On death and dying - an exploratory and evaluative study of a reflective, interdisciplinary course element in undergraduate anatomy teaching.
BACKGROUND
Teaching in palliative care aims not only at providing students with specialized knowledge in symptom therapy in advanced disease, but also at developing a professional attitude consistent with the principles and philosophy of palliative care. Reflecting about one's own or the patient's death and dying is considered essential for empathic patient care. In medical education the dissection course is often the first encounter with the issue of death and dying and represents a significant emotional challenge to many medical students.Against this background we implemented a new course element in preparation for the dissection course, offering opportunity to reflect own experiences with death and dying and providing support in finding a balance between authentic empathy and pragmatic action towards deceased persons. We discuss issues such as dignity and professional distance and reason whether guided support for medical students regarding these issues might influence their future attitude as doctors caring for their patients.


METHODS
In tandem, we performed a formal evaluation of the seminar and explored the students' experiences with death and dying, their expectations and fears in the run-up to the dissection course and their attitude towards dissection.


RESULTS
This article describes the structure and the concept of this new interdisciplinary course element and presents the results of the formal course evaluation as well as the explorative part of the accompanying research. Medical students had broad experiences with death and dying even before the dissection course. 89.1% of students had worried about some kind of emotional stress during the dissection course before, but 61.7% stated to have actually perceived emotional stress afterwards. The willingness to donate one's own body for anatomy purposes decreased significantly during the course. The given room for reflection and discussion was appreciated by the students, who felt that the effects of this seminar might be of use even beyond the dissection course.


CONCLUSIONS
This new course element successfully assisted medical students during the dissection room experience and gave opportunity to reflection and discussion on death and dying. The accompanying research confirmed the demand for support and gave insight into experiences, emotions and attitudes of medical students.
Department of Palliative Medicine, University Medical Center Göttingen, Göttingen, Germany. bernd.alt-epping@med.uni-goettingen.de.
Bernd
B
Alt-Epping
Constanze
C
Lohse
Christoph
C
Viebahn
Nicole von
Nv
Steinbüchel
Gesine
G
Benze
Friedemann
F
Nauck
D000293:Adolescent; D000328:Adult; D000715:Anatomy / Q000193:education*; D001293:Attitude to Death; D003643:Death; D004210:Dissection / Q000523:psychology*; D004504:Education, Medical, Undergraduate; D004644:Emotions; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D013315:Stress, Psychological; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult