William Brooks is the director of the Gross Anatomy Lab and Surgical Anatomy Lab.Medical students have traditionally taken an in-depth anatomy course during their first semester of medical school. The experience of dissecting a cadaver and memorizing long lists of anatomic structures has been a rite of passage into the field of medicine for generations.

But in recent years, as medicine—and medical education—has become more team-based and interdisciplinary, medical schools across the country are bringing anatomy training out of its silo and integrating it with other areas of study. At the same time, new technologies offer innovative ways to teach anatomy and encourage teamwork among students. With grant funding to update lab space and a new approach to the curriculum, UAB’s anatomy program is making some big changes.

New Learning Model

The traditional semester of in-depth anatomy training has always given medical students a strong foundation. However, it was often hard to retain that knowledge throughout the remaining years of medical school. “The limitation of teaching anatomy as a standalone course, in which students dissect a cadaver from beginning to end, was that most students never revisited the anatomy lab again,” says Craig Hoesley, M.D., senior associate dean for medical education and chair of the Department of Medical Education.

For example, Hoesley says he took anatomy during the first half of his first year of medical school. Although he had an excellent professor and learned the material, he says he didn’t remember much of his earlier anatomy training by the time he started surgery rotations in his third year. To avoid that, UAB now teaches anatomy in sections to correspond with other learning modules. “When students study respiratory health, they dissect the chest cavity. When they study reproductive health, they dissect the pelvic area,” Hoesley says.

UAB’s new anatomy training format is in step with many medical schools across the country. “Curricular time dedicated to anatomy instruction has gradually declined over the past 30 years at the national level,” says William Brooks, Ph.D., associate professor in the Department of Cell, Developmental and Integrative Biology and director of the Gross Anatomy Lab and Surgical Anatomy Lab. “At the same time, many medical schools including UAB have integrated anatomy with other disciplines into organ system-based curricula. With these changes, anatomy as a discipline has merged with physiology, histology, and pathology.”

While students still memorize lists of anatomic structures, their instruction now focuses more heavily on how anatomy fits into a systematic approach to the diagnosis and treatment of disease, Brooks says.

Next-Generation Tools

As health care has become more high-tech, so too has a typical anatomy lab. Last year, Brooks submitted a grant to the UAB Health Services Foundation and received $80,000 to equip the anatomy lab with eight large-screen TVs and instructor iPads, which allow faculty to use a variety of digital resources during anatomy labs.

“This makes it more of a teaching lab and not just a dissection space,” Hoesley says. Brooks notes that the instructor can now project live cadaveric dissections for the entire class to see, which enables him or her to point out interesting pathologies or anatomical variations.

The grant money is also funding a set of plastinated anatomical specimens, which will teach students how to dissect anatomic regions that are often more difficult. (Plastination is a technique to preserve bodies or body parts in which the water and fat are replaced by plastics, resulting in specimens that retain properties of the original sample but do not decay.)

Medical students are not the only ones who use UAB’s Anatomy Lab; the School of Dentistry and other health professions programs also use the space. And team-based learning has become the new normal in anatomy instruction. “This allows students to put anatomy into clinical practice and work together to solve problems, thereby developing their teamwork skills,” says Brooks.

For instance, students work through clinical scenarios during a team-based lesson. They decide when to order certain tests and radiographs and how to interpret radiographs, make diagnoses, and choose surgical approaches. “They literally get to apply anatomy to clinical practice,” Brooks says. “Through this, students develop a deeper knowledge of anatomy and see why it is relevant for their work as a physician.”

Broadening the Scope

Critics of the new approach to anatomy training say medical schools aren’t doing as much dissection as they used to, Hoesley says. “However, about 90 percent of the human body is dissected during the first two years of medical school,” he notes. “And in the last two years, students can come back and do additional dissections that fit into their medical focus.”

Each year at UAB, first-year medical students learn about and dissect the chest and abdomen during the Fundamentals of Medicine, Cardiovascular, Pulmonary, Gastrointestinal, and Renal modules, Brooks says. Second-year students learn about and dissect the head, neck, pelvis, and limbs during the Neurosciences, Musculoskeletal and Skin, and Reproduction modules.

“Anatomy of each organ system is taught through lectures, team-based learning activities, and cadaveric dissections during each organ system module,” Brooks says. “In conjunction with anatomy, radiology and hands-on ultrasound are taught during the preclinical years. All students take part in learning to perform ultrasound of the heart, gall bladder, FAST (focused assessment with sonography for trauma) exam, knee, and wrist.”

Options for studying anatomy continue to expand. The lab has partnered with the Department of Genetics to give students a unique experience that will integrate anatomy with medical genetics. Next year, the lab plans to perform whole genome sequencing of cadavers, allowing students to analyze the genetic data of their cadaver and correlate genetic disease risk factors with the anatomical variations they may encounter during dissection, Brooks says.

Although the fundamentals of anatomy haven’t changed, health care approaches are continually evolving, and medical education must keep pace in order to properly prepare students for their future careers. Moreover, as the way students are accustomed to learning changes, the methods of teaching anatomy must keep pace. “Changes to the way anatomy is taught keep anatomy current and in line with modern practice of medicine,” Brooks says. “These changes also conform to the learning styles of the millennial generation, who prefer and perform better with hands-on, experiential, team-based learning.”

By Nancy Mann Jackson