Reduction of mental distress in the dissection course by introducing the body donor experience through anatomical demonstrations of organ systems

Abstract

The practice of dissection teaches students not only the foundations of anatomical knowledge but also encourages the development of professional competencies. Yet, the dissection of cadavers in the gross anatomy course can be a stress factor for medical students. There are a minor proportion of students who demonstrate strong emotional reactions in anticipation of being confronted with a cadaver. Therefore, in 2008, the authors implemented a voluntary course entitled, "Anatomical demonstrations of organ systems" (AD-OS) in advance of the dissection course to ease this psychological burden. The question of whether attendees of AD-OS showed less mental distress at the start of the dissection course compared with those that had not or only infrequently visited AD-OS was addressed. AD-OS attendees assessed their expected mental distress using a five-point Likert scale before starting the dissection course and a second time at the end of their first day, after they had been confronted with a cadaver. AD-OS was evaluated as excellent and the majority of students participated actively during teaching sessions. Overall, female students showed higher levels of mental distress. AD-OS attendees assessed themselves as being less burdened by mental distress than members of the control group. Longitudinal analysis revealed that students who visited AD-OS showed a marked decrease of their mental distress level, comparing prospective and retrospective ratings. This was significantly (P < 0.001; Z = -6.061) different from nonattendees or those who visited AD-OS only infrequently. AD-OS satisfied its intended teaching goals and proved that a step-by-step introduction of dissection through anatomical demonstrations helped to reduce the mental distress of students. Future studies are planned to measure mental distress with objective instruments.

Thoughts on practical core elements of an ethical anatomical education

“…Another interesting approach aimed at the reduction of mental distress before the dissection course was taken by anatomical educators at the University of Ulm/Germany. They introduced a voluntary course of “Anatomical demonstration of organ systems” before the actual dissection course and could show that participants of this preparatory course later felt significantly less mental distress during dissection than their peers (Böckers et al, ). This result coincides with the experience at Harvard Medical School, where students were given the opportunity to visit the dissection labs and encounter donors on an individual basis together with a faculty member before the course.…”

Professional and Personal Competency Development in Near‐peer Tutors of Gross Anatomy: A Longitudinal Mixed‐methods Study

“…Over the last few decades, many investigations have explored the various opportunities and challenges of peer tutoring in gross anatomy. A well‐known issue for many students undertaking gross anatomy is the stress reaction due to handling human remains during and after cadaver demonstration and dissection (e.g., Snelling et al, ; Bataineh et al, ; Arráez‐Aybar et al, ; Cahill and Ettarh, ; Böckers et al, ). To keep the effects of such distress on teaching and learning to a minimum, some schools have developed training courses during which peer tutors learn to recognize signs of distress in students, and moreover study how to manage challenging situations during the tutorials (Shiozawa et al, ; Alvarez et al, ).…”

Anonymous body or first patient? A status report and needs assessment regarding the personalization of donors in dissection courses in German, Austrian, and Swiss Medical Schools

“…Other authors assumed that this balance might be important for the nascent doctor to remain “grounded” (Hammer, ) or psychologically healthy (Thomas et al, ). Perceiving the body donor as a “first patient” (Weeks et al,; Rizzolo, ; Böckers et al, ; Talarico, ) or as a “great teacher” (Winkelmann and Güldner, ; Bohl et al, ) could represent important principles for achieving this desired balance.…”