Supporting Minority Cultures during Initial Engagements with Body Donors in the Dissecting Room: A Pilot Study Exploring Perspectives of Pasifika Medical Students around Culture and Cultural Safety
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| Title: | Supporting Minority Cultures during Initial Engagements with Body Donors in the Dissecting Room: A Pilot Study Exploring Perspectives of Pasifika Medical Students around Culture and Cultural Safety |
|---|---|
| Language: | English |
| Authors: | Jacob Madgwick, Lynley Anderson, Jon Cornwall (ORCID |
| Source: | Anatomical Sciences Education. 2025 18(2):160-171. |
| Availability: | Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us |
| Peer Reviewed: | Y |
| Page Count: | 12 |
| Publication Date: | 2025 |
| Document Type: | Journal Articles Reports - Research |
| Education Level: | Higher Education Postsecondary Education |
| Descriptors: | Medical Students, Student Attitudes, Human Body, Anatomy, Donors, Educational Environment, Cultural Awareness, Consciousness Raising, Laboratory Procedures, Minority Group Students, Culturally Relevant Education, Ethnicity, Pacific Islanders, Cultural Background, Student Behavior, Barriers |
| DOI: | 10.1002/ase.2541 |
| ISSN: | 1935-9772 1935-9780 |
| Abstract: | The first experience of medical students in the dissecting room (DR) is a challenging event. Few data exist around whether or how culturally appropriate support is required in the DR for students from ethnic minorities. This pilot study explored Pasifika (peoples with heritage from the Pacific Islands) students' first experience of the DR and exposure to body donors to explore cultural perspectives around this event. Participants were second year Pasifika medical students with no prior engagement with body donors. Following a first exposure to body donors, semi-structured face-to-face interviews were conducted. Questioning explored how Pasifika students experienced initial DR engagement in regard to Pasifika culture and cultural safety. Interviews were recorded, transcribed, and analyzed thematically. Eight Pasifika students were interviewed (ages 18-32 years, mean 21.3 years, five females); mean interview duration 24.5 min. Four themes were identified: cultural observations, student behaviors, cultural safety, and cultural comfort. Dominant messages included the cultural challenges presented by this event, conformity of cultural behavior, identification of cultural safety being appropriate, and illumination of potential cultural support strategies. Current mechanisms supporting cultural safety were identified as adequate, which juxtaposed against behavior where students could not act in a culturally authentic manner. Suggestions were made around improving cultural comfort, such as the presence of elders or Christian-focused elements such as prayer. Enhanced cultural support could increase cultural comfort for the initial DR and body donor experience of Pasifika students, which may facilitate increased cultural knowledge and promote cultural diversity within the medical student cohort. |
| Abstractor: | As Provided |
| Entry Date: | 2025 |
| Accession Number: | EJ1459985 |
| Database: | ERIC |
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| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwGq1vwamtDgDh5FgJwedisCAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDEbiOqUEM286HvlkogIBEICBmg75HHr8LdjuDcv4eX5MHom6q6kKMFtPfPDeN3UdJVga7Wgtzl3yw7nYjBPBdyFC-6z2AbpwAHSmKsdJOq-t0I2UQGq9lA12Vq4B-uKn3k-h5gzJfGStxs2ZLgSAZlPDd6JX0ShYp5yeJo53zlcOP_W3R1nm4D16PQzFP4gap0TK-eqGcnl0fciGU1L0ZqNndPvWL5Zqh7ocwRc= Text: Availability: 1 Value: <anid>AN0183846600;[8z8k]01feb.25;2025Mar21.05:14;v2.2.500</anid> <title id="AN0183846600-1">Supporting minority cultures during initial engagements with body donors in the dissecting room: A pilot study exploring perspectives of Pasifika medical students around culture and cultural safety </title> <p>The first experience of medical students in the dissecting room (DR) is a challenging event. Few data exist around whether or how culturally appropriate support is required in the DR for students from ethnic minorities. This pilot study explored Pasifika (peoples with heritage from the Pacific Islands) students' first experience of the DR and exposure to body donors to explore cultural perspectives around this event. Participants were second year Pasifika medical students with no prior engagement with body donors. Following a first exposure to body donors, semi‐structured face‐to‐face interviews were conducted. Questioning explored how Pasifika students experienced initial DR engagement in regard to Pasifika culture and cultural safety. Interviews were recorded, transcribed, and analyzed thematically. Eight Pasifika students were interviewed (ages 18–32 years, mean 21.3 years, five females); mean interview duration 24.5 min. Four themes were identified: cultural observations, student behaviors, cultural safety, and cultural comfort. Dominant messages included the cultural challenges presented by this event, conformity of cultural behavior, identification of cultural safety being appropriate, and illumination of potential cultural support strategies. Current mechanisms supporting cultural safety were identified as adequate, which juxtaposed against behavior where students could not act in a culturally authentic manner. Suggestions were made around improving cultural comfort, such as the presence of elders or Christian‐focused elements such as prayer. Enhanced cultural support could increase cultural comfort for the initial DR and body donor experience of Pasifika students, which may facilitate increased cultural knowledge and promote cultural diversity within the medical student cohort.</p> <p>Keywords: anatomy education; body donor; cultural safety; culture; dissection room; medical education; Pasifika</p> <hd id="AN0183846600-2">INTRODUCTION</hd> <p>Internationally, there has been a recent shift in the demographic profile of medical students[[<reflink idref="bib1" id="ref1">1</reflink>], [<reflink idref="bib3" id="ref2">3</reflink>]] which has seen an increase in ethnic, cultural, and socioeconomic diversity within medical school cohorts.[<reflink idref="bib4" id="ref3">4</reflink>] Although this increase in diversity is an essential step for the development of a culturally equipped and diverse workforce, cultural difficulties that provide barriers to educational achievement exist for these students throughout their educational journey.[[<reflink idref="bib5" id="ref4">5</reflink>], [<reflink idref="bib7" id="ref5">7</reflink>]] Catering to the needs of culturally heterogeneous student populations presents difficulties given typical contemporary Western curricula and teaching practices do not necessarily address the needs of minority or under‐represented populations.[<reflink idref="bib8" id="ref6">8</reflink>] To address these difficulties, universities are developing more supportive and inclusive curricula[[<reflink idref="bib9" id="ref7">9</reflink>]] that seek to mitigate the impact of culture on the teaching environment, including how curricula are taught, the environments in which students learn, the diversity among the staff, and the availability of cultural support.[[<reflink idref="bib7" id="ref8">7</reflink>], [<reflink idref="bib11" id="ref9">11</reflink>]] To further support such changes, frameworks, and concepts focused on addressing the impact and influence of culture have been created to address the needs of these diverse student populations. These include ideas such as culturally responsive pedagogy and cultural competence for both students and staff; however, one of the most prominent ideas to be developed is the concept of cultural safety.[<reflink idref="bib12" id="ref10">12</reflink>]</p> <hd id="AN0183846600-3">The concept of cultural safety</hd> <p>Originating out of Aotearoa New Zealand (NZ) in the early 1980s,[[<reflink idref="bib13" id="ref11">13</reflink>]] the concept of cultural safety was developed to illuminate the inequalities and barriers faced by indigenous populations[<reflink idref="bib15" id="ref12">15</reflink>] after Māori (indigenous NZ peoples) healthcare students described feeling culturally unsafe within the predominantly Westernized teaching environment.[[<reflink idref="bib15" id="ref13">15</reflink>], [<reflink idref="bib17" id="ref14">17</reflink>]] Although there is no definitive definition of this concept, key elements include the examination of oneself and the potential impact of one's own culture on the world and the constant reflection on one's own biases around culture.[<reflink idref="bib12" id="ref15">12</reflink>] It also includes identifying and questioning social, structural, and power inequities.[[<reflink idref="bib19" id="ref16">19</reflink>]] Cultural safety should be defined by the population to whom it applies to enable appropriate recognition of culture and cultural values.