Federal Army Hospital, Oberer Eselsberg 40, 89081 Ulm, Germany.
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Billings BK, Kramer B, Augustine TN, Brits D, Hutchinson EF, Libhaber E, Štrkalj G. Leading the transition to ethical human body sourcing in Africa: The South African experience. Ann Anat 2024; 254:152263. [PMID: 38588731 DOI: 10.1016/j.aanat.2024.152263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/01/2024] [Accepted: 04/04/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The use of human bodies for anatomy education and research forms an integral part of the training of health professionals around the world. However, the ethical acquisition of human remains for this purpose has been a challenge in many countries, particularly for those on the African continent. South African institutions have however, been able to progressively transition to a more ethical approach to human body acquisition. The aim of the current study was to investigate the provenance of human bodies and the number used in South African health sciences institutions during the period 2017-2021. METHODS an online self-administered anonymised questionnaire was circulated to all health sciences institutions in South Africa. Questions were focused on establishing the provenance and the associated number of bodies and body donor programmes. RESULTS responses were received from thirteen of the fourteen South African institutions. All thirteen institutions use human bodies for teaching and research, with the majority of the institutions being reliant on bequests (77%) and family donations (62%), and less on unclaimed remains (46%). Most institutions have established body donor programmes. Four institutions were negatively affected by the effects of the pandemic. Memorial services, which continued during the pandemic, were conducted by eight of the thirteen institutions. CONCLUSION South Africa is leading the transition to the ethical acquisition of human remains on the African continent. It is hoped that South African institutions will soon transform to the exclusive sourcing of bodies through willed donation and provide guidance and support for the other countries on the continent.
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Affiliation(s)
- Brendon K Billings
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Beverley Kramer
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tanya N Augustine
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Desiré Brits
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Erin F Hutchinson
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elena Libhaber
- Health Sciences Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Goran Štrkalj
- Department of Anatomy, Faculty of Medicine and Health, The University of New South Wales, Sydney, Australia
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Kuo I, Hunt B, Doyle D, Fakhoury P, Ha H, Garmo L, Cardwell M, Gillenkirk A, Ridge E, Ren T, Sirhan N, Ireland N, Fegan T, McCollum K, Timmerman K, Root K, Klukkert ZS, Pandey J. Growing Medical Educators from Medical Students by Supporting Self-directing Learning Opportunities Born Out of Cadaveric Dissection. MEDICAL SCIENCE EDUCATOR 2024; 34:309-313. [PMID: 38686145 PMCID: PMC11055840 DOI: 10.1007/s40670-023-01968-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 05/02/2024]
Abstract
This study focuses on a subset of medical students who participated in an anatomy dissection program and undertook an additional self-directed learning (SDL) project investigating incidental findings of cadaveric pathology. The value of SDL activity is explored as a means of enhancing medical student education, particularly its student perceived value in preparing and developing them as future medical educators. It was assessed whether the project advanced student interest in medical education by analyzing their motivations for participation. The results of the study highlight the potential of SDL as an experiential learning opportunity for medical students and the role of anatomic pathology in connecting multiple domains of medical education.
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Affiliation(s)
- Ian Kuo
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Bradley Hunt
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - David Doyle
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Patrick Fakhoury
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Hyungee Ha
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Lucas Garmo
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Marian Cardwell
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Aleah Gillenkirk
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Emily Ridge
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Tom Ren
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Nicholas Sirhan
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Nicole Ireland
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Taylor Fegan
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Katherine McCollum
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Kiara Timmerman
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Kyle Root
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
| | - Zachary S. Klukkert
- Department of Anatomy and Cell Biology, Oklahoma State University Center for Health Sciences, 1111 West 17th Street, Tulsa, OK 74107 USA
| | - Jyotsna Pandey
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48859 USA
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Hanley LC, Ou J, Ritter D, Chew A, Monteiro K, Dumenco L. Bridging Anatomy, Histology, and Pathology: A Novel Curriculum Component Incorporating Self-directed Learning for First-Year Medical Students. MEDICAL SCIENCE EDUCATOR 2023; 33:1055-1059. [PMID: 37886303 PMCID: PMC10597915 DOI: 10.1007/s40670-023-01870-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 10/28/2023]
Abstract
During cadaveric dissection or prosection, medical students frequently encounter pathology that can be a springboard to further learning. We designed a novel educational activity linking anatomy, histology, and pathology that incorporated self-directed learning and teamwork, followed by feedback and instruction from pathologists. Post-activity, more than 97% of students rated the activity as useful (Likert scale of 1 to 5), indicating this activity should be continued in the future. Strengths included self-directed learning, content and design, and teamwork, peer, and faculty interactions. Clarity of assignment expectations, range of pathologies, and virtual presentation format remained areas for improvement.
