1
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Štrkalj G. Bodies in the anatomy laboratory: A note on terminology. ANATOMICAL SCIENCES EDUCATION 2024; 17:1358-1360. [PMID: 38923210 DOI: 10.1002/ase.2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/20/2024] [Accepted: 03/03/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Goran Štrkalj
- Department of Anatomy, University of New South Wales, Sydney, New South Wales, Australia
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2
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Choi WJ. Teaching respect for body donors: A US medical student perspective. ANATOMICAL SCIENCES EDUCATION 2024; 17:687-692. [PMID: 38183161 DOI: 10.1002/ase.2373] [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: 08/01/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024]
Abstract
Recent controversies over the mismanagement of body donors in US medical schools have raised public concerns over the ethical treatment of bodies in "anatomical gift" programs. Despite widespread moral outrage at such cases, medical students may still make seemingly inconsequential mistakes or jokes that in fact constitute acts of disrespect. This may partially be attributed to the process of desensitization in working with human remains, and indicates a further need to inculcate into medical students the ethical responsibilities of working with body donors. Donation agreement statements that lack specific information about the respectful treatment of bodies in the anatomy laboratory may serve as an additional point of concern for potential donors seeking reassurance about the future treatment of their bodies. This viewpoint draws from the anecdotal experiences of medical students to portray two scenarios of medical students' disrespectful conduct toward body donors, and constructs an account of moral respect for human remains based on respect for posthumous autonomy and respect in attitude. It then provides suggestions for US medical schools to incorporate this ethical framework into their anatomy curricula to instill respectful dispositions in its students and facilitate a more robust informed consent process for potential donors who entrust their bodies to medical students.
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Affiliation(s)
- William J Choi
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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3
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Ma A, Ding Y, Lu J, Wo Y, Ding W. An examination of the status, contexts of anatomical body donation, and perspectives in China. Ann Anat 2024; 253:152230. [PMID: 38367949 DOI: 10.1016/j.aanat.2024.152230] [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: 01/05/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
Body donation is a valuable resource in medical education, research, clinical diagnosis, and treatment. Consequently, donors are honored as "Silent Mentors" in Chinese medical schools. This article briefly reviews the history, current status, and strategies to promote body donation in China (excluding data from Hong Kong, Macao, and Taiwan regions) and discusses the problems encountered in body donation work in China. After establishing the People's Republic of China in 1949, the central government issued regulations on the use of dissected bodies. In 2001, the "Shanghai Regulations on Body Donation" were officially implemented and became China's first local legislative regulation on body donation. Subsequently, local legislative regulations and rules on body donation were issued in various regions to promote smooth and orderly body donation. There has been tremendous development in body donation in China for more than 40 years; however, the progress of this partial work has been uneven in various areas owing to the influence of traditional ethical concepts. It is, therefore, imperative to legislate body donations at a national level. Raising the public's scientific literacy and changing the traditional concept of funerals can create a positive social atmosphere for body donation, thus increasing the public's awareness and willingness to donate their bodies. Donating the body at the end of life contributes to life science and medical causes and is a noble act worthy of praise.
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Affiliation(s)
- Airong Ma
- Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Ying Ding
- Health School affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, PR China
| | - Jianfei Lu
- Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yan Wo
- Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Wenlong Ding
- Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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4
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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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5
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Claveria A, Bachour D, Balta JY, Antonacci R, Ventura NM, Noel GPJC. A comparison of student perspectives on body donation across healthcare professional programs: From prosection- to dissection-based curricula. ANATOMICAL SCIENCES EDUCATION 2024; 17:558-570. [PMID: 38299426 DOI: 10.1002/ase.2383] [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: 05/27/2023] [Revised: 11/17/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
Donor-centered education offers students the opportunity to not only acquire visual and tactile experiences for applying anatomical knowledge but also a chance for students to reflect upon fundamental humanistic principles. The exploration of differences in students' viewpoints on body donation and the utilization of body donors in their education remains unexplored across various healthcare professional programs, which has an impact on student learning and experience. This study aimed to qualitatively examine the similarities and differences in student perspectives regarding body donation across three healthcare professional programs. One-page reflections from nursing (n = 37), physical and occupational therapy (n = 49), and medical students (n = 66) regarding their experiences in the anatomy laboratory at McGill University were collected and analyzed using a deductive approach based on themes and sub-themes outlined by Stephens et al. in 2019. Despite differences in their curricula, there were few discrepancies across the programs' reflections suggesting that donor-based learning had similar effects on each user group. Most students across the healthcare professional programs mentioned that their positive laboratory experiences motivated them to donate their bodies, extending the privilege they had to future generations. Nursing students did not reflect upon the notion that working with body donors provided unique learning experiences in the anatomy laboratory. Likewise, physical and occupational therapy (PT/OT) students did not address the importance of maintaining the privacy of body donors by covering certain body parts during lab. These findings show that prosection- and dissection-based exercises encourage reflective practices associated with these of medical ethics, highlighting an important advantage to including donor-based learning in anatomical education.
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Affiliation(s)
| | - Dona Bachour
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Québec, Canada
| | - Joy Y Balta
- Anatomy Learning Institute, Point Loma Nazarene University, San Diego, California, USA
- Division of Anatomy, Department of Surgery, University of California, San Diego, La Jolla, California, USA
| | - Rosetta Antonacci
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
| | - Nicole M Ventura
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Québec, Canada
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, McGill University, Montreal, Québec, Canada
| | - Geoffroy P J C Noel
- Division of Anatomy, Department of Surgery, University of California, San Diego, La Jolla, California, USA
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Québec, Canada
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, McGill University, Montreal, Québec, Canada
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6
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Ghosh SK, Walocha JA. Responsible research in the practice of anatomy: Attributes relevant to body donors and human tissues sourced from them. Ann Anat 2024; 252:152184. [PMID: 37926402 DOI: 10.1016/j.aanat.2023.152184] [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: 09/13/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
Responsible Research involves setting moral examples before fellow academicians and the society as a whole. The concept of Responsible Research applies appropriately to ethical sourcing and handling of human tissues. The present study was undertaken to analyze present situation regarding implementation of attributes of Relevant Research in relation to body donors in anatomical research. A literature search of relevant, peer-reviewed, published articles was undertaken from indexed databases (Medline & PubMed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar) for this study. The following attributes of Responsible Research were identified for possible intervention: the fact that research was conducted on human tissues from body donors and details regarding ethical handling thereof may be explicitly mentioned in method section; expression of gratitude towards body donors by authors may be included in acknowledgement section; editor's and publisher's note in support of adoption of attributes of Responsible Research may be included in published research. Adherence to best practices in terms of ethical guidelines requires anatomists to embrace a responsible approach in research from an inclusive perspective. Accordingly, practice of acknowledging the body donors may be nurtured and augmented to include the anonymised dead (human tissues from unclaimed bodies and unknown source) provided the research protocol received clearance from authorities concerned with ethical scrutiny. Moreover, adoption of the practice in review articles will enhance the boundaries of Responsible Research in anatomical science. Thus, few recommendations are proposed as epilogue for effectual implementation of the notion floated in present study.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, Phulwarisharif, Patna 801507, India.
