Samyog article corrected DS jan 10 for pdf.docx


https://doi.org/10.22502/jlmc.v10i2.480 Original Research Article

Students’ Perception in Learning Human Anatomy
Towards Dissection or Prosection

Samyog Mahat,a,d Sarun Koirala,b,d Sandip Shah,c,d Laxman Khanalc,d

ABSTRACT:
Introduction: Cadaveric dissection has been used as a traditional method of teaching and learning for
many years. With time, changes in medical curriculum has reduced the time for anatomy learning and
seeking alternative methodology moving away from traditional learning. With the introduction of new
methodology and technology the question arises whether it is still effective enough to follow the old
traditional mode of teaching and learning. With ever changing medical education it is important to
recognize students perceptive and attitudes toward the learning different method. Therefore, this study
aimed to determine students’ perception towards prosection and dissection in learning anatomy. Methods:
The first year medical students were included in the study. The study was carried after the series of lecture
as per curriculum. The students were divided into four groups. Each group dissected the cadaver followed
by observation of the prosected cadaver explained by the faculty. Questionnaires were prepared related to
dissection and prosection and sent to the students using google form. The students' perception towards
dissection and prosection was recorded. The results were tabulated and subjected to statistical analysis.
Percentage of students opting for dissection and prosection was calculated. Results: The majority of
students (82.5%) preferred dissection over prosection, 2.6% opted for prosection over dissection and
14.9% were still not sure which method of teaching and learning is favorable. Conclusion: The study
reflected the traditional method of dissection was more favorable to students while alternative methods
can also provide better insight to learning.

Keywords: Cadaver, Dissection, Prosection.

Submitted: February 24, 2022.
Accepted: November 20, 2022.
Published: March 9, 2023.

a- Lecturer, Department of Human Anatomy
b- Additional Professor, Department of Human

Anatomy
c- Associate Professor, Department of Human

Anatomy
d- B.P. Koirala Institute of Health Sciences,

Dharan, Nepal

Corresponding Author:
Samyog Mahat

Email: samyoganatomy@gmail.com
ORCID: https://orcid.org/0000-0001-8357-0436

INTRODUCTION:
For decades, cadaveric dissection has been
used as a core teaching tool in delivering
anatomy curriculum in medical
schools.[1,2,3] Traditional cadaveric
dissection facilitates several educational
benefits especially obtaining a
three-dimensional perspective of human body
structures and appreciation of anatomical
variations.[4,5,6,7]

How to cite this article:
Mahat S, Koirala S, Shah S, Khanal L. Students’
Perception in Learning Human Anatomy Towards
Dissection or Prosection. J Lumbini Med Coll.
2022;10(2):7 pages.
DOI:
https://doi.org/10.22502/jlmc.v10i2.
Epub: March 9, 2023.

J. Lumbini Med. Coll. Vol 10, No 2, Jul-Dec 2022

https://doi.org/10.22502/jlmc.v10i2.480
mailto:samyoganatomy@gmail.com
https://orcid.org/0000-0001-8357-0436
https://doi.org/10.22502/jlmc.v9i2.416


Mahat S, et al. Students’ Perception in Learning Human Anatomy Towards Dissection or Prosection.

Cadaveric dissection aids in improving
students' manual practicing skills including
touch mediated perception of the body, use of
basic instruments and hand-eye coordination
relevant to a variety of basic clinical
procedures, create ethical awareness and
promote professionalism.[8,9,10,11] Over the
past decades, with considerable medical
curriculum reform, conducting extensive
cadaveric dissection has been debated due to
its slow and tedious approach, limited
availability of cadavers, the difficulties
imposed by the ethical issues for their use,
high costs, time intensity, requirement for
highly skilled teachers and the emotionally
challenging nature of cadaveric
dissection.[2,10,12,13] With considerable
transformation in anatomical teaching over
the past decade, need for developing
alternative methods of learning gross anatomy
is clearly evident.[12,14] Another alternative
methods is combination of dissection and
prosection or prosection alone.[15,16,17]
Prosection is a preserved specimen of cadaver
after part of it is dissected by the
demonstrator.[6] Prosection requires less time
and less financial burden.[6,7] With
curriculum reform, the question of which
method is better to teach gross anatomy
remains to be addressed.[18] Hence, the
present study was conducted to address the
students’ perception towards dissection and
prosection in learning gross anatomy.

