Abstract:

Even after 43 years of anatomy teaching I continue to be deeply moved whenever I view a cadaver or hold a heart or brain in my hand. New teaching methodologies are increasingly using virtual world teaching, interactive models, educational games and Avatars. Through this wave of virtual reality education are important affective domain learning outcomes at risk?

During the mid to late 1900s, Bloom and his colleagues recognised that learning could be divided into three categories or domains; cognitive (knowledge), affective (attitude) and psychomotor (skills). The highest level of affective domain learning outcomes involve the “development in one’s personal and civic life a code of behaviour based on ethical principles consistent with democratic ideals” (1). Domains of professionalism in relation to medical practice include ethical practice, reflection/self-awareness, responsibility for actions, respect for patients, teamwork and social responsibility (2).

So, what is the impact of studying anatomy through dissection? In answering this question, most anatomists and students will talk about the value in learning anatomy and of understanding function. While this is true, I believe it goes far beyond this simplistic view. Studying the human body or cadaver can be an emotional experience, sharing the grief of the family following the death of the person they loved as well as a source of wonder at the beauty and perfection of the human body. We are reminded of how much we take life for granted as we go about our day to day activities. In other words, it puts life into perspective. Medical training all too often remains grounded in the biomedical model, with the cognitive domain overshadowing the psychosocial development and needs of learners (3).

Some of the unique aspects of cadaveric dissection include the realistic nature of this teaching medium that allows students to grasp a clear visuo-spatial picture of the organization of human body, experience the texture of human tissues, witness and comprehend pathological conditions while learning the normal and compare the normal vs pathological (4). Student views range from “enhances my respect for the human body” to “makes learning of anatomy more interesting”. Our results suggest that the more thorough, enduring and contextual learning experience provided by cadaveric dissections are better appreciated in clinical workplaces where the knowledge could be applied to clinical situations.

This paper presents an overview of current views regarding affective domain learning outcomes and anatomy teaching methodologies. It highlights the likely importance of the use of human body parts and of dissection in the development of various domains of professionalism in relation to medical practice. As educators should we be more mindful of what learning outcomes might be threatened through replacing reality with virtual reality?

References:
[1] Krathwohl, et al 1966 Taxonomy of Educational Objectives: The Classification of Educational Goals. Handbook II: Affective Domain. Longmans, London.
[2] Slotnick, HB and Hilton, SR 2006 Proto-professionalism and the dissecting laboratory. Clinical Anatomy 19:429-436.
[3] McLean, M and Gibbs, TJ 2009 Learner-centred medical education: Improved learning or increased stress? Educ for Hth:22(3).
[4] Dissabandara L, et al 2015 Role of cadaveric dissections in modern medical curricula: A study on student perceptions. Anat and Cell Biol;48(3):205-212.

Keywords:

Virtual reality, affective domain, learning outcomes, medicine, anatomy.