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kopernica 12, Krakow 31-034, Poland
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7
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Bhattacharjee S, Ghosh SK. The Sun Also Rises: Tracing the evolution of humanistic values in anatomy pedagogy and research, including cadaveric acquisition practices. J Anat 2023; 243:1031-1051. [PMID: 37525506 PMCID: PMC10641044 DOI: 10.1111/joa.13938] [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: 02/15/2023] [Revised: 06/04/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023] Open
Abstract
Anatomy has always been at the intersection of the socio-cultural and political landscape, where new ideas constantly replace older wisdom. From ancient Egyptians through the Greeks, and then the Romans, finally culminating into the European Renaissance-all the significant eras of human civilisation have left their insignia and distinct marks on the evolution of anatomical practices. Despite its utility as a tool for anatomy pedagogy and research that has proven its worth over millennia, cadaveric dissection has particularly been subject to political and social vicissitudes. A major debate about anatomical dissection lay with the ethical considerations, or its lack thereof, while acquiring corpses for demonstration in the dissection halls. From antiquity, anatomical dissection-often synonymous with medical studies-had typically been carried out on the dead bodies of executed criminals with certain laws, such as the Murder Act of 1752, facilitating such uses. Gradually, the uses of unclaimed bodies, resourced primarily from the impoverished sections of society, were also introduced. However, these body acquisition protocols often missed the crucial element of humanism and ethical considerations, while knowledge augmentation was taken as sufficient reasoning. Unfortunately, a gross disregard towards humanistic values promulgated heinous and illegal practices in acquiring corpses, including grave robbery and even murders like in the case of Burke and Hare murders of 1828. Follow-up legislation, such as the Anatomy Act of 1832, and comparable laws in other European nations were passed to curb the vile. What distils from such a historical discourse on humane values in anatomy dissection, or medical science in general, is that the growth and integration of humanism in anatomy have never been linear, but there were intermittent and, yet, significant disruptions in its timeline. For example, there were serious human rights violations in anatomical practices during the Third Reich in Germany that perpetrated the holocaust. The medical community has kept evolving and introducing new moral values and principles while using such egregious events as lessons, ultimately resulting in the Declaration of Helsinki in 1964. This article revisits the heterogeneous journey of integrating humanistic values in anatomy practice. Such humanistic traits that, like medical science, have also developed over centuries through the inputs of physicians, researchers, and philosophers-from Greece to modernity with an important stopgap at the Renaissance-are a fascinating lore that deserves to be re-envisioned through the lens of contemporary values and ethos. In parallel to human medicine, humanistic values continue to influence veterinary medicine, a welcome development, as our society condemns animal cruelty in any form. There are lessons to be learned from this historical journey of how humanism shaped many of the concepts that anatomists use now. Finally, and most importantly, it might prevent the medical community from repeating the same mistakes by cautioning against the traps that are there, and in a convoluted world where morality as such is eroding from our social fabric, will always be there. Such historical account acts as a righteous, ethical, and contextual compass to guide the existing and upcoming anatomists in discerning between light and dark, right and wrong, and roads-to be or not to be-taken.
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Kerner AM, Biedermann U, Bräuer L, Caspers S, Doll S, Engelhardt M, Filler TJ, Ghebremedhin E, Gundlach S, Hayn-Leichsenring GU, Heermann S, Hettwer-Steeger I, Hiepe L, Hirt B, Hirtler L, Hörmann R, Kulisch C, Lange T, Leube R, Meuser AH, Müller-Gerbl M, Nassenstein C, Neckel PH, Nimtschke U, Paulsen F, Prescher A, Pretterklieber M, Schliwa S, Schmidt K, Schmiedl A, Schomerus C, Schulze-Tanzil G, Schumacher U, Schumann S, Spindler V, Streicher J, Tschernig T, Unverzagt A, Valentiner U, Viebahn C, Wedel T, Weigner J, Weninger WJ, Westermann J, Weyers I, Waschke J, Hammer N. The chemicals between us-First results of the cluster analyses on anatomy embalming procedures in the German-speaking countries. ANATOMICAL SCIENCES EDUCATION 2023; 16:814-829. [PMID: 37183973 DOI: 10.1002/ase.2285] [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: 02/17/2023] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 05/16/2023]
Abstract
Hands-on courses utilizing preserved human tissues for educational training offer an important pathway to acquire basic anatomical knowledge. Owing to the reevaluation of formaldehyde limits by the European Commission, a joint approach was chosen by the German-speaking anatomies in Europe (Germany, Austria, Switzerland) to find commonalities among embalming protocols and infrastructure. A survey comprising 537 items was circulated to all anatomies in German-speaking Europe. Clusters were established for "ethanol"-, formaldehyde-based ("FA"), and "other" embalming procedures, depending on the chemicals considered the most relevant for each protocol. The logistical framework, volumes of chemicals, and infrastructure were found to be highly diverse between the groups and protocols. Formaldehyde quantities deployed per annum were three-fold higher in the "FA" (223 L/a) compared to the "ethanol" (71.0 L/a) group, but not for "other" (97.8 L/a), though the volumes injected per body were similar. "FA" was strongly related to table-borne air ventilation and total fixative volumes ≤1000 L. "Ethanol" was strongly related to total fixative volumes >1000 L, ceiling- and floor-borne air ventilation, and explosion-proof facilities. Air ventilation was found to be installed symmetrically in the mortuary and dissection facilities. Certain predictors exist for the interplay between the embalming used in a given infrastructure and technical measures. The here-established cluster analysis may serve as decision supportive tool when considering altering embalming protocols or establishing joint protocols between institutions, following a best practice approach to cater toward best-suited tissue characteristics for educational purposes, while simultaneously addressing future demands on exposure limits.
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Affiliation(s)
- Alexander Michael Kerner
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Uta Biedermann
- Institute of Anatomy I, University Hospital Jena, Jena, Germany
| | - Lars Bräuer
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Svenja Caspers
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sara Doll
- Department of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
| | - Maren Engelhardt
- Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria
| | - Timm J Filler
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Stefanie Gundlach
- Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | | | - Stephan Heermann
- Institute for Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Laura Hiepe
- Institute of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Bernhard Hirt
- Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Tübingen, Germany
| | - Lena Hirtler
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Romed Hörmann
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Kulisch
- Institute of Functional Anatomy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Lange
- Institute of Anatomy I, University Hospital Jena, Jena, Germany
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rudolf Leube
- Department of Anatomy and Cell Biology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Annika Hela Meuser
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | | | | | - Peter H Neckel
- Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Tübingen, Germany
| | - Ute Nimtschke
- Institute of Anatomy, Technical University Carl Gustav Carus Dresden, Dresden, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Prescher
- Department of Anatomy and Cell Biology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Michael Pretterklieber
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Stefanie Schliwa
- Institute of Anatomy, Anatomy and Cell Biology, University of Bonn, Bonn, Germany
| | - Katja Schmidt
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Andreas Schmiedl
- Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Christof Schomerus
- Institute of Anatomy, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gundula Schulze-Tanzil
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Nuremberg, Germany
| | - Udo Schumacher
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Schumann
- Institute of Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Volker Spindler
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Johannes Streicher
- Department of Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Thomas Tschernig
- Institute of Anatomy and Cell Biology, Saarland University, Homburg, Germany
| | - Axel Unverzagt
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Ursula Valentiner
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Thilo Wedel
- Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Janet Weigner
- Institute of Veterinary Anatomy, Freie Universität Berlin, Berlin, Germany
| | - Wolfgang J Weninger
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | | | - Imke Weyers
- Institute of Anatomy, University of Lübeck, Lübeck, Germany
| | - Jens Waschke
- Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology Dresden, Dresden, Germany
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Bharambe VK, Prasad A, Bokan R, Kalthur S, Manvikar P, Puranam V. The anatomist’s perspective today towards human body donation for procurement of cadavers for study of human anatomy. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/13054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Anatomy is the study of structure of human body. Dissection of human cadavers has always been an integral part of study of anatomy as well as research in it. Till now the only source for cadavers for dissection purposes were unclaimed bodies. Today the need for bodies for medical education has increased and most medical schools are experiencing difficulties in procuring the requisite number of cadavers.<b> </b>Body donation programs may help fulfil this need of the medical schools. The present study was an attempt to analyze the attitude of the anatomists towards different aspects of body donation. 24.7% of the participants stated that they have insufficient cadavers, 12.3% claimed surplus cadavers while 62.8% claimed sufficient cadavers. 26% of the anatomists were unaware of the necessity for a death certificate and 35% were unaware of the necessity for a unique identification document for carrying out body donation.
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Affiliation(s)
| | - Arun Prasad
- Symbiosis Medical College for Women, Symbiosis International Deemed University, Pune, INDIA
| | - Raju Bokan
- Department of Anatomy, AIIMS, Guwahati, INDIA
| | - Sneha Kalthur
- Department of Anatomy, Kasturba Medical College, Manipal, INDIA
| | | | - Vatsalaswamy Puranam
- Department of Anatomy, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pune, INDIA
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10
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Boscolo-Berto R, Porzionato A, Stecco C, Macchi V, De Caro R. Reference centers for tissue and body donations: Compulsory requirements in Italy. Clin Anat 2023; 36:465-470. [PMID: 36514860 DOI: 10.1002/ca.23990] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
Recent Italian legislation (Law No. 10/2020) establishes the legal, ethical and technical requirements governing how individuals can donate their bodies or tissues post-mortem for study, training, and scientific research purposes. A ministerial working group has recently approved some of the law's implementing rules relating to technical issues. The rules for implementing the new legislation, retrieved from the legal databases and translated into English, are discussed. For the first time in Italy, the law establishes compulsory requirements and minimum characteristics-in terms of logistics, safety, availability of staff, space, and equipment-for institutions to be recognized as reference centers for the conservation and use of bodies and tissues donated post-mortem for study, training and scientific research purposes. This makes it possible to standardize the features of such reference centers nationwide, and to coordinate their activities and potential future development, while ensuring basic operational efficiency and workplace safety, the provision of adequate facilities, buildings and equipment, and staff training. The law and its implementing rules discussed here are the first to establish criteria and compulsory requirements for centers receiving body and tissue donations in Italy. This is a step forward for the whole anatomy community, providing practical guidelines for body donation programs and related facilities in other countries too.