METHODS:
A cross-sectional descriptive study was
conducted among the first year bachelor of
medicine and bachelor of surgery (MBBS)
students of B.P. Koirala Institute of Health
Sciences from September to November 2021.
The total number of students in the first year
was hundred. All of the hundred respondents
were included in the study after obtaining a
written consent. A prior approval of
Institutional Ethics committee was taken
before commencement of the study (Code
No.: IRC/2137/021). The respondents were

briefed about the study and all those students
who volunteered for study were included. The
study was done after routine anatomy
program lectures and practical class of upper
and lower limbs. All the students were
exposed to identical series of lecture. All
students followed the same syllabus according
to the curriculum of the institution. Each
series of lectures was followed by practical
dissection class. Practical classes were
coordinated and conducted by anatomy
faculties and staffs. During practical, students
were divided into four subgroups and were
exposed to dissection mainly followed by
additional prosection in each table. Each
group was assigned to one cadaver for
dissection and prosection. Following
dissection of body by students, dissected
structures were demonstrated by the table
teacher. In prosection method, students were
asked to observe the cadaver while the table
teacher dissected the body and demonstrated
to the students. Eleven questionnaires were
designed for evaluation of the study program
by Likert style survey from previously
published study.[6] Structured questionnaire
was based on multiple choice questions.
Google form was created for the questions
and was distributed to the students through
their respective email address during the
period. Response was taken from the students
for the structured questionnaire prepared
using Google form. Students were asked to
response the listed questionnaire A-K shown
in Table1 using the five point Likert scale.

Responses: 1 strongly disagree, 2-disagree,
3-not sure, 4-agree, and 5-strongly agree. The
results were analyzed statistically using the
SPSS 16.0 software. Frequency and
percentage were calculated.

RESULTS:

The questionnaire was responded by a total of
74 students. No prior experience with
cadaveric specimens or dissection was
experienced by the students before attending

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Mahat S, et al. Students’ Perception in Learning Human Anatomy Towards Dissection or Prosection.

the sessions. The majority of the respondents
(82.5%) ranked dissection based learning very
high in terms of their anatomical learning
when comparing with prosection, 2.6%
students also favored prosection based
learning while 14.9% of respondents were not
sure which methodology to prefer. More than
two-thirds (82.5%) of respondents stated their
preference in prosection because of time
management is better in comparison to
dissection. The majority of respondents
(>45%) disagreed or strongly disagreed with
questionnaire that reflected positive
perceptions of cadaveric prosection:
-Knowledge gained from prosection is more
-Interest generated towards subject is more
with prosection
-With prosection there is more scope for
application of knowledge in future than with
dissection
-With prosection, there is better understanding
of spatial orientation of body than with
dissection

Majority of the students (69%) also agreed
with the equal opportunity for everyone
participation in prosection. Comparing
structural details better witnessed with
prosection than with dissection, student
agrees/strongly agrees (52.6%) better
structural details in prosection.
The frequency and percentage of students
responded to each statement is shown in
[Table 1] Figure 1 shows most common
responses to each question and their
respective frequency

DISCUSSION:
The current study showed relevant findings
about student perceptions with regard to
positive and negative aspects of prosection
and dissection in learning anatomy. Student’s
assessment and feedback about different
methodology of learning is useful in changing
and improving medical education curriculum

as changes is taking place globally to improve
standards of education.[17] A change in
methodology of teaching and learning
modalities develops in response to student’s
requirement and institution.

Majority of participants held positive
perceptions about the effectiveness of
cadaveric dissections in better understanding
of anatomical structures and knowledge. Our
study also showed that student’s perception
towards time management and equal
opportunity is better in prosection as
compared to dissection. Our findings correlate
with the previous study done by Dissabandara
et al. which showed that students perception
towards dissection is time consuming,
difficult in finding correct structures as
compared to other forms of learning
anatomy.[2] Time consuming may be due to
difficulty in finding structure at once during
cutting the body. Equal opportunity is not
received by all the students in dissection may
be due to students ratio is higher in
comparison to inadequate availability of
cadaver for dissection.

A previous study done by Topp et al. found
that prosection provides greater insight into
anatomical variations than dissection.[15] Our
study showed mixed perception of students
towards different anatomical learning
methods providing greater insight to
anatomical variations. This may be due to
different populations targets used in different
studies. These study findings differed from
the study conducted by Rizzolo et al. which
included student’s perception towards
prosection helps more than dissection to
reinforce and apply concepts learned from
lectures.[19] Our study demonstrated that
about forty percent of students agree
dissection can help them to reinforce and
apply concepts learned from lecture. This
difference in findings may be due to different
setting used in the study.

