SEARCH

SEARCH BY CITATION

Keywords:

  • anatomy;
  • architecture;
  • laboratory design;
  • education;
  • informatics

Abstract

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED

General notions of architecture are familiar to anatomists, and they frequently use the word in describing the functional structures of cells, tissues, and whole organisms. Beyond concepts relating to orderly structure, anatomists infrequently encounter the profession of architecture and practicing architects. Significantly, anatomists can work with architects in the design and building of laboratories and classrooms, efforts that can have sustained effects on the practice of anatomy. In this paper, we consider cooperative interactions between anatomists and architects in designing new laboratories that accommodate educational innovations and increasingly valuable dissection resources. We begin by introducing architecture and architects in their roles in design and building. We next consider essential features and technologies for new laboratories that support a combination of classical dissection, prosection, models, and computer-based information. Different working conditions are reviewed for designing renovations of existing facilities, long-term planning for new, same-institution buildings, and extramural planning and construction for new medical schools. Whatever the project, anatomists work with architects in repeated interactive planning meetings that arrive at working laboratory designs by a process similar to successive approximation. In consulting on designs for extramural institutions, anatomists must balance client administration and faculty needs with objective oversight of practice-side design features, constraints, and capacity for innovative uses with new curricula. Architects are the key agents in producing laboratories designed for flexible and innovative anatomical education, although client-favored models for Internet-based technology can limit future use of cadavers in multiyear teaching of medical and health sciences students. Anat Rec (Part B: New Anat) 289B:241–251, 2006. © 2006 Wiley-Liss, Inc.


INTRODUCTION

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED

Anatomists are familiar with general notions of architecture, and their research and teaching employ words and phrases such as “cytoarchitecture,” “architectonics,” and “cortical architecture” (Shutt and Lindberg,2000; Swanson,2003). Conversely, anatomical metaphors have been used in scholarly works on architectural structure (Mansell,1979; Blier,1987; Greene,1991). Beyond borrowed constructional concepts relating to the orderly structure of organisms, anatomists infrequently encounter architecture or architects. Significantly, however, anatomists can work with architects in the design and building of laboratories and instructional facilities, and these collaborations can have sustained local effects on the teaching and practice of anatomy. One exemplary historic building, an anatomy demonstration amphitheater designed by Thomas Jefferson, stood at the University of Virginia from 1827 to 1938 (Fig. 1).

thumbnail image

Figure 1. Thomas Jefferson's design for an anatomy demonstration amphitheater built at the University of Virginia, as depicted on the U.S. National Park Service historical Web site. Top: elevations, architectural front, and interior views of the building. Bottom: floorplans for the first and second floors, showing corner spiral stairways leading to the octagonal seating gallery. Floorplans and elevations are key visualizations for anatomists consulting with architects on laboratory design.

Download figure to PowerPoint

In this article, we consider cooperative interactions between anatomists and architects in designing new laboratories that accommodate increasingly valuable dissection facilities, information technologies, and the flexibility to accommodate new instructional methods and technology in evolving curricula.

For a better working understanding of the profession, we begin with a brief introduction to architecture and how architects approach design and building. We then focus in particular on essential features for new gross anatomy laboratories because of their specialized functions compared to newer multidisciplinary basic sciences laboratories. We review optimal features for large medical school anatomy laboratories that frequently support multiple class activities, including dental, nursing, physical therapy, and postgraduate courses. As the debate continues about the relative values of traditional dissection and specimen/model laboratory exercises (Guttman et al.,2004; McLachlan and Patten,2006), we consider integrating new sorts of activities, including those employing unembalmed specimens and new technologies. Three differently scaled design scenarios are reviewed: intramural renovation, long-term facility planning, and new extramural school construction projects. We end by discussing the implications of new anatomy laboratory designs, including those that do not support dissection, as curricula evolve in the ever changing business of education.

AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED

Like life sciences professors and health sciences practitioners, contemporary architects are college-trained professionals with scholarly degrees and postbaccalaureate training. As with other professions that established academic foundations in the 19th century, schools of architecture at major universities and scholarly institutes have undergraduate and graduate programs.

