Anxiety of first cadaver demonstration in medical, dentistry and pharmacy faculty students

Medical students' initial experiences of the dissection room and interaction with body donors: A qualitative study of professional identity formation, educational benefits, and the experience of Pasifika students

The first experience of medical students in the dissecting room (DR) likely influences professional identity formation (PIF). Sparse data exist exploring how exposure to the DR and body donors without undertaking dissection influences PIF, or how culture may influence this experience. This qualitative study explored students' first, non-dissection DR experience to determine how this contributes to PIF, including the impact of culture through a Pasifika-student lens. It also explored student perspectives on what learning opportunities are unique to this experience. Medical students with no prior DR experience were recruited and then interviewed after initial engagement with the DR and body donors. Questions included participant experiences, cultural perspectives, and how the DR differed from other teaching experiences. Interviews were recorded, transcribed, and analyzed thematically. Twenty students were interviewed (mean age 22 years, 12 females; 8 Pasifika) resulting in 520 min of audio recording (mean 26 min). Four primary themes were identified: professional identity formation, educational elements, death and spirituality, and cultural perspectives. Three subthemes including student experiences, behaviors, and environment were developed within each theme. Findings indicate development of PIF likely occurs from a single engagement with body donors without undertaking dissection, including recognition of professional role. Culture can play an important role for students, with several Pasifika students viewing the DR as a "cultural purgatory". Unique learning experiences are identified, such as cultural awareness around behaviors with the dead. The experience is an educational "threshold concept" where students likely undergo substantial developments in PIF, and educational initiatives to support students are outlined.

Cadaver Dissection Experience for First-Time Dissectors: a Hypothetical Three-Pronged Approach for Student Preparation

This systematic review synthesized evidence for the development of a preparatory process for first-time dissectors, geared toward improving cadaver dissection (CD) experiences. Eleven studies focused on pre-CD intervention were selected from a literature search in PubMed, the Education Resources Information Centre (ERIC), Google Scholar, PsycNET, and the Cochrane Library. A three-pronged preparatory process was formulated for first-time dissectors based on the evidence from the review. The process includes (1) background assessment; (2) pre-CD education; and (3) gradual exposure and desensitization. The preparatory process shows some hypothetical potential for decreasing negative CD-related experiences, but it still needs validation before implementation.

Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel- and ethanol-glycerin-embalmed tissues

Anatomical dissection is known to serve as an integral tool in teaching gross anatomy, including postgraduate training. A variety of embalming techniques exist, resulting in different haptic and optical tissue properties. This study aimed to objectify learning outcomes and medical student perceptions related to the use of two widely used embalming techniques, namely Thiel and ethanol-glycerin embalming. Between 2020 and 2022, first- and second-year medical students enrolled in the course on topographic anatomy participated in this study. Objective structured practical examinations were carried out for the head, neck, thorax, abdomen, pelvis, and extremity regions following regional dissection just before the oral examinations began. Six to ten numbered tags were marked in prosections of each region in Thiel- and ethanol-glycerin-embalmed specimens. Following the examinations, the students were surveyed regarding the suitability of the two embalming techniques with respect to preservation, colorfastness, tissue pliability, and the suitability in preparing for their anatomy examinations. Consistently higher scores were achieved for the thoracic and abdominal regions in ethanol-glycerin-embalmed specimens when compared to Thiel. No benefit was found for Thiel-embalmed upper or lower extremities. Tissues embalmed with ethanol-glycerin were rated higher for preservation and suitability to achieve the learning objectives, tissue pliability was rated higher for Thiel-embalmed tissues. Ethanol-glycerin embalming appears to offer certain advantages for undergraduate students in recognizing visceral structures, which may align with students' ideas on tissue suitability for their learning. Consequently, the benefits reported for Thiel embalming for postgraduate study unlikely reflect its suitability for novices.

Longitudinal Follow-Up of Death Anxiety and Psychophysical-Symptom Experience of Participants in the Silent Mentor Program

This study assessed death anxiety (Death Anxiety Questionnaire, DAQ) and psychophysical- (psychological and physical) symptom experience following cadaveric dissection among the Silent Mentor Program (SMP) participants before thawing (T1), after the suturing, dressing and coffining session (T2), and one month post-program (T3). There was a significant decline in the total DAQ score comparing T1 and T2 (t = 7.69, p < 0.001) and T2 and T3 (t = 5.00, p < 0.001) and T1 and T3 (t = 10.80, p < 0.001). There was a significant reduction in total psychological-symptom score comparing T1 and T2 (t = 4.92, p < 0.001) and between T1 and T3 (t = 4.85, p < 0.001). However, for the physical-symptom experience, a significant increase in the physical-symptom score between T1 and T2 (t = -3.25, p = 0.001) was reported but the scores reduced significantly one month after the program (T2-T3; t = 4.12, p < 0.001). The mentoring concept of the SMP program has beneficial effects on improving attitude towards death and psychophysical-symptom experience associated with cadaver dissection.

Prespecialist perceptions of three-dimensional heart models in anatomical education

PURPOSE

This article aims to discuss the use of three-dimensional (3D) printed models of vascular variation cases as an educational tool for undergraduate and postgraduate anatomy students.

METHODS

This advanced study involved ten anatomy assistants who were provided with five distinct cases of congenital cardiovascular variations, each accompanied by a computed tomography angiography (CT-A) and 1:1 solid model format. The residents were asked to generate perceptions for both formats and then compare these perceptions based on identifying the variation, defining the structural features, and evaluating relevant educational perspectives.