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Mahat S, et al. Students’ Perception in Learning Human Anatomy Towards Dissection or Prosection.

Table 1: Showing frequencies and percentage of students rating to questionnaire (N = 74)

Statements Strongly
Agree
n (%)

Agree
n (%)

Not Sure
n (%)

Disagree
n (%)

Strongly
Disagree
n (%)

A Knowledge gained from
prosection is more compared to
dissection

2 (2.7%) 12
(16.2%)

26
(35.2%)

30
(40.5%)

4 (5.4%)

B Time management is good with
prosection compared to
dissection

12 (16.2%) 49
(66.3%)

11
(14.9%)

1 (1.3%) 1 (1.3%)

C Interest generated towards
subject is more with prosection
compared to dissection

2 (2.7%) 12
(16.2%)

14
(19.0%)

40 (54%) 6 (8.1%)

D With prosection there is more
scope for application of
knowledge in future than with
dissection

0 (0%) 8
(10.8%)

23
(31.1%)

35
(47.3%)

8 (10.8%)

E Prosection helps more than
dissection to reinforce and apply
concepts learned from lectures

0 (0%) 15
(20.3%)

28
(37.9%)

30
(40.5%)

1 (1.3%)

F With prosection, there is better
understanding of spatial
orientation of body than with
dissection

1 (1.3%) 27
(36.5%)

19
(25.8%)

25
(33.7%)

2 (2.7%)

G Everyone gets equal opportunity
for participation in prosection

9 (12.2%) 42
(56.8%)

13
(17.6%)

8 (10.7%) 2 (2.7%)

H With prosection, systems
interrelation in the body is better
understood

1 (1.3%) 26
(35.2%)

27
(36.5%)

17
(22.9%)

3 (4.1%)

I Prosection provides greater
insight into anatomical variations
than dissection

3 (4.1%) 26
(35.1%)

17
(22.9%)

24
(32.5%)

4 (5.4%)

J Structural details better
witnessed with prosection than
with dissection

4 (5.4%) 35
(47.2%)

15
(20.3%)

15
(20.3%)

5 (6.8%)

K I prefer dissection over other
forms of learning cadaver

24 (32.5%) 37
(50.0%)

11
(14.9%)

1 (1.3%) 1 (1.3%)

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Mahat S, et al. Students’ Perception in Learning Human Anatomy Towards Dissection or Prosection.

Figure1. Most common responses to each question and their respective frequency

In our study, 82.5% of students preferring
dissection over prosection for learning
anatomy whereas study conducted by
Dinsmore et al. showed only 8.5% of the
responding students preferred traditional
dissection; 78.8% chose examination of
prosected materials with faculty.[16] This
difference might be due to students not getting
equal opportunity to dissect the cadaver. The
study conducted by J.O. Nnodim et al.
showed that structures imprinted better on
dissector’s mind, one learns to dissect- a skill
useful later in surgery while prosection is
effective, very time-economical and all
important structures are seen.[20] Our study
also showed similar results as students
(55.8%) favoring prosection as there is more
scope for application of knowledge in future
than with dissection and 82.5% of students
opting prosection as time management is good
while learning with prosected cadaver
compared to dissection. Our findings
correlates with the study conducted by Smith

et al. which demonstrated that majority of
students agreed prosection helped them
appreciate relationships between
structures.[21] Moreover, in our study 52.6%
of students agreed that structural details is
better witnessed with prosection than with
dissection. Study conducted by Whelan et al.
showed majority of students valued the ability
to improve three dimensional and spatial
knowledge of anatomy during the course of
dissection.[22] Our study also showed that
nearly two-thirds of the students agreed that
there is better understanding of spatial
orientation of body in prosected body than
with dissection, nearly two-thirds of
participants disagreed with above statements
whereas nearly one-fourth of participants
were neutral to the statements. Limitation of
the study includes, BDS students as well as
second year MBBS students could have been
included in the study.

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Mahat S, et al. Students’ Perception in Learning Human Anatomy Towards Dissection or Prosection.

CONCLUSION:
Use of traditional cadaveric dissection to
facilitate teaching and learning is becoming
difficult because of limited availability of
cadaver, ethical issues, and students to
cadaveric ratio. Our study showed majority of
student’s opted dissection over prosection as it
is efficient in acquiring surgical skills and
good clinical practice. Although majority of
participants sought the importance of
dissection in many ways but students also
disagreed towards sole method of delivering
anatomy practical as prosection provided
good insight to anatomical variation and time
management was better than with other forms
of methodology used in learning. Therefore
the introduction of diverse method is required
to facilitate learning technique in laboratory.

