Plastination in Anatomy Learning: An Experience at Cambridge University

Efficacy of plastinated specimens in anatomy education: A systematic review and meta-analysis

Plastination, a permanent preservation method for human tissues and organs, is increasingly being used in anatomy education. However, there is a paucity of systematic reviews and meta-analyses summarizing the educational efficacy of plastinated specimens. This meta-analysis compared the assessment scores of students exposed to plastinated specimens against those exposed to other common instructional methods. A systematic search was conducted through four databases, from 2000 to July 2022. Titles and abstracts of the retrieved records were screened according to predetermined eligibility criteria. Of the 159 records screened, 18 were subjected to full-text review. Among the 18 studies, five articles reported post-intervention test scores for intervention (plastinated) and control (other modalities) groups. Studies were subjected to GRADE quality assessment, and four studies with moderate to high ratings were included for meta-analysis. Students' perceptions (n = 15 studies) were qualitatively analyzed using an inductive narrative analysis. No significant effect was detected between the intervention (n = 417) and control groups (n = 422) (standardized mean difference = 0.08; 95% CI [-0.36, 0.52]; p = 0.73). Four themes emerged from students' perceptions: ease of use, motivation to study, spatial understanding, and learning preference. Overall, student performance outcomes comparing the use of plastinated specimens versus other instructional modalities are very limited. This meta-analysis suggests that knowledge gained from plastinated specimens is comparable to learning achieved through other modalities; though this outcome should be interpreted with caution as there is currently insufficient evidence for definitive conclusions.

Research advances and trends in anatomy from 2013 to 2023: A visual analysis based on CiteSpace and VOSviewer

As the cornerstone of medicine, the development of anatomy is related to many disciplines and fields and has received extensive attention from researchers. How to integrate and grasp the cutting-edge information in this field quickly is a challenge for researchers, so the aim of this study is to analyze research in anatomy using CiteSpace and VOSviewer in order to identify research hotspots and future directions. To offer a fresh viewpoint for assessing the academic influences of researchers, nations, or institutions on anatomy, and to examine the development of hotspots in anatomical study and to forecast future trends. A total of 4637 anatomy-related publications from 2013 to 2023 were collected from Web of Science Core Collection databases. Their temporal distribution, spatial distribution, cited authors, co-cited journals, keywords, and disciplinary connections in the literature were analyzed using CiteSpace and VOSviewer, and a knowledge graph was constructed. The temporal distribution shows a general fluctuation in the amount of literature published from 2013 to 2023. In spatial distribution, the total number of published articles was highest in the United States, the United Kingdom, and China, the United States leading. Tubbs, Rhoton, Iwanaga, and LaPrade are important authors in anatomy. Clinical Anatomy, Surgical and Radiologic Anatomy, and Journal of Anatomy were the most highly cited journals. Analysis of keywords and citation emergence showed that the research hotspots and trends in anatomy focused mainly on anatomy education, digital technology, and surgical management. At the same time, anatomy showed a trend toward multidisciplinary crossover, developing closer relationships with molecular biology, immunology, and clinical medicine. Current research in anatomy focuses on innovative reform of the educational model and the application and promotion of digital technology. Also, multidisciplinary cross-fertilization is an inevitable trend for the future development of anatomy.

Creation of 21st century anatomy facilities: designing facilities for integrated preclinical education in the Middle East

BACKGROUND

The establishment of new anatomy facilities needs to accommodate a combination of modern teaching modalities that best align with evidence-based best teaching practices. This article describes the process in which our state-of-the-art anatomy laboratories were designed and implemented, and how these facilities support aspects of modern anatomy education.

METHODS

A list of best practices for anatomy education in a modern medical curriculum was summarized from the literature. To assess student satisfaction, a survey related to student perception of the anatomy facilities (5-point Likert scale) was conducted.

RESULTS

Our educational modalities include a broad range of teaching approaches. The Instructional Studio houses prosected and plastinated specimens, and cadaveric dissections are performed. Each of our three Dry Laboratories allow for active learning and interaction between small student groups. The Webinar Room acts as a conference room for departmental and online meetings, discussions with students, and dialogues with affiliated hospitals via the internet. The Imaging Center is equipped with a Sectra® medical educational platform, CAE Vimedix® Virtual Medical Imaging Ultrasound Training System, and Philipps Lumify® Ultrasound devices to train students to conduct and interpret sonographic images. Moreover, the Complete Anatomy® program is made available to all our students.