RESULTS

The vascular origin measurement values compared to the statistically evaluated real values of the related cases showed that models were 1:1 identical copies. Qualitative assessment feedback from five stations supported the usefulness of 3D models as educational tools for organ anatomy, simulation of variational structures, and overall medical education and anatomy training. Models showcasing different anatomical variations such as aortic arch with Type 2 pattern, a right-sided aortic arch with Type 2 pattern, an aberrant right subclavian artery, arteria lusoria in thorax, and a left coronary artery originating from pulmonary trunk in an Alcapa type pattern allow for better analysis due to their complex anatomies, thus optimizing the study of variation-specific anatomy. The perception level in the 3D model contained higher points in all of the nine parameters, namely identification of cardiovascular variations, defining the vessel with anomaly, aortic arch branch count and appearance order, feasibility of using it in peers and student education. 3D models received a score 9.1 points, while CT-A images were rated at 4.8 out of 10.

CONCLUSION

3D printed anatomical models of variational cardiovascular anatomy serve as essential components of anatomy training and postgraduate clinical perception by granting demonstrative feedback and a superior comprehension of the visuospatial relationship between the anatomical structures.

Anxiety, emotions, and thoughts of veterinary medicine students during their first visit to the dissection room

The use of cadavers is essential for veterinary anatomy learning. However, facing an animal corpse can be stressful for veterinary students because of their empathy toward animals. The objective of this study was to evaluate veterinary medicine students' emotions, feelings, and anxiety levels related to practicals with dog cadavers. Two questionnaires were administered to 1st year students (n = 168) at CEU Cardenal Herrera University in Valencia (Spain) before and after their first practical session with cadavers. The application of State-Trait Anxiety Inventory questionnaires showed that "state anxiety" decreased significantly (p < 0.05), from a score of 14.8 before the practical to 10.4 after, and that female students showed higher but not significantly different levels than males. Most (64%) of the students were not willing to donate the bodies of their pets, and those students were more stressed before the practical than their peers, although their anxiety levels significantly decreased by the end of the session. The majority of the students answered positively about emotions, such as feeling calm, safe, not nervous, relaxed and not worried before the practical, and this increased significantly to more than 80% by the end of the session. The visualization of educational videos prior to the session was evaluated positively by students. These results agree with those reported in other health science disciplines, showing that students face practical sessions with corpses in a similar way and suggesting that the use of videos can help decrease anxiety and enhance their learning experience.

Determining baseline anatomy knowledge among professional allied health students

Health professional students often struggle with anatomy coursework despite undergraduate coursework in anatomy. Educators must identify early on whether students may struggle in order to target remediation. The purpose of the study was to elucidate whether an assessment tool administered before the start of a professional anatomy course correlated with allied health students' course performance. Students over four years were given a quiz covering anatomy knowledge they were expected to know upon matriculation to their professional program. A supplemental data form was administered at the course's conclusion to identify prior anatomy experience and topics in which students felt deficient. Pre-quiz scores significantly correlated with examination performance throughout the course. Students reported feeling most deficient in neurobiology (54.9%) and anatomy terminology (39.1%). Videos were created to target these deficient knowledge areas; students who watched the videos did better in course assessments than those who did not. Most respondents (98.0%) recommended students take an undergraduate anatomy course prior to starting a health professional program. These results indicate that a quiz assessing anatomy knowledge among matriculating students may identify students with the potential to struggle in a professional anatomy course early on. Responses outlined areas in which students felt deficient, which allows educators to target topics early with intervention tools such as the review videos in this study. Finally, most respondents strongly recommended undergraduate coursework in anatomy prior to starting a professional health program, which outlines students' recognition that a solid foundation in anatomical knowledge is important to success in professional programs.

The Effect of Visualization Techniques on Students of Occupational Therapy during the First Visit to the Dissection Room

Background: Part of the basic teaching of human anatomy are prosection sessions with a human corpse, which may generate stress or anxiety among students. The objective of this work was to study how, through the visualization technique (a coping technique), these levels could be reduced before starting prosection classes. Methods: A cross-sectional pilot study was conducted involving first-year students who had never participated in screening sessions. Prior to the visit, occupational therapy students underwent a viewing session (visualization technique). On the day of the visit, before and after the screening session, an anonymous questionnaire was distributed to find out about aspects of the students’ experiences, such as their feelings and perceptions. The State−Trait Anxiety Inventory was used to assess anxiety. Results: The baseline levels of anxiety measured remained stable (from 18.5 to 18.2 points), with no differences being found (p > 0.05). The levels of emotional anxiety measured fell from 15.2 to 12.6 points (p < 0.05). Before starting the class, there were six students (17.1%) with anxiety criteria, and this figure was doubled at the end of the session (33.3%) (p < 0.05). Conclusions: Sessions in a dissection room can cause stressful experiences and change the emotional balances of some students. The results obtained and published here showed no significant differences after the visualization technique. We found that the students believed that the prosection sessions were very useful for teaching anatomy.

Exploring factors influencing dental students’ negative emotions during a gross anatomy laboratory in Taiwan

Background/purpose

Negative emotions of medical students during a gross anatomy laboratory are documented in the field of medical education, but those of dental students are relatively less reported in the literature. The purpose of the present study was to explore negative emotions of dental students during the gross anatomy laboratory and possible influential factors.

Materials and methods

Basic demographic variables, gross anatomy learning attitudes, and/or life attitudes were collected at five time points among year 2 dental students (n = 49) at a medical university in northern Taiwan. Multi-hierarchical regression analyses were executed to explore possible factors that led to negative emotions.

