Evaluating Perceptions of Otorhinolaryngology Trainees on Soft Body Cadavers Use in Postgraduate Anatomical Education

To become a surgeon is to learn a language written in flesh and bone. For centuries, the most effective way to learn this language has been to study the human body directly, using donated bodies as the primary text. This practice, known as cadaveric dissection, allows trainees to see how muscles, nerves, and blood vessels connect in three dimensions, building a mental map that textbooks and screens cannot fully replicate. However, the bodies used for this study are not always the same. Some are treated with strong chemicals to preserve them for long-term storage, while others are kept frozen and then thawed to remain soft and pliable, mimicking the texture of a living person. As medical training evolves, a critical question has emerged: which of these methods best prepares a surgeon for the operating room, and how do the doctors in training feel about the tools they are asked to use?

A team of researchers at the University of Malaya set out to answer this question by listening to the surgeons of tomorrow. They focused on a group of doctors specializing in otorhinolaryngology, the field dedicated to the ears, nose, and throat. These specialists must navigate some of the most intricate and delicate structures in the human body, making the accuracy of their anatomical training vital. The researchers gathered sixty-one surgical residents from four different medical universities in Malaysia to share their honest opinions. The study was not a test of surgical skill, but rather a survey of perception, asking these trainees to compare the experience of learning on soft, thawed bodies against the traditional method of learning on bodies preserved in formalin, a chemical solution that hardens tissues.

The results revealed a clear preference for the soft bodies, particularly when it came to the feeling of the tissue under the hand. When the residents were asked about the realism of the experience, a large majority found the soft bodies far superior. They reported that these specimens offered more natural colors and a texture that felt like real human tissue, which helped them understand how different parts of the body relate to one another in space. For those planning a career in surgery, the soft bodies were seen as a powerful motivator, enhancing their desire to learn and helping them visualize complex three-dimensional structures. One specific finding stood out: the residents felt that the soft bodies were significantly better for understanding the orientation of structures, a crucial skill when operating in tight, deep spaces where a surgeon cannot see the entire picture at once.

Despite this strong preference for the soft bodies, the researchers noted that the older, chemical-preserved bodies still held a practical advantage in the laboratory. More than half of the residents admitted that the formalin-preserved bodies were easier to hold and store, likely because the chemical treatment makes the tissues firmer and less prone to breaking apart during handling. However, when it came to the actual act of touching and revising their knowledge, the residents overwhelmingly chose the soft bodies. They preferred the tactile experience of working with fresh, frozen tissue for their self-directed study sessions, finding that the realistic feel helped them retain information better than the stiff, chemical-treated alternatives.

The study also looked at whether age or gender influenced these opinions. The researchers found that the residents' year of training did not change their views; whether a doctor was in their first year or their fourth, the preference for the soft bodies remained consistent. There were some differences based on age, with certain groups of older or younger residents valuing specific aspects of the training more than others, but the overall trend was the same. Interestingly, the female residents in the study felt even more strongly than their male counterparts that the soft bodies improved their understanding of anatomy in a clinical context. This suggests that the realistic nature of the training tool resonates deeply across different demographics of surgical trainees.

While digital tools like virtual reality and three-dimensional models are becoming common in medical schools, this research highlights what those technologies still lack: the ability to feel the tissue. The surgeons in the study emphasized that the hands-on experience of cutting and manipulating real human tissue provides a depth of understanding that screens cannot offer. It is not just about seeing the anatomy; it is about feeling the resistance of a muscle or the slipperiness of a nerve. The study concludes that while soft bodies present logistical challenges for hospitals, such as the need for freezing and thawing equipment, their value in building surgical confidence and skill is undeniable. For the doctors learning to operate on the complex landscape of the head and neck, the soft body remains the most trusted teacher, bridging the gap between the classroom and the operating room.