Prosection

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A prosection is the dissection of a cadaver (human or animal) or part of a cadaver by an experienced anatomist in order to demonstrate for students anatomic structure.[1] In a dissection, students learn by doing; in a prosection, students learn by either observing a dissection being performed by an experienced anatomist or examining a specimen that has already been dissected by an experienced anatomist (etymology: Latin pro- "before" + sectio "a cutting")[2]

A prosection may also refer to the dissected cadaver or cadaver part which is then reassembled and provided to students for review.[3]

Use of prosections in medicine[edit]

Prosections are used primarily in the teaching of anatomy in disciplines as varied as human medicine, chiropractic, veterinary medicine, and physical therapy.[4] Prosections may also be used to teach surgical techniques (such as the suturing of skin), pathology, physiology, reproduction medicine and theriogenology, and other topics.

The use of the prosection teaching technique is somewhat controversial in medicine. In the teaching of veterinary medicine, the goal is to "create the best quality education ... while ensuring that animals are not used harmfully and that respect for animal life is engendered within the student."[5] Others have concluded that dissections and prosections have a negative impact on students' respect for patients and human life.[6][7] Some scholars argue that while actual hands-on experience is essential, alternatives such as plastinated or freeze-dried cadavers are just as effective in the teaching of anatomy while dramatically reducing the number of cadavers or cadaver parts needed.[8][9][10][11] Other alternatives such as instructional videos, plastic models, and printed materials also exist. Some studies find them equally effective as dissection or prosections,[12][13] and some schools of human medicine in the UK have abandoned the use of cadavers entirely.[14] But others question the usefulness of these alternatives, arguing dissection or prosection of cadavers are required for in-depth learning and teach skills alternatives cannot.[15][16][17] Some scholars and teachers go so far as to argue that cadavers and prosections are irreplaceable in the teaching of medicine.[18]

Whether prosections are as effective as dissections in the teaching of medicine is also an unsettled aspect of medical education. Some have concluded that prosections are equally effective.[19][20][21][22] However, others argue that the use of prosections is not as effective,[4] and that dissections help students learn about "detached concern," better understand medical uncertainty, and allow teachers to raise moral issues about death and dying.[23]

Some academics conclude that the effectiveness of prosections versus dissection or other alternatives depends on the type of anatomy or the discipline being taught (e.g., anatomy versus pathology), that the teaching of anatomy is yet insufficiently understood, and that existing studies are too narrow or limited to draw conclusions.[24][25][26][27]

References[edit]