Results

Students who were older, had more-positive attitudes towards life, and had more-positive attitudes towards the anatomy laboratory tended to have weaker negative emotions when they first faced the cadavers. Having a tendency to care about and help people and having a grateful attitude also significantly predicted weaker negative emotions at the middle and end of the semester, respectively.

Conclusion

Negative emotions of younger dental students who first encounter a cadaver should be of concern. Striving to improve students' positive attitudes toward life, positive attitudes toward the gross anatomy laboratory, willingness to care about and help people, and an overall grateful attitude may help reduce negative emotions during the gross anatomy laboratory. At an institutional level, integrating educational activities that reduce negative emotions toward cadavers by dental students is highly recommended.

Advances and challenges in the detection of academic stress and anxiety in the classroom: A literature review and recommendations

In recent years, stress and anxiety have been identified as two of the leading causes of academic underachievement and dropout. However, there is little work on the detection of stress and anxiety in academic settings and/or its impact on the performance of undergraduate students. Moreover, there is a gap in the literature in terms of identifying any computing, information technologies, or technological platforms that help educational institutions to identify students with mental health problems. This paper aims to systematically review the literature to identify the advances, limitations, challenges, and possible lines of research for detecting academic stress and anxiety in the classroom. Forty-four recent articles on the topic of detecting stress and anxiety in academic settings were analyzed. The results show that the main tools used for detecting anxiety and stress are psychological instruments such as self-questionnaires. The second most used method is acquiring and analyzing biological signals and biomarkers using commercial measurement instruments. Data analysis is mainly performed using descriptive statistical tools and pattern recognition techniques. Specifically, physiological signals are combined with classification algorithms. The results of this method for detecting anxiety and academic stress in students are encouraging. Using physiological signals reduces some of the limitations of psychological instruments, such as response time and self-report bias. Finally, the main challenge in the detection of academic anxiety and stress is to bring detection systems into the classroom. Doing so, requires the use of non-invasive sensors and wearable systems to reduce the intrinsic stress caused by instrumentation.

YouTube-based course orientation videos delivered prior to matriculation fail to alleviate medical student anxiety about anatomy

Gross anatomy is a source of anxiety for matriculating medical students due to the large volume of information presented in a truncated timeline, and because it may be their first exposure to human cadavers. This study aimed to assess if video-based resources would affect matriculating medical students' anatomy state anxiety levels. Videos were designed to be short, YouTube-based units that served to provide orientation information about the anatomy course, dissection facilities, and available study resources to dispel anxiety around beginning their anatomy studies. To evaluate the impact of the videos, students in two consecutive matriculating years (2018 and 2019) completed the validated State-Trait Anxiety Inventory and a demographic questionnaire. The 2019 cohort (n = 118) served as the experimental group with access to the videos; while the 2018 cohort (n = 120) without video access served as a historical control. Analyses revealed that the groups were equivalent in terms of trait anxiety (P = 0.854) and anatomy state anxiety even when student video exposure was controlled (P = 0.495). Anatomy state anxiety was only significantly lower in students with prior formal anatomy exposure (P = 0.006). Further inquiry into students' prior anatomy experience identified that individuals with post-secondary dissection experience were significantly less anxious than those without formal anatomical experience (P = 0.023). These results may serve as a cautionary tale to educators; while preference for video-based instructional materials is prevalent in the literature, videos delivered on public social media platforms fail to prepare students for the psychological impact of studying human anatomy.

A Novel Cadaveric Embalming Technique for Enhancing Visualisation of Human Anatomy

Within the discipline of anatomical education, the use of donated human cadavers in laboratory-based learning activities is often described as the 'gold standard' resource for supporting student understanding of anatomy. Due to both historical and educational factors, cadaveric dissection has traditionally been the approach against which other anatomy learning modalities and resources have been judged. To prepare human donors for teaching purposes, bodies must be embalmed with fixative agents to preserve the tissues. Embalmed cadavers can then be dissected by students or can be prosected or plastinated to produce teaching resources. Here, we describe the history of cadaveric preservation in anatomy education and review the practical strengths and limitations of current approaches for the embalming of human bodies. Furthermore, we investigate the pedagogic benefits of a range of established modern embalming techniques. We describe relevant cadaveric attributes and their impacts on learning, including the importance of colour, texture, smell, and joint mobility. We also explore the emotional and humanistic elements of the use of human donors in anatomy education, and the relative impact of these factors when alternative types of embalming process are performed. Based on these underpinnings, we provide a technical description of our modern Newcastle-WhitWell embalming process. In doing so, we aim to inform anatomy educators and technical staff seeking to embalm human donors rapidly and safely and at reduced costs, while enhancing visual and haptic tissue characteristics. We propose that our technique has logistical and pedagogic implications, both for the development of embalming techniques and for student visualisation and learning.

Anticipatory Feelings About Dissection: An Exercise for the First Day of a Gross Anatomy Course

Studies have demonstrated that students experience a variety of intense emotions in anticipation of human anatomical dissection, including enthusiasm, gratitude, responsibility, apprehension, detachment, anxiety, and spiritual or moral reflection. The exercise described here provides an opportunity to start a conversation about the complexity of students' emotional reactions to the anatomy experience. The intention of this exercise is to normalize the variety of emotions that anatomy students experience, both to demonstrate to students that their emotions are normal and to encourage the empathy for others' reactions which may differ from their own. In the lecture hall setting before the first day of dissection, students are asked to draw how they feel about the dissection experience and are provided an opportunity to discuss their drawings with their peers. The course director then provides a slide show demonstration of drawings from previous years, and experienced anatomy faculty facilitate a large group discussion in which students react to the drawing exercise and slide show and ask questions which are addressed by the faculty. This exercise provides an opportunity for students to practice appropriately communicating about emotionally complex experiences in a professional setting. The exercise is straightforward to implement and is easily modifiable for different class sizes and curricular structures.

