The educational value of cadaver dissection

[Wizard of Oz]

My school has meet-and-greet with our body donor's family before and after the dissection. In my family's case, it seemed a lot like they didn't really know what we were doing with the body. I think that they were under the impression that we'd be investigating the reason for her death.

After completing gross anatomy, I'm sorry to say that I didn't learn that much from the dissection, nor do I think that the body donor would be as likely to consent if they actually saw what the body looked like upon the semester's end.

Many schools have done away with microbiology labs and converted histo to digital imagery, yet I somehow think that suggesting the omission of gross anatomy lab would be considered blasphemy to administrators. On the other hand, I think that I owe an apology to my donor's family.

Is gross anatomy simply a rite of passage? Are there schools that have a non-traditional approach to anatomy? Does anyone else share my view that the lab didn't really help them learn?

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[Law2Doc]

Is gross anatomy simply a rite of passage? Are there schools that have a non-traditional approach to anatomy? Does anyone else share my view that the lab didn't really help them learn?

It's more than just a rite of passage (although it certainly is that). It serves a big role in demystifying the human body and death. It also serves as one of the better bonding and teambuilding experiences you are likely to have in med school. Sure, there are probably higher yield ways to learn anatomy. But the experience itself is valuable, in my opinion. And first year would be pretty deadly if you spent all those lab hours in lecture instead.

 

[Tired]

It's more than just a rite of passage (although it certainly is that). It serves a big role in demystifying the human body and death. It also serves as one of the better bonding and teambuilding experiences you are likely to have in med school. Sure, there are probably higher yield ways to learn anatomy. But the experience itself is valuable, in my opinion. And first year would be pretty deadly if you spent all those lab hours in lecture instead.

In addition, I think there are substantial benefits to learning anatomy from a cadaver versus using images or prosections. Actually having the chance to explore the spatial relationships between structures really gave me a much better understanding on surgical anatomy. And having both the time and opportunity to dissect out structures myself made my Surgery clerkship much easier. When you have the time to poke around a body cavity, you perform a lot better in the OR, despite the attending pimping you like crazy.

Honestly, I'm a little shocked that anyone would find the exercise pointless. Wiz, did you already know all that anatomy? Did you really look at various structures and go, "Oh, of course that's the _____"?

Or is the issue that you really don't think you need to learn such in depth gross anatomy? I can see how, if you're interested in IM, FP, or Psych, it might seem like a waste of time. For myself, I would have much preferred to do gross anatomy later (like say, now, before I start internship), rather than in my pre-clinical years. If I had my way, it would be an elective . . .

 

[LuckyBambooGirl]

As much as I do not like being in the gross anatomy lab, I feel that it has been a valuable experience. At our school we have an overview anatomy course freshman year and during the second year we revisit the systems. As I sit through lectures this year, I am amazed at all the things I remember from first year anatomy. Not so much specific details, but more of a sense of relationships and 3D structures and how everything fits together. Before I started medical school, I had never been around dead people before and I had no personal experience with death. I am greatful for the exposure to death that I had in anatomy lab, before I have to deal with it with real patients. I cannot imagine learning all the anatomy without having the tactile experience and seeing what the organs really look like and how they are related. Anatomy lab also lets you see the variation and similarities between different people. Although I am greatful that I am almost done with anatomy, I am glad that I had the experience!

 

[Flopotomist]

I agree with the OP. I find it odd that we are trained to question the evidence behind everything EXCEPT the best method for teaching anatomy. If you even MENTION the possibility that prosections MIGHT be better - voices cry out "BLASPHEMY!" and you are banished to the dungeons. It seems like dissection is performed more as a hazing ritual than an educational goal.

I would MUCH rather spend 6 hours walking between prosected cadavers and having somebody show me what is what and LEARNING then spending 6 hours painstakingly cleaning some random structure only to later discover that I have been cleaning the wrong thing.

 

[Tired]

I agree with the OP. I find it odd that we are trained to question the evidence behind everything EXCEPT the best method for teaching anatomy. If you even MENTION the possibility that prosections MIGHT be better - voices cry out "BLASPHEMY!" and you are banished to the dungeons. It seems like dissection is performed more as a hazing ritual than an educational goal.

I would MUCH rather spend 6 hours walking between prosected cadavers and having somebody show me what is what and LEARNING then spending 6 hours painstakingly cleaning some random structure only to later discover that I have been cleaning the wrong thing.

Have you done Surgery yet? If so, you don't think Gross was worth anything?

