The human body is a complex, unique structure consisting of 206 bones, enough veins and arteries to travel the circumference of the Earth two and a half times, a digestive tract as long as 20-30 feet in length, the brain contains approximately 100 billion neurons which interact with a nervous system that connects the entire body, in addition to a vast array of organ systems and functions that we are still discovering. Therefore, medical professionals seek an in depth, extensive, and progressive understanding of this intricacy and uniqueness. Fresh-frozen cadavers offer a unique opportunity to examine the human anatomy and physiology in a state which is very close to a living organism making them invaluable to medical students, doctors, and researchers alike. They provide an opportunity for these medical professionals to become more skilled and knowledgeable, which, in turn, reduces patient injury and risk. They also provide a wide range of variety which mirrors the unique anatomy of real life patients. In addition, the use of cadavers contributes to the advancement of medicine including medical procedures and technologies.
The Foundation of Building Skill and Knowledge
The health of patients is of primary importance to medical professionals; therefore, the more skilled doctors are the fewer mistakes there will be. Considering the billions of dollars spent annually on medical malpractice lawsuits and insurance, the advanced skill and insight of medical professionals not only benefits patients but also those in the healthcare profession. When health professionals are first taught, and trained to perform medical and dental procedures on fresh-frozen cadavers the learning curve is expedited, allowing these professionals to experience the medical procedure in a very real world context without the risks to the patient. This real-world experience will make them more skilled when performing the actual procedure, resulting in better outcomes for the patients.
Various educational technologies have been developed to explain the anatomy and physiology of humans to avoid the costs and limited access to cadavers, however, consistently, educators and students have found the use of cadavers irreplaceable. One study found that “cadaver-based learners” could identify parts of the human body at a rate 16% higher than multi-media based learners, in addition, they were able to explain the anatomy with a rate of 11% more accuracy than the media-based learners. This provides quantitative evidence of the effectiveness of hands-on-learning.
Although, there are benefits in utilizing technology, when it comes to training healthcare professionals for the real world the “gold standard” is the closest thing to a live specimen, which are fresh-frozen cadavers. This was noted in a study performed by the National Institute of Health, which “described cadaver models as ‘the gold standard for technical skills training’.” Adding:
Body donors become the first patients for doctors making the opportunity to work on fresh-frozen cadavers an invaluable “foundation of every treatment and diagnosis the future physicians will render. A dead body can become a life-saving tool down the road.” (National Geographic)
Neal Rubinstein, associate professor of cell developmental biology at Perelman School of Medicine at the University of Pennsylvania, noted the importance of the use of cadavers in providing a “three-dimensional picture of the body” for students, saying: “What we’re really trying to do is teach them what’s under the skin. Most physicians don’t cut into a body when they’re practicing medicine, but they have to know what’s underneath if they stick a needle here or there. Almost every physician needs to have a good three-dimensional picture of the body in their head.”
Adding to this, Trudy Van Houten, director of Clinical Anatomy at Harvard Medical School, says when doctors examine patients, “it’s that mental map that guides their fingers. What dissection gives them is an idea of how deep things are. You can’t get that from a picture.”
Dr. Altamiro Flavio, having first-hand experience working on fresh-frozen cadavers at The MARC Institute, had to say this about his experience: “Some medical procedures should be first taught in cadavers in order to avoid future injuries in patients during a procedure. It protects the patients from injuries and doctors from medical errors. The cadaver is irreplaceable, even when students use an atlas book. Most atlas book are made of drawings, they don’t replace the reality of the cadaver. Books offer a 2D vision of the anatomy, and the cadavers offer a 3D vision and also many other learning opportunities. Training medical procedures in fresh frozen cadavers is something that can contribute for a fast-professional growing. After having procedures done in well preserved specimens they can be dissected to check the range and accuracy of your treatment. This is something impossible to do in patients.”
We Are All Different, Yet Similar
Another advantage of training on human specimens is that we are all different, containing slightly different anatomies and physiologies. While the general similarities can be taught in text books and with simulations, the uniqueness is difficult to convey through these techniques, which are unable to simulate the varying anatomy of the living human body like cadaver training can. Fresh-frozen cadavers provide a wide range of unique physiologies to learn from. In receiving this training, students are prepared for the surprises they will face in the real world, as well as, build an appreciation for the uniqueness of everyone.
For example, one cadaver’s brain can demonstrate how it had forced its way into connective tissue in the skull after a massive stroke had killed the person. Another cadaver shows a tumor that had spread from the mouth up through the eye and into the brain. (National Geographic)
As a professor in the Department of Organismal Biology and Anatomy at the University of Chicago, Callum Ross has an extensive understanding of this uniqueness, commenting on this, he said:
“You could pass a probe through a hole in the side of this person’s face all the way up into their brain. They had this cancer long enough that it had all scarred over on the outside. They’d been living like this. So the question came up, ‘In what circumstance would a person get into this situation? What was it like?’ You discover things when you dissect people that you can’t discover if it’s 25 bodies on a computer. You don’t find all this randomness, and you can’t ask these questions.” While some medical imaging programs have variation and pathology built in, Ross says it’s impossible to re-create the actual experience.
