Restoration of an academic historical gross pathology collection—refreshed impact on current medical teaching?

Abstract

The declaration of Leiden pronounces the demand to conserve pathological-anatomical collections as cultural heritage. Likewise, the Institute of Pathology of the Friedrich-Alexander-University Erlangen-Nuremberg owns macroscopic pathological-anatomical specimens reaching back over 150 years. The purpose of this work is to examine the impact, meaning, and perception of such historical preparations during the current medical curriculum. Additionally, the experiences from the renovation process can be used as a template for other institutes. All preparations were documented, photographed, and catalogued in an electronic database. During a restoration period, a series of didactically suitable specimens were professionally restored. Hereby, the help of a special course of interested students was admitted. In a second step, the specimens were integrated into the regular teaching of students in macroscopic pathology. An evaluation was carried out on two student cohorts with and without historical specimens by means of a questionnaire with 23 items and two free text fields. In total, 1261 specimens were registered covering diseases from almost the complete human body with a strong representation of the cardiovascular, urinary, gastrointestinal, and central nervous systems. Hereby, exceptional rare and untreated cases with medical relevance could be found and stepwise implemented into the curriculum. The student evaluation positively addressed that the courses became livelier and interactive. Furthermore, a more comprehensive overview and a better understanding of the macroscopic pathology were appreciated. However, more self-study time with the specimen was demanded. The authenticity of historical specimens contrasts with the tendency to carry out virtual "online" didactic methods. The stereoscopic view on often untreated and, therefore, unbiased cases enhances a skill-oriented deeper understanding of diseases. In conclusion, historical specimens regain interest and even didactic value, especially in an era of declining autopsy rates.

Voices from the past: results of the ESP history of pathology working group survey on pathology museums

“…It was during the sixteenth and seventeenth centuries that specific spaces, housing anatomical and pathological specimens were instituted with the aim of teaching medical students [4]. Pathological collections substantially improved when the fixation techniques, devised by Johann Carl Kaiserling (1869-1942) and Leonhard Jores (1866-1935), allowed the natural colours of moist preparations to be maintained or restored for long-term display [5].…”

“…Virtual microscopy courses and technically elaborated learning tools are in easy reach of pathologists and their students. Digitisation presents a great opportunity for scientific museums, providing access to materials via the web, minimizing damage to original items, increasing interest in these institutions and ensuring maximum public access to their collections [5,12]. Indeed, one of the tasks of a pathology museum is to convey human pathology to the general public.…”

The reproduction of human pathology specimens using three-dimensional (3D) printing technology for teaching purposes

“…In light of the trends described above, it could be debated whether identification and the ability to describe anatomical pathology in gross specimens is still a relevant and appropriate component of a modern medical undergraduate training. Some academic pathologists still hold the view that this domain is important in undergraduate education (Eichhorn et al 2018), whilst others suggest that this skill is only needed during specialist pathology training (Bell et al 2008). The reduction in specimen-based pathology teaching in medical school programs has been in part caused by a reduction in the pathology content within the curriculum as well as a greater focus on the molecular/ genetic mechanisms of disease.…”

“…In some institutions, pathology teaching has become integrated into the clinical environments, such as tertiary hospitals. Over several decades many medical schools have repurposed the space occupied by their pathology specimen museums (Marreez et al 2010) and microscopy rooms, although some still advocate for the use of such resources (Eichhorn et al 2018). Some argue that pathology museums, in addition to being important resources for the understanding of disease pathogenesis and prognosis and the reasoning process in clinical medicine (Ferrari et al 2001), provide a reminder of progress made…”

Scan and Learn: Quick Response Code Enabled Museum for Mobile Learning of Anatomy and Pathology

“…Although, innovative alternative technologies have widened the horizons of learning, they have compromised the value of the medical museum as an educational resource (Cook, ; Wakefield, ; Marreez et al, ). The need for protection and preservation of anatomy and pathology collections was discussed (Eichhorn et al, ). Medical museums still have their appeal and can serve as an important center for independent learning and appreciation of 3D anatomy and pathologic anatomy (Shibata et al, ; Fulcheri, ; Wang et al, ).…”