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Prosection Or Dissection? 1 Prosection or Dissection? 1 Running head: Prosection or Dissection? Prosection or Dissection? A Comparative Study of Student Opinions on the Use of Cadavers in Community Colleges Darren C. Mattone HAPS-I In partial fulfillment of the requirements for Biol 505 Paul Krieger June 13, 2008 Prosection or Dissection? A Comparative Study of Student Opinions Prosection or Dissection? 2 on the Use of Cadavers in Community Colleges As the need for health care professionals increases, many community colleges and four-year colleges are instituting programs that will eventually fill the gaps in the health care field. To keep up with the current demand for workers in the burgeoning health care fields, many colleges are instituting new or modified programs to prepare students for future employment. Cadavers are often part of these programs. The majority of schools utilizing cadavers at the undergraduate level typically have allied health programs including mortuary science, chiropractic medicine (Conway, 1985) and/or nursing. Considering the fact that most allied health students only need an Associate’s degree to become qualified for employment, the concern is in the quality of the training they receive during their concentrated undergraduate education (Peterson, 1993). These students must reach an appropriate level of competency. One way to develop competency in anatomy is through the use of human cadavers. Why invest in a cadaver laboratory when many high quality models, books, and pieces of technology available for learning anatomy? While the aforementioned resources are beneficial for learning anatomy, cadavers (prosected or dissected) provide a 3-D perspective not found with books or electronic media (Aziz et al., 2002; Leung, Lu, & Tien-Shang, 2006; McLachlan, Bligh, Bradley, & Searle, 2004; Yeager, 1996). Cadavers also lead to an understanding of the spatial orientation of the body, lead to a better understanding of large organs (Parker, 2002), and may provide insight into the anatomical variation that exists between humans (Jones, Prosection or Dissection? 3 1997; Skidmore, 1995). Cadavers also act as a mechanism to reinforce and apply concepts learned from lectures (McLachlan et al., 2004). When implementing a cadaver-based lab curriculum into an existing program, colleges face many challenges including student involvement and mode of use (dissection v. prosection), time, space, class size, costs and issues of management. When deciding to add a cadaver component, it is also important for a college to recognize student views and attitudes toward this learning tool. Since there is little or no literature on these challenges or on undergraduate student perspectives, this paper addresses both of these issues Student involvement is one key topic that needs to be addressed when using cadavers. Will the students dissect the cadavers or will they observe cadavers that have been predissected (prosected)? This question is not unique to undergraduate schools; it is also being contemplated at the graduate level. Many medical schools have turned to the use of prosected specimens due a decrease in allotted time for anatomy courses (Winkelmann, 2007). A common concern of using prosected specimens is their value in learning. Research has shown that student learning from prosected specimens is just as effective, if not more effective, than traditional dissection (McLachlan et al, 2004; Parker, 2002). Sinclair (1965) illustrated that medical students learning anatomy through the use of prosected cadavers performed better on practical and subjective assessments than those learning through traditional dissection. Alexander (1970) showed that physical therapy students using prosected specimens showed no Prosection or Dissection? 4 significant difference in learning and recall from those learning through traditional dissection. Nnodim (1990), in a study similar to Sinclair’s, demonstrated that medical students learning the anatomy of the lower limb via prosection scored significantly better than those learning through traditional dissection. Further examination of these students revealed that learning with prosected cadavers helped them understand the material better than when they learned the upper limb through dissection. In addition, these students were able to complete their learning in about 74% of the time (Leung et al., 2006; Peterson, 1993). After five years retention rates of both groups showed no significant differences (Leung et al., 2006; Nnodim, Ohanaka, & Osuji, 1996). Use of prosected specimens may also reduce student anxiety, a recognized issue for students working with cadavers (Charlton & Smith, 2000; Conway, 1985; Penney, 1985; Skidmore, 1995; Winkelmann, 2007). When students dissect cadavers anxiety about the physical act of cutting may linger through the entire dissection experience (Penney, 1985). Another important issue to consider when implementing cadavers in a curriculum is class size. Consider the following scenario: A college intends for all its students to learn through dissection. It enrolls 240 students per year in its anatomy course. This would require the use of 30 cadavers, assuming a ratio of eight students to one cadaver. Space implications for housing 30 specimens and financial implications stemming from the annual turnover of the specimens become large limiting factors. On the other hand, this same college, for a much lower cost Prosection or Dissection? 