Impacts of a gross anatomy laboratory course on medical students' emotional reactions in Taiwan: the role of high-level emotions

BACKGROUND

Gross anatomy laboratory course at medical school is usually an important learning subject for medical students; however, seeing a cadaver often makes them feel uncomfortable. According to the broaden-and-build theory, positive emotions broaden our inventory of thoughts and actions, and build physical, mental, and social resources. Research on positive psychology found that through direct thanks and positive reframing, people who feel gratitude show fewer depressive symptoms. The present study tried to reduce students' negative emotions towards cadavers by sequential activities, such as family interviews and an initiation ceremony, which induced gratitude and other positive emotions.

METHODS

The Emotional Reactions Towards Cadavers Scale (ERTCS) was used to evaluate medical students' emotional reactions after they see a cadaver. Third year medical students (n = 105) at Taipei Medical University in northern Taiwan completed ERTCS on three occasions within a single semester during academic year 2016. Repeated-measures ANOVA and hierarchical regression analyses were then conducted to identify any changes in the emotional reactions of these students.

RESULTS

The ERTCS showed satisfactory internal consistency and a three-factor structure, i.e., negative emotions, high-level emotions, and excited emotions. High-level emotions were the highest, and negative emotions were the lowest among the three in our sample. Three-wave data showed that participants' high-level emotions increased, negative emotions decreased, and the former simultaneously predicted the latter after controlling for the influence of gender, religious beliefs, experience of the death of a family member or friend, and burnout level.

CONCLUSIONS

While past research usually focused on coping strategies to reduce medical students' negative emotions, our study supported the broaden-and-build theory, which emphasizes positive emotions, and demonstrated that elevating medical students' gratitude to 'silent mentors' is an effective way. It is suggested that combining dissection courses with medical humanities can help students successfully handle negative emotions during a gross anatomy laboratory course.

What emotions do physical therapy students feel during their first visit to the dissection room?

Dissections are a fundamental practical methodology for teaching human anatomy. However, this experience can be stressful, generating anxiety situations among students. This study tries to understand the attitudes, reactions, fears and anxiety state among students earning a physiotherapy degree when facing their first prosection. A cross-sectional before-and-after study was carried out with students who were provided with an anonymous "ad hoc" questionnaire and the State-Trait Anxiety Inventory (STAI).The values obtained from the total STAI questionnaire remained stable and unchanged during the prosection (p > 0.05). The levels of trait anxiety (TA) and state anxiety (SA) remained stable except in female students, who showed higher TA and SA scores, with a significance of p < 0.05 before and after the prosection. Although 100% of the students were satisfied with the dissection practices, the experience can provoke stressful responses and should be addressed using coping mechanisms, especially among female students.

Initiating Students' Reflections on Life's Passing in the Anatomy Course - an International Observation at 14 Universities

BACKGROUND

Medical and dental students' feelings and thoughts about the topic of death and life's passing are often associated with learning in the gross anatomy course, when students begin working with a deceased body donor in order to study human anatomy. Little is known of whether the format of anatomy teaching has an impact on these experiences. An observational study was performed to capture the initiation of students' sentiments on the topic of life's passing during the anatomy course at 14 international universities, identify common themes regarding these thoughts, and to study the connection to variations in anatomy course formats and included elements.

METHOD

Preclinical anatomy students reflected on one question (i.e., "How did your experience in the anatomy laboratory bring about your reflections on the meaning of life and human existence as well as the sanctity of one's passing?"). Written assignments were collected and anonymously coded. Information on anatomy courses was obtained via faculty questionnaires.

RESULT

A variety of themes were identified at the different schools, correlated with different anatomy formats and elements. Results indicate that the courses that offer hands-on cadaveric dissections may play an important role in triggering these sentiments.

DISCUSSION

The initiation of students' sentiments about the topic of death varies and includes several themes. There can be a connection to the way anatomy is taught, particularly if hands-on comprehensive cadaveric dissection or prosections are included.

CONCLUSION

In summary, anatomy courses can initiate students' thinking about life's passing - particularly in schools that offer hands-on cadaveric dissections or prosections.

Physician Associate Students' Experience of Anatomy Dissection

The role of physician assistant/associate (PA) has expanded from its inception in the United States over 50 years ago, to European countries including Ireland. While there is an increasing body of evidence exploring the role and training of PAs in clinical settings, there is a scarcity of research exploring PA students' perspectives in relation to their experience of anatomy dissection, or how these experiences may contribute to the development of their core professional identity. Students in the first two cohorts of PA Program at the Royal College of Surgeons in Ireland program were invited to interviews which solicited them to reflect and report on their own experiences of anatomical dissection during their course. Participants' responses were analyzed using a thematic inductive approach; common themes and patterns were organized into a hierarchical structure, which generated the final framework of themes. Ten participants took part in the study; only one had previous personal experience of dissection, while two further participants had some familiarity with prosected specimens. The first theme concerned the participants' expectation of anatomical dissection, with sub-themes of preconceptions, smell, and emotions. The second theme involves discussion of coping strategies that the participants used, including talking, viewing the cadaver as their first patient, and naming (or not naming) the cadaver. The third theme includes how the participants' talked about respect and compassion in the dissection room, development of team working skills, and awareness of bereavement and organ donation. A number of recommendations were also made for the experience and orientation of future students in such a program.

