Developing essential anatomical competencies in an osteopathic medical curriculum without cadaver dissection

Abstract

The benefits of not scheduling cadaver dissection into first year medical curricula are clear: numerous hours otherwise spent in the gross lab become available for distribution among the many other areas which curriculum designers increasingly find themselves pressured to include intoever more intense, challenging courses of study. However, the risks of eliminating cadaver dissection include depriving students of a major medium for tactile training and the development of manual skills honed by dissection. Perhaps even more significantly, eliminating cadaver dissection poses a greater challenge to students’ acquisition of a working knowledge of human gross anatomy and obtaining a competent understanding of structural organization necessary for patient examination and interpreting diagnostic imaging studies – crucial to many aspects of competent medical practice. Burrell College of Osteopathic Medicine's integrated first year curriculum, being developed for the arrival of its inaugural class in August 2016, excludes cadaver dissection by training students to examine anatomical structure first through 2‐D and 3‐D cadaver dissection image examination using virtual systems such as the Anatomedia Online and Anatomage platforms, followed closely by examination of diagnostic images, skeletal models, and model patient examination. In the Osteopathic Manipulative Medicine(OMM) lab, using imaging studies as their roadmap, students will obtain crucial tactile skills and anatomical knowledge, with the advantage of palpating tissues, anatomical features and landmarks on living tissue of model patients rather than non‐compliant cadaveric tissue. Cognitive correlations to multiple imaging modalities are incorporated into the curriculum from day one to ensure immediate student exposure to reading patient x‐ray, ultrasound, CT, MRI, and other images. The spiral design of BCOM’ sorgan system based curriculum facilitates content review while further building upon these skills throughout the first year. In the second year, anatomical imaging integrated into pathology presentations will continue to expand and refine expertise in these areas. The objective is to train a physician with a solid understanding patient anatomy for the purposes of physical exam as well as OMM, and competent in utilizing diagnostic imaging technologies dependent upon anatomical knowledge early in pre‐clinical education.