[<reflink idref="bib21" id="ref17">21</reflink>] The concept carries a valuable educational message as it highlights the importance of students to interact, respect, and empathize with people of different cultures.[<reflink idref="bib22" id="ref18">22</reflink>]</p> <hd id="AN0183846600-4">Cultural safety in medical education and the dissection room</hd> <p>Medical schools play a crucial role in developing culturally aware and competent physicians who work with patients from diverse cultural backgrounds.[[<reflink idref="bib1" id="ref19">1</reflink>], [<reflink idref="bib23" id="ref20">23</reflink>]] Therefore, understanding and addressing how culture may influence medical education is not merely a matter of sensitivity or politeness, it is essential to developing culturally aware and competent future healthcare professionals.[<reflink idref="bib25" id="ref21">25</reflink>] Because of this, concepts encompassing culture are becoming more prominent in education, including topics such as cultural safety, which has become more visible in medical education.[[<reflink idref="bib19" id="ref22">19</reflink>], [<reflink idref="bib26" id="ref23">26</reflink>]] Literature around educational experiences has identified that a lack of cultural safety and support negatively affects many minorities' experiences.[[<reflink idref="bib6" id="ref24">6</reflink>], [<reflink idref="bib27" id="ref25">27</reflink>]] Medicine can be a challenging program of study, involving many different cognitive and emotional challenges. This includes the first student experiences of the dissection room (DR) which are widely understood to be the most challenging and stressful.[[<reflink idref="bib28" id="ref26">28</reflink>]] Despite this being well known, there is limited knowledge of how different cultures perceive this experience, and despite the reports of some minority cultures experiencing cultural dissonance within the DR experience[<reflink idref="bib30" id="ref27">30</reflink>] the phenomena remains largely unexplored. Understanding how different cultures react to their initial experiences within the DR is important as appropriate support and interventions can then be developed as required.</p> <p>Aotearoa NZ is an ethnically diverse nation.[<reflink idref="bib2" id="ref28">2</reflink>] One of the largest minority groups within Aotearoa NZ are the Pasifika peoples: those persons with heritage from the Pacific Islands, such as Samoan, Tongan, and Fijian. While there are differences between the cultures represented by these countries, there are also strong similarities around heritage and culture and it is common to examine this group of cultures as a homogeneous entity. Increases in Pasifika medical students within NZ over recent years[<reflink idref="bib31" id="ref29">31</reflink>] indicate it is essential strategies are developed to support this student group, who often struggle to achieve tertiary education success[<reflink idref="bib7" id="ref30">7</reflink>] for multiple reasons including socioeconomic factors such as funding and poor access to educational opportunities.[<reflink idref="bib32" id="ref31">32</reflink>] Low levels of cultural safety have been shown to adversely affect Pasifika student success,[[<reflink idref="bib6" id="ref32">6</reflink>], [<reflink idref="bib27" id="ref33">27</reflink>]] and having culturally safe spaces, early engagement, and representative teaching staff is critical in cultivating positive academic outcomes for this student group.[[<reflink idref="bib11" id="ref34">11</reflink>], [<reflink idref="bib32" id="ref35">32</reflink>]] Reports also suggest the need for more Pasifika support and understanding of culture within tertiary education institutions.[[<reflink idref="bib7" id="ref36">7</reflink>], [<reflink idref="bib33" id="ref37">33</reflink>]] At present, there is no literature exploring Pasifika culture within medical education, including a void around the initial Pasifika student experience of body donors within the DR, and it is therefore unclear whether the experience presents cultural difficulties for this group. This study sought to explore Pasifika medical student perspectives around culture and cultural safety during the first exposure to body donors.</p> <hd id="AN0183846600-5">METHODOLOGY</hd> <p></p> <hd id="AN0183846600-6">Research method and approach</hd> <p>The pilot study method was qualitative and involved semi‐structured, face‐to‐face interviews were performed by author JM. The method involved adoption of a constructivist paradigm which sought to highlight the social and subjective elements of reality and knowledge creation,[<reflink idref="bib35" id="ref38">35</reflink>] which included the use of participant experience. This was an appropriate paradigm for use in this instance because of the subjective and social nature of exploring student experiences.[<reflink idref="bib36" id="ref39">36</reflink>] The research team acknowledged their own ideas and backgrounds will potentially influence the analysis[<reflink idref="bib37" id="ref40">37</reflink>]; therefore, reflective thematic analysis was performed to address the subjective interpretation of the data.[<reflink idref="bib38" id="ref41">38</reflink>] Ethics approval for this project was acquired from the University of Otago Human Ethics Committee (ref. D23/061). The data presented here were gathered as part of a larger project.[<reflink idref="bib39" id="ref42">39</reflink>]</p> <hd id="AN0183846600-7">Study context and setting</hd> <p>The University of Otago medical degree (MB ChB) is a 6‐year undergraduate entry program with a student cohort of 300 per annum. Students mostly enter the program at year two after a year of basic health sciences that forms the basis of a competitive entry process. They proceed into a 2‐year period of predominantly biological sciences education (years two and three of the degree program), followed by 3 years of mostly clinical placement and study. In the second year of the program, students undertake an anatomy component, where they undertake work in the DR which involves dissection of body donors. In the early part of the second year, prior to undertaking anatomy study in the DR, a Māori ceremony called a whakawātea is performed to spiritually cleanse the space and create a safe environment.[<reflink idref="bib40" id="ref43">40</reflink>] Students are all encouraged to attend this ceremony as it constitutes a spiritual event, and not a religious ceremony, to allow students of all cultures and backgrounds to participate. During this ceremony, the students are taken into the DR for the first time; however, they do not see body donors who are kept covered within bags. At the ceremony, a Kaumatua (Māori elder) is present, and waiata (commemorative songs of mourning) and Māori prayers are performed.</p> <p>Approximately, 4 weeks after the whakawātea, students attend two sessions on the same day to prepare them for the first engagement with body donors in the DR. These are a lecture focused on the ethics and history of bodies in medical science, including the history of body donation at this institution, and another session where a documentary is shown. The documentary is "Donated to Science"[<reflink idref="bib41" id="ref44">41</reflink>] which includes interviews with donors (pre mortem) and student reactions to working with donor bodies. Students are also informed about expectations for working in the DR in regard to respect of body donors, behavior, and dress code during these sessions. The first interaction and engagement with body donors occurs within days of these sessions, at a laboratory session titled "Introduction to the Dissection Room." No dissection occurs in this introductory session, where students are introduced to their body donor with the covering bag being removed while the face and genitals remaining covered. Students are encouraged to touch, move, and palpate the body donor over a 20‐min period while the tutor provides information; this takes approximately 20 min. A Kaumatua is present for this session to offer spiritual support to all who are present. Students next visit their body donor 3 weeks later, when dissection begins for the first time. In between these sessions, students work with prosections, plastinates, and models in the DR environment without having further engagement with body donors.