Anatomy From Nazi Germany to Today

This viewpoint reviews the anatomical body procurement used in Nazi Germany, notes the continued use of those images, and calls for disclosure of the biographical history of the people whose bodies and tissues are now studied.

National Survey on Canadian Undergraduate Medical Programs: The Decline of the Anatomical Sciences in Canadian Medical Education

The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.

Survey of Gross Anatomy Education in China: The Past and the Present

Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990-1999, 2000-2009, and 2010-2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000-2009 to 36.10 ± 47.26 in 2010-2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990-1999 to 14.22 ± 5.0 in 2010-2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000-2009 to 1:33.2 in 2010-2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.

A brief review of recent discoveries in human anatomy

In the last few years, a cluster of anatomical discoveries has been reported which overturned the long existing dogmas about the structure and function of human body. First to come was the discovery that established the existence of a lymphatic system pertaining to the central nervous system (CNS). CNS was believed to be anatomically immune privileged owing to the absence of any lymphatics and presence of the blood-brain barrier around it, but latest research has established beyond any reasonable doubt that true lymphatic channels carry immune cells in meninges thus challenging the existing theory. Studies also supported the presence of a 'Glymphatic system' (created by the perivascular spaces lined with the leptomeninges and a sheath of glial cells) in the CNS draining interstitial metabolic waste from CNS. The second discovery unraveled the previously unknown parts of the human mesentery in adult and established that it is a continuous entity all along the intra-abdominal gut tube against the previous notion that it is fragmented in the adult humans. A very recently reported third discovery demonstrated a previously unknown tissue component-'interstitium'-a networked collagen bound fluid-filled space existent in a number of human organs. All these structures bear considerable applied importance towards the pathogenesis, prognostic and diagnostic investigations and management of human diseases. This article attempts to present a brief review of all three remarkable discoveries and emphasizes their applied importance within the realm of medical sciences.

Pelvis Anatomy Tutorial Using Radiological Images

Introduction

Improving integration between basic science and clinical application is essential in medical education. Anatomy courses can do this by focusing on medical imaging interpretation. Most imaging textbooks rely on structural identification, which novice learners often struggle to apply to the health care environment, particularly in complex regions like the pelvis, which is multifaceted and differs substantially between sexes. To address this deficit, this resource extends our imaging-based tutorial series.

Methods

This tutorial was a self-administered PowerPoint incorporating X-ray, computed tomography, and magnetic resonance imaging, which are all often used for the pelvic region, as well as self-quizzing and clinical applications. Using repeated-measures, control/experimental design, the tutorial was evaluated as a review tool for 57 Australian medical students in preclerkship years. Participants were evaluated by a rating self-efficacy scale, knowledge-based testing (multiple-choice, short-answer, and identification questions), and feedback to open-ended questions.

Results

Results indicate that the tutorial significantly improved direct knowledge (p = .006), as the experimental group's posttutorial scores for direct questions were superior by 21% on average. Significant improvements occurred specifically for direct short-answer and indirect image-identification questions.

Discussion

These results suggest the tutorial is an effective review tool. While previous tutorials were evaluated as adjunct tools, this tutorial was evaluated post-anatomy teaching with similar results. Students improved in direct and applied anatomy following tutorial exposure. This suggests that the tutorial series comprises valuable review and supplementary materials. None of our tutorials have been evaluated as a sole mechanism for teaching anatomy or imaging.

National survey on anatomical sciences in medical education

The drivers for curricular change in medical education such as the addition of innovative approaches to teaching, inclusion of technology and adoption of different assessment methods are gaining momentum. In an effort to understand how these changes are impacting and being implemented in gross anatomy, microscopic anatomy, neuroanatomy/neuroscience, and embryology courses, surveys were sent out to course directors/discipline leaders at allopathic Medical Schools in the United States during the 2016-2017 academic year. Participants in the study were asked to comment on course hours, student experiences in the classroom and laboratory, amount of faculty participation, the use of peers as teachers in both the classroom and laboratory, methods used for student assessment and identification of best practices. Compared to data published from a similar survey in 2014, a number of changes were identified: (1) classroom hours in gross anatomy increased by 24% and by 29% in neuroanatomy/neuroscience; (2) laboratory hours in gross anatomy decreased by 16%, by 33% in microscopic anatomy, and by 38% in neuroanatomy/neuroscience; (3) use of virtual microscopy in microscopic anatomy teaching increased by 129%; and (4) the number of respondents reporting their discipline as part of a partially or fully integrated curriculum increased by greater than 100% for all four disciplines. Anat Sci Educ 11: 7-14. © 2017 American Association of Anatomists.