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Affiliation(s)
- Rafael Boscolo-Berto
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Bodies, Padova, Veneto Region, Italy.,National Reference Center for the Preservation and Use of Gifted Bodies, Padova, Italy
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11
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Chen WL. Body Donation Registration in Taiwan: Reasons and Associated Psychological Factors. Healthcare (Basel) 2023; 11:healthcare11070969. [PMID: 37046896 PMCID: PMC10093931 DOI: 10.3390/healthcare11070969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/15/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Dissection is an essential element of medical training and depends on the availability of cadavers. However, traditional Chinese culture widely regards the body as a gift from one’s parents that should remain intact after death, resulting in a shortage of cadavers for medical training and research. This situation changed in Taiwan when Master Cheng Yen, the founder of the Buddhist Tzu Chi Medical Foundation, supported the donation of bodies to medical science. This study aimed to investigate the current situation of body donation in Taiwan, including donors’ motivation and psychological characteristics. A questionnaire was conducted with 681 adult participants, including 336 people who pledged to donate their bodies to medical science after death and a control group comparable in age, gender, and level of education. All participants answered questions regarding anxiety over death, purpose in life, gratitude, altruism, and life satisfaction. In addition, the registered donor group answered questions regarding the motivation for donating their bodies to science. The main influencing factors were to help advance medical science, make a positive contribution to society, and release attachment from the body. Further, many male participants indicated the desire to reduce trouble and expenses that their families would incur in making funeral and burial or cremation arrangements. The main predictors of donating one’s body to medical science were low anxiety concerning death, a high level of altruism, and gratitude.
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Affiliation(s)
- Wan-Lan Chen
- Department of Human Development and Psychology, Tzu Chi University, Hualien 970048, Taiwan
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12
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Anatomical variations of the flexor carpi ulnaris in the fetal period. ANTHROPOLOGICAL REVIEW 2023. [DOI: 10.18778/1898-6773.85.4.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Introduction: The Flexor Carpi Ulnaris (FCU) is a part of the palmar the forearm muscle group and one of the most important muscles for upper limb functioning - is responsible for flexion and adduction of the hand at the radio-carpal joint. There are clinically significant but rare anatomical variations of FCU. The variability of the FCU has not been described up to now, and no typology of the muscle based on its more variable terminal attachment has been created.
Aim of the study: Determination of FCU muscle typology based on available fetal material.
Material and methods: A total of 114 human fetuses (53 female, 61 male) between 117 and 197 days of fetal life were eligible for the study. Preparations were carried out using classical anatomical techniques based on a previously published procedure. Thanks to that significant anthropometric landmarks were visible for the gathering of metric measurements. Metric measurements were taken and statistically analysed using R-Project software.
Results: A new typology was created based on variable muscle insertions. Additionally, the presence of an atypically located, additional, separated muscle belly was described. A comparison of measurements of the left upper limb in relation to the right upper limb showed significant differences for forearm length to the anthropometric point of the stylion radiale, limb length, total FCU length and FCU length which means that the left limb is longer than the right limb. A comparison of FCU insertion types between left and right upper limb showed there’s no significant difference between counts of each type.
Conclusion: The FCU is a muscle that is easy to palpate and may therefore act as a topographical marker for healthcare professionals. Knowledge of its variability is not only of theoretical importance but also has clinical significance. The current publication demonstrates presence of variability in FCU terminal attachment. Certainly, this topic requires further research and continued work on a detailed understanding of forearm anatomy in the fetal period.
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13
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One Size Does Not Fit All in Remote Anatomy Teaching. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1397:55-77. [DOI: 10.1007/978-3-031-17135-2_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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14
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Jenkin RA, Garrett SA, Keay KA. Altruism in death: Attitudes to body and organ donation in Australian students. ANATOMICAL SCIENCES EDUCATION 2023; 16:27-46. [PMID: 35344291 PMCID: PMC10084255 DOI: 10.1002/ase.2180] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 05/25/2023]
Abstract
Health education, research, and training rely on the altruistic act of body donation for the supply of cadavers. Organ transplantation and research rely on donated organs. Supply of both is limited, with further restrictions in Australia due to requirements for a next-of-kin agreement to donation, irrespective of the deceased's pre-death consent. Research suggests health workers are less likely to support the donation of their own bodies and/or organs, despite recognizing the public good of donation, and that exposure to gross anatomy teaching may negatively affect support for donation. Attitudes to body and organ donation were examined in Australian students studying anatomy. Support for self-body donation (26.5%) was much lower than support for self-organ donation (82.5%). Ten percent of participants would not support the election of a family member or member of the public to donate their body, and just over 4% would not support the election of a family member to donate their organs, with one-to-two percent not supporting this election by a member of the public. Exposure to gross anatomy teaching was associated with an increased likelihood of consideration of issues about body and organ donation, whether for self, family, or the public, and registration as an organ donor. Exposure decreased participants' willingness to donate their own body, with those who practiced a religion least likely to support body donation. Gross anatomy courses provide an opportunity to inform future healthcare workers about altruistic donation, albeit with a recognition that religious or cultural beliefs may affect willingness to donate.
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Affiliation(s)
- Rebekah A. Jenkin
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
| | - Samuel A. Garrett
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
- University of SydneyCamperdownNew South WalesAustralia
| | - Kevin A. Keay
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
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15
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Nawras M, Aoun J, Yazdi V, Hecht M, Khuder S, Frank P. Assessing the Ethical Concerns of Medical Students in the Gross Anatomy Lab. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231168505. [PMID: 37051224 PMCID: PMC10084544 DOI: 10.1177/23821205231168505] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES Cadaver dissection has become the gold-standard for anatomical education in US medical schools. Ethical issues regarding cadavers may not be as obvious as in living patients, which can lead to their potential neglect in medical school curricula. In this study, we assessed the different ethical concerns (ECs) of medical students regarding cadavers in the gross anatomy lab (GAL), gathered student information, including self-reported academic performance (AP) in the GAL, and determined the best predictors for a student's EC. METHODS All second-year medical students at the University of Toledo were invited to complete an anonymous, online-survey. Participants were presented with 10 hypothetical but realistic lab scenarios and asked to rate their EC for each on a 5-point Likert scale. Gender, age, and scores received in the GAL course were also collected. A multiple linear regression model was used to find the best predictors of the total EC score. RESULTS A total of 112 (63%) responses to the online-survey were recorded. The highest EC was for Q7: Taking pictures of the cadaver. The lowest EC was for Q10: The dissection of cadavers itself is an EC. Gender was the best predictor of total EC, followed by age. Female total EC was significantly higher than that for males (35.8 ± 5.5 vs 33.1 ± 7.9). Female scores for Q1 and Q2 were significantly higher than those for males. Total EC for students in the age group 25 to 34 was significantly higher than those in the age group 18 to 24 (35.9 ± 6.1 vs 33.9 ± 7.2). No significant difference was found for individual scenarios. AP was not significantly related to the total score or the scores of the individual scenarios. CONCLUSION The significant differences in ECs of medical students found in our study indicate that not all students have the same outlook towards the GAL specifically and ECs generally.
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Affiliation(s)
- Mohamad Nawras
- Mohamad Nawras, University of Toledo, College of Medicine and Life Sciences, Toledo, OH 43614, USA.
