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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 15  |  Issue : 1  |  Page : 14-18

Is cadaveric dissection vital in anatomy education? Perceptions of 1st and 2nd year medical students


Department of Human Anatomy, University of Nairobi, Nairobi, Kenya

Date of Web Publication19-Sep-2016

Correspondence Address:
Philip Mwachaka
Department of Human Anatomy, University of Nairobi, P. O. Box 30197, Nairobi
Kenya
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1596-2393.190822

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  Abstract 


Introduction: The use of innovative ways of teaching anatomy as well as shortage of cadavers for dissection have raised questions as to whether dissection should continue to be used in teaching anatomy. This study aimed to assess the views of medical and dental students on the importance of dissection in learning gross anatomy, and whether they would prefer other ways of learning anatomy instead of cadaveric dissection. Materials and Methods: First- and second-year students enrolled at the University of Nairobi (Kenya) were asked to fill an online questionnaire. Data gathered were analyzed using Statistical Package for Social Sciences. Results: Ninety-eight (83 medical and 15 dental) students participated in the study. All students agreed dissection was useful in learning anatomy. Up to 95.2% of medical and 86.7% of dental students favored dissection. Most students strongly agreed or agreed that dissection helped them to develop three-dimensional (3D) awareness of the human body (94.9%), work as a team (89.8%), learn medical terminology (85.7%), and learn how to use basic surgical instruments (80.6%). Dissection was preferred to use of 3D models, prosected specimens, computer-aided learning techniques, or modern imaging techniques by 63.3%, 60.3%, 37.7%, and 34.4% of the students, respectively. Conclusion: Dissection is an important resource for learning anatomy. Other teaching techniques should be used to supplement dissection rather than replace it.

Keywords: Anatomy, cadaveric dissection, medical students


How to cite this article:
Mwachaka P, Saidi H, Mandela P. Is cadaveric dissection vital in anatomy education? Perceptions of 1st and 2nd year medical students. J Exp Clin Anat 2016;15:14-8

How to cite this URL:
Mwachaka P, Saidi H, Mandela P. Is cadaveric dissection vital in anatomy education? Perceptions of 1st and 2nd year medical students. J Exp Clin Anat [serial online] 2016 [cited 2020 Dec 3];15:14-8. Available from: https://www.jecajournal.org/text.asp?2016/15/1/14/190822




  Introduction Top


In recent years, the relevance and value of dissection as a tool for teaching anatomy to medical students have been under discussion at different fora (Mulu and Tegabu, 2012). Cadaveric dissection has been the main anatomy learning tool for many medical schools for more than 400 years (Azer and Eizenberg, 2007). Innovative ways of teaching anatomy such as use of prosected specimens, three-dimensional (3D) models, radiologic pictures, and computer-aided learning (CAL) have raised questions as whether dissection should at all be used in teaching anatomy (Azer and Eizenberg, 2007; Kennedy et al., 2000; McLachlan and Patten, 2006; McNulty et al., 2009; Turney, 2007). Opponents of dissection have stated that dissection is expensive, time-consuming, and is associated with physical and emotional stress of the students (Aziz et al., 2002; Hussein et al., 2014; McLachlan and Patten, 2006). This study purposed to assess the views of 1st and 2nd year medical students on the importance of dissection in learning gross anatomy, and whether they would prefer other ways of learning anatomy instead of cadaveric dissection.


  Materials and Methods Top


Subjects and Setting

This study enrolled 1st and 2nd year medical students at the University of Nairobi in Kenya, where cadaveric dissection is the main tool used for teaching gross anatomy. Both the Bachelor of Medicine and Surgery (MBChB) and Bachelor of Dental Surgery (BDS) students dissected the entire human body during their 1st year of study. Ninety-eight students completed an anonymous online-based questionnaire. All participants were informed of the aims of the study, and their involvement was voluntary. This survey was conducted between August 11, 2014 and September 10, 2014.

Questionnaire

Variables collected in the self-administered questionnaire included the year of study, gender, whether they liked dissection, and reasons for liking or not liking dissection. Students were also asked to complete a 5-point Likert scale questions regarding (1) the advantages of learning gross anatomy through dissection and (2) whether they would prefer other techniques of learning anatomy instead of dissection.

Statistical Analysis

Statistical analysis was done using the Statistical Package for Social Sciences (SPSS version 21) for Windows (SPSS Inc., Chicago, USA). The options in the 5-point Likert scale were coded as follows: Strongly agree (1), agree (2), not sure (3), disagree (4), and strongly disagree (5). Average satisfaction index was then derived from the sum of the product of the frequency (n) and the Likert scale response divided by total number of responses. The students' responses were compared on the basis of demographic variables including the course undertaken (MBChB or BDS) and year of study (1st year vs. 2nd year) using Mann–Whitney's U- test. P < 0.05 was considered significant.


