Abstract
Introduction: In April 2011 a reflective, interdisciplinary course module in preparation for the dissection course was implemented at the medical faculty in Göttingen. This module comprised an introductive lecture and seminar. It was developed in collaboration of the departments of Palliative Care, Medical Psychology and Sociology, and Anatomy. The course element includes topics like dignity and professional distance during the dissection course and their relation to the future doctor-patient-relationship. The implementation of this new course module was accompanied by explorative and evaluative research including a formal didactical evaluation and an exploration of the students experiences with death and dying, their feelings in the run-up to the dissection course as well as the association of emotional stress, stress induced symptoms and emotional blunting. Methods: Students were surveyed using self developed questionnaires before entering the dissection room (day 1), after the reflective seminar (day 3) and at the end of the dissection course (day 88). The quantitative data was processed with EvaSys, STATISTICA, SPSS and Excel. Statistical tests, analyses of variance and reliability were used; further open questions required a qualitative approach using Mayring´s content analysis. Results: On average 64,2% returned the questionnaires, 37.3% of the participants were male and 62.7% female, with a mean age of 21.9 years. Medical students in Göttingen have a lot of broad experiences with death and dying: nearly every student had already been involved in the death of a family member or friend. Before the anatomy course began, most students felt motivated and positive before entering the dissection room; only one fifth had to deal with fear. The dissection course triggered emotional stress, even though the experienced stress level was lower than initially assumed by the students themselves. Overall, 61.7% felt some kind of emotional stress during the dissection course. Further results showed that 39.1% of the students suffered from symptoms like fainting, nightmares and loss of appetite in connection with the dissection course. The majority of the respondents (81.4%) agreed to the statement "The dissection room experiences had contributed to a certain emotional blunting". Even though more than half of the students had prepared themselves mentally in some kind for the anatomy course all respondents considered a special preparation for the anatomy course as necessary. As part of the formal course evaluation, students appreciated the opportunity for self-reflection. They majority felt not only stimulated to think about the subject of death and dying, but also felt better prepared for the handling of deceased persons because of the worked out supports about empathy, dignity and distance. Conclusion: Our newly implemented course element is an appropriate, effective and necessary preparation for the dissection course. Even though many students had had previous experience with death and dying, emotional stress in context with the dissection course has been proven and requires prevention or intervention.
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