</p> <hd id="AN0183846600-8">Participant recruitment</hd> <p>Students were recruited from the second‐year student cohort. Inclusion criteria for the study included having no prior engagement of experience with the DR or with body donors, and having experienced only one session in the DR engaging with body donors. At the time of interview, the participants would have entered the DR four times, including the single time students are introduced to their body donor, the whakawātea, and two sessions where prosections and models are used (and donors are not utilized). Recruitment of Pasifika students was undertaken by author JM, who distributed information via the Pasifika student support center to Pasifika medical students. In 2023, the Pasifika cohort of second‐year medical students comprised 30 students from a total of 295, with other ethnicities being New Zealand European (<reflink idref="bib103" id="ref45">103</reflink>), Asian (<reflink idref="bib87" id="ref46">87</reflink>), Māori (<reflink idref="bib46" id="ref47">46</reflink>), Middle Eastern (<reflink idref="bib13" id="ref48">13</reflink>), Other European (<reflink idref="bib9" id="ref49">9</reflink>), Other (<reflink idref="bib4" id="ref50">4</reflink>), South American (<reflink idref="bib2" id="ref51">2</reflink>), and African (<reflink idref="bib1" id="ref52">1</reflink>). However, not all Pasifika students were eligible to participate because of prior interaction with body donors post mortem (e.g., dead persons within the DR setting, potentially during prior degree completion such as a BSc in anatomy). Social media and posters placed within areas students aggregate were also used to recruit students. Signed informed consent was acquired by participants prior to interview.</p> <hd id="AN0183846600-9">Data collection and analysis</hd> <p>Face‐to‐face, semi‐structured interviews, which included acquiring basic demographic information, were undertaken by author JM on the premises of the University of Otago. All interviews were recorded on digital devices and later transcribed using a software application (Otter.ai Inc., Mountain View, CA). Transcripts were subsequently checked for accuracy against audio recordings, and the software package Nvivo 14 (Lumivero, Denver, CO) used to assist data management throughout the analysis. Data were anonymized, and both audio recordings and transcripts stored on a password‐protected hard drive which only researchers could access. Information power was facilitated through the narrow aims of the study, and the specificity of the population of interest (Pasifika medical students). Further, the use of Pasifika student JM to undertake interviews ensured strong dialogue was obtained through his experience as a medical student and ability to engage authentically with Pasifika students through shared culture and background. The case nature of the study (single year of medical students, single institution) also contributed to the information power.[<reflink idref="bib42" id="ref53">42</reflink>]</p> <p>The questioning used for the interview was developed by the researchers prior to the interview as part of the study design. The open‐ended questioning sought to elicit information around cultural safety during the initial DR and body donor experience, exploring this experience and phenomenon through the lens of Pasifika culture and including perspectives around cultural needs during this event. The interviewer responded to subject queues in developing the conversation around this topic to ensure exploration of depth that was sufficient to address the question.</p> <p>Interviews were analyzed by thematic analysis[<reflink idref="bib38" id="ref54">38</reflink>] with the study methodology underpinned by a data‐driven approach.[<reflink idref="bib42" id="ref55">42</reflink>] Two investigators (JM, JC) read over data to become familiar with content before coding began; this included multiple reading of data and note‐taking to identify meanings and patterns that could be utilized during analysis. The two investigators then independently analyzed interviews, creating codes for the data then collating these together. After this was completed, they compared codes and looked for themes within the data using mind mapping.[<reflink idref="bib43" id="ref56">43</reflink>] This was performed by utilizing a large sheet of paper and markers to draw, label, and link information to assist the illumination of common themes. Once this was completed, the research team came together to discuss the created themes and explore how and why these were generated, enabling reflection among the group that assisted consolidation, agreement, and consensus around the themes. Names were then given to the themes, while sub‐themes were also named and agreed upon. Regular meetings between the research team were scheduled throughout the duration of the study to ensure consolidation of interpretations, reduce the positionality of researchers, and establish concordance around interpretation of the data while supporting the fidelity of the study.</p> <hd id="AN0183846600-10">Team reflexivity</hd> <p>Before data collection began, there were regular meetings of team members to provide the opportunity to discuss the project and reflect on the research plan and methodology. The research team comprised persons with a range of experience and culture, including a medical student of Pasifika heritage (JM). The co‐investigators including a bioethics academic and previous physiotherapist (LA) of 30 years academic experience, a medical education and bioethics academic who was also a physiotherapist (JC) with 25 years' research experience, with the research team supported by input from a Pasifika advisor who was an academic and medical doctor. The research background of the team ranged from novice to expert, including some with extensive experience in qualitative research (LA, JC). Research expertise also included foci of the proposed study, with author LA having a research focus that includes professional identity formation in health professional students, while JC had a research focus on ethics in anatomy and has published extensively on the dissection room environment and anatomy education. All team members had prior experience engaging with body donors in the DR when they were students, which contributed insight to the study design and method. The perspective of Pasifika author JM and the Pasifika advisor facilitated interpretation of cultural nuances and experiences which would underpin a deeper understanding of data and promotion of reflection among the research team, thereby contributing to the trustworthiness of findings and interpretation. The research team meetings prior to data collection highlighted the importance of Pasifika perspectives and were valuable in allowing team members to examine their own cultural assumptions and positionality.</p> <hd id="AN0183846600-11">RESULTS</hd> <p>Eight participants of Pasifika heritage were interviewed. Ages ranged from 18 to 32 years, with three males (Table 1). Interviews ranged from 19 min 52 s to 27 min 40 s (mean 24 min 38 s). Four dominant themes were identified, including 1. Cultural Observations, 2. Pasifika Student Behaviors, 3. Cultural Safety for Pasifika Students in the Dissection Room, and 4. Furthering Cultural Comfort for Pasifika Students (Figure 1). Themes 2, 3, and 4 included subthemes.</p> <p>1 TABLE Demographic characteristics of second‐year medical student Pasifika participants.</p> <p> <ephtml> &lt;table&gt;&lt;thead valign="bottom"&gt;&lt;tr&gt;&lt;th align="left"&gt;Participant demographics&lt;/th&gt;&lt;/tr&gt;&lt;tr&gt;&lt;th align="left"&gt;Number&lt;/th&gt;&lt;th align="left"&gt;Age&lt;/th&gt;&lt;th align="left"&gt;Gender&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody valign="top"&gt;&lt;tr&gt;&lt;td align="left"&gt;1&lt;/td&gt;&lt;td align="left"&gt;18&lt;/td&gt;&lt;td align="left"&gt;Female&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;2&lt;/td&gt;&lt;td align="left"&gt;18&lt;/td&gt;&lt;td align="left"&gt;Female&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;3&lt;/td&gt;&lt;td align="left"&gt;19&lt;/td&gt;&lt;td align="left"&gt;Male&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;4&lt;/td&gt;&lt;td align="left"&gt;19&lt;/td&gt;&lt;td align="left"&gt;Female&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;5&lt;/td&gt;&lt;td align="left"&gt;19&lt;/td&gt;&lt;td align="left"&gt;Female&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;6&lt;/td&gt;&lt;td align="left"&gt;22&lt;/td&gt;&lt;td align="left"&gt;Male&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;7&lt;/td&gt;&lt;td align="left"&gt;23&lt;/td&gt;&lt;td align="left"&gt;Female&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;8&lt;/td&gt;&lt;td align="left"&gt;32&lt;/td&gt;&lt;td align="left"&gt;Male&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/8Z8K/01feb25/ase2541-fig-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="ase2541-fig-0001.jpg" title="1 Schematic illustration detailing the themes and subthemes from interviews with Pasifika medical students after their first exposure to body donors in the dissection room, where issues around culture, cultural safety, and support for students were explored." /> </p> <p></p> <hd id="AN0183846600-13">Theme 1: Cultural observations</hd> <p>Participant 8: "You see it (bodies) all the time in the movies. But to see it firsthand is a bit confronting to see so many dead bodies in one place."