Architecture students complete an accredited general curriculum, including theory, history, design, drawing, structures, planning, and construction methods, prior to graduating with a degree, typically in 4 to 5 years. Professional education curricula usually include project design competitions supervised by mentoring faculty, with apprenticeship and intern training in independent architectural practices. Training and further experience leading to professional licensure typically continue after graduates join architectural firms.

In the United States, licensing of architectural practitioners, as with medicine, is administered through examination by individual state licensing boards. Licensed American architects most frequently join the American Institute of Architects, hence the use of the abbreviation “AIA” in formally listing a practicing architect's name. Additional certification can come from the National Council for Architectural Registration Boards (NCARB), which allows architects to practice across state boundaries. More recently, certification for Leadership in Energy and Environmental Design (LEED) acknowledges compliance with consensus-based U.S. standards for designing environmentally sustainable (“green”) buildings.

Architects can be engaged in several levels of practice, from design drafting to project architect and principal (partner) in a larger corporate practice. Architects in training may work at commercial firms as designers while they are gaining experience and qualifying for licensing. In the small business niche, a single licensed architect may occupy all the major design-related roles, in addition to running the business operations of the practice.

In larger architectural practices where many architects are employed at all levels of design and operations, senior principals assume more specialized executive responsibilities for business management and finances, operations, or client management. Some firms may also include engineering or construction management as an integral part of their services. More comprehensive perspectives on architects and their professional practices can be found in Cuff (1992) and Lewis (1998).

A crucial talent for architects is to be able to work effectively with a variety of different types of clients and their employees in designing new buildings and facilities. The planning meeting is the main venue for interacting with clients to discuss project needs and structural specifications, to review proposed designs and floorplans, and to define structural details and crucial facility use factors. From interactions that establish the most important features for a proposed project to those that specify increasingly fine design details for final construction, repeated cycles of meetings and other architect-client communications drive the design process.

With their intrinsic attention to structural details and functions, anatomists and architects share essential concerns that facilitate the design process. Like anatomists, architects understand and view functional structure at many levels of representation; unlike anatomists, architects must design real structures to be built according to complicated standards. Furthermore, architects' deep expertise and attention to a broad range of building details insulate clients (like anatomists' academic employers) from construction, engineering, and regulatory concerns, such as occupational safety standards for ventilation systems and seismic anchoring for surgical light fixtures. They also work with the project contractors to ensure proper construction of their designs. Stated eloquently by architect Jon Kanda (personal communication, 2006), as an agent of the owner/client, “the value of the architect is not only to provide design services and solutions to problems, but to guide and to protect the owner through the building process.”

Beyond the more mundane details of building functional facilities, though, architects are supremely concerned with the overall esthetics and appearance of their design products: do they look good? Successful architects are artists by nature and not craftspersons. Asserting a characteristic building style is an important part of designing structures that meet the client's needs. Negotiation skills help them arrive at working plans for esthetically satisfying structures for influential clients with strong project agendas. A historical perspective on this personal imperative can be seen in Michaelangelo Buonarotti's assertion that he was the ultimate designer of St. Peter's Basilica, although it was commissioned by the pope, and cardinals had strong preferences for window design (Cuff,1992: p. 72).

Modern architects are thus the principal agents for practically rendering the ideal new laboratory features desired by anatomists. Examining all these structural design details is beyond the scope of this article, so the following discussion focuses on some of the most important aspects.

THE NEW ANATOMISTS' NEW LABORATORIES

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED

As curricula have evolved in individual medical schools across North America (Drake,1998; Drake et al.,2002), anatomy teaching laboratories have been redesigned to accommodate new methods, technologies, and practices. In that context, we will consider the anatomist's perspectives on the most important features for designing new facilities that support more than one class of student (e.g., residents, dental, nursing, physical therapy). Table 1 lists a range of these essential structural concerns.