Cadaveric dissection as an educational tool for anatomical sciences in the 21st century

Anatomical education has been undergoing reforms in line with the demands of medical profession. The aim of the present study is to assess the impact of a traditional method like cadaveric dissection in teaching/learning anatomy at present times when medical schools are inclining towards student-centered, integrated, clinical application models. The article undertakes a review of literature and analyzes the observations made therein reflecting on the relevance of cadaveric dissection in anatomical education of 21st century. Despite the advent of modern technology and evolved teaching methods, dissection continues to remain a cornerstone of anatomy curriculum. Medical professionals of all levels believe that dissection enables learning anatomy with relevant clinical correlates. Moreover dissection helps to build discipline independent skills which are essential requirements of modern health care setup. It has been supplemented by other teaching/learning methods due to limited availability of cadavers in some countries. However, in the developing world due to good access to cadavers, dissection based teaching is central to anatomy education till date. Its utility is also reflected in the perception of students who are of the opinion that dissection provides them with a foundation critical to development of clinical skills. Researchers have even suggested that time has come to reinstate dissection as the core method of teaching gross anatomy to ensure safe medical practice. Nevertheless, as dissection alone cannot provide uniform learning experience hence needs to be complemented with other innovative learning methods in the future education model of anatomy. Anat Sci Educ 10: 286-299. © 2016 American Association of Anatomists.

Googling in anatomy education: Can google trends inform educators of national online search patterns of anatomical syllabi?

The role of e-learning platforms in anatomy education continues to expand as self-directed learning is promoted in higher education. Although a wide range of e-learning resources are available, determining student use of non-academic internet resources requires novel approaches. One such approach that may be useful is the Google Trends^© web application. To determine the feasibility of Google Trends to gain insights into anatomy-related online searches, Google Trends data from the United States from January 2010 to December 2015 were analyzed. Data collected were based on the recurrence of keywords related to head and neck anatomy generated from the American Association of Clinical Anatomists and the Anatomical Society suggested anatomy syllabi. Relative search volume (RSV) data were analyzed for seasonal periodicity and their overall temporal trends. Following exclusions due to insufficient search volume data, 29 out of 36 search terms were analyzed. Significant seasonal patterns occurred in 23 search terms. Thirty-nine seasonal peaks were identified, mainly in October and April, coinciding with teaching periods in anatomy curricula. A positive correlation of RSV with time over the 6-year study period occurred in 25 out of 29 search terms. These data demonstrate how Google Trends may offer insights into the nature and timing of online search patterns of anatomical syllabi and may potentially inform the development and timing of targeted online supports to ensure that students of anatomy have the opportunity to engage with online content that is both accurate and fit for purpose. Anat Sci Educ 10: 152-159. © 2016 American Association of Anatomists.

The development of anatomy: from macroscopic body dissections to stem cell-derived organoids

Anatomy as a descriptive topic of research and instruction in medicine has been increasingly influenced by discoveries in molecular cell and developmental biology and most recently the advent of human induced pluripotent stem cells and organoids. We summarize here how anatomy has been influenced by developmental and stem cell biologists, and how in vitro modelling of the three-dimensional body environment is emerging to understand structure and function of cells during differentiation processes in development and disease.

Changing undergraduate human anatomy and physiology laboratories: perspectives from a large-enrollment course

In the present article, a veteran lecturer of human anatomy and physiology taught several sections of the laboratory component for the first time and shares his observations and analysis from this unique perspective. The article discusses a large-enrollment, content-heavy anatomy and physiology course in relationship to published studies on learning and student self-efficacy. Changes in the laboratory component that could increase student learning are proposed. The author also points out the need for research to assess whether selective curricular changes could increase the depth of understanding and retention of learned material.