I hated anatomy when I did it my first and second years. I thought it was a waste, I hated that it was mandatory, and I studied it as little as possible. During my third year, my thinking changed entirely. If I could get back in there now and go through the same stuff all over again, I would.

 

[OncoCaP]

My school has meet-and-greet with our body donor's family before and after the dissection. In my family's case, it seemed a lot like they didn't really know what we were doing with the body. I think that they were under the impression that we'd be investigating the reason for her death.

After completing gross anatomy, I'm sorry to say that I didn't learn that much from the dissection, nor do I think that the body donor would be as likely to consent if they actually saw what the body looked like upon the semester's end.

Many schools have done away with microbiology labs and converted histo to digital imagery, yet I somehow think that suggesting the omission of gross anatomy lab would be considered blasphemy to administrators. On the other hand, I think that I owe an apology to my donor's family.

Is gross anatomy simply a rite of passage? Are there schools that have a non-traditional approach to anatomy? Does anyone else share my view that the lab didn't really help them learn?

I often wondered what the deal was on the donation side. I earnestly hope that very few donor families have misconceptions about what the donation is for and what is going on with the cadaver.

Maybe you simply didn't have a good instructor? It seems like there is a good opportunity to learn a lot from a cadaver, particularly for those interested in going into surgery and those who need to be convinced that surgery really isn't for them ....

...
I would MUCH rather spend 6 hours walking between prosected cadavers and having somebody show me what is what and LEARNING then spending 6 hours painstakingly cleaning some random structure only to later discover that I have been cleaning the wrong thing.

Better to make mistakes on a cadaver than in the OR, no?

 

[Wizard of Oz]

Great points about demystifying and such. I hadn't really thought about the experience in that way because I was never personally uncomfortable with the situation. As a med tech, I'd already handled my fair share of surgical and autopsy specimens.

Honestly, I'm a little shocked that anyone would find the exercise pointless. Wiz, did you already know all that anatomy? Did you really look at various structures and go, "Oh, of course that's the _____"?

I barely studied in the lab, but I indeed did find myself saying that a lot at the practical. I also frequently said, "I have no way of knowing what that is because I can't see the origin." It's just that the lecture part of the course was so much more detailed that the structures were pretty obvious at practical time since they were dissected out very much contrary to the way you'd go about accessing them in a surgical procedure.

Or is the issue that you really don't think you need to learn such in depth gross anatomy?

Oh no, I really do think that I learned a great deal. In fact, I think that there were some areas where more detail would have been appreciated. Despite the fact that I have no interest in surgery, I believe that a lot of valuable material is covered in gross anatomy. I just didn't learn much from the lab.

On the issue of time commitment, had I spent the hours in lab instead studying for the lecture part of the course, I would be a lot more confident about my ability to repeat the material come USMLE I.

 

[OncoCaP]

Have you done Surgery yet? If so, you don't think Gross was worth anything?

I hated anatomy when I did it my first and second years. I thought it was a waste, I hated that it was mandatory, and I studied it as little as possible. During my third year, my thinking changed entirely. If I could get back in there now and go through the same stuff all over again, I would.

Besides just being more interested and knowing more, how would you approach it differently? (any tips)

 

[drlisa0318]

If all you learn of anatomy is graphics, it will be much more difficult to translate the two-dimensional imagery to the three-dimensional patient, even if the imagery is in 3-D (even if you're practicing family medicine.) Even artists, turning a three-dimensional object into a two-dimensional image have to learn anatomy (skeletal, musculature, all of it, in fact) in order to understand and correctly paint, or draw, or sculpt a believable representation of a person or animal. Understanding the spatial relationships, as Tired touched on, and understanding how the spatial relationships change with movement is an important part of being a physician.

For a great visual on the muscular and skeletal relationships with movement check this site. (Granted, this is of a horse, but somehow I don't think they'll ever use this for people, since the subjuects would have to be nude, unless they were in body stockings.) http://vetmedicine.about.com/gi/dyn...u=http%3A//www.anatomyinmotion.com/vhorse.htm

 

[Non-TradTulsa]

My school has meet-and-greet with our body donor's family before and after the dissection. In my family's case, it seemed a lot like they didn't really know what we were doing with the body. I think that they were under the impression that we'd be investigating the reason for her death.

Is gross anatomy simply a rite of passage? Are there schools that have a non-traditional approach to anatomy? Does anyone else share my view that the lab didn't really help them learn?