Acknowledgement: Department of Anatomy,
BPKIHS, Dharan, Nepal

Conflict of interest: None of the authors have
a conflict of interest.

Source of Fund: No funds were available.

REFERENCES :

1. Ghosh SK. Human cadaveric dissection:
A historical account from ancient Greece
to the modern era. Anat Cell Biol.
2015;48(3):153-69. PMID: 26417475
DOI:
https://doi.org/10.5115/acb.2015.48.3.153

2. Dissabandara LO, Nirthanan SN, Khoo
TK, Tedman R. Role of cadaveric
dissections in modern medical curricula:
A study on student perceptions. Anat Cell
Biol. 2015;48(3):205-12. PMID:
26417481 DOI:
https://doi.org/10.5115/acb.2015.48.3.205

3. Magee R. Art macabre: Resurrectionists
and anatomists. ANZ J Surg.
2001;71(6):377-80. PMID: 11409024
DOI:
https://doi.org/10.1046/j.1440-1622.2001.
02127.x

4. Aziz MA, Mckenzie JC, Wilson JS,

Cowie RJ, Ayeni SA, Dunn BK. The
human cadaver in the age of biomedical
informatics. Anat Rec. 2002;269(1):20-32.
PMID: 11891622 DOI:
https://doi.org/10.1002/ar.10046

5. Ghosh SK. Cadaveric dissection as an
educational tool for anatomical sciences in
the 21st century. Anat Sci Educ.
2017;10(3):286-99. PMID: 27574911
DOI: https://doi.org/10.1002/ase.1649

6. Pushpa NB, Deepa B, Pushpalatha K.
Students’ Perception on Dissection and
Prosection in Learning Gross Anatomy.
International Journal of Anatomy,
Radiology and Surgery.
2019;8(3):AO25-AO27. Available from:
http://www.ijars.net/articles/PDF/2505/41
534_CE[Ra1]_F(SHU)_PF1(AG_SHU)_P
FA(SHU)_PB(AG_SHU)_PN(SHU).pdf

7. McWatt SC, Newton GS, Umphrey GJ,
Jadeski LC. Dissection versus Prosection:
A Comparative Assessment of the Course
Experiences, Approaches to Learning, and
Academic Performance of Non-medical
Undergraduate Students in Human
Anatomy. Anat Sci Educ.
2021;14(2):184-200. PMID: 32539226
DOI: https://doi.org/10.1002/ase.1993

8. Moore NA. To dissect or not to dissect?
Anat Rec. 1998;253(1):8-9. PMID:
9556018 DOI:
https://doi.org/10.1002/(sici)1097-0185(1
99802)253:1%3C8::aid-ar6%3E3.0.co;2-z

9. Ellis H. Teaching in the dissecting room.
Clin Anat. 2001;14(2):149-51. PMID:
11241750 DOI:
https://doi.org/10.1002/1098-2353(200103
)14:2%3C149::aid-ca1023%3E3.0.co;2-u

10. Jeyakumar A, Dissanayake B,
Dissabandara L. Dissection in the Modern
Medical Curriculum: An Exploration into
Student Perception and Adaptions for the
Future. Anat Sci Educ.
2020;13(3):366-80. PMID: 31168930
DOI: https://doi.org/10.1002/ase.1905

11. Kinirons SA, Reddin VM, Maguffin J.

J. Lumbini Med. Coll. Vol 10, No 2, Jul-Dec 2022 jlmc.edu.np

https://pubmed.ncbi.nlm.nih.gov/26417475/
https://pubmed.ncbi.nlm.nih.gov/26417481/
https://pubmed.ncbi.nlm.nih.gov/26417481/
https://pubmed.ncbi.nlm.nih.gov/11409024/
https://pubmed.ncbi.nlm.nih.gov/11891622/
https://pubmed.ncbi.nlm.nih.gov/27574911/
https://pubmed.ncbi.nlm.nih.gov/32539226/
https://pubmed.ncbi.nlm.nih.gov/9556018/
https://pubmed.ncbi.nlm.nih.gov/9556018/
https://doi.org/10.1002/(sici)1097-0185(199802)253:1%3C8::aid-ar6%3E3.0.co;2-z
https://doi.org/10.1002/(sici)1097-0185(199802)253:1%3C8::aid-ar6%3E3.0.co;2-z
https://pubmed.ncbi.nlm.nih.gov/11241750/
https://pubmed.ncbi.nlm.nih.gov/11241750/
https://pubmed.ncbi.nlm.nih.gov/31168930/
http://jlmc.edu.np


Mahat S, et al. Students’ Perception in Learning Human Anatomy Towards Dissection or Prosection.

