Plastination in Anatomy Teaching: Comparative Effectiveness Versus Formalin -Fixed Cadavers and Digital/3D Models - An Updated Systematic Review

Background: Plastination, introduced by von Hagens in the late 1970s, represents a significant advancement in the preservation of anatomical specimens. This updated systematic review evaluates the comparative effectiveness of plastinated specimens, formalin-fixed cadavers, and digital/3D models in anatomy education. Material and Methods: A comprehensive literature search was conducted using PubMed, Scopus, Embase, Web of Science, ERIC, and CINAHL databases. Studies published from 2010 onward involving medical, dental, allied health, and veterinary students were included. Study quality was assessed using RoB 2 for RCTs and ROBINS-I for non-randomised studies—the Kirkpatrick training evaluation framework guided outcome assessment. Results: Twelve studies met inclusion criteria, including randomised controlled trials, quasi-experimental studies, observational cohorts, and systematic reviews. Evidence demonstrates that plastinated specimens produce comparable or superior learning outcomes to formalin-fixed cadavers in knowledge acquisition and spatial understanding. Students consistently reported positive perceptions of plastinated materials, particularly regarding odour elimination, durability, and reduced exposure to hazardous chemicals. Comparative studies with 3D-printed models and digital resources reveal complementary rather than competing educational roles. Conclusion: Plastination represents a valuable, evidence-supported adjunct to anatomy teaching. The accumulated evidence supports integrating plastinated specimens with traditional dissection and digital modalities in a multimodal approach, rather than treating them as complete replacements. Future research should prioritise rigorous, adequately powered randomised controlled trials assessing long-term retention and clinical skills transfer. Keywords: Plastination, Anatomy education, Cadaveric dissection, 3D printing, Medical education, Learning outcomes.