Table 1. Essential features, aspects and issues for modern anatomy laboratory design
Features/AspectsVariable Details and Issues
curricula supportedsingle or multiple disciplines (medical, allied health sciences, undergraduate), continuing medical education; student dissection emphasized or prosections and other instructional methods
class session sizeswhole large classes or subgroups; simultaneous different classes
specimen tank layoutsingle large lab, sub-divisions, or multiple smaller labs; number of students per tank; working space between stations; capacity for growth or reconfiguration for different uses
ventilationclosed return downdraft tanks vs. whole room systems; climate control
room subdivisionsnone; subdividing walls and doors; transparency; small group rooms
entry doorstraffic patterns; security provisions; relation to other facilities (e.g., willed body area)
lightinggeneral room lighting and spotlights; fixture types and mounting locations; windows, daylight and view controls (window treatments, etc.)
computers/network“tank-side” workstations and position; display types desired; network support related to content intended (e.g., high-speed for video); wireless capabilities (speed reductions, limits < 25 connections/router)
audiovisual supportpublic announcement (audio system) with wireless microphone; speaker locations; room video displays, type, analog and computer capabilities; wiring patterns related to room use (e.g., splittable system for sub-rooms); AV system location; whiteboards, display boards, posters
student locker roomsseparate male/female facilities; wash facilities; showers; seating
plumbing/fixturesNumber of sinks and hand washing station capacity related to class sizes; hands-free operation; self-draining countertops; soap dispenser types; safety stations (eye wash etc.); vacuum lines, electrical outlets
trash and sharpsspace for receptacles and locations; types of containment
storage spaceplentiful in-lab, out-of-lab; display space for models, specimens, supplies
willed body areaproximity to lab; accessibility and security; educational support resources
estheticscolors; wall and window treatments; wall protection; glass; metal work

Cadaver dissection practices in anatomy laboratories have been established, updated, and reconfigured over the last several centuries. For example, Renaissance-style dissection demonstration theaters and later large multicadaver student dissection laboratories have been redesigned and built in many schools according to the changing educational practices and building methods of contemporary periods (Fig. 2).

thumbnail image

Figure 2. Anatomy laboratory facilities at Washington University School of Medicine circa 1918, showing early versions of features familiar to contemporary anatomists. Top: Anatomy and pathology demonstration amphitheater with ranked seating, strong external lighting, and surgical spotlights. Bottom: Partial view of a large subdivided student dissection laboratory, with electric ceiling and spot lighting, sinks, and model display cases. A specimen lies on one of the dissection tables in the right foreground, while a student group works at the tables in the area behind the display cases. Images from the Becker Medical Library, Washington University School of Medicine, used with permission.

Download figure to PowerPoint

In many “classical” late-20th-century laboratory designs, dissection exercises for an entire medical school class (e.g., > 100 students) have been accommodated in a single large room, with regularly spaced student dissection tables. For example, UCLA's original gross anatomy laboratory from the late 1960s had 37 dissection stations, accommodating four students per cadaver.

With individual institutions' prior preferences and in newer curricula, classes may be broken into multiple smaller groups for laboratory sessions and problem-based learning, permitting anatomy laboratory spaces to be subdivided or to be distributed among several smaller rooms. Furthermore, in many institutions, student dissection may have been drastically reduced or eliminated, with the substitution of prosected specimen observation, regional model displays, and computer workstation-based exercises. While these factors may further reduce the amount of floor space needed for cadaver dissection tanks, they place more emphasis on logically designing reconfigurable space and fixtures for student exercises using models and PC workstations.

Historically, adequate laboratory ventilation has been one of the principal design concerns with the use of formaldehyde-embalmed cadavers. At present, two major approaches are favored: individual downdraft and high-rate ceiling-floor systems.

With individual downdraft ventilation systems, air is drawn through special dissection tanks by flexible return ducts (large hoses) connected to the laboratory's air withdrawal system. This approach assumes that formaldehyde (and other embalming chemical) vapors are heavier than air. Ideal as it may sound to some users, it does provide some practical constraints for per-unit space, tank positioning, and reconfigurability. To save space, for example, tanks might be configured in X-shaped groups of four, with return hoses at table heads connecting to a single central intake box.