Cadaveric anatomy in the future of medical education: What is the surgeons view?

Reduced contact hours and access to cadaveric/prosection-based teaching in medical education has led to many doctors reporting inadequate anatomical knowledge of junior doctors. This trend poses significant risk, but perhaps most of all in surgery. Here the opinions of surgeons regarding current and future teaching practices in anatomy were surveyed. Eighty surgeons were invited to complete a questionnaire, 48 of which were returned for a 60% response rate. Respondents were asked to select the method they viewed as the best method of teaching anatomy. Sixty-five percent of respondents selected "cadaver/prosection demonstration" (P < 0.001), while 55% of respondents, thought it should be enhanced in anatomy education (P < 0.001). Finally, respondents were asked to select what form of imaging should be further explored in anatomical education. Seventy-five percent of respondents' selected computerized tomography (CT) imaging compared to other imaging modalities (P < 0.001). These data show that surgeons view cadaveric/prosection-based teaching as the most beneficial method of teaching anatomy and that it should be enhanced in medical education. Furthermore, surgeons suggested that CT should be further integrated into anatomical education. These findings support the continued use of cadaveric/prosection-based teaching, and will help inform the integration of radiology in the design and implementation of anatomy teaching in medical education.

History of teaching anatomy in India: from ancient to modern times

Safe clinical practice is based on a sound knowledge of the structure and function of the human body. Thus, knowledge of anatomy has been an essential tool in the practice of healthcare throughout the ages. The history of anatomy in India traces from the Paleolithic Age to the Indus Valley Civilization, the Vedic Times, the Islamic Dynasties, the modern Colonial Period, and finally to Independent India. The course of the study of anatomy, despite accompanying controversies and periods of latencies, has been fascinating. This review takes the reader through various periods of Indian medicine and the role of anatomy in the field of medical practice. It also provides a peek into the modern system of pedagogy in anatomical sciences in India.

The role of radiology in preclinical anatomy: a critical review of the past, present, and future

RATIONALE AND OBJECTIVES

Radiology has been an increasingly important component of preclinical anatomy instruction since the 1960s. The global status of medical imaging pedagogies and radiologists' roles in medical anatomy education is not well established but is important in determining the specialty's contribution to undergraduate medical education.

MATERIALS AND METHODS

PubMed was searched with various combinations of MeSH terms including "radiology," "undergraduate medical education," and "anatomy." Articles were reviewed for relevance, and referenced articles of possible relevance were hand-traced to ensure a wide capture of articles.

RESULTS

Although more medical schools around the world are using medical imaging to teach anatomy, some regions, such as the United States, show a decline in the proportion of imaging taught by radiologists. Lectures, small group discussions, and self-instruction remain the mainstay of current pedagogies and have witnessed dramatic changes over the past few decades with respect to the types of imaging used. Newer pedagogies use contextual and hands-on experiences to improve spatial and application principles. Qualitative and quantitative studies report somewhat mixed results of pedagogical efficacies but demonstrate generally high acceptance by students and instructors and often significant exam score improvement. Radiology as a specialty must overcome several challenges for it to become more involved in anatomy education, including teaching incentives and protected academic time.

CONCLUSIONS

As anatomy instruction and clinical medicine grow increasingly digital, it is ever more important that radiologists continue to develop new anatomy pedagogies and contribute to anatomy education in greater roles.

Dissecting the history of anatomy in the Third Reich--1989-2010: A personal account

This paper is a personal narrative of involvement with the revelations of the use of anatomical and pathological specimens of victims of Nazi terror. The narrative documents responses to the question of the retention and use of anatomical and pathological specimens from victims of Nazi terror by leading academic and scientific institutions and organizations in Germany and Austria including the government of the Federal Republic of (West) Germany, the University of Tübingen, the University of Vienna, the Max Planck Society and the Anatomische Gesellschaft. It begins with the public revelations of 1989 and concludes with the September 2010 Symposium on the History of Anatomy during the Third Reich at the University of Würzburg. The narrative documents a 22-year transition in attitude and responses to the investigation and documentation of the history of anatomy and pathology during the Third Reich. The chronicle includes the 1989 proposed "Call for an International Commemoration" by the author, together with the bioethicist Professor Arthur Caplan, on the occasion of the planned burial of the misbegotten specimens and the responses to that proposal.

