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Grachan JJ, Robinson R, Doll J, Stevens K, Leeper BJ. Donor memorialization practices at religious institutions in the United States. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 38610080 DOI: 10.1002/ase.2426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 03/11/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024]
Abstract
Many institutions worldwide honor the gift of human body donors through memorial services, ceremonies, and various other means, such as guided reflection or art activities. Memorial services can vary when it comes to the name, who is involved in the planning, and who may attend. Within the United States, the role of religion in the planning and delivery of these ceremonies at religious institutions has yet to be actively explored. This study aimed to collect information about human body donor memorialization practices at religious institutions in the United States to help guide further suggestions for enhancing inclusivity in these practices. This study utilized a voluntary survey that was distributed to anatomy educators and human body donor programs to complete if they were from a religious institution that utilized human body donors. Based on the data collected in this study (n = 39), most religious institutions have some form of donor memorialization practices, which may or may not include a formal memorial service. In these practices described by survey participants, religion was commonly represented using an interfaith approach, in which campus ministry often assisted in planning and facilitating the memorialization. Those with masses/services refer to them by different names, and most occur in a religious-specific place on campus. In conclusion, among survey participants at religious institutions that utilize and memorialize human body donors, most take an inclusive interfaith approach to their memorialization practices, as this can be more representative of the body donors and students who learn from them.
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Affiliation(s)
- Jeremy J Grachan
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Rhiannon Robinson
- Department of Anatomy & Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Julie Doll
- Department of Natural Sciences, University of St. Francis, Joliet, Illinois, USA
| | - Kelsey Stevens
- Department of Health Sciences, Briar Cliff University, Sioux City, Iowa, USA
| | - Bobbie J Leeper
- Biology and Physician Assistant Programs, Seton Hill University, Greensburg, Pennsylvania, USA
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2
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Leeper BJ, Grachan JJ, Robinson R, Doll J, Stevens K. Honoring human body donors: Five core themes to consider regarding ethical treatment and memorialization. ANATOMICAL SCIENCES EDUCATION 2024; 17:483-498. [PMID: 38197550 DOI: 10.1002/ase.2378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/11/2024]
Abstract
Dissection of human body donors is a common component of anatomy curricula, as it provides opportunities for tactile and intellectual engagement unmatched otherwise. Additionally, interaction with human body donors contributes to the "hidden curriculum" of allowing students to begin to ethically practice patient care with empathy, respect, and compassion. With this, there have been various proposed guidelines for the ethical treatment of human body donors, with most focusing on student reflections and a final ceremony for honoring the donors, but there are numerous other ways throughout the course to incorporate ethical values and to guide students to consider the humanity of the donor. This article proposes that institutions consider the incorporation of five easily implemented formalized ethical themes for working with human body donations into daily practices: (1) reflect the donor as possessing human dignity, (2) recognize the donor's role of the "First Patient" or "Silent Teacher," (3) honor the gift of human body donation, (4) recognize the decedent's family, and (5) consider inclusivity in memorialization practices. Multiple recommendations for integrating these five themes throughout the course are provided. The incorporation of these five core themes can assist in alleviating the psychological stress that some students struggle with in dissection courses, foster the feelings and attributes that comprise the hidden curriculum and are the desired characteristics of a caring medical provider, and discourage misuse and mistreatment of donors.
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Affiliation(s)
- Bobbie J Leeper
- Biology and Physician Assistant Programs, Seton Hill University, Greensburg, Pennsylvania, USA
| | - Jeremy J Grachan
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Rhiannon Robinson
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Julie Doll
- Department of Natural Sciences, University of St. Francis, Joliet, Illinois, USA
| | - Kelsey Stevens
- Department of Health Sciences, Briar Cliff University, Sioux City, Iowa, USA
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3
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Brenner E, Bleys RLAW, de Caro R, Catereniuc I, Chirculescu ARM, Destrieux C, Eppler E, Filgueira L, Kachlik D, Kiss P, Lee C, Matveeva N, Natsis K, Pais D, Paulsen F, Piagkou M, Quondamatteo F, Reglődi D, Şendemir E, Tranum-Jensen J, Tutkuviene J, Vázquez Osorio MT. The legal and ethical framework governing body donation in Europe - 2nd update on current practice. Ann Anat 2024; 252:152195. [PMID: 38042354 DOI: 10.1016/j.aanat.2023.152195] [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: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. METHODS For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. RESULTS Perspectives on the legal and ethical framework governing body donation in Europe. CONCLUSIONS We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies.
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Affiliation(s)
- Erich Brenner
- Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Austria; Trans-European Pedagogic Anatomical Research Group (TEPARG).
| | - Ronald L A W Bleys
- Department of Anatomy, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Raffaele de Caro
- Section of Anatomy, Department of Human Anatomy and Physiology, University of Padova, Italy; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | - Ilia Catereniuc
- Department of Anatomy and Clinical Anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Andy R M Chirculescu
- Department of Anatomy and Embryology, Faculty of Medicine, C Davila University, Bucharest, Romania; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | | | | | - Luis Filgueira
- Anatomy, Faculty of Science and Medicine, University of Fribourg, Switzerland
| | - David Kachlik
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Péter Kiss
- Department of Anatomy, University of Pécs, Hungary
| | - Clive Lee
- Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Niki Matveeva
- Department of Anatomy, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Konstantinos Natsis
- Laboratory of Anatomy and Anatomy of Surgery, Aristotele University School of Medicine, Thessaloniki, Greece
| | - Diogo Pais
- Departamento de Deontologia, Bioética e DireitoMédico, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | - Friedrich Paulsen
- Institute for Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Maria Piagkou
- Department of Anatomy and Surgical Anatomy, National and Kapodistrian University of Athens, Greece
| | - Fabio Quondamatteo
- Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dóra Reglődi
- Department of Anatomy, University of Pécs, Hungary
| | - Erdoğan Şendemir
- Anatomy Department, Medical Faculty, Uludağ University, Bursa, Turkey; Trans-European Pedagogic Anatomical Research Group (TEPARG)
| | - Jørgen Tranum-Jensen
- Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Janina Tutkuviene
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Lithuania
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4
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HadaviBavili P, İlçioğlu K. Artwork in anatomy education: A way to improve undergraduate students' self-efficacy and attitude. ANATOMICAL SCIENCES EDUCATION 2024; 17:66-76. [PMID: 37933725 DOI: 10.1002/ase.2352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/07/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
Anatomy is one of the leading subjects in health science, and students need a strong anatomy background in these fields. Traditional lecturer-oriented anatomy education is based predominantly on passive learning methods. In recent years, alternative educational methods like hands-on art and 3D atlas-based education methods have become more popular as competitive alternatives to traditional approaches. This is a prospective, randomized, longitudinal, interventional study, and a total of 181 undergraduate students participated in this study. A comparative design was used with two groups: Artwork and Atlas. This study aims to evaluate the effectiveness of creative and artistic approaches in improving undergraduate students' attitudes and self-efficacy toward anatomy courses. A Pearson correlation, an independent t-test, and a paired t-test were used to analyze the results. Both groups experienced a negative mean score on the anatomy self-efficacy scale, suggesting an increase in anatomy self-efficacy, and showed significant self-efficacy improvements (p < 0.005). An independent t-test analysis found no statistically significant difference between the Atlas group and the Artwork group on the anatomy self-efficacy scales (pretest and posttest) and the anatomy attitudes scale (p > 0.005). Artwork-based education and learning methods can be used as active learning methods to improve students' self-efficacy toward anatomy. This method allows learners to employ their creative abilities in order to express their ideas visually, making complex concepts easier to comprehend. It can also help students develop practical, problem-solving, critical thinking, and teamwork skills. It is cost-effective and engaging since it does not need any expensive equipment.
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Affiliation(s)
- Parisa HadaviBavili
- Faculty of Health Sciences, Department of Midwifery, Sakarya University, Sakarya, Turkey
- Department of Midwifery, Institute of Health Science, Sakarya University, Sakarya, Turkey
| | - Kevser İlçioğlu
- Faculty of Health Sciences, Department of Nursing/Obstetrics and Gynaecology Nursing, Sakarya University, Sakarya, Turkey
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Hortsch M. The Michigan Histology website as an example of a free anatomical resource serving learners and educators worldwide. ANATOMICAL SCIENCES EDUCATION 2023; 16:363-371. [PMID: 36453096 DOI: 10.1002/ase.2239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/16/2022] [Accepted: 11/23/2022] [Indexed: 05/11/2023]
Abstract
With anatomical education becoming a global endeavor, free online resources offered via the Internet or other electronic venues are of increasing importance for teaching and learning communities worldwide. Students and instructors from developing countries, often limited in access to modern instructional resources by infrastructural and financial constraints, are frequent users of such online learning tools. During the recent Covid-19 pandemic when all academic institutions were forced to quickly switch to a non-contact mode of teaching, free online instructional resources were often essential for continuing the educational mission. However, there are a number of obstacles and issues that need to be considered when creating and offering such learning resources. These include the type, quality, and completeness of the content, their educational purpose, access to technical and financial resources, copyright and ethical issues, and more. Educators, who plan to generate and maintain free online resources, should also be aware that such projects usually require a considerable long-term time commitment. In this article, these issues are discussed using the Michigan Histology website as an example. The discussion also addresses how e-learning resources like the Michigan Histology website supported online learning during the recent Covid-19 pandemic.