Cultivation of humanistic values in medical education through anatomy pedagogy and gratitude ceremony for body donors

BACKGROUND

One of the most important objectives of modern medical education is to empower medical students to become humanistic clinicians. Human anatomy plays a crucial role in this mission by using cadavers to cause reflections on death, dying, illness, and the role of medical practitioners in humanistic care. The objective of this study was to introduce, describe, and evaluate the impact of a ceremony in honor of the body donors on ethical and humanistic attitudes of medical students.

METHODS

We used a phenomenological research approach to explore and understand the lived experiences of the anatomy teachers as they teach anatomy in the context of humanism and ethics. A separate survey of third-year medical students was carried out to understand their perceptions of changes in themselves, respect for donors and donor families, and their relationship with patients. Data were collected in two phases: a desktop review of teaching materials followed by in-depth interviews of the main anatomy teachers followed by a self-administered, 5-item Likert scaled questionnaire given to students.

RESULTS

In the present article, we describe the rituals conducted in honor of body donors at our School of Medicine. We also describe the lived experiences of anatomy teachers as they work on improving humanistic education quality through the introduction of the concept of "silent mentor" which refers to a cadaver that quietly allows medical students to learn from it. In turn, a ceremony in honor of body donors who have altruistically donated their bodies so that learning anatomy through dissection would be possible is also introduced. A survey of the impact of the ceremony in honor of body donors on medical students revealed positive responses in terms of promoting studying anatomy (3.96 Vs 3.95) as well as reflections on own death (4.44 Vs 4.35), the life of body donors (4.07 Vs 4.04), and how to humanely view future patients and their significant others (4.32 Vs 4.24) relative to those that did not attend the ceremony (5-item Likert scale). The majority of the students that attended the ceremony also indicated that it had a positive impact on their future doctor-patient relationship, thinking about the possibility of donating their body for teaching as well as about medical ethics. Most of them also think that attending the ceremony helped reduce their anxiety, fear, and disgust of seeing corpses or dissecting and 90% insisted that memorial ceremonies should continue being conducted at Zhongshan Medical School.

CONCLUSION

The combination of the anatomy component of the basic medical curriculum and gratitude ceremonies as well as activities to promote body bequeathal programs might help to accomplish the goal of cultivating high-quality medical students and professionals for the future. The long-term benefits would be a medical graduate who exudes empathy, relates well with patients and their significant others, leading to a productive doctor-patient relationship.

Evaluation of attitudes and opinions of medical faculty students against the use of cadaver in anatomy education and investigation of the factors affecting their emotional responses related thereto

INTRODUCTION

The encounter with the cadaver is one of the few experiences that have a profound effect on the educational life of the medical students. The objective of this study was to investigate medical student's attitudes and opinions towards the use of cadaver in anatomy education, as well as the factors affecting the emotional reactions they demonstrate in their repeated encounter with the cadaver.

MATERIAL AND METHODS

Before the study, ethics committee approval for the study was obtained from the Gaziantep University Clinical Researches Ethical Committee (decision date and number: 2016/40). Two different questionnaires were administered to 351 students who participated in the study. Questionnaire-I was administered before the student's first encounter with the cadaver, whereas Questionnaire-II was administered twice, one after student's first encounter with the cadaver and the other after student's fifth encounter with the cadaver.

RESULTS

The females got significantly more excited before their first encounter with the cadaver, and that they felt more fear and more sadness for the cadaver (p = 0.001, p = 0.002, and p = 0.019, respectively). On the other hand, the males felt significantly readier to see the cadaver (p = 0.002). It was found that statements of emotional shock, excitement, sadness, and fear coming from the participants decreased significantly after their fifth encounter with the cadaver (p = 0.028, p = 0.001, p = 0.048, and p = 0.039, respectively).

CONCLUSION

Repeated encounters with cadavers were found to have reduced the negative emotions felt by the students, but have negatively affected the thoughts of the students in respect of donating their bodies.

The influence of humanised anatomical pedagogy on psychophysiological responses and academic achievement in nursing students

Anatomy, a fundamental subject in nursing education, provides students with knowledge of human structure and function. The study was to explore the influence of humanised anatomy educational method on nursing students' psychophysiological responses and academic achievement to human anatomy using cadavers, and to examine the correlations between the students' characteristics (such as gender), psychophysiological responses, and academic achievement in anatomy. A correlational study design was adopted. A total of 80 participants with a 4-year BSN degree were recruited from a nursing school located in eastern Taiwan. Human anatomy teaching using cadavers was delivered. Standardised and researcher-modified questionnaires were used to collect data. Either parametric or nonparametric methods were used for data analysis depending on data distribution. A small proportion of students experienced physical symptoms and stress. Gender difference was observed in death anxiety caused by working with cadavers. All psychophysiological responses of students did not influence their achievement. Further, the students demonstrated that using cadavers had a certain level of engagement with the course, which was positively correlated with academic grades. This study suggests that human anatomy using cadavers is a feasible educational method to broaden students learning experience in class.

Anxiety levels among health sciences students during their first visit to the dissection room

BACKGROUND

The teaching of human anatomy is often based on practices of cadaver dissection and prosected specimens. However, exposure to human cadavers might be stressful and anxiety-inducing for students. The aim of this study is to explore the degree of satisfaction and anxiety among first-year students in the Medicine, Occupational Therapy, Speech Therapy and Nursing programmes at the Universidad de Castilla-La Mancha (Spain) who are experiencing their first dissection/prosection practice to develop stress coping strategies.

