Novel dissection of the central nervous system to bridge gross anatomy and neuroscience for an integrated medical curriculum

Abstract

Medical schools in the United States continue to undergo curricular change, reorganization, and reformation as more schools transition to an integrated curriculum. Anatomy educators must find novel approaches to teach in a way that will bridge multiple disciplines. The cadaveric extraction of the central nervous system (CNS) provides an opportunity to bridge gross anatomy, neuroanatomy, and clinical neurology. In this dissection, the brain, brainstem, spinal cord, cauda equina, optic nerve/tract, and eyes are removed in one piece so that the entire CNS and its gateway to the periphery through the spinal roots can be appreciated. However, this dissection is rarely, if ever, performed likely due to time constraints, perceived difficulty, and lack of instructions. The goals of this project were (i) to provide a comprehensive, step-by-step guide for an en bloc CNS extraction and (ii) to determine effective strategies to implement this dissection/prosection within modern curricula. Optimal dissection methods were determined after comparison of various approaches/tools, which reduced dissection time from approximately 10 to 4 hours. The CNS prosections were piloted in small group sessions with two types of learners in two different settings: graduate students studied wet CNS prosections within the dissection laboratory and medical students used plastinated CNS prosections to review clinical neuroanatomy and solve lesion localization cases during their neurology clerkship. In both cases, the CNS was highly rated as a teaching tool and 98% recommended it for future students. Notably, 90% of medical students surveyed suggested that the CNS prosection be introduced prior to clinical rotations. Anat Sci Educ 11: 185-195. © 2017 American Association of Anatomists.

What do medical students learn from dissection?

“…These opinions concur with some anatomical educators, who believe that prosections can replace dissection (Nnodim, ; Nnodim et al, ; McLachlan and Regan De Bere, ). Similarly, there is existing evidence that some students favor prosection over dissection (Nnodim, ; Dinsmore et al, , Hlavac et al, ). The current study did not ask for the students' thoughts on the use of cadaveric dissection for learning anatomy against the sole usage of prosections (as an alternative), but students at the University of Otago are fortunate to first undertake a system‐based study of anatomy using prosections, before completing regional dissection study.…”

Mapping Neuroscience in the Field of Education through a Bibliometric Analysis

“…Curriculum reform related to neuroscience is the focus of research in this knowledge community. In C8, new software tools are incorporated [ 86 , 87 ] and the curriculum undergoes cross-disciplinary reform [ 88 , 89 ].…”

Exploring effectiveness in brain removal techniques: A comparison of approaches

“…Preservation of structures may be a result of increased time and attention to removal of the brain as well as increased practice in brain removal by the dissector. It is also possible that more technical approaches will lead to improved preservation, such as in the detailed approaches of brain removal as outlined in other studies (Felle et al, 1995;Long et al, 2014;Hlavac et al, 2018).…”

“…Only a handful of articles have been written outlining a more detailed approach to brain removal than as presented in many dissection manuals (Felle et al, 1995; Long et al, 2014; Hlavac et al, 2018). Felle et al (1995) introduced an additional cut to the occipital bone to facilitate a posterior approach which they suggested allows better preservation of cranial nerves and vasculature.…”