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Affiliation(s)
- Michael Hortsch
- Department of Cell and Developmental Biology, University of Michigan Medical School, Michigan, Ann Arbor, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Michigan, Ann Arbor, USA
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6
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Wu A, McWatt SC, Utomo R, Talis A, Xiao QY, Saraci K, Brassett C, Sagoo MG, Wingate R, Chien CL, Traxler H, Waschke J, Vielmuth F, Sigmund A, Yamada Y, Sakurai T, Zeroual M, Olsen J, El-Batti S, Viranta-Kovanen S, Keay K, Stewart W, Mao Y, Lang A, Kunzel C, Bernd P, Kielstein H, Noël GPJC. A thematic analysis of students' discussions on death and body donation in international online focus groups. ANATOMICAL SCIENCES EDUCATION 2023. [PMID: 36883007 DOI: 10.1002/ase.2265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Historically, Anatomy education is an in-person discipline involving exposure to human body donors that facilitates personal and professional growth through, in part, the initiation of reflection on the topic of death. However, during the COVID-19 pandemic the decreased exposure to cadaveric anatomy for many health professions students may have influenced the depth of their individual reflections on this topic. Accordingly, this study aimed to investigate the effect of an alternate approach-focus group discussions between peers with varying degrees of exposure to cadaveric material-that may offer one strategy to stimulate deep reflection on the topic of death. A programmatic intervention was introduced, wherein students (n = 221) from 13 international universities discussed differences in their anatomy courses during small focus group sessions as part of an online exchange program. An inductive semantic thematic analysis was conducted on responses to an open-ended text-response question on how the activity influenced students' reflections about death. Resulting themes were organized into categories that described the content and topics of the students' discussions as they grappled with this sensitive topic. The students reportedly engaged in deep reflection and expressed an increased sense of connectedness with their peers, despite their disparate exposure levels to cadaveric anatomy and being physically distanced. This demonstrates that focus groups with students experiencing different laboratory contexts can be used to help all students reflect on the topic of death and that interchanges between dissecting and non-dissecting students can initiate thoughts about death and body donation among non-dissecting students.
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Affiliation(s)
- Anette Wu
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons Columbia University, New York, New York, USA
| | - Sean C McWatt
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rachel Utomo
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Austin Talis
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Que Yun Xiao
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Kerstin Saraci
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Cecilia Brassett
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Mandeep Gill Sagoo
- Department of Anatomy and Neurobiology, School of Centre for Education, King's College London, London, UK
| | - Richard Wingate
- Department of Anatomy and Neurobiology, School of Centre for Education, King's College London, London, UK
| | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hannes Traxler
- Center for Anatomy and Cell Biology, Medical University Vienna, Vienna, Austria
| | - Jens Waschke
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Fransziska Vielmuth
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Anna Sigmund
- Institute of Anatomy, Vegetative Anatomy, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Yukari Yamada
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Sakurai
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mina Zeroual
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Jorgen Olsen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Salma El-Batti
- Department of Cardiovascular Surgery, University of Paris, Paris, France
| | | | - Kevin Keay
- Discipline of Anatomy and Histology, The University of Sydney, Sydney, New South Wales, Australia
| | - William Stewart
- Anatomy Section, Department of Surgery, Yale University, New Haven, Connecticut, USA
| | - Yinghui Mao
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons Columbia University, New York, New York, USA
| | - Ariella Lang
- Columbia College, Columbia University, New York, New York, USA
| | - Carol Kunzel
- College of Dental Medicine, Columbia University, New York, New York, USA
| | - Paulette Bernd
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons Columbia University, New York, New York, USA
| | - Heike Kielstein
- Institute of Anatomy and Cell Biology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany
| | - Geoffroy P J C Noël
- Anatomy Division, Department of Surgery, University of California San Diego, San Diego, California, USA
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7
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Ruth AA, Nesbitt A, Johnson LE. Flexible, short-duration outreach sessions in the human anatomy laboratory provide authentic, humanistic experiences. ANATOMICAL SCIENCES EDUCATION 2023; 16:280-290. [PMID: 35776633 DOI: 10.1002/ase.2209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 05/04/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
Anatomy laboratories can provide rich opportunities for outreach to K-12 and college students interested in pursuing careers in health, medicine, or science. At the University of Missouri, the Department of Pathology and Anatomical Sciences has designed flexible, one-hour interactive sessions that typically cover basic anatomical concepts using whole-body donors. In order to evaluate whether short-duration programs were impactful in increasing enthusiasm for anatomy and the health professions sciences, we used mixed methods to study participant experience covering three topics: (1) enthusiasm for anatomy, (2) interest in pursuing a career in healthcare professions, and (3) perception of the importance of whole-body donation. The same questions were asked pre- and post-session, and the post-session survey had additional questions related to student satisfaction. Quantitative analyses showed an increased interest in anatomy and appreciation for whole-body donation following the session. Students also perceived that they had a better understanding of the body and what it would be like to attend a health professions school. Thematic analysis revealed an appreciation for contextualizing the size, position, and hands-on feel of anatomical structures, and emphasized that students felt that they understood the body better after having seen a donor's anatomy. This work shows that short-duration, flexible outreach sessions involving whole-body donors can provide students with a rare opportunity to confirm their contextual understanding of anatomy, and provide students with an authentic, and humanistic experience.
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Affiliation(s)
- Aidan A Ruth
- Center for Anatomical Science and Education, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Allison Nesbitt
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Laura E Johnson
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, Missouri, USA
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8
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Messerer DAC, Behr JL, Kraft SF, Schön M, Horneffer A, Kühl SJ, Benedikt Seifert L, Huber-Lang M, Böckers TM, Böckers A. The gross anatomy course: SARS-CoV-2 pandemic-related effects on students' learning, interest in peer-teaching, and students' perception of its importance. ANATOMICAL SCIENCES EDUCATION 2022. [PMID: 36564994 DOI: 10.1002/ase.2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic required adjustments and limitations in university teaching, thereby challenging teaching concepts in anatomy requiring in-person contact, including the gross anatomy course. Therefore, the present study investigates the impact of COVID-19-associated adjustments on students' perception of the gross anatomy course's importance and quality, students' preferred learning setting and outcome, and their motivation to involve themselves in academic activities, including becoming a future peer-teacher of the course. Using paper-based questionnaires in Ulm, Germany, 397 (response rate: 82.3%) students of the winter term of 2020/2021 were surveyed using quantitative and qualitative items, which were compared with cohorts prior to the pandemic. Students reported a higher global rating on course quality during COVID-19 (pre-COVID-19: 5.3 ± 0.9, during-COVID-19: 5.6 ± 0.7, p < 0.001; 1 = very bad, 6 = very good). Students' perceived importance of the gross anatomy course showed a small but significant increase (pre-COVID-19: 4.2 ± 0.6, during-COVID-19: 4.3 ± 0.6, p < 0.001; 1 = strongly disagree, 6 = strongly agree). Students' motivation to apply as a peer-teacher remained stable, nevertheless, they reported less interest in transferring their knowledge to junior students. Finally, students reported that they spent significantly more learning time alone and their examination grades remained unchanged during the pandemic. Astonishingly, despite radical changes of the teaching environment due to COVID-19, students appreciate the offered teaching and highly valued the gross anatomy course.
