Posted by: barn owl | December 8, 2008

Teaching Tuesday: Theatrum Anatomicum

ResearchBlogging.org
No, it’s not a bar on Bourbon Street, but rather a novel medical teaching facility at Ulm University in Germany. Recent legislation on study fees in Germany has provided funding for the development of improved medical education facilities. For the faculty in the Institute of Anatomy and Cell Biology at Ulm University, this opened up an opportunity to incorporate basic instruction in surgical invasive procedures into the gross anatomy course, and to include clinician colleagues as role models for the students.

The widespread incorporation of active dissection of human cadavers in gross anatomy courses, at most American and many European medical schools, became possible because of modern willed body programs. Prior to the twentieth century, cadavers were obtained following executions, or through illegal means, and medical students merely observed passively while a professor, or a barber-surgeon in some cases, performed the dissection. In the last decade, the importance of active dissection in gross anatomy instruction has been questioned, as the learning experience and approaches vary greatly within a class of medical students (Winkelmann et al., 2007). However, several studies indicate that active dissection is the most efficient method to achieve learning objectives in gross anatomy courses, and thus the designers of the Theatrum anatomicum sought to combine classical cadaveric dissection with clinically relevant instruction.

Boeckers and colleagues (2008 ) describe the Theatrum anatomicum as mimicking a clinical setting for “operations” and “procedures” on cadavers, which is juxtaposed with a dissection room and multiple monitors to display close-ups of the area of interest. A gently inclining grandstand, which can accommodate 50-60 students, is positioned near the mobile operating table. There is also an adjacent scrub room, so that students can learn how to “scrub in” properly for a surgical procedure. The educators envision an anatomy course in this setting that allows integration of surgical techniques and invasive procedures into a basic sciences context. Several clinical departments at Ulm University, including Orthopedics, Neurosurgery, ENT, and Anesthesiology, have agreed to demonstrate procedures to preclinical medical students, using the new Theatrum anatomicum.

As a gross anatomy instructor, I find this idea quite attractive. Clinical faculty join us in dissection lab to demonstrate procedures on cadavers, and a dedicated facility for such training sessions would be more efficient and instructive. Boecker and colleagues propose that the opportunities to assist in surgical procedures on cadaver “patients” will provide motivation for students, and that the hands-on skills practice will increase confidence and professionalism, prior to clinical rotations. To date, they have conducted a few postgraduate training sessions and anatomical demonstrations in the Theatrum anatomicum, and student responses have been quite favorable.

References:

Winkelmann A, Hendrix S, and Kiessling C (2007) What do students actually do during a dissection course? First steps towards understanding a complex learning experience. Acad. Med. 82, 989-995.

A BOECKERS, U FASSNACHT, T BOECKERS (2008). “Theatrum anatomicum” – A revived teaching facility in gross anatomy Annals of Anatomy – Anatomischer Anzeiger DOI: 10.1016/j.aanat.2008.08.004

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