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 Table of Contents  
ORIGINAL ARTICLE
Year : 2015  |  Volume : 14  |  Issue : 2  |  Page : 101-104

Attitude of Jos University medical students to their initial encounter with cadavers in the dissecting room


1 Department of Human Anatomy, University of Jos, Jos, Nigeria
2 Department of Human Physiology, University of Jos, Jos, Nigeria
3 Department of Community Medicine, University of Jos, Jos, Nigeria

Date of Web Publication19-Feb-2016

Correspondence Address:
A I Shugaba
Department of Human Anatomy, University of Jos, Jos
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1596-2393.177027

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  Abstract 


Objective: This study aimed to discover the emotional reactions, attitudes and beliefs of undergraduate medical students of University of Jos medical school to 1st time encounter with human cadaver. Materials and Methods: A structured pretested and validated questionnaire was administered to 450 students of 200 to 500 levels all at the same time in May 2012. The age of the students ranged from 21 to 26 years with mean age of 23.1 years. Results: 26.1%, 15.6%, 32.3%, and 15.2% of the 200, 300, 400, and 500 level students, respectively, indicated great anxiety as their reaction to the first experience with cadaver. The fear of infection was the most common cause of worry for the studied population (71.4%, 70%, 49.3%, and 87.3% for the 200, 300, 400, and 500 levels, respectively). A number of students had no symptoms on their first encounter with cadavers (40.5% of 200, 34.4% of 300, 27.7% of 400, and 51.9% of 500 levels) however; dizziness was a common symptom experienced. Conclusion: Overwhelming majority were of the opinion that cadaver dissection should not be substituted with visuals because cadaver dissection gives the students better appreciation of the three-dimensional. Assessment of the attitudes and reactions of medical students could help medical tutors to formulate better strategies to develop academic and clinical competences.

Keywords: Attitude, cadavers, dissecting room, encounter, Jos, medical students


How to cite this article:
Shugaba A I, Usman Y M, Shimwen F J, Uzokwe C B, Shinku F, Rabiu A M, Hassan Z I. Attitude of Jos University medical students to their initial encounter with cadavers in the dissecting room. J Exp Clin Anat 2015;14:101-4

How to cite this URL:
Shugaba A I, Usman Y M, Shimwen F J, Uzokwe C B, Shinku F, Rabiu A M, Hassan Z I. Attitude of Jos University medical students to their initial encounter with cadavers in the dissecting room. J Exp Clin Anat [serial online] 2015 [cited 2019 Nov 12];14:101-4. Available from: http://www.jecajournal.org/text.asp?2015/14/2/101/177027




  Introduction Top


Active dissection and examination of prosected specimens are among the major methods of learning anatomy, which offers important opportunities for cultivating an attitude of professionalism at an early stage in medical education. Numerous medical schools in the United States and abroad have determined that anatomy taught through cadaver dissection is untenable (Aziz et al., 2002). However, arguments against dissection tend to ignore the emotional growth students experience in the process. Cadaver dissection prepares the students for one of the core dilemmas of patient care, namely the need to be personally engaged yet clinically not interested (Aziz et al., 2002). This dilemma, traditionally encountered with the first incision in the dissection laboratory, will persist throughout professional life, and it must, therefore, be addressed in order to provide humanistic care with scientific objectivity. The necessity and utility of cadaver dissection experiences have been questioned by so many people in the society, with some schools even substituting virtual training (i.e., the use of plastic models or computers) for actual dissection (Aziz et al., 2002).

More recent studies have indicated that anatomy is only moderately or not very stressful and in fact generate considerable excitement and enthusiasm among the large majority of students (Rajkumari et al., 2008; Charlton et al., 1994; Rajkumari and Singh, 2007; McGarvey et al., 2001). Other studies of the anatomy dissecting room experience have reported that although the majority of their students expressed a positive attitude toward the initial encounter with the cadaver, a small percentage of students found it traumatic, 58% of their students suffer symptoms suggestive of posttraumatic stress disorder (Finkstein and Mathers, 1990; Penny 1985; O'Carroll et al., 2002; Evans and Fitzgibbon, 1992; Selvratnam et al., 2001; Horne et al., 1990; Abu-Hijleh et al., 1997). Studies conducted in Nigerian revealed that few (a third) preclinical students identified the dissecting room as a very important stress while majority of them found it exciting (Nnodim 1996; Izunya et al., 2010).

There is, therefore, the need for the experienced by medical students in the dissecting room to be explored thoroughly in many different medical schools across the nation and indeed other parts of the world so that there will be overwhelming evidence for or against the use of cadaver in learning anatomy.