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Affiliation(s)
- David Alexander Christian Messerer
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital Ulm, Ulm, Germany
- Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jonathan Lukas Behr
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
| | - Sophie Felice Kraft
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
| | - Michael Schön
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
| | - Astrid Horneffer
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - Susanne Julia Kühl
- Institute of Biochemistry and Molecular Biology, Ulm University, Ulm, Germany
| | - Lukas Benedikt Seifert
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital Ulm, Ulm, Germany
| | - Tobias Maria Böckers
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - Anja Böckers
- Institute for Anatomy and Cell Biology, Medical Faculty, Ulm University, Ulm, Germany
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9
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Wu A, Xiao QY, McWatt S, Utomo R, Talis A, Saraci K, Brassett C, Sagoo MG, Wingate R, Chien CL, Traxler H, Waschke J, Vielmuth F, Yamada Y, Sakurai T, Zeroual M, Olsen J, El-Batti S, Viranta-Kovanen S, Keay K, Stewart W, Kunzel C, Bernd P, Kielstein H, Noël GPJC. The Anatomy Course During COVID-19: The Impact of Cadaver-Based Learning on the Initiation of Reflection on Death. MEDICAL SCIENCE EDUCATOR 2022; 32:1033-1044. [PMID: 36097588 PMCID: PMC9453724 DOI: 10.1007/s40670-022-01609-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, in-person cadaveric dissection laboratories for teaching anatomy were omitted by many schools around the world. While knowledge domains can be easily evaluated via remote exams, non-traditional discipline-independent skills such as those encouraged through reflection on the topic of death are often overlooked. This study investigated how different anatomy course formats played a role in initiating students' reflections on death during the COVID-19 pandemic. METHOD In fall 2020, 217 medical, dental, premedical, and health sciences students from 13 international universities discussed differences in their anatomy courses online. Formats of anatomy courses ranged from dissection-based, prosection-based, hybrid (combination of dissection and prosection) to no laboratory exposure at all. Students' responses to the question, "Did/does your anatomy course initiate your thinking about life's passing?" were collected, and they self-reported themes that were present in their reflections on death using a multiple-choice prompt. Statistical analyses to detect differences between students with and without exposure to cadavers were performed using the chi-squared test. RESULTS When comparing students who had exposure to human anatomical specimens to those who had no exposure, the majority of students with exposure thought that the course did initiate thoughts about life's passing, compared to students without exposure (P < 0.05). Reflection themes were consistent across groups. DISCUSSION These findings indicate that anatomy dissection courses are important for the initiation of students' feelings about the topic of death. Omission of cadaveric dissection- or prosection-based laboratories will decrease the likelihood that students initiate reflection on this topic and gain important transferable skills.
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Affiliation(s)
- Anette Wu
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Que Yun Xiao
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Sean McWatt
- Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | - Rachel Utomo
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Austin Talis
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Kerstin Saraci
- Institute of Anatomy, Faculty of Medicine, Vegetative Anatomy, Ludwig Maximilian University, Munich, Germany
| | - Cecilia Brassett
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Mandeep Gill Sagoo
- Department of Anatomy and Neurobiology, School of Centre for Education, King’s College London, London, UK
| | - Richard Wingate
- Department of Anatomy and Neurobiology, School of Centre for Education, King’s College London, London, UK
| | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hannes Traxler
- Center for Anatomy and Cell Biology, Medical University Vienna, Vienna, Austria
| | - Jens Waschke
- Institute of Anatomy, Faculty of Medicine, Vegetative Anatomy, Ludwig Maximilian University, Munich, Germany
| | - Franziska Vielmuth
- Institute of Anatomy, Faculty of Medicine, Vegetative Anatomy, Ludwig Maximilian University, Munich, Germany
| | - Yukari Yamada
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Sakurai
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
- Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mina Zeroual
- Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | - Jorgen Olsen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Salma El-Batti
- Department of Cardiovascular Surgery, University of Paris, Paris, France
| | | | - Kevin Keay
- Discipline of Anatomy and Histology, The University of Sydney, Sydney, Australia
| | - William Stewart
- Anatomy Section, Department of Surgery, Yale University, New Haven, CT USA
| | - Carol Kunzel
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Paulette Bernd
- Department of Medicine and Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Heike Kielstein
- Institute for Anatomy and Cell Biology, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
| | - Geoffroy P. J. C. Noël
- Anatomy Division, Department of Surgery, University of California San Diego, San Diego, CA USA
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10
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Carroll MA, McKenzie A, Tracy-Bee M. Movement System Theory and Anatomical Competence: Threshold Concepts for Physical Therapist Anatomy Education. ANATOMICAL SCIENCES EDUCATION 2022; 15:420-430. [PMID: 33825338 DOI: 10.1002/ase.2083] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 03/27/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
This viewpoint proposes eight anatomy threshold concepts related to physical therapist education, considering both movement system theory and anatomical competence. Movement system theory provides classifications and terminology that succinctly identifies and describes physical therapy practice from a theoretical and philosophical framework. The cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal systems are all included within this schema as the movement system theory encompasses all body systems interacting to create movement across the lifespan. Implementing movement system theory requires an ability to use human anatomy in physical therapist education and practice. Understanding the human body is a mandatory prerequisite for effective diagnosis, assessment, treatment, and patient evaluation. Anatomical competence refers to the ability to apply anatomic knowledge within the appropriate professional and clinical contexts. Exploring the required anatomical concepts for competent entry-level physical therapist education and clinical practice is warranted. The recommended threshold concepts (fluency, dimensionality, adaptability, connectivity, complexity, stability or homeostasis, progression or development, and humanity) could serve as an integral and long-awaited tool for guiding anatomy educators in physical therapy education.
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Affiliation(s)
- Melissa A Carroll
- Division of Healthcare Professions, Doctor of Physical Therapy Program, DeSales University, Center Valley, Pennsylvania
| | - Alison McKenzie
- Department of Physical Therapy, Chapman University, Irvine, California
- Department of Neurology, University of California, Irvine, California
| | - Mary Tracy-Bee
- Biology Department, University of Detroit Mercy, Detroit, Michigan
- Department of Movement Science, Physical Therapy Program, Oakland University, Rochester, Michigan
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11
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Khabaz Mafinejad M, Taherahmadi M, Asghari F, Mehran Nia K, Mehrpour SR, Hassanzadeh G, Farahani P, Hosseini Dolama R. Teaching professionalism in cadaver dissection: medical students' perspective. J Med Ethics Hist Med 2022; 14:7. [PMID: 35035795 PMCID: PMC8696593 DOI: 10.18502/jmehm.v14i7.6751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
This study was designed to facilitate freshman medical students’ adaptation to the dissection room and familiarize them with the related ethical codes. Single-group post-test design research was conducted at Tehran University of Medical Sciences in 2018 - 2019. The program began with a brief explanation of the necessity of the subject, and after a documentary film was shown, the principles of professional and ethical behaviors in the dissection room were discussed by a panel of experts. In the end, a valid and reliable evaluation questionnaire (Cronbach's alpha coefficient = 0.89) was distributed among the students. A total of 129 questionnaires were completed and returned. Overall, 94.4% of the students believed that the program provided an excellent opportunity to reflect on professional behaviors during practical anatomy sessions. In addition, 92.8% of the students believed that they would use the ethical points mentioned in the program in the future. Content analysis of the open questions produced three main categories: "motivating learning", "application of theory in practice" and "changing the attitude toward responsibility". The results indicate that adequate preparation for cadaver dissection sessions and learning about professional behavior codes in the first exposure can help medical students to better understand the principles of professional behaviors.
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Affiliation(s)
- Mahboobeh Khabaz Mafinejad
- Assistant Professor, Department of Medical Education, Education Development Center, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taherahmadi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Asghari
- Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kobra Mehran Nia
- Assistant Professor, Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeeid Reza Mehrpour
- Associate Professor, Department of Orthopedics and Trauma Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanzadeh
- Professor, Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Farahani
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Hosseini Dolama
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
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12
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Ok F, Gürses İA. Evaluation of Information on Body Donation Promotion at Official Websites of Turkish Anatomy Departments. ANATOMICAL SCIENCES EDUCATION 2021; 14:816-827. [PMID: 32991784 DOI: 10.1002/ase.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/25/2020] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Abstract
Raising public awareness of body donation is crucial for countries like Turkey that have struggling donation programs. The official websites of anatomy departments may contribute to achieving this goal. Nevertheless, previous studies reported institutional or individual reluctance of departments or anatomists, respectively, due to an expectation of adverse publicity. This study aimed to investigate whether the official websites of Turkish anatomy departments provided information on body donation and analyzed the content of these websites. Websites of anatomy departments at 100 medical faculties were evaluated. Only 12 departments (12%) provided information on body donation with varying content. A thematic analysis of the information provided revealed five main themes. These were (1) legal aspects, (2) significance, (3) acceptance/rejection criteria, (4) availability, and (5) redirection. All departments (n = 12, 100%) outlined the legal aspects of body donation, seven departments (58%) highlighted the significance of body donation, seven departments (58%) provided contact information for potential donors, five departments (41%) covered acceptance/rejection criteria, and three departments (25%) provided a link to the official website of the Turkish Society of Anatomy and Clinical Anatomy. Thus, Turkish anatomy departments were reluctant to provide information on body donation, and the content of provided information varied greatly among departments. This lack of information, coordination, and participation in existing awareness activities for body donation in anatomy department websites may be contributing to the low numbers of body donations and donor registrations seen nationally.
