Perceptions of selected undergraduate medical students in the Philippines on the effectiveness of the combined use of plastinated and formalin-preserved brains in neuroanatomy education: A cross-sectional study

Background and Objective@#Neuroanatomy is both terrifying to learn and problematic to teach, and the different methods of neuroanatomical education have their own strengths and weaknesses. In this cross-sectional study, we evaluated the perception of undergraduate medical students towards the combined use of plastinated and formalinpreserved brain specimen in their neuroanatomy course. @*Methods@#A bridging program was designed for students whose medical education was interrupted by the COVID-19 pandemic in order to reinforce the knowledge and understanding of anatomy that they acquired in a virtual environment. A total of 175 first year medical students participated in this learning activity, which included seven stations in neuroanatomy spread across two hours, and covered the anatomy of the circle of Willis, brainstem, cranial nerves, spinal cord, internal cerebrum, and external cerebrum. To evaluate short-term learning, the students were asked to take a quiz containing 10 multiple-choice questions before and after the learning activity. In addition, the students also answered a survey containing 11 Likert-type questions asking about their perception of the learningactivity. @*Results@#Following the learning activity, mean test scores increased from 4.73 (SD 1.74) to 5.32 (SD 1.52; mean difference 0.59, p = 0.008). Majority of the students (mean 81%, range 43-93%) had a neutral or positive perception of plastinated brain specimen, and on factor analysis, plastinated brain specimen were found to be both practical and useful for learning neuroanatomy. However, the participants perceived plastinated brain specimen alone to be insufficient for learning neuroanatomy, and a multimodal approach to learning neuroanatomy is ideal. @*Conclusion@#Plastinated brain specimens were found to be an effective complement to formalin-preserved brain, and these should be used by medical schools when designing neuroanatomy learning activities for their students.

Hunchback with “S” Shape Spine: Cadaveric Case series

Introduction: Kyphosis is a sharp posterior angulation due to localized collapse or wedging of one or more vertebrae and scoliosis is the lateral curvature of the spine. These may occur due to a congenital defect, fracture, and sometimes pathological or spinal tuberculosis. Materials and Methods: During routine cadaver dissection, four cases of kyphoscoliosis were identified. In the first case, a protrusion on the posterior surface of the trunk of the cadaver at L1 level was observed in a 60- year-old male. The lungs were collapsed and adherent with the pleura and thoracic wall. The posterior wall of the stomach was adherent to the pancreas and a depression was noted on the anterior surface of abdominal aorta. The T12 and L1 vertebrae were fused, and the spine was deviated to the left side. The anterior aspect of the body of L1 vertebrae was marginally eroded. The second case of kyphoscoliosis was from 80-year-old female cadaver. The descending and abdominal aorta had an abnormal course along the vertebral column, third and fourth cases were observed with slight protrusion and scoliosis but not much changes in the vertebral column. Results: The cause of the deformity was confirmed by pathological examination of the tissues showed inter vertebral disc degeneration with calcification and ossification and osteopenia. The underlying etiology can be tuberculosis, injuries, or infections. Conclusion: Severe kyphoscoliosis can affect wide range of systems in the body. It will affect not only the respiratory system also pressure on great vessels as a consequence of bony deformity.

Does education about death and dying decrease stress generated in the dissection room? / ¿Disminuye el estrés generado en la sala de disección la formación sobre la muerte y el moribundo?

SUMMARY: Positive effects on reducing students' stress have been reported across numerous university settings when anatomy preparatory seminars have been provided. To date, this type of preparation for coping with cadaver dissection has not been studied in Spanish universities. The aim of this study is to evaluate how first-year Spanish medical students face the dissecting room and whether previous preparation about death and dying reduces the stress generated. We performed an interventional study with students who received preparatory classes before the dissection practices (Experimental Group, EG) and with students who did not (Control Group, CG). Sociodemographic data and a self-assessment on stress symptoms were collected through a questionnaire completed before and after the dissection practices. No differences were found in the self-report of symptoms of stress among students who consider themselves religious or not, or between students who had a family member in the healthcare environment or not. However, in the EG, the students who had ample experience with terminally ill patients or death reported fewer stress symptoms. Unexpectedly, the number of selfreported stress symptoms after the dissection practice was higher in EG students. In conclusion the stress levels of first-year Spanish medical students not only did not improve after receiving preparatory classes about death and dying and discussion groups, but it gets worse. We found a relationship between student stress measured and experience with terminally ill patients or death. Additional studies are needed to identify the most suitable preparation for Spanish medical students.

