Use and Perceptions of Plastination Among Anatomy Medical Educators in the United States

Traditionally, medical schools have maintained collections of cadaveric tissues and organs to engage students in anatomy. Such collections are often stored in preservative solutions that are toxic, volatile and carcinogenic. Plastination is an alternative tissue preservation technique in which the water and lipids are replaced with polymers. Thus, the tissues are as benign as a manufactured plastic model, yet anatomically authentic. Plastination was popularized by Body Worlds and Body Works exhibits and is used in medical education internationally; however, its use within U.S. medical schools is not widely discussed in the anatomical literature. Among the 786 peer‐reviewed articles about plastination from 1977–2016, 15% are from U.S. institutions. The objective of this study was to determine the use and perceptions of plastination as an anatomical teaching tool among medical educators in the U.S. A 16‐item survey was developed in Qualtrics and approved by the Colorado Multiple Institutional Review Board. Question types included multiple choice, free response, semantic differential, dichotomous and contingency based. Survey items focused on four main areas: (1) availability and use of cadaveric dissection, (2) familiarity with plastination, (3) integrations of plastination in current curriculum, and (4) perceptions of plastination as a teaching tool. Survey invitations were posted on the American Association of Anatomists Open Forum and emailed to anatomy course directors at 139 allopathic (MD) and 38 osteopathic (DO) schools nationally. Descriptive statistics were performed using SAS. 120 U.S. anatomists completed the survey; 68% indicated they teach MD students (n=81), and 19% teach DO students (n=23). Analysis was restricted to these 98 respondents representing 77 medical schools across 37 states. Of these, 100% had heard of plastination, 78% had attended a Body Worlds and Body Works exhibit, but less than 40% currently utilize plastinates for medical anatomy education. When prompted to explain why plastination is not used, several themes emerged. Most prominently was a preference for the dissection experienced, followed by cost, availability, lack of resources and negative past experiences related to durability and quality. 75% of medical anatomy educators perceived plastination as a good supplement to, but not a replacement for, dissection, 19% indicated no curiosity to use plastination or considered it not useful, 10% expressed ethical concerns about plastination in general, and only 1% considered plastination a good alternative to replace dissection. These findings suggest that plastinates are more widely used in the U.S. than reflected by the literature; however, perceptions regarding their utility are varied with a dominant theme towards their use to supplement, but not replace, cadaveric dissection.