Are Real Cadavers Better Than Virtual Ones?
Reading Time: 4 minutesBy dissecting physical or virtual dead bodies, medical students learn about more than just human anatomy., Are real cadavers better than virtual ones?
Cadavers have been used in medical training for centuries, and dissections are a rite of passage for first-year students in medical school. Traditionally, the cadavers being dissected were real human beings who donated their bodies to science before their death, and the process of dissecting—or at least inspecting—a cadaver gives students a physical representation of human anatomy.
Over the past decade, however, medical schools have been experimenting with ways of teaching anatomy without the body, supplementing or replacing real cadavers with virtual ones. In 2019 Case Western Reserve University debuted its HoloAnatomy program, which runs on Microsoft’s mixed-reality HoloLens headset.* During the height of the coronavirus pandemic, many other schools were forced to implement digital options. And despite the return to in-person learning, body shortages could make virtual anatomy more of a necessity.
Morgan Wiley is an aspiring OB-GYN who is currently in his fourth year at a medical school in Kentucky. Like most med school students, he had to take a semester of anatomy. ‘It’s meant to teach you anatomy in a spatial fashion,’ he explained. ‘It’s supposed to help you study the different structures, how they are in the body, so you can have a better idea of how everything is incorporated.’
Wiley’s program used prosections—cadavers already dissected by a professional—but the course also integrated all sorts of virtual tools. There was an app in which students could play with pictures of the human body, with an ‘overlay of color’ so they could identify the structures on the picture of the cadaver. And there was Wiley’s favorite app, Anatomy Atlas, which presented a 3D rendering of the body. ‘You can take out certain structures of the body. You can look at only the bones or only the muscles or only the lymphatic [system] or all three at the same time. You can twirl it around and frame it however you want to.’
Michael Denham, a medical student at Columbia University, used a similar software as Wiley in his first year of medical school. Although cadavers were still very much a part of the curriculum, the software functioned as a supplement. ‘We would go through some of the 3D models together to try and understand how all the structures were related to one another spatially, in a way that you can’t do with a physical body on the table,’ Denham said.
As Mark Griswold, a radiology professor at Case Western, explained, physical cadaver labs are expensive to run. There are biohazards, and it’s costly to create a lab that’s up to modern environmental regulations. There are other compelling reasons not to use physical cadavers, including the fact that it’s difficult to see anatomy like lymph nodes, certain blood vessels, and the pancreas on a physical cadaver. These were the primary motivations for Case Western’s integration of HoloAnatomy into its anatomy program. Students use virtual reality headsets that project 3D models of either the male or female body—according to studies, this has been a relative success.
Ohio State University also uses similar reality tools—but as a supplement to physical cadaver instruction. ‘It really helps the students build that spatial 3D relationship in the body that you can only really do in the lab, hands-on,’ said Derek Harmon, a professor at OSU. ‘No other resource really gives you that mental map.’
Using virtual anatomy doesn’t just make it easier to see certain structures. It also standardizes the process. ‘It’s consistent for everybody,’ said Marc J. Kahn, the dean of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas. ‘If you have human cadavers, they’re all different in some way, shape, or form. With the virtual, they’re all looking at the same body. The arteries are in the same place. The veins are in the same places.’
Some virtual tools provide students the ability to mimic surgical procedures—something that isn’t realistic with cadavers. Using virtual cadavers also allows more time for other important aspects of medical school training. For Wiley, that meant spending more time in radiology and looking at imaging—experience that, as he points out, is applicable to every field, not just procedural subspecialties. ‘If adding more virtual things means we can learn more information in our first and second year, I’m all for it,’ he remarked.
Some are more skeptical about the feasibility of these tools on their own. Since its inception eight years ago, UNLV has used solely virtual tools. But this semester, it introduced a physical cadaver program into its medical school curriculum, citing the importance of sensory input for anatomical education. ‘Seeing it in books or seeing it in pictures or on virtual cadavers is always nice and neat, in a sense,’ UNLV anatomy instructor Owen McCloskey explained. ‘But in the actual human body, it’s not as pretty.’
Others highlighted the importance of being able to feel the body during dissection in anatomy education. ‘When you get to have the ability to be hands-on and actually explore this area yourself as a learner, it’s one of those things that those memories are engrained in your head,’ Harmon, the OSU professor, said. ‘You can only get so much at looking at an image or drawing. By being hands-on, in person, and manipulating the tissues, students gain this very valuable 3D spatial map.’
The University of Texas at San Antonio has also stuck to a more traditional head-to-toe anatomy experience for that reason. The school offers a digital anatomy lab as an enhancement—not a replacement—but the primary focus is on the physical cadaver.
‘There’s no way, at least right now with this day and age, it’s impossible to have the same complexity that a human body presents,’ explained Omid Rahimi, director of the Human Anatomy Program of the UT Health Science Center at San Antonio. ‘A future surgeon, you would want them to have their hands on the real person before they do any procedure on anyone.’
Beyond its practical role in teaching students about anatomical structures, there are additional intangible lessons wrapped up in cadaver education—about death, the frailty of life, and how to respect bodies—that can’t always be replicated with virtual tools. A cadaver is ‘the first patient students encounter,’ Griswold says, and ‘it’s the student’s first encounter with death.’ Because of this, students at Case Western spend the first two weeks doing conventional cadaver dissection, writing reflections about death and their first patient.
‘I don’t think it’s an inferior way to do things,’ Wiley said about using virtual cadavers. ‘The bigger question is: How much do we value tradition? Is that enough to keep something going? It’s a huge resource burden to do a cadaver lab. If we can’t prove that it’s better, is it worth doing simply for tradition? I think that’s a question we need to answer as a field.’
Reference: https://slate.com/technology/2023/11/virtual-cadavers-anatomy-medical-school.html
Ref: slate
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