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Affiliation(s)
- Fatma Ok
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - İlke Ali Gürses
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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13
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Oliveira AGFD, Gonçalves AF, Soares JN, Salgado LHN, Santana BS, Passos MV, Reis JLDO, Arantes GC, Campos LFS, Carvalho MS, Gama LCFD, Rezende AB. The creation of a body donation program at Federal University of Juiz de Fora in Brazil: academic importance, challenges and donor profile. Anat Cell Biol 2021; 54:489-500. [PMID: 34657839 PMCID: PMC8693134 DOI: 10.5115/acb.21.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/23/2021] [Accepted: 08/10/2021] [Indexed: 11/27/2022] Open
Abstract
Dissection and human specimens study remain the gold standard method for teaching anatomy. Due to the increasing health science courses in Brazil, the traditional way of obtaining bodies for scientific purposes, the unclaimed ones, became insufficient. In addition, this source is no longer ethically appropriate according to anatomists. In order to maintain the teaching quality, the Federal University of Juiz de Fora (UFJF) in Brazil, inspired by successful initiatives around the world, created a body donation program; Sempre Vivo. Besides the bureaucratic difficulty faced during its regulation, the implementation of a body donation program requires special attention regarding the religiosity, culture and uniqueness of the city's inhabitants. Informing people can demystify the process, avoid prejudice and increase the number of donors. In this way, an outreach project was designed to publicize Sempre Vivo and raise public awareness. In the first six years, Sempre Vivo reached the mark of 64 registered donors and seven bodies received. The donor’s profile corresponds to female (70.3%), 57 years of age, retired (50.8%), spiritist (53.1%) and with 12 years or more of formal education (90.6%). Considering that the UFJF has not received unclaimed bodies for ten years, the program was considered satisfactory up to this level and, in the future, it may be the exclusive source of anatomical specimens. The description of the creation and the publicizing of Sempre Vivo, the overcome challenges, as well as the donors’ profile, may encourage and facilitate the foundation of similar programs in Brazil and abroad.
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Affiliation(s)
| | | | - Júlia Nunes Soares
- Department of Anatomy, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | | | | | | | | | | | | | | | - Alice Belleigoli Rezende
- Department of Anatomy, Federal University of Juiz de Fora, Juiz de Fora, Brazil.,Department of Medical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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14
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Philp J. Bodies and bureaucracy: The demise of the body snatchers in 19th century Britain. Anat Rec (Hoboken) 2021; 305:827-837. [PMID: 34636494 DOI: 10.1002/ar.24794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/25/2021] [Accepted: 09/08/2021] [Indexed: 02/02/2023]
Abstract
As European anatomical teaching developed in the middle ages, anatomists found themselves balanced between the educational and judicial systems. Dissection was associated with the final stages of legal prosecutions and the supply of bodies was severely limited. Driven by increasing student demand for dissection, anatomists found themselves pushed to explore alternative routes for body supply. This led to association with the developing profession of grave robber, body snatchers, and even murderers. Keen to protect themselves from increasing vulnerability to legal prosecution, the eminent anatomists of the United Kingdom pushed for government legislation to provide a supply of cadaveric material for education. This article looks at the development of the Anatomy legislation in the United Kingdom in 1832. By highlighting three events in the early 1800s, it demonstrates that the development of the legislation was for addressing the concerns of the anatomists rather than any ethical concerns about the cadaveric supply. The poorest in society were used to develop the medical understanding of the more wealthy before, during, and after the introduction of the legislation. The first event made the anatomists criminal liable for body supply while the latter two events linked anatomists with murderers. The increasing demand for legislation to provide a supply of cadaveric material released the anatomists from the financial burden of dealing with grave robbers while still allowing dissection tables to be supplied with the poorest in society.
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Affiliation(s)
- Janet Philp
- University of Edinburgh, Old College, Edinburgh, UK
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15
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de Carvalho Filho MA, Hafferty FW, Pawlina W. Anatomy 3.0: Rediscovering Theatrum Anatomicum in the wake of Covid-19. ANATOMICAL SCIENCES EDUCATION 2021; 14:528-535. [PMID: 34363339 PMCID: PMC9135058 DOI: 10.1002/ase.2130] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/07/2021] [Indexed: 05/07/2023]
Abstract
The Covid-19 pandemic has challenged medical educators internationally to confront the challenges of adapting their present educational activities to a rapidly evolving digital world. In this article, the authors use anatomy education as proxy to reflect on and remap the past, present, and future of medical education in the face of these disruptions. Inspired by the historical Theatrum Anatomicum (Anatomy 1.0), the authors argue replacing current anatomy dissection laboratory (Anatomy 2.0) with a prototype anatomy studio (Anatomy 3.0). In this studio, anatomists are web-performers who not only collaborate with other foundational science educators to devise meaningful and interactive content but who also partner with actors, directors, web-designers, computer engineers, information technologists, and visual artists to master online interactions and processes in order to optimize students' engagement and learning. This anatomy studio also offers students opportunities to create their own online content and thus reposition themselves digitally, a step into developing a new competency of stage presence within medical education. So restructured, Anatomy 3.0 will prepare students with the skills to navigate an emergent era of tele and digital medicine as well as help to foreshadow forthcoming changes in medical education.
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Affiliation(s)
- Marco Antonio de Carvalho Filho
- Life and Health Sciences Research InstituteSchool of MedicineUniversity of MinhoBragaPortugal
- Center for Education Development and Research in Health Professions (CEDAR)Lifelong Learning, Education and Assessment Research Network (LEARN)University Medical Centre GroningenGroningenThe Netherlands
| | - Frederic W. Hafferty
- Division of General Internal MedicineDepartment of MedicineMayo Clinic College of Medicine and ScienceMayo ClinicRochesterMinnesotaUSA
- Program in Professionalism and ValuesMayo ClinicRochesterMinnesotaUSA
| | - Wojciech Pawlina
- Department of Clinical AnatomyMayo Clinic College of Medicine and ScienceMayo ClinicRochesterMinnesotaUSA
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16
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Maloney S, Pather N, Foo J, Lazarus MD. Spending Wisely: The Role of Cost and Value Research in the Pursuit of Advancing Anatomical Sciences Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:263-269. [PMID: 33068329 DOI: 10.1002/ase.2027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Studies of "cost and value" in anatomical sciences education examine not only what works, but at what cost, thus evaluating the inputs and outputs of education. This research provides insights into how to use available resources (e.g., academic time, budgets, infrastructure) as a mechanism to obtaining the maximum outcomes available. The purpose of this viewpoint article is to expand on the application of cost and value concepts to anatomical sciences education, contextualizing these concepts through a deeper dive into the more costly educational approaches of human donor dissection. In doing so, both questions and opportunities are raised for the discipline of anatomical sciences going forward. Educational decisions, inclusive of cost and value appraisals, consider the range of outcomes for which the activity is designed to achieve, and the activity's integration with the philosophy of the educational program it is contributing to; these decisions, thus, evaluate more than just cost alone. Healthcare students' engagement with human donor dissection pedagogy offers an array of reported non-economic benefits, including non-traditional discipline-independent skill (NDIS) development (e.g., professionalism, teamwork skills). These skills are often harder to measure, but are no less important to the final pedagogical decision-making process. The goal of cost and value research is to create an evidence-base toward education that delivers maximum value for a given spend. Anatomy educators, researchers, and decision makers who embrace cost and value dialogue, and interpret and apply findings from studies of educational costs, are best positioned to improve the educational value for their learners and provide effective outputs for all stakeholders.
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Affiliation(s)
- Stephen Maloney
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Nalini Pather
- Department of Anatomy, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Jonathan Foo
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Centre for Scholarship in Health Education, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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17
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McDaniel KG, Brown T, Radford CC, McDermott CH, van Houten T, Katz ME, Stearns DA, Hildebrandt S. Anatomy as a Model Environment for Acquiring Professional Competencies in Medicine: Experiences at Harvard Medical School. ANATOMICAL SCIENCES EDUCATION 2021; 14:241-251. [PMID: 32657538 DOI: 10.1002/ase.2000] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 06/03/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
Anatomy education provides students with opportunities to learn structure and function of the human body, to acquire professional competencies such as teamwork, interpersonal skills, self-awareness, and to reflect on and practice medical ethics. The fulfillment of this wide potential can present challenges in courses that are part of an integrated curriculum and shorter than traditional courses. This new reality, together with students' increasing concern about the stresses within medical education, led to efforts at Harvard Medical School to implement practical steps toward an optimal learning environment in anatomy. These were based on core elements of ethical anatomy education and principles of trauma-informed care. Anatomy is conceptualized here as the "first clinical discipline," with relational interactions between anatomical educators, medical students, and body donors/patients. Essential prerequisites for the implementation of this work were support by the medical school leadership, open partnership between engaged students and faculty, faculty coordination, and peer-teaching. Specific interventions included pre-course faculty development on course philosophy and invitations to students to share their thoughts on anatomy. Student responses were integrated in course introductions, combined with a pre-dissection laboratory visit, an introductory guide, and a module on the history and ethics of anatomy. During the course, team-building activities were scheduled, and self-reflection encouraged, for example, through written exercises, and elective life-body drawing. Students' responses to the interventions were overall positive, but need further evaluation. This first attempt of a systematic implementation of an optimal learning environment in anatomy led to the identification of areas in need of adjustment.
