Preclinical student reactions to dissection, death, and dying

The objective of the present study was to determine the reactions of preclinical medical students to dissection; cognate issues. A questionnaire was administered to a class of 148 students; the stimulus items inquired about the frequency of mental and physical symptoms, causes of stress, degree of upset occasioned by dissection, previous encounters with death, mental preparedness at the commencement of the course, reactions to dissecting room activities, coping strategies, and the desirability of a course on death and dying. Nearly a quarter of the sample reported an increase in the frequency of mental and physical symptoms. A third of the students identified the dissecting room as a "very important" stressor. Only for female respondents were "dissecting room" and "great difficulty of work" significantly associated as causes of stress. Over three-quarters of the students were upset at the beginning of dissection and about a third remained disturbed after 101.5 hours. Sixty students had seen a dead body previously and 30 students had been bereaved within the 2 years preceding the study. However, neither prior exposure to a dead body nor bereavement was a safeguard against persistent upset by dissection. The initial reactions were mostly negative, but neutral and positive attitudes later supervened. The coping strategies cited did not suggest any significant distortion attributable to the unseemly origins of the cadavers. A compulsory formal course on death and dying during both preclinical and clinical stages was considered desirable by the majority of respondents, more for personal and clinical reasons than for dissection-related ones.