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16
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Ghosh SK. Evolving strategies in whirlwind mode: The changing face of anatomy education during Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:1103-1119. [PMID: 35924417 PMCID: PMC9537882 DOI: 10.1002/ase.2214] [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: 02/16/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 05/28/2023]
Abstract
The Covid-19 pandemic stipulated adoption of unfamiliar strategies for delivering anatomy education in online mode. The factors which determine education strategies are variable across geographical regions. It was perceived that an overview of education strategies around the globe would be useful for anatomists. Hence this narrative review was undertaken to collate observations from different geographical regions pertaining to education strategies adopted during the pandemic. Data relevant to the topic of study were extracted from 12 articles that were selected from an initial pool of 317 articles based on search criteria set for the review. Subtle differences in core education strategies implied that baseline response from anatomists was similar across regions. It was evident that online digital tools were key elements of education strategies adopted by educators for delivering online anatomy classes across the globe. Interestingly, a considerable gap in terms of number and variety of online tools used for anatomy education (those requiring commercial purchase) was noted between economically developed and developing regions. This may have an impact on learning outcome for students and may even lead to variations in anatomical knowledge by regions. It was observed that offline human dissection sessions were incorporated into online practical classes in one region as positive cases showed a declining trend. This positive development is worth emulating elsewhere based on cautious assessment of prevailing situation. From a broad perspective timely introduction of education strategies ensured delivery of anatomy education during the pandemic and gave an evolved outlook to the fabric of anatomy education.
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17
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Gasmalla HEE, Mossa AH, Taha MH, Wadi MM, Shehzad K, Abdalla ME, Hadie SNH. Promoting more future-ready anatomy education after the Covid-19 pandemic: A scoping review. ANATOMICAL SCIENCES EDUCATION 2022; 15:1120-1137. [PMID: 36205041 DOI: 10.1002/ase.2227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 09/19/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
The coronavirus disease 2019 (Covid-19) pandemic caused an abrupt transition from face-to-face to online anatomy teaching, learning, and assessment. Although online education has ensured the continuity of anatomy education during the pandemic, its implementation has been challenging, and its effectiveness has been questioned. Therefore, literature pertinent to online anatomy education during the pandemic is crucial to explain Covid-19's disruptions to this field. Accordingly, this scoping review explored changes, disruptions, and gaps in anatomy teaching and assessment during Covid-19 using an enhanced version of Arksey and O'Malley's six-stage protocol. Five online databases were searched for articles that described changes and disruptions in anatomy education. Three independent researchers were involved in titles, abstracts, and full texts screening, while another four researchers were independently involved in data extraction, charting, and synthesis. This review revealed six themes: immediate strategic plans and actions, teaching and learning changes, online assessment practice, students' and educators' receptivity and adaptability, online learning and assessment effects, and future directions. It also revealed four gaps: non-future-ready curricula, learning obstacles, administrative and teaching challenges, and online education ethical issues. The results were reported in tabular and narrative forms, following the PRISMA Extension for Scoping Reviews (PRISMA-ScR guidelines). Understanding the evolution and gaps in anatomy education during the Covid-19 pandemic will help anatomists design future-ready, adaptable curricula.
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Affiliation(s)
- Hosam Eldeen Elsadig Gasmalla
- Warwick Medical School, University of Warwick, Coventry, UK
- Department of Anatomy, Faculty of Medicine, Al Neelain University, Khartoum, Sudan
| | - Abubakr H Mossa
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed H Taha
- Medical Education Centre and College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Majed M Wadi
- Department of Medical Education, Qassim College of Medicine, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Khalid Shehzad
- Department of Anatomy and Histology, Qassim College of Medicine, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Mohamed Elhassan Abdalla
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Siti Nurma Hanim Hadie
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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18
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Mueller CM, Allison SM. In their own words: impact of donor information and personal statements on humanization of donors in a gross anatomy course. ADVANCES IN PHYSIOLOGY EDUCATION 2022; 46:426-437. [PMID: 35695290 DOI: 10.1152/advan.00068.2022] [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: 04/15/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Humanization of donors in gross anatomy courses has been reported to facilitate professional behavior in healthcare students. However, there is a lack of research investigating whether students' knowledge of donor information is associated with humanization of whole body donors. To address this gap, the present study aimed to 1) determine whether knowledge of donor information is associated with greater humanization of donors and 2) investigate student perceptions of receiving donor information. Donor information was provided to students at the beginning of the course (cohort A) or at midsemester (cohort B). Questionnaires utilized quantitative and qualitative methods to assess humanization and student perceptions at the beginning, middle, and end of the semester. Independent t tests demonstrated that there was no statistically significant difference in mean humanization scores between cohorts A and B before the first dissection [t(37) = 0.449, P = 0.656], at midsemester [t(35) = -1.546, P = 0.131], or at the end of the semester [t(28) = 0.004, P = 0.997]. Thematic analysis demonstrated that as the semester progressed students' view of dissection as an invasion of privacy and the donor as a patient decreased. Themes delineated from students' open-ended responses revealed that students felt a connection with their donors; that the donors' consenting information gave permission to dissect; and that the information gave students an invaluable learning experience. Students demonstrated detached concern toward their donor, viewing the donor as a learning tool or educator rather than a patient. However, their responses also indicated the development of a deeper, personal connection to donors.NEW & NOTEWORTHY A look at the use of donor personal statements and information to humanize donors and how it influenced students' experiences in a gross anatomy laboratory.
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Affiliation(s)
- Caroline M Mueller
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio
| | - Sara M Allison
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan
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19
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Schurr AF, Burg BJ, Dickinson E, Granatosky MC. No cuts, no buts: Satisfaction of first-year medical students with a hybrid prosection-based model for learning gross anatomy during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:827-838. [PMID: 35726438 PMCID: PMC9350165 DOI: 10.1002/ase.2205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/31/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
Few realized the extent of disruption that the Covid-19 global pandemic would impose upon higher anatomical education. While many institutions were obliged to adopt a fully-remote online model, the New York Institute of Technology College of Osteopathic Medicine strove to develop a curriculum that would allow medical students to receive an in-person anatomy education. A hybrid model that emphasized learning from prosected cadavers and self-study stations was implemented, with the remainder of the students' time directed toward studying at home. Through an anonymous survey aimed at gleaning student satisfaction, this study demonstrates that this hybrid prosection-based anatomy course aligned with student preferences both assuming no health risk (64.6% agreed) and given the current risk of contracting Covid-19 (78.5% agreed). Generally, students felt that their education was equal to that of previous years (Likert scale = 3.24 ± 1.05), fostered an appreciation for anatomy (4.56 ± 0.59), promoted teamwork (4.13 ± 0.85), and prepared them for practical examinations (4.18 ± 0.74). Linear mixed-effect models demonstrated that specific differences in results could be attributed to students' preconceived preferences toward student-led dissections and to past medical training. Importantly, most students "disagree" (1.97 ± 1.00) that they were concerned about the risk of exposure to Covid-19 during in-person anatomy laboratory sessions. Areas requiring improvement were identified by the model, including the provision of access to the cadavers outside of the regularly scheduled laboratory times (3.89 ± 1.08). These findings should be utilized when designing future gross anatomy courses in response to the "new normal".
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Affiliation(s)
- Alissa F. Schurr
- New York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
| | - Brandon J. Burg
- New York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
| | - Edwin Dickinson
- Department of AnatomyNew York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
| | - Michael C. Granatosky
- Department of AnatomyNew York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
- Center for Biomedical InnovationNew York Institute of Technology College of Osteopathic MedicineOld WestburyNew YorkUSA
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20
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Chandrasekaran R, Radzi S, Kai PZ, Rajalingam P, Rotgans J, Mogali SR. A validated instrument measuring students' perceptions on plastinated and three-dimensional printed anatomy tools. ANATOMICAL SCIENCES EDUCATION 2022; 15:850-862. [PMID: 34694750 DOI: 10.1002/ase.2147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
Due to the modernization of the medical curriculum and technological advancements, anatomy education has evolved beyond cadaveric dissection alone. Plastination techniques, three-dimensional (3D) modeling, and 3D printing technologies have progressively gained importance. However, there are limited valid and reliable surveys to evaluate students' perceptions of these new anatomy tools. Hence, this study aimed to develop a validated instrument to measure students' learning satisfaction, self-efficacy, humanistic values, and perceived limitations of plastinated and 3D printed models. A 41-item survey (five-point Likert scale, 1 = strongly disagree to 5 = strongly agree) was administered to Year 1 undergraduate medical students following a randomized controlled crossover study that evaluated plastinated and 3D printed cardiac and neck models. Ninety-six responses were received, and a factor analysis was performed with the Kaiser-Meyer-Olkin sampling adequacy of 0.878. The confirmatory factor analysis yielded a 4-factor, 19 items model that had a good fit with the latent constructs of x 2 (147) = 211.568, P < 0.001, root mean square error of approximation = 0.068, root mean square residual = 0.064, comparative fit index = 0.946, and Tucker Lewis index = 0.937. The Cronbach's alpha for the individual factors ranged from 0.74 to 0.95, indicating good internal consistency. This demonstrated a psychometrically valid and reliable instrument to measure students' perceptions toward plastinated and 3D printed models.
