A Layered Approach to Teaching Breathing in Dissection Lab

Abstract

Introduction A search on the word “breathing” yields over 940 million Google results (2021). Nestor's Breath (2020) has garnered mainstream attention and curiosity. We propose that breathing (via intubation) in a layered fresh tissue dissection can create a more three dimensional understanding of breath when linked to experientials in a movement-based anatomy lab. Literature continues to look at the importance of dissection in tactile learning (Granger 2004). Topp (2014), noted a concern in medically oriented labs in that, “pattern and form are not immediately apparent...” Others have commented that the combination of movement and dissection lab helps to reinforce understanding and retention of concepts in medical school students (Vertel et al., 2020). Methods Review of current dissectors included Gray's Clinical Photographic Dissector (Loukas et al., 2018), Netter (2018) Thiele, Stecco (2015) as well as anatomical models, such as those created through plastination. In addition, the authors’ expertise in dissection and movement was the basis for a 2020 dissection with a group of yoga therapists and related movement and medical professionals. Steps for fresh tissue dissection: 1) tracheotomy was performed, tubing inserted, and lungs inflated with body in first preparation with pectoralis major, pectoralis minor and serratus anterior muscles reflected from the midline to lateral 2) ribs were clipped laterally and reflected from the level of clavicles. Lung inflation shown with the pericardial sac and relationship to ribcage and lungs 3) dissection continued in stages to highlight relationship with the diaphragm 4) discussion continued in breathing lab utilizing various props to demonstrate the role of the diaphragm in breathing, and yoga concepts to represent the movement of air into and out of the system. Reinforcing the idea of breath as shape-change in the cavities was emphasized, with the distinction of shape and volume change in the thoracic cavity, and shape but not volume change in the abdominal cavity (Kaminoff, Matthews, 2007). Results Relational movement was demonstrated at every level of dissection, from the lungs inflated pre-rib cutting, to lungs in situ with muscles and ribs reflected to highlight the relationship of the lungs, diaphragm and pericardium. The combination of a layered cadaver dissection of lung inflation with the addition of breath applications through movement lab was found to have a high rate of participant satisfaction in being able to more fully visualize human breathing. Video footage of both was documented for educational purposes. Typical survey reports included comments such as: “the demonstration changed my ideas about breathing. I can now visualize the connections in a way that book learning alone never accomplished.” Conclusion/Significance Creating a demonstration of breathing in situ at different levels of dissection puts this important function of human life in context for students of all levels, and effective learning of breath can be enhanced through applications like yoga breathing. Student learning in dissection lab, whether in person or virtually requires application to the living body. Context matters. Future investigations could test learning outcomes from the video footage (both dissection and movement labs) in this approach in repeated settings.