</p> <p>The cultural observations theme arose from comments specifically relating to the impact or role of culture on things that Pasifika students saw or experienced, whether that originated from themselves, their Pasifika peers, or non‐Pasifika classmates, where culture was deemed to be strongly underpinning or influencing the event. The majority of Pasifika students found the introduction to the DR an experience that was deeply confronting to their cultural values. This is because, within Pasifika culture, elders are viewed with reverence and filial piety is a strong social trait, therefore considering the use of an older person for the purposes of undertaking anatomy and dissection (most body donors in the DR are over 60 years of age[<reflink idref="bib44" id="ref57">44</reflink>]) went against their foundational beliefs. Although most Pasifika students were able to rationalize it as part of their learning instead of a taboo experience, they still felt a deep sense of wrongness about what they were doing. This made the experience of being in the DR feel unsafe for some students.</p> <p>Participant 3: "Because all old people are very valuable in our culture. They're seen as wise people. And you're raised with the idea that no harm will be done to the elders of the family. When you come here and see what happens it makes it even worse. You start thinking, oh, this could be someone's grandpa this could be my grandpa because, in our culture, we treat every old person as our grandpa."</p> <p>The experience was contradictory to one of the essential parts of Pasifika culture: respect for the dead. As one Pasifika student reported (participant 7), "In my...cultural beliefs, you just let them rest, because they are at rest."</p> <p>Participant 2: "In the Cook Islands, we don't really get involved with dead people a lot. Even at funerals. I just go there, and I don't really interact with the body but I'm just being in the presence of it. And I think that's hard for me in that dissecting room."</p> <p>Pasifika students were also confronted with the behaviors of other non‐Pasifika students, who acted in ways that were viewed as not appropriate to Pasifika culture, and students drew assumptions about the level of respect other students were showing body donors.</p> <p>Participant 8: "I was taught by my parents when you walk in front of a dead person, to make sure to be respectful in whatever way you can. I think that is why we try to occupy the least amount of space. Or to say 'tulou', that is our way of showing respect to the person. So, seeing people walk in so casually....I think that was the thing that hit me most."</p> <hd id="AN0183846600-14">Theme 2: Pasifika student behaviors</hd> <p>The theme "Pasifika Student Behavior" includes reference to the way Pasifika students felt they had to behave or act within the DR environment. This included two subthemes, related to how students altered their behaviors during the initial DR experience with body donors, and how students felt the physical DR space influenced their behavior.</p> <hd id="AN0183846600-15">Subtheme 1: Conformity of cultural behavior</hd> <p>There was a dominant theme that identified Pasifika students could not act in a way appropriate to their culture, leading to Pasifika students needing to conform to the actions of their peers. Hence, acts such as making yourself smaller (sign of respect) or saying "tulou" (the Pasifika word for "excuse me") when walking past the bodies were avoided as participants chose instead to avoid behaviors that they viewed as culturally appropriate in order to conform within a larger student group.</p> <p>Participant 5: "I don't know I feel like everyone looks at the (body donor) like it's a 'normal' thing. So, it's like peer pressure since everyone views this as normal or doesn't really have a reaction. You feel that you can't have a reaction."</p> <p>Some Pasifika students felt they could not show the respect they wanted out of fear of judgment or being viewed as a weakness. This was especially true for the male Pasifika students who felt a need to portray a stoic outward appearance during the first engagement with body donors, as the ways in which they show respect to the dead could be viewed as emasculating to a non‐Pasifika person. This further accentuated the internal conflict for Pasifika students, as they felt their behaviors and actions were limited to the actions of their peers.</p> <p>Participant 6: "I just ended up following the guy that was in front of me because if I was to show my way of respect I'd look like a frigid or frail person just walking in. I'd look weird."</p> <p>Hidden pressures influenced how Pasifika students behaved: many Pasifika students had difficulties rationalizing how they should interact with the donor as it was in direct opposition to one of their core cultural principles, which is respect for elders or "filial piety." As mentioned by one Pasifika student, "Once someone dies, you let them rest." Despite the internal conflict many experienced, Pasifika students conformed to their peers' actions regardless of the internal strife this created.</p> <p>Participant 8: "They (Pasifika students) sort of just follow what the other cultures do. That's what I...what I felt."</p> <p>This resulted in some Pasifika students disengaging or becoming more reserved when interacting with the donors. Consequently, this caused some students to stand behind their peers when exposed to body donors and feel uncomfortable physically interacting with them.</p> <p>Participant 6: "It feels disrespectful in a way to walk in front (of a body)...to walk like casually, in front of a deceased person."</p> <hd id="AN0183846600-16">Subtheme 2: Dissection room influences behavior</hd> <p>Pasifika students of the DR space demanded behavior that conformed to the requirements for the area, viewing it as a "sacred" space. This was supported by a dominant thread containing references to "respect," which centered on the environment containing elderly, dead persons. This means there was an inherent behavior that was expected in the DR space, in the way Pasifika students were to act.</p> <p>Participant 4: "...More like you have to be respectful, like sort of like the same feeling when you're going to walk into...a church."</p> <hd id="AN0183846600-17">Theme 3: Cultural safety for Pasifika students in the dissection room</hd> <p>Cultural safety was a theme of interest, and was a specific focus of interviews where students were questioned about their perspectives, reflections, and definitions around "cultural safety" and how this was located within this DR experience.</p> <hd id="AN0183846600-18">Subtheme 1: Defining cultural safety</hd> <p>Within this subtheme the dominant discourse was focused around respect. This included respect of values and beliefs that were associated with culture.</p> <p>Participant 1: "I guess to me, it's (cultural safety) respecting my values. Yeah. So as a Cook Islander, I have a set of values that I've been brought up with surrounded by my family and coming into a different space where they respect those values. Yeah, that's when I would feel culturally safe."</p> <p>The respect of one culture in considering the culture of another also entailed not subjecting another culture to mockery for their beliefs or actions, and also extending to ways of doing things that were culturally safe.</p> <p>Participant 7: "(Cultural safety is) to make sure that other people feel respected in their cultures and in their beliefs and their ways of doing things."</p> <p>It was viewed as disrespectful to not act in a way that was culturally safe, as this did not demonstrate the respect deserved by another culture.</p> <hd id="AN0183846600-19">Subtheme 2: Further mechanisms directed at cultural safety are not required</hd> <p>The dominant response around discussions about cultural safety in the dissection room was that Pasifika students felt no additional mechanisms were required to address cultural safety.</p> <p>Participant 6: "I'd say that it was (culturally safe)... No, I think everything that's happened so far, has been that felt quite good enough, from a cultural standpoint as well. I don't think there's anything big or anything at all that they would need to change. I think everything's done quite well."</p> <hd id="AN0183846600-20">Theme 4: Furthering cultural comfort for Pasifika students</hd> <p>To provide an understanding around cultural support during the initial DR and body donor experience, participants discussed existing cultural support while also providing suggestions for how cultural support could be further improved.</p> <hd id="AN0183846600-21">Subtheme 1: Observations on existing cultural support</hd> <p>A dominant thread within data was that students did recognize cultural support existed in and around the initial DR experience, however it was not interpreted as specific to Pasifika peoples.</p> <p>Participant 3: "I wouldn't say culturally inappropriate (for Pasifika) just an absence of culturally, culturally minded...or not a lot of understanding."</p> <p>When reflecting on their introduction to the physical rooms or space of the DR, the Māori practices around the whakawātea were much appreciated by Pasifika students as they did offer a spiritual and cultural means to show respect through the waiatas, prayer and ceremony. This was akin to how Pasifika would show their respect in this situation.