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Affiliation(s)
| | - Taylor Brown
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | | | - Cynthia H McDermott
- Department of Cell Biology, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Trudy van Houten
- Program in Medical Education at Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Brigham's and Women's Hospital, Boston, Massachusetts
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Martha E Katz
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dana A Stearns
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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18
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Holland JC, Ní Dhónaill R, Clarke M, Joyce P. Physician Associate Students' Experience of Anatomy Dissection. ANATOMICAL SCIENCES EDUCATION 2021; 14:52-61. [PMID: 32452170 DOI: 10.1002/ase.1984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
The role of physician assistant/associate (PA) has expanded from its inception in the United States over 50 years ago, to European countries including Ireland. While there is an increasing body of evidence exploring the role and training of PAs in clinical settings, there is a scarcity of research exploring PA students' perspectives in relation to their experience of anatomy dissection, or how these experiences may contribute to the development of their core professional identity. Students in the first two cohorts of PA Program at the Royal College of Surgeons in Ireland program were invited to interviews which solicited them to reflect and report on their own experiences of anatomical dissection during their course. Participants' responses were analyzed using a thematic inductive approach; common themes and patterns were organized into a hierarchical structure, which generated the final framework of themes. Ten participants took part in the study; only one had previous personal experience of dissection, while two further participants had some familiarity with prosected specimens. The first theme concerned the participants' expectation of anatomical dissection, with sub-themes of preconceptions, smell, and emotions. The second theme involves discussion of coping strategies that the participants used, including talking, viewing the cadaver as their first patient, and naming (or not naming) the cadaver. The third theme includes how the participants' talked about respect and compassion in the dissection room, development of team working skills, and awareness of bereavement and organ donation. A number of recommendations were also made for the experience and orientation of future students in such a program.
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Affiliation(s)
- Jane C Holland
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Maeve Clarke
- Department of Oncology, Beaumont Hospital, Dublin, Ireland
| | - Pauline Joyce
- Physician Associate Program, Royal College of Surgeons in Ireland, Dublin, Ireland
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19
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Zwier RK. Slicing through Thin Layers of Humanity: Narratives of the Abject. THE JOURNAL OF MEDICAL HUMANITIES 2020; 41:501-513. [PMID: 32008143 DOI: 10.1007/s10912-020-09613-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This essay examines narratives about cadaver dissection through the lens of psychoanalytic theory in order to better understand the nature of medical students' socialization into medicine and its implications for physician-patient communication. The theoretical framework provided by Julia Kristeva focuses attention on the nature of subject-formation in relation to abjection - that which reveals the contingent nature of the speaking self. Analysis of memoirs and other narratives by medical students demonstrates that students encounter the abject in the process of dissecting a corpse, but are rigorously trained to map over this experience using the technical tools of biomedicine. Other students rely on dark and morbid forms of humor to develop a sense of emotional distance from their cadaver. This analysis reveals new insights about the nature of the gap between physicians and their patients. In particular, it indicates that this gap is not fixed or static but fluid and malleable. Physicians are always shifting between the symbolic realm of biomedicine and the affective, semiotic mode of encountering the abject. This malleability provides the key to training and educating medical students, socializing them in such a way that they are reflexive about this process of oscillation. How physicians handle the reality of their fluctuation between the semiotic and the symbolic is what will determine their ability to engage with patients.
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Affiliation(s)
- Robin Kanak Zwier
- 1401 Cathedral of Learning, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA.
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20
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Goss AL, Rethy L, Pearl RL, DeLisser HM. The "difficult" cadaver: weight bias in the gross anatomy lab. MEDICAL EDUCATION ONLINE 2020; 25:1742966. [PMID: 32182202 PMCID: PMC7144266 DOI: 10.1080/10872981.2020.1742966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 06/10/2023]
Abstract
Background: The prevalence of overweight and obesity continues to rise and is associated with increased morbidity and mortality. Weight bias is common among physicians and medical students and limits the therapeutic alliance between providers and patients with overweight and obesity.Objective: The authors sought to explore the relationship between the gross anatomy course and medical student attitudes towards weight and obesity.Design: The authors employed a mixed-methods approach consisting of semi-structured interviews and anonymous web-based surveys of first-year medical students taking gross anatomy at one USA medical school. They analyzed transcripts of interviews and free-text survey responses using a grounded theory approach and performed tests of association to investigate the relationship between demographic information, responses to multiple-choice survey questions and weight bias.Results: A total of 319 (52%) first-year medical students (2015-2018) completed the survey and 33 participated in interviews. Of survey respondents, 71 (22%) responded that the course had changed how they felt about people with overweight/obesity. These respondents were also more likely to affirm that the course had affected their views toward their own bodies (p < 0.001). Qualitative data analysis identified three overarching themes within students' descriptions of the effects of the gross anatomy lab on attitudes toward bodies perceived to have excess weight: these bodies were described as 1) difficult, 2) unhealthy, and 3) evoking disgust. Students extrapolated from their experiences with cadavers to imagined interactions with future patients, relying heavily on the narrative of the difficult patient.Conclusions: At one USA medical school, students perceived their experiences in gross anatomy as shaping their attitudes toward individuals with overweight or obesity. Efforts to reduce medical student weight bias ought to target this previously unexplored potential site of weight bias.
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Affiliation(s)
| | - Leah Rethy
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca L. Pearl
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Horace M. DeLisser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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21
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McBain K, Azimov B, O'Brien J, Noël GPJC, Ventura NM. Evaluating the integration of pre-mortem body donor imaging into a dissection-based medical anatomy course. BMC MEDICAL EDUCATION 2020; 20:384. [PMID: 33097041 PMCID: PMC7583208 DOI: 10.1186/s12909-020-02300-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Medical faculties are currently embracing a modernistic approach to anatomical education that integrates diagnostic imaging largely through post-mortem computed tomography scanning of body donors. Post-mortem imaging, however, poses a multitude of challenges. The purpose of this study was to assess the implementation of pre-mortem donor-specific diagnostic imaging on student learning and dissection experience in addition to understanding the potential impact on students' preparation for clinical practice. METHODS Students in a fourth-year medicine elective course were divided into groups; group 1 received pre-mortem donor-specific diagnostic imaging, while group 2 received pathology-specific diagnostic imaging, a collection of images relating to the type(s) of pathologies the donors exhibited, though not specific to the donors themselves. Both groups also received a donor-specific case vignette. A convergent, parallel mixed methods design was employed. This included integrating data from group responses to a study participant survey and students' academic assessment scores analyzed quantitatively through statistical analyses with data from focus group sessions investigating the psychosocial aspects of the student dissection experience and perceptions of the imaging use in the course analyzed qualitatively. RESULTS As compared to students receiving pathology-specific diagnostic imaging, the quantitative results demonstrated that students receiving pre-mortem donor-specific diagnostic imaging more positively supported the relevancy of diagnostic imaging to their understanding of anatomy, valued the integration for future practice, and suggested an earlier integration within their medical curriculum. Qualitatively, two main themes were observed: the influence of diagnostic imaging integration on dissection experience and on professional mindset. Although both student groups received imaging corresponding to their body donor, consideration towards the humanistic nature of the body donor as a patient with a history was limited to student feedback from the donor- specific diagnostic imaging group. CONCLUSION Overall the integration of pre-mortem donor-specific diagnostic imaging into anatomical dissection provided students with practical skill development, an enhanced dissection experience, and reinforced personal qualities critical for future practice.
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Affiliation(s)
- Kimberly McBain
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Brandon Azimov
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Jeremy O'Brien
- Department of Diagnostic Radiology, McGill University, Montreal, Quebec, Canada
| | - Geoffroy P J C Noël
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, McGill University, Strathcona Anatomy and Dentistry Building, 3640 University Street, Montreal, QC, H3A 0C7, Canada
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Nicole M Ventura
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, McGill University, Strathcona Anatomy and Dentistry Building, 3640 University Street, Montreal, QC, H3A 0C7, Canada.
