Human dissection and attitudes of preclinical students to death and bereavement

Two questionnaires were used to gather information about preclinical education concerning death and bereavement. One was mailed to Heads of Anatomy Departments of 26 UK medical schools. The other was distributed to 220 first‐ and 210 second‐year preclinical students in Cambridge. Among curricular organizers (77% response rate), the motivation for giving such education was primarily to improve knowledge about dissection, and only secondarily and infrequently to prepare students for clinical practice or to address their attitudes or feelings. In contrast, the primary concern of students (response rate 54%) was preparation for encounters with death in clinical practice (61–85%), lesser concerns being to address their own fears and feelings (30–40%) or knowledge about the dissecting room, cadavers, etc. (23–37%). Students were also asked about their reactions to dissection in order to determine whether the dissecting room might provide an opportunity for teaching about death. Most (66%) admitted experiencing moderate to extreme apprehension in advance of dissection. Apprehension was associated, on starting dissection, with very strong reactions, which in some cases interfered with learning. Some (27%) dealt with this by depersonalization. The only previous experiences that showed a significant association with the occurrence during dissection of interfering and/or non‐task‐related thoughts and feelings were (i) for both men and women the occurrence and quality of handling of death experience(s) at school, and (ii) for a group of male students the experience of the death of more than one close non‐family friend. A strategy for effective use of the dissecting room in studies on death is outlined.