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      Human cadaveric dissection: a historical account from ancient Greece to the modern era

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          Abstract

          The review article attempts to focus on the practice of human cadaveric dissection during its inception in ancient Greece in 3rd century BC, revival in medieval Italy at the beginning of 14th century and subsequent evolution in Europe and the United States of America over the centuries. The article highlights on the gradual change in attitude of religious authorities towards human dissection, the shift in the practice of human dissection being performed by barber surgeons to the anatomist himself dissecting the human body and the enactment of prominent legislations which proved to be crucial milestones during the course of the history of human cadaveric dissection. It particularly emphasizes on the different means of procuring human bodies which changed over the centuries in accordance with the increasing demand due to the rise in popularity of human dissection as a tool for teaching anatomy. Finally, it documents the rise of body donation programs as the source of human cadavers for anatomical dissection from the second half of the 20th century. Presently innovative measures are being introduced within the body donation programs by medical schools across the world to sensitize medical students such that they maintain a respectful, compassionate and empathetic attitude towards the human cadaver while dissecting the same. Human dissection is indispensable for a sound knowledge in anatomy which can ensure safe as well as efficient clinical practice and the human dissection lab could possibly be the ideal place to cultivate humanistic qualities among future physicians in the 21st century.

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          The human cadaver in the age of biomedical informatics.

          Major national and international critiques of the medical curriculum in the 1980s noted the following significant flaws: (1) over-reliance on learning by rote memory, (2) insufficient exercise in analysis and synthesis/conceptualization, and (3) failure to connect the basic and clinical aspects of training. It was argued that the invention of computers and related imaging techniques called to question the traditional instruction based on the faculty-centered didactic lecture. In the ensuing reform, which adopted case-based, small group, problem-based learning, time allotted to anatomical instruction was severely truncated. Many programs replaced dissection with prosections and computer-based learning. We argue that cadaver dissection is still necessary for (1) establishing the primacy of the patient, (2) apprehension of the multidimensional body, (3) touch-mediated perception of the cadaver/patient, (4) anatomical variability, (5) learning the basic language of medicine, (6) competence in diagnostic imaging, (7) cadaver/patient-centered computer-assisted learning, (8) peer group learning, (9) training for the medical specialties. Cadaver-based anatomical education is a prerequisite of optimal training for the use of biomedical informatics. When connected to dissection, medical informatics can expedite and enhance preparation for a patient-based medical profession. Actual dissection is equally necessary for acquisition of scientific skills and for a communicative, moral, ethical, and humanistic approach to patient care. Anat Rec (New Anat) 269:20-32, 2002. Copyright 2002 Wiley-Liss, Inc.
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            Do we need dissection in an integrated problem-based learning medical course? Perceptions of first- and second-year students.

            The introduction of a problem-based learning (PBL) curriculum at the School of Medicine of the University of Melbourne has necessitated a reduction in the number of lectures and limited the use of dissection in teaching anatomy. In the new curriculum, students learn the anatomy of different body systems using PBL tutorials, practical classes, pre-dissected specimens, computer-aided learning multimedia and a few dissection classes. The aims of this study are: (1) to assess the views of first- and second-year medical students on the importance of dissection in learning about the anatomy, (2) to assess if students' views have been affected by demographic variables such as gender, academic background and being a local or an international student, and (3) to assess which educational tools helped them most in learning the anatomy and whether dissection sessions have helped them in better understanding anatomy. First- and second-year students enrolled in the medical course participated in this study. Students were asked to fill out a 5-point Likert scale questionnaire. Data was analysed using Mann-Whitney's U test, Wilcoxon's signed-ranks or the calculation of the Chi-square value. The response rates were 89% for both first- and second-year students. Compared to second-year students, first-year students perceived dissection to be important for deep understanding of anatomy (P < 0.001), making learning interesting (P < 0.001) and introducing them to emergency procedures (P < 0.001). Further, they preferred dissection over any other approach (P < 0.001). First-year students ranked dissection (44%), textbooks (23%), computer-aided learning (CAL), multimedia (10%), self-directed learning (6%) and lectures (5%) as the most valuable resources for learning anatomy, whereas second-year students found textbooks (38%), dissection (18%), pre-dissected specimens (11%), self-directed learning (9%), lectures (7%) and CAL programs (7%) as most useful. Neither of the groups showed a significant preference for pre-dissected specimens, CAL multimedia or lectures over dissection. Both first- and second-year students, regardless of their gender, academic background, or citizenship felt that the time devoted to dissection classes were not adequate. Students agreed that dissection deepened their understanding of anatomical structures, provided them with a three-dimensional perspective of structures and helped them recall what they learnt. Although their perception about the importance of dissection changed as they progressed in the course, good anatomy textbooks were perceived as an excellent resource for learning anatomy. Interestingly, innovations used in teaching anatomy, such as interactive multimedia resources, have not replaced students' perceptions about the importance of dissection.
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              Anatomy: a must for teaching the next generation.