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
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22
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Jiang J, Chen Q, Zhang M, Hong T, Huang K, Meng H, Ding J, Zhang L. Effects of Commemorations and Postdonation Services on Public Willingness to Donate Bodies in China. ANATOMICAL SCIENCES EDUCATION 2020; 13:218-229. [PMID: 31074191 DOI: 10.1002/ase.1892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 06/09/2023]
Abstract
Multiple body donation programs have been established throughout China over the last 20 years, but these programs remain challenged by an insufficient supply of cadavers for medical education. The commemoration of body donors is a feature of many successful programs, and adopting this practice throughout the country could be an important element of raising public awareness and encouraging body donation among the public. The present study aimed to investigate public views on the commemoration of whole-body donors and postdonation services in China by analyzing the factors that influence participants' willingness to donate. A survey was conducted using convenience sampling with a non-probability sampling method, and data were analyzed using chi-square and post hoc multiple comparisons tests. A total of 1,800 questionnaires were distributed, 1,717 were returned, and 1,605 were considered valid. Of the respondents, 20.87% were willing to donate, and 64.80% thought that it is necessary to commemorate donors. The results of multiple comparisons demonstrated that the elderly and those with a higher educational level were more willing to donate than participants in other groups. Education was also found to influence views on donation memorial activities, and the chi-square test revealed that conducting commemorations and improving postdonation services can promote the establishment of successful donor programs in China and improve the social acceptance of body donation.
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Affiliation(s)
- Jingwen Jiang
- School of Basic Medical Sciences, Nanjing Medical University, Nanjing, People's Republic of China
| | - Qinghuo Chen
- Jinling Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China
| | - Mingyi Zhang
- School of Pediatrics, Nanjing Medical University, Nanjing, People's Republic of China
| | - Tongtong Hong
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Kun Huang
- Kangda College, Nanjing Medical University, Lianyungang, People's Republic of China
| | - Haojie Meng
- School of Pediatrics, Nanjing Medical University, Nanjing, People's Republic of China
| | - Jiong Ding
- Department of Human Anatomy, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, People's Republic of China
- Body Donation Receiving Station, Nanjing Medical University, Nanjing, People's Republic of China
| | - Luqing Zhang
- Department of Human Anatomy, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, People's Republic of China
- Body Donation Receiving Station, Nanjing Medical University, Nanjing, People's Republic of China
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23
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Kaye A, Miranda M, Jones T. The Donor Letter Project: Learning Professionalism and Fostering Empathy in an Anatomy Curriculum. THE JOURNAL OF MEDICAL HUMANITIES 2019; 40:607-612. [PMID: 31468252 DOI: 10.1007/s10912-019-09573-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
While cadaver dissection remains an unmatched learning tool for structural anatomy, recent shifts in medical culture and pedagogy indicate that developing humanistic practices and fostering empathic responses are crucial components of early medical education. The Donor Letter Project (DLP) was designed to accompany a traditional dissection curriculum, and the pilot, described here, tested its quality and efficacy. In 2017, family members of recently deceased donors to the Colorado State Anatomical Board were invited to submit letters about their loved ones, and forty-seven first-year medical students at the University of Colorado School of Medicine volunteered to read the letters after their human anatomy course. The students then completed a survey about their experience. Because student and donor family responses to the DLP were overwhelmingly positive, the DLP will be repeated with incoming medical school classes, and an addendum to the State Anatomical Board donation application will invite donors to submit letters along with their enrollment materials that may be read by students at the time of donation.
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Affiliation(s)
- Abigail Kaye
- University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Madison Miranda
- University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Therese Jones
- Center for Bioethics and Humanities, Fulginiti Pavilion for Bioethics and Humanities - Mailstop B137, 13080 E. 19th Avenue, Aurora, CO, 80045, USA.
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24
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Cope JM, Precht MC, Hannah MC, Bennett CC. Naming the Dead: What information do Physical Therapy and Physician Assistant Anatomy Faculty Share With Students? ANATOMICAL SCIENCES EDUCATION 2019; 12:636-644. [PMID: 30661289 DOI: 10.1002/ase.1862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 06/09/2023]
Abstract
In this novel study, the researchers quantify cadaver information provided to Physical Therapy (PT) and Physician Assistant (PA) anatomy faculty and ask what portion of that information is then shared with students. Descriptive statistics were used to the describe demographics of the study respondents and to report survey responses. The majority (60% or greater) of faculty who teach anatomy to PT and PA students have clinical degrees matching the student groups they teach. Chi-square analysis showed no appreciable difference (P < 0.001) between PT and PA anatomy faculty in the amount of cadaver information they receive or then share with students. There was a difference in the type of cadaver information (identifying vs. non-identifying) that is received and then shared by these faculty. Faculty are more likely to receive non-identifying cadaver information (93%) than identifying information (40%) (P < 0.0001) and share non-identifying information (83%) than identifying information (26%) with students (P < 0.0003). Interestingly, there is no consensus as to whether sharing cadaver information is respectful or disrespectful to those who donate their bodies for anatomy education and research. Further research is warranted into the reasons anatomy faculty withhold cadaver information from students and in the value, if any, for students knowing more about the cadavers they are learning from.
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Affiliation(s)
- Janet M Cope
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, North Carolina
| | | | - Mary C Hannah
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, North Carolina
| | - Cynthia C Bennett
- Department of Physician Assistant Studies, School of Health Sciences, Elon University, Elon, North Carolina
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25
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Iaconisi J, Hasselblatt F, Mayer B, Schoen M, Böckers TM, Böckers A. Effects of an Educational Film About Body Donors on Students' Empathy and Anxiety Levels in Gross Anatomy. ANATOMICAL SCIENCES EDUCATION 2019; 12:386-398. [PMID: 30925012 DOI: 10.1002/ase.1880] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/10/2019] [Accepted: 03/11/2019] [Indexed: 06/09/2023]
Abstract
While most German anatomy institutes provide only limited information about body donors and their lives, students have expressed a desire to learn more about these individuals, especially about their motivations to donate their bodies for the sake of medical education. In order to gratify this wish, as well as to further humanize body donors, an educational film was compiled, and a study designed to capture the film's effects on medical students. This is the first study using standardized, validated psychological tools to evaluate the impact of an educational film about body donors on students' empathy and psychological stress levels. The study followed a longitudinal, controlled, and cluster randomized design, including 77 (48 females/29 males) participants who watched the video either before, midway, or after the dissection course. Questionnaires were completed at four points in time applying the Jefferson Scale for Empathy (JSPE-S) and the Interpersonal Reactivity Index (IRI) to measure empathy. Psychological stress levels were recorded by the Brief Symptom Inventory (BSI). Overall, students recommended the film to be shown to all students (median 6.0; maximum on the six-point Likert scale). Viewing the film revealed no significant changes between study groups or over time in JSPE-S sum scores. All groups demonstrated a significant reduction of BSI values before the dissection course actually started and increased values during the course, but both developments appeared not to be associated with the intervention. Overall, the educational film did not correlate with any negative effects on students' empathy and psychological stress levels, and it was strongly approved of by students, as it provided more humanizing personal information about body donors without violating their anonymity.
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Affiliation(s)
- Julia Iaconisi
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Friederike Hasselblatt
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Benjamin Mayer
- Faculty of Medicine, Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Michael Schoen
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Tobias Maria Böckers
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Anja Böckers
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
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26
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Gürses İA, Ertaş A, Gürtekin B, Coşkun O, Üzel M, Gayretli Ö, Demirci MS. Profile and Motivations of Registered Whole-Body Donors in Turkey: Istanbul University Experience. ANATOMICAL SCIENCES EDUCATION 2019; 12:370-385. [PMID: 30548175 DOI: 10.1002/ase.1849] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 06/09/2023]
Abstract
Little is known regarding the profiles of whole body donors in Muslim majority countries where donation is scarce. Therefore, this study aims to profile registered donors in Turkey by means of a survey. The explored data could be used to improve ongoing campaign efforts and ethical practices such as commemoration services. Registered donors of the donation programs at the two faculties of medicine of Istanbul University were compared with the national population and a cluster analysis was performed to reveal any concealed sub-groups. Data from 188 respondents were analyzed. The majority of registered donors were married (42%), male (65.4%), aged over 50 years (76%), held a tertiary education degree (49.7%), and were irreligious (58.5%). Cluster analysis revealed two groups with significantly different educational levels, marital statuses, and religious choices. Regarding whether their bodies could be used for education or research, the majority (64.5%) of the respondents left the decision to the anatomy department. Similarly, 73.8% approved indefinite use of their organs, body parts and/or skeletons. The respondents were also willing to share their medical history (94.2%) and personal information (81.6%) if needed. Motivational themes for body donation including usefulness, impermanence, religion, awareness, and kinship were devised after a thematic analysis. Among the respondents, 56.5% were registered organ donors and 63.3% were frequent blood donors. The results of this study provide data that may help revising informed consent forms, developing and implementing thanksgiving ceremonies, and selecting additional targets for supporting body donation campaign activities such as organ and blood donation units.