With high-rate ceiling-to-floor ventilation systems, incoming air is distributed by ceiling ducts centered over clusters of tanks, and outgoing air is removed by high-rate floor-level exhaust ducts located within peripheral walls. A high rate of room air exchange keeps individual formaldehyde exposures well below the parts-per-million regulatory thresholds dictated by Occupational Safety and Health Administration (OSHA) and other safety standards.

Other necessary features of dissection laboratories include a combination of diffuse room and individual spot lighting, multiple sinks for hand washing and instrument cleaning, counter tops for specimen displays, models, and computer workstations.

Beyond the use of embalmed materials, important considerations may be given to special laboratory features to support unembalmed cadaver use. At UCLA, for example, renovated anatomy laboratory facilities (circa 2000) have supported the use of unembalmed materials for laparoscopic robotics instruction, emergency medicine techniques sessions for 4th-year medical students and emergency medical technicians, and graduate medical education classes. Structural provisions of the renovation included creating a more restricted area convenient for sterile cleaning and blood-borne pathogen (universal) procedures compliance. This entailed partially subdividing a larger laboratory, with the special procedures located proximal to the willed body facility. As an alternative, other fresh tissue exercises have also been accommodated by a more classical demonstration theater or autopsy room facility.

Large-scale modern anatomy laboratories have relied on built-in audiovisual systems for addressing the entire class and showing videos. Custom audio systems, including wireless microphones, distribution amplifiers, and feedback suppressors, remain essential for daily use during relatively noisy laboratory sessions, whether dissections, prosections, models, or computer media are in use. To some degree, however, computer use may reduce the need for large-scale video displays for playing VCR or DVD media, as considered below.

Although planning computer layouts and networking seems straightforward, they present nontrivial implementation challenges. A laboratory could be designed to allow several different computer location and network implementation schemes, depending on the desired laboratory instruction methods. For example, if anatomists propose to use computers as an integrated instructional resource/medium around a dissection tank, the laboratory design might have compact personal computers (PCs) and monitors or screens suspended from the ceiling, together with the lighting. This may constrain other potential uses above above-tank view space (e.g., room video monitors).

Alternatively, for a more mobile configuration, small computer carts or laptop pedestals could be parked next to dissection tanks, consuming more floor space. If desired, PC workstations can also be sited in a separate small group room, facilitating activities such as guided virtual anatomy exercises.

For the greatest transmission speed and reliability currently in large laboratories, copper network wiring can be used to connect each desired laboratory terminal or dissection-side PCs. Wireless network routers and PC WiFi cards can be used for a smaller number of simultaneous connections, but even below a working maximum of 25 per router, simultaneous connections can unacceptably slow individual PC responses for multimedia applications (e.g., clinical dissection videos) or broadcast group sessions.

Prior to meeting with architects to design a laboratory, anatomists should collect and weigh their ideas and preferences about the aforementioned design variables, those listed in Table 1, and others that arise due to special intramural circumstances or curricular needs. Ultimately, local faculty anatomists should come to the planning table with a comprehensive vision of what they want their new laboratory to include to meet current, anticipated, and innovative teaching needs at their institution.

THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED

In this section, we examine some practical scenarios in which anatomists can work with architects to help design new facilities. These share the previously discussed common needs for supporting ongoing laboratory instruction while introducing technical innovations and anticipating changes in curriculum. They differ in terms of scope of work planned, overall design constraints, and increasing project complexity.

In simple renovation, relatively short-term planning is undertaken to arrive at new design specifications for renovating or replacing existing aging facilities within an institution. Extensive technical improvements may be desired, but the constraints of the available existing space and building layout place limits on the scope of changes in the facility's structure.

In early planning for new laboratories for a new school at an existing institution, the preliminary scope of project planning can be much broader than in a simple renovation. Designs are not limited to making the best use of existing space, and there may be greater latitude in generating novel facilities. Architects work with anatomists to specify general laboratory needs and initial floorplans that can be used as starting designs that integrate with those for the other major rooms and overall mechanical layout of new buildings.