RESUMEN: Se han informado efectos positivos en la reducción del estrés en los estudiantes de numerosos entornos universitarios cuando se han impartido seminarios preparatorios de anatomía. Hasta la fecha, este tipo de preparación para hacer frente a la disección del cadáver no se ha estudiado en las universidades españolas. El objetivo de este estudio es evaluar cómo los estudiantes de medicina españoles de primer año se enfrentan a la sala de disección y si la preparación previa sobre la muerte y el moribundo reduce el estrés generado. Realizamos un estudio de intervención con estudiantes que recibieron clases preparatorias antes de las prácticas de disección (Grupo Experimental, GE) y con estudiantes que no las recibieron (Grupo de Control, GC). Se recogieron datos sociodemográficos y síntomas de estrés mediante un cuestionario de autoevaluación antes y después de las prácticas de disección. No se encontraron diferencias en los síntomas de estrés valorados, entre los estudiantes que se consideran religiosos y los que no, ni tampoco entre los estudiantes que tenían o no un familiar en el entorno sanitario. Sin embargo, en el GE, en los estudiantes que tenían una amplia experiencia con pacientes con enfermedades terminales o con la muerte se observaron menos síntomas de estrés. Inesperadamente, el número de síntomas de estrés recogidos después de la práctica de disección fue mayor en los estudiantes del GE. En conclusión, los niveles de estrés de los estudiantes españoles de medicina de primer año no solo no mejoraron después de recibir las clases preparatorias sobre la muerte y el moribundo y establecer grupos de discusión, sino que empeoraron. Encontramos una relación entre la medición del estrés en los estudiantes y la experiencia con pacientes con enfermedades terminales o con la muerte. Se necesitan estudios adicionales para identificar la preparación más adecuada para los estudiantes de medicina españoles.

The Approach of Anatomists towards Voluntary Body Donation: Inspiring or Dispiriting???

Background: Body donation is a noble act towardscontributing to medical education and research.Although anatomists encourage the general populationto donate bodies, the attitude of anatomists towarddonating their bodies is less discussed in the literature.Aim and Objectives: The present study was conductedto obtain the knowledge, attitude and practice ofanatomists towards voluntary body donation. Materialand Methods: The study was conducted among theanatomists of different Medical Colleges of SouthIndia. To assess the knowledge, attitude, and practicesof voluntary body donation, a semi-structuredquestionnaire was designed and distributed to theanatomists. Results: The study involved 102anatomists. The majority 58.3% stated that the primarysource of supply of cadavers was from the bodydonation program. When it came to voluntary bodydonation, only 32.4% of the anatomists were willing todonate their bodies. The facilitating factors forwillingness to donate were contributions to medicaleducation 60.3%, personal satisfaction 7.4%,motivation to the general public 4.4%, andencouragement from a close friend/ colleague 2.9%.The factors that abstained individuals from donatingwere: restriction from family members 30.9%, malhandling of the cadavers 29.4%, and ritual beliefs20.6%. Conclusion: The approach of anatomiststowards donating their bodies is not promising. It maydiscourage the general public from donating theirbodies. Therefore, it is equally important to inspire andencourage the anatomists towards body donation.

Cadaver Dissection: Attitude and Perception of Its Importance Among Medical and Health Science Students in Learning Anatomy

@#Introduction: Anatomy continues to be an important basic subject in medicine and other related health sciences which is delivered by method of either through lectures or demonstration. Thus, having a gross anatomy practical with cadaver is a crucial phase for the students to have a deep understanding about anatomy of human body. The objective of this study is to explore the attitude and perception of medical and health science students in the importance of cadaver dissection in learning anatomy. Methods: A cross-sectional study was conducted by distributing closed structured questionnaires to 270 respondents consisting of socio-demographic in part one, frequency on practical with dissected cadaver in part two, the attitude of student towards the dissected cadaver in part three, suggestion for improvement during practical with cadaver in part four and the value of cadavers during practical in part five. The collected data were processed by using Statistical Package for Social Sciences (SPSS) version 23.0. Result: Descriptive statistical evaluation shows majority of the students perform practical with cadavers. They find cadaveric dissection exciting with no feeling of stress and anxiety. Many of them never had an emotional shock when exposing themselves to the cadavers for the first time accepting the cadaveric dissection ethically. The students recommended keeping cadaveric dissection in the health science curriculum. Conclusion: The cadaveric dissection helps in grounded understanding of anatomy. It promotes and develops psychomotor skills in students. The findings of the study discovered dissection to be a motivating tool in learning anatomy.

