Academic journal article New Zealand Journal of Psychology

Impact of Cadaver Dissection on Medical Students

Academic journal article New Zealand Journal of Psychology

Impact of Cadaver Dissection on Medical Students

Article excerpt

Concern has been raised over the psychological trauma some medical students appear to experience when undertaking human dissection. While previous research has been undertaken overseas, the present study sought to further investigate this phenomenon within a New Zealand university. Questionnaires were administered to 100 students attending the Auckland School of Medicine both immediately prior to their first dissection experience and at intervals over the following two years. A small but significant proportion (10%) exhibited a stress reaction one week following the first dissection, with the percentages dropping to 6.3 at one month, 3.6 at 8 months, 2.1 at one year, and zero at 2 years. Multivariate regression analysis associated preexisting psychological morbidity and stress related to the impending dissection with post dissection trauma. Coping behaviours were used relatively infrequently and associations with gender, ethnicity and baseline psychological variables identified. These results suggest that the initial stress associated with human dissection dissipates relatively rapidly, but such a finding should not be used to undermine efforts to identify and support the relatively few students who may initially be distressed by the experience.

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Dissection of the human body is employed as a method of instruction in anatomy courses at both the Auckland and Otago medical schools in New Zealand. Although a time-honoured and almost universally accepted educational process, over the last 10-15 years attention has been drawn to the traumatic effects of dissection on some students and the implications of such trauma on subsequent education and practice (Charlton, Dovey, Jones, & Blunt, 1994; Gustavson, 1988; Hafferty, 1988). Aspects of dissection that medical students are reported to find distressing include revulsion at the sight and smell of the cadavers, shock at confronting death, desecration and dismemberment, violation of cultural taboos, dehumanisation, and invasion of privacy (Hafferty, 1988; Jones, 2000). The process is said to confront students with their fears and anxieties regarding life, death and human mortality that require time to resolve (Gustavson, 1988).

Investigations into such 'dissection trauma' have produced varying results, with reported proportions of students exhibiting distress ranging from 5 to 25 percent (Jones, 2000). Some authors found symptoms of severe depression, anxiety, insomnia and intrusive visual imagery that appear to resemble the symptoms of post-traumatic stress disorder (Gustavson, 1988). In an Auckland-based study of physiotherapy and occupational therapy students exposed to cadavers and prosections, Hancock, Williams and Taylor (1998) reported that 9% exhibited an initial post-traumatic stress reaction, but this proportion subsequently dropped to 2.1% on re-testing 18 months later. Many students reported that dissection was their first direct encounter with dead bodies, and that for some it was the first time they had seen 'a naked old person, let alone a naked old and dead person'. The researchers commented that to cut into the human body, to dismember it, to mutilate, and disassemble it, was outside the realm of everyday experience, and one that normally would constitute an extreme violation of societal norms.

In the present study the researchers adopted the concept of stress as being the substantial imbalance between demands that are made and the ability of individuals and groups to respond with the support available (Taylor, 2002a). Since its inception the concept had been defined both as the strain imposed upon an object or person and as the consequence of tension (Taylor, 2002b), but in line with recent empirical and theoretical developments (cf. Zeidner & Endler, 1996), the interactional model just described is preferred. Consistent with that model, when designing the present project the authors considered a cluster of aetiological factors concerning individuals, their histories and immediate circumstances that McFarlane and Yehuda (1996) presented. …

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