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Medical Students' Initial Experiences of the Dissection Room and Interaction with Body Donors: A Qualitative Study of Professional Identity Formation, Educational Benefits, and the Experience of Pasifika Students

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Title: Medical Students' Initial Experiences of the Dissection Room and Interaction with Body Donors: A Qualitative Study of Professional Identity Formation, Educational Benefits, and the Experience of Pasifika Students
Language: English
Authors: Jacob Madgwick, Lynley Anderson, Jon Cornwall (ORCID 0000-0003-4607-3988)
Source: Anatomical Sciences Education. 2026 19(2):280-300.
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: 21
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Tests/Questionnaires
Education Level: Higher Education
Postsecondary Education
Descriptors: Medical Students, Laboratory Procedures, Human Body, Donors, Professional Identity, Student Experience, Cultural Influences, Student Attitudes, Death, Religion, Student Behavior, Environmental Influences, Pacific Islanders, Foreign Countries
Geographic Terms: New Zealand
DOI: 10.1002/ase.2504
ISSN: 1935-9772
1935-9780
Abstract: The first experience of medical students in the dissecting room (DR) likely influences professional identity formation (PIF). Sparse data exist exploring how exposure to the DR and body donors without undertaking dissection influences PIF, or how culture may influence this experience. This qualitative study explored students' first, non-dissection DR experience to determine how this contributes to PIF, including the impact of culture through a Pasifika-student lens. It also explored student perspectives on what learning opportunities are unique to this experience. Medical students with no prior DR experience were recruited and then interviewed after initial engagement with the DR and body donors. Questions included participant experiences, cultural perspectives, and how the DR differed from other teaching experiences. Interviews were recorded, transcribed, and analyzed thematically. Twenty students were interviewed (mean age 22 years, 12 females; 8 Pasifika) resulting in 520 min of audio recording (mean 26 min). Four primary themes were identified: professional identity formation, educational elements, death and spirituality, and cultural perspectives. Three subthemes including student experiences, behaviors, and environment were developed within each theme. Findings indicate development of PIF likely occurs from a single engagement with body donors without undertaking dissection, including recognition of professional role. Culture can play an important role for students, with several Pasifika students viewing the DR as a "cultural purgatory". Unique learning experiences are identified, such as cultural awareness around behaviors with the dead. The experience is an educational "threshold concept" where students likely undergo substantial developments in PIF, and educational initiatives to support students are outlined.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1498740
Database: ERIC
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  Value: <anid>AN0192092998;[8z8k]01feb.26;2026Mar09.06:47;v2.2.500</anid> <title id="AN0192092998-1">Medical students' initial experiences of the dissection room and interaction with body donors: A qualitative study of professional identity formation, educational benefits, and the experience of Pasifika students </title> <p>The first experience of medical students in the dissecting room (DR) likely influences professional identity formation (PIF). Sparse data exist exploring how exposure to the DR and body donors without undertaking dissection influences PIF, or how culture may influence this experience. This qualitative study explored students' first, non‐dissection DR experience to determine how this contributes to PIF, including the impact of culture through a Pasifika‐student lens. It also explored student perspectives on what learning opportunities are unique to this experience. Medical students with no prior DR experience were recruited and then interviewed after initial engagement with the DR and body donors. Questions included participant experiences, cultural perspectives, and how the DR differed from other teaching experiences. Interviews were recorded, transcribed, and analyzed thematically. Twenty students were interviewed (mean age 22 years, 12 females; 8 Pasifika) resulting in 520 min of audio recording (mean 26 min). Four primary themes were identified: professional identity formation, educational elements, death and spirituality, and cultural perspectives. Three subthemes including student experiences, behaviors, and environment were developed within each theme. Findings indicate development of PIF likely occurs from a single engagement with body donors without undertaking dissection, including recognition of professional role. Culture can play an important role for students, with several Pasifika students viewing the DR as a "cultural purgatory". Unique learning experiences are identified, such as cultural awareness around behaviors with the dead. The experience is an educational "threshold concept" where students likely undergo substantial developments in PIF, and educational initiatives to support students are outlined.