Learning anatomy in med school: Is it still necessary to work with cadavers?

The study of human anatomy is a cornerstone of medical education, providing students with a fundamental understanding of the human body’s structure. Traditionally, first-year medical students have been introduced to anatomy through dissecting cadavers in anatomy labs. However, recent technological advancements have offered alternatives such as prosections (preserved specimens dissected by experts) and virtual anatomy platforms, such as Complete Anatomy or Biodigital.

Many schools adopted new hybrid or completely virtual approaches to anatomy lessons during the COVID-19 pandemic, mine included, and some have continued to do so. I was concerned about potential negative impacts of having learned anatomy remotely, so I brought it up with my anatomy professor, Amanda Troy, PhD, and anatomy fellow Adam Berry, OMS IV. We ended up having an important discussion about the benefits and drawbacks of the different approaches to learning anatomy.

Below, we’ll explore the pros and cons of using cadaveric anatomy labs versus prosections/virtual anatomy exclusively as the primary mode of instruction for first-year medical students.

Pros of cadaveric anatomy labs

• Realistic hands-on experience: Working with human cadavers allows students to gain firsthand experience in manipulating and dissecting human tissues, closely mimicking what they will encounter in clinical practice. This tangible experience can help build a strong foundation for future clinical work.

• Enhanced three-dimensional understanding: Cadaveric dissection allows students to explore the three-dimensional nature of human anatomy, which can be challenging to grasp through two-dimensional images or virtual simulations. This more profound understanding of spatial relationships among anatomical structures is vital for future surgical and interventional procedures.

• Development of collateral skills: Cadaveric labs foster the development of other skills, including teamwork, communication and professionalism. Students commonly work in small groups, promoting collaboration and communication as they dissect and learn from one another. Moreover, they learn to treat the cadaver with respect, an experience that promotes professionalism and empathy toward patients. Cadaver lab is often viewed as a “rite of passage,” engaging med students with the reality of human mortality as they spend time in the lab.

• Exposure to variability: Human bodies vary significantly from one person to another. Cadaveric dissection exposes students to this variability, helping them appreciate individual differences. Understanding that all bodies are unique is critically important in medical practice. This firsthand experience prepares students for the diversity of patients they will encounter.

Cons of cadaveric anatomy labs

• Ethical and emotional challenges: Working with human cadavers can be emotionally challenging for some students. It requires them to confront the ethical and emotional aspects of handling human remains, sometimes leading to emotional distress or a sense of unease for some students.

• Time-consuming learning: Dissecting a human cadaver is time-consuming, often requiring several hours or even days to cover a single topic thoroughly. This can lead to a slower pace of learning, making it challenging to cover the entire curriculum in a timely manner.

• Health and safety concerns: Working with cadavers involves certain health and safety risks, including exposure to formaldehyde and other chemicals used for preservation and the use of sharps. Students and instructors must follow strict safety protocols for an optimal, safe experience.

Pros of prosections

• Expertly prepared specimens: Prosections are human cadavers that have been professionally dissected by experts, showcasing anatomical structures with precision and clarity. This eliminates the need for students to spend time dissecting and allows them to focus solely on learning.

• Time-efficiency: Prosections allow students to cover a broader range of anatomical structures in less time than cadaveric dissection. This can be particularly advantageous in a packed medical school curriculum.

• Lower emotional and ethical burdens: Since students do not participate in the dissection process, the emotional and ethical burden associated with cadaveric labs is reduced. This can make learning anatomy a more comfortable experience for those who find such aspects challenging.

• Consistency: Prosections provide consistency in anatomical presentation, ensuring that all students have access to identical high-quality specimens. This consistency can help standardize the learning experience across different cohorts of students.

Cons of prosections

• Lack of hands-on experience: The primary drawback of prosections is that they do not offer the same hands-on experience as cadaveric dissection. Students miss out on the opportunity to develop tactile skills and the spatial understanding that can be invaluable in clinical practice.

• Limited exploration: While prosections showcase dissected structures with precision, students may have limited opportunities for exploration beyond what is already presented. They may not have the chance to investigate structures that aren’t part of the pre-prepared specimens.

Pros of virtual anatomy

• Accessibility: Virtual anatomy platforms are highly accessible and can be used by students at any time and from any location. This accessibility can be particularly advantageous for remote or distance learning and for medical schools with limited resources.

• Interactive learning: Virtual anatomy platforms often include interactive features such as 3D models, quizzes and simulations. These features can engage students and promote active learning, enhancing students’ understanding of anatomical structures.

• Repetition and customization: Students can repeat virtual dissections and simulations as often as needed to reinforce their understanding of anatomical structures. Additionally, these platforms often allow customization, enabling students to focus on specific areas of interest.

• Reduced ethical concerns: Virtual anatomy eliminates the ethical and emotional concerns associated with working on human cadavers or prosections. This can create a more comfortable learning environment for students. Increasingly, virtual anatomy platforms allow for customization of skin tone, gender and anatomic variation, allowing for more diversity and representation in the curriculum.

Cons of virtual anatomy

• Lack of realism: Virtual anatomy, while informative, cannot fully replicate the tactile experience of working with actual human tissues. Students may miss out on the sensory feedback from physically dissecting a cadaver or handling prosections.

• Lack of dissection experience: Often, the anatomy lab is a starting point for the development of tactile, cautious instrumentation and procedural skills. The anatomy lab experience has often been cited as a determining factor for a student’s decision to pursue surgery or a procedure-based specialty, which is an interesting component of the experience to consider.

• Reduced exposure to variability: Virtual anatomy platforms may provide a standardized experience but do not expose students to the variability of human bodies they will encounter in clinical practice. This can be a limitation when preparing for diverse patient populations.

Weighing the pros and cons

My first year of medical school was during the peak of COVID-19, and our anatomy lab was closed. I experienced anatomy via textbooks and virtual platforms. Faculty also did live broadcasts from the lab, which were helpful but did not make up for the hands-on experience. I was later able to make up for the missed experience through a research study that involved cadavers, and I definitely noticed a major difference after experiencing both approaches.

Ultimately, a combination of these teaching methods may be the most effective approach, allowing students to benefit from the strengths of each modality. As medical education continues to evolve, institutions must carefully weigh the pros and cons of these different approaches to ensure that their students receive the most comprehensive and practical anatomy education possible to help them better serve future patients.

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