Documenting Donor Anatomical Variation and Pathology in the Anatomy Lab

Abstract

Anatomy donors are health professions students’ first patients and once‐in‐a‐lifetime teachers. Several institutions have introduced “first patient” humanistic exercises to connect human anatomy with clinical observation skills and for student reflection, including providing deidentified medical history of the donor to the students. For the past several years at the University of Missouri, students have been given personal and medical history provided by the donor at the time of enrollment. However, during the course of dissection, students frequently found anatomical variations and medical pathologies not previously documented by the donor to the program. These medical history discrepancies are partially due to the donor population of the University of Missouri Gift of Body Program, where some donors enroll as early as decades before death. To focus student attention on normal anatomical variation and the donor as a first patient with life history, a donor findings sheet was introduced in the summer of 2019 for a physical therapy anatomy course. On the first day of lab, students were introduced to their donors and were asked to observe and record visible markings, scars, and medical devices, and reason about equipment or procedures. The students briefly discussed the implications of their findings on the daily lives of their donors. Throughout the course, students continued to record anatomical variations, medical devices, and surgical procedures. After each of four units, students rotated anatomy laboratory tables to work with new donors and different classmates. A hand‐off from one table of students to the next was facilitated by the donor findings sheet. When comparing the donor findings sheet with the provided donor medical history, students recorded additional surface anatomy, anatomical variations or medical procedures that had not been reported in donor medical histories for thirteen of the sixteen donors (81%). Medical pathologies and procedures were documented more than anatomical variations. Pacemakers, hysterectomies, mastectomies, and spine conditions were most frequently recorded. Of the three donors with no previous medical history, students recorded medical conditions, surgeries or anatomical variations for two of the three donors. The documentation and discussion of the donor findings help students to see all patients as teachers, encourage exploration of human variation, practice documenting, and apply clinical observation and reasoning skills. Future analyses will incorporate student feedback of their perception of humanism in the anatomy lab, and their role in the documentation of variation and pathology in their donors.Support or Funding InformationNA