METHODS

A total of 204 health sciences students participated in this study. The State-Trait Anxiety Inventory was used to evaluate anxiety.

RESULTS

'State Anxiety' (SA) decreased significantly throughout the course (p < 0.05), from 20.7 ± 19.29 to 13.7 ± 11.65 points. Statistical differences (p < 0.05) in SA were found between the different health sciences, and pre-practice SA was significantly different from post-practice SA. The students with the highest pre-practice SA levels were nursing students (31.8 ± 33.7 points), but medical students had the highest post-practice SA levels (18.4 ± 12.82 points).

CONCLUSIONS

Although students were satisfied with dissection practices (96.8% of them recommended that the practices be retained for future courses), the experience can provoke stressful responses that must be addressed using advanced preparation and coping mechanisms, especially among medical and nursing students.

Anxiety among nursing students during their first human prosection

Dissection and prosection practices using human cadavers are a key component of macroscopic anatomy education in different Health Sciences university degrees. However, first-hand interaction with cadavers can be distressing for students, generating anxiety on a number of levels. This study aims to shed light on the reactions, fears and different states of anxiety experienced by nursing students in to a single anatomy room experience over a five-hour period, and examined reactions pre and post same. A descriptive study of these students was designed in order to understand their feelings and emotions, based on the distribution of anonymous "ad hoc" questionnaires before and after the practices. Also, State-Trait Anxiety Inventory (STAI) questionnaires were administered in order to assess their anxiety levels: Trait Anxiety (TA), which measures basal anxiety levels, and State Anxiety (SA), which measures individual emotional responses during a specific event (in this case, the prosection practice). The results of this study indicate that basal anxiety levels, measured as TA, remained stable and unchanged during the practice (p > 0.05). SA or emotional anxiety levels, on the other hand, dropped from 21.3 to 17.8 points (p < 0.05). Before the start of the practical exercise, 17.6% of the students admitted experiencing some kind of anxiety. Afterwards, however, 90.2% of the students said they would recommend these practices. They considered that prosection practices very useful for their education and recommended that they be retained for future courses. However, our study also showed the relevance of using coping mechanisms before the first contact with the dissecting room, especially for those students who did not feel emotionally prepared for it beforehand.

Anxiety among Medical Students when Faced with the Practice of Anatomical Dissection

Practical training in the dissection of human cadavers is a fundamental and traditional component of human anatomy education in medical schools. This practice, however, can be stressful for students and can generate a certain amount of anxiety. The aim of this study is to explore the attitudes, reactions, and anxiety levels of first-year medical students when working in the dissecting room, over a period of one year, and to relate these anxiety levels to the results of our educational program. This is a before and after descriptive study of students at the University of Castilla-La-Mancha. Questionnaires were distributed among them before and after their dissection practices in order to understand their feelings and emotions and their satisfaction about this activity. State-Trait Anxiety Inventory questionnaires were used to assess the students' 'state anxiety' (SA), which dropped significantly from 49.1% to 14% by the end of their first year. Female students started with higher levels of SA than their male counterparts but by the end of the year these had dropped to similar levels. Anxiety and fearful thoughts tended to drop (P > 0.05). In contrast, uncertainty levels showed significant changes, falling from 44.4% to 12.3%. Nonetheless, 100% of students would go through the experience again. Indeed, 98.2% considered that dissection practices were useful in reinforcing the theoretical aspects of their education, and 80.7% believed that dissecting was more useful than theoretical models. Although students were satisfied with dissection practices the experience cause stressful responses.

Anatomical prosection practices in the Occupational Therapy degree. Student anxiety levels and academic effectiveness

CONTEXT

The practice of anatomical dissection and/or prosection on human cadavers is an essential component of human anatomy training programmes. However, this activity can be stressful for inexperienced students when exposed to cadavers for the first time, and it may generate high anxiety levels. The aims of this study are threefold: 1) to analyse the thoughts and feelings of first-year students of the Occupational Therapy degree about prosection practices; 2) to examine their anxiety levels in relation to these practices; and 3) to evaluate how useful and effective they are as an educational tool for anatomy training.

METHODS

This is a before-and-after cross-sectional study of first-year students of the Occupational Therapy degree at the Universidad de Castilla-La Mancha, Spain. These students had not previously participated in prosection practices. An anonymous questionnaire was distributed among the students before and after the practice, in order to examine their feelings and perceptions during the practice. To examine their anxiety levels, we used a State-Trait Anxiety Inventory (STAI) questionnaire. To assess their learning outcomes the students had to complete two practical tests of recognition of anatomical structures, one before attending the practice and one immediately afterwards.

RESULTS

Basal anxiety levels, measured as trait anxiety (TA), remained stable and did not show significant differences during the practice (p>0.05). Their emotional anxiety, measured as state anxiety (SA), dropped from 14.7 to 10 points (p<0.05) after the practice. Before the start of the practice 11 students (19%) showed signs of anxiety, and these remained so at the end of the practical session (p>0.05). As for their academic performance, we observed that the number of students able to pass the test after attending the prosection practice increased notably (by more than 60%). Additionally, 100% of the students recommended that the practice be retained for future courses, giving it an approval rate of 9.1 out of 10.

CONCLUSION

Although anatomy is usually an attractive subject for Occupational Therapy students and they value prosection practices positively, they remain a potentially complex and stressful experience. Some students find that their experiences in the dissecting room can upset their emotional balance, however, the implementation of coping mechanisms could be a very effective strategy to reduce their anxiety and also to improve their learning outcomes, helping to strengthen their practical knowledge of anatomy as we have observed in this study. The students not only value positively these practices, they also believe that they are an extremely useful tool for both teaching and learning anatomy, and they recommend their routine use as part of the training process.