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Affiliation(s)
- Linda C. Hanley
- Warren Alpert Medical School, Brown University, Providence, RI USA
| | - Joyce Ou
- Warren Alpert Medical School, Brown University, Providence, RI USA
| | - Dale Ritter
- Warren Alpert Medical School, Brown University, Providence, RI USA
| | - Amy Chew
- Warren Alpert Medical School, Brown University, Providence, RI USA
| | | | - Luba Dumenco
- Warren Alpert Medical School, Brown University, Providence, RI USA
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Fletcher L, King L, Criswell S, Herr MJ. Pathology education project (PEP): A pilot program to spark student understanding in pathology as a career. Acad Pathol 2023; 10:100084. [PMID: 37215755 PMCID: PMC10196332 DOI: 10.1016/j.acpath.2023.100084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/25/2023] [Accepted: 03/27/2023] [Indexed: 05/24/2023] Open
Abstract
According to the National Resident Matching Program in 2022, 631 pathology positions were offered. In total, 248 senior applicants from United States (US) allopathic schools filled 36.6% of these positions. To bolster medical student understanding of pathology, a medical school pathology interest group organized a multi-day activity to introduce rising second-year medical students to pathology as a career. Five students completed both pre- and post-activity surveys assessing their knowledge of the specialty. All five students had a BA/BS degree as their highest level of education. Only one student indicated that he or she had previously shadowed a pathologist as a medical laboratory scientist for a duration of four years. Two students indicated that they were interested in internal medicine, one indicated radiology, one forensic pathology or radiology, and one was undecided. During the activity, students biopsied tissue from cadavers in the gross anatomy lab. Thereafter, students participated in the standard tissue processing by shadowing a histotechnologist. Under the guidance of a pathologist, students microscopically examined slides and discussed the clinical findings. Post-activity survey results indicated that participation increased their knowledge of pathology as a career with a median increase of 0.8 points (range: 0.2 to 1.6) on a 5-point Likert scale. Students also indicated that their participation increased their knowledge of pathology skills and techniques-median increase of 1.2 (range: 0.8 to 1.8). This activity can be implemented by medical educators to expose medical students to pathology as a career with the benefit of increasing student knowledge in the specialty.