  Results Top


Demographic Data

Ninety-eight students participated in the study. Out of them, 45 (45.9%) were 1st year medical students. Fifty-four (55.1%) participants were male students. [Table 1] summarizes the sociodemographic data of the study participants.
Table 1: Analysis of the study population

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Like for Dissection

The students were asked whether or not they liked dissection. Most students in both the MBChB (95.2%) and BDS (86.7%) groups liked cadaveric dissection as a tool for learning gross anatomy [Table 2]. The reasons for not liking dissection were strong smell of formalin (three students) and poorly preserved cadavers leading to difficulties in identifying structures (three students).
Table 2: Liking for cadaveric dissection

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Advantages of Dissection

All students agreed that dissection was a useful tool for learning anatomy [Table 3]. Most students strongly agreed or agreed that dissection helped them to develop 3D awareness of the human body (94.9%), work as a team (89.8%), learn medical terminology (85.7%), and learn how to use basic surgical instruments (80.6%). Up to 40.8% of the students were undecided as to whether dissection taught them how to respect the dead. More than two-thirds of the students disagreed that dissection is only necessary for those interested in surgical careers. None of the variables studied revealed statistically significant differences between 1st and 2nd year or MBChB and BDS students [Table 4].
Table 3: Advantages of dissection

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Table 4: Comparison of responses according to year of study and course undertaken

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Should Dissection be Replaced by Other Methods of Learning Anatomy?

More than 60% of the students disliked the use of 3D anatomy models and prosected human specimens instead of dissection (average satisfaction indices >3). Although the students welcomed the use of computer-aided techniques and radiologic anatomy, none of these two methods had average satisfaction indices of ≥2 [Table 5]. There were no statistically significant differences in the responses given by the different study groups [Table 6].
Table 5: Use of other teaching methods instead of dissection

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Table 6: Comparison of responses regarding use other teaching methods instead of dissection between 1st and 2nd year students as well as between Bachelor of Medicine and Bachelor of Surgery and Bachelor of Dental Sciences students

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  Discussion Top


In recent years, the relevance of cadaveric dissection in learning anatomy has been questioned. Some medical schools have all together abandoned dissection and replaced it with other tools such as prosected specimens and computer programs. In our set up, however, dissection is the main mode of teaching gross anatomy for both medical and dental students.

This study indicated that most students liked cadaveric dissection and even ranked it as the most important resource for learning anatomy. These findings concur with reports from previous studies (Azer and Eizenberg, 2007; Karau et al., 2014; Mulu and Tegabu, 2012). Dissection is the key in the training of a medical student as its helps the student to develop the 3D awareness of the human body in both visual and tactile ways (Granger, 2004). The present study reports that up to 94.9% of students agree that dissection helped them appreciate the 3D structure of the body. One student said, “although cadaveric dissection was involving, I was able to appreciate how different parts looked in a real body specimen rather than how they appear in the anatomy  Atlas More Detailses and videos. It was a good way of blending theoretically acquired knowledge (from books and dissection videos) with the practical knowledge.”

Dissection is important in building interpersonal skills such as the ability to work in a team. This virtue is significant because it establishes a routine by which the students continue to work with in later years as clinicians (Granger, 2004; Lempp, 2005). In the current study, 89.8% of the students either strongly agreed or agreed that dissection helped them work as a team. The students reported that dissection “provided a good platform for discussion with table mates” which “made the learning process even easier.” Previous studies have reported that the bonding of the dissection team helps foster coping with distress of the dissection laboratory as well as stress of 1st year in medical school (Hussein et al., 2014; Mulu and Tegabu, 2012).

Dissection is a practical subject and therefore imparts to the student's basic surgical skills such as handling of surgical instruments (Granger, 2004; Moore, 1998). In the current study, 80.6% of the students agreed that dissection taught them how to handle basic surgical instruments. Furthermore, more than two-thirds of the students disagreed that dissection was only necessary for those interested in surgical careers. This suggests that the value of dissection goes beyond surgical interests. Besides teaching students on the use of surgical instruments, dissection helps students to learn the language of medicine. Most medical terminologies are based on Terminologia Anatomica, and it is in the dissection laboratory where the students first come across these terms (Kachlik, et al., 2008; Rosse, 2001).

Innovative ways of teaching anatomy such as the use of prosected specimens, 3D models, radiologic pictures, and CAL have led some to raise questions as to whether dissection should at all be used in teaching anatomy (Azer and Eizenberg, 2007; Kennedy, et al., 2000; McLachlan and Patten, 2006; Turney, 2007). In the current study, however, more than 60% of the students rejected the use of 3D models and prosected specimens instead of dissection. This further reinforces the value of cadaveric dissection in anatomy learning.

The current study found that 49% of the students welcomed the use of imaging instead of dissection. Imaging techniques such as ultrasonography, computer-aided tomography scans, and magnetic resonance imaging when used to supplement dissection offer a number of advantages to the students. Visualizing anatomy in real time such as during ultrasonography enables the students to appreciate dynamic aspects such as how anatomy is influenced by different physiologic states (McLachlan, 2004; Miles, 2005; Swamy and Searle, 2012). Unfortunately, the use of these imaging techniques is limited by their cost, lack of the 3D touch sensation, and the need for understanding the radiologic principles of each technique.