I'm sure somebody will correct me if I'm wrong, but I thought I remembered reading that UCSF was going to prosections with a demonstrator rather than whole-body student-run dissections. I thought that was a good idea at the time that I read it - but now I realize that I had an extremely difficult time with prosections on anatomy practicals - somehow I just can't ever get oriented properly to disemboweled parts.

Anatomy was not my favorite subject by a wide margin, but I do see some usefulness to it. I've been told that you often see your medical school cadaver when you're trying to visualize structures under the skin of a patient. Given that I have no plans for surgery, I can see some possible truth to that.

Our school's approach of meeting with the donor's family both before and after the course is pretty cool. I do think it provides an incentive for the younger students to have some respect for the cadaver since they know the details of the person who inhabited that body as well as the family who wants the ashes of the cadaver back.

My cadaver was pretty sad by the end of the semester also and I certainly wouldn't want the family to see it. I think my family thought we would do some minor "exploring" - not turn the cadaver into something that would fit into a Hefty bag. If we had done a better job of keeping the cadaver moist all semester, we might have been exposed to more formaldehyde but the remains wouldn't have looked so sad by the end of the semester. We made tons of amateur mistakes during dissection but I never saw anyone deliberately deface the cadaver which made me feel better about the whole thing.

 

[WholeLottaGame7]

At my school we actually did a little of both, though I think it was more to minimize the amount of time/cadavers necessary.

I think overall it was a helpful exercise, even when it was incredibly frustrating and not particularly useful (a lot of head/neck). I could see in the future with virtual reality where it would not be necessary, but as of now I don't see any better way to teach it.

I, too, questioned just how much the donors/families knew about the process, for a variety of reasons. A) All of the patients were quite old, leading me to wonder just how aware they were of the process when they were agreeing to it. B) How much was actually explained to them. Donating organs is one thing, agreeing to have my torso chopped in half, my pelvis bisected, and my head cut into a thousand different pieces is something else entirely.

Demystifying is one word for it, desensitizing is another word that comes to mind

 

[dutchman]

My school has meet-and-greet with our body donor's family before and after the dissection. In my family's case, it seemed a lot like they didn't really know what we were doing with the body. I think that they were under the impression that we'd be investigating the reason for her death.

After completing gross anatomy, I'm sorry to say that I didn't learn that much from the dissection, nor do I think that the body donor would be as likely to consent if they actually saw what the body looked like upon the semester's end.

Many schools have done away with microbiology labs and converted histo to digital imagery, yet I somehow think that suggesting the omission of gross anatomy lab would be considered blasphemy to administrators. On the other hand, I think that I owe an apology to my donor's family.

Is gross anatomy simply a rite of passage? Are there schools that have a non-traditional approach to anatomy? Does anyone else share my view that the lab didn't really help them learn?

Everything sounded Ok until the part about meeting the family. What the hell is the relevance of that?

 

[Wizard of Oz]

Everything sounded Ok until the part about meeting the family. What the hell is the relevance of that?

The relevance is that only through talking to them did I realize that the body donation program had not been adequately explained, at least in my donor's case. It also emphasizes the personal nature of the experience, and only by talking to them did I realize that the value of the body to the family probably outweighs the educational value that I received from it. I can't speak for the other seven people in my group though.

 

[anon-y-mouse]

Unlike the OP, I gained a whole lot from lab. The physical experience of dissecting and finding some particular structure (and then teaching that structure to others) really helped me learn anatomy. Yes, I can look at the lingual nerve or hypoglossal nerve in a textbook or in Rohen, but the experience of finding them and tracing their course really reinforced those concepts to me and helped me form a mental map. And to the people who spent hours dissecting to get nothing out of it, perhaps you had really bad instruction or guidance. With a trained faciliator, people can really get a lot out of it.

And yes, during surgery, it really helped me visualize structures and appreciate fascial compartments, size of vessels/organs/etc. I would have been lost if I hadn't dissected the structure or that general area.

My professor told me that there was a move a few years ago to go to entirely prosections, but that didn't work out in terms of educational value, so they came back full circle for dissections (and prosections in part, in some cases). I'm not entirely sure of the details, but he was telling me about some anatomists conference he attended where they discussed this.

As for families, yes, the bodies are in poor condition after dissection, but that's what gross anatomy is about. Yes, faces are hemidissected and hands are disarticulated, etc... but that's all in the name of helping someone learn: the physical bodies are useless in a grave anyway, and are going to be cremated. At my school, we handled the cadavers with great respect, and I feel that any reasonable family knowing this would be totally fine. "Mangling" in some cases definitely had to be done... I wanted to see the course of the facial nerve in the facial canal with its genu, so I took a drill and carefully dissected it. Although this is presumptuous, I'm sure my cadaver would have felt extremely content knowing that his remains taught me so much about the human body.

