Demographic and motivational factors affecting the whole-body donation programme in Nanjing, China: a cross-sectional survey

Research and application discussion of cranial bone model preparation method based on three-dimensional reconstruction and 3D printing technology

PURPOSE

The aim of this study was to find an alternative method to meet traditional human anatomy teaching and clinical needs in order to solve the problem of cranial specimen attrition and specimen resource shortage due to long-term use.

METHODS

We performed a computed tomography (CT) scan of a well-preserved male cranial specimen and used Mimics 19.0 software for 3D reconstruction and cranial block separation. Subsequently, we compared the recognition ability of the processed cranial digital model with that of the 3D body digital model and used 3D printing to create the cranial model and compare it with the physical specimen.

RESULTS

Twenty-two cranial bone block models were obtained, excluding the hyoid bone. Their 3D reconstructed digital models had better bony landmark recognition than the 3D body human digital models, and the differences between the 3D printed models and the physical specimens were minimal. In addition, only one stereolithography (STL) file was required to produce the cranial models, which facilitates repetitive printing at any time.

CONCLUSION

By isolating cranial bone blocks through 3D reconstruction techniques and preparing high-quality cranial models in combination with 3D printing techniques, this study solves the problem of shortage of cranial teaching specimens for the sustainable development of clinical and medical schools.

Historical trends and current experiences of anatomical body donation in two Zimbabwean medical schools

BACKGROUND

Body donation is integral to anatomy education, but procurement can be ethically fraught. While voluntary donation is preferred, the use of unclaimed bodies, although considered unethical, is a primary means for body procurement in some countries. This mixed methods study examined historical trends and anatomy technical staff perspectives on body donation in two Zimbabwean medical schools.

METHODOLOGY AND MAIN FINDINGS

In Phase 1, 194 cadaver paper records from January 1984 to January 2021 were reviewed. Unclaimed bodies accounted for 67% while 33% (all white Zimbabweans) were voluntarily donated. Most cadavers were black Africans (62.4%) followed by white Zimbabweans (34.0%). Race was not indicated in seven (3.6%) records. In Phase 2, semi-structured interviews were conducted with seven technicians responsible for sourcing cadavers at the two institutions. Data were thematically analysed resulting in the development of eight themes, arranged into three domains. Cadaver procurement themes related to (1) cadaver source, (2) adherence to procurement guidelines, (3) screening for suitability, and (4) cultural and religious beliefs. Cadaver embalmment focused on (5) embalming practices, and (6) hospital mortuary-based embalming. Finally, (7) disposal processes and (8) resource constraints were found to influence cadaver disposal practices.

CONCLUSIONS

Contrary to best practice, there is continued reliance on the use of unclaimed bodies to support anatomy education in the two Zimbabwean medical schools. Improving the ethical sourcing of bodies requires increased efforts to educate all Zimbabweans, especially the black majority, about the role and importance of voluntary body donation in medical education. Additionally, well-structured, and well-resourced body donation programs could enhance ethical procurement.

Challenges to sourcing human bodies for teaching and research in Africa: Are the challenges insurmountable?

The teaching and learning of human anatomy by dissection has existed for thousands of years. Over the centuries, evolving ethical considerations for the sourcing of human bodies for dissection have resulted in a transition from the use of unconsented individuals to that of body donors and the institution of body donation programmes around the world. However, major challenges on the African continent have resulted in the continued use of unconsented or unclaimed bodies and the ethical dilemma for African anatomy departments regarding their use. Some of the key difficulties in sourcing donor bodies which exist on the African continent emanate from religious, cultural, societal trust and other confounding factors. This manuscript explores the challenges and suggests ways in which some of these constraints may be overcome.

Willingness toward post-mortem body donation to science at a Mexican university: an exploratory survey

BACKGROUND

Voluntary post-mortem donation to science (PDS) is the most appropriate source for body dissection in medical education and training, and highly useful for biomedical research. In Mexico, unclaimed bodies are no longer a legal source, but PDS is legally possible, although scarcely facilitated, and mostly ignored by the general population. Therefore, we aimed to evaluate the attitude and willingness for PDS and to identify a sociodemographic profile of people with willingness toward PDS.

METHODS

A validated on-line survey was distributed by the convenience method via the social networks of a Catholicism-inspired, private university in northern Mexico. Frequency analyses of all variables and coded free comments were complemented with association studies.

RESULTS

Although the responder cohort (n = 143) was too small and biased to be representative of the university community (n = 13,500), willingness to post-mortem organ donation was 90.7% and to PDS 70.7%. In this cohort, PDS willingness had the strongest association with mature age (> 40 years old; P, 0.0008). Among young adults, willingness to PDS was the lowest among volunteers from technical and business schools and the highest among those from the social sciences (P, 0.009). Respondents from the social sciences were also the most consistent between attitude and behavior with respect to organ donation. A free comment option revealed respondents were interested in the unusual taboo topic.

CONCLUSIONS

A small, but sufficiently large proportion expressed willingness toward PDS. In our university cohort, which was biased in higher education and altruism, mature age and social interest were associated with PDS willingness.

Survey on health students' knowledge and perception on body donation for scientific research, education, and training after specific Italian law no. 10/2020

BACKGROUND

Practicing on the human body was considered extremely relevant for health professionals' education, but a drastic reduction was observed due to an increase in alternative virtual and multimedia means, and, in Italy, also due to a lack of regulation. Italian Law 10/2020 regulates body donation for research and training through an advanced directive for post-mortem body donation.

METHODS

A cross-sectional study was carried out to investigate the law knowledge and body donation perception of health students of any degree courses enrolled at the University of Pavia, Italy, in 2021, through ad hoc web questionnaire.