Minimally Invasive Horizontal Intercartilaginous Incision during Tracheostomy – A Cadaveric Study / 체질인류학회지

The paper describes a minimally invasive tracheostomy technique that uses an intercartilaginous incision without resection of the tracheal cartilage and discusses its feasibility. A total of 20 adult cadavers (13 males and 7 females) were included in this study. The distance from the arch of the cricoid cartilage to the thyroid isthmus, maximal displacement of the thyroid isthmus, number of tracheal rings underneath the thyroid isthmus, and maximally opened distance resulting from an intercartilaginous incision were measured. The mean distance from the arch of the cricoid cartilage to the thyroid isthmus was 21.4±5.0 mm. The thyroid isthmus mainly overlaid the 3rd and 4th tracheal rings. The mean maximal displacement of the thyroid isthmus was 9.0±2.8 mm. Minimally invasive tracheostomy via an intercartilaginous incision is a feasible technique. A skin incision 2 cm below the cricoid cartilage enables exposure of the thyroid isthmus and anular ligament between the 2nd and 3rd tracheal rings. The intercartilaginous incision allows sufficient space for the tracheostomy tube. An intercartilaginous incision without resection of a tracheal ring can be a good alternative tracheostomy technique, especially for patients who require transient tracheostomy.

Factors Influencing Self-directed Learning Ability of Anatomy using Cadaver Dissection: Focusing on Beginning Nursing Students / 의료커뮤니케이션

BACKGROUND: The study is descriptive research study to investigate the self-directed learning ability to explore the facts that influence of anatomy using cadaver dissection beginning nursing students.METHODS: A descriptive research design was used. The data was collected from 31st May to 7 June, 2016. The participants were total 121 first-year nursing students in C University. This anatomy practicum course was composed of three session, and each session was composed of 3hours, 60minutes of body structure and anatomy lecture, 90 minutes of cadaver dissection, and 30minutes of summary.RESULTS: The results of the study showed that satisfaction with cadaver dissection was statistically significant in the usefulness in connection with the major of nursing (r=.543, p < .001), educational understanding (r=.465, p < .001), and nursing learning motivation (r=.517, p < .001). As the nursing learning motivation increased, self-directed learning ability increased. Also nursing learning motivation influenced self-directed learning (β=0.266, p < .01).CONCLUSION: It is necessary to develop a program that can link theoretical education with practicum education of anatomy using cadaver dissection for efficient learning of the anatomy major courses of nursing students.

Experiences of first year medical students from their teachers beyond the grave / The Health Sciences Journal

Introduction@#Dissecting cadavers to study Human Anatomy is an integral part of first year medical education. The aim of this study was to describe the experiences of the first year medical students during their first day of cadaver dissection.@*Methods@#This study analyzed interviews of three first year medical students, chosen via purposive sampling, who were present during the first day of cadaver dissection in gross anatomy. Interviews were transcribed and analyzed through a Husserlian descriptive phenomenological approach.@*Results @#Five common themes were identified: 1) fear of the unknown, 2) group dynamics, 3) sense of awe and amazement of the cadaver's body, 4) respect for the body, and 5) taming of death as a rite of passage to being a doctor.@*Conclusion @#Of the five emergent themes, taming death as a rite of passage to being a doctor is the essence of the experiences of the first year medical students during the first day of cadaver dissection.

The Effect and Suggestions for Operation of Cadaver Dissection Program for Dental Hygiene Students / 체질인류학회지

Cadaver dissection is an effective method for learning structure and function of the human body. However, division of health science is conducting an anatomy lecture lean toward theory because it is impossible to operate their own practice program. This study was performed to propose a customized anatomy practice program plan that reflects needs of students majoring dental hygiene. A survey was conducted to 138 students majoring dental hygiene at D university. We used a structured questionnaire to analyze general characteristics of a subject, opinions about cadaver dissection, educational method and the demands of a program. Then we acquired frequency, mean, standard deviation, and correlation coefficient value. Furthermore, we also performed independent t-test and variance analysis (ANOVA) by using R program (version 3.2.2). A majority of students responded positively in items of necessity, satisfaction and comprehension of cadaver dissection. Dissection using cadaver marked a highest response (48.6%) among the methods of anatomic education. As for an appropriate time required for education, 72 students (52.2%) responded 30 minutes for an orientation time and 46 students (33.3%) for an observation time. Students also responded head and neck area and skeletal system to be the top priority for observation. In order to operate systemic cadaver dissection program, practical institutions should provide an active system. Contents of a necessity and procedure of cadaver donation should be included in preliminary education, with a thoughtful consideration to minimize negative psychological response of students during educational process. In observation, we should organize program focused on head and neck region and a three-dimensional structure of skeletal system. We expect our study to provide useful information in composing cadaver dissection program for dental hygiene students in the future.