</p> <p>Keywords: anatomy education; body donor; cultural perspectives; dissection room; ethics; medical education; professional identity formation; threshold concept</p> <hd id="AN0192092998-2">INTRODUCTION</hd> <p>The use of the dissection room (DR) and body donors to teach anatomy remains a ubiquitous element of healthcare education,[[<reflink idref="bib1" id="ref1">1</reflink>]] with exposure to the DR and body donors previously identified as important in forming the professional identity of new medical students.[<reflink idref="bib3" id="ref2">3</reflink>], [<reflink idref="bib4" id="ref3">4</reflink>], [<reflink idref="bib5" id="ref4">5</reflink>], [<reflink idref="bib6" id="ref5">6</reflink>] Professional identity can be defined as "a representation of self, achieved in stages over time during which the characteristics, values, and norms of a profession are internalized, resulting in an individual thinking, acting, and feeling like a professional",[<reflink idref="bib7" id="ref6">7</reflink>] and professional identity formation (PIF) is the process of acquiring this identity. Within the DR environment students can acquire nontechnical, discipline‐independent skills (NTDIS) that contribute to PIF such as professionalism,[<reflink idref="bib8" id="ref7">8</reflink>] teamwork,[[<reflink idref="bib9" id="ref8">9</reflink>]] empathy,[[<reflink idref="bib11" id="ref9">11</reflink>]] multidisciplinarity,[<reflink idref="bib13" id="ref10">13</reflink>] acknowledgment of death and dying,[<reflink idref="bib14" id="ref11">14</reflink>] and communication skills.[<reflink idref="bib15" id="ref12">15</reflink>] There are also said to be other contributors to PIF in the DR environment, which are sometimes identified as being elements of the "hidden curriculum",[<reflink idref="bib16" id="ref13">16</reflink>] such as exposure and socialization to professional behaviors and standards.</p> <p>What is not clear is whether or how elements of PIF occur immediately upon exposure to this environment, or whether PIF occurs when medical students are exposed to the DR and body donors but do not perform dissection. This makes it difficult to plan student support or scaffold PIF for student immersion in the DR prior to dissection taking place. In addition, there is sparse literature on whether students from different cultures within a medical student cohort will have the same experience when first exposed to the DR and body donors.[[<reflink idref="bib17" id="ref14">17</reflink>]] Cultural background appears to influence how PIF may occur[<reflink idref="bib19" id="ref15">19</reflink>] and is, therefore, an important consideration in the planning and delivery of educational resources. Currently, it is unclear whether different cultural groups may require individualized scaffolding to support PIF in the DR. Within Aotearoa New Zealand, student cohorts are particularly multicultural, so this study also looked to determine whether and how culture influences students' first DR experiences by including the perspectives of Pasifika students (persons of the Pacific, from the Polynesian islands). While local efforts have been made to address the needs of Maori students,[<reflink idref="bib20" id="ref16">20</reflink>] views of Pasifika medical students have thus far remained unexplored, and there is a paucity of literature on the influence of culture in the DR experience[[<reflink idref="bib17" id="ref17">17</reflink>]] to guide educational initiatives.</p> <p>Furthermore, despite the suggestion that the DR and body donor experience is important for medical students over and above the learning of anatomy,[[<reflink idref="bib5" id="ref18">5</reflink>], [<reflink idref="bib21" id="ref19">21</reflink>]] it is broadly unknown whether there are unique elements of this experience that cannot be found elsewhere in healthcare curricula. When some institutions are establishing medical curricula without donor programs or using body donors,[[<reflink idref="bib23" id="ref20">23</reflink>]] it is arguably necessary to acquire data that examines the maintenance of using body donors to teach anatomy, given there are limited data supporting dissection being superior for meeting anatomy learning outcomes.[[<reflink idref="bib24" id="ref21">24</reflink>]] This lack of information about what makes the DR experience different from other aspects of medical training raises the question: how do students perceive their first encounter with the DR and body donors, and does this minimal exposure contain experiences that are unique to this environment?</p> <p>The aims of this qualitative study were therefore: (<reflink idref="bib1" id="ref22">1</reflink>) to gain an understanding of how medical students perceived their initial experiences of the DR and body donors prior to dissection occurring, and explore how these may relate to PIF; (<reflink idref="bib2" id="ref23">2</reflink>) to explore whether Pasifika students have a different experience to other students in their initial DR experiences and what this means for their PIF; and (<reflink idref="bib3" id="ref24">3</reflink>) to explore which learning experiences in this environment are unique to engagement with the DR and body donor. Information from the study will assist the development of fit‐for‐purpose support and education strategies for medical students' first experience with the DR and PIF in this learning space, and inform how the DR and body donor experience may contribute to a unique educational experience.