And I'm not sure about your school, but I certainly was able to find out why my cadaver had passed away and even studied the histopathology involved.

 

[Jaydiggity21]

I'm sure somebody will correct me if I'm wrong, but I thought I remembered reading that UCSF was going to prosections with a demonstrator rather than whole-body student-run dissections. I thought that was a good idea at the time that I read it - but now I realize that I had an extremely difficult time with prosections on anatomy practicals - somehow I just can't ever get oriented properly to disemboweled parts.

Anatomy was not my favorite subject by a wide margin, but I do see some usefulness to it. I've been told that you often see your medical school cadaver when you're trying to visualize structures under the skin of a patient. Given that I have no plans for surgery, I can see some possible truth to that.

Our school's approach of meeting with the donor's family both before and after the course is pretty cool. I do think it provides an incentive for the younger students to have some respect for the cadaver since they know the details of the person who inhabited that body as well as the family who wants the ashes of the cadaver back.

My cadaver was pretty sad by the end of the semester also and I certainly wouldn't want the family to see it. I think my family thought we would do some minor "exploring" - not turn the cadaver into something that would fit into a Hefty bag. If we had done a better job of keeping the cadaver moist all semester, we might have been exposed to more formaldehyde but the remains wouldn't have looked so sad by the end of the semester. We made tons of amateur mistakes during dissection but I never saw anyone deliberately deface the cadaver which made me feel better about the whole thing.

No, I just finished anatomy at UCSF and we did pretty much all the dissections, and also learned a few procedures (cricotyrotomy, chest tube palcement, fasciotomy, femoral artery wire placement, etc)

 

[Wizard of Oz]

And I'm not sure about your school, but I certainly was able to find out why my cadaver had passed away and even studied the histopathology involved.

I think my person had Crohn's Disease according to the family, but it's unclear to me if that was her COD. I didn't think Crohn's was normally fatal. She was missing parts of her intestines and a few other organs. One of my group members, however, got the impression from the family that her docs were covering something up and/or we were going to solve the case ala CSI.

I don't think that the issue was poor instruction or guidance. My prof is Rohen's buddy and wrote the BRS for Gross. He was a great teacher.

...and also learned a few procedures (cricotyrotomy, chest tube palcement, fasciotomy, femoral artery wire placement, etc)

Now this sounds like a good plan.

 

[Pinkertinkle]

Anatomy lab = waste of time

 

[osmodiar]

Anatomy lab = waste of time

It makes my skin crawl when i hear medical students say that dissection labs are a waste of time. Arteries arent red, veins arent blue, nerves arent yellow just like in your Netter or whatever anatomy book you're using.
Knowing the structures is VERY important and not only if you're going to be a surgeon, but to be able to UNDERSTAND the incredible machine that is the human body.
I live in Quebec, canada and my university is the only one in the province that still offers the anatomy lab. They tried to cut it down last year but we had to fight to keep it. It saddens me that the other schools felt that anatomy wasnt important enough to be thaught during the preclinical years.

It is true wizard that when you see huge boxes with severed human parts scrambled together it can be viewed as "amoral" or "disgusting", but there's no better ways to learn. People think that when they give their body to science they might help cure cancer and whatnot, but the truth is they end up in pieces on a university dissection table.
I sure won't give my body to science =)

 

[Doctor Bagel]

I don't think I got as much out of anatomy lab as the time it took up, but then I hated it and had a bad attitude about being there. Overall, I think I'd get more out of studying from prosections instead of wasting time trying to find tiny nerves and whatnot. I will say that our lab could have been better in that we really, really needed more instructors in lab. By the end of the course, we had all of one instructor actually making rounds. Also, our dissector sucked and was full of repetitive and extraneous information. I'm a first year and haven't done a surgery rotation yet, so it's possible I'll change my mind about its value. However, I suspect I'll view my surgery rotation as just something to survive in much the same way I viewed gross dissections.

As for meeting the family -- I'm a little apprehensive about it this time. We met them in August before we started dissecting, so there was really no element of weirdness. We did learn about how he died, and meeting the family did reinforce our always using his real name when talking about him. Meeting them after we've destroyed his body, though, will be strange. I'm wondering if they'll ask us questions about his body.

 

[Law2Doc]

Meeting them after we've destroyed his body, though, will be strange. I'm wondering if they'll ask us questions about his body.

