Fewer medical students are open to body donation after dissecting human cadavers

Abstract

Introduction: Cadaver dissection has long been hailed as a vital component of medical education. Although most physicians acknowledge positive impacts of cadaver dissection on their learning, they are less likely to will their bodies for anatomical dissection than the general public. This study aims to determine whether the proportion of medical students open to willed body donation changes after completing cadaver dissection. Methods:We conducted a longitudinal study surveying 323 medical students across three cohorts before and after anatomical dissection of human cadavers. Through the survey, students indicated whether they would will their body for anatomical dissection. Additionally, students responded to items regarding the rationale underlying their decision, demographics and perceived effects of anatomical dissection on medical education. Results:The proportion of students who expressed openness to willed body donation decreased by 25% after cadaver dissection. Of the 171 students who initially stated they would will their body, 61 (35%) changed their response after completing cadaver dissection. Those who cited religion as a motivating factor were less likely to show openness to body donation, whereas those who cited ethical factors were more likely.Conclusions: This study documents a substantial decrease in the proportion of students open to willed body donation after completion of cadaver dissection. Despite this, students almost universally report educational benefits of cadaver dissection. This raises interesting questions regarding the emotional impact of cadaver dissection and the ethical implications of willed body donation. | INTRODUCTIONAnatomical dissection of human cadavers has long been considered a rite of passage in medical education. 1 Prior to the SARS-CoV-2 pandemic, around 90% of US medical schools still incorporated cadaver labs into their anatomy curriculum. 2 Although the pandemic spurred a shift toward virtual learning, the majority of medical schools still offer in-person labs for first-year students. 2 Many studies have documented a positive impact of cadaver dissection on student learning. [3][4][5] Likewise, the majority of physicians, particularly those in surgical specialties, look favourably on their experiences with cadaver dissection. 5,6 Despite this, a disproportionately small number of physicians donate their bodies to medical school Willed Body Programs. [7][8][9] The discordance between the proportion of physicians who claim to have benefited from cadaver dissection and the proportion willing to donate their own body for medical education remains poorly explained. It is reasonable to posit that physicians, having directly experienced the positive impact of cadaver dissection on their

Dissecting the dissection experience: Whither the need for humanising the cadaver

“…5,9 Such coping strategies may also facilitate positive emotional connections with cadavers by providing a humanistic frame of reference with which students can relate. 2,3,5,6 In this way, students may offset negative emotions associated with dissection and develop empathic skills, as well as a sense of purpose and responsibility, that promote behavioural empathy and positive attitudes with cadavers and, eventually, future patients. [3][4][5][6]9 Moreover, by recognising and acknowledging the cadaver's humanity, students feel gratitude toward their donor and may identify more strongly with their decision to donate their body, possibly inspiring them to also consider body donation.…”

“…Despite endorsing its educational benefit, the proportion of students willing to donate their body decreased by 25% after dissection; of the students who were initially open to body donation, 35% changed their response post-dissection. 3 Among factors explored by the authors, one warranting further discussion is the emotional experience of dissection. To appreciate this nuanced process, and the tensions within, the domains of empathy provide a useful framing.…”

“…2,3,5,6 In this way, students may offset negative emotions associated with dissection and develop empathic skills, as well as a sense of purpose and responsibility, that promote behavioural empathy and positive attitudes with cadavers and, eventually, future patients. [3][4][5][6]9 Moreover, by recognising and acknowledging the cadaver's humanity, students feel gratitude toward their donor and may identify more strongly with their decision to donate their body, possibly inspiring them to also consider body donation. 4 Students seeking emotional connection through humanising coping strategies (e.g., naming, identification, and intentional respect for the donor) likely maintain the roles of 'patient' and 'teacher'.…”

“…Conversely, students seeking emotional connection through humanising coping strategies (e.g., naming, identification, and intentional respect for the donor) likely maintain the roles of ‘patient’ and ‘teacher’, engendering a sense of respect while also reconciling the roles versus anonymity tension through embracing—rather than rejecting—these roles 5,9 . Such coping strategies may also facilitate positive emotional connections with cadavers by providing a humanistic frame of reference with which students can relate 2,3,5,6 . In this way, students may offset negative emotions associated with dissection and develop empathic skills, as well as a sense of purpose and responsibility, that promote behavioural empathy and positive attitudes with cadavers and, eventually, future patients 3–6,9 .…”

“…This framework is described to contextualise a discussion inspired by an article in this issue of Medical Education exploring willed body donation in medical learners. In their study, Gerbert and Zhang 3 surveyed medical students about their openness to body donation both before and after anatomical dissection. Despite endorsing its educational benefit, the proportion of students willing to donate their body decreased by 25% after dissection; of the students who were initially open to body donation, 35% changed their response post‐dissection 3 .…”