In final preconstruction planning, major efforts are directed at producing final working designs and floorplans for construction deadlines on a new medical school building project. Substantial changes and refinements in early laboratory designs occur during iterative design review meetings between client anatomists, project architects, and consultants advising the architecture firm.

Intramural Anatomy Laboratory Renovation

Ideally, the impetus to renovate an existing laboratory will emerge from proactive cooperative relations between an institution's anatomy faculty and their supportive administration. Most directly, the deans and chairpersons would agree to finance substantial anatomy facility improvements to enhance use of preserved specimens and to introduce new networked computers and other technology while upgrading the laboratory's physical plant and utilities. The author has been involved in several such intramural laboratory and computer facility redesign projects over the last decade. The largest of these was the previously mentioned “down-to-the-walls floor-and-ceiling” renovation of a 40-year-old classical anatomy dissection laboratory with a capacity for 150 students.

For anatomists, floorplan diagrams (blueprints) are crucial elements in the design process (e.g., Fig. 3), and understanding them facilitates working effectively with project architects. If anatomists can use these renderings to envision the dynamics of teaching sessions and other activities within proposed laboratory designs, potential usage issues or restrictions can be identified.

thumbnail image

Figure 3. Two architectural floorplans demonstrating initial large changes in layout for laboratory facilities for a new medical school. Left: initial proposed plan for the entire fourth floor of the medical education building, showing a single large gross anatomy laboratory, willed body facility, and “virtual anatomy” computer laboratory, along with faculty offices (bottom) and “generic” basic sciences computer laboratories (far left). Right: rough sketch of a redesigned floorplan, following initial planning meetings between the project architect and consulting anatomist and between the architect and client faculty. Note the repositioning of the virtual anatomy laboratory to adjoin the basic sciences computer laboratory (left), the subdivision of the laboratory by glass walls and doors, and reconfiguration of the willed body area for access privacy. Images by Katherine Wise, reproduced by permission from Co Architects.

Download figure to PowerPoint

Depending on the specific circumstances, a facilities planning committee may also be involved in the laboratory planning, design, and construction process, or project directors and architects may work more directly with client anatomists. This may provide additional consensus opinions on features needed by other staff users. Whatever the case, an institutional or contracted architect will serve as project director and the primary interface for input from faculty anatomists.

On the whole, the initial design parameters presented to the architect's team would reflect the most important features for the anatomists, including dissection station accommodations, ventilation, lighting, work surfaces, and fixtures. Some of the technical needs will have been stipulated in general terms at the outset of the design phase of the project, culminating in a starting set of floorplan drawings and other documents.

The remainder of the project design details, floorplans, and other documents would be developed through subsequent cycles of evaluative and formative meetings between architects, anatomists, and other project administrators. For example, as previously described, a large original laboratory space could be subdivided, generating consideration of other design details, such as wall type, doors specifications, and relative subroom sizes. As we will also consider below, staff anatomists may desire a separate small-group room for new computer-based learning activities or “virtual anatomy” sessions.

Staging of construction is an important issue that must be dealt with early in project planning, particularly if the laboratory to be renovated is the school's principal facility. Given that instruction in large laboratories may go on year-round, early administrative decisions must be made about the classes to be displaced during the proposed building periods. In addition to providing alternative space for ongoing classes, considerable other storage may need to be found for equipment and materials from the laboratory to be renovated. Whatever the circumstances, the project architect plays a vital role in managing deadline oriented construction.

Depending on local circumstances, as the project proceeds toward construction, anatomists may find themselves drawn further into specific subcontractor interactions. For example, in the aforementioned renovation at UCLA, the author became involved in finding separate audiovisual system and network contractors who could install the specified wiring and equipment on a tight budget and already-scheduled construction. Such things can give the anatomist a very large stake in the ultimate success of the technical components of a renovated teaching laboratory.

After completion of construction, daily use of a renovated laboratory will reveal design successes, as well as shortcomings and new ideas for practical refinements. Considering these insights will sharpen the anatomist's design vision and act as a valuable prelude to long-range planning for new facilities.