[Refutation of traditional views of the disease and formation of the scientific basis of pathology (17-19th centuries)]

This paper focuses on the revision of disease concepts that prevailed during the Galenism era and the formation of the scientific basis of pathology at the time of two scientific revolutions of the 17-19th centuries.

Dinosaurs in the year of Darwin

This special issue of The Anatomical Record explores the recent advances in the functional morphology and paleobiology of dinosaurs. Although Darwin did not study dinosaurs because paleontology was in its infancy a century and half ago, he considered both paleontology and anatomy as essential subjects for establishing the validity of evolution. The study of dinosaurs constitutes a vigorous subdiscipline within vertebrate paleontology, and anatomists and evolutionary functional morphologists constitute an especially creative subgroup within dinosaur paleontology. The collection of 17 papers presented in this issue encompass cranial anatomy, postcranial anatomy, and paleobiology of dinosaurs and other archosaurs. Soft tissue subjects include studies of brain structure, jaw adductor muscles, and keratinous appendages of the skull. Taxonomically, it includes four papers with a focus on theropods, including Tyrannosaurus, five papers dealing with ceratopsians, three papers on hadrosaurs, and one on ankylosaurs. Modern anatomical techniques such as CT scanning, finite element analysis, and high resolution histology are emphasized. The visual presentation of results of these studies is spectacular. Results include the first-ever life history table of a plant-eating dinosaur; a determination of the head orientation of Tyrannosaurus and its relatives based on interpretation of the semicircular canals. The claws of Velociraptor appear to best adapted for tree climbing, but not for horrific predatory activities. Pachyrhinosaurus evidently used its massive head for head butting. The tail club of the armored dinosaur Euoplocephalus had the structural integrity to be used as a weapon. The pages abound with insights such as these. Dinosaurs once dead for millions of years live again!

Terminologia anatomica in the past and the future from perspective of 110th anniversary of Polish Anatomical Terminology

Professional terminology is commonplace, particularly in the fields of mathematics, medicine, veterinary and natural sciences. The use of the terminology can be international, as it is with Anatomical Terminology (AT). In the early age of modern education, anatomists adopted Latin as the international language for AT. However, at the end of the 20th century, the English language became more predominant around the world. It can be said that the AT is a specific collection of scientific terms. One of the major flaws in early AT was that body structures were described by varying names, while some of the terms was irrational in nature, and confusing. At this time, different international committees were working on preparing a unified final version of the AT, which in the end consisted of 5,640 terms (4,286 originally from the Basle Nomina Anatomica, BNA). Also, each country wanted to have its own nomenclature. In order to accomplish this, each country based their nomenclature on the international AT, and then translated it into their own language. The history of the Polish Anatomical Terminology (PAT) is unique, and follows the events of history. It was first published in 1898, at a time when its neighbours partitioned the territory of Poland. During 150 years, the Polish culture and language was under the Russification and Germanization policy. It is important to note, that even with such difficult circumstances, the PAT was the first national AT in the world. The PAT was a union of the accepted first BNA in Latin and the original Polish anatomical equivalents. This union formed the basis for theoretical and clinical medicine in Poland.

In praise of tedious anatomy

Functional neuroimaging is fundamentally a tool for mapping function to structure, and its success consequently requires neuroanatomical precision and accuracy. Here we review the various means by which functional activation can be localised to neuroanatomy and suggest that the gold standard should be localisation to the individual's or group's own anatomy through the use of neuroanatomical knowledge and atlases of neuroanatomy. While automated means of localisation may be useful, they cannot provide the necessary accuracy, given variability between individuals. We also suggest that the field of functional neuroimaging needs to converge on a common set of methods for reporting functional localisation including a common "standard" space and criteria for what constitutes sufficient evidence to report activation in terms of Brodmann's areas.

Civility, comportment, and the anatomy theater: Girolamo Fabrici and his medical students in Renaissance Padua

Public anatomies have been characterized as carnivalesque events: like the Carnival, they took place in January and February and celebrated bodily existence. However, in late sixteenth-century Padua and its famous anatomy theater, the annual, public anatomy was a formal, ceremonial event. Girolamo Fabrici, the leading anatomist, gave a philosophical presentation of his research, a presentation organized by topic rather than by the gradual dissection of corpses. For medical students, the annual anatomy and the theater itself encouraged silence, obedience, and docility, reinforcing the virtues that permeated the late humanist environment of Renaissance Padua.