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Affiliation(s)
- Ramya Chandrasekaran
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Shairah Radzi
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Peh Zhen Kai
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Preman Rajalingam
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Jerome Rotgans
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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21
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Chaudhuri JD. An initial preparation for human cadaveric dissection ameliorates the associated mental distress in students. ANATOMICAL SCIENCES EDUCATION 2022; 15:910-927. [PMID: 34143562 DOI: 10.1002/ase.2112] [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: 02/12/2020] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 06/12/2023]
Abstract
It is universally recognized that cadaveric dissection is an essential part of anatomy training. However, it has been reported to induce mental distress in some students and impair their intrinsic motivation (IM) to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation of students for cadaveric dissection. Therefore, it is hypothesized that providing relevant information prior to cadaveric dissection will ameliorate the mental distress, enhance the IM of students, and improve their academic performance. A cohort of occupational therapy students enrolled in an anatomy course were psychologically prepared for cadaveric dissection. Students were provided with a curated list of YouTube videos and peer-reviewed journal articles related to cadaveric dissection prior to the commencement of the anatomy course. All students were also required to attend an oral presentation immediately before commencing dissection. The control group included students who had not been provided with any resources in preparation for cadaveric dissection. Compared to the control group, students who had been prepared demonstrated better quality of cadaveric dissection, improved academic performance, reported less mental distress and greater IM. Moreover, students reported the oral presentation to be most relevant and journal articles to be least useful in their preparation. Therefore, this is an effective approach in the amelioration of mental distress and improvement of performance in anatomy students. Consequently, this study represents a paradigm shift in the pedagogy of anatomy, and could represent a vital element in the evolution of a revitalized anatomy curriculum.
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Affiliation(s)
- Joydeep Dutta Chaudhuri
- School of Occupational Therapy, College of Health Sciences, Husson University, Bangor, Maine, USA
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22
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Balta JY, Venne G, Noël GPJC. 10 tips on working with human body donors in medical training and research. Anat Sci Int 2022; 97:307-312. [PMID: 35143025 PMCID: PMC9167808 DOI: 10.1007/s12565-022-00651-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/25/2022] [Indexed: 11/15/2022]
Abstract
Human body donors selflessly decided to make the ultimate gift to donate their bodies to education. Being on the receiving end, the health sciences education community owes it to the donors to ensure that they are being treated with utmost respect by promoting and developing high ethical standards and maximizing the benefits from this gift. Working with human body donors for research purposes has increased over the years, while regulations associated with these processes did not change. This article draws upon current literature and author’s experiences to offer practical tips for health educators and everyone working with body donors to achieve these goals. We offer 10 practical tips that help in starting the conversation about the best ways to work with body donors to maximize their contribution to health sciences education.
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Affiliation(s)
- Joy Y Balta
- Division of Anatomy, College of Medicine, The Ohio State University, Columbus, OH, USA.
| | - Gabriel Venne
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Geoffroy P J C Noël
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Division of Anatomy, School of Medicine, University of California, San Diego, CA, USA
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23
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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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24
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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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25
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Ghosh SK. Lacunae regarding dearth of dissection-based teaching during COVID-19 pandemic: how to cope with it? Surg Radiol Anat 2021; 44:75-79. [PMID: 34415384 PMCID: PMC8378110 DOI: 10.1007/s00276-021-02822-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 08/16/2021] [Indexed: 12/23/2022]
Abstract
Introduction In view of the ongoing COVID-19 pandemic, anatomy education programs were amended so as to shift to primarily online mode from physical classes. In the whole process, main concern area that has emerged is regarding dearth of physical human dissection sessions. There is enough evidence available in literature to suggest that dissection room is an ideal place to cultivate and inculcate discipline independent skills or humanistic skills among the students. These include attributes in relation to ethical practice, professionalism, communication skills, empathy and compassion. Imbibing these skills are an essential element of medical education curriculum as it is desirable that students exhibit these traits when they begin medical practice. Hence deficiency in terms of exposure to physical dissection sessions can adversely affect training of medical students on a long term. Methods A literature search of relevant, peer-reviewed, published articles was undertaken from indexed databases (Medline and PubMed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar) for this study. Results To counter the pertinent issue in online anatomy teaching program, a few measures have been suggested in this paper based on identification of actual deficit areas in terms of learning and analysis thereof. Live streaming of real time dissection, awareness sessions on human dissection, online interactive learning sessions and reflective thoughts-based exercise can contribute to building discipline independent skills in present scenario. Conclusion Incorporation and implementation of these interventions within the realm of online anatomy education programs during COVID-19 pandemic can possibly contribute towards desirable learning outcomes.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, 3rd Floor, Academic Building, Phulwari Sharif, Patna, Bihar, 801507, India.
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Tesfaye S, Hamba N, Kebede W, Bajiro M, Debela L, Nigatu TA, Gerbi A. Assessment of Ethical Compliance of Handling and Usage of the Human Body in Anatomical Facilities of Ethiopian Medical Schools. Pragmat Obs Res 2021; 12:65-80. [PMID: 34285629 PMCID: PMC8285299 DOI: 10.2147/por.s321646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Human anatomy has historically been a cornerstone in medical education and is special in that it uses human remains kept in various anatomical facilities like a morgue, gross anatomy laboratory, or museums for instruction and research. While serving knowledge advancement facilitating clinical practice and research, human cadaver handling, and usage at all levels, such as cadaver sourcing, transportation, storage, preservation, dissection, and final disposal deserves in return the utmost respect. In Ethiopia, even though there is not enough information on when, where, and by whom the first cadaver dissection was conducted, dissection is being conducted in many of its medical schools. Despite ethical necessity surrounding human body usage in every anatomical setting, there is still ethical and legal uncertainty due to several challenging barriers which is severe in developing nations including Ethiopia. The aim of this study is, therefore, to assess ethical practices of handling and usage of the human body to promote, in the near future, formulation and implementation of acceptable, respectful, and ethical guidelines for the anatomy dissection laboratories and related settings in Ethiopia. Methods A multicentered cross-sectional study was used at selected anatomy facilities of eight Ethiopian medical schools. The collected data through structured questionnaires and checklists were cleaned, preset and entered in to SPSS version 20 for analysis. Internal consistency and reliability were measured by using Cronbach’s alpha. Results The study result showed vivid human body ethical breaches that ranged from lack of power by anatomy unit to oversee the process during sourcing, transportation, embalming, caring, and dissection of cadavers in the anatomy laboratories to student’s mistreatment of cadavers. Conclusion In addition to lack of compliance due to lack of standard ethical guidelines or policies regarding human body usage, the compliance-based professional development is also nonexistent. The ethical way of body sourcing is through body donation; however, in Ethiopia, anatomy teaching exclusively depends on unclaimed bodies. Using a body for dissection that is solely sourced unethically may generate a negative emotional sense of life for anatomy instructors, technical assistants, morticians, and medical students. We inspire better provision of moral and ethical exercise with the good practice concerning the human body through recognizing the humanity and uniqueness of the deceased person. The results of this study serve as a serious condemnation of practices in Ethiopian anatomy facilities and we urge the Anatomical Society of Ethiopia to play its part in changing the present practices related to ethical and legal uncertainty of the human body usage.