A Questionnaire Study to Investigate Stress among Future Pharmacists by Gender and Year Group

BACKGROUND

This work aimed to ascertain future pharmacists' stressors and stress-coping practices.

METHODS

Queens' University Belfast Year 2 and 4 pharmacy students were invited to participate in an ethically approved, pre-piloted questionnaire study. Section A was the 10-item Perceived Stress Scale, Sections B and C related to stressors and stress-coping mechanisms, and Section D gathered non-identifiable demographic information. Data analysis largely took the form of descriptive statistics.

RESULTS

A response rate of 94.2% (213/226) was obtained. The mean Perceived Stress Scale score was 19.94 [standard deviation (SD) 6.37], with females having a higher mean score than males (20.55 SD 5.67 versus 18.16 SD 7.42). Common general stressors were career choice, employment opportunities, and finance. Common degree-specific stressors were particular assessments (objective structured clinical examinations and one-off written examinations) and the amount of course material. Popular stress-coping practices included getting emotional support from friends and family and using self-distractions.

CONCLUSION

Stress appears to be an issue among these future pharmacists, and potentially more so for females. While the main stressors are unsurprising, this UK data enables comparisons to be made and helps inform support mechanisms within the university.

A New Approach to Body Donation for Medical Education: The Silent Mentor Programme

Cadaveric dissection is an integral component of medical education. There had been concerns about negative impact on medical students exposed to deceased donors before their clinical years, but most studies reported overall positive outcome following this form of teaching. Due to reducing number of body donations in most parts of the world, many institutions are adopting alternative models especially for the teaching of gross anatomy. A new body donation programme that incorporate humanistic values in the procurement process was initiated by Tsu Chi University of Taiwan in 1996. Early observations following teaching with the so-called “silent mentors” noted less negative emotional impact on the students. With increasing number of body donation following the initiation of the silent mentor programme as reported in some regions, we will be able to continue the time-honoured cadaveric dissection for anatomy teaching, at the same time promoting humanistic values on junior doctors.

Effects of a "silent mentor" initiation ceremony and dissection on medical students' humanity and learning

OBJECTIVES

Many medical schools in Taiwan have adopted a dignified "silent mentor" initiation ceremony to strengthen student's medical humanity and increase their learning attitudes. This ceremony consists of introductions of the body donor's conduct and deeds, wreath-laying, and a tea party. However, few empirical studies have examined the influences of the ceremony and dissection on medical humanity. This study explored if the initiation ceremony and the course can help students care more about others, develop more positive attitudes toward death, improve learning effectiveness in the course, and decrease negative emotions the first time they see a cadaver.

METHODS

The Attitudes Towards Death and Love and Care subscales of the life attitude inventory, Learning Effectiveness of Gross Anatomy Laboratory Scale (LEGALS), and Emotional Reactions Towards Cadavers Scale were adopted to examine differences before (T1) and after (T2) medical students attended an initiation ceremony at a university in northern Taiwan. Whether these effects lasted to the end of the semester (T3) was also tested.

RESULTS

After the ceremony, students' attitudes towards death increased, negative emotions towards cadavers decreased, but love and care and the LEGALS did not significantly change. Data from T3 showed a similar pattern, but high-level emotions (e.g., being respected, cherished, and grateful) and the LEGALS were significantly higher than those at T1.

DISCUSSION

The initiation ceremony, which showed a body donor's deeds and attitudes toward life and death when they were alive, could help medical students gain more mature attitudes towards death and decreased negative emotions. Learning between T2 and T3 might have caused significant changes in high-level emotions and the LEGALS at T3. Arranging reflective writing with guided discussion by a teacher before and after the ceremony is highly recommended.

Learning from human cadaveric prosections: Examining anxiety in speech therapy students

Human anatomy education often utilizes the essential practices of cadaver dissection and examination of prosected specimens. However, these exposures to human cadavers and confronting death can be stressful and anxiety-inducing for students. This study aims to understand the attitudes, reactions, fears, and states of anxiety that speech therapy students experience in the dissection room. To that end, a before-and-after cross-sectional analysis was conducted with speech therapy students undertaking a dissection course for the first time. An anonymous questionnaire was administered before and after the exercise to understand students' feelings and emotions. State-Trait Anxiety Inventory questionnaires (STAI-S and STAI-T) were used to evaluate anxiety levels. The results of the study revealed that baseline anxiety levels measured using the STAI-T remained stable and unchanged during the dissection room experience (P > 0.05). Levels of emotional anxiety measured using the STAI-S decreased, from 15.3 to 11.1 points (P < 0.05). In the initial phase of the study, before any contact with the dissection room environment, 17% of students experienced anxiety, and this rate remained unchanged by end of the session (P > 0.05). A total of 63.4% of students described having thoughts about life and death. After the session, 100% of students recommended the dissection exercise, giving it a mean score of 9.1/10 points. Anatomy is an important subject for students in the health sciences, and dissection and prosection exercises frequently involve a series of uncomfortable and stressful experiences. Experiences in the dissection room may challenge some students' emotional equilibria. However, students consider the exercise to be very useful in their education and recommend it. Anat Sci Educ 10: 487-494. © 2017 American Association of Anatomists.

Cadaver dissection: A positive experience among Saudi female medical students

Objectives

The objectives of this study were to evaluate first-year undergraduate female preclinical medical students' behaviours, experiences, and emotions regarding cadaver dissection. The evaluation was performed during the 2013–2014 academic year, six months after starting the dissection course.