Anatomical investigations and their ethical dilemmas

The multi-faceted nature of modern anatomy comes as a surprise to many, especially when confronted by such seemingly different topics as cadavers and human embryo research. However, even these disparate facets of anatomy are linked by common underlying ethical considerations. This article traces historical views of anatomy and places them alongside the more contemporary dimensions of whole-body plastination, use of human material obtained under unethical circumstances, and human embryo research. These dimensions introduce issues of respect, human dignity, consent, scientific integrity, and societal expectations.

The future of interdisciplinary research and training: how to conquer the silo guardians

We have entered a new era in biomedical research in which large interdisciplinary teams are being established to answer important scientific questions. Scientists of multidisciplinary backgrounds within universities are combining forces and inter-institutional consortia that include alliances between academia and industry are springing up around the country to generate breakthrough advances. A number of driving forces are at work to establish these collaborative research approaches. By contrast, there also are barriers to be surmounted by institutions with silo mentalities for effective partnerships to be established. In order for this new era of research to reach maximal effectiveness, new approaches to education of the young and retraining of established administrators and scientists must take place. These issues were explored thoroughly at the 2006 annual meeting of the Association of Anatomy, Cell Biology and Neurobiology Chairpersons (AACBNC) that was held in Aruba from January 18 to 21. The theme of this historic meeting was the Future of Interdisciplinary Research and Training: Breaking Down the Barriers. In this introductory article, we discuss the formation of a trendsetting Institute of Biomedical Sciences and Technology, the concept of the AACBNC meeting, and the influence of the Institute on the content of the meeting. The proceedings of this meeting, including Nobel Laureate Papers and Nobel Round-Table Discussions on the future of interdisciplinary research and training, are contained in this special issue of Experimental Biology and Medicine, a journal dedicated to the publication of multidisciplinary and interdisciplinary research in the biomedical sciences.

A tale of two speeds: challenges for research universities

This manuscript represents a presentation to the Annual Conference of the Association of Anatomy, Cell Biology and Neurobiology Chairpersons. The author is responding to the question, "How can university administrations nurture both interdisciplinary and inter-institutional collaboration and cooperation?" The presentation makes the point that university administrators must be cognizant of the changing dynamics of interdisciplinary and inter-institutional collaboration and cooperation due to the speed of the Internet and the speed of travel today. Those institutional leaders, and their universities, that recognize that the world has become flat will flourish, while those locked in a silo mentality will perish.

Re-engineering Colles: form, function and fragility fractures

Of the twenty nine anatomy professors in the Royal College of Surgeons in Ireland, primus inter pares is Abraham Colles. In his 1811 book A Treatise on Surgical Anatomy he revolutionised the subject by teaching it topographically, seeking "to describe the relative position of the parts and to point out the subservience of anatomical knowledge to surgical practice". Today we have extended this to 'clinical practice' and, in the Anatomy Room, students are guided through each region by clinically trained staff, from surface anatomy via three-dimensional dissection to radiological images. This is augmented by online histology and radiology courses and DVDs in which dissection footage, edited by a content analysis engine, is used to preview and review practical classes. In the same book, Colles also wrote that 'the fixed and immutable laws of mathematics are little applicable to the science of medicine'. Computer-aided learning argues against this. So does research which links fatigue microdamage to bone remodelling and the development of algorithms to predict, and thus prevent, osteoporotic fractures. Mechanical principles are being used to develop scaffolds for tissue engineering and to optimise the mechanical environment of seeded mesenchymal stem cells. While Colles' teaching approach holds true, in biomechanics, tissue engineering and computing, mathematical laws are now being successfully applied to medical science.

Should we continue teaching anatomy by dissection when …?