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Affiliation(s)
- Solomon Tesfaye
- Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Niguse Hamba
- Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wakjira Kebede
- Immunology Unit, School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mitiku Bajiro
- Parasitology Unit, School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Lemessa Debela
- Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tihahun Alemayehu Nigatu
- Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Asfaw Gerbi
- Anatomy Unit, Department of Biomedical Sciences, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Naidoo N, Al-Sharif GA, Khan R, Azar A, Omer A. In death there is life: perceptions of the university community regarding body donation for educational purposes in the United Arab Emirates. Heliyon 2021; 7:e07650. [PMID: 34381903 PMCID: PMC8333108 DOI: 10.1016/j.heliyon.2021.e07650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/29/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022] Open
Abstract
Human body dissection is the traditional instructional method for anatomy education worldwide, providing a kinaesthetic learning experience that is often challenging to achieve with other teaching techniques. However, due to lack of body donation programs in Middle Eastern medical schools, dead bodies are imported from abroad. Since literature suggests that the body shortage is influenced by reluctance to donate one's body, this study aimed to determine the perceptions of faculty, staff, and students regarding body donation for educational purposes at a new Dubai-based medical school. An online dually translated questionnaire was administered to the target population (322), of which 150 participants representative of faculty, staff, and students, responded. Although 111 (74.0 %) of participants considered body donation to be appropriate for educational and research purposes, only 44 (29.3 %) of participants expressed willingness to donate their bodies. Reluctance to donate 106 (70.7 %) appeared to be mostly influenced by religion, psychological barrier, and familial reasons. The emergence of four themes (i.e., resource, barrier, humanitarian, and awareness) and the identification of a potential donor group within the group that was willing to donate provided insight into the level of awareness within the university community. Furthermore, such findings may assist to establish future body donation programs and strategize recruitment approaches, especially when there is an ensuing dearth of anatomical donations.
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Affiliation(s)
- Nerissa Naidoo
- College of Medicine, Mohammed Bin Rashid University, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Ghadah A. Al-Sharif
- College of Medicine, Mohammed Bin Rashid University, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Raeesa Khan
- College of Medicine, Mohammed Bin Rashid University, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Aida Azar
- College of Medicine, Mohammed Bin Rashid University, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Amar Omer
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University, Dubai Healthcare City, Dubai, United Arab Emirates
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Initiating Students' Reflections on Life's Passing in the Anatomy Course - an International Observation at 14 Universities. Ann Anat 2021; 237:151741. [PMID: 33892095 DOI: 10.1016/j.aanat.2021.151741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Medical and dental students' feelings and thoughts about the topic of death and life's passing are often associated with learning in the gross anatomy course, when students begin working with a deceased body donor in order to study human anatomy. Little is known of whether the format of anatomy teaching has an impact on these experiences. An observational study was performed to capture the initiation of students' sentiments on the topic of life's passing during the anatomy course at 14 international universities, identify common themes regarding these thoughts, and to study the connection to variations in anatomy course formats and included elements. METHOD Preclinical anatomy students reflected on one question (i.e., "How did your experience in the anatomy laboratory bring about your reflections on the meaning of life and human existence as well as the sanctity of one's passing?"). Written assignments were collected and anonymously coded. Information on anatomy courses was obtained via faculty questionnaires. RESULT A variety of themes were identified at the different schools, correlated with different anatomy formats and elements. Results indicate that the courses that offer hands-on cadaveric dissections may play an important role in triggering these sentiments. DISCUSSION The initiation of students' sentiments about the topic of death varies and includes several themes. There can be a connection to the way anatomy is taught, particularly if hands-on comprehensive cadaveric dissection or prosections are included. CONCLUSION In summary, anatomy courses can initiate students' thinking about life's passing - particularly in schools that offer hands-on cadaveric dissections or prosections.
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Singal A, Sahni D, Chaudhary P, Singh H. Virtual thanks giving to a cadaver by medical students exposed to learning anatomy before and amidst COVID-19 pandemic. Surg Radiol Anat 2021; 43:523-527. [PMID: 33630106 PMCID: PMC7905426 DOI: 10.1007/s00276-021-02715-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/12/2021] [Indexed: 11/29/2022]
Abstract
Purpose Due to COVID-19 pandemic, Thanks giving ceremony to cadaver was different this year in two ways: the students were partially exposed to cadaveric dissections (for 7 months) and later learned Anatomy via online classes due to lockdown (for 5 months) and secondly it was not feasible to gather for the ceremony so virtual platform was preferred. The purpose of this study was to discern the gratitude for cadaver and to recognize the importance of cadaveric dissection from the reflection of students who experienced hybrid anatomy learning amidst COVID-19. Methods The study was conducted on 48 first year medical students who were admitted to the college in August 2019 and were willing to participate. An online invitation was sent to students to participate in virtual thanks giving to cadaver ceremony on the last day of their anatomy class (August 2020). Results Though the students partially studied gross anatomy with the aid of dissections on the cadaver; however, they expressed respect and gratitude to the silent mentor in the form of a card, poem, drawing or paragraph and shared it via google classroom platform. The students wished if they could continue their anatomy course in dissection hall as paused due to COVID-19 pandemic. Conclusions Reflection of these students may mark impact on future anatomy students who may or may not get the chance for dissections. The thanks-giving gesture will also help to bind medical science and humanity especially during the crisis of pandemic.
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Affiliation(s)
- Anjali Singal
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.
| | - Daisy Sahni
- Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Priti Chaudhary
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
| | - Harsimranjit Singh
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
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Palmer EG, Reddy RK, Laughey W. Teaching Professionalism to Medical Students Using Dissection-Based Anatomy Education: a Practical Guide. MEDICAL SCIENCE EDUCATOR 2021; 31:203-213. [PMID: 33163287 PMCID: PMC7598239 DOI: 10.1007/s40670-020-01137-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/25/2020] [Indexed: 06/11/2023]
Abstract
Professionalism is a core competency for all healthcare professionals and is a subject of great interest within the academic community due to its vital importance in delivering the highest quality patient care. Despite this, professionalism remains difficult to define, teach and assess. The potential use of anatomy education in teaching professionalism has been increasingly highlighted within the literature, but still remains an underutilised tool in medical education. Therefore, this practical guide offers evidence-based practical points for successfully incorporating professionalism within a dissection-based anatomy course delivered to undergraduate medical students.
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Affiliation(s)
- Emilia G. Palmer
- Hull York Medical School, University of York, John Hughlings Jackson Building, University Road, Heslington, York, YO10 5DD UK
| | - Rohin K. Reddy
- Hull York Medical School, University of York, John Hughlings Jackson Building, University Road, Heslington, York, YO10 5DD UK
| | - William Laughey
- Hull York Medical School, University of York, John Hughlings Jackson Building, University Road, Heslington, York, YO10 5DD UK
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El-Haddad J, Prvan T, Štrkalj G. Attitudes of Anatomy Students toward Commemorations for Body Donors: A Multicultural Perspective. ANATOMICAL SCIENCES EDUCATION 2021; 14:89-98. [PMID: 32539194 DOI: 10.1002/ase.1994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/02/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
Many medical schools practice commemorative ceremonies to honor body donors. Attitudes of medical education stakeholders toward these ceremonies have not yet been fully investigated. The aim of this study was to explore anatomy students' attitudes toward commemorations at a multicultural institution which has not introduced these ceremonies yet. A survey was carried out on different groups of anatomy students that were exposed and not yet exposed to human remains. The survey was used to record basic demographic data from the respondents, ask if they would support the establishment of an anatomy commemoration and in which format. A total of 756 anatomy students participated in the survey (response rate 69.8%). The majority (76.3%) were in favor of introducing a commemoration for donors. The associations of students' gender, attitude toward body donation, and level of exposure to human remains with attitudes toward commemoration for donors were identified (P < 0.05), whereas ethnicity and religion seemed to have no influence on attitudes (P > 0.05). Most students believed that anatomy staff and students should organize the commemoration. There was a preference for the commemoration to be secular with revealed identities of donors, and not recorded for social media. The support for the establishment of commemorations transcended cultural and religious differences and confirmed students' respectful attitude toward donors. Anatomy commemorations seem to have potential not only to engage students with one another, and donor families, but also to pave the way for students to become life-long ethical and empathetic learners and practitioners.