</p> <p>Participant 7: "Yes the whakwātea process (was nice). Just because I think Polynesian people are very spiritual people. And because of whakawātea is Māori. They are also very spiritual people too. So I think I really enjoyed that."</p> <p>The existence of some elements of Māori culture around the introduction to the DR assisted in providing a spiritual element to the DR experience, though this was identified as more appropriate for supporting Māori and not Pasifika students.</p> <p>Participant 3: "There was the whakawātea, but that was more geared towards Māori."</p> <p>Participant 7: "I think the whakawātea and all that was really nice. I think the prayer (was useful), but because the prayer was in Māori ... I can't understand Māori. But I do feel that there definitely was like a nice spiritual aspect to it."</p> <hd id="AN0183846600-22">Subtheme 2: Suggestions to improve cultural comfort</hd> <p>Participants made suggestions as to what would make a difference to their comfort in the DR, from a cultural perspective. Pasifika students suggested an explanation from leaders within their community to reduce some of the barriers for working in this space would be welcome, to gain permission to engage fully with the DR and donors. They felt the way to make this experience more permissible for their culture was by being spoken to by elders, Pasifika doctors, or respected community members. For them, this would act to break down the taboos of the space into being one that is culturally acceptable.</p> <p>Participant 8: "Someone like a community leader from the community that comes in or a pacific doctor. That can explain to us what we juggle inside mentally regarding dead people because we put so much emphasis on tapu or dead people."</p> <p>Some participants indicated the inclusion of religious elements specific to dominant Pasifika religions could make the experience more culturally appropriate. Some suggestions included additions of small items of religious focus, such as prayers within the DR.</p> <p>Participant 2: "A prayer would have been good. I mean, again, I can't speak for all Samoans. I can speak for most, or it's like prayer, maybe a Samoan pastor would be really helpful for just preparing...and building off that."</p> <p>This also extended to the attendance in the DR by religious personnel, such as pastors, to provide assistance to students.</p> <p>Participant 3: "Yeah, I think if there was a pastor who could just stand with me...after seeing the body, and five minutes alone with him or anyone another spiritual leader. I guess because...in my culture so you get a lot of reassurance when people have that person, that reassurance in the learning space... this is a little bit helpful to kind of make you feel more comfortable in that environment."</p> <p>Other students suggested having a separate prayer room would be useful, so students that felt they needed to could participate in prayer.</p> <p>Participant 4: "Having a cross in the building with the bodies and having a prayer room right next to the place where the cadavers are... Doing a prayer before we even begin by introducing and revealing the body, so we are prepared for the bodies."</p> <p>Suggestions were also made around providing a separate opportunity for Pasifika students to engage with body donors, to show their respect. This would allow students to act in ways that were culturally appropriate.</p> <p>Participant 8: "I think a point would be, should be, giving [the] opportunity to Pacific Islander students to show their respect...like the way that they approach dead people...allowing them to say 'tulou'."</p> <hd id="AN0183846600-23">DISCUSSION</hd> <p>Historically, Pasifika perspectives are absent from medical education literature, and there is no literature on Pasifika student perspectives of first engagement with body donors in the DR. The aim of this study was to explore cultural experiences of Pasifika students in their first experience with body donors in the DR to ascertain perspectives that could establish an understanding around cultural safety for this group and experience. Pasifika students found the initial interactions with body donors in the DR a confronting experience that challenged their cultural beliefs and associated cultural behaviors. While the initial DR experience was often not congruent with Pasifika culture and students felt they had to modify their behavior to "fit in," this inability to behave authentically in the DR juxtaposed with the suggestion that further support directed specifically at addressing cultural safety was not required. Existing cultural support for students was identified within Māori cultural practices within the DR; however, they were not wholly fulfilling from a cultural perspective and students indicated additional support directed at their own culture could be useful. The feedback indicated how Pasifika student cultural needs may be further supported within the DR.</p> <hd id="AN0183846600-24">Literature on the cultural perspectives of medical students within the dissection room is spa...</hd> <p>Literature on the perspectives of minority students or the specific influence of culture on the DR and body donor experience is sparse. Navajo (indigenous North American peoples) medical students entering the DR indicated they felt confronted with an ultimatum of compromising their moral integrity and cultural beliefs to partake in their medical education.[<reflink idref="bib30" id="ref58">30</reflink>] The compromise of culture and cultural beliefs is not an uncommon phenomenon for minority groups, as many often feel intense pressure to culturally assimilate when entering Westernized environments such as tertiary education.[[<reflink idref="bib8" id="ref59">8</reflink>], [<reflink idref="bib11" id="ref60">11</reflink>]] The reports of Navajo student experiences is similar to views expressed in this study where students conformed to behaviors of other non‐Pasifika students; this highlights the pressure placed upon minority students to conform and set aside their culture when engaging with challenging environments,[<reflink idref="bib45" id="ref61">45</reflink>] at the expense of culture and cultural values. In the only other perspective on the impact of culture on medical student experiences of the DR, Hussein et al.[<reflink idref="bib46" id="ref62">46</reflink>] found that students' culture was viewed as an important factor in the initial DR experience, yet students were undecided on whether or how their culture influenced their perceptions of the DR.</p> <hd id="AN0183846600-25">Defining cultural safety for Pasifika students</hd> <p>The concept of cultural safety has grown in prominence becoming an integral part of discussions around culture,[[<reflink idref="bib19" id="ref63">19</reflink>], [<reflink idref="bib25" id="ref64">25</reflink>]] playing a central role within Aotearoa NZ not only at an educational level, but also to address moral and political discourses across various sectors.[<reflink idref="bib16" id="ref65">16</reflink>] The topic has become one of the most significant cultural considerations within tertiary education, both informing and challenging the historically ethnocentric perspectives that have formed the foundations of past educational curricula (Wepa, 2003).[[<reflink idref="bib18" id="ref66">18</reflink>], [<reflink idref="bib25" id="ref67">25</reflink>], [<reflink idref="bib47" id="ref68">47</reflink>]] While definitions of "what" cultural safety is may vary, a common element of the concept remains the definition should be generated by the population of interest.[[<reflink idref="bib20" id="ref69">20</reflink>]] In this study, students defined their cultural safety as being underpinned by respect of the values, beliefs, and ways of doing things that Pasifika persons identify with, and it was viewed as disrespectful not to offer this respect to another culture.</p> <hd id="AN0183846600-26">Cultural safety and the initial body donor experience</hd> <p>The initial DR experience provided multiple instances where cultural challenges existed for Pasifika students; this included observations and transactions that would not be normal or acceptable in Pasifika culture. These instances suggest that there can, by definition, be an argument made that the initial exposure of Pasifika students to body donors in the DR contains elements that are not congruent with a definition of cultural safety for this student group. However, this must be considered against perspectives that suggested Pasifika students did not think they required further support around cultural safety and that current practices were adequate. Therefore, while a face value interpretation is that cultural safety is being compromised, Pasifika students themselves did not suggest they required additional cultural support. This is difficult to reconcile, as it juxtaposes with suggestions that students could not behave in a manner authentic to their culture. Further exploration is required to identify the factors that underpin this behavior.