The central role that human dissection has long held in clinical education is being reevaluated in many institutions. Despite the impression that many institutions are abandoning dissection, very few have and most of those have reinstated dissection within a few years. What are the inherent qualities that lead institutions back to dissection? In our efforts to redesign a shortened dissection course, our consultations with a broad range of clinicians lead us to understand how the rhythms of clinical practice are modeled and developed in the small-group setting of the dissection laboratory. Following further consultation with colleagues who have experimented with different models of anatomy instruction, we discuss three themes in support of dissection. First, problem-solving in the dissection laboratory develops the habits-of-mind of clinical practice. Second, relating dissection to imaging modalities develops the spatial reasoning skills needed to understand computer simulations, interpret imaging data, and interact with surgeons, radiologists, and patients. Third, the human face of dissection fosters self-reflection and integration of the cognitive and affective skills required for medical practice. Through group process, the collaborative effort of dissection teams develops essential of attributes of clinical professionalism.

Anatomical ontologies: names and places in biology

Recently, ideas from the field of ontology have been picked up by computer scientists as a basis for encoding knowledge and with the hope of achieving interoperability and intelligent system behavior. The use of anatomy ontologies to represent space in biological organisms, specifically mouse and human are reviewed here.

Ontology has long been the preserve of philosophers and logicians. Recently, ideas from this field have been picked up by computer scientists as a basis for encoding knowledge and with the hope of achieving interoperability and intelligent system behavior. In bioinformatics, ontologies might allow hitherto impossible query and data-mining activities. We review the use of anatomy ontologies to represent space in biological organisms, specifically mouse and human.

Promoting graduate student interest and participation in human gross anatomy

For many years, graduate students at the University of North Texas Health Science Center (UNTHSC) were reluctant to enroll in dissection-based human gross anatomy courses. Furthermore, few graduate faculty mentors would allow their students to enroll in these courses. The significant amount of time allotted to courses such as anatomy and its effect on students' research programs have been identified by faculty as the primary reason for this lack of enthusiasm. For example, prior to 1999, graduate students taking human gross anatomy at UNTHSC registered for a 13-semester credit hour (SCH) course that was offered only in the fall semester. In the last 5 years, the anatomy teaching faculty in the Department of Cell Biology and Genetics (CGEN) restructured the human gross anatomy course for graduate students. A series of small, compact anatomy courses, ranging from 3-7 SCHs, are now offered throughout the school year to replace the single anatomy course. The CGEN faculty designed courses based on single or multiple body systems that varied in length from a few weeks to an entire semester. This change was initiated with the implementation of a system-based approach to anatomy instruction in our medical school curriculum and the elimination of our graduate anatomy course. With the development of six anatomy courses covering the entire human body, we have had a significant increase in graduate student participation. Moreover, the shorter duration of the courses has made them more appealing to graduate faculty mentors who want to keep graduate students focused on their research.

Provision of anatomical teaching in a new British medical school: Getting the right mix

In response to a government report, which recommended a substantial increase in the number of medical students in the United Kingdom by 2005, several new medical schools have been set up throughout the country. One such school, the Brighton and Sussex Medical School (BSMS), recently opened its doors to new students. BSMS offers a 5-year medical curriculum that uses an integrated systems-based approach to cultivate academic knowledge and clinical experience. Anatomy is one of the core elements of the program and, as such, features strongly within the modular curriculum. The challenge for the anatomy faculty has been to decide how best to integrate anatomy into the new curriculum and what teaching modalities should be used. A multidisciplinary approach has been taken using both traditional and contemporary teaching methods. Unlike most of the other new medical schools, BSMS uses cadaveric dissection as the cornerstone of its teaching, as the faculty believes that dissection still provides the most powerful technique for demonstrating anatomy as well as enhancing communication and teamwork skills. The dissection experience is handled using an understanding and professional way. However, to ensure that our students do not become detached from the process of patient-focused care, emphasis in the dissecting room environment is also placed on respect and compassion. To enhance conceptual understanding of structure and function and provide further clinical relevance, we are using imaging technology to demonstrate living anatomy. Unique to the BSMS curriculum is the teaching of the anatomy in the later years of the program. During specialist rotations, students will return to the dissecting room to study the anatomy relevant to that area. Such vertical integration ensures that core anatomical knowledge is gained at the most appropriate level relative to a student's clinical experience.