“The human body is still the best three-dimensional model we have,” Van Houten says. “It can look innovative to switch to virtual anatomy teaching, but you can be really innovative teaching in the gross anatomy lab.”
There are innumerable factors affecting the uniqueness of an individual from gender, health, environment, and genetics there is an endless list of possibilities, which is why it is so difficult to replicate this “randomness” in a textbook or simulation. In addition, the presentation of pathology within these unique environments can only be seen within cadavers. “Tumor formations, enlarged organs, or past surgical procedures” are not only observed with the student’s eyes, but they get a hands-on experience with these pathologies when cadavers are utilized.
Cadavers Are Crucial to Advancements
Training with cadavers contributes to the development of advanced techniques and approaches. Medical procedures, pharmaceuticals, and medical devices can all be tested and perfected on fresh-frozen cadavers, ensuring the safety of future patients who benefit from these advancements. After having procedures done in the specimens the professionals or students can dissect the anatomical specimen and check the range and accuracy of the treatment.
Cadavers “allow doctors to practice on patients who don’t feel pain. They help surgeons develop new procedures without risking lives. Dentists dissect their heads and torsos, and physical therapists study their musculoskeletal systems. Pharmaceutical companies test drugs on them, and automakers employ them as crash-test dummies. At the University of Tennessee's
Forensic Anthropology Center—nicknamed “the Body Farm”—CSI teams learn how corpses decompose over time.
But the majority of cadavers teach.”
In testing the biomechanical function of medical devices, cadavers can demonstrate how the device will perform in both healthy and diseased individuals. “For example, the pullout force of bone screws, which can be used for fixation of fractures and is subjected to high in vivo loads, and can be measured to determine its fixation strength. The bone screws are inserted in healthy or osteoporotic bone and the force to pull out the screw from the bone is measured using a mechanical test system. Other biomechanical examinations of a medical device can be conducted by loading the device under various conditions (i.e., cyclic, axial compression/tension, or torsional loading) based on the clinical application. One example of this is examination of the behavior of spinal motion preserving implants in human lumbar spine specimens loaded in flexion, extension, rotation, and lateral bending loads.”
NASA, too, has integrated the use of cadavers in the testing of its equipment to ensure the safety of its astronauts, stating:
“In limited cases, postmortem human subject tests may be performed when insufficient data are available from simulations that use dummies or from mathematical modeling of the human body responses. This is particularly critical where the dynamic responses of internal organs and soft tissue must be evaluated. Using a combination of test methods, the engineering and scientific teams at NASA are able to enhance astronaut safety by designing landing attenuation systems that will minimize accelerations imparted to the crew and significantly reduce the potential for injuries."
Keith Cowing, a writer for SpaceRef.com, added:
Nothing simulates the effects of a dynamic and potentially hazardous environment on a living organism better than an actual living organism. Given that humans are large, upright bipeds, the biomechanics of a human body are unique from most other large animals. How an animal moves affects how the body handles physical stresses in normal and abnormal situations. Animals that walk on all fours handle biomechanical stresses differently than do humans. Indeed, the internal architecture of their bones is different given that there bones are internally constructed to handle the loads that a quadruped experiences - not only as it grows - but as it moves around on a daily basis.
Using human bodies is the ideal way to test vehicles for their ability to protect human life - and what happens when such systems exceed their design capacity and the chance of injury results. Also, given the inherent nature of testing of such risks, using volunteers is often unethical.
Another area in which the use of cadavers has contributed to advancement is pharmaceuticals. Cadavers act as a bridge between animal testing and human trials when developing new pharmaceutical drugs. Having this bridge is invaluable to ensuring the safety of patients and in lowering the risk when conducting human trials making it “possible to evaluate new drugs or new formulations, and assess risk of exposure to a toxic compound”. “Use of real human tissue is also critical in the development of techniques, products and procedure to improve drug delivery systems.”
The MARC Institute, Innovation in the Making
The MARC Institute is leading the way in the use of fresh-frozen cadavers, they recognize that cadavers are an invaluable, and irreplaceable resource for the medical student and professional. Catering to the advancement of modern medicine they offer a variety of courses to healthcare professionals including: Spine, Orthopedics, Pain Management, Anatomy, Dental, Plastic Surgery, Dermatology and CMF. In addition, the facilities at The MARC Institute are designed to accommodate the student, practitioner, and researcher with advanced technologies and equipment, as well as, facilities for large and small groups for education or research purposes. We invite you to learn more about what we offer by visiting The MARC Institute either in person or online.