Educating medical students about death and dying.

Black, Dora; Hardoff, Daniel; Nelki, J

doi:10.1136/adc.64.5.750

Cited by 34 publications

(30 citation statements)

References 28 publications

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“…However, if a depersonalized view of patients is not to develop and become fixed, a second component to the strategy is required. T h e experiences of the dissecting room should be called on later, and perhaps used as a relevant personal and professional starting point, within a unified death and bereavement "curriculum" (Barton, 1972;Barton et al, 1972;Bloch, 1976;Bleeker and Pomerantz, 1979;Black et al, 1989). Such an approach could be isolated specifically within the context of Anatomy Departments but might be better integrated longitudinally in a preclinical and clinical teaching course.…”

Section: Discussionmentioning

confidence: 96%

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Human dissection and attitudes of preclinical students to death and bereavement

Druce

Johnson

1994

Clinical Anatomy

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Two questionnaires were used to gather information about preclinical education concerning death and bereavement. One was mailed to Heads of Anatomy Departments of 26 UK medical schools. The other was distributed to 220 first-and 210 second-year preclinical students in Cambridge. Among curricular organizers (77% response rate), the motivation for giving such education was primarily to improve knowledge about dissection, and only secondarily and infrequently to prepare students for clinical practice or to address their attitudes or feelings. In contrast, the primary concern of students (response rate 54%) was preparation for encounters with death in clinical practice (61-85%), lesser concerns being to address their own fears and feelings (30-40%) or knowledge about the dissecting room, cadavers, etc. (23-37%). Students were also asked about their reactions to dissection in order to determine whether the dissecting room might provide an opportunity for teaching about death. Most (66%) admitted experiencing moderate to extreme apprehension in advance of dissection. Apprehension was associated, on starting dissection, with very strong reactions, which in some cases interfered with learning. Some (27%) dealt with this by depersonalization. The only previous experiences that showed a significant association with the occurrence during dissection of interfering andlor non-task-related thoughts and feelings were (i) for both men and women the occurrence and quality of handling of death experience(s) at school, and (ii) for a group of male students the experience of the death of more than one close non-family friend. A strategy for effective use of the dissecting room in studies on death is outlined.

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Section: Discussionmentioning

confidence: 96%

“…There is no consensus on answers to these questions. Some authors (Bloch, 1975;Black et al, 1989) have focused on the clinical years, as being "when working with people begins." T h e Medical School responses also questioned whether topics perceived as clinical could be introduced easily into a largely scientific preclinical curriculum.…”

Section: Discussionmentioning

confidence: 99%

Human dissection and attitudes of preclinical students to death and bereavement

Druce

Johnson

1994

Clinical Anatomy

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“…They follow objective routines on patients who are treated as objects. T h e dehumanization of both physician and patient is an unhealthy foundation on which to base a profession that aims to heal (see Nuland, 1994;Hull, 1991;Dyer, 1992;Black et al, 1989;Home et al, 1990).…”

Section: Discussionmentioning

confidence: 99%

Human gross anatomy: A crucial time to encourage respect and compassion in students

1995

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We suggest four ways in which human gross anatomy instructors can reinforce respect and compassion in students. First, encourage respectful language in the laboratory. The term “donor” should be used instead of “cadaver” or “corpse” in referring to the donated body because this promotes appreciation for the students' first “patient.” Second, provide the students with the actual name, age, history, and likely cause of death of the donor so that they more fully appreciate the donor as having once been a living human being. Third, prompt students to explore feelings and discuss topics stimulated by the intense experience of human dissection. Suggested topics include the students' feelings about dissecting a human being, the difficulty in deciding to donate one's body, the central importance of anatomy to a medical practitioner's role, and the historical development of the study of anatomy. Fourth, hold a memorial ceremony, in which both students and faculty participate, as a positive closure to an emotionally and intellectually intense course. Additionally, a ceremony reinforces salutary values in students, enhances social bonding among students, and encourages their appreciation of various cultural and religious beliefs. These methods introduce a new dimension of experience for anatomy students. We have developed these methods in response to what we view as a negative trend in the medical profession in which health care becomes technical and patients become objects. It is our role as faculty to reinforce respectful and compassionate attitudes in medical students from the very beginning. © 1995 WiIey‐Liss, Inc.

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“…Younger physicians are more likely to encounter difficulty facing their own feelings about death and this can become very stressful (FirthCozens, 1987). Herman Feifel (1966) hypothesized that many students enter medicine because of their own above-average fear of death and, that by entering patients will develop (Black et al, 1989). As Coombs (1978) observed, becoming a doctor requires more than learning a body of knowledge and a set of skills; it also requires a significant transformation in the person of the student.…”

Section: Introductionmentioning

confidence: 96%