</p> <p>The thread that highlighted Pasifika students could not act in a manner that was authentic to their culture demands further exploration, in order to clarify whether it is reasonable or necessary to expect students to put culture to one side in educational or professional settings. This position appears at odds with current educational and cultural trends where culture is viewed as a necessary and important part of society, and should therefore not be suppressed or neglected.[[<reflink idref="bib16" id="ref70">16</reflink>], [<reflink idref="bib18" id="ref71">18</reflink>]] It is therefore necessary to determine whether the actions of students to leave their culture at the door is desirable or justified. If the answer is "no," further support could be developed to ensure students can be authentic within the DR space in their first engagement with body donors.</p> <p>For Pasifika peoples, the burial and laying of the body to rest is a sacred practice,[<reflink idref="bib27" id="ref72">27</reflink>] and yet, this is directly in contrast to the essence of the DR where body donors are actively utilized and are contributors to a learning experience for many student groups.[<reflink idref="bib48" id="ref73">48</reflink>] As such, the experience of the DR and initial engagement with body donors for Pasifika students challenged culturally accepted practices around respect for the dead, which are potentially different to Western perspectives where the use of persons for the purpose of body donation is more widely accepted.[<reflink idref="bib44" id="ref74">44</reflink>] Assimilation pressures felt by Pasifika students to conform to the behaviors observed in other students presented a cultural challenge that highlighted struggles to understand the behavior of other students and drive loss of "normal" cultural responses. Pasifika students indicated a desire to undertake behaviors that were culturally appropriate around the dead; however, they felt unable to do this and instead mirrored the actions of other students so as not to appear "weak" or "frail." This is potentially problematic as it represents a move away from authentic behavior and suggests that a person's culture and cultural responses are potentially incorrect or unwelcome. This may contribute to students feeling isolated from peers, with a potential consequence being poor engagement and adverse impact on student achievement.[[<reflink idref="bib7" id="ref75">7</reflink>], [<reflink idref="bib11" id="ref76">11</reflink>]]</p> <p>The DR environment also clashed with the religious perspectives of students, where the body is viewed as "something sacred" and "you just don't donate your body to science." This was reinforced by the absence of Pasifika body donors or donors of ethnicities other than white European.[<reflink idref="bib44" id="ref77">44</reflink>] This has been an observation previously reported around anatomy learning for Pasifika students,[<reflink idref="bib27" id="ref78">27</reflink>] where it has been noted the DR can be an environment that presents challenges to religious beliefs.[<reflink idref="bib49" id="ref79">49</reflink>] A dominant thread within the data was the positive spiritual support provided by the integration of Māori practices around the initial DR exposure,[<reflink idref="bib40" id="ref80">40</reflink>] indicating that some cultural practices can be successfully integrated into the DR environment that will support multiple cultures. However, this further highlighted the internal conflict experienced by Pasifika students, who opined that despite the positive impact of Māori cultural elements in the DR their own Pasifika culture did not yet have a place in this space. Pasifika students therefore appreciated the integration of Māori practices for providing cultural support, yet felt that this did not adequately address their cultural needs.</p> <hd id="AN0183846600-27">Pasifika students did not think further improvements around cultural safety was necessary</hd> <p>Data also highlighted a dominant theme indicating there was no requirement for further resources to be specifically aimed at their cultural safety in the initial engagement with body donors, despite highlighting they could not be authentic to their culture during this experience. This was perhaps because students had addressed the issue of cultural dissonance during this event by adopting the perspective that the DR was a place exempt from the normal rules around culture—a cultural purgatory. It is unclear whether this rationalization would be a learned coping mechanism, or an adaptation to a more Westernized view of how the DR "should" be experienced by their observations of other students. It is possible this may signify early adoption of clinical detachment skills, which occurs as students manage the emotional requirements of the DR[[<reflink idref="bib50" id="ref81">50</reflink>], [<reflink idref="bib52" id="ref82">52</reflink>]] and is a skill that contributes to the professional identity formation resulting from DR immersion.[[<reflink idref="bib53" id="ref83">53</reflink>]]</p> <p>Ethnic minorities often feel strong pressure to conform to the predominant beliefs of the situation, irrespective of the stress it can cause[<reflink idref="bib36" id="ref84">36</reflink>] when cultural norms and beliefs are challenged or undermined. It is therefore possible that the reason Pasifika students did not ask for further support around cultural safety was a reason that is Pasifika‐centric: often persons of Pasifika origin will not want to challenge Western, cultural, or elder perspectives or behaviors and a high threshold is required to "complain" or ask for change.[<reflink idref="bib36" id="ref85">36</reflink>] This perspective is congruent with theories on participatory social‐capital[<reflink idref="bib55" id="ref86">55</reflink>] whereby minorities can feel they do not "belong" due to prior exclusion, culture mismatch, or existing cultural expectations. As part of this experience, students may feel possible anxiety around a fear of being negatively stereotyped[<reflink idref="bib56" id="ref87">56</reflink>] or becoming further isolated[<reflink idref="bib57" id="ref88">57</reflink>] which some students may view as a threat to their ongoing success in the medical program. Further exploration of Pasifika and other minority student experiences of the DR is required to examine factors underpinning the role of culture in student assimilation within the DR environment, and how students manage to adopt, reject, or balance demands of their culture in this space.</p> <hd id="AN0183846600-28">Suggestions for enhancing cultural comfort for Pasifika students</hd> <p>Addressing the cultural needs of minority students is necessary for reducing barriers and inequities.[[<reflink idref="bib7" id="ref89">7</reflink>], [<reflink idref="bib11" id="ref90">11</reflink>], [<reflink idref="bib32" id="ref91">32</reflink>]] Yet, systemic barriers such as time, cost, and social pressures are often cited in defense of facilitating change within curricula[<reflink idref="bib15" id="ref92">15</reflink>] even when the act of creating and cultivating cultural safety is becoming more common within healthcare professions.[[<reflink idref="bib18" id="ref93">18</reflink>], [<reflink idref="bib47" id="ref94">47</reflink>], [<reflink idref="bib58" id="ref95">58</reflink>]] The previous integration of cultural practices such as the whakawātea into the DR, which was first introduced in 1989 as a means of cultural support at the request of Māori students,[<reflink idref="bib40" id="ref96">40</reflink>] has shown benefits not only for Māori but also for non‐Māori students.[[<reflink idref="bib40" id="ref97">40</reflink>], [<reflink idref="bib59" id="ref98">59</reflink>]] This experience is consistent with literature that highlights the advantages of culturally safe practices in increasing the cultural knowledge of all students,[<reflink idref="bib60" id="ref99">60</reflink>] while providing a safe framework for minority students to engage and thrive in their education. Pasifika students did appreciate the support focused on Māori culture, but intimated this was not specific support directed at "their" culture. In order to reduce some of the cultural pressures felt by Pasifika students, the creation and utilization of culturally safe practices could cultivate improved experiences and engagement for this student group.[[<reflink idref="bib11" id="ref100">11</reflink>], [<reflink idref="bib61" id="ref101">61</reflink>]]</p> <p>Pasifika students described the different ways in which they could be further supported culturally. This included being spoken to by community leaders (Pastors, Pasifika doctors, or even senior students) or having these persons support them in the DR, having more Pasifika staff within the DR, allowing separate time to show their respect to the dead, and the incorporation of Christian‐based religious support, were reported as ways to address Pasifika's cultural needs. Religion, and in particular Christianity,[<reflink idref="bib27" id="ref102">27</reflink>] plays a central role within the Pasifika worldview with the "indigenous elements of their identity" and the Christian faith is common within Pasifika communities.