Department of Neurology, University of California San Francisco, San Francisco, California.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Anat Sci Educ. 2019 Jul;12(4):349-359. doi: 10.1002/ase.1868. Epub 2019 Mar 1.
Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview-based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. All students oscillated involuntarily between seeing the cadaver as a specimen for learning and seeing the cadaver as a person, with some students intentionally cultivating one of these ways of seeing over the other. These views shaped students' emotional and moral responses to the experiences of dissection. The "specimen" view facilitated a technical, detached approach to dissection, while the "person" view made students engage emotionally. Further, students who intentionally cultivated a "specimen" view generally felt less moral distress about dissection than students who intentionally cultivated a "person" view. The concept of respect gave students permission to perform dissections, but "person-minded" students developed more complex rules around what constituted respectful behavior. Both groups of students connected the gross anatomy experience to their professional development, but in different ways. "Specimen-minded" students intentionally objectified the body to learn the emotional control physicians need, while "person-minded" students humanized the body donor to promote the emotional engagement required of physicians. These findings support efforts to integrate professionalism teaching into gross anatomy courses, particularly content, addressing the balance between professional detachment and concern.
医学院越来越多地将专业精神培训纳入他们的大体解剖课程，通过解剖经验教授道德行为和人文态度。然而，许多学校在教授专业精神的同时，仍继续采用传统的、技术导向的解剖学教育方法。本基于访谈的研究探讨了学生如何看待遗体捐献者以及他们在这样一所医学院通过解剖学到的专业课程。所有学生都不由自主地在将尸体视为学习的标本和将尸体视为一个人之间摇摆不定，有些学生故意培养其中一种观点。这些观点塑造了学生对解剖体验的情感和道德反应。“标本”观点促进了对解剖的技术、超脱的方法，而“人”的观点则使学生情感投入。此外，故意培养“标本”观点的学生通常比故意培养“人”观点的学生对解剖的道德困扰感更小。尊重的概念允许学生进行解剖，但“以标本为中心”的学生围绕什么构成尊重性行为制定了更复杂的规则。两组学生都将大体解剖经验与他们的专业发展联系起来，但方式不同。“以标本为中心”的学生故意将身体客观化，以学习医生所需的情绪控制，而“以人为本”的学生将遗体捐献者人性化，以促进医生所需的情感投入。这些发现支持将专业精神教学融入大体解剖课程的努力，特别是在内容方面，要解决专业超脱与关注之间的平衡问题。