CONCLUSION

The layout of our newly created Anatomy Facilities allows for all aspects of modern medical education mentioned in the literature. These educational modalities and teaching approaches are highly appreciated by our faculty and students. Moreover, these technologies allowed for a smooth transition from on-site anatomy teaching to online education during the COVID pandemic.

Practical anatomy classes: An alternative to improve the learning of middle school students

Anatomy is the branch discipline focused on studying organisms' physical structures and parts. Although technological advances are broadening the anatomy study, the practices of prosection and dissection of human cadavers and animals remain a primary teaching method. Despite the large body of research supporting its benefits, in some countries, cadaveric prosection and dissection of vertebrate animals in secondary education have been banned. In the current study, to prevent a lack of access to anatomical sciences education, the use of plastinated biological specimens was proposed for teaching practical biology in middle and high schools. The study was conducted in the 2014 academic year. Eighty-seven middle school students participated in the experiment. Groups consisted of: (i) theoretical classes only; (ii) theoretical class plus prosection with fresh specimens class; (iii) theoretical class plus expository with plastinated specimens classes. A post-test grade method was used to assess the impact of such tasks on the learning experience of each group. An ANOVA test and multiple regression model were used to analyze the effects of the variables of interest. Our study highlighted that students who underwent the plastination practical class had higher overall performance and a higher mean post-test grade than those in the pure theoretical group. A favorable effect of a positive self-knowledge assessment on the students' performance was found, supporting the self-efficacy model of human behavior. Thus, the current study provides further evidence to support the use of plastinated specimens as an effective teaching method in countries where dissection is not feasible.

Students' learning experiences of three-dimensional printed models and plastinated specimens: a qualitative analysis

BACKGROUND

Traditional cadaveric dissection is declining whilst plastinated and three-dimensional printed (3DP) models are increasingly popular as substitutes to the conventional anatomy teaching and learning methods. It is unclear about the pros and cons of these new tools and how they impact students' learning experiences of anatomy including humanistic values such as respect, care and empathy.  METHODS: Ninety-six students' views were sought immediately after a randomized cross-over study. Pragmatic design was used to investigate the learning experiences of using plastinated and 3DP models of cardiac (in Phase 1, n = 63) and neck (in Phase 2, n = 33) anatomy. Inductive thematic analysis was conducted based on 278 free text comments (related to strengths, weaknesses, things to improve), and focus group (n = 8) transcriptions in full verbatim about learning anatomy with these tools.

RESULTS

Four themes were found: perceived authenticity, basic understanding versus complexity, attitudes towards respect and care, and multimodality and guidance.

CONCLUSIONS

Overall, students perceived plastinated specimens as more real and authentic, thus perceived more respect and care than 3DP models; whereas 3DP models were easy to use and prefered for learning basic anatomy.

Wet Specimens, Plastinated Specimens, or Plastic Models in Learning Anatomy: Perception of Undergraduate Medical Students

BACKGROUND

Methods of teaching anatomy have shown major change as the medical undergraduate curriculum became more challenging. Traditional teaching methods like dissection and wet specimens are nowadays widely replaced by anatomical models, plastination, and technology-enhanced applications.

AIM

To explore the perception of undergraduate students of three methods of learning anatomy, which are wet specimens, plastinated specimens, and plastic models.

METHODS

This is a descriptive, cross-sectional, questionnaire-based study that included a sample of 268 male and female undergraduate medical students of the third and fourth study years at Ibn Sina National College for Medical Studies in Saudi Arabia.

RESULTS

Students in this study preferred wet specimens in regard to motivation to gaining anatomical knowledge in clinical context and usefulness for surgical career. On the other hand, they preferred plastinated specimens when it comes to feasibility of use, ability to differentiate between structures, and understanding complex structures.

CONCLUSION

Although the findings in general refer to preferring the use of wet specimens, no one modality seems to be enough for effectively learning anatomy. A combination of various modalities can provide the best benefit for medical students in this regard.