[<reflink idref="bib62" id="ref103">62</reflink>] Within contemporary literature on this topic, these are all factors consistent with creating and cultivating a culturally safe space, especially for Pasifika.[[<reflink idref="bib8" id="ref104">8</reflink>], [<reflink idref="bib27" id="ref105">27</reflink>]]</p> <p>It may also be useful to provide information specific to Pasifika students around cultural challenges they may experience in the DR, to ensure they are aware and can plan for these potential encounters, while also educating all students about the differences they may observe around students and cultural interactions in the DR. This could occur around the time of the preparatory sessions for the DR to allow socialization of concepts and facilitate discussions between students around the content. Implementation of these concepts could lead to improved educational outcomes,[<reflink idref="bib19" id="ref106">19</reflink>] increased cultural knowledge for all students,[<reflink idref="bib60" id="ref107">60</reflink>] and the promotion of cultural diversity among medical schools.[<reflink idref="bib24" id="ref108">24</reflink>] Finally, if Pasifika body donors could be recruited to the DR space, this would allow students to see persons from their own culture and potentially help break down barriers around the "taboo" nature of the experience.[<reflink idref="bib63" id="ref109">63</reflink>] However, there are likely significant barriers to encouraging body donation practices in Pasifika communities including donation being an act contrary to dominant culture and religious beliefs, and a strategy to achieve this would require extensive consultation and consideration.[[<reflink idref="bib64" id="ref110">64</reflink>], [<reflink idref="bib66" id="ref111">66</reflink>]]</p> <hd id="AN0183846600-29">LIMITATIONS</hd> <p>This study has a small sample size which may restrict the generalizability of the findings and may not capture the full diversity of experiences and perspectives of Pasifika medical students. This is acknowledged through the description of the study as a pilot. It is also unclear how gender may have influenced data and data interpretation, given the numbers of either self‐identified female and male participants. However, the pool of available students to sample from was limited and the resulting sample represents a reasonable proportion of those students who were available, and there was no reasonable opportunity nor necessity to address gender bias when recruiting. The sample may be subject to selection bias, as participants were selected through convenience sampling, potentially leading to an overrepresentation of certain viewpoints while underrepresenting others. Furthermore, the study's context and location‐specific nature means the results may not be applicable to different settings or populations. Despite this, there are extremely limited published data available on this topic, and the work therefore represents a significant contribution to the literature while the data obtained provide valuable insights into cultural safety in the DR. Last, the term Pasifika refers to peoples from the Pacific Islands and this group is made up of multiple different nationalities including Samoan, Fijian, and Tongan. Given the multiple groups represented by the collective term "Pasifika," future research with larger, more diverse samples and multiple data collection methods would help to validate and extend these findings to the Pasifika peoples and other groups.</p> <hd id="AN0183846600-30">CONCLUSION</hd> <p>Globally, progress is being made in the development of culturally inclusive curricula.[[<reflink idref="bib9" id="ref112">9</reflink>]] Few studies have explored the influence of culture on medical students' initial experiences of the DR and engagement with body donors to determine whether this event presents unique cultural challenges.[[<reflink idref="bib30" id="ref113">30</reflink>], [<reflink idref="bib46" id="ref114">46</reflink>]] At this institution, findings from this study suggest Pasifika students' initial experiences with body donors in the DR are culturally challenging, resulting in enforced conformity and abandonment of some culturally‐driven behaviors.[<reflink idref="bib8" id="ref115">8</reflink>] Pasifika students did not believe further resources specifically aimed at cultural safety were necessary, despite not being able to act or behave in a manner authentic to their culture during the initial engagement with body donors. They did suggest ways in which Pasifika culture could be supported and assisted in the DR, and highlighted that cultural elements focused specifically at Māori culture[<reflink idref="bib40" id="ref116">40</reflink>] were useful but perhaps not entirely adequate for their own cultural needs. Targeted interventions, such as support by Pasifika elders that included permission to abstain or divert from normal cultural processes or behaviors, or religious elements incorporated into the DR or environment,[[<reflink idref="bib27" id="ref117">27</reflink>], [<reflink idref="bib49" id="ref118">49</reflink>]] may assist Pasifika students from a cultural perspective in their introduction to the DR. In addition, development of specific information related to the interaction of the DR environment and Pasifika culture may assist Pasifika and all medical students in their first engagements with this space. Further exploration into the cultural needs of minority students is essential to develop culturally inclusive spaces that facilitate authentic engagement, legitimize cultural responses and behavior in the DR, and support student achievement.</p> <hd id="AN0183846600-31">AUTHOR CONTRIBUTIONS</hd> <p> <bold>Jacob Madgwick:</bold> Conceptualization; data curation; formal analysis; project administration; writing – original draft; writing – review and editing. <bold>Lynley Anderson:</bold> Formal analysis; project administration; supervision; writing – original draft; writing – review and editing. <bold>Jon Cornwall:</bold> Conceptualization; formal analysis; project administration; supervision; visualization; writing – original draft; writing – review and editing.</p> <hd id="AN0183846600-32">ACKNOWLEDGMENTS</hd> <p>The authors would like to thank Dr. Latika Samalia, Department of Anatomy, University of Otago, for her feedback on this manuscript.</p> <ref id="AN0183846600-33"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Brottman MR, Char DM, Hattori RA, Heeb R, Taff SD. 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Anat Sci Educ. 2008 ; 1 (2): 56 – 59.</bibtext> </blist> </ref> <aug> <p>By Jacob Madgwick; Lynley Anderson and Jon Cornwall</p> <p>Reported by Author; Author; Author</p> <p></p> <p>Jacob Madgwick, is a fourth‐year medical student currently undertaking a gap year to complete a BMedSc(Hons) research degree at the Centre for Early Learning in Medicine at the Otago Medical School, University of Otago, Dunedin, New Zealand. He is of Samoan heritage and is interested in cultural safety, Pasifika perspectives on medical education, ethics in anatomy, and the impact of translational research in healthcare delivery.</p> <p>Lynley Anderson, Dip. Phty., M.HealSci. (Bioethics), Ph.D. (Bioethics), is currently convener of Professional Development for Early Learning in Medicine, and Deputy Dean (Dunedin), at the Otago Medical School, University of Otago, Dunedin, New Zealand. She is interested in professional identity formation in health professional students and is also involved in mapping experiences of medical students in their clinical years. Lynley has been involved in writing codes of ethics for medical students in New Zealand and for professional medical and physiotherapy bodies. She is a member of the Australasian Association of Bioethics and Health Law (AABHL).</p> <p>Jon Cornwall, Ph.D., is currently an Education Adviser in the Centre for Early Learning in Medicine at the Otago Medical School, University of Otago, Dunedin, New Zealand. He is interested in body donation and the use of human tissue in education, research, and healthcare, and is one of three academics guiding the "Bioethics Unicorns" initiative that seeks to promote ethics and professional education in gross anatomy. Jon is the Chair of the Federative International Committee for Ethics in the Medical Humanities (FICEM) for the International Federation of Associations of Anatomists (IFAA).