Does education about death and dying decrease stress generated in the dissection room? / ¿Disminuye el estrés generado en la sala de disección la formación sobre la muerte y el moribundo?

SUMMARY: Positive effects on reducing students' stress have been reported across numerous university settings when anatomy preparatory seminars have been provided. To date, this type of preparation for coping with cadaver dissection has not been studied in Spanish universities. The aim of this study is to evaluate how first-year Spanish medical students face the dissecting room and whether previous preparation about death and dying reduces the stress generated. We performed an interventional study with students who received preparatory classes before the dissection practices (Experimental Group, EG) and with students who did not (Control Group, CG). Sociodemographic data and a self-assessment on stress symptoms were collected through a questionnaire completed before and after the dissection practices. No differences were found in the self-report of symptoms of stress among students who consider themselves religious or not, or between students who had a family member in the healthcare environment or not. However, in the EG, the students who had ample experience with terminally ill patients or death reported fewer stress symptoms. Unexpectedly, the number of selfreported stress symptoms after the dissection practice was higher in EG students. In conclusion the stress levels of first-year Spanish medical students not only did not improve after receiving preparatory classes about death and dying and discussion groups, but it gets worse. We found a relationship between student stress measured and experience with terminally ill patients or death. Additional studies are needed to identify the most suitable preparation for Spanish medical students.

RESUMEN: Se han informado efectos positivos en la reducción del estrés en los estudiantes de numerosos entornos universitarios cuando se han impartido seminarios preparatorios de anatomía. Hasta la fecha, este tipo de preparación para hacer frente a la disección del cadáver no se ha estudiado en las universidades españolas. El objetivo de este estudio es evaluar cómo los estudiantes de medicina españoles de primer año se enfrentan a la sala de disección y si la preparación previa sobre la muerte y el moribundo reduce el estrés generado. Realizamos un estudio de intervención con estudiantes que recibieron clases preparatorias antes de las prácticas de disección (Grupo Experimental, GE) y con estudiantes que no las recibieron (Grupo de Control, GC). Se recogieron datos sociodemográficos y síntomas de estrés mediante un cuestionario de autoevaluación antes y después de las prácticas de disección. No se encontraron diferencias en los síntomas de estrés valorados, entre los estudiantes que se consideran religiosos y los que no, ni tampoco entre los estudiantes que tenían o no un familiar en el entorno sanitario. Sin embargo, en el GE, en los estudiantes que tenían una amplia experiencia con pacientes con enfermedades terminales o con la muerte se observaron menos síntomas de estrés. Inesperadamente, el número de síntomas de estrés recogidos después de la práctica de disección fue mayor en los estudiantes del GE. En conclusión, los niveles de estrés de los estudiantes españoles de medicina de primer año no solo no mejoraron después de recibir las clases preparatorias sobre la muerte y el moribundo y establecer grupos de discusión, sino que empeoraron. Encontramos una relación entre la medición del estrés en los estudiantes y la experiencia con pacientes con enfermedades terminales o con la muerte. Se necesitan estudios adicionales para identificar la preparación más adecuada para los estudiantes de medicina españoles.

Willingness toward organ and body donation among anatomy professors and students in Mexico.

Most anatomists agree that cadaver dissection serves as a superior teaching tool in human anatomy education. However, attitudes toward body donation vary widely between different individuals. A questionnaire was developed to determine the attitudes toward body and organ donation among those who learn the most from cadavers: medical students, medical student teaching assistants, medical students involved in research, and anatomy professors. A cross-sectional, prospective study was designed in which the questionnaire was distributed among first-year human anatomy students before undertaking cadaver dissection at the beginning of the semester, and then again after a commemoration service at the end of the course. The questionnaire items included demographic data, as well as questions designed to characterize participants' attitudes regarding body/organ donation from strangers, family members, and whether participants would consider such practices with their own bodies. Out of a total of 517 students enrolled in the Human Anatomy course in the Medical School at the Universidad Autónoma de Nuevo León, Mexico during January to June 2016, 95% responded to the first (491) and second (490) surveys. Participants' opinions on their own organ donation was similar before and after exposure to cadaver dissection, with between 87% and 81% in favor of such practices, and only 3% against it, in both surveys. Participants' willingness to donate their own bodies, as well as those of family members, increased, while reluctance regarding such practices decreased by half (P < 0.0001 and P < 0.05). Professors had the highest rates of positive opinions regarding their own body donation (74.9%), with 18.8% undecided. Low opposition toward organ and body donation remains prevalent among both anatomists and physicians in training in Mexico. Anat Sci Educ 10: 589-597. © 2017 American Association of Anatomists.