Charlton R, Dovey S M, Jones D G, Blunt A
University of Otago Medical School, Dunedin, New Zealand.
Med Educ. 1994 Jul;28(4):290-5. doi: 10.1111/j.1365-2923.1994.tb02714.x.
A study was conducted to determine whether the attitudes of medical students to death and caring changed during the 3 months following exposure to cadaver dissection. All first-year students were invited to complete a questionnaire immediately before their initial cadaver dissection experience, after 6 weeks, and after a further 3 months. The questionnaire reflected attitudes to death, violent death, death of someone known to the respondent and caring when someone known to the respondent is seriously injured. Ethnicity and previous exposure to dying has no effect on responses, but overall men students' reactions were significantly less than for women (P < 0.001). The responses given on the final part of the questionnaire after 3 months were significantly lower than those to most questions in the first part of the questionnaire. The exceptions were those questions where the subject in the given scenario was known to the respondent, where reactions were rated significantly greater (P < 0.001) in the follow-up questionnaire and can be explained on the basis that they were a personal referent. Students rapidly develop a coping mechanism which enables them to view cadaver dissection as an occupation quite divorced from living human beings. During these early months of training solicitude decreases for those who die who are unknown to them, but concern for personal referents increases. Educators should be aware of the dramatic change of attitudes among students and the process of professionalization which might influence their caring of future patients.
一项研究旨在确定医学生在接触尸体解剖后的3个月内，其对死亡和关怀的态度是否发生了变化。所有一年级学生在首次尸体解剖体验前、6周后以及再过3个月后，均被邀请填写一份问卷。该问卷反映了对死亡、暴力死亡、受访者认识的人的死亡以及受访者认识的人受重伤时的关怀态度。种族和先前接触死亡情况对回答没有影响，但总体而言，男学生的反应明显低于女学生（P < 0.001）。3个月后问卷最后部分给出的回答明显低于问卷第一部分的大多数问题。例外情况是给定情景中的对象为受访者认识的那些问题，在后续问卷中这些问题的反应评分明显更高（P < 0.001），这可以解释为它们是个人参照对象。学生们迅速形成一种应对机制，使他们能够将尸体解剖视为与活人完全不同的一项工作。在培训的最初几个月里，他们对不认识的死者的关怀减少，但对个人参照对象的关注增加。教育工作者应意识到学生态度的巨大变化以及可能影响他们对未来患者关怀的职业化过程。