              J Older (2004)
              Teaching anatomy to both undergraduate medical students and medical graduates is in the midst of a downward spiral. The traditional anatomy education based on topographical structural anatomy taught by didactic lectures and complete dissection of the body with personal tuition, has been replaced by a multiple range of special study modules, problem-based workshops, computers, plastic models and many other teaching tools. In some centres, dissected cadaver-based anatomy is no longer taught. Changing the undergraduate medical curriculum in the UK has taken place without any research into the key aspects of knowledge necessary or comparing methods of teaching. There is no agreement on a common national core curriculum and as a result, numerous new curricula have been introduced. No external audit or validation is carried out, so medical schools have been free to teach and assess their own work themselves. There is a great divergence in medical schools across the UK and Ireland in teaching medicine in general and anatomy in particular. Published data on the impact of these changes is scant. The reduction in undergraduate teaching and knowledge of anatomy has caused great concern, not only for undergraduates but also to postgraduate students, especially in surgery. This, together with a change in basic surgical training, a marked reduction in demonstrator posts and a change in examination standards, has set up a system that is allowing young men and women with a poor knowledge of anatomy to become surgeons. There should be a full public debate at every level; the Royal Colleges, specialist associations, the Universities, Government, both health and education. This debate should highlight areas of concern, explore in depth and define a minimal core curriculum for anatomy. Teaching must be enhanced with a critical look at both teachers and methods. The dominance of research must be reassessed to establish an equitable cohabitation with teaching. The place of basic science, especially anatomy in basic surgical teaching, must be examined. A thorough knowledge of anatomy should be required in the new MRCS-UK. This should be mandatory as a preliminary to higher surgical training. The teaching of anatomy in surgical specialities must be improved. Does the dissecting room still have a place in educating our under- and postgraduate students? Yes--a sound knowledge of anatomy is essential if the medical practitioner is going to accurately define and successfully treat the problem presented by the patient. The dissected cadaver remains the most powerful means of presenting and learning anatomy as a dynamic basis for solving problems. The cadaver must not be dismissed as obsolete. Dissection has survived the most rigorous test of pedagological fitness--the test of time. The student--cadaver--patient encounter is paramount in medical education.

                Author and article information

                Journal
                Anat Cell Biol
                Anat Cell Biol
                ACB
                Anatomy & Cell Biology
                Korean Association of Anatomists
                2093-3665
                2093-3673
                September 2015
                22 September 2015
                : 48
                : 3
                : 153-169
                Affiliations
                Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Kolkata, West Bengal, India.
                Author notes
                Corresponding author: Sanjib Kumar Ghosh. Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata 700104, West Bengal, India. Tel: +91-9007187207, Fax: +91-11-4157-1111, drsanjib79@ 123456gmail.com
                Article
                10.5115/acb.2015.48.3.153
                4582158
                26417475
                c45a683a-cf76-410f-b096-8a1ef73b415b
                Copyright © 2015. Anatomy & Cell Biology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 May 2015
                : 24 July 2015
                : 19 August 2015
                Categories
                Review Article

                Cell biology
                human dissection,de liuzzi,vesalius,grave robbing,anatomy act,national socialist regime,body donation,uniform anatomical gift act

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