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Affiliation(s)
- İlke Ali Gürses
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Ertaş
- Department of Anatomy, Istanbul University, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Başak Gürtekin
- Department of Biostatistics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Osman Coşkun
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Üzel
- Department of Anatomy, Istanbul University, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Özcan Gayretli
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Selman Demirci
- Department of Anatomy, Istanbul University, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
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27
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Stephens GC, Rees CE, Lazarus MD. How does Donor Dissection Influence Medical Students' Perceptions of Ethics? A Cross-Sectional and Longitudinal Qualitative Study. ANATOMICAL SCIENCES EDUCATION 2019; 12:332-348. [PMID: 30903742 DOI: 10.1002/ase.1877] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/07/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
The contribution of donor dissection to modern anatomy pedagogy remains debated. While short-term anatomy knowledge gains from dissection are questionable, studies suggest that donor dissection may have other impacts on students including influencing medical students' professional development, though evidence for such is limited. To improve the understanding of how anatomy education influences medical student professional development, the cross-sectional and longitudinal impacts of donor dissection on medical students' perceptions of ethics were explored. A cross-sectional and longitudinal qualitative study was undertaken at an Australian university where student responses to online discussion forums and in-person interviews were analyzed. Data were collected across the 1.5 years that undergraduate medical students received anatomy instruction (three semesters during first and second years). A total of 207 students participated in the online discussion forums, yielding 51,024 words; 24 students participated in at least 1 of 11 interviews, yielding over 11 hours of interview data. Framework analysis identified five themes related to ethics in an anatomical education context: (1) Dignity, (2) Beneficence, (3) Consent, (4) Justification for versus the necessity of dissection, and (5) Dichotomy of objectification and personification. The dominant themes of students' ethical perceptions changed with time, with a shift from focusing on donors as people, toward the utility of donors in anatomy education. Additionally, themes varied by student demographics including gender, ancestry, and religiosity. Together this study suggests a strong impact of donor dissection on priming students' focus on medical ethics and provides further advocacy for formal and purposeful integration of medical ethics with anatomy education.
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Affiliation(s)
- Georgina C Stephens
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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28
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Cornwall J, Hildebrandt S. Anatomy, Education, and Ethics in a Changing World. ANATOMICAL SCIENCES EDUCATION 2019; 12:329-331. [PMID: 31125503 DOI: 10.1002/ase.1898] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/09/2019] [Accepted: 05/21/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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29
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Wainman BC, Cornwall J. Body Donation after Medically Assisted Death: An Emerging Consideration for Donor Programs. ANATOMICAL SCIENCES EDUCATION 2019; 12:417-424. [PMID: 30848063 DOI: 10.1002/ase.1874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
Around the world, the recent introduction of assisted death laws has meant that undertaking medical assistance in dying (MAID) is now an option for some persons wishing to end their life. Some of these people donate their bodies to medical science, and by doing so have created a new route from which donor programs can now receive bodies. Such donations have also illuminated a myriad of novel ethical questions. This article considers the emotive and controversial topic of MAID in relation to body donation, describing the experiences of McMaster University, Canada, where several MAID body donors have been received by the anatomical donor program. It provides background on the development and implementation of MAID in Canada, and describes the experience of staff and students at McMaster to MAID donations. It also explores the relevance of MAID to body donation programs, and discusses several of the ethical challenges facing body donation programs who may encounter MAID body donors. These include the appropriateness of accepting MAID donors, issues with informed consent, the effect of personal engagement with MAID donors, information sharing around MAID donations, governance issues, and negative historical parallels between MAID and euthanasia. Suggestions on how to manage MAID body donation focus on how issues affecting institutions, faculty, and students may be approached utilizing appropriate transparency and communication, some of which may facilitate student professional development around the topic of MAID. It is also suggested that the development of ethically appropriate guidelines on MAID body donations may positively guide the anatomical community.
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Affiliation(s)
- Bruce C Wainman
- Pathology and Molecular Medicine and Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
| | - Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
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30
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Champney TH. A Bioethos for Bodies: Respecting a Priceless Resource. ANATOMICAL SCIENCES EDUCATION 2019; 12:432-434. [PMID: 30589510 DOI: 10.1002/ase.1855] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
The value that willed body donors provide to medical education is priceless. Their precious gift helps to teach anatomy, spatial relationships between morphological structures, anatomical variation, and professionalism to medical students in a way that plastic models, podcasts, and lectures cannot. They are also an important resource for medical research and a wide variety of postgraduate training opportunities. While many body donation programs throughout the world are nonprofit organizations, there are body donation companies in the United States that sell donors for-profit. These "body brokers" have accumulated large profits from this business. It is incongruous that others would profit from such a priceless, freely donated gift. To prevent this incongruity, it is proposed that the international anatomical community develop a normative culture (a bioethos) for body donation programs. This would involve the conscious and systematic development of ethical principles for the day-to-day policies and practices of institutions that collect and use human bodies. With the development of this bioethos, a cultural shift in how donors are treated would occur and, over time, this would become the normal practice. These principles would become fundamental and foundational for the procurement and use of priceless human tissues.
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Affiliation(s)
- Thomas H Champney
- Department of Cell Biology, University of Miami, Miller School of Medicine, Miami, Florida
- Institute for Bioethics and Health Policy, University of Miami, Miller School of Medicine, Miami, Florida
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31
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Hildebrandt S. The Role of History and Ethics of Anatomy in Medical Education. ANATOMICAL SCIENCES EDUCATION 2019; 12:425-431. [PMID: 30580499 DOI: 10.1002/ase.1852] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
While time spent on anatomical education in medical school curricula has been diminishing over the last decades, the recognized role of anatomical dissection has expanded. It is perceived by many students and faculty not only as the means of learning the structure and function of the human body, but also as an opportunity for the acquisition of professional competencies such as team work, patient-doctor interaction, medical epistemology, self-awareness, and an understanding of medical ethics. This viewpoint article proposes that this learning process can be supported effectively through studying examples from the history of anatomy, as insights from this history can help illuminate contemporary ethical issues in anatomy and medicine. Anatomical education can thus provide not only the opportunity of gaining awareness of ethical questions, but also a chance to practice these new insights within the protected environment of the laboratories, in interaction with the dead and the living. Consequently, a new role has developed for anatomists, which includes the interweaving of the scholarly exploration of the history and ethics of anatomy with the practical application of research results into a reframed concept of anatomical education. Anatomy, as a foundational discipline in the medical curriculum, can thus provide a first step on the educational path of empathetic and humane medical caregivers.
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MESH Headings
- Anatomists/organization & administration
- Anatomists/psychology
- Anatomy/education
- Anatomy/ethics
- Anatomy/history
- Cadaver
- Clinical Competence
- Curriculum/trends
- Dissection
- Education, Medical, Undergraduate/ethics
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/trends
- Ethics, Medical/education
- Ethics, Medical/history
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, 21st Century
- Humans
- Professional Role
- Schools, Medical/ethics
- Schools, Medical/organization & administration
- Schools, Medical/trends
- Students, Medical/psychology
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Affiliation(s)
- Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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32
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Jones DG. Three-dimensional Printing in Anatomy Education: Assessing Potential Ethical Dimensions. ANATOMICAL SCIENCES EDUCATION 2019; 12:435-443. [PMID: 30554454 DOI: 10.1002/ase.1851] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/05/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
New technological developments have frequently had major consequences for anatomy education, and have raised ethical queries for anatomy educators. The advent of three-dimensional (3D) printing of human material is showing considerable promise as an educational tool that fits alongside cadaveric dissection, plastination, computer simulation, and anatomical models and images. At first glance its ethical implications appear minimal, and yet the more extensive ethical implications around clinical bioprinting suggest that a cautious approach to 3D printing in the dissecting room is in order. Following an overview of early groundbreaking studies into 3D printing of prosections, organs, and archived fetal material, it has become clear that their origin, using donated bodies or 3D files available on the Internet, has ethical overtones. The dynamic presented by digital technology raises questions about the nature of the consent provided by the body donor, reasons for 3D printing, the extent to which it will be commercialized, and its comparative advantages over other available teaching resources. In exploring questions like these, the place of 3D printing within a hierarchical sequence of value is outlined. Discussion centers on the significance of local usage of prints, the challenges created by regarding 3D prints as disposable property, the importance of retaining the human side to anatomy, and the unacceptability of obtaining 3D-printed material from unclaimed bodies. It is concluded that the scientific tenor of 3D processes represents a move away from the human person, so that efforts are required to prevent them accentuating depersonalization and commodification.