Long-Term Planning for New Intramural Facilities

In the present environment, with projected shortfalls in the number of medical students in training for a rapidly growing population of patients, a number of academic institutions are planning or building new medical schools. These may aim to replace aging existing facilities at a given campus, or they may be entirely new schools to serve new regions. For example, the University of California is presently engaged in long-term (decadal) planning for a new building for its David Geffen School of Medicine at UCLA, as well as for completely new schools at Riverside and Merced.

In the context of such a proposed or anticipated project, several key things generally occur to initiate the design of new facilities. After the academic administration decides that it wants to begin early planning for building a school, it issues a request for submissions (RFS) to selected architects and architectural publications. Firms submit formal responses to the specific administrative and design stipulations of the RFS, and the client administration decides which architectural firm to retain.

After the chosen firm begins planning for a new project, faculty anatomists are most likely to be meeting with principals, project architects, and designers. Because a principal is often the senior architect on a large project, he or she will frequently want to meet early in the design process with the people who will be responsible for the major rooms and facilities in the new school. On the whole, though, the most substantial and productive interactions in planning meetings will be with project architects and designers.

The principal task will be to determine the amount and layout of floor space and overall structural needs for the anatomy facilities, so that this information can be combined with other programs' needs and physical plant requirements for design of initial working floorplans and models of the new buildings. This may require a relatively small number of meetings with anatomists over a few years.

After the acceptance of the initial design by faculty and client administration, several more processes must occur before the overall project can be approved and move to final design. These actions can include approvals by university regents, trustees, and state government (e.g., legislative endorsement), securing public, private, and corporate funding and land use permitting.

Final Design for a New School

As long-term planning becomes medium- and short-term, the chosen architectural firm will work expeditiously to arrive at detailed plans so that construction can begin. Among the architects' many project management concerns, working documents must be presented on deadlines for project approvals and construction permits from relevant city, county, and state authorities. Many details remain to be added to the overall design specifications and many substantial changes can still be made, even though specific general floorplans and schematics will have been laid out and approved in earlier planning meetings at all administrative levels.

As in more simple renovations, architects and project planners will continue to meet with intramural anatomy faculty participants, ensuring increasing attention to all relevant details, from final floorplans and technical needs such as lighting to aesthetic considerations such as wall and floor treatments. Separately, the architecture firm will employ extramural consultants to review and to critique the developing designs as part of the iterative review-redesign-update cycle leading to final working plans and documents.

In assisting with the design of new medical school laboratories, the consulting anatomist best views the development more from the employing architectural firm's perspective, serving also as an agent for the client's (anatomists') needs and interests by providing ongoing objective technical overview of the development process. The consultant can also provide the architect directly with creative suggestions and technical alternatives for emergent design challenges, which can be drafted and presented to the clients as alternative designs. Depending on the consulting anatomist's technical experience and the desired project innovations, the contributed alternative design ideas can result in some very substantial changes in the original project plans, as illustrated in some of the following examples.

The initial project floorplan can change significantly very early in the final design process. For instance, client anatomists may decide that they want to subdivide what had originally been planned as a single large laboratory, following presentation of alternatives developing out of architect-consultant meetings. This is illustrated in Figure 3 by an initial project's unitary laboratory floorplan (Fig. 3, left) and a rough sketch of an alternative design floorplan (Fig. 3, right), with a suggested room dividing scheme aimed at better supporting anticipated curricular changes. The client faculty approved the draft design of a partial subdividing wall with large doors that also allowed large laboratory exercises. Subsequent design changes built on that.

In an example of early changes evoking additional permutations, consider the siting of willed body facilities relative to the rest of the anatomy suite rooms. As shown in Figure 3, faculty anatomists desired a separate, small-group-oriented “virtual anatomy” computer laboratory, and in the initial design, it shared the willed body rooms' far (east) wall. After the consultant reinforced concerns about undesired esthetic associations between the cadaver preparation area and the “cozy,” small-group computer facilities, the virtual anatomy room was moved in the first redesign that added the dividing wall to the main dissecting laboratory (Fig. 3, right).

