Medical School Culture Influences How Students View the Gross Anatomy Lab

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4018.

ABSTRACT

INTRODUCTION: The culture of medical school can often guide the emotional development of students during their training. At Boston University School of Medicine, there is an explicit culture to refer to human bodies used in anatomy education as “donors” rather than “cadavers”. The main reason we use the word ‘donor’ is to show respect for people who have chosen to generously donate their bodies to science, to help future doctors learn. Intrinsically, the word “donor” describes someone who is capable of making the decision to donate, and implies that this person is, or was, alive. The word “corpse”, by definition, is a human body used by medical students and scientists to study anatomy. Our goal was to determine if students will use the word ‘donor’ even though by definition it means ‘corpse’, due to medical school culture and a desire to adhere to social norms.

METHODS: We used a validated survey instrument to compare students’ emotional experiences of a traditional dissection-based course in 2019, with those of a prosection-based course in 2020, necessitated by distancing requirements space during the COVID-19 pandemic. Free-text responses were collected and organized into datasets, which were analyzed by raters unaware of the year of study. We used theory-based thematic analysis, starting with a word frequency method to generate primary codes. The following codes were generated by individual reviewers, then in group discussion, until thematic saturation was reached.

RESULTS: Across all datasets, and across study years, donor was a common primary code that was further analyzed. This code was used in several connotations, or subcodes. Giver1 was used to refer to a person who previously lived. For example, “I appreciate that donors have given their bodies to science to help us learn.” (Prosection group: 37%. Dissection group: 48%). Giver2 has been used as a synonym for corpse. For example, “spending time with the donors was absolutely necessary to solidify knowledge of anatomy”. (Prosection group: 48%. Dissection group: 39%). “Cadaver” was not a high-frequency word in any dataset.

DISCUSSION: The High Frequency of the Donor Subcode2 illustrates that when students describe a body in the lab that they are dissecting/learning from (by definition, a cadaver), they replace the term ‘cadaver’ with donor, whether actively or unconsciously. This subcode is an example of how medical school culture and social norms can shape how students think and/or talk about the anatomy lab. The use of the word donor, which is characteristically defined as “a person who chooses to donate,” inherently reminds students that this body was a previously living person; when performing dissections, this recall can cause complex emotional reactions that may require time and facilitation to process. While the primary function of using the word giver is to show respect, perhaps the secondary function is to allow students to compartmentalize conflicting thoughts and feelings on a single topic, which is a skill that will help them to grow and develop as medical students.

PMID:35555440 | DOI:10.1096/fasebj.2022.36.S1.R4018

Martha K. Merrill