</p> </aug> <nolink nlid="nl1" bibid="bib11" firstref="ref9"></nolink> <nolink nlid="nl2" bibid="bib12" firstref="ref10"></nolink> <nolink nlid="nl3" bibid="bib13" firstref="ref11"></nolink> <nolink nlid="nl4" bibid="bib15" firstref="ref12"></nolink> <nolink nlid="nl5" bibid="bib17" firstref="ref14"></nolink> <nolink nlid="nl6" bibid="bib19" firstref="ref16"></nolink> <nolink nlid="nl7" bibid="bib21" firstref="ref17"></nolink> <nolink nlid="nl8" bibid="bib22" firstref="ref18"></nolink> <nolink nlid="nl9" bibid="bib23" firstref="ref20"></nolink> <nolink nlid="nl10" bibid="bib25" firstref="ref21"></nolink> <nolink nlid="nl11" bibid="bib26" firstref="ref23"></nolink> <nolink nlid="nl12" bibid="bib27" firstref="ref25"></nolink> <nolink nlid="nl13" bibid="bib28" firstref="ref26"></nolink> <nolink nlid="nl14" bibid="bib30" firstref="ref27"></nolink> <nolink nlid="nl15" bibid="bib31" firstref="ref29"></nolink> <nolink nlid="nl16" bibid="bib32" firstref="ref31"></nolink> <nolink nlid="nl17" bibid="bib33" firstref="ref37"></nolink> <nolink nlid="nl18" bibid="bib35" firstref="ref38"></nolink> <nolink nlid="nl19" bibid="bib36" firstref="ref39"></nolink> <nolink nlid="nl20" bibid="bib37" firstref="ref40"></nolink> <nolink nlid="nl21" bibid="bib38" firstref="ref41"></nolink> <nolink nlid="nl22" bibid="bib39" firstref="ref42"></nolink> <nolink nlid="nl23" bibid="bib40" firstref="ref43"></nolink> <nolink nlid="nl24" bibid="bib41" firstref="ref44"></nolink> <nolink nlid="nl25" bibid="bib103" firstref="ref45"></nolink> <nolink nlid="nl26" bibid="bib87" firstref="ref46"></nolink> <nolink nlid="nl27" bibid="bib46" firstref="ref47"></nolink> <nolink nlid="nl28" bibid="bib42" firstref="ref53"></nolink> <nolink nlid="nl29" bibid="bib43" firstref="ref56"></nolink> <nolink nlid="nl30" bibid="bib44" firstref="ref57"></nolink> <nolink nlid="nl31" bibid="bib45" firstref="ref61"></nolink> <nolink nlid="nl32" bibid="bib16" firstref="ref65"></nolink> <nolink nlid="nl33" bibid="bib18" firstref="ref66"></nolink> <nolink nlid="nl34" bibid="bib47" firstref="ref68"></nolink> <nolink nlid="nl35" bibid="bib20" firstref="ref69"></nolink> <nolink nlid="nl36" bibid="bib48" firstref="ref73"></nolink> <nolink nlid="nl37" bibid="bib49" firstref="ref79"></nolink> <nolink nlid="nl38" bibid="bib50" firstref="ref81"></nolink> <nolink nlid="nl39" bibid="bib52" firstref="ref82"></nolink> <nolink nlid="nl40" bibid="bib53" firstref="ref83"></nolink> <nolink nlid="nl41" bibid="bib55" firstref="ref86"></nolink> <nolink nlid="nl42" bibid="bib56" firstref="ref87"></nolink> <nolink nlid="nl43" bibid="bib57" firstref="ref88"></nolink> <nolink nlid="nl44" bibid="bib58" firstref="ref95"></nolink> <nolink nlid="nl45" bibid="bib59" firstref="ref98"></nolink> <nolink nlid="nl46" bibid="bib60" firstref="ref99"></nolink> <nolink nlid="nl47" bibid="bib61" firstref="ref101"></nolink> <nolink nlid="nl48" bibid="bib62" firstref="ref103"></nolink> <nolink nlid="nl49" bibid="bib24" firstref="ref108"></nolink> <nolink nlid="nl50" bibid="bib63" firstref="ref109"></nolink> <nolink nlid="nl51" bibid="bib64" firstref="ref110"></nolink> <nolink nlid="nl52" bibid="bib66" firstref="ref111"></nolink> |
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| Header | DbId: eric DbLabel: ERIC An: EJ1459985 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Supporting Minority Cultures during Initial Engagements with Body Donors in the Dissecting Room: A Pilot Study Exploring Perspectives of Pasifika Medical Students around Culture and Cultural Safety – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Jacob+Madgwick%22">Jacob Madgwick</searchLink><br /><searchLink fieldCode="AR" term="%22Lynley+Anderson%22">Lynley Anderson</searchLink><br /><searchLink fieldCode="AR" term="%22Jon+Cornwall%22">Jon Cornwall</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-4607-3988">0000-0003-4607-3988</externalLink>) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Anatomical+Sciences+Education%22"><i>Anatomical Sciences Education</i></searchLink>. 2025 18(2):160-171. – Name: Avail Label: Availability Group: Avail Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 12 – Name: DatePubCY Label: Publication Date Group: Date Data: 2025 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research – Name: Audience Label: Education Level Group: Audnce Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink> – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Medical+Students%22">Medical Students</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Human+Body%22">Human Body</searchLink><br /><searchLink fieldCode="DE" term="%22Anatomy%22">Anatomy</searchLink><br /><searchLink fieldCode="DE" term="%22Donors%22">Donors</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Environment%22">Educational Environment</searchLink><br /><searchLink fieldCode="DE" term="%22Cultural+Awareness%22">Cultural Awareness</searchLink><br /><searchLink fieldCode="DE" term="%22Consciousness+Raising%22">Consciousness Raising</searchLink><br /><searchLink fieldCode="DE" term="%22Laboratory+Procedures%22">Laboratory Procedures</searchLink><br /><searchLink fieldCode="DE" term="%22Minority+Group+Students%22">Minority Group Students</searchLink><br /><searchLink fieldCode="DE" term="%22Culturally+Relevant+Education%22">Culturally Relevant Education</searchLink><br /><searchLink fieldCode="DE" term="%22Ethnicity%22">Ethnicity</searchLink><br /><searchLink fieldCode="DE" term="%22Pacific+Islanders%22">Pacific Islanders</searchLink><br /><searchLink fieldCode="DE" term="%22Cultural+Background%22">Cultural Background</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Behavior%22">Student Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Barriers%22">Barriers</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1002/ase.2541 – Name: ISSN Label: ISSN Group: ISSN Data: 1935-9772<br />1935-9780 – Name: Abstract Label: Abstract Group: Ab Data: The first experience of medical students in the dissecting room (DR) is a challenging event. Few data exist around whether or how culturally appropriate support is required in the DR for students from ethnic minorities. This pilot study explored Pasifika (peoples with heritage from the Pacific Islands) students' first experience of the DR and exposure to body donors to explore cultural perspectives around this event. Participants were second year Pasifika medical students with no prior engagement with body donors. Following a first exposure to body donors, semi-structured face-to-face interviews were conducted. Questioning explored how Pasifika students experienced initial DR engagement in regard to Pasifika culture and cultural safety. Interviews were recorded, transcribed, and analyzed thematically. Eight Pasifika students were interviewed (ages 18-32 years, mean 21.3 years, five females); mean interview duration 24.5 min. Four themes were identified: cultural observations, student behaviors, cultural safety, and cultural comfort. Dominant messages included the cultural challenges presented by this event, conformity of cultural behavior, identification of cultural safety being appropriate, and illumination of potential cultural support strategies. Current mechanisms supporting cultural safety were identified as adequate, which juxtaposed against behavior where students could not act in a culturally authentic manner. Suggestions were made around improving cultural comfort, such as the presence of elders or Christian-focused elements such as prayer. Enhanced cultural support could increase cultural comfort for the initial DR and body donor experience of Pasifika students, which may facilitate increased cultural knowledge and promote cultural diversity within the medical student cohort. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2025 – Name: AN Label: Accession Number Group: ID Data: EJ1459985 |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1002/ase.2541 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 160 Subjects: – SubjectFull: Medical Students Type: general – SubjectFull: Student Attitudes Type: general – SubjectFull: Human Body Type: general – SubjectFull: Anatomy Type: general – SubjectFull: Donors Type: general – SubjectFull: Educational Environment Type: general – SubjectFull: Cultural Awareness Type: general – SubjectFull: Consciousness Raising Type: general – SubjectFull: Laboratory Procedures Type: general – SubjectFull: Minority Group Students Type: general – SubjectFull: Culturally Relevant Education Type: general – SubjectFull: Ethnicity Type: general – SubjectFull: Pacific Islanders Type: general – SubjectFull: Cultural Background Type: general – SubjectFull: Student Behavior Type: general – SubjectFull: Barriers Type: general Titles: – TitleFull: Supporting Minority Cultures during Initial Engagements with Body Donors in the Dissecting Room: A Pilot Study Exploring Perspectives of Pasifika Medical Students around Culture and Cultural Safety Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Jacob Madgwick – PersonEntity: Name: NameFull: Lynley Anderson – PersonEntity: Name: NameFull: Jon Cornwall IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 1935-9772 – Type: issn-electronic Value: 1935-9780 Numbering: – Type: volume Value: 18 – Type: issue Value: 2 Titles: – TitleFull: Anatomical Sciences Education Type: main |
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