Teaching procedural skills to medical students using unembalmed cadavers

Abstract

The Clinical Skills Immersion Experience (CSIE) is a required part of the third‐year medical school curriculum at The Ohio State University and teaches procedural skills through a series of authentic, hands‐on exercises. Of the 20 procedures taught in the program, five are performed on unembalmed cadavers in the anatomy morgue. Here we focus on how to prepare cadavers to train students in three procedures involving aspiration of fluid from body cavities. For thoracentesis, a cadaver is placed in a sitting position and fluid (1% phenoxyethanol tinted with food coloring) is injected into both pleural cavities. For pericardiocentesis, the pericardial cavity is accessed by reflecting skin, superficial fascia, pectoralis major and minor muscles, and removing a small section of the anterior chest wall. The pericardial sac is opened and a rubber balloon filled with 300 ml of phenoxyethanol fluid is inserted between the diaphragm and the heart. The balloon has been sealed by dipping in wax to allow repeated needle punctures. The abdominal cavity of the cadaver prepared for paracentesis is first expanded by insufflation as if for laparoscopic surgery. The expanded abdomen is then filled with 4‐5 liters of phenoxyethanol fluid. Students rate the training exercises using cadaver models among the highest of all procedures and comment frequently on the realism of the experience.