Prosection

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

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] 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.^[7] Other alternatives such as instructional videos, plastic models, and printed materials also exist. Some studies find them equally effective as dissection or prosections,^[8] and some schools of human medicine in the United States have abandoned the use of cadavers entirely.^[9] 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.^[10] Some scholars and teachers go so far as to argue that cadavers and prosections are irreplaceable in the teaching of medicine.^[11]

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.^[12] 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.^[13]

But 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 not yet well-enough understood, and that existing studies are too narrow or limited to draw conclusions.^[14]

References

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. Clinically Oriented Anatomy. Philadelphia, Pa.: Lippincott Williams & Wilkins, 2006. ISBN 0-7817-3639-0
4. Debra Berube, Christine Murray, and Kathleen Schultze. "Cadaver and Computer Use in the Teaching of Gross Anatomy in Physical Therapy Education." Journal of Physical Therapy Education. Fall 1999.
5. Siri Martinsen and Nick Jukes. "Towards a Humane Veterinary Education." Journal of Veterinary Medical Education. 32:4 (Winter 2005).
6. Norman Gustavson. "The Effect of Human Dissection on First-Year Students and Implications for the Doctor-Patient Relationship." Journal of Medical Education. 63:1 (January 1988); J.A. Provo and C.H. Lamar. "Prosection as an Approach to Student-centered Learning in Veterinary Gross Anatomy." Journal of the American Veterinary Medical Association. 206:2 (January 15, 1995).
7. Othman Mansor. "Use of Plastinated Specimen in a Medical School With a Fully Integrated Curriculum." Journal of the International Society for Plastination. 11:1 (1996); 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. "How Useful Is Plastination in Learning Anatomy?" Journal of Veterinary Medical Education. 34:2 (Spring 2007); Ann T. Stotter, A.J. Becket, J.P.R. Hansen, I. Capperauld, H.A.F. Dudley. "Simulation in Surgical Training Using Freeze Dried Material." British Journal of Surgery. 73:1 (January 1986); C.L. Greenfield, A.L. Johnson, C.W. Smith, S.M. Marretta, J.A. Farmer, and L. Klippert. "Integrating Alternative Models into the Existing Surgical Curriculum." Journal of Veterinary Medical Education. 21:1 (Spring 1994).
8. J.F. Guy and A.J. Frisby. "Using Interactive Videodiscs to Teach Gross Anatomy to Undergraduates at the Ohio State University." Academic Medicine. 67:2 (February 1992); D.J. Griffon, P. Cronin, B. Kirby, and D.F. Cottrell. "Evaluation of a Hemostasis Model for Teaching Ovariohysterectomy in Veterinary Surgery." Veterinary Surgery. 29:4 (2000).
9. J. McLachlan, J. Bligh, P. Bradley, and J. Searle "Teaching Anatomy Without Cadavers." Medical Education. 38 (2004).
10. Christine Laura Theoret, Éric-Norman Carmel, and Sonia Bernier. "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 (Spring 2007); S.A. Azer and N. Eizenberg. "Do We Need Dissection in an Integrated Problem-Based Learning Medical Course? Perceptions of First- and Second-Year Students." Surgical Radiologic Anatomy. 29:2 (March 2007); J.L. Perry, and D.P. Kuehn. "Using Cadavers for Teaching Anatomy of the Speech and Hearing Mechanisms." The ASHA Leader. 11:10 (September 5, 2006).
11. M.E. Gordinier, C.C. Granai, N.D. Jackson, et al. "The Effects of a Course in Cadaver Dissection on Resident Knowledge of Pelvic Anatomy: An Experimental Study." Obstetrics and Gynecology. 86:1 (1995).
12. G.R. Bernard. "Prosection Demonstrations as Substitutes for the Conventional Human Gross Anatomy Laboratory." Journal of Medical Education. 47:9 (September 1972); Karl K. White, Lynn G. Wheaton, and Stephen A. Greene. "Curriculum Change Related to Live Animal Use: A Four-Year Surgical Curriculum." Journal of Veterinary Medical Education. 19:1 (Winter 1992); N.A. Jones, R.P. Olafson, and J. Sutin. "Evaluation of a Gross Anatomy Program Without Dissection." Journal of Medical Education. 53:3 (March 1978); Justin Alexander. "Dissection Versus Prosection in the Teaching of Anatomy." Journal of Medical Education. 45:8 (August 1970).
13. Lisa M. Parker. "What's Wrong With the Dead Body? Use of the Human Cadaver in Medical Education." Medical Journal of Australia. 176:2 (2002).
14. J.T. Soley and B. Kramer. "Student Perceptions of Problem Topics/Concepts in a Traditional Veterinary Anatomy Course." Journal of the South African Veterinary Association. 72:3 (September 2001); Martin A. Cake. "Deep Dissection: Motivating Students beyond Rote Learning in Veterinary Anatomy." Journal of Veterinary Medical Education. 33:2 (Summer 2006); Jon Rosenson, Jeffrey A. Tabas, and Pat Patterson. "Teaching Invasive Procedures to Medical Students." Journal of the American Medical Association. 291:1 (January 7, 2004); Gary J. Patronek and Annette Rauch. "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 (January 1, 2007).