Novel dissection of the central nervous system to bridge gross anatomy and neuroscience for an integrated medical curriculum.

Medical schools in the United States continue to undergo curricular change, reorganization, and reformation as more schools transition to an integrated curriculum. Anatomy educators must find novel approaches to teach in a way that will bridge multiple disciplines. The cadaveric extraction of the central nervous system (CNS) provides an opportunity to bridge gross anatomy, neuroanatomy, and clinical neurology. In this dissection, the brain, brainstem, spinal cord, cauda equina, optic nerve/tract, and eyes are removed in one piece so that the entire CNS and its gateway to the periphery through the spinal roots can be appreciated. However, this dissection is rarely, if ever, performed likely due to time constraints, perceived difficulty, and lack of instructions. The goals of this project were (i) to provide a comprehensive, step-by-step guide for an en bloc CNS extraction and (ii) to determine effective strategies to implement this dissection/prosection within modern curricula. Optimal dissection methods were determined after comparison of various approaches/tools, which reduced dissection time from approximately 10 to 4 hours. The CNS prosections were piloted in small group sessions with two types of learners in two different settings: graduate students studied wet CNS prosections within the dissection laboratory and medical students used plastinated CNS prosections to review clinical neuroanatomy and solve lesion localization cases during their neurology clerkship. In both cases, the CNS was highly rated as a teaching tool and 98% recommended it for future students. Notably, 90% of medical students surveyed suggested that the CNS prosection be introduced prior to clinical rotations. Anat Sci Educ 11: 185-195. © 2017 American Association of Anatomists.