The Evolution of Educational Technology in Veterinary Anatomy Education

"All learning is in the learner, not the teacher." Plato was right. The adage has passed the test of time and is still true in an era where technology accompanies us in not only professional but also recreational life every day, everywhere. On the other hand, the learner has evolved and so have the sources being used to satisfy curiosity and learning. It therefore appears intuitive to embrace these technological advances to bring knowledge to our pupils with the aim to facilitate learning and improve performance. It must be clear that these technologies are not intended to replace but rather consolidate knowledge partly acquired during more conventional teaching of anatomy. Veterinary medicine is no outlier. Educating students to the complexity of anatomy in multiple species requires that three-dimensional concepts be taught and understood accurately if appropriate treatment is to be set in place thereafter. Veterinary anatomy education has up to recently walked diligently in the footsteps of John Hunter's medical teaching using specimens, textbooks, and drawings. The discipline has yet to embrace fully the benefits of advancement being made in technology for the benefit of its learners. Three-dimensional representation of anatomy is undeniably a logical and correct way to teach whether it is through the demonstration of cadaveric specimen or alternate reality using smartphones, tablets, headsets or other digital media. Here we review some key aspects of the evolution of educational technology in veterinary anatomy.

Histologic Reliability of Tissues from Embalmed Cadavers: Can They be Useful in Medical Education?

Background:

Current trends in medical curricula are shifting from teaching histology and pathology as stand-alone disciplines. Therefore, it would be useful to examine the potential value of integrating these into the anatomical dissection experience.

Objectives:

The aim of this study was to assess the histologic reliability of tissues taken from embalmed cadavers in an anatomy laboratory.

Materials and Methods:

A total of 112 tissue samples were obtained using standard autopsy techniques from various organs (heart, lung, thyroid, skeletal muscle, bone and skin) of 11 cadavers available at the anatomy laboratory of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, in 2019. Samples were prepared using the standard paraffin procedure followed by cutting sections at 4-μm thickness and staining with standard hematoxylin and eosin stain. Using predefined criteria, the quality of the samples was evaluated by two board-certified histopathologists and each slide was categorized as good, satisfactory or poor.

Results:

Overall, 34.2% and 60.3% of the slides were of good and satisfactory quality, respectively. A significant difference in tissue quality was found between various organs. Thick skin and bone tissues had the highest “good” rating (84.6% and 81.8%, respectively), while thyroid and lung tissues had the highest “poor” rating (20% and 13.6%, respectively).

Conclusion:

Most of the tissues acquired from the embalmed cadavers were of good or satisfactory quality, thereby indicating the beneficial use of histological tissue from cadavers for educational purposes. Future research into how these findings translate into meaningful medical education would be beneficial.

Plastination-A scientific method for teaching and research

Over the last four decades, plastination has been one of the best processes of preservation for organic tissue. In this process, water and lipids in biological tissues are replaced by polymers (silicone, epoxy, polyester) which are hardened, resulting in dry, odourless and durable specimens. Nowadays, after more than 40 years of its development, plastination is applied in more than 400 departments of anatomy, pathology, forensic sciences and biology all over the world. The most known polymers used in plastination are silicone (S10), epoxy (E12) and polyester (P40). The key element in plastination is the impregnation stage, and therefore depending on the polymer that is used, the optical quality of specimens differs. The S10 silicone technique is the most common technique used in plastination. Specimens can be used, especially in teaching, as they are easy to handle and display a realistic topography. Plastinated silicone specimens are used for displaying whole bodies, or body parts for exhibition. Transparent tissue sections, with a thickness between 1 and 4 mm, are usually produced by using epoxy (E12) or polyester (P40) polymer. These sections can be used to study both macroscopic and microscopic structures. Compared with the usual methods of dissection or corrosion, plastinated slices have the advantage of not destroying or altering the spatial relationships of structures. Plastination can be used as a teaching and research tool. Besides the teaching and scientific sector, plastination becomes a common resource for exhibitions, as worldwide more and more exhibitions use plastinated specimens.

