Claire F. Smith

The employment of anatomy demonstrators (ADs) has grown unexpectedly over two decades to meet increasing educational demands. However, their role is poorly understood and defined. There is therefore a need to better understand ADs, to maximize their potential as educators and build the integrity and transparency of UK anatomical education. Through a mixed methods approach this study explored ADs: demographics, role descriptors, experiences within the role, barriers to the role, and the potential of ADs. An online questionnaire ( n = 50) and three virtual focus groups ( N = 13) were analyzed using thematic analysis to identify emerging patterns and themes. The findings highlight that ADs are generally young people from diverse backgrounds with an even gender split. The role and its responsibilities seemingly vary substantially between universities, with ADs employed in numerous different ways. Being an AD appears to be an overall positive experience and ADs enjoy their work. Furthermore, ADs care about anatomical education and want to engage in discussions to improve their role and develop medical education. This study has expanded the understanding of the UK AD role and concludes that the UK AD role is a varied and often rewarding post that is enjoyed by diverse, engaged individuals who are primarily resident doctors by background. This study provides practical recommendations for anatomy departments to improve the experience for ADs and hopes to stimulate greater interest in ADs in order to maximize their educational potential.

Sharp contrasts exist between recent examples of public dissection. This includes for‐profit public dissections and not‐for‐profit, consented dissection and documentation. All have frequently become conflated and met with concern by the anatomical community. However, historically, anatomy and human tissue were accessible to all, as public dissections, in museums, and as curated exhibits. Changing societal values in response to criminal activities led to regulations that restricted access to human remains, reserving it to those privileged with training in the field of medicine. These protections of deceased humans, while vital, have unintentionally limited public engagement and potentially spurred ethically dubious practices. Now, public desire for anatomical understanding clashes with professional responsibilities to uphold dignity, respect, and consent. Recent for‐profit public autopsies ostensibly aim to educate but also raise questions about commodification and consent. This article argues that the ethical acceptability of public dissection and display hinges not on the acts themselves but on adherence to informed consent, respect for human dignity, and transparent processes. While appeals to public good (e.g., science or education) are common justifications, they must be balanced against the rights of the deceased and their communities. As anatomists, at a transformational period, we must understand the spectrum of reactions and develop better guidelines to meet both public and professional needs. In the US and UK, responsibility often falls to the anatomy community. In an attempt to uphold “best practices,” has the community, unintentionally, closed the gate on public knowledge, and unintentionally, precipitated egregious ethical failures?

Recently, there has been an emphasis on keeping the study of anatomy using donor material confined to the domain of medical and allied healthcare professionals. Given the abundance of both accurate and inaccurate information online, coupled with a heightened focus on health following the COVID‐19 pandemic, one may question whether it is time to review who can access learning anatomy using donors. In 2019, Brighton and Sussex Medical School (BSMS) obtained a Human Tissue Authority Public Display license with the aim of broadening the reach of who could be taught using donor material. In 2020, BSMS received its first full‐body donor with consent for public display. Twelve workshops were delivered to student groups who do not normally have the opportunity to learn in the anatomy laboratory. Survey responses (10.9% response rate) highlighted that despite being anxious about seeing inside a deceased body, 95% felt more informed about the body. A documentary “My Dead Body” was filmed, focusing on the rare cancer of the donor Toni Crews. Viewing figures of 1.5 million, and a considerable number of social media comments highlighted the public's interest in the documentary. Thematic analysis of digital and social media content highlighted admiration and gratitude for Toni, the value of education, and that while the documentary was uncomfortable to watch, it had value in reminding viewers of life, their bodies, and their purpose. Fully consented public display can create opportunities to promote health‐conscious life choices and improve understanding of the human body.

