The Emotional Experiences of Students in Dissection‐ and Prosection‐based Cadaveric Anatomy Courses

Abstract

IntroductionCadaver‐based anatomy courses provide opportunities for students to grow psychosocially and professionally. Engaging with cadaveric specimens encourages students to explore complex intersections of empathy, compassion, and professional responsibility in a way that is valuable for their development as future health professionals. As curricular time decreases, prosection‐based curricula offer a temptingly efficient alternative to curricular designs in which the students do the dissections. However, a concern is that prosection‐based curricula may not provide the same emotional resonance as dissection and therefore jettison a major benefit of the anatomy laboratory experience. The COVID‐19 pandemic provided a natural experiment in which to explore this concern. We compared the emotional impacts of dissection vs. learning solely from prosected (pre‐dissected) specimens. Our hypothesis was that students learning from prosected specimens would feel less connected to the donors and overall have a more intellectual, less emotional experience in the course.MethodsWe used a validated survey instrument to compare the emotional experiences of students in a traditional dissection‐based course in 2019 to those in a prosection‐based course in 2020, necessitated by spatial distancing requirements during the COVID‐19 pandemic. The survey included two free‐response questions and 27 Likert scale questions categorized as: Donor as a person; Donor as a patient; Interaction with cadaveric specimens; Emotional reactions during course. The groups were compared using a multivariate general linear model that controlled for multiple comparisons and grounded theory thematic analysis of the qualitative data.ResultsStudents in both years reported overall high ratings for enjoyment, appreciation, and gratitude for the experience. Students in the dissection‐based course more frequently felt empathy for and connection to the donor and the donor’s family than did students in the prosection course (Donor as a person: Wilk's Λ = 0.780, p<0.001). Students in the dissection‐based course also more frequently felt feelings of disgust, anxiety, and wanting to avoid the anatomy laboratory (Interaction with cadaveric specimens: Wilk's Λ = 0.696, p<0.001). Students in the prosection‐based course more frequently enjoyed the laboratory experience and felt fascinated by the anatomy (Emotional reactions: Wilk's Λ = 0.898, p<0.007). Qualitative analyses clarified that the negative feelings in the dissection group focused on the process of dissection and a desire for more explicit support for emotional processing.DiscussionBoth groups in this study had positive experiences in the anatomy laboratory. The students in the dissection group reported a wider range of emotions and were more actively aware of their empathy for the donors, while the prosection students reported a more homogeneous positive experience. These results suggest that dissection‐based curricula provide richer opportunities for students to practice navigating complex emotions in a professional setting. Anatomy faculty must support students’ psychosocial growth by acknowledging and facilitating their exploration of these experiences.