Anatomy Teaching, a "Model" Answer? Evaluating "Geoff", a Painted Anatomical Horse, as a Tool for Enhancing Topographical Anatomy Learning

Development of new methods for anatomy teaching is increasingly important as we look to modernize and supplement traditional teaching methods. In this study, a life-sized equine model, "Geoff," was painted with surface and deep anatomical structures with the aim of improving students' ability to convert theoretical knowledge into improved topographical anatomy knowledge on the live horse. Third and fourth year veterinary medicine students (n = 45) were randomly allocated into experimental (used "Geoff") and control (used textbook) groups. The efficacy of the model was evaluated through a structured oral exam using a live horse. Questionnaires gathered information on student confidence and enjoyment of the task. There was no significant difference in the performance of experimental and control groups either immediately (44±20% vs. 40±21%; P = 0.504) or 9 weeks after the learning intervention (55±17% vs. 55±20%; P = 0.980). There were however specific questions on which the experimental group performed better than controls, and for which gender effects were apparent. The students using "Geoff" showed a transient gain in confidence following the session (Likert scale 2.7 to 3.6) however the initial increase was no longer present at the second test. There was a significant influence of gender on confidence with greater confidence gains in females in the Experimental group. The students found the model to be extremely useful and both groups found the sessions enjoyable. The model will be of benefit as a complementary learning tool for students.

Preservation of macroparasite species via classic plastination: an evaluation

Plastination is a preservation method for biological specimens, with important advantages over classic conservation techniques with formaldehyde or alcohol. Plastinated specimens are dry, odourless, and free of carcinogenic and toxic solutions. There are only few references about the plastination of parasites. Moreover, there is no information on the effect of plastination on the morphology and morphometry of these animals. The aim of this study was to define a plastination protocol to preserve various species of parasites, namely the nematodes Parascaris equorum (Goeze, 1782); Ascaris suum Goeze, 1782 and Dirofilaria immitis (Leidy, 1856); the acanthecephalan Macracanthorhynchus hirudinaceus (Pallas, 1781); the trematodes Fasciola hepatica Linnaeus, 1758 and Dicrocoelium dendriticum (Rudolphi, 1819) and the tapeworm Taenia sp. in the best morphological and morphometric conditions. Results showed that some individuals suffered collapse (P. equorum, A. suum, and D. dendriticum). However, other parasites presented good results with almost no change after plastination (D. immitis, M. hirudinaceus and F. hepatica). In conclusion, conventional plastination allowed anatomical preservation of all helminths tested, but modifications to the protocol are needed to prevent collapse.

Construction of the Equine Digestive System: A Tool for Teaching Topographical Anatomy

Anatomy is traditionally regarded as a difficult, non-motivating course involving a large body of theoretical and practical content, and it is often associated with high levels of dropout and failure. Given the relevance of the topic, we propose an alternative active multisensory teaching tool consisting of the construction of a low-fidelity anatomical model assembled into an articulated equine skeleton. Model construction and assembly assists students in the recognition of the topography and anatomical boundaries of the equine abdominal digestive system. Digestive system organs (liver, pancreas, stomach, small and large intestines) were constructed using common, easily available materials, such as newspaper, balloons, laminated rubber sheets, and polyethylene cylinders. The method described in this study is a low-cost, user-friendly teaching tool that is potentially applicable across different academic disciplines and that can also be used to construct models of other systems and species. However, it should be combined with other anatomy teaching methods because it does not provide detailed representation of specific digestive system organ features.

Use and perceptions of plastination among medical anatomy educators in the United States

Traditionally, medical schools have maintained collections of tissues/organs to engage students in anatomy. Such collections are often stored in volatile and toxic preservatives. Plastination is an alternative tissue preservation technique in which polymers replace water and lipids resulting in benign, dry, and anatomically authentic specimens. Plastination is used in medical education internationally; however, its use within U.S. medical schools is not widely discussed in the anatomical literature. This study aimed to determine the knowledge, use, and perceptions of plastination as a teaching tool among U.S. anatomy medical educators. A total of 98 medical anatomy educators who fit inclusion criteria and teach allopathic (MD) students and/or osteopathic (DO) students in the United States completed a national survey, representing 77 medical schools across 37 states. Of these, 100% had heard of plastination, 57% correctly defined plastination, but only 39% currently utilize plastinates for anatomy education. The most frequent explanation for nonuse of plastinates was a preference for the dissection experience, followed by lack of resources and negative past experiences related to durability and quality. A majority (75%) of U.S. medical anatomy educators perceived plastination as a good supplement to, but not a replacement for, cadaveric dissection, 19% indicated no curiosity to use plastination or considered it not useful, and 14% expressed ethical concerns. These findings suggest plastinates are more widely used in the United States than reflected by the literature; however, perceptions regarding their utility indicate a dominant theme for their use to supplement, not replace, cadaveric dissection. Clin. Anat, 2017. © 2017 Wiley Periodicals, Inc.