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Affiliation(s)
- Joyce El-Haddad
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
- Department of Anatomy, School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Tania Prvan
- Department of Statistics and Mathematics, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Goran Štrkalj
- Department of Anatomy, School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Guo K, Luo T, Zhou LH, Xu D, Zhong G, Wang H, Xu J, Chu G. Cultivation of humanistic values in medical education through anatomy pedagogy and gratitude ceremony for body donors. BMC MEDICAL EDUCATION 2020; 20:440. [PMID: 33203381 PMCID: PMC7672936 DOI: 10.1186/s12909-020-02292-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/09/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND One of the most important objectives of modern medical education is to empower medical students to become humanistic clinicians. Human anatomy plays a crucial role in this mission by using cadavers to cause reflections on death, dying, illness, and the role of medical practitioners in humanistic care. The objective of this study was to introduce, describe, and evaluate the impact of a ceremony in honor of the body donors on ethical and humanistic attitudes of medical students. METHODS We used a phenomenological research approach to explore and understand the lived experiences of the anatomy teachers as they teach anatomy in the context of humanism and ethics. A separate survey of third-year medical students was carried out to understand their perceptions of changes in themselves, respect for donors and donor families, and their relationship with patients. Data were collected in two phases: a desktop review of teaching materials followed by in-depth interviews of the main anatomy teachers followed by a self-administered, 5-item Likert scaled questionnaire given to students. RESULTS In the present article, we describe the rituals conducted in honor of body donors at our School of Medicine. We also describe the lived experiences of anatomy teachers as they work on improving humanistic education quality through the introduction of the concept of "silent mentor" which refers to a cadaver that quietly allows medical students to learn from it. In turn, a ceremony in honor of body donors who have altruistically donated their bodies so that learning anatomy through dissection would be possible is also introduced. A survey of the impact of the ceremony in honor of body donors on medical students revealed positive responses in terms of promoting studying anatomy (3.96 Vs 3.95) as well as reflections on own death (4.44 Vs 4.35), the life of body donors (4.07 Vs 4.04), and how to humanely view future patients and their significant others (4.32 Vs 4.24) relative to those that did not attend the ceremony (5-item Likert scale). The majority of the students that attended the ceremony also indicated that it had a positive impact on their future doctor-patient relationship, thinking about the possibility of donating their body for teaching as well as about medical ethics. Most of them also think that attending the ceremony helped reduce their anxiety, fear, and disgust of seeing corpses or dissecting and 90% insisted that memorial ceremonies should continue being conducted at Zhongshan Medical School. CONCLUSION The combination of the anatomy component of the basic medical curriculum and gratitude ceremonies as well as activities to promote body bequeathal programs might help to accomplish the goal of cultivating high-quality medical students and professionals for the future. The long-term benefits would be a medical graduate who exudes empathy, relates well with patients and their significant others, leading to a productive doctor-patient relationship.
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Affiliation(s)
- Kaihua Guo
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Tao Luo
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Li-Hua Zhou
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China.
- Department of Anatomy, Sun Yat-sen University School of Medicine, Sun Yat-Sen University, Guangzhou, 510089, People's Republic of China.
| | - Dazheng Xu
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Guangming Zhong
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Huaqiao Wang
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Jie Xu
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Guoliang Chu
- Department of Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China.
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The practice of ethics in the context of human dissection: Setting standards for future physicians. Ann Anat 2020; 232:151577. [PMID: 32688021 PMCID: PMC7366954 DOI: 10.1016/j.aanat.2020.151577] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/18/2020] [Accepted: 06/24/2020] [Indexed: 02/07/2023]
Abstract
It is a much desirable skill among physicians that clinical practice should be guided by ethical norms. The dissection room experience provides an opportunity for nurturing the principles of ethical practice among medical students early in the curriculum. When the exercise of human dissection is followed within the boundaries of ethics it effectively props an ideal example for the young minds to emulate in the future. Hence in every stage of dissection room activity precious human body needs to be handled in an ethical manner so as to set a standard for the students. The present review is an attempt to collate the recommendations documented by researchers as per ethical guidelines in the context of human dissection. The review highlights on the ethical norms which needs to be adhered to while receiving the human body of a donor and during preservation of the same. It reflects on ideal ethical behaviour in the dissection room during the act of dissection and finally emphasize on the respectful disposal of the human remains in an ethical manner. The intended purpose of this article is to support uniform adoption of the recommendations for ethical handling of human bodies used in anatomical dissection.
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Boscolo-Berto R, Porzionato A, Stecco C, Macchi V, De Caro R. Body donation in Italy: Lights and shadows of law No. 10/2020. Clin Anat 2020; 33:950-959. [PMID: 32427400 DOI: 10.1002/ca.23623] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/10/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Recently, law No. 10 of February 10, 2020, entitled "Rules regarding the disposition of one's body and post-mortem tissues for study, training, and scientific research purposes" was introduced in Italy. Although its provisions respond to a constructive subject, some practical issues are evident in the approved text. MATERIALS AND METHODS A systematic review of the literature was performed by searching online medical and juridical databases to identify publications and Italian law provisions related to body donation programs. RESULTS The updated regulatory framework was outlined and compared to that in force previously, and the following features are discussed: (a) matter of law; (b) donors' information and consent; (c) reference centers and funding, and (d) procedural regulatory details. Several critical issues were detected in the approved wording with respect to teaching/training recipients, the role of university anatomy institutes, family members' exclusion from participating in the donation process in any capacity, the duration of donation, the management of corpses, partial donations, and the compatibility with organ donation. Suggestions are provided to overcome certain operational limitations in implementing the regulation, which is still being drafted to date. CONCLUSIONS This article shares with the international scientific community the principles and controversies underlying a regulatory innovation introduced in Italy to allow legislative amendments to inadequate provisions of body donation, as well as draw the attention of the entire anatomic community to critical issues if other countries undertake the same legislative reform.
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Affiliation(s)
- Rafael Boscolo-Berto
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Corpses, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Corpses, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Corpses, Padova, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Corpses, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy.,Veneto Region Reference Center for the Preservation and Use of Gifted Corpses, Padova, Italy
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Sasi A, Hegde R, Dayal S, Vaz M. 'Life after Death - the Dead shall Teach the Living': a Qualitative Study on the Motivations and Expectations of Body Donors, their Families, and Religious Scholars in the South Indian City of Bangalore. Asian Bioeth Rev 2020; 12:149-172. [PMID: 33717335 PMCID: PMC7747233 DOI: 10.1007/s41649-020-00117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022] Open
Abstract
In India, there has been a shift from using unclaimed bodies to voluntary body donation for anatomy dissections in medical colleges. This study used in-depth qualitative interviews to explore the deeper intent, values and attitudes towards body donation, the body and death, and expectations of the body donor (N = 12), as well as their next of kin (N = 7) and representative religious scholars (N = 12). All donors had enrolled in a body bequest programme in a medical school in South India. This study concludes that body donors are philanthropists with deep-rooted values of altruism and service, who are often willing to forgo traditional religious and cultural death rituals. The next of kin are often uncomfortable with the donor's decision, and this suggests that it is important that dialogue/counselling occurs at the time of the bequest, if the donor's wishes are to be respected. Religious injunctions are often misinterpreted; this implies that religious leaders/scholars can play a significant role in addressing these misconceptions which are barriers to body donation. Body bequest programmes in India may be enhanced by positioning body donation as 'daana'-giving without any expectation of return for a higher purpose, including ceremonies of respect in medical colleges. Furthermore, increased public engagement and awareness about body bequest programmes are also important to enhance participation. When medical students internalise what body donors expect of them, i.e. altruism, empathy with patients and becoming 'good doctors', it will help to ensure that the donation was not in vain and that the dead truly teach the living.