I guess it would go something like - "We are very appreciative of your father's generous donation -- he had a good heart... and spleen" j/k

 

[smq123]

I don't think I got as much out of anatomy lab as the time it took up, but then I hated it and had a bad attitude about being there. Overall, I think I'd get more out of studying from prosections instead of wasting time trying to find tiny nerves and whatnot.

However, I suspect I'll view my surgery rotation as just something to survive in much the same way I viewed gross dissections.

I think that being forced to trace out the different structures helps understand the physiology. At my school, second year clinical medicine is arranged by organ system. For example, when the surgeons describe how they'd manage a pancreatic tumor, I can visualize what they're talking about so clearly...because I had to dig out those structures with my own hands. I can understand how this tumor might cause jaundice, etc. The lab experience has proven to be really helpful later on.

My friend HATED gross lab. He had nightmares from it. He now thinks he wants to be a surgeon because he loved his surgery rotation. Go figure.

 

[SanDiegoSOD]

It's more than just a rite of passage (although it certainly is that). It serves a big role in demystifying the human body and death.

I agree with this line - it has certainly played a role in demystifying death for me. But as for the OPs question/comments, I would say that anatomy dissections certainly arent what they're cracked up to be. Our school has 20 bodies, working out to 5 students per body. I think we could easily get by with 2 or 3, where people learn anatomy out of books and then go in post-dissection to verify structures and pull it all together. I don't see a need for myself or other students to do the actual cutting and cleaning.

 

[Non-TradTulsa]

Meeting them after we've destroyed his body, though, will be strange. I'm wondering if they'll ask us questions about his body.

I hear ya. The only real criticism I have of the process is that the family wasn't adequately prepared that we are only trying to study normal anatomy - the perception that we would express some opinion on the death seems to be pretty common.

My family made quite a point of explaining that my cadaver had multiple pins in several bones and explained the circumstances of the broken bones. I know they're going to ask about that again. I just keep reminding myself.... Appropriate response: "Yes, I did see some pins, and XXX was very brave to have put up with the discomfort." Inappropriate response: "See 'em? Heck, I ruined three perfectly good brand new blades on 'em all in the same week!"

 

[Wizard of Oz]

It is true wizard that when you see huge boxes with severed human parts scrambled together it can be viewed as "amoral" or "disgusting", but there's no better ways to learn. People think that when they give their body to science they might help cure cancer and whatnot, but the truth is they end up in pieces on a university dissection table.
I sure won't give my body to science =)

I don't think that it's amoral or disgusting at all. I have great respect for my donor's body and her family. There is, however, an issue of informed consent that is lacking if they don't understand what we're doing with them. I don't think that I could go back to my donor's family and comfortably say, "I sure won't give my body to science like your mother did."

We live in a society that respects human life over all other forms, and even though most people in my state would probably call me an atheist, I have to think about my donor's value system. I do feel like an arse for saying that I didn't learn that much while I dismembered a human body, but honestly, I didn't.

 

[Bertelman]

I'm kind of surprised that some schools let you meet the donor family. I'm not sure how that would have supplemented my learning experience. I guess it would have been nice to receive maybe some notes the family left behind talking a little about their loved one, but I'm not sure I would want to meet them. I guess if it puts the family at ease, though, it's a good thing.

As for some misunderstanding from the family on the purpose of the donation, a few things come to mind. First, many of these donors made their arrangements prior to death, thus the family may not have been involved. The entity arranging the donation may not have been directly involved with the family at the time of death, thus the family may have been receiving their info from a funeral director, etc. Even if there was direct communication between the family and the donation agency, certain details may have been glossed over because 1) the days immediately after death are a sensitive period, and that's not really when I would like to find out what is going to happen to my grandmother's posterior cervical triangle; 2) again, consent was likely obtained prior to death, thus these details are not necessarily disclosed to the family; 3) the outcome of the donation may not be known at that time, i.e. the body may be used for any number of activities, like training for surgeons at some conference somewhere, where they may only dissect the arm, etc.

Finally, for those that have not made it to the ward yet, you will experience a unique ocurrence when dealing with families. You may explain everything in excruciating detail, using lay terms, and ask them to repeat the info. Then you return the next day and it's as though the conversation never happened. Your family may have had all the info, and either forgot the crucial details or created their own reality that sounded a little better. The body may have been donated a year ago, so time is a factor as well.

 

[Tired]

I think Bertelman is right on regarding the "informed consent" aspect of body donation. While the family may be very confused about what the school will do with the body, I suspect the patient themself is frequently much more informed.