RESULTS

485 students participated to this survey; median age was of 21 years (25th-75th percentiles, 20-23), 73.2% were females, and 62.5% were medical students. Among them 14.9% knew the Italian law 10/2020. Age was the only variable associated with students' knowledge of the law. Further, 8.3% reported the current availability of cadaveric practice, 85.6% of health students acknowledged usefulness of cadaveric practice, with a significant difference between medical and non-medical students (71.4% vs 28.6%, p < 0.001). Overall, 59.7% would donate their body, rising to 62.7% with reference to specific law regulation, with 30.5% and 28.7% undecided, respectively. 51.3% of participants answered not practicing religious faith, 82.9% with Catholic families, without significance on the knowledge of the law.

CONCLUSIONS

Poor knowledge of the law compared with great interest and acknowledged cadaveric practice usefulness highlighted the need for better information, especially among health students, where critical discussion could be more valuable. Then, there arises the urgent need to fill the gaps within university studies and syllabuses, to relaunch the central role that cadaveric practice and research had in the education of health professionals. Consequences on basic and specific health students' skills, on health education quality in general, and further on health professionals' expertise must be carefully considered.

The Attitude of Medical Students Toward Voluntary Body Donation: A Single Institute Survey and Narrative Review of Global Trends

INTRODUCTION

Voluntary body donation (VBD) programs form the backbone of cadaveric teaching and learning in medical schools. It benefits the medical fraternity the most. Yet, there is a dearth of VBD practice among medical students. We aimed to understand the knowledge and attitude of first-year medical students in a tertiary institute with a systematic review of willingness toward VBD among undergraduate students worldwide.

METHODS

 The first-year medical undergraduates were given a 12-item questionnaire to assess their knowledge and attitude toward VBD. Statistical tests were applied to analyze the difference between the variables. We systematically searched Google Scholar, PubMed, and SCOPUS databases until October 15, 2022. Data concerning knowledge, awareness, and attitude toward VBD among undergraduates of medical backgrounds were extracted and analyzed qualitatively.

RESULTS

A total of 82.5% of students returned the completed responses. A significant association was seen between their attitudes toward whole body donation by strangers (p=0.043) and family members (p=0.035). The religion of the participants significantly affected their opinions on VBD and their willingness to pledge themselves (p=0.034). For the review, 20 studies were selected to be analyzed qualitatively. These studies included 4232 undergraduate students globally who were assessed for knowledge, awareness, and attitude toward VBD. Around 50% of the studies were published in India. The first study included was published in 2008. Seven studies were exclusively conducted on medical undergraduates, while the rest consisted of a mixed cohort. The attitude and knowledge of medical undergraduates on VBD were assessed via questionnaires containing both open-ended and closed-ended questions.

CONCLUSION

Based on observations from our survey and review, we concluded that while undergraduate students have a highly positive attitude toward VBD, their rate of pledging is low. The most prominent barrier to this attitude is their experience with cadavers in the dissection hall. Hence, we recommend a revisit of cadaver handling practices and the establishment of appropriate protocols for safe and deferential cadaver handling.

The impact of enhancing publicity and commemoration of body donors at Zhengzhou University, China

As a fundamental subject of medical education, human anatomy plays a critical role in the development of medical science. However, because of multiple factors including cultural conservativism and limited social understanding, China is facing a particularly severe shortage of bodies donated for anatomy education. Zhengzhou University (ZZU) has continued to uphold whole-body dissection as the preferred method for medical students to learn anatomy. For this study, records of registered individuals (who have signed a body donation agreement) and donors (whose bodies have been received) from 2001 to 2020 were collected and analyzed. The aim of this study was to explore the factors influencing the body donation program (BDP) at ZZU, and then reinforce the social understanding for the BDP. The results showed a significant increase in the numbers of both registered individuals and donors since 2015, which is the year the publicity and commemoration in honor of donors were increased. There were no significant differences between the biological male and female sexes in the registered individuals, but the number of male donors (12.85 ± 10.86, per year) was significantly higher than that of female donors (4.75 ± 4.53, per year). The current donor profile at ZZU is male in his 60/70s, while the profile of registered individuals is male or female in their 60s. Strengthening the publicity and commemoration in honor of donors may contribute to the implementation of BDPs.

Graphic medicine meets human anatomy: The potential role of comics in raising whole body donation awareness in Italy and beyond. A pilot study

Cadaver dissection has always played a fundamental role in medical education. However, especially in Italy, the topic of body donation has remained partially unknown for years. The current study analyses graphic medicine as a new possible communication tool, evaluating and reflecting, with second-year students enrolled in the International School of Medicine and Surgery at the University of Bologna, about its potentialities for body donation awareness-raising in both the scientific community and the general population. For the first time in an Italian University, two graphic medicine workshops were organized focusing on human anatomy and body donation. Seminars were positively evaluated by students using a four items Likert-scale question: mean 3.54 (± SD 0.73) for the Likert question about the experiences of the workshops; 3.88 (± 0.33) for the Likert question regarding the use of graphic medicine in body donation awareness campaigns among the general population; 3.59 (± 0.65) for the Likert question regarding the use of graphic medicine in body donation awareness campaigns among the scientific community. Furthermore, the open-ended questions included in the anonymous questionnaire were analyzed using the constructivist grounded qualitative analysis, whence various themes emerged. Finally, five graphic medicine projects about body donation were created by students, proving their interest in testing this method to promote body donation, focusing the attention on different communicative aspects. Considering the results of this pilot study, the co-creative collaborative use of graphic medicine could be evaluated as an additional strategy to increase body donation awareness-raising in Italy and beyond, especially in the non-experts' community.

In death there is life: perceptions of the university community regarding body donation for educational purposes in the United Arab Emirates

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.