Current integration of dissection in medical education in Australia and New Zealand: Challenges and successes

Abstract

The reduced use of dissection associated with the introduction of integrated systems problem-based learning curricula, graduate-entry programs and medical school expansion is a frequent topic of discussion and debate in modern medical training. The purpose of this study was to investigate the impact of these changes to the medical education landscape, by looking at the current utilization and integration of dissection in medical schools, in Australia and New Zealand. A survey and an invitation to participate in an interview were distributed to all Australian Medical Council-accredited medical schools. Sixteen schools (76%) responded to the survey and five interviews (24%) were conducted. Dissection was a component of the medical program in 12 of the 16 schools surveyed. The opportunity for medical students to dissect human cadavers was found to be related to whether the medical school was established pre- or post-2000 (P = 0.003) but was not significantly associated to undergraduate- or graduate-entry (P = 0.64), program length (P = 0.59) or the number of commencing students (P = 0.07). The methods used for the delivery and integration of dissection varied between schools. Despite substantial changes to the delivery of anatomy in Australian and New Zealand medical schools, a variety of approaches have been adopted to ensure dissection remains an integral component of medical student education. Based on our findings, a number of recommendations were formulated to encourage the integration of dissection, regardless of the didactics of the program, to enhance the anatomical knowledge of students.

Benefits of extracurricular participation in dissection in a prosection‐based medical anatomy program

“…The main benefits to participation in dissection electives were related to learning style, group-work, and knowledge development. The positive notions regarding learning style and teamwork represent benefits attributed to cadaveric dissection described elsewhere (Patel and Moxham, 2008;Kerby et al, 2011;Davis et al, 2014;Bouwer et al, 2016). Notably, these benefits are not easily captured by conventional examinations.…”

“…This de‐emphasis of cadaveric dissection in medical schools has been described in the United States (Drake et al, ), Canada (Ovsenek, ), the United Kingdom (Chapman et al, ), Europe (Pais et al, ), and Australia and New Zealand (Craig et al, ; Moscova et al, ; Bouwer et al, ). Notably, this trend is common to both undergraduate entry medical schools (Ovsenek, ) as well as medical schools where graduate‐level entry is more common (Craig et al, ; Bouwer et al, ). In both cases, there appears to be increased reliance on previously dissected cadaveric material (prosections).…”

Predictors of confidence in anatomy knowledge for work as a junior doctor: a national survey of Australian medical students

“…Despite the historical prominence of dissection in medical education, the rationale for its use as a teaching method has stemmed from tradition, rather than a demonstrated impact on learning outcomes [ 28 , 29 ]. A recent survey of Australian medical faculties revealed that dissection is still available in at least 12 of the 20 medical schools with a graduating cohort in 2015 [ 30 ], coinciding with a trend towards increasing use of alternative teaching methods over the past two decades [ 7 , 21 ].…”

Dissection Course in Anatomy as Stimulus to Independent Research and to a Real Step into Medicine

“…In the recent years, an impressive number of alternative methods of learning anatomy approach. Sometimes, dissection is being totally replaced by the use of new technologies, or changes in the medical curriculum leave a short amount of time for dissection, according to Bouwer et al and to Whelan et al 19,20 Every method has its unique features and advantages, mostly because of opportunities of vital study, visual quality, and ethical aspects. However, according to Estai et al, who composed a comparative analysis of all teaching and learning techniques that are used in medical universities nowadays, these methods have serious disadvantages in comparison to dissection.…”