The Effect of Education Program of Cadaver Dissection for the Paramedical Students / 체질인류학회지

A purpose of the study is to provide basic information in order to find better ways for more effective cadaver dissection education by analyzing education effect on paramedical students after cadaver dissection. By using questionnaires composed of 12 questions, we have surveyed 1,041 paramedical students who participate in cadaver dissection in 2013 and analysed the results. The paramedical students are the department of nursing science, operation treatment, physical therapy, alternative medicine, clinical pathology, emergency rescue and dental hygienics. As a result, we have found that cadaver dissection makes students have more respect for human life and dignity, helps students learn anatomy and major. Furthermore, the degrees of satisfaction, interest, intention of afterward participation in cadaver dissection afterward are high. However, the degrees of intention of cadaver donations are low. We need to develop cadaver dissection programme customized for each majors in order to helps students have more respect for human life and dignity, more professionalism, more effective cadaver dissection education.

Students' perception of anatomy education at a Korean medical college with respect to time and contents / 대한해부학회지

Among medical education institutions worldwide, the time allotted for anatomy instruction has decreased without any reasonable time optimization suggestions. In addition, the utility of cadaver dissection has long been debated. Herein, we surveyed students' perceptions of anatomy education with respect to time and hands-on cadaver dissection, at Seoul National University College of Medicine. With the help of a questionnaire, we surveyed third- and fourth-year students at our institute who had completed the anatomy module as freshmen as well as their clinical clerkship. At our institute, students complete 50 hours of anatomy lectures and 120 hours of dissection laboratory during their first year. According to the survey responses, they generally considered these durations to be adequate for achieving their anatomy education goals. Almost all the students regarded the dissection laboratory as an essential and most helpful modality. Thus, we suggest that these ranges of time along with cadaver dissection could be useful guidelines for optimized anatomy education. The survey data also indicated that a more clinically oriented anatomy education could improve students' results.

The Effect of Observation Program of Cadaver Dissection for the Paramedical Students / 체질인류학회지

The effects of observation program of cadaver dissection for paramedical students were surveyed and obtained the following results. After observation of cadaver dissection, the students who will participate next time with their own will, who think this program is essential for anatomy study, who understand the orientation contents, and who think their anatomical knowledge elevated were increased. However, the number staffs of medical school who think this program is essential for paramedical students were about 1/3. The problems obtained in the observation program of cadaver dissection were discordance with teaching schedule, long orientation and observation time, and the 1/2 or above staffs leading this program were teaching assistants and medical students. Through this observation program of cadaver dissection, the paramedical students were aware of the meaning of cadaver donation and the noble will of donors certainly, and gained an opportunity feel the dignity of life.

Current Anatomical Cadaver Dissection and the Limitation of the Act of Corpse Dissection and Preservation / 체질인류학회지

The Act of Corpse Dissection and Preservation is the prime law related with anatomical cadaver dissection in Korea. Consider the social and cultural situation at the year of 1995 when the law established, it has much epochal contents. Now, however, it has many regulations, such as the purpose of establishment the law, object of dissection, management of cadaver after dissection, and the lack of body donation movement, which are not coincide with current anatomical dissection field. In order to supplement such insufficiencies, it is necessary to revise the Act of Corpse Dissection and Preservation as soon as possible. Furthermore, it is recommended to establish a new law supporting the body donation movement and management for activation of anatomical dissection education, which eventually extend the basis of the development of medical science.

Living anatomy in the 21st century: how far can we go.

Living anatomy, defined as the anatomy revealed on living humans, is gaining importance in modern anatomy education, and has even been considered to replace cadaver-based anatomy study. We discussed the modalities through which living anatomy can be studied and explore the feasibility of using them to replace cadaver-based anatomy. We believe that the study of anatomy via the three main modalities of living anatomy, namely, surface anatomy, medical imaging and surgical procedures, rely on a foundation of sound knowledge of the three-dimensional anatomy. While a cadaver is still the best study material for the construction of a three-dimensional image of human anatomy, considering the pressure to reduce the hours geared towards anatomy education, education in anatomy in 21st century must be revolutionized to utilize the state-of–the-art modalities to formulate a contemporary anatomy course. Such modalities allow students to carry on self –directed learning, leading to a positive outcome in anatomy education. The problem arises if we have to incorporate more living anatomy, the time necessary for dissection needs to be minimized or compromised. We sincerely believe that the time has come to address this issue in the anatomy curriculum.