  1. ^ "Prosection." In Dorland's Illustrated Medical Dictionary. 30th ed. Douglas Anderson, ed. Philadelphia, Pa.: Saunders, 2007. ISBN 0-7216-0146-4
  2. ^ "Prosector." In Stedman's Medical Dictionary. 25th ed. William R. Hensyl, ed. Baltimore, MD.:Williams & Wilkins, 1990. ISBN 0-683-07916-6
  3. ^ Keith L. Moore, Arthur F. Dalley, and A.M.R. Agur (2006). Clinically Oriented Anatomy. Philadelphia, Pa.: Lippincott Williams & Wilkins. ISBN 0-7817-3639-0
  4. ^ a b Debra Berube, Christine Murray, and Kathleen Schultze (1999). "Cadaver and Computer Use in the Teaching of Gross Anatomy in Physical Therapy Education". Journal of Physical Therapy Education.CS1 maint: multiple names: authors list (link)
  5. ^ Siri Martinsen and Nick Jukes (2005). "Towards a Humane Veterinary Education". Journal of Veterinary Medical Education. 32 (4): 454–60. doi:10.3138/jvme.32.4.454. PMID 16421828.
  6. ^ Norman Gustavson (1988). "The Effect of Human Dissection on First-Year Students and Implications for the Doctor-Patient Relationship". Journal of Medical Education. 63 (1): 62–4. doi:10.1097/00001888-198801000-00011. PMID 3336047.
  7. ^ J.A. Provo and C.H. Lamar (1995). "Prosection as an Approach to Student-centered Learning in Veterinary Gross Anatomy". Journal of the American Veterinary Medical Association. 206 (2): 158–61. PMID 7751212.
  8. ^ Othman Mansor (1996). "Use of Plastinated Specimen in a Medical School With a Fully Integrated Curriculum" (PDF). Journal of the International Society for Plastination. 11: 16.
  9. ^ Rafael M. Latorre, Mari P. García-Sanz, Matilde Moreno, Fuensanta Hernández, Francisco Gil, Octavio López, Maria D. Ayala, Gregorio Ramírez, Jose M. Vázquez, Alberto Arencibia, and Robert W. Henry (2007). "How Useful Is Plastination in Learning Anatomy?". Journal of Veterinary Medical Education. 34 (2): 172–6. doi:10.3138/jvme.34.2.172. PMID 17446645.CS1 maint: multiple names: authors list (link)
  10. ^ Ann T. Stotter, A.J. Becket, J.P.R. Hansen, I. Capperauld, H.A.F. Dudley (1986). "Simulation in Surgical Training Using Freeze Dried Material". British Journal of Surgery. 73 (1): 52–4. doi:10.1002/bjs.1800730122. PMID 3512022.CS1 maint: multiple names: authors list (link)
  11. ^ C.L. Greenfield, A.L. Johnson, C.W. Smith, S.M. Marretta, J.A. Farmer, and L. Klippert (1994). "Integrating Alternative Models into the Existing Surgical Curriculum". Journal of Veterinary Medical Education. 21.CS1 maint: multiple names: authors list (link)
  12. ^ J.F. Guy and A.J. Frisby (1992). "Using Interactive Videodiscs to Teach Gross Anatomy to Undergraduates at the Ohio State University". Academic Medicine. 67 (2): 132–3. doi:10.1097/00001888-199202000-00021. PMID 1546993.
  13. ^ D.J. Griffon, P. Cronin, B. Kirby, and D.F. Cottrell (2000). "Evaluation of a Hemostasis Model for Teaching Ovariohysterectomy in Veterinary Surgery". Veterinary Surgery. 29 (4): 309–16. doi:10.1053/jvet.2000.7541. PMID 10917280.CS1 maint: multiple names: authors list (link)
  14. ^ J. McLachlan, J. Bligh, P. Bradley, and J. Searle (2004). "Teaching anatomy without cadavers". Medical Education. 38 (4): 418–424. doi:10.1046/j.1365-2923.2004.01795.x. PMID 15025643.CS1 maint: multiple names: authors list (link)
  15. ^ Christine Laura Theoret, Éric-Norman Carmel, and Sonia Bernier (2007). "Why Dissection Videos Should Not Replace Cadaver Prosections in the Gross Veterinary Anatomy Curriculum: Results from a Comparative Study". Journal of Veterinary Medical Education. 34 (2): 151–6. doi:10.3138/jvme.34.2.151. PMID 17446641.CS1 maint: multiple names: authors list (link)
  16. ^ S.A. Azer and N. Eizenberg (2007). "Do We Need Dissection in an Integrated Problem-Based Learning Medical Course? Perceptions of First- and Second-Year Students". Surgical and Radiologic Anatomy. 29 (2): 173–80. doi:10.1007/s00276-007-0180-x. PMID 17318286.
  17. ^ J.L. Perry, and D.P. Kuehn (2006). "Using Cadavers for Teaching Anatomy of the Speech and Hearing Mechanisms". The ASHA Leader. 11 (12): 14–28. doi:10.1044/leader.FTR6.11122006.14.
  18. ^ M.E. Gordinier, C.C. Granai, N.D. Jackson (1995). "The Effects of a Course in Cadaver Dissection on Resident Knowledge of Pelvic Anatomy: An Experimental Study". Obstetrics and Gynecology. 86 (1): 137–9. doi:10.1016/0029-7844(95)00076-4. PMID 7784009.CS1 maint: multiple names: authors list (link)
  19. ^ G.R. Bernard (1972). "Prosection Demonstrations as Substitutes for the Conventional Human Gross Anatomy Laboratory". Journal of Medical Education. 47 (9): 724–8. doi:10.1097/00001888-197209000-00007. PMID 5057480.
  20. ^ Karl K. White, Lynn G. Wheaton, and Stephen A. Greene (1992). "Curriculum Change Related to Live Animal Use: A Four-Year Surgical Curriculum". Journal of Veterinary Medical Education. 19.CS1 maint: multiple names: authors list (link)
  21. ^ N.A. Jones, R.P. Olafson, and J. Sutin (1978). "Evaluation of a Gross Anatomy Program Without Dissection". Journal of Medical Education. 53 (3): 198–205. doi:10.1097/00001888-197803000-00005. PMID 344885.CS1 maint: multiple names: authors list (link)
  22. ^ Justin Alexander (1970). "Dissection Versus Prosection in the Teaching of Anatomy". Journal of Medical Education. 45 (8): 600–6. doi:10.1097/00001888-197008000-00007. PMID 5433736.
  23. ^ Lisa M. Parker (2002). "What's Wrong With the Dead Body? Use of the Human Cadaver in Medical Education". Medical Journal of Australia. 176 (2): 74–6. doi:10.5694/j.1326-5377.2002.tb04290.x. PMID 11936290.
  24. ^ J.T. Soley and B. Kramer (2001). "Student Perceptions of Problem Topics/Concepts in a Traditional Veterinary Anatomy Course". Journal of the South African Veterinary Association. 72 (3): 150–7. doi:10.4102/jsava.v72i3.639. PMID 11811703.
  25. ^ Martin A. Cake (2006). "Deep Dissection: Motivating Students beyond Rote Learning in Veterinary Anatomy". Journal of Veterinary Medical Education. 33.
  26. ^ Jon Rosenson, Jeffrey A. Tabas, and Pat Patterson (2004). "Teaching Invasive Procedures to Medical Students". Journal of the American Medical Association. 291.CS1 maint: multiple names: authors list (link)
  27. ^ Gary J. Patronek and Annette Rauch (2007). "Systematic Review of Comparative Studies Examining Alternatives to the Harmful Use of Animals in Biomedical Education". Journal of the American Veterinary Medical Association. 230 (1): 37–43. doi:10.2460/javma.230.1.37. PMID 17199490.