Population representation among anatomical donors and the implication for medical student education

Abstract

Dissection provides a unique opportunity to integrate anatomical and clinical education. Commonly, cadavers are randomly assigned to courses, which may result in skewed representation of patient populations. The primary aim of this study was to determine if the anatomical donors studied by students at the University of Massachusetts Medical School (UMMS) accurately represent the disease burden of the local patient population. This cross-sectional study compared the University of Massachusetts Memorial Medical Center patient claims data and body donation data from the UMMS Anatomical Gift Program (AGP). This study examined age, race, sex, and morbidities within a 10-year timeframe in 401,258 patients and 859 anatomical donors who met inclusion criteria. An independent t test was conducted to compare the mean ages of the two populations. Chi square analysis was conducted on race, sex, and 10 morbidity categories. A Fischer's exact test was conducted for two morbidity categories with n < 10. Demographic analysis showed a significant difference in age, and racial representation between the populations. No statistical difference was found regarding sex. Morbidities were separated into 22 ICD-10 categories. Twelve categories were excluded and 10 were analyzed for population comparison. Two categories were over represented and seven were under-represented in the AGP population. One category showed no significant difference between populations. Targeted selection of cadavers in anatomy courses would improve morbidity variability in the anatomy lab. In addition, AGP acceptance guidelines should be evaluated to increase disease variation among the donor population. Clin. Anat. 31:250-258, 2018. © 2017 Wiley Periodicals, Inc.

BODIES R US: Ethical Views on the Commercialization of the Dead in Medical Education and Research

“…There are cases where the willingness of local communities to donate is damaged, if benefit of the donation is perceived to be going to "others". This may be one of the reasons for the reluctance of African Americans to donate in a society still carrying the historic burden of racism and socioeconomic inequality (Davidson, ; Halperin, ; Collins et al, ).…”

Analysis of Population Representation Among Willed Whole-Body Donors to Facilitate the Construction of a Body Donation Program in China: From the Perspective of Medical Students and Anatomists

“…The average age was 76.2 years at the time of their donation, but donors dying from neoplasms were significantly younger. Previous research indicated that the anatomy experience should provide medical students with the understanding of the patient population in the local area (Collins et al, 2017). The top four causes of death among general Beijing residents in 2015 are neoplasms, heart diseases, cerebrovascular diseases, and respiratory diseases, totally accounting for 82.8% among all deaths (Wang, 2016).…”

“…In this regard, our body donation program roughly represents the general population in Beijing. Thus, our students can study relevant normal and abnormal human anatomy, as their transition from medical students to qualified doctors (Collins et al, 2017;Sheikh et al, 2016).…”

Racism, structural racism, and the American Association for Anatomy: Initial report from a task force

“…Several studies have shown that Blacks are less likely than Whites to participate in either organ or full body donation programs because of medical mistrust and iatrophobia (Boulware et al, 2004;Siminoff et al, 2006). Similar body donation trends are observed for other historically marginalized groups in the United States (Collins et al, 2018), as well as abroad (Kramer and Hutchinson, 2015;Zhang et al, 2020). The reluctance of these groups to donate is at least in part a reflection of the historic burden of racism and socioeconomic inequality in science and medicine.…”