Background During the COVID-19 pandemic, in-person cadaveric dissection laboratories for teaching anatomy were omitted by many schools around the world. While knowledge domains can be easily evaluated via remote exams, non-traditional discipline-independent skills such as those encouraged through reflection on the topic of death are often overlooked. This study investigated how different anatomy course formats played a role in initiating students’ reflections on death during the COVID-19 pandemic. Method In fall 2020, 217 medical, dental, premedical, and health sciences students from 13 international universities discussed differences in their anatomy courses online. Formats of anatomy courses ranged from dissection-based, prosection-based, hybrid (combination of dissection and prosection) to no laboratory exposure at all. Students’ responses to the question, “Did/does your anatomy course initiate your thinking about life's passing?” were collected, and they self-reported themes that were present in their reflections on death using a multiple-choice prompt. Statistical analyses to detect differences between students with and without exposure to cadavers were performed using the chi-squared test. Results When comparing students who had exposure to human anatomical specimens to those who had no exposure, the majority of students with exposure thought that the course did initiate thoughts about life’s passing, compared to students without exposure ( P < 0.05). Reflection themes were consistent across groups. Discussion These findings indicate that anatomy dissection courses are important for the initiation of students’ feelings about the topic of death. Omission of cadaveric dissection- or prosection-based laboratories will decrease the likelihood that students initiate reflection on this topic and gain important transferable skills.

Historically, Anatomy education is an in‐person discipline involving exposure to human body donors that facilitates personal and professional growth through, in part, the initiation of reflection on the topic of death. However, during the COVID‐19 pandemic the decreased exposure to cadaveric anatomy for many health professions students may have influenced the depth of their individual reflections on this topic. Accordingly, this study aimed to investigate the effect of an alternate approach—focus group discussions between peers with varying degrees of exposure to cadaveric material—that may offer one strategy to stimulate deep reflection on the topic of death. A programmatic intervention was introduced, wherein students (n = 221) from 13 international universities discussed differences in their anatomy courses during small focus group sessions as part of an online exchange program. An inductive semantic thematic analysis was conducted on responses to an open‐ended text–response question on how the activity influenced students' reflections about death. Resulting themes were organized into categories that described the content and topics of the students' discussions as they grappled with this sensitive topic. The students reportedly engaged in deep reflection and expressed an increased sense of connectedness with their peers, despite their disparate exposure levels to cadaveric anatomy and being physically distanced. This demonstrates that focus groups with students experiencing different laboratory contexts can be used to help all students reflect on the topic of death and that interchanges between dissecting and non‐dissecting students can initiate thoughts about death and body donation among non‐dissecting students.

Background During the COVID‐19 pandemic, in‐person cadaveric dissection to teach anatomy was often omitted. While knowledge‐based assessment can be evaluated via remote exams, soft skills (e.g., reflections on the topic of death) can often be overlooked. This study aims to quantitatively investigate how different anatomy course formats play a role in initiating students’ reflections on life's passing, during the COVID‐19 pandemic. Method In the fall semester of 2020, 216 medical, dental, premedical undergraduate, and health sciences students from 14 international universities discussed (in small groups) differences in their anatomy courses as part of an online exchange program. Formats of anatomy education delivery in the 14 universities ranged from dissection, hybrid dissection‐prosection, and prosection only, to no laboratory exposure during the pandemic. Students’ responses to the question, “Did/does your Anatomy course initiate your thinking on life's passing?” were collected utilizing a multiple‐choice question and a short essay. Statistical analysis was performed using Chi‐square analysis. Results 105 students dissected (group 1), 21 had a hybrid dissection‐prosection class (group 2), and 79 had no dissection (group 3). 11 students did not have an anatomy course. Within the 3 groups, 149 students had exposure to human anatomical specimens and 52 students did not. A majority of students in groups 1 and 2 reported that the anatomy course helped them to initiate reflections on the topic of death, compared to those in group 3 (75% and 71% respectively, versus 36%, p<0.05). The majority of students who had exposure to human anatomical specimens thought that the course did initiate thoughts about life's passing, compared to students who did not have this exposure (p<0.05). Students who did not dissect during the time of the pandemic felt that talking with their peers who did dissect during this period (i.e., at schools that did offer dissection) resulted in initiating thoughts about the topic of death. Discussion Anatomy dissection courses and exposure to human anatomical specimens help initiate reflection on the topic of life's passing. During the COVID‐19 pandemic interactions between students who do not dissect and their peers who do dissect help initiate thoughts about the topic of death in the non‐dissecting students, as reflected by their essays. Without exposure to human bodies there is less chance that students will think about this subject. Conclusion Anatomy dissection courses are important for the initiation of students’ feelings about the topic of death. During the COVID‐19 pandemic, dissecting students can help non‐dissecting students with initiating reflections about life's passing by discussing this subject with each other.

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