Ethical Dilemmas Posed in the Care of Obese Patients in the Emergency Department

Venkat, Arvind; Larkin, Gregory Luke

doi:10.18785/ojhe.1001.05

Cited by 1 publication

(1 citation statement)

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“…Many students in this study likened technical difficulties of dissecting larger cadavers to technical difficulties of performing surgery on patients with obesity, and concluded that gross anatomy had taught them about challenges they would later encounter when examining and proceduralizing patients with obesity. Several studies have found that obesity increases rates of surgical wound infection, intraoperative blood loss and operative timecomplications that might well be described as making such surgeries more 'difficult' [33][34][35][36]. Gross anatomy might then be seen as preparing students for technical challenges they might face later in training.…”

Section: Discussionmentioning

confidence: 99%

The “difficult” cadaver: weight bias in the gross anatomy lab

Goss

Rethy

Pearl

et al. 2020

Medical Education Online

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Background: The prevalence of overweight and obesity continues to rise and is associated with increased morbidity and mortality. Weight bias is common among physicians and medical students and limits the therapeutic alliance between providers and patients with overweight and obesity. Objective: The authors sought to explore the relationship between the gross anatomy course and medical student attitudes towards weight and obesity. Design: The authors employed a mixed-methods approach consisting of semi-structured interviews and anonymous web-based surveys of first-year medical students taking gross anatomy at one USA medical school. They analyzed transcripts of interviews and free-text survey responses using a grounded theory approach and performed tests of association to investigate the relationship between demographic information, responses to multiple-choice survey questions and weight bias. Results: A total of 319 (52%) first-year medical students (2015-2018) completed the survey and 33 participated in interviews. Of survey respondents, 71 (22%) responded that the course had changed how they felt about people with overweight/obesity. These respondents were also more likely to affirm that the course had affected their views toward their own bodies (p < 0.001). Qualitative data analysis identified three overarching themes within students' descriptions of the effects of the gross anatomy lab on attitudes toward bodies perceived to have excess weight: these bodies were described as 1) difficult, 2) unhealthy, and 3) evoking disgust. Students extrapolated from their experiences with cadavers to imagined interactions with future patients, relying heavily on the narrative of the difficult patient. Conclusions: At one USA medical school, students perceived their experiences in gross anatomy as shaping their attitudes toward individuals with overweight or obesity. Efforts to reduce medical student weight bias ought to target this previously unexplored potential site of weight bias.

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Section: Discussionmentioning

confidence: 99%