Ethics, transplantation, and the changing role of anatomists

Anatomists are regarded as custodians of cadaveric material donated to science. Almost every facet of medical science has experienced explosive advances. This has impacted directly on anatomists and their role. Increasingly, anatomists are raising concerns with regard to the treatment of human tissue (Jones,2002, Clin. Anat. 15:436-440). The Korperwelten (Bodyworlds) of Gunther von Hagens et al. (1987, Anat. Embryol. 175:411-421) has evoked considerable debate about the treatment of human cadavers. Thus far clinical anatomists have had little role to play in policy formulation, legislation, and ethical imperatives as applied to cadaveric donation for organ transplantation. Anatomists play an even more negligible role in the raging ethical controversy around live related/unrelated organ transplantation. Due to the critical international shortage of cadaveric donors, boundaries are being pushed to meet the needs of potential recipients (Ohler,2001, Prog. Transplant. 11:160-161). Constant reappraisal of these ethical and moral issues is therefore appropriate. Issues that relate to cultural and economic imperialism and pronouncements of international transplant societies may also require re-evaluation. The legislature governing the donation of human tissue in various countries is usually governed by a Human Tissue Act or its equivalent. In general, such acts are congruent with the Human Tissue Act (South Africa: Government Gazette 9, November 2001; No. 22824) that states "It is an offense to charge a fee in relation to the donation of human organs." In many countries, however, various lay press report that "the sale of body parts is now coming of age." Terms such as "rewarded gifting" and "donors" being transformed into "vendors" are opening a Pandora's Box (Nelson et al.,1993, "Financial incentives for organ donation: a report on the UNOS ethics committee payment subcommittee"). Cameron and Hoffenberg (1999, Kidney Int. 55:724-732) feel strongly that arguments in favour of the sale of organs are sufficiently cogent to warrant further discussion. Equally disturbing is the use of executed prisoners as organ donors. In the developing world there are additional socio-economic, indigenous and cultural, religious, and ethical issues to consider. In addition, strategies that are ethically sound and morally acceptable to expand the pool of living donors must keep pace with recent advances in medicine. A paradigm shift is required for anatomists to contribute to the international ethical debate, not only as custodians of the dead but also as protectors of the living. Their voices should be heard in transplantation and other forums, and contribute to the ethical debate as well as relevant evolving legislature.

Dissection as a teaching tool: Past, present, and future

Cultural changes, scientific progress, and new trends in medical education have modified the role of dissection in teaching anatomy in today's medical schools. We discuss in this article the role of dissection itself, the value of which has been under debate for the last 30 years. The importance of dissection is considered from different points of view: educational, bioethical, and human values. Included are different opinions from professors and students. Finally, the current practice of dissection is described for some universities in the United States and Europe, showing its use as a learning tool.

Attitudes of Turkish anatomists toward cadaver donation

There is an insufficient number of cadavers in anatomy education in Turkey. This is because of decreased number of unclaimed bodies and very few cadaver donations. Increasing the number of cadaver donation is one of the probable solutions. Although anatomists encourage people to donate bodies, the attitudes of anatomists toward donating their own bodies for dissection is not well known. In this study, the attitudes of Turkish anatomists toward cadaver donation were evaluated. The questionnaires were sent to the anatomists in Turkey by mail and E-mail. Eighty-three anatomists replied to the questionnaire. The main solutions proposed for cadaver insufficiency included increasing the supply of unclaimed bodies (77.1%) and increasing body donation (78.3%). Further, 51.8% of the respondents thought that increasing body donation was a long-term solution. The general belief (83.1%) was that a campaign would help to increase body donation and 47% of respondents were willing to participate in such a campaign. Of the 83 anatomists, 20.5% of the respondents donated their organs and 49.4% were planning to donate them. Further, 15.7% were planning to donate their bodies; however, 63.9% did not consider donating. The main reasons of the respondents to object the donation were: to be dissected by a colleague (15.7%), the unacceptability of donation by family (26.5%), psychological reasons (43.4%), the anxiety of disrespectful behavior to cadavers (26.5%), and religious beliefs (3.6%). Although the majority of the respondents objected to donating their bodies due to psychological reasons, body donation was proposed as the main solution of cadaver insufficiency.