Methods

A 14-statement questionnaire was administered to a group of 200 first-year undergraduate female preclinical medical students at the College of Medicine, King Abdulaziz University (KAU), KSA. For each question, the students responded by selecting either “Yes,” “No,” or “Undecided.” Statistical analysis was performed after collection of the questionnaire responses.

Results

The results showed that 90% of the students agreed that cadaver dissection provided the best and shortest way to study anatomy. Also, 89% were excited during their first visit to the dissection room, and 79% were satisfied that dissection of a cadaver was ethically acceptable. The majority of the students (over 90%) declared that dissection of a cadaver was one of the best teaching strategies for facilitating the acquisition of knowledge of human anatomy.

Conclusions

Saudi female first-year undergraduate medical students at KAU showed positive attitudes toward cadaver dissection during their human anatomy course. This study prompts the need for exploration of gender differences in perception regarding cadaver dissection.

An anatomy precourse enhances student learning in veterinary anatomy

Veterinary anatomy is often a source of trepidation for many students. Currently professional veterinary programs, similar to medical curricula, within the United States have no admission requirements for anatomy as a prerequisite course. The purpose of the current study was to evaluate the impact of a week-long precourse in veterinary anatomy on both objective student performance and subjective student perceptions of the precourse educational methods. Incoming first year veterinary students in the Louisiana State University School of Veterinary Medicine professional curriculum were asked to participate in a free precourse before the start of the semester, covering the musculoskeletal structures of the canine thoracic limb. Students learned the material either via dissection only, instructor-led demonstrations only, or a combination of both techniques. Outcome measures included student performance on examinations throughout the first anatomy course of the professional curriculum as compared with those who did not participate in the precourse. This study found that those who participated in the precourse did significantly better on examinations within the professional anatomy course compared with those who did not participate. Notably, this significant improvement was also identified on the examination where both groups were exposed to the material for the first time together, indicating that exposure to a small portion of veterinary anatomy can impact learning of anatomical structures beyond the immediate scope of the material previously learned. Subjective data evaluation indicated that the precourse was well received and students preferred guided learning via demonstrations in addition to dissection as opposed to either method alone. Anat Sci Educ 9: 344-356. © 2015 American Association of Anatomists.

Enhancing paramedics procedural skills using a cadaveric model

BACKGROUND

Paramedic education has evolved in recent times from vocational post-employment to tertiary pre-employment supplemented by clinical placement. Simulation is advocated as a means of transferring learned skills to clinical practice. Sole reliance of simulation learning using mannequin-based models may not be sufficient to prepare students for variance in human anatomy. In 2012, we trialled the use of fresh frozen human cadavers to supplement undergraduate paramedic procedural skill training. The purpose of this study is to evaluate whether cadaveric training is an effective adjunct to mannequin simulation and clinical placement.

METHODS

A multi-method approach was adopted. The first step involved a Delphi methodology to formulate and validate the evaluation instrument. The instrument comprised of knowledge-based MCQs, Likert for self-evaluation of procedural skills and behaviours, and open answer. The second step involved a pre-post evaluation of the 2013 cadaveric training.

RESULTS

One hundred and fourteen students attended the workshop and 96 evaluations were included in the analysis, representing a return rate of 84%. There was statistically significant improved anatomical knowledge after the workshop. Students' self-rated confidence in performing procedural skills on real patients improved significantly after the workshop: inserting laryngeal mask (MD 0.667), oropharyngeal (MD 0.198) and nasopharyngeal (MD 0.600) airways, performing Bag-Valve-Mask (MD 0.379), double (MD 0.344) and triple (MD 0.326,) airway manoeuvre, doing 12-lead electrocardiography (MD 0.729), using laryngoscope (MD 0.726), using Magill® forceps to remove foreign body (MD 0.632), attempting thoracocentesis (MD 1.240), and putting on a traction splint (MD 0.865). The students commented that the workshop provided context to their theoretical knowledge and that they gained an appreciation of the differences in normal tissue variation. Following engagement in/ completion of the workshop, students were more aware of their own clinical and non-clinical competencies.

CONCLUSIONS

The paramedic profession has evolved beyond patient transport with minimal intervention to providing comprehensive both emergency and non-emergency medical care. With limited availability of clinical placements for undergraduate paramedic training, there is an increasing demand on universities to provide suitable alternatives. Our findings suggested that cadaveric training using fresh frozen cadavers provides an effective adjunct to simulated learning and clinical placements.

Human anatomy: let the students tell us how to teach

Anatomy teaching methods have evolved as the medical undergraduate curriculum has modernized. Traditional teaching methods of dissection, prosection, tutorials and lectures are now supplemented by anatomical models and e-learning. Despite these changes, the preferences of medical students and anatomy faculty towards both traditional and contemporary teaching methods and tools are largely unknown. This study quantified medical student and anatomy faculty opinion on various aspects of anatomical teaching at the Department of Anatomy, University of Bristol, UK. A questionnaire was used to explore the perceived effectiveness of different anatomical teaching methods and tools among anatomy faculty (AF) and medical students in year one (Y1) and year two (Y2). A total of 370 preclinical medical students entered the study (76% response rate). Responses were quantified and intergroup comparisons were made. All students and AF were strongly in favor of access to cadaveric specimens and supported traditional methods of small-group teaching with medically qualified demonstrators. Other teaching methods, including e-learning, anatomical models and surgical videos, were considered useful educational tools. In several areas there was disharmony between the opinions of AF and medical students. This study emphasizes the importance of collecting student preferences to optimize teaching methods used in the undergraduate anatomy curriculum.