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33
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Caplan I, DeCamp M. Of Discomfort and Disagreement: Unclaimed Bodies in Anatomy Laboratories at United States Medical Schools. ANATOMICAL SCIENCES EDUCATION 2019; 12:360-369. [PMID: 30586224 DOI: 10.1002/ase.1853] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 06/09/2023]
Abstract
Use of unclaimed bodies for anatomy teaching in undergraduate medical education continues, but is ethically controversial. The purposes of this study were to estimate the proportion of United States (US) medical schools using unclaimed bodies in first-year anatomy laboratories, to determine whether schools inform students of this use, and to explore anatomy course leaders' attitudes toward unclaimed body use. Anatomy course leaders from 146 US medical schools that had independent preclinical programs including anatomy were surveyed. Survey results were analyzed with descriptive statistics and statistical tests of association. Free text responses were analyzed using a thematic editing style of qualitative content analysis. Of 89 responses (response rate, 61.0%), 11 schools (12.4%) reported possible use of unclaimed bodies. Course leaders from these schools reported greater comfort with using unclaimed bodies compared to leaders from other schools (P < 0.01). Although most course leaders (49/76, or 64.5%) believed it was important or very important to inform students about use of unclaimed bodies, respondents from schools where unclaimed bodies could be used were more neutral (P < 0.01). Qualitative findings revealed deep disagreement and contradictory views about how unclaimed body use relates to ethical principles of respect for persons and justice. Continued use of unclaimed bodies, varying levels of comfort with their use, and disagreement about the practices' underlying morality suggest a need for greater ethical reflection about the permissibility of unclaimed body use in clinical anatomy and for educational interventions that teach students about its history, ethics, and contemporary practice.
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Affiliation(s)
- Ilan Caplan
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Matthew DeCamp
- Johns Hopkins Berman Institute of Bioethics, John Hopkins University, Baltimore, Maryland
- Division of General Internal Medicine, Department of Medicine, John Hopkins University, Baltimore, Maryland
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34
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Stephan CN, Ross AH. Letter to the Editor - A Code of Practice for the Establishment and Use of Authentic Human Skeleton Collections in Forensic Anthropology. J Forensic Sci 2019; 63:1604-1607. [PMID: 30176194 DOI: 10.1111/1556-4029.13859] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Carl N Stephan
- Laboratory for Human Craniofacial and Skeletal Identification, School of Biomedical Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Ann H Ross
- Forensic Analysis Laboratory, Department of Biological Sciences, North Carolina University, Raleigh, NC, 27695-7614
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35
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Cornwall J, Poppelwell Z, McManus R. "Why did you really do it?" A mixed-method analysis of the factors underpinning motivations to register as a body donor. ANATOMICAL SCIENCES EDUCATION 2018; 11:623-631. [PMID: 29762910 DOI: 10.1002/ase.1796] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 03/02/2018] [Accepted: 04/08/2018] [Indexed: 06/08/2023]
Abstract
Individuals who register as body donors do so for various reasons, with aiding medical science a common motivation. Despite awareness of several key reasons for donation, there are few in-depth explorations of these motivations to contextualize persons' reasons for donating. This study undertakes a mixed-method exploration of motivations for body donation to facilitate deeper understanding of the reasons underpinning donor registration. A survey of all newly registered body donors at a New Zealand university was performed over a single year. The survey included basic demographic information, a categorical question on reason for donation, a free-text question on donation motivation, and a free-text question allowing "other" comments on body donation. Basic statistical analysis was performed on demographic and categorical data, and thematic analysis used on free-text responses. From 169 registrants, 126 people (average age 70.5 years; 72 female) returned completed surveys (response rate 75%). Categorical data indicate a primary motivation of aiding medical science (86%). Fifty-one respondents (40%) provided free-text data on motivation, with other comments related to motivation provided by forty-one (33%). Common themes included reference to usefulness, uniqueness (pathophysiology and anatomy), gift-giving, kinship, and impermanence of the physical body. Consistent with previous studies, the primary reason for body donation was aiding medical science, however underpinning this was a complex layer of themes and sub-themes shaping motivations for choices. Findings provide important information that can guide development of robust informed consent processes, aid appropriate thanksgiving service delivery, and further contextualize the importance of medical professionals in body donation culture.
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Affiliation(s)
- Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
- Institute for Health Sciences, Zurich University of Applied Science, Zurich, Switzerland
| | - Zoe Poppelwell
- School of Social and Cultural Studies, Victoria University of Wellington, Wellington, New Zealand
| | - Ruth McManus
- School of Anthropology and Sociology, University of Canterbury, Christchurch, New Zealand
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36
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Hasselblatt F, Messerer DAC, Keis O, Böckers TM, Böckers A. 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. ANATOMICAL SCIENCES EDUCATION 2018; 11:282-293. [PMID: 29742328 DOI: 10.1002/ase.1744] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/19/2017] [Accepted: 09/17/2017] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Friederike Hasselblatt
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - David A C Messerer
- Department of Evaluation and Quality Management, Ulm University, Faculty of Medicine, Ulm, Germany
| | - Oliver Keis
- Department of Evaluation and Quality Management, Ulm University, Faculty of Medicine, Ulm, Germany
| | - Tobias M Böckers
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Anja Böckers
- Faculty of Medicine, Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
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Gürses İA, Coşkun O, Öztürk A. Current status of cadaver sources in Turkey and a wake-up call for Turkish anatomists. ANATOMICAL SCIENCES EDUCATION 2018; 11:155-165. [PMID: 28657659 DOI: 10.1002/ase.1713] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 04/21/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
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 (rs = 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.
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MESH Headings
- Anatomists
- Anatomy/education
- Awareness
- Cadaver
- Dissection
- Education, Medical, Undergraduate/economics
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/organization & administration
- Faculty, Medical
- Female
- Human Body
- Humans
- Legislation, Medical
- Schools, Medical/economics
- Schools, Medical/organization & administration
- Surveys and Questionnaires
- Time Factors
- Tissue and Organ Procurement/economics
- Tissue and Organ Procurement/legislation & jurisprudence
- Tissue and Organ Procurement/methods
- Tissue and Organ Procurement/statistics & numerical data
- Turkey
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Affiliation(s)
- İlke Ali Gürses
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Osman Coşkun
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Adnan Öztürk
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Ghosh SK. Paying respect to human cadavers: We owe this to the first teacher in anatomy. Ann Anat 2017; 211:129-134. [PMID: 28279760 DOI: 10.1016/j.aanat.2017.02.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/05/2017] [Accepted: 02/06/2017] [Indexed: 11/26/2022]
Abstract
Every human cadaver which undergoes anatomical dissection enriches medical science and deserves to be treated with utmost respect. The aim of the present study is to identify the practices followed by medical schools across the globe to ensure that the human cadaver is treated with respect and dignity while it is utilized within the domain of medical education. The article undertakes a review of the literature and takes note of the practice of students taking an oath prior to dissecting cadavers whereby they reflect on their conduct and habits in the dissection room. It emphasizes the guidelines adopted by medical schools to ensure respectful handling of human cadavers during dissection and highlights traditional ways to honor them followed in some parts of the world. The article attempts to focus on the noble endeavor of funeral ceremonies to pay homage to the departed soul who enlightened the students with the knowledge of human anatomy. Finally it converges on the memorial services incorporated into anatomy programs to instill in students an appreciation of the humanity of those who went under the knife as a service to mankind. Based on the observations made in the present study some recommendations are also proposed regarding good practices in human cadaveric dissection. In order to bind science and humanity it is critical to realize our responsibility to reciprocate the anatomical gift of a human body with respect, compassion, care and dignity.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, ESIC Medical College, Gulbarga Sedam Road, Gulbarga, Karnataka 585106, India.
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Ceremonies of gratitude following the dissection course: A report on procedures in departments of anatomy in German speaking countries. Ann Anat 2017; 210:18-24. [DOI: 10.1016/j.aanat.2016.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 10/06/2016] [Accepted: 10/06/2016] [Indexed: 11/21/2022]
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Kahn PA, Champney TH, Hildebrandt S. The incompatibility of the use of unclaimed bodies with ethical anatomical education in the United States. ANATOMICAL SCIENCES EDUCATION 2017; 10:200-201. [PMID: 27911987 DOI: 10.1002/ase.1672] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 11/16/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Peter A Kahn
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Thomas H Champney
- Department of Cell Biology, University of Miami Medical School, Miami, Florida
| | - Sabine Hildebrandt
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
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Jones DG, King MR. Maintaining the anonymity of cadavers in medical education: Historic relic or educational and ethical necessity? ANATOMICAL SCIENCES EDUCATION 2017; 10:87-97. [PMID: 27123986 DOI: 10.1002/ase.1618] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
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.
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Affiliation(s)
- D Gareth Jones
- Department of Anatomy, Otago School of Medical Sciences, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Mike R King
- Bioethics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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