UH Med Now

Challenges arose from the COVID-19 pandemic when the anatomy department at the John A. Burns School of Medicine (JABSOM) had to pause the donations of cadavers to its Willed Body program in early in 2020 (the program will resume accepting applications as soon as it is able and we will post a story when that happens).

First-year medical students learn anatomy through body donors reverently referred to as their “silent teachers.” Most challenging  was the pandemic necessitating 6-feet social distancing directives. Prior to the pandemic, six students were assigned to a silent teacher to learn about the life of the body before them.  The students are usually shoulder-to-shoulder during this learning objective.

Nicole Nakamatsu is a third-year medical student at JABSOM.

A solution was necessary to keep the medical students on track with that first-year anatomy curriculum. JABSOM’s Nicole Nakamatsu (MS 2023) devised an extended reality (XR), case-based approach for learning anatomy that Professor Scott Lozanoff, PhD, Nakamatsu, and 15 faculty and colleagues conducted during the fall of 2019. 

“Dr. Lozanoff started this project with a vision that I supported even if I didn’t fully understand — until I saw some of the early creations. Simply amazing. I was hooked,” said Steve Labrash, CFSP, director of the Willed Body Program. 

Steven Labrash, CFSP, JABSOM Willed Body program director.

“For the students to be able to see clinically relevant images (3D model) of their silent teachers before, during, and after the anatomy labs, is inspiring. This synergy of traditional cadaver dissection with the innovative models that Scott’s team is creating is the future of anatomy.”  

Nakamatsu established a workflow that had the cadavers given MRIs so that the students can get an idea of their silent teachers’ bodies before the first cut. This resulted in a poster presentation and the 2022 publication of her study,  “Case-based radiological anatomy instruction using cadaveric MRI imaging and delivered with extended reality web technology,” by the European Journal of Radiology. Nakamatsu has given the presentation several times, with enthusiastic reception. 

“The interest in and reception of this project has been overwhelmingly positive. This workflow and innovative way of learning and teaching could change the way that anatomy is taught here at home and around the world,” Nakamatsu said.

Professor Scott Lozanoff, PhD.

“It turned out to be very prophetic since COVID struck the following unit and we used the techniques that Nicole helped develop for our online hybrid anatomy labs. These include streaming demonstrations of dissections as well as interactive 3D models derived from segmentations, artistic models and photogrammetric dissections,” Lozanoff said. 

According to Lozanoff, the workflow is very complicated as it involves faculty from several different units who coordinate to transport donors to the hospital, MRI scan the donors, transfer scans to the JABSOM server, review radiology of the donor, create radiology reports that include 3d models as well as pathology reports, and then present in a case-based fashion.

“Nicole worked diligently to coordinate this broad array of faculty to achieve this interdisciplinary outcome,” Lozanoff said. “In addition, radiology scans can be viewed with virtual reality computers (z-space) in the lab. The system uses our altruistic local donors so that our medical students are seeing clinical conditions specific to our own community and that they will certainly see in their clinical training.  No other program in the country has established such an extensive workflow that includes MR scans of their willed body donors.”

“I wanted to show that a multi-departmental workflow with MRI and XR technology, and our unique patient group, represented by the Willed Body Program, could support hypothesis-driven learning based on radiological anatomy,” Nakamatsu said. “The end result is that it promotes student exploration and engagement in our JABSOM cohorts.”

Nicole surveyed medical students in anatomy and based on her study, 97% of the class wanted more case-based presentations of the donors. The system was used again the following year and 82% of the class surveyed preferred hybrid labs compared to in person lectures, which opens the door to explore new ways of mastering course content.

Nakamatsu’s outstanding sense of organization, ability to work constructively and professionally with her colleagues and faculty, and her excellent time management and communication skills brought this effort together to achieve a successful outcome. 

“Nicole isn’t done yet. In May, she reported on a second study that she did in collaboration with Dr. Güneş Aytaç (TOBB University of Economics and Technology, School of Medicine, Ankara, Turkey) that will describe an international study using these same online techniques,” Lozanoff said. “We certainly have come a long way from students looking at a 2D picture in a powerpoint lecture! This is just the beginning.”

Added Nakamatsu: “Our team has continued to build on these concepts to better characterize the benefits of these new methods of learning. Be on the lookout for new projects reported by our team.”

By Paula Bender, UH Med Now

A 3-dimensional model of a brain from a Willed Body program donor.