It is noteworthy that 45.9% of the students in the present study approved the use of CAL techniques instead of dissection. Studies have demonstrated that CAL techniques are more useful in students' revision rather that in their primary teaching, and are useful in complementing learning using other resources such as dissection and textbooks (Azer and Eizenberg, 2007; Jastrow and Vollrath, 2003, 2002).


  Conclusion Top


This study further reinforces the importance of dissection in learning anatomy. The student survey indicates that other teaching techniques, in particular, radiologic anatomy and computer-aided learning techniques may be used to supplement dissection rather than to replace it.[19]

Acknowledgment

We would like to thank all the students who took part in the study.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

 
  References Top

1.
Mulu A., Tegabu D. (2012). Medical students' attitudinal changes towards cadaver dissection: A longitudinal study. Ethiop J Health Sci 22 (1):51-8.  Back to cited text no. 1
    
2.
Azer S.A., Eizenberg N. (2007). Do we need dissection in an integrated problem-based learning medical course? Perceptions of first- and second-year students. Surg Radiol Anat 29 (2):173-80.  Back to cited text no. 2
    
3.
Kennedy D., Eizenberg N., Kennedy G., Kennedy D., Eizenberg N., Kennedy G. (2000). An evaluation of the use of multiple perspectives in the design of computer facilitated learning. Australas J Educ Technol 16 (1):13-25.  Back to cited text no. 3
    
4.
McLachlan J.C., Patten D. (2006). Anatomy teaching: Ghosts of the past, present and future. Med Educ 40 (3):243-53.  Back to cited text no. 4
    
5.
McNulty J.A., Sonntag B., Sinacore J.M. (2009). Evaluation of computer-aided instruction in a gross anatomy course: A six-year study. Anat Sci Educ 2 (1):2-8.  Back to cited text no. 5
    
6.
Turney B. (2007). Anatomy in a modern medical curriculum. Ann R Coll Surg Engl 89 (2):104-7.  Back to cited text no. 6
    
7.
Aziz M.A., McKenzie J.C., Wilson J.S., Cowie R.J., Ayeni S.A., Dunn B.K. (2002). The human cadaver in the age of biomedical informatics. Anat Rec 269 (1):20-32.  Back to cited text no. 7
    
8.
Hussein I.H., Hankin M., Dany M., Wasserman J., Jurjus A. (2014). Perception and emotional impact of dissection on medical students (LB13). FASEB J 28 1 Suppl: LB13.  Back to cited text no. 8
    
9.
Karau P.B., Wamachi A., Ndede K., Mwamisi J., Ndege P. (2014). Perception to cadaver dissection and views on anatomy as a subject between two pioneer cohorts in a Kenyan Medical School. Anat J Afr 3 (2):318-23.  Back to cited text no. 9
    
10.
Granger N.A. (2004). Dissection laboratory is vital to medical gross anatomy education. Anat Rec B New Anat 281B (1):6-8.  Back to cited text no. 10
    
11.
Lempp H.K. (2005). Perceptions of dissection by students in one medical school: Beyond learning about anatomy. A qualitative study. Med Educ 39 (3):318-25.  Back to cited text no. 11
    
12.
Moore N.A. (1998). To dissect or not to dissect? Anat Rec 253 (1):8-9.  Back to cited text no. 12
    
13.
Kachlik D., Baca V., Bozdechova I., Cech P., Musil V. (2008). Anatomical terminology and nomenclature: Past, present and highlights. Surg Radiol Anat SRA 30 (6):459-66.  Back to cited text no. 13
    
14.
Rosse C. (2001). Terminologia anatomica: Considered from the perspective of next-generation knowledge sources. Clin Anat 14 (2):120-33.  Back to cited text no. 14
    
15.
McLachlan J.C. (2004). New path for teaching anatomy: Living anatomy and medical imaging vs. dissection. Anat Rec B New Anat 281B (1):4-5.  Back to cited text no. 15
    
16.
Miles K.A. (2005). Diagnostic imaging in undergraduate medical education: An expanding role. Clin Radiol 60 (7):742-5.  Back to cited text no. 16
    
17.
Swamy M., Searle R.F. (2012). Anatomy teaching with portable ultrasound to medical students. BMC Med Educ 12 (1):99.  Back to cited text no. 17
    
18.
Jastrow H., Vollrath L. (2003). Teaching and learning gross anatomy using modern electronic media based on the visible human project. Clin Anat 16 (1):44-54.  Back to cited text no. 18
    
19.
Jastrow H., Vollrath L. (2002). Anatomy online: Presentation of a detailed WWW atlas of human gross anatomy-reference for medical education. Clin Anat 15 (6):402-8.  Back to cited text no. 19
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]


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