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Affiliation(s)
- Lily Fletcher
- University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA
| | - Lauren King
- University of Tennessee Health Science Center College of Medicine Department of Pathology and Laboratory Medicine, Memphis, TN, USA
| | - Shelia Criswell
- University of Tennessee Health Science Center College of Health Professions, Department of Diagnostic and Health Sciences, Memphis, TN, USA
| | - Michael J. Herr
- University of Alabama at Birmingham Heersink School of Medicine, Department of Cell, Developmental, and Integrative Biology, Birmingham, AL, USA
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Schön M, Steinestel K, Spiegelburg D, Risch A, Seidel M, Schurr L, Fassnacht UK, Golenhofen N, Böckers TM, Böckers A. Integration of Scientific Competence into Gross Anatomy Teaching Using Poster Presentations: Feasibility and Perception among Medical Students. ANATOMICAL SCIENCES EDUCATION 2020; 15:89-101. [PMID: 33128816 DOI: 10.1002/ase.2031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023]
Abstract
Scientific competences as defined in the German competency framework describes the ability to think independently and act scientifically, and forms a central component of medical education. This report describes its integration into anatomical teaching. On the basis of the findings in dissection courses from two consecutive years, students worked on either a case report (n = 70) or an original work (n=6) in the format of a scientific poster while learning to use primary literature. Posters were evaluated by juror teams using standardized evaluation criteria. Student perception of the project was estimated by quantitative and qualitative data obtained from the faculty´s course evaluation and an online-survey. Overall, students worked collaboratively and invested extra-time (median [MD] 3.0 hours) in poster creation. Primary literature was integrated in 90.8% of the posters. Overall poster quality was satisfactory (46.3 ±8.5 [mean ±standard deviation] out of 72 points), but several insufficiencies were identified. Students integrated information gained from the donor´s death certificate, post-mortem full-body computer tomography (CT) scan (22.4%) and histopathological workup (31.6%) in their case reports. Students were positive about the experience of learning new scientific skills (MD 4 on a six-point Likert scale), but free text answers revealed that some students experienced the project as an extra burden in a demanding course. In summary, it was feasible to introduce students to science during the dissection course and to increase interest in science in approximately a third of the survey respondents. Further adjustments to ensure the posters´ scientific quality might be necessary in the future.
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Affiliation(s)
- Michael Schön
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Konrad Steinestel
- Institute for Pathology and Molecular Pathology, Federal Army Hospital, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Doreen Spiegelburg
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Annika Risch
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Mira Seidel
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Leon Schurr
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Ulrich Kai Fassnacht
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Nikola Golenhofen
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Tobias Maria Böckers
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
| | - Anja Böckers
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University Ulm, Ulm, Germany
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Abuhaimed AK, Almulhim AM, Alarfaj FA, Almustafa SS, Alkhater KM, Al Yousef MJ, Al Bayat MI, Madadin M, Menezes RG. Histologic Reliability of Tissues from Embalmed Cadavers: Can They be Useful in Medical Education? SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2020; 8:208-212. [PMID: 32952513 PMCID: PMC7485655 DOI: 10.4103/sjmms.sjmms_383_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/29/2019] [Accepted: 07/09/2020] [Indexed: 12/02/2022]
Abstract
Background: Current trends in medical curricula are shifting from teaching histology and pathology as stand-alone disciplines. Therefore, it would be useful to examine the potential value of integrating these into the anatomical dissection experience. Objectives: The aim of this study was to assess the histologic reliability of tissues taken from embalmed cadavers in an anatomy laboratory. Materials and Methods: A total of 112 tissue samples were obtained using standard autopsy techniques from various organs (heart, lung, thyroid, skeletal muscle, bone and skin) of 11 cadavers available at the anatomy laboratory of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, in 2019. Samples were prepared using the standard paraffin procedure followed by cutting sections at 4-μm thickness and staining with standard hematoxylin and eosin stain. Using predefined criteria, the quality of the samples was evaluated by two board-certified histopathologists and each slide was categorized as good, satisfactory or poor. Results: Overall, 34.2% and 60.3% of the slides were of good and satisfactory quality, respectively. A significant difference in tissue quality was found between various organs. Thick skin and bone tissues had the highest “good” rating (84.6% and 81.8%, respectively), while thyroid and lung tissues had the highest “poor” rating (20% and 13.6%, respectively). Conclusion: Most of the tissues acquired from the embalmed cadavers were of good or satisfactory quality, thereby indicating the beneficial use of histological tissue from cadavers for educational purposes. Future research into how these findings translate into meaningful medical education would be beneficial.
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Affiliation(s)
| | - Abdulaziz M Almulhim
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faris A Alarfaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Salam S Almustafa
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khulood M Alkhater
- Department of Anatomy, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed J Al Yousef
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Methal I Al Bayat
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Madadin
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ritesh G Menezes
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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