Six people were interviewed about the possibility of becoming posthumous body donors. Interview transcripts were analyzed using interpretative phenomenological analysis. Individual-level analysis suggested a common interest in Personhood Concerns and a common commitment to Enlightenment Values. Investigations of these possible themes across participants resulted in identification of two sample-level themes, each with two subthemes: Autonomy, with subthemes of agency and consent, and Rationality, with subthemes of knowledge/epistemology and materialism/ontology. This paper concentrates on the former. Consent for posthumous body donation was felt to sometimes fall short of adequately identifying donors’ preferences about what happened after consent was given, even with respect to actions for which consent established permission. In turn, paucity of information about donors’ preferences limited others’ ability to act as proxy agents to facilitate donors’ posthumous autonomy. Thus, while consent may curtail violations of people’s autonomy by authorizing actions for which permission has been established, it may fall short of facilitating their autonomy in ways that might be possible with greater knowledge of those people’s desires. Alternative methods of establishing consent are explored that might better-determine people’s desires and thereby improve others’ ability to act as proxy agents for them to facilitate their subsequent (even posthumous) autonomy.

Body donation is a prosocial act providing a unique learning experience to students, ultimately impacting on patient care and science. With an increasing number of training professionals, there is an increasing need for body donors, yet little is understood about donors' beliefs and preferences. A four‐center study aimed to understand donors' perceptions, 843 responses highlighted a significant relationship between completing a body donor consent form and being both an organ donor and having ever donated blood (p < 0.01). In exploring donor intentions, 69% had been considering donation for fewer than five years, 40% knew another body donor, and 27% had a family member or friend currently registered. Of those who had requested donor information packs, 97% had completed body donation consent forms. Of these, 92% had not selected any time restriction for their donation and 96% had consented to images being taken. Almost all (98%) were aware that their donation might not be accepted. Donors' motives highlighted a wish to: improve education, improve health care, advance science, and contribute to the greater good. A bimodal response was observed with body donation being used to save relatives money and inconvenience. Donors felt comfortable with their bodies being used by medical, dental, and allied health professionals; however, donors were less comfortable with their bodies being used by other groups. Only 57% were comfortable with artists, beauticians and yoga teachers using their remains. Understanding donors' motivations and decision‐making process is vital to ensure resources for future and to meet any changing requirements of both donors and those studying them.

The anatomy and even existence of a common tendinous origin of the extraocular eye muscles, or annulus of Zinn, has widely been debated in anatomical literature. This study explored the anatomical origins of the recti muscles, their course into the orbit and the dural connections of the common tendinous origin with the skull base. Twenty orbits of ten adult human cadavers were dissected. The orbital apex and its dural connections were photographed. Histological examination of apical specimens was performed. In all cadavers, extraocular muscles were observed to have a common tendinous origin at the orbital apex, continuous with dural connections extending into the skull base. Accessory slips of the medial rectus were observed across all cadavers. Dual heads of the lateral rectus were observed in fourteen orbits of seven cadavers. The origin of the levator palpebrae superioris appeared to be contiguous with the superior rectus at the common tendinous origin in all but one cadaver. These results support the existence of a common tendinous origin of the extraocular muscles, that is continuous with the skull base dura. In addition, they support the existence of variations in orbital anatomy including dual or accessory muscle slips of the extraocular muscles.

Altruism is consistently identified as the dominant motive for body donation. Over 12 months, 843 people who requested body donation information packs also completed research questionnaires that included open-ended questions about their motives. Abductive analysis suggested two distinct sets of altruistic motives: those seeking benefits for medical professionals and patient groups (“medical altruism”) and those seeking benefits for friends and family (“intimate altruism”). Either could facilitate or impede body donation. Altruism may not be best understood as a unitary motive invariably promoting body donation. Rather, it is a characteristic of various motives, each of which seek benefits for specific beneficiaries.

Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's “Tomorrow's Doctors.” The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full‐time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part‐time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system‐based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub‐disciplines.

The use of different ways to view the body has always been associated with anatomy. With advancing technology, the use of ultrasound has become more portable and accessible as a way for students to learn anatomy. Moreover, ultrasound’s direct clinical context makes it an important skill that students need to acquire and be competent in, not only after graduation but on clinical placements as a student. There does appear to be a learned skill in being able to interpret ultrasound images and to be able to relate the anatomy seen to existing anatomical knowledge. In addition, there is a learned skill in being able to correctly hold the ultrasound probe and gain clear images. Because ultrasound use and interpretation is a skill it therefore needs to be taught as part of undergraduate medical and allied health care professional education. A key to successful training is regular teaching sessions distributed longitudinally throughout the curriculum with active, hands-on learning time being the focus of any teaching session.