Effects of Alternating Dissection with
Peer Teaching and Faculty Prosected
Cadaver Demonstrations in a Physical
Therapy and Occupational Therapy Gross
Anatomy Course. Anat Sci Educ.
2019;12(5):468-77. PMID: 30452788
DOI: https://doi.org/10.1002/ase.1833

12. Fruhstorfer BH, Palmer J, Brydges S,
Abrahams PH. The use of plastinated
prosections for teaching anatomy--The
view of medical students on the value of
this learning resource. Clin Anat.
2011;24(2):246-52. PMID: 21322047
DOI: https://doi.org/10.1002/ca.21107

13. Jaiswal R, Sathe S, Gajbhiye V, Sathe R.
Students Perception on Methods of
Anatomy Teaching and Assessment.
International Journal of Anatomy and
Research. 2015;3(2):1103-8. Available
from:
http://dx.doi.org/10.16965/ijar.2015.161

14. Alexander J. Dissection vs Prosection in
the teaching of anatomy. Journal of
Medical Education. 1970;45(0):600-6.

15. Topp KS. Prosection vs. dissection, the
debate continues: Rebuttal to Granger.
Anat Rec B New Anat. 2004;281(1):12-4.
PMID: 15558780 DOI:
https://doi.org/10.1002/ar.b.20037

16. Dinsmore CE, Daugherty S, Zeitz HJ.
Teaching and learning gross anatomy:
Dissection, prosection, or “Both of the
Above?”. Clin Anat. 1999;12(2):110-4.
PMID: 10089036 DOI:
https://doi.org/10.1002/(sici)1098-2353(1
999)12:2%3C110::aid-ca5%3E3.0.co;2-3

17. Aziz M, Kernick ET, Beck Dallaghan GL,
Gilliland KO. Dissection Versus
Prosection: a Comparison of Laboratory
Practical Examinations. Med Sci Educ.
2020;30(1):47-51. PMID: 34457635 DOI:
https://doi.org/10.1007/s40670-019-00839
-6

18. Kerby J, Shukur ZN, Shalhoub J. The
relationships between learning outcomes
and methods of teaching anatomy as

perceived by medical students. Clin Anat.
2011;24(4):489-97. PMID: 20949485
DOI: https://doi.org/10.1002/ca.21059

19. Rizzolo LJ. Human dissection: An
approach to interweaving the traditional
and humanistic goals of medical
education. Anat Rec. 2002;269(6):242-8.
PMID: 12467081 DOI:
https://doi.org/10.1002/ar.10188

20. Nnodim JO. Learning human anatomy: by
dissection or from prosections? Med
Educ. 1990;24(4):389-95. PMID:
2395432 DOI:
https://doi.org/10.1111/j.1365-2923.1990.t
b02456.x

21. Smith MJ, Wilkinson T. Does a functional
prosection provide a more effective
method of learning the anatomy of the
forearm and hand than a 3D online
anatomy resource? MedEdPublish.
2018;7(3):1-12. DOI:
https://doi.org/10.15694/mep.2018.00002
08.1

22. Whelan A, Leddy JJ, Ramnanan CJ.
Benefits of extracurricular participation in
dissection in a prosection-based medical
anatomy program. Anat Sci Educ.
2018;11(3):294-302. PMID: 28881412
DOI: https://doi.org/10.1002/ase.1724

J. Lumbini Med. Coll. Vol 10, No 2, Jul-Dec 2022 jlmc.edu.np

https://pubmed.ncbi.nlm.nih.gov/30452788/
https://pubmed.ncbi.nlm.nih.gov/21322047/#:~:text=The%20majority%20of%20students%20(94,of%20anatomy%20in%20real%20life.
https://pubmed.ncbi.nlm.nih.gov/15558780/
https://doi.org/10.1002/ar.b.20037
https://pubmed.ncbi.nlm.nih.gov/10089036/
https://pubmed.ncbi.nlm.nih.gov/34457635/
https://pubmed.ncbi.nlm.nih.gov/20949485/
https://pubmed.ncbi.nlm.nih.gov/12467081/
https://pubmed.ncbi.nlm.nih.gov/28881412/
http://jlmc.edu.np