  Materials and Methods Top


This was a cross-sectional study that was conducted among the medical students of the University of Jos. Because cadaver dissection is a lifelong experience that cannot be easily forgotten, the study population included the 500, 400, 300 and 200 level students. A total of 450 students were recruited for this study. Data were collected using a structured pretested and validated self-administered questionnaire. The basic components of the questionnaire were an introduction of the researchers/research, biodata of the respondents and questions about what they felt during their first encounter with the cadaver in the dissection room. Pretesting and validation of questionnaire was done from a pilot study earlier conducted with an internal consistency of 0.8. Informed consent was sought and obtained from the study population before data were collected. Data were analyzed using SPSS version 17 software (SPSS Inc., Chicago, IL).


  Discussion Top


The student-cadaver-patient encounter is more important than any other thing in the medical profession because it gives a better appreciation of the three-dimensional anatomy (Andres and Diana-Zulima, 2011).

Students' amphitheater practice evoked positive feelings in most students [Table 1]: Curiosity (84.7) and anxiety (23.3%), as stated in a Colombian study revealing that majority of the students were curiously waiting for their first experience as reported by 54.8%, 50%, 38.7%, and 41.8% of 2nd, 3rd, 4th, and 5th year students, respectively, while just a few 1.6% of year 2, 2.2% of year 3, 0.7% of year 4, and 0% of year 5 students said it was scary/horrible (Andres and Diana-Zulima, 2011).
Table 1: The reaction of students to first experience with the cadaver

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The most frequent cause of fear [Table 2] in this study was the fear of infection as reported by 71.4%, 70%, 49.3%, and 87.3% of 200, 300, 400, and 500 level students and the smell of the room as stated by 66.7% of year 2 students, 70% year 3, 34.8% year 4, and 86.1% year 5 students. This was comparable to the findings of a Malaysian study which reported fear of infection between 61.4% of year 1 students and 34.6% of year 2 students (Selvratnam et al., 2001).
Table 2: The cause of fear

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The most frequent strategy [Table 3] used by our students to overcome fear was by focusing on the task (71.4% of the year 2, 76.7% of year 3, 60% of year 4, and 59.5% of year 5 students) and relaxation by (47.6%, 30%, 36.1%, and 54.4% of 2nd, 3rd, 4th, and 5th of year students). The most frequent methods of coping in other studies were rationalization, relaxation, discussion with fellow students, friends and family (Abu-Hijleh et al., 1997; Horne et al., 1990).
Table 3: The strategies used to overcome fear

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Some studies have reported that few students (30%) showed physical symptoms [Table 4] on first exposure to cadavers in the dissecting room (Horne et al., 1990), 46% of students experiencing some level of fear before and during the initial dissecting room practical (Abu-Hijleh et al., 1997) and 50% of 1st year students and 56.6% of 2nd year students showing no symptoms on first contact with cadaver. However, 17.1% of 1st-year students and 21.1% of 2nd-year students suffered prolonged symptoms lasting over a year (Selvratnam et al., 2001).
Table 4: Symptoms experienced on first entry into the dissecting room

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In this study, no student experienced prolonged symptoms [Table 5] but most of the students stated that they experienced symptoms only on their first visit (25.4% of year 2, 40% of year 3, 34.8% of year 4, and 30.4 of year 5 students). This study also showed that the most common symptoms were dizziness (experienced by 51.6%, 37.8%, 48.4%, and 45.6% respectively for 2nd, 3rd, 4th, and 5th year students) followed by loss of appetite as reported by (27%, 33.3%, 42.6%, and 59.55%, respectively for 2, 3, 4, and 5 hundred level students).
Table 5: The duration of the symptoms

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Furthermore, most of our students (97.6%, 91.1%, 93.5%, and 98.7%, respectively of 200, 300, 400, and 500 levels) admitted that cadaver dissection enhanced their level of understanding anatomy [Table 6] and this is in tandem with findings of other similar studies (Rajkumari et al., 2008; Johnson 2002; Mutyala and Cahill, 1999; Week et al., 1995).
Table 6: Whether cadaver dissection enhances level of understanding anatomy

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Expectedly, on the issue of replacing actual cadaver dissection with visual alternative in the nearest future [Table 7], majority of our students across all the levels of training did not agree to cadaver replacement (80.2% of year 2 students, 85.6% of year 3 students, 84.5% of year 4 students, and 87.3% of year 5 students). This finding is consistent with what was obtained in previous studies (Leong 1999; Jones 2001; Parker 2002; Johnson 2002; McLachlan et al., 2004).
Table 7: Should actual cadaver dissection be substituted with visual dissection

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Studies have also reported that Cadaver dissection gives students a better appreciation of the three-dimensionality of human anatomy, which is not possible with the plastic models or computers and that removal or attenuation of cadaver dissection is bound to impair the students' ability to apply the scientific method during diagnosis (Aziz et al., 2002; McLachlan et al., 2004; Parker 2002).