5 and in an average sized space, could accommodate three to four prosected specimens. If organized properly, all 240 students could learn from those cadavers. Additionally, with the proper care, the prosected specimens can last several years before needing to be replaced. This paper describes a study conducted by the author on the views and attitudes of students relating to the use of cadavers in undergraduate anatomy and physiology courses and on student preferences for prosection or dissection. Data from this study may be used by schools when determining whether to implement cadavers and/or whether to require prosection or dissection procedures. This study will add to the existing body of research by presenting primary data from students that have worked with cadavers and from those that have not. It may also provide schools a starting point for developing their own survey instrument to answer questions not supplied by this study. This study addressed the following questions regarding the use of cadavers at the undergraduate level: (1) Are the views and attitudes between the schools similar? (2) Do students believe there is a benefit in using cadavers to learning anatomy? (3) Is there any indication by students towards a preference for prosection or dissection? Prosection or Dissection? 6 Methodology This mixed-method study was conducted at the end of the 2008 winter semester and involved students from two community colleges in the central region of western Michigan. Muskegon Community College, located in Muskegon, Michigan, has a total student population of 4,466 (U.S. Department of Education, 2008), and currently does not use cadavers in its anatomy and physiology courses. Grand Rapids Community College, located in Grand Rapids, Michigan, has a total student population of 15,224 (U.S. Department of Education, 2008), and currently has five prosected cadavers for use by their anatomy and physiology students (Krieger, 2008). Despite the difference in population size, both colleges have very similar demographics (Table 1). These similar demographics make these two schools valid subjects for comparison. Table 1: Demographic Information MCC GRCC Population 4,466 15,224 Full Time 40.9% 43.5% Part Time 59.1% 56.5% Female 56% 51.6% Male 44% 48.4% Full-Time Retention 62% 62% White non-Hispanic 84% 78% Black non-Hispanic 8% 10% Hispanic 3% 6% Asian/Pacific Islander 1% 2% American Indian 1% 1% Race/Ethnicity Unknown 3% 2% Non-resident alien 0% 1% Prosection or Dissection? 7 Muskegon Community College offers two one-semester anatomy and physiology courses. The first semester course (Biology 105) is a general overview of human anatomy. The second semester course (Biology 106) includes anatomy but emphasizes detailed physiology of the various organ systems and cellular metabolism. (Biology 105 is a prerequisite for Biology 106.) The entire human body is taught over two semesters, but this course sequence is not a conventional two- semester course (Muskegon Community College, 2008). Grand Rapids Community College offers a traditional two-semester course sequence, Biology 121 and Biology 122, each covering approximately one half of the body systems per semester (Grand Rapids Community College, 2008). Muskegon Community College offered three sections of each course in the Winter 2008 semester; approximately 140 and 160 students were enrolled, respectively (Muskegon Community College, 2008). The students sampled for this study were drawn from two of the daytime sections of Biology 106. Students in Biology 105 were not asked to participate in this survey. Grand Rapids Community College offered seven sections of Biology 121 and eight sections of Biology 122 during the Winter 2008 semester (Grand Rapids Community College, 2008). Total enrollment in these courses was 252 and 288 students, respectively. The students from Grand Rapids Community College that participated in this study were drawn from one section of Biology 121 and two sections of Biology 122 (Krieger, 2008). Prosection or Dissection? 8 Students were asked to rate various statements about their anatomy and physiology
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