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Affiliation(s)
| | - Radhika Hegde
- Department of History of Medicine, St. John’s Medical College, Bangalore, India
| | - Stephen Dayal
- Department of Anatomy, St. John’s Medical College, Bangalore, India
| | - Manjulika Vaz
- Division of Health and Humanities, St. John’s Research Institute, Bangalore, India
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Who is willing to donate their bodies in China? Perceptions, attitudes and influencing factors among citizens of Changsha. Ann Anat 2020; 229:151483. [DOI: 10.1016/j.aanat.2020.151483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/13/2020] [Accepted: 01/26/2020] [Indexed: 02/07/2023]
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Abdellatif H. Time Spent in Practicing Dissection Correlated with Improvement in Anatomical Knowledge of Students: Experimental Study in an Integrated Learning Program. Cureus 2020; 12:e7558. [PMID: 32269892 PMCID: PMC7138458 DOI: 10.7759/cureus.7558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction and aim Cadaveric dissection has long been used as the main domain for teaching anatomy in medical schools. However, recently with a limited number of cadavers and time for practicing dissection, prosections and anatomical models are widely used and may replace traditional dissection. We aimed to explore the possible association between practicing dissection and test results among medical students and to determine whether there are differences in achievements between students who studied anatomy by cadaveric dissection and those who used prosections and anatomical models. Methods The study was conducted at the University of Bisha, College of Medicine, Saudi Arabia, during the period from March to August 2017. Students were randomly assigned to one of two groups (50 in each). The first group studied anatomy (upper limb course) by practicing dissection while the other studied it by using prosections and anatomical models. Both groups were subjected to the same final assessments. Scores of both groups were compared by using the Student’s t-test. Correlation analysis between time spent in practicing dissection (carefully registered using a predesigned portfolio and an attendance logbook) and assessment grades was implemented using the rank-based Pearson correlation coefficient. Results Students practicing dissection achieved higher grades (169 ± 1.99) than those who studied anatomy by only using prosections and anatomical models (142 ± 1.78, p<0.001). There was an association between the time spent in practicing dissections and overall anatomy summative assessments (r2=0.841, p<0.001). Students expressed positive responses towards the effectiveness and value of practicing dissection. Conclusions We concluded that practicing dissection helps students to achieve higher results than learning using only models and prosections. Time spent in practicing dissection correlated with final assessment results. Further research is required to measure not only the statistical significance of results but also their educational effectiveness and long term learning outcomes.
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Affiliation(s)
- Hussein Abdellatif
- Human and Clinical Anatomy, Sultan Qaboos University, College of Medicine and Health Sciences, Muscat, OMN.,Anatomy and Embryology, Faculty of Medicine, University of Mansoura, Mansoura, EGY
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Cadaver as a first teacher: A module to learn the ethics and values of cadaveric dissection. J Taibah Univ Med Sci 2020; 15:94-101. [PMID: 32368204 PMCID: PMC7184209 DOI: 10.1016/j.jtumed.2020.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/28/2020] [Accepted: 03/01/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives The undergraduate medical students must be made aware of the ethical and humanistic values of cadaveric dissection. This study therefore designed, implemented, and evaluated the impact of the module 'Cadaver as a Teacher' (CrAFT) that examines the ethical values of cadaveric dissection. Methods This prospective, multimethod study involved 447 first-year undergraduate medical students who had participated in all three sessions of the CrAFT module. Activities included interactive lectures, individual assignments, and a poster-making competition. Students offered a silent tribute and wrote words of gratitude down on a tribute wall. They also expressed their thoughts in the form of essays, poems, and collages. These reflections were qualitatively analysed to generate themes. At the end of the module, an online quiz was conducted to assess the knowledge gained by the students. Their scores were correspondingly recorded and calculated. Results The major themes identified were: cadaver as a teacher, acknowledgement and thanksgiving, bonding, and empathy. Out of all the test takers, 316 students (94.32%) scored more than a five out of ten. The students strongly felt that the module effectively sensitised them towards the ethical and humanitarian aspects of handling cadavers. Conclusions The implementation of an educational module about cadavers is a novel approach towards sensitising medical students. The students believed that sensitising them early on would have helped them establish a practice grounded in professionalism, human values, and empathy.
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Transformation of the role of human dissection in medical education: cultivating principles of medical ethics. Surg Radiol Anat 2020; 42:855-856. [PMID: 32166341 DOI: 10.1007/s00276-020-02453-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/02/2020] [Indexed: 12/13/2022]
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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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Goss AL, Viswanathan VB, DeLisser HM. Not Just a Specimen: A Qualitative Study of Emotion, Morality, and Professionalism in One Medical School Gross Anatomy Laboratory. ANATOMICAL SCIENCES EDUCATION 2019; 12:349-359. [PMID: 30739388 DOI: 10.1002/ase.1868] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview-based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. All students oscillated involuntarily between seeing the cadaver as a specimen for learning and seeing the cadaver as a person, with some students intentionally cultivating one of these ways of seeing over the other. These views shaped students' emotional and moral responses to the experiences of dissection. The "specimen" view facilitated a technical, detached approach to dissection, while the "person" view made students engage emotionally. Further, students who intentionally cultivated a "specimen" view generally felt less moral distress about dissection than students who intentionally cultivated a "person" view. The concept of respect gave students permission to perform dissections, but "person-minded" students developed more complex rules around what constituted respectful behavior. Both groups of students connected the gross anatomy experience to their professional development, but in different ways. "Specimen-minded" students intentionally objectified the body to learn the emotional control physicians need, while "person-minded" students humanized the body donor to promote the emotional engagement required of physicians. These findings support efforts to integrate professionalism teaching into gross anatomy courses, particularly content, addressing the balance between professional detachment and concern.
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Affiliation(s)
- Adeline L Goss
- Department of Neurology, University of California San Francisco, San Francisco, California
| | - Vidya B Viswanathan
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Horace M DeLisser
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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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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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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Kumar Ghosh S, Kumar A. Building Professionalism in Human Dissection Room as a Component of Hidden Curriculum Delivery: A Systematic Review of Good Practices. ANATOMICAL SCIENCES EDUCATION 2019; 12:210-221. [PMID: 30376608 DOI: 10.1002/ase.1836] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 05/05/2023]
Abstract
The core values in medical practice which are essential for the humane outlook of a physician are clubbed within the domain of medical professionalism. Professionalism along with other discipline-independent skills (human skills) is propagated implicitly in medical schools as components of a "hidden curriculum." Evidence suggests a strong association between "hidden curriculum" delivery and development of professionalism in the human dissection room. In this review article, the authors have tried to highlight a few exclusive practices adopted by medical schools which enhance the implementation of the "hidden curriculum" within the practice of human dissection and successfully inculcate the key components of professionalism such as integrity, respect, and compassion among students. These distinctive concepts are aimed at humanizing the experience of anatomical dissection by revealing the identity of the donors along with their personal details either through display of video clips of donor interviews, interactions with the family members of the donor over a meal or recognition of the donor as a mentor and organizing memorial services in honor of donors after conclusion of the dissection in the presence of their family members. The resounding success of these good practices in building professionalism among medical students from the onset of the academic curriculum has signaled a new chapter in anatomical sciences education. It has become imperative to recognize the visionary efforts of a select few medical educators and begin incorporating these recent trends into the delivery of the "hidden curriculum" within the evolving gross anatomy education model.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
| | - Ashutosh Kumar
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
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Chang HJ, Kim HJ, Rhyu IJ, Lee YM, Uhm CS. Emotional experiences of medical students during cadaver dissection and the role of memorial ceremonies: a qualitative study. BMC MEDICAL EDUCATION 2018; 18:255. [PMID: 30419880 PMCID: PMC6233563 DOI: 10.1186/s12909-018-1358-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/22/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND It has been well reported that the emotional experiences of medical students in the gross anatomy laboratory could have significant impacts on their professional identity formation. This qualitative study aimed to investigate students' emotions towards cadaver dissection and the educational role of memorial ceremonies. METHODS A total of 37 students from eight teams were recruited in the team-based dissection course during two consecutive academic years (2016 and 2017) at one medical school. In focus group interviews, students were encouraged to express and discuss their emotions regarding cadaver dissection and memorial ceremonies. RESULTS The participants described their apprehension and anxiety during their first encounter with cadavers that diminished through gradual exposure. Unfortunately, their positive emotions such as gratitude and responsibility also tended to decline under the pressure of excessive workloads and frequent examinations. Memorial ceremonies, including not only large-scale events but also daily rituals, had educational effects that they prevented the decline of students' responsibility and respect during the dissection course. CONCLUSION Educators should assist medical students in overcoming their initial distress and maintaining respectful attitudes throughout the dissection course. Memorial ceremonies can be effective educational tools for fostering appropriate attitudes and ethical practice in the gross anatomy laboratory.
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Affiliation(s)
- Hyung-Joo Chang
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Hyun Jung Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141 South Korea
| | - Im Joo Rhyu
- Department of Anatomy, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Chang-Sub Uhm
- Department of Anatomy, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
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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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Techataweewan N, Panthongviriyakul C, Toomsan Y, Mothong W, Kanla P, Chaichun A, Amarttayakong P, Tayles N. Human body donation in Thailand: Donors at Khon Kaen University. Ann Anat 2018; 216:142-151. [DOI: 10.1016/j.aanat.2017.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/10/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
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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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