I, for one, fully intend to give my body to anyone who can use it, and my family be damned. Once you're dead, the body is just meat. Granted, we ought not disrespect the body, but for me that's because you don't want to disrespect the gift, not because of any lingering awareness or spirit in the (now preserved) flesh.

Most people with any kind of religious or spiritual sensibilities understand that once the "soul" or "spirit" has departed the body, it is no longer really that person laying on your table. And for the atheists, hell, when you're dead, you're dead, so why would they care? I don't really get what all the fuss is about . . .

 

[dutchman]

The relevance is that only through talking to them did I realize that the body donation program had not been adequately explained, at least in my donor's case. It also emphasizes the personal nature of the experience, and only by talking to them did I realize that the value of the body to the family probably outweighs the educational value that I received from it. I can't speak for the other seven people in my group though.

I think you misunderstood me, I was not refering to it's relevance to your story but the relevance to the actual class. Why should students be made to talk to the families of their cadavars? As if it is not already creepy enough.

 

[Wizard of Oz]

I think you misunderstood me, I was not refering to it's relevance to your story but the relevance to the actual class. Why should students be made to talk to the families of their cadavars? As if it is not already creepy enough.

Well to hear my professors speak of it, we were supposedly pioneers in this revolutionary way of teaching gross anatomy. I think that the point was to solve problems with disrespect of the body. The program has been in place for five years at my school.

Here is what our school says about it:

"Medical education has the difficult task of presenting the science of medicine without losing sight of humanism. The traditional approach to learning gross anatomy has focused on the cadaver as a specimen from which students learn the structure of the human body.

A dissection team of eight first year students meet with family members of the specific donor. Students receive orientation about what to discuss, pose appropriate questions, and are encouraged to learn the donor's life story. Families are invited to participate fortified with the information regarding medical school and the importance of students personalizing the learning environment of gross anatomy. Table discussions are facilitated by Faculty familiar with the course, its content, and the scientific and emotional challenges facing the students as they learn gross anatomy.

Family members comment that this is a healthy environment for discussing the loss of a loved family member. Students are uniformly positive about the experience; however, some students experience feelings of inadequacy. Overall they express a commitment to learning from the donor. Faculty comments include notice of the students' balance of sensitivity with candidness and the family's willingness to be forthcoming in most of the exchanges."

We have another memorial dinner next month now that the class is over.

 

[dutchman]

Well to hear my professors speak of it, we were supposedly pioneers in this revolutionary way of teaching gross anatomy. I think that the point was to solve problems with disrespect of the body. The program has been in place for five years at my school.

Here is what our school says about it:

"Medical education has the difficult task of presenting the science of medicine without losing sight of humanism. The traditional approach to learning gross anatomy has focused on the cadaver as a specimen from which students learn the structure of the human body.

A dissection team of eight first year students meet with family members of the specific donor. Students receive orientation about what to discuss, pose appropriate questions, and are encouraged to learn the donor's life story. Families are invited to participate fortified with the information regarding medical school and the importance of students personalizing the learning environment of gross anatomy. Table discussions are facilitated by Faculty familiar with the course, its content, and the scientific and emotional challenges facing the students as they learn gross anatomy.

Family members comment that this is a healthy environment for discussing the loss of a loved family member. Students are uniformly positive about the experience; however, some students experience feelings of inadequacy. Overall they express a commitment to learning from the donor. Faculty comments include notice of the students' balance of sensitivity with candidness and the family's willingness to be forthcoming in most of the exchanges."

We have another memorial dinner next month now that the class is over.

No disrespect meant, but I think the guys that run that program are clearly out of touch with reality. Having a life story to go with your cadavar is nothing more than a mind game(a bad one for that matter). There is no way I can concieve of how that will help you learn anatomy any better.

 

[Tired]

No disrespect meant, but I think the guys that run that program are clearly out of touch with reality. Having a life story to go with your cadavar is nothing more than a mind game(a bad one for that matter). There is no way I can concieve of how that will help you learn anatomy any better.

I'll second that. Gross Anatomy lab is there to teach you anatomy, not to provide some touchy-feely lesson about respecting the dead or connecting with families. That's what our clinical time is for.

On the other hand, if they are doing it to promote body donation to the general public (like if they invite the media to your memorial services, the way they do at my school), it makes a little more sense.

 

[JadedSurgeon]

The cadaver lab at my school has cute poetry and letters posted around the lab to remind us of how special the bodies are. Then I sawed roughly through the sternum and made jokes about smell of burning bone.


Anyone seen "Hostel"?

