Post-Traumatic Stress and Academic Performance Among Entry-Level Doctoral Physical Therapy Students in a Human Anatomy Cadaver Dissection Course

Abstract

Background: Dissection of human cadavers can be a stressful experience for students. Purpose: The purposes of this study were twofold: 1) to determine if physical therapy students develop or experience a worsening of post-traumatic stress disorder (PTSD) symptoms during exposure to and dissection of human cadavers; and 2) to determine if these symptoms are related to academic performance. Methods: Previous history of a diagnosis of anxiety or post-traumatic stress disorder and level of prior exposure to cadavers were recorded among 26 entry-level first semester doctoral students in physical therapy (DPT) taking gross human anatomy. Their level of anxiety about working with cadavers before and after the course was recorded. The Life Events Checklist (LEC-5) for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was used as a self-report measure to record potentially traumatic events in a subject’s life prior to the study and during the course. Subjects also completed the Post-Traumatic Stress Disorder Checklist (PCL-5) at the beginning and end of the course to assess for symptoms of post-traumatic stress disorder. Student performance was assessed using written and practical examination grades. Results: Overall, the PCL-5 score for the group decreased significantly over the semester (p = 0.01). However, 3 subjects’ PCL-5 scores increased. Risk factors present among these subjects included previous diagnosis of post-traumatic stress disorder or anxiety, combat exposure, history of physical or sexual abuse, lack of previous exposure to cadavers, and coinciding traumatic events. Written examination performance was not significantly related to either change in PCL-5 (p = 0.84) or post-PCL-5 (p = 0.69) scores. Practical examination performance was not significantly related to either change in PCL-5 (p = 0.28) or post-PCL-5 (p = 0.51) scores. However, consistent with previous research, students with a history of post-traumatic stress disorder and/or anxiety did have statistically significant lower written examination scores. Conclusions: Physical therapy students neither developed nor experienced a worsening of, but rather a reduction in, PTSD symptoms during exposure to and dissection of human cadavers. Overall, symptoms of PTSD did not seem to be related to academic performance.