An Anatomical Consideration on the Safety of a Meridian Point (Danchu, CV17) in Acupuncture Therapy / 全日本鍼灸学会雑誌

Aim : Since it was reported that acupuncture at Danchu (CV17) was critical when the needle penetrated through the congenital sternal foramen, we decided to study the incidence of the congenital sternal foramen, as well as the distance between the body surface and the back side of the sternum at Danchu, in order to know the safe depth of acupuncture penetration.<BR>Method : 1) We selected 51 cadavers to examine the incidence of congenital sternal foramen and, if any, to study its structure. We also selected 21 cadavers to measure the cadaveric thickness of the sternum. 2) We selected 31 people to measure the incidence of the congenital sternal foramen and the distancebetween the body surface and the back side of the sternum at the point of Danchu.<BR>Results : 1) We found one out of 51 cadavers which had congenital sternal foramen. The location of the foramen was at the height of the fourth intercostal space. It was round-shaped, 9mm in diameter, and filled with hard connective tissue. The thickness of the sternum ranged from 9 to 15mm with an average of 11.5 ± 2mm. 2) There was no one who had the congenital sternal foramen among the 32 people. The distance between the body surface and the back side of the sternum ranged from 11 to 31mm with an average of 18.8 ± 5mm.<BR>Conclusion; 1) The incidence of the congenital sternal foramen in this study was one in 51 cadavers and zero in 32 people. 2) We concluded that acupuncture at Danchu within a depth of 10mm is sufficiently, even if congenital sternal foramen exists.

A shorter human anatomy teaching program: less expensive but effective

The principal change proposed in the teaching of gross anatomy is the inclusion of prosection as a part of the teaching program in coordination with dissection, demonstrations and study of anatomical and x-ray platesGreater emphasis on surface anatomy is also recommendedAs regards cadaver dissection, two suggestions are discussed: 1. Curtailment of the exposure of insignificant details to make dissection less time-consuming and to focus the attention of the dissector to the more important parts and structures2. Early dissection of the extremities to forestall excessive dehydration and hardening of these parts of the body. (Summary)

Status of Cadaver Collection of Medical Colleges for Their Anatomy Education in Korea / 체질인류학회지

This study eximaned the status of cadaver collection of medical colleges in Korea for their anatomy education during the last thirty years. The total collected number of cadavers during the first decade (1971 ~1980) were 1, 182. The numbers increased year gradually and it showed 1, 771 during the second decade (1981 ~1990). Thereafter the collection rate dropped suddenly to 607 during the period of 1991 ~1996. Compare to the total number of medical colleges (from 14 to 41 schools) and medical students (from 1,300 to 3,300 students) during the examined period, the ratios of medical students joining to dissection per cadaver were getting worse until the donation of cadavers become popular after 1994. In 1995 ~1996, 83.2% of total collected cadavers in Korea were available from donation, while the donation rate in 1989 ~1990 was only 7.5%. We have been tried to collect donated cadavers for richly available cadavers and to prepare that combination of plastination materials and models with advanced tools for visualization provides the look and feel of real dissection.

Human body composition determined by cadaver dissection / 体力科学

Sixty-two embalmed cadavers of elderly Japanese individuals, ranged in age from 44-98 years (48 males, 14 females), were completely dissected, and the weights of skin plus subcutaneous adipose tissue (SSATW) and Triceps Surae Muscle (TSMW) determined. Then subcutaneous adipose tissue free weight (SSATFW) was determined by subtracting SSATW from body weight (BW) .<BR>SSATW and percentage of SSATW relative to BW in females (8.9 kg, 19.8%) were larger than those in males (6.1 kg, 12.7%) . On the other hand, TSMW and percentage of TSMW relative to BW in males (313.6 g, 0.65%) were larger than those in females (210.6g, 0.49%) . BW, SSATFW, TSMW were highly correlated (p<0.01) with each other in males. However, in females, TSMW was not significantly correlated (p>0.05) with those variables. The slopes of regression lines for SSATW against BW and SSATFW for females were about twice as steep as those for males.<BR>From these results, it was suggested that females carried a higher proportion of their adipose tissue externally than males and relationship between muscle weight and inner adipose tissue weight in females was more variable than in males.