 

[Non-TradTulsa]

No disrespect meant, but I think the guys that run that program are clearly out of touch with reality. Having a life story to go with your cadavar is nothing more than a mind game(a bad one for that matter). There is no way I can concieve of how that will help you learn anatomy any better.

The program has nothing to do with learning anatomy any better. I can understand that it might sound a bit "creepy" - I wasn't too excited about it. I think you should recognize, however, that you haven't been through the experience. You're passing judgement on something you haven't even seen. I enjoyed meeting my donor family and it was a very positive experience (which admittedly surprised me).

The program of introducing medical students and donor families serves two purposes: one, it has dramatically reduced incidences of students treating cadavers with less than the respect that they deserve, and two, it's a very good early teaching experience for students in dealing with a sensitive situation with families.

The donor memorial isn't next month, Wiz, it's next week. I'm glad it's not around block time but I'm not excited about pressing my white coat my first week back.

 

[Wizard of Oz]

The donor memorial isn't next month, Wiz, it's next week. I'm glad it's not around block time but I'm not excited about pressing my white coat my first week back.

Yeah I guess you're right. I've been sick all week so my brain is still in 2006.

 

[cfdavid]

While sloppy and unorganized at times, gross lab really was a great learning experience. Nothing can equal (at this point) being able to touch and feel structures, and to get a handle on relationships the way a cadaver allows. I felt I learned a lot, even though the labs were sometimes quite long, and the fact that I had some in my group with attention spans of two year olds.

Also, consider the surgical specialties. How would you be even remotely prepared for a surgical residency without having some exposure to a cadaver. That being said, I can understand how many families may not fully understand how they donated their loved ones to "medical science". A bit more than an autopsy.....

 

[Flopotomist]

I think the point of my earlier post was missed. Perhaps the gross lab IS the most efficient way of teaching anatomy - but the fact that we are not even allowed to question this is ludicrous. We should research how students best learn anatomy, and if it is dissection, so be it. If it is NOT, then we should try something else. I think it may be a hybrid of the two frankly...

 

[Igor]

I have to agree with the OP

med school, resideny, job in internal medicine..

Now I was lucky and I had a great surgery rotation in 3rd year. I think you have to learn anatomy but you don't need anatomy lab. I learned phsyiology without a lab, pharm without a lab and biochem without a lab.

Anatomy lab was just time I lost where I could have been enjoying life or learning something useful. It should be optional.

 

[usrael]

I also agree w/ the OP.
Today we dissected the gluteal region and we spent two hours just "digging" into fat. I felt bad for the team and for the donor.
In our case we do not have an instructor. Profs will sometimes drop by to check on us, but we're on our own (from lab 1). i think that the prosection approach is much better.

 

[45408]

I, too, questioned just how much the donors/families knew about the process, for a variety of reasons. A) All of the patients were quite old, leading me to wonder just how aware they were of the process when they were agreeing to it. B) How much was actually explained to them. Donating organs is one thing, agreeing to have my torso chopped in half, my pelvis bisected, and my head cut into a thousand different pieces is something else entirely.

I doubt anyone was duped into this. Some of my classmates have said that they now fully intend to donate their bodies, and one of my classmate's grandfathers asked her about it, and she told him what happens, and he said that he wants to donate his body. No, he probably doesn't realize they'll be cutting his head in half, removing his brain, transecting his penis and skinning his entire body, but do you really need to explain all that to someone?


I thought anatomy was extremely useful, I had never realized the relationship of a lot of structures to other structures, even after spending dozens of hours cuddled up with Frank Netter, and I think actually touching things made a huge difference. Pro-sections get really nasty and indistinguishable after a while (we did have a few of them) compared to the nice red gluteus maximus that George had.

 

[45408]

I think the point of my earlier post was missed. Perhaps the gross lab IS the most efficient way of teaching anatomy - but the fact that we are not even allowed to question this is ludicrous. We should research how students best learn anatomy, and if it is dissection, so be it. If it is NOT, then we should try something else. I think it may be a hybrid of the two frankly...

do you know for a fact that they haven't looked into this legitimately? maybe they have....

 

[Wizard of Oz]

No, he probably doesn't realize they'll be cutting his head in half, removing his brain, transecting his penis and skinning his entire body, but do you really need to explain all that to someone?

Yes. To me, that's included in "informed consent."

 

[MDstudent79]

I agree with much of what's been said here.

Yes, I learned a LOT from gross. Yes, the dissection does have a purpose (desensitizing you with the body, learning about death, learning about fascia!!, etc.).