Relocating the virtual anatomy laboratory also changed the access characteristics for the willed body suite's entry pathways. Since there were crucial client concerns about cadaver security, student locker room isolation from willed body areas, and ease of student and willed body access, the architects subsequently developed three alternative floorplans proposing solutions for the client anatomists. These are illustrated in Figure 4.

thumbnail image

Figure 4. Updated partial floorplans for the project shown in Figure 3, with three different designs for student locker room facilities and the willed body program area. The plus markers indicate the part of A shown in the lower partial floorplans. Note the variations in configuration for student locker rooms and shower locations, and alternative locations for willed body program doors and access hall. A: Separate student locker room and willed body (WB) area doors and entryways, with the WB entry door located at the top of a major stairwell (asterisk). B: Common door and shared entryway for student locker rooms and WB area. C: Separate student locker room and WB area doors and entryways, with the WB entry door located outside of the stairwell, directly opposite the elevator. After meetings with faculty anatomists and the consulting anatomist, design C was chosen. It preserved separate entryways and gave gurneys direct access to the WB area from the elevator, without turning sharp corners through a stairwell landing. Images by Katherine Wise, reproduced by permission from Co Architects.

Download figure to PowerPoint

As can be seen, two of these designs preserved separate doors and access halls for student locker and willed body rooms. In one of these (Fig. 4A), gurneys bearing donor remains would have to make two right angle turns through the top of a stairwell on traveling about 20 feet from the elevator. In Figure 4C, redesigned student locker rooms placed a separate, secured willed body entrance directly opposite the elevator door. In the remaining alternative (Fig. 4B), student locker rooms and the willed body rooms shared a common access hall and door directly opposite the elevator. On presentation, the client faculty decided to proceed further with the separate, elevator aligned door scheme shown in Figure 4C.

These illustrate but a few of the large and small changes that could develop during the latter design phase. As the cycle's end nears, more detailed visualizations (Fig. 5) show the cumulative product of design evolution with greater detail and clarity. Final meetings between the architects and clients and with the architect's consultants ensure that all approved final design details, large and small, are documented in the working project documents as construction begins. After final administrative approval and permits are issued, construction proceeds, and the architects oversee the work of the building contractors, with timely project updates to client anatomists.

thumbnail image

Figure 5. Roof-off three-dimensional rendering of the final laboratory design shown under development in Figures 3 and 4. Note more prominent smaller details such as locker rooms, dissection tanks, sinks, dividing wall doors, and air returns below whiteboard on dividing wall. Image by Katherine Wise, reproduced by permission from Co Architects.

Download figure to PowerPoint

DISCUSSION

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED

Architects are the key agents in building new anatomy laboratories, and interacting with these professionals in the design process is a very direct and rewarding way to effect facilities that support educational innovation. To put it in scientific terms, since designing structures is a multivariate process involving problem solution by successive approximation, proactively contributing key variables and parameters facilitates optimal solutions.

As seen in the examples cited herein, some initial reorganizing of large pieces of the floorplan puzzle can rapidly transform the layout of a renovation or a new school. Making structural provisions for using new technology and teaching methods can lead to novel laboratory designs that appeal to the eye while adding new functionality. Envisioning teaching sessions and other student activities in proposed laboratory designs can help anatomists identify potential usage issues or restrictions to implementing new educational activities.

In looking at existing and planned anatomy laboratories as well as historical documents, it can be seen that some of the time-honored methods of anatomy dissection, prosection, models, and demonstrations have been recombined and implemented in different ways over many years at many medical schools. For example, the classical anatomical demonstrations once given in Padova's (Padua's) anatomy amphitheater found their counterparts in 20th-century anatomy/pathology theaters and current fresh tissue dissection rooms. Small group activities using models and dissections in subdivided laboratories were already well established by the late 19th century.

It is easy to see that there is no one right way to build a contemporary anatomy laboratory, and what is most important to a specific institution is what they can develop to meet their carefully considered existing and future needs, including capacity for innovation. In that regard, the author thoroughly agrees with Drake (1998) that the best curriculum is that which serves best a particular school. However, facilities can easily be planned that disadvantageously reduce resources for previously supported cadaver-based instruction, while favoring generalizable computer-based multimedia for reasons of best educational practice, space restrictions, and economy.

