JERUSALEM — Researchers at the Hebrew University of Jerusalem published a study in Nature Medicine asserting that dissecting with ancient anatomical instructions highlights limitations in current medical simulations. The study, titled "What Galen's dissections reveal about tacit learning in modern medical education," demonstrated that Galen's texts reveal the challenge of transmitting tacit knowledge in medical training.

Professor Orly Lewis of the Hebrew University of Jerusalem's Faculty of Humanities' classical studies department led the study. The research team included Dr. Andrés Pelavski, a classicist and practicing physician, and Professor Joshua Milgram, who has experience in surgery and teaching veterinary anatomy. Expert veterinary surgeons and medical physicians participated in the research from planning through performance and analysis.

The researchers recreated a dissection of a female pig's abdominal wall and peritoneum using instructions from the second book of Galen's Anatomical Procedures. Galen, a Roman physician, authored this text 19 centuries ago, and it is the only surviving ancient text that provides such specific instructions. His text instructs readers to cut superficially around the umbilicus until the underlying tissue appears whiter than surrounding structures.

"Even Galen's highly detailed written instructions weren't enough to guide us, and today's augmented reality simulations face the same challenge," Lewis said. "We can program the visible steps of a procedure, but simulations still struggle to transmit the physical intuition of an experienced physician." She added that medical knowledge has never been transmitted by words or images alone. "Even the most detailed instructions leave something out – and that missing knowledge may be exactly what future doctors need most," Lewis said.

"If virtual reality, augmented reality, and digital simulations are to replace or supplement hands-on training, they must identify and incorporate the tacit dimensions of medical skill acquisition, including touch, pressure, resistance, timing, and embodied judgment," Lewis said.

Why It Matters

This research highlights a potential gap in modern medical education's increasing reliance on digital simulation technologies. By demonstrating the limitations of detailed written instructions, even from an ancient source like Galen, the study suggests that current virtual and augmented reality tools may not fully replicate the process of acquiring essential, non-explicit medical skills. This has implications for how future doctors are trained, emphasizing the need for digital tools to integrate the often-overlooked tactile and intuitive aspects of medical practice.