Statewide, UAMS shares its cadavers

— Medical students have studied anatomy using cadavers for ages, but some other health-care students in the state have begun doing the same in recent years thanks to Arkansans who donate their bodies to science and the state’s medical school.

The Anatomical Gift Program at the University of Arkansas for Medical Sciences shares donated bodies, when it has enough, with three instate universities offering studies such as pre-medicine and physical therapy, said the program’s director, Bruce Newton.

Tim Wakefield, a professor of biological science at John Brown University in Siloam Springs, said roughly 25 undergraduates in such majors as biology, chemistry, biochemistry and sports medicine benefit from cadaver laboratories each fall.

Other teaching tools such as textbook diagrams and physical models are no comparison with real tissue, said Wakefield, who taught anatomy and physiology at other schools without cadavers.

“All the anatomical structures always look perfect because it’s a model and it never changes,” he said, whereas the cadavers show students the variations and imperfections of real organs, muscles and other tissues.

“This may not look exactly like what you’ve pictured in your head, or in this book or on this model,” Wakefield said, adding that most models depict a person in “peak condition,” rather than, say, an elderly person who has lived in a wheelchair or someone who led a sedentary lifestyle.

Kevin Garrison, an associate professor in the physical therapy department at the University of Central Arkansas in Conway, agreed.

For graduate-level UCA students studying physical therapy and occupational therapy, even the most cutting-edge 3-D computer models can’t compare with a real body, he said.

“I’m a bit of a traditionalist and feel like you can’t replace hands-on, kinesthetic learning,” Garrison said.

Dissecting bodies allows students to see 3-D relationships between organs, what’s above and below, and how deep structures are, he said.

“And for us, because we’re not surgeons, your hands are your scalpels,” Garrison said.

Under Garrison, future therapists learn to use their fingers to palpate muscles, tendons and nerves as part of their patient assessments and master massage techniques.

“Our students do the full dissection. We do the complete systems, head to toe,” he said.

This helps students prepare for the day they’ll have to treat a postoperative patient and helps them visualize the “normal variation” of size and placement of muscle tissue, Garrison said. People are sometimes missing a muscle, have a split muscle, or have a muscle that attaches in a different place than where the textbook says it should, he said.

The students also see for themselves that arteries “tend to follow a textbook style” more than veins, he said.

‘TACTILE LEARNERS’

Each fall, roughly 100 of UCA’s physical therapy and occupational therapy students benefit in a comprehensive way from cadaver studies. Another 50-60 students studying undergraduate kinesiology and graduate-level communication disorders - a program formerly known as speech therapy/speech pathology - get some time with them as well.

At Arkansas State University in Jonesboro, 30 graduate students a year in its physical-therapy department work with the UAMS cadavers, said associate professor Shawn Drake.

As the graduate students dissect them in the fall, the coursework of roughly 100 undergraduate students in the gross anatomy class is coordinated so they can observe the cadavers soon after dissection and throughout the spring semester, she said.Others who observe them include roughly 60 nursing students a year, who spend one day per semester in the lab, and occasionally area high-school students.

Some students remember lessons much better by doing and observing than by textbook memorization, Drake said.

“Some students are tactile learners,” she said.

CONSIDERING DONATION

Someone considering tissue donation must first consider whether to donate organs for transplant or the entire body, because a person can’t do both, Newton said.

“We need a complete cadaver, except for the eyes,” he said. “We encourage people to do a donor eye donation.”

On its website, www.uams.edu, UAMS has a frequently-asked-questions page about the program on which it outlines three methods to donate.

The first method, which UAMS prefers, is one in which the donor applies directly to UAMS for enrollment in the program by mailing a written request or calling the program’s Little Rock office. Newton said prospective donors can also drop by.

“Your enrollment relieves the next of kin of the burden of making a decision under the handicap of grief,” the website says, protecting both survivors and UAMS’ anatomical division within its neurobiology and developmental sciences department.

A second method is including one’s wishes in a last will and testament, preferably prepared by an attorney and communicated to relatives in advance. The third method is by putting the request on one’s driver’s license.

A donor body also must meet certain health criteria, so that the educational value of the body is high and medical students and teaching physicians are protected from infectious diseases, Newton said.

“If you, for example, have hepatitis, tuberculosis or HIV/AIDS, we would not accept the body for donation,” he said.

Bodies with localized cancers can be used, but widespread cancer would compromise the organs, as would any major trauma the person had suffered, such as that from a car accident.

In December, the program had 30 inquiries and 13 new people registered, Newton said.

He predicted that the need for donors will grow with the need for more doctors and health professionals.

CONFIDENTIALITY MAINTAINED

UAMS has used cadavers for teaching as long as anyone can remember, Newton said, as have other medical schools around the country. Act 436 of 1989 apparently amended earlier versions of the Anatomical Gift Act law.

“It goes into some detail about who can deny a donation,” he said. “I don’t think that happens very often.”

He suggested that making one’s wishes known in several ways - enrolling with UAMS, discussing one’s plans with relatives, putting one’s request to donate in a will and having the information on the driver’s license - might be the best way to ensure such wishes are carried out.

UAMS offers donors confidentiality when they donate their body to science, Newton said. Those working with the bodies never know the person’s identity or even age. No photography or visitors are allowed in the labs.

“We have the utmost respect for the willed body,” he said.

JBU’s Wakefield said his undergraduate students frequently have an advantage over their peers when they go on to medical school or other medically related graduate school studies where cadavers have been commonplace for many years.

“I’ve had former students e-mail me and say, ‘I’m the only student here who’s ever worked with a cadaver,’” he said of the now first-year medical students studying gross anatomy. “They often become the leaders of their group.

“They have seen these structures before. They’ve manipulated them before. They’ve dissected them before,” Wakefield added.

Arkansas, Pages 7 on 01/07/2013

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