As members of the American Association of Anatomists well know, there are many more types of anatomy teaching laboratories in use than the very specialized medical school facilities described in this article. These include those in community, private, and liberal arts colleges, osteopathic, chiropractic, and physical therapy schools, which may be less likely to depend on large-scale student dissection exercises and associated donated body programs. In these many cases, designing modern, computer-reliant teaching laboratories may in fact constitute the best current practice serving educational efficiency and innovation. In a similar way, one can rationalize the appropriate accommodation of fundamental histology, neuroanatomy, and embryology instruction in more generic common-use networked computer facilities.

This anatomist would assert that large medical schools, with historically active donated body programs, are ill-served in planning new laboratories that do not support dissection activities, on rationales of fiscal resource conservation and new preclinical curricula. With ongoing curricular changes in many schools, increasing later anatomy instruction is in fact being demanded for clinical in-service and residency training, particularly for surgery. Administration can reasonably view a new anatomy laboratory as more than just a first-year medical student training facility, but also as a valuable resource for the institution's allied health sciences, graduate programs, and revenue-generating continuing medical education courses.

Beyond pragmatic administrative rationales, in the context of current trends in teaching professionalism, retaining dissection laboratories provides continuing resources for anatomy learning activities that enhance the acquisition of professional attitudes and behaviors. Crucial anatomy-related professional learning opportunities include those related to death and disease, respectful use of human remains, and surgical consequences (Lachman and Pawlina,2006; Pawlina,2006; Slotnick and Hilton,2006).

Over the past decade, this author has written a number of articles introducing new technology for three-dimensional anatomical visualization, intelligent informatics, and education (Trelease,1996,1998,2002,2006a,2006b; Trelease et al.,2000). All of these papers specifically discussed issues relating to rational and humanistic integration of information technologies into anatomy. As a whole, these innovative technologies have been viewed as complements, and not practical alternatives, to traditional active-learning methods (e.g., dissection and prosection exercises), as well as to newer activities such as clinical problem-based learning.

However, as more recent work has indicated (Trelease,2006b), technology can be transformative, greatly changing the nature of learning environments. The development of Web-centered popular student culture has enabled and empowered some administrators' beliefs that most preclinical medical education content can be satisfactorily and inexpensively delivered by networked computer programs. Most aspects of lectures and didactic basic concept presentation can currently be delivered by Web-based multimedia. Indeed, with the early promotion of such concepts by the Association of American Medical Colleges and the rise of foreign Internet-based medical schools, predominantly computer-based learning could prevail in increasingly business-oriented medical schools. Nonetheless, the best practices in anatomical education may continue to include teaching students in part through well-integrated and active explorations of the substance of whole human bodies in innovatively designed new laboratories.

Acknowledgements

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED

For support, advice, and immersing the author in their masterful designs, special thanks go to principal Scott Kelsey; project architect Jon Kanda; and Katherine Wise, designer, of CO Architects (http://www.coarchitects. com). For years of collegial good humor and support on renovation projects he managed, gratitude to Robert Mahterian. Thanks to Philip Skroska, manager of the Visual and Graphic Archives, for access to and licensing of historical laboratory images from the Bernard Becker Medical Library, Washington University School of Medicine. Finally, the author would like to recognize the editorial board leadership and support ofDr. Duane Haines and the inspired professionalism of managing editor Dr. Mark Paalman. The New Anatomist will be greatly missed, gentlemen.

LITERATURE CITED

  1. Top of page
  2. Abstract
  3. INTRODUCTION
  4. AN ANATOMIST'S INTRODUCTION TO ARCHITECTS AND ARCHITECTURE
  5. THE NEW ANATOMISTS' NEW LABORATORIES
  6. THREE SCENARIOS: RENOVATION, LONG-TERM PLANNING, AND FINAL DESIGN FOR NEW SCHOOLS
  7. DISCUSSION
  8. Acknowledgements
  9. LITERATURE CITED