  Conclusion Top


This study found that anxiety, fear and stress are being experienced by medical students during their first encounter with a cadaver in the dissecting room. It is, therefore, very important that medical educators bring up new ideas/strategies to reduce such problems in the dissecting room. Further studies, especially in other regions of the country are highly recommended to possibly replicate the findings in this study.

Acknowledgment

We wish to appreciate the 200–500 level students of the University of Jos medical school for volunteering to respond to our questionnaires sincerely despite the tight schedules of medical school and the Department of Human Anatomy, University of Jos for the moral support we got for this study.[22]

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

 
  References Top

1.
Abu-Hijleh M.F., Hamdi N.A., Moqattash S.T. (1997). Attitudes and reactions of Arab medical Students to the dissection room. Clin Anat 10:272-8.  Back to cited text no. 1
    
2.
Andres J.G., Diana-Zulima U.M. (2011). Colombian Medical Students' Attitudes towards dissection during their anatomy classes and their relation with a score on the Jefferson scale of Physician Empathy. Rev Fac Med 59 (4):281-309.  Back to cited text no. 2
    
3.
Aziz M.A., McKenzie J.C., Wilson J.S. (2002). The human cadaver in the age of biomedical informatics. Anat Rec 269 (1):20-3.  Back to cited text no. 3
    
4.
Charlton R., Dovey S.M., Jones D.G. (1994). Effects of cadaver dissection on the attitudes of medical students. Med Educ 28 (4):290-5.  Back to cited text no. 4
    
5.
Evans E.J., Fitzgibbon G.H. (1992). The dissection room: Reactions of 1st year med students. Clin Anat 5 (4):311-20.  Back to cited text no. 5
    
6.
Finkstein P., Mathers L. (1990). Post traumatic stress among medical students in the anatomy dissection laboratory. Clin Anat 3:219-26.  Back to cited text no. 6
    
7.
Horne D.J., Tiller J.W., Eizenberg N. (1990). Reactions of first year medical student to their initial encounter with a cadaver in the dissecting room. Acad Med 65 (10):645-6.  Back to cited text no. 7
    
8.
Izunya A., Oaikhena G., Nwaopara A. (2010). Attitudes to cadaver dissection in a Nigerian medical school. Asian J Med Sci 2:89-94.  Back to cited text no. 8
    
9.
Johnson J.H. (2002). Importance of dissection in learning anatomy: Personal dissection versus peer teaching. Clin Anat 15 (1):38-44.  Back to cited text no. 9
    
10.
Jones D.G. (2001). Reassessing the importance of dissection: A critique and elaboration. Clin Anat 10:123-7.  Back to cited text no. 10
    
11.
Leong S.K. (1999). Back to basics. Clin Anat 12 (6):422-6.  Back to cited text no. 11
    
12.
McGarvey M.A., Farrell T., Conroy R.M. (2001). Dissection: A positive experience. Clin Anat 14 (3):227-30.  Back to cited text no. 12
    
13.
McLachlan J., Bradley P., Searle J., Bligh J. (2004). Teaching anatomy without cadavers. Med Educ 38:418-24.  Back to cited text no. 13
    
14.
Mutyala S., Cahill D.R. (1999). Catching up. Clin Anat 9:53-6.  Back to cited text no. 14
    
15.
Nnodim J.O. (1996). Preclinical student reactions to dissection, death and dying. Clin Anat 9:175-82.  Back to cited text no. 15
    
16.
O'Carroll R.E., Whiten S., Jackson D. (2002). Assessing the emotional impact of cadaver dissection on medical students. Med Educ 36 (6):550-4.  Back to cited text no. 16
    
17.
Parker L.M. (2002). Anatomical dissection: Why are we cutting it out? Dissection in undergraduate teaching. ANZ J Surg 72 (12):910-2.  Back to cited text no. 17
    
18.
Penny J.C. (1985). Reactions of medical students to human dissection. J Med Educ 60:58-60.  Back to cited text no. 18
    
19.
Rajkumari A., Das B.K., Sangma G.T. (2008). Attitudes and views of first year medical students towards cadaver dissection in anatomy learning. Calicut Med J 6 (4):1-6.  Back to cited text no. 19
    
20.
Rajkumari A., Singh Y. (2007). Body donation and its relevance in anatomy learning: A review. J Anat Soc India 56:1-6.  Back to cited text no. 20
    
21.
Selvratnam L., Francis P.J., Unit H. (2001). Stress Perception in First Year Med Students Attending an Urban Med. School in Malaysia in Abstract Book for Inaugural Symposium: Asian Med. Edu in the 21st century, 34-5.  Back to cited text no. 21
    
22.
Week S.E., Harris E.E., Kinzey W.G. (1995). Human gross anatomy: A crucial time to encourage respect and compassion in students. Clin Anat 8 (1):69-79.  Back to cited text no. 22
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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