But...did I get as much out of three hours of fat-picking as I did typically out of thirty minutes of a good prosection from one of the TAs? I don't think so.

I think ideally we should all be required to do x number of hours of dissection, but that we shouldn't have to dissect the ENTIRE body. Most instruction should come from prosection instructions.

But what do I know? I'm just a first-year, so my opinions might change.

I do know that I think I'd get a LOT more out of gross if I had to take it again in a year or so. That's why I'm consdering applying for one of the TA positions in my third year.

 

[45408]

Yes. To me, that's included in "informed consent."

I disagree. For one, it's up to individual students as to what they're going to dissect out - some pelvises weren't hemisected, only a few eyes were removed, etc. I think informed consent would be "Your body will be used in the instruction of medical students and/or residents in the course of their training to teach them of the many structures throughout the entire body. The gross anatomy course uses cadavers for complete anatomical dissection to teach our next generation of doctors." Telling them that the students may dislike removing the fat from their ischioanal fossa is a little gratuitous.

 

[beefballs]

I agree with the OP. I find it odd that we are trained to question the evidence behind everything EXCEPT the best method for teaching anatomy. If you even MENTION the possibility that prosections MIGHT be better - voices cry out "BLASPHEMY!" and you are banished to the dungeons. It seems like dissection is performed more as a hazing ritual than an educational goal.

I would MUCH rather spend 6 hours walking between prosected cadavers and having somebody show me what is what and LEARNING then spending 6 hours painstakingly cleaning some random structure only to later discover that I have been cleaning the wrong thing.

thats the whole point. Gross was the most fun I have had in any class, because you were looking at how things related and worked, I garnered a greater understanding by cutting digging looking for what runs where, what demarcates a split in the nerve etc myself than being shown it like some museum tour. interactive learning is much more beneficial than sittingf there listening to somebody point out stuff

 

[Dookter]

My school has meet-and-greet with our body donor's family before and after the dissection. In my family's case, it seemed a lot like they didn't really know what we were doing with the body. I think that they were under the impression that we'd be investigating the reason for her death.

After completing gross anatomy, I'm sorry to say that I didn't learn that much from the dissection, nor do I think that the body donor would be as likely to consent if they actually saw what the body looked like upon the semester's end.

Many schools have done away with microbiology labs and converted histo to digital imagery, yet I somehow think that suggesting the omission of gross anatomy lab would be considered blasphemy to administrators. On the other hand, I think that I owe an apology to my donor's family.

Is gross anatomy simply a rite of passage? Are there schools that have a non-traditional approach to anatomy? Does anyone else share my view that the lab didn't really help them learn?

I found lab to be absolutely useless, so I didn't go. It might annoy some people if they knew I aced anatomy b/c I spent my time learning instead of farting around in lab. I'm actually annoyed that lab participation is part of my grade this block. It means I have to go sit in neuro lab twiddling my thumbs, not learning anything, just b/c some administrator somewhere seems to "know" that I will learn better by actually being there.

 

[MyNameIsOtto]

I think cadaver dissection is a traditional rite of passage that must remain in our medical curriculum...It teaches one to have a greater respect for the human body and demystifies death.

One thing I wonder is how many med students decided they would want to donate their body to a medical school for student dissection or other related things such as teacher prosection?

 

[Bitsy3221]

I did not thoroughly enjoy anatomy lab during M1 year nor did I always learn a lot from it, however I did experience the occasional "ah ha" moments when I found the nerve or mucle attachment I was looking for. I remember feeling the same way a lot of you did: time wasted, low yield, not enough instruction, bad group, better to use prosections, etc.

In retrospect I can say I did take a lot from the experience and often think back to what I saw in that lab. Every time I put in a central line or float a Swan I visualize the relationship of the vessels and find that it makes this process much easier. I also found this experience a bit of a defining time in my education, although I did not at the time. I know it is frustrating to constantly be told by those older than you to "trust them" and that they know what is good for you, etc. etc., but far more often than not I have found that that usually is the case. Medical education, although not perfect, has been and continues to be examined and reexamined a thousand times over, and will likely make you a pretty good doctor. Just hang in there, jump through the hoops, realize that every experience has value and when you least expect it you will pull something out of your a$$ from one of these "low yield" experiences and wow yourself. That is why YOU are the doctor, not the PA, nurse, RT, etc.

In addition, my school's administration has been trying to cut out gross lab in favor of prosections and computer modules for the past several years and every year the students lead the push to maintain the lab. The students leading this push are often the same ones that hated the lab during first year.