Unclaimed Bodies in Anatomical Education: Medical Student Attitudes at One U.S. Medical Institution.

IF 2.1 3区 教育学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES
Teaching and Learning in Medicine Pub Date : 2025-01-01 Epub Date: 2023-11-15 DOI:10.1080/10401334.2023.2277843
Malcolm A Matheson, John R Gatti, Lawrence D Reid, Sharaya N Gallozzi, Siobhán B Cooke
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引用次数: 0

Abstract

Phenomenon: Dissection of cadavers is a common practice in anatomical education. To meet demand for cadavers, some medical institutions facilitate dissection of individuals who did not provide consent during their life. This includes the bodies of individuals who passed away with either no living kin or no kin able to claim and bury their body. Recent literature demonstrates widespread discomfort with this practice among anatomy course directors at U.S. institutions, bringing into question continuation of this practice. However, attitudes among medical students must similarly be assessed as they represent key stakeholders in the dissection process. The purpose of this study was to assess prevailing attitudes among a sample of medical students at one U.S. medical institution regarding the dissection of unclaimed bodies and identify emerging themes in ethical viewpoints.

Approach: Two-hundred-twelve students (35% response rate) at one U.S. medical institution completed an anonymous online survey. Students came from different class cohorts at various stages of their training. Survey items were developed to capture students' academic and emotional experience with anatomical dissection and to identify emerging themes in attitudes.

Findings: Students reported high regard for cadaveric dissection in general with 170 (80%) respondents endorsing it as critical to anatomical education. Regarding dissection of unclaimed bodies, 30% of students found the practice ethical while 47% of students found the practice unethical. Multivariate analysis found that ethical view was directly associated with comfort level (OR= 156.16; 95% CI: 34.04, 716.40). Most students expressed comfort dissecting self-donated bodies (n = 206, 97%), while fewer students expressed comfort dissecting unclaimed bodies (n = 66, 31.1%). This latter finding significantly correlated with gender (t = 3.361. p < 0.05), class cohort (F = 3.576, p < 0.01), but not with religious affiliation or age. Thematic analysis revealed the following themes in student responses: (1) invoking ethical paradigms to either justify or condemn the practice, (2) subjective experiences, and (3) withholding judgment of the practice.

Insights: Many students expressed negative attitudes toward the dissection of unclaimed bodies, with some citing issues of social vulnerability, justice, and autonomy. These findings indicate that many students' ethical code may conflict with institutional policies which permit this practice. Medical school represents a critical time in the professional development of trainees, and development practices which align with the moral code of local institutions and stakeholders is crucial.

解剖教育中无人认领的尸体:一所美国医疗机构医学生的态度。
现象:解剖尸体是解剖教学中常见的做法。为了满足对尸体的需求,一些医疗机构便利对生前未表示同意的人进行解剖。这包括那些去世后没有在世亲属或没有亲属能够认领和埋葬他们尸体的人的尸体。最近的文献表明,在美国机构的解剖学课程主任中,这种做法普遍不舒服,这对这种做法的延续提出了质疑。然而,医学生的态度必须同样进行评估,因为他们代表了解剖过程中的关键利益相关者。本研究的目的是评估美国某医疗机构医学生样本中对无人认领尸体解剖的普遍态度,并确定伦理观点中的新主题。方法:美国一家医疗机构的212名学生(35%的回复率)完成了一项匿名在线调查。学生们来自不同的班级,处于不同的训练阶段。开发调查项目是为了通过解剖来捕捉学生的学术和情感经历,并确定态度中出现的主题。研究结果:学生普遍高度重视尸体解剖,170名(80%)受访者认为尸体解剖对解剖学教育至关重要。关于解剖无人认领的尸体,30%的学生认为这种做法是道德的,47%的学生认为这种做法是不道德的。多变量分析发现,道德观与舒适程度直接相关(OR= 156.16;95% ci: 34.04, 716.40)。大多数学生对自己捐献的遗体表示满意(n = 206, 97%),而对无人认领的遗体表示满意的学生较少(n = 66, 31.1%)。后一项发现与性别显著相关(t = 3.361)。洞察:许多学生对无人认领的尸体解剖持消极态度,一些人认为这是社会脆弱性、正义和自主权的问题。这些发现表明,许多学生的道德准则可能与允许这种做法的机构政策相冲突。医学院是学员专业发展的关键时期,符合当地机构和利益攸关方道德准则的发展实践至关重要。
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来源期刊
Teaching and Learning in Medicine
Teaching and Learning in Medicine 医学-卫生保健
CiteScore
5.20
自引率
12.00%
发文量
64
审稿时长
6-12 weeks
期刊介绍: Teaching and Learning in Medicine ( TLM) is an international, forum for scholarship on teaching and learning in the health professions. Its international scope reflects the common challenge faced by all medical educators: fostering the development of capable, well-rounded, and continuous learners prepared to practice in a complex, high-stakes, and ever-changing clinical environment. TLM''s contributors and readership comprise behavioral scientists and health care practitioners, signaling the value of integrating diverse perspectives into a comprehensive understanding of learning and performance. The journal seeks to provide the theoretical foundations and practical analysis needed for effective educational decision making in such areas as admissions, instructional design and delivery, performance assessment, remediation, technology-assisted instruction, diversity management, and faculty development, among others. TLM''s scope includes all levels of medical education, from premedical to postgraduate and continuing medical education, with articles published in the following categories:
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