Student and facilitators’ comments from ‘Facing Dissection and Death: Coping Styles

Students:

“I really enjoyed seeing the interpretations of anatomy lab that were shown in the lecture. I almost wished, too, to see a picture or photo of the face of a cadaver to prepare me for seeing the actual thing in the lab”.

“I found it interesting to get the perspective of other students and helpful to express my own opinions. I felt the timing was appropriate. I liked the presentation on palliative care and found that it stirred my emotions. Her philosophy on life and death was refreshing”.

“I didn’t feel this session was at all necessary; perhaps making it optional for those who choose would be better”.

“On the whole, I feel comfortable with the cadaver so I didn’t get too much from the small group discussion. The palliative care presentation was a lot more beneficial than the student observations”.

“Great timing for this discussion. The additional presentation on dying wasn’t supposed to be included but I found it very thought-provoking and recommend including it in additional years”.

“This session was extremely useful. The lecturer was magnificent. Thank you. I was so glad Dr. Bertman had a chance to give the presentation on palliative care. It really brought us back to thinking about the process of disease”.

“I was generally impressed with the session. I wonder if in addition a session earlier on in the year of just groups of students (w/o a leader) might stimulate us to bring up some issues earlier. I very much appreciated this session, though, especially the amphitheatre presentations”.

“I think it is really helpful to know that I am not alone in some of my concerns regarding dissection, it helps to hear other people voice their concerns. This group was very beneficial for me. I also really enjoyed Dr. Bertman’s two presentations – they stimulated lots of thought and emotion for me”.

“So far for me, a lot of this has not been a problem emotionally; but thinking about dissecting the face is a bit disquieting, so I think this session is a good idea”.

“This coping session brought a little life back into the cadavers. Anatomy will be less mechanical because of it”.

“Very well thought-out program. I enjoyed it and found it quite beneficial. Both presentations by Dr. Bertman were very good”.

“I appreciate the acknowledgement that anatomy can be emotionally difficult. The 2nd presentation was interesting; though I’m not sure it necessarily should have been done during that session”.

“More poetry/words from students and others – more suggested readings…”

“I wish that our class was invited to submit poetry and drawings for the presentation”.

“The second set of lecture slides were a little unexpected and quite emotional. The difference before dissecting a dead person and coping with death is huge, and I’m not sure I was completely ready for that”.

“Both sessions were very helpful in dealing with suppressed emotions”.

“Even thought our small groups had trouble opening up at first, in the en it was really valuable”.

“The lecture by Dr. Bertman was excellent”.

“I think that even smaller groups might have been more facilitative, but I did get a lot out of it”.

“I think this session is much needed and I’m really grateful that UMASS takes the time to address these issues. My only suggestion is to invite families of the cadavers to this presentation, so that they can see the compassion we have for their loved one’s gift”.

“Ray talked about anatomy as an experience rather than a class. A separate talk about that would be nice at the beginning of class in August”.

“Definitely more sessions would be helpful”.

“For me, what is most difficult is being confronted by the unexpected. (That is why the pelvis was hard for me), but I saw this coming in August and this session has also prepared me”?

“The hospice presentation was also very moving and I thought it was an issue often shunted to the side in our medical education”.

“It would be very helpful if we were provided a list of questions to ponder, at our leisure, before the presentation…this would help facilitate discussion and provide order, which might help quieter individuals express themselves”.

“I think it’s interesting to hear what other people have to say, but I’m skeptical of planned moments of profundity and think that most of this sort of work is done on one’s own”.

“Much of this is self guided. I loved hearing my peers apprehensions and thoughts”.

“The presentations were excellent”.

“Presentation done beautifully…next time pass around some tissues”.

“Dr. Gagliardi is fabulous”!

Facilitators’ responses:

√ Class agreed this was appropriately timed in the curriculum.

√ Several comments about how difficult it was to incise the skin in any part of the body. Applying a scalpel to facial skin will be particularly hard.

√ Relation of body to spirit, soul. How does that affect the students’ approach to dissection and to the concept of donation?

√ Do donors know what really goes on in this course, specifically regarding hemi-section? Uniform apprehension about the process and the result. This led to a discussion of desecration. Does the donor’s altruistic action minimize the very negative connotation of desecration? Student comments included “surreal, nauseating, wrong, unnatural, hard.”

√ One student started to say how surprised he was that he was relatively unaffected by what goes on in anatomy. I encouraged him to say more, and encouraged the group to respond to his comments, but this went nowhere.

√ Discussion of how funeral homes make an effort to restore facial and hand skin color to minimize the visible signs of death. Related question about what happens to the fluid within the eyes?

√ The group was evenly split about whether it should be composed of cadaver table foursomes or more randomly created by alphabet. Some students felt they had already processed a lot of the sensitive material in their own groups informally, for instance.

√ Lots of concerns about looking at face and hands and lots of discussion.

√ We talked about these worries together (many tears) and how the groups planned to deal with these concerns. Then, I suggested (actually asked) if they’d find it helpful to go downstairs now, glove up, and look at the face together. Somewhat to my amazement the groups talked it over, and 10 minutes later almost everyone gathered on A-level where they quietly “met” their cadavers face to face. More tear, but I think also much comfort and support. I will try to follow up to see whether in retrospect they agree this helped them. (Evals were completed before we went downstairs). As a facilitator this was an amazing experience – and I was honored to be part of it. This group of students was the polar opposite of last year’s group – it’s amazing how differently their discussions can go.

√ Students really appreciated amp (large group) presentation. I thought it was a great idea to have students in audience reading!

√ Disengagement vs. intellectual involvement vs. emotional styles of coping. How each style can work under different circumstances.

√ Trusting dissection team

√ A couple of students found it difficult to discuss this in “the abstract” and suggested offering a ‘debriefing’ opportunity following head/neck dissection session.

√ At beginning of course, identity of donor: 5 no change 10 first name 1 full name

√ Proud, possessive, see old people – think about anatomy