Self‐guided clinical cases for medical students based on postmortem CT scans of cadavers

Abstract

In the summer of 2009, we began full body computed tomography (CT) scanning of the pre-embalmed cadavers in the University of Michigan Medical School (UMMS) dissection lab. We theorized that implementing web-based, self-guided clinical cases based on postmortem CT (PMCT) scans would result in increased student appreciation for the clinical relevance of anatomy, increased knowledge of cross-sectional anatomy, and increased ability to identify common pathologies on CT scans. The PMCT scan of each cadaver was produced as a DICOM dataset, and then converted into a Quicktime movie file using Osirix software. Clinical cases were researched and written by the authors, and consist of at least one Quicktime movie of a PMCT scan surrounded by a novel navigation interface. To assess the value of these clinical cases we surveyed medical students at UMMS who are currently using the clinical cases in their coursework. Students felt the clinical cases increased the clinical relevance of anatomy (mean response 7.77/10), increased their confidence finding anatomical structures on CT (7.00/10), and increased their confidence recognizing common pathologies on CT (6.17/10). Students also felt these clinical cases helped them synthesize material from numerous courses into an overall picture of a given disease process (7.01/10). These results support the conclusion that our clinical cases help to show students why the anatomy they are learning is foundational to their other coursework. We would recommend the use of similar clinical cases to any medical school utilizing cadaver dissection as a primary teaching method in anatomy education.

Imaging in anatomy: a comparison of imaging techniques in embalmed human cadavers

“…So far, we are using ultrasound examinations in line with the 'living anatomy’ seminars and provide head and hip, knee and shoulder joint CT and MRI scans of our body donors. Based on our own experiences, we agree with the findings of Chew et al [9] and Bohl et al [15] that combining post-mortem radiological images and anatomical dissection of the same body donor leads to a greater gain in knowledge than using real patient images that are not comparable to the dissected cadavers in a one-to-one manner.…”

“…Not only it enhances the students’ learning effects in anatomy but it also increases the overall understanding of medical imaging, thus improving the students’ long-term ability to identify anatomical structures both in vivo and in medical images [5-7,9,15]. Based on these encouraging reports, we have introduced medical images to our education in gross anatomy several years ago.…”

Cadaver Dissection Is Obsolete in Medical Training! A Misinterpreted Notion

“…I agree with Inuwa et al [82] that traditional and modern curricula can be taught together, instead of discarding the traditional methods of anatomy teaching. Additionally, many other techniques like radiographs, cadaver computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasound [44, 83, 84], computer media, CD ROM [20], and computer-aided holographic models [85] have been added to CD in anatomy teaching. These modifications, with some exceptions [86], have enhanced 3-dimensional perception and the understanding of the human body, thus moving closer to safe medical practice.…”

Simulation techniques in the anatomy curriculum: review of literature

“…This method uses different techniques, e.g. : classical clinical PBL, clinical cases for medical students based on computed tomography scans, real patient clinical cases based on real patients' problems or documented case presentation of the tutorials in the form of patient/physician history taking and physical examination videos [11,14,15,46,49]. However, the interactive lectures seem to be the most sophisticated variants of the PBL method during which small-group tutorial sessions are integrated into each anatomical section and use anatomical models, bones, radiographs, and interactive 3-dimensional (3D) images [18].…”