Anatomical instruction and training for professionalism from the 19th to the 21st centuries

For most of the 19th century, anatomists in the United States saw the affective, emotional aspects of human dissection as salient ingredients in professional formation. Professionalism (or character) signified medical integrity and guaranteed correct professional conduct. As gross anatomy came under siege in the late-19th and early-20th centuries, crowded out of medical curricula by the new experimental sciences, medical educators rethought what it was that dissecting a human body stood to give medical students. As they embraced a new understanding of professionalism premised on an allegiance to science, anatomists celebrated the habits of mind and sensibility to scientific investigation that could be acquired at the dissecting table. One consequence was a deliberate distancing of gross anatomy from the art of medicine, and with it a de facto suppression of attention to the affective components of human dissection. During this period in the opening decades of the 20th century, the norm of silence about the emotional dimensions of dissection was set in place. The confluence of various movements by the 1960s and 1970s both revived attention to the emotional experience of dissection and sparked a renewed discussion about the relationship between the affective components of learning anatomy and the professional formation of future healers. There is a need to balance the tension between the affective and scientific aspects of anatomy, and by extension the tension between the art and science of medical practice. One method is to use small-group learning societies as a means to cultivate and meld both dimensions of the professional ethic. Clin. Anat. 19:403-414, 2006. (c) 2006 Wiley-Liss, Inc.