Medical Students’ Fear of Death in a Gross Anatomy Course with Cadaveric Dissection
Authors: Klender Sara , Notebaert Andrew , Dehon Erin 
Published: April 2020

Background

Prior research suggests that medical students with higher fear of death are more likely to feel that providing care to terminally ill patients would have a negative personal impact. This negative perception concerning end‐of‐life care may carry into students’ careers as clinicians. Previous studies have shown that physicians with higher fear of death reported more difficulty in end‐of‐life communication and decision‐making. Because cadaveric dissection serves as an important introduction to death and dying issues, it is important to understand how this experience relates to students’ fear of death.

Aim

The current study aimed to identify which demographic characteristics are associated with medical student fear of death and describe how fear of death changes throughout the duration of a gross anatomy course with cadaveric dissection.

Methods

Procedures were carried out according to the protocol approved by the Institutional Review Board of the University of Mississippi Medical Center (IRB # 2018‐0221) and informed consent was obtained from all participants. First year medical gross anatomy students’ were surveyed during the fall semester of 2019. Fear of death was surveyed using sixteen items from three subscales of the Multidimensional Fear of Death Scale (MFODS): Fear of the Dead (6 items), Fear of Being Destroyed (4 items), and Fear for the Body After Death (6 items). For each item, students use a Likert type scale to select the degree to which they agree or disagree with the statement, with lower scores indicating a higher fear of death. Baseline fear of death scores and demographic data (age, gender, undergraduate GPA, MCAT, and prior anatomy experience) were collected on the first day of the course, prior to beginning cadaveric dissection. These baseline scores were then correlated to demographics. To determine how fear of death changed throughout the course, the MFODS was also given at each of the four block examinations. This data was analyzed using repeated measures ANOVA.

Results

Of the 170 students invited to participate, 143 (84.1%) completed the baseline survey. Of those students, 57.3% had a prior anatomy experience while only 25.2% had prior exposure to cadavers. At the time of the baseline survey, average scores for the MFODS subscales were: Fear of the Dead (20.13 out of 30); Fear of Being Destroyed (13.57 out of 20); Fear for the Body After Death (22.99 out of 30). Complete data is currently being collected and analyzed.

Discussion

Results of this study will determine if medical students’ fear of death is associated with specific demographic characteristics and how fear of death changes throughout a gross anatomy course. Understanding these relationships will allow instructors to implement interventions to support students with higher fear of death and identify a time point at which an intervention would be most beneficial. Ultimately, this would provide another means to support medical students and train physicians who are well equipped to handle end‐of‐life issues.