Table of Content Volume 7 Issue 1 - July 2018
Role of traditional cadaveric dissection in learning –Perceptions of 1st MBBS students
Kirti Solanke1, Deepti Kulkarni2*, Archana Shekokar3
1,2Assistant Professor, 3Professor and HOD, Department of Anatomy, SKNMC, Pune, Maharashtra, INDIA. Email: deepti_mok@yahoo.com
Abstract Anatomy forms one of the basic subjects for medical and allied courses. Anatomy is traditionally taught and learned through didactic lectures, cadaveric dissection and tutorials/demonstrations. However, recent advances in information technology, computers, imaging techniques, plastination techniques etc. provide many alternate options for teaching and learning the subject. This combined with difficulties in procuring and preserving cadavers, financial and time constraint has prompted modern anatomists to question the relevance of traditional cadaveric dissection in education of anatomy. Few also claim that dissection produces strain on students. Said so, it is also not necessary that all the new technologies will always be available in all institutes. In addition, traditional cadaveric dissection has many other advantages like practice of handling human tissues, finding the body structures by yourself, promoting team work and reducing fear of death etc. As we teach anatomy to First year M.B.B.S. students by combining old and new methods, present study is done to compare the advantages and disadvantages of different methods as experienced by students and also to note their reactions in dissection hall. Present study was conducted on 200 1st year MBBS students by collecting feedback using Questionnaires in the dept. of Anatomy, SKNMC throughout different times of education year. With traditional method, most of the students experienced different physical symptoms like nausea, headache, watering, also fear and anxiety. Initial exposure with cadavers caused physical and emotional stress to students. This stress can be reduced by combining other teaching methods with Dissection. Perhaps it was preferred by most students. New methods are complimentary but not as replacement for traditional Dissection. Key Words: Anatomy, Cadaver, Dissection, Learning methods, Stress.
Anatomy forms one of the basic subjects for medical and allied courses. Anatomy is traditionally taught and learned through didactic lectures, cadaveric dissection and tutorials/demonstrations. Dissection is accepted universally for training and skill development in learning Anatomy5. But at the same time, exposure to cadavers constitutes potential stress8, in form of physical and psychological impact10. Some studies claim that dissection produces strain on students1,7 However, recent advances in information technology computers, imaging techniques, plastination techniques etc provide many options for teaching and learning the subject. This, combined with difficulties in procuring and preserving cadavers, financial and time constraint has prompted modern anatomists to question the relevance of traditional cadaveric dissection in education of anatomy. However, all the new technologies may not be available in all institutes. In addition, traditional cadaveric dissection has many other advantages like practice for handling human tissues, finding the body structures yourself, team work, reducing fear of death etc. As we teach anatomy to First year M.B.B.S. students by combining old and new methods i.e. cadaveric dissection, prosection and use of computers for showing dissected parts, present study is done to compare the advantages and disadvantages of different methods as experienced by students and also to note their reactions in dissection hall.
MATERIAL AND METHODS After getting permission from Institutional ethical committee, students were explained about the study and consent was taken. The study was conducted on 200 1st year MBBS students by using Questionnaires in the dept. of Anatomy. Repeaters and readmitted students were excluded. 4 Questionnaires were given. 1stquestionnaire on 1st day of dissection, which includes questions to judge feelings, attitude of students on very 1st day of dissection. 2nd questionnaire was given to the students after one month of dissection. The changes in their attitude towards dissection and their appraisal about different methods of teaching were noted. 3rd questionnaire was provided to the students at the end of 1st term and their appraisal of teaching methods as well as changes in their attitudes was noted. 4th and final questionnaire was answered by the students after first M.B.B.S. final examination, when they were exposed to university examination.
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Table 5: Was dissection room stressful?
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DISCUSSION Bhaskar Patel et al state that 84.67% of the students considered dissection is important in anatomy learning. 91.33% students agreed actual hands on training on cadaver gives better result than demonstration on specimen. In present study 85% considered dissection essential and 77.5% were mentally prepared for that.89.5% had consideration that cadaver was once a living thing. Study by Mishra Purvi et al shows that 70.6% were excited when they first saw cadavers (56% present study). 40.6% recommend body donation. 83.3% say dissection is must to understand gross anatomy and say it should be continued. Study by Vinay Kumar et al says fear and depression decreased from 61.33 to 3.33% (12 to 6% in present study) and 14.66 to 0.66% (13 to 6.5%in present study) while interest and excitement has increased significantly. Most of the symptoms decreaased and 98% consider dissection as important part of anatomy. Study by Nirmalya Saha et el says, 96% never seen cadaver before (78% in present study). Majority felt dissection is important and enhances thinking in logical manner.78.8% says dissection should not be replaced. 98% had gratitude to people who donated bodies. G Agnihotri et al (2010)1 studied reactions of first year Indian medical students to the dissection hall experience. Their study revealed that majority of the students feel fear and apprehension at the beginning, but overcome it within 6-8weeks. In their study, 34.66% had seen a dead body before, but still had anxiety, apprehension at the beginning. As many as 82% felt that an interaction with anatomy staff before entering dissection hall would lessen the emotional impact( 41.5% in present study). They found that the practice of anatomy allows the student to learn how to face up to and adapt his / her emotional reactions and attitudes; this gives human cadaver dissection great importance as an educational strategy and as a professional training tool in technical and emotional skill training. Similar results are reported by A Malu and D Tegabu (2012)2 for Ethiopian students.
CONCLUSION Present study shows that physical and psychological symptoms likenausea and fear has decreased over the period of time. Formalin fumes and eye irritation were causing more discomfort. Assistance by teacher will help to overcome the stress. Most of the students still prefer dissection as important part in learning Anatomy but combination with other learning methods will be helpful. So better interactions with students by pre-education sessions will improve their attitude and help them to cope up. Though other teaching methods are useful, Dissection remains indispensible part of Anatomy.
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