</p> <hd id="AN0192092998-3">MATERIALS AND METHODS</hd> <p></p> <hd id="AN0192092998-4">Research method and approach</hd> <p>The research method was qualitative and comprised face‐to‐face interviews. The constructivist paradigm was used by the researchers, which illuminates the subjective and social aspects of knowledge creation and reality,[<reflink idref="bib26" id="ref25">26</reflink>] including the use of participant experience. Due to the subjective and social nature of exploring medical students' initial experiences of the DR, constructivism was viewed as an appropriate theory, in which to underpin the methodology of this study.[<reflink idref="bib27" id="ref26">27</reflink>] The researchers also recognize that their backgrounds and ideas will often be reflected in the analysis,[<reflink idref="bib28" id="ref27">28</reflink>] and reflective thematic analysis was also undertaken to acknowledge the researcher's own subjective interpretations of the data.[<reflink idref="bib29" id="ref28">29</reflink>]</p> <p>The research team included a medical student of Pasifika heritage (JM), supervised by the co‐authors that included a medical education academic/physiotherapist with experience and research expertise in ethics in anatomy (JC), a bioethics academic/physiotherapist with experience and research expertise around PIF (LA). Input from an academic staff member of Pasifika heritage who was also a medical doctor was obtained during study development and data analysis to provide guidance and perspective on Pasifika data, providing a reality check on data and contributing to the trustworthiness of interpretation and findings. Regular meetings of the multidisciplinary team were planned to occur throughout the study to establish concordance around data interpretation, while also facilitating an understanding of each other's roles in the team.[<reflink idref="bib30" id="ref29">30</reflink>]</p> <hd id="AN0192092998-5">Context and setting</hd> <p>Students at the Otago Medical School undertake a six‐year undergraduate entry medical program (MB ChB degree). Three hundred students per annum are enrolled in the course. These students then progress into a predominantly preclinical two‐year period that is followed by a further three years of clinical work and studies. In their first year of the medical program, students are introduced to the DR, body donors, and dissection through the anatomy component of the course. Early in the teaching year a whakawātea[[<reflink idref="bib20" id="ref30">20</reflink>], [<reflink idref="bib31" id="ref31">31</reflink>]] is performed in the DR. This is a Māori (indigenous New Zealand culture) ceremony used to cleanse the DR spiritually and create a safe environment. During this ceremony, in which new medical students are brought into the DR, body donors are kept covered within body bags and students do not see any uncovered bodies. A local Kaumatua (Māori elder) is present and waiatas (commemorative song) and a Māori prayer are performed. One month after the whakawātea students are shown the documentary "Donated to Science",[<reflink idref="bib32" id="ref32">32</reflink>] which includes the stories of a small number of body donors (via pre‐mortem interviews) and students' reactions to their interactions with the donor bodies. During this session, expectations of students within the DR around behavior, dress code, and respect for body donors are outlined. There are also separate bioethics and PIF sessions that occur prior to being introduced to the DR, which deal with the ethical use of body donors and provide an introduction to PIF, respectively.</p> <p>The first student interaction with body donors occurs the day following the lecture and documentary. This first engagement with body donors is split into three different and sequentially attended stations due to the cohort's size. The first group is exposed to prosections on one side of the laboratory, the second group is taken to the anatomy museum (outside of the DR), while the third group is introduced to a donor body. Each station is attended for 20 min, and no dissection occurs in this introductory session. The group with the donor is introduced to them slowly, with the face and genitals initially covered; the face covering is removed after the students feel comfortable enough to proceed. Throughout this process, the tutor explains the procedures and rules that students will follow when interacting with body donors and when undertaking dissections in future laboratories. The students are then allowed to touch, move, and palpate the donor under the tutor's guidance. Dissection laboratories begin some three weeks after this introductory session, with further sessions of anatomy teaching using models and prosections occurring in the interim.</p> <hd id="AN0192092998-6">Recruitment</hd> <p>Participants were recruited from the first‐year student cohort with inclusion criteria being having no prior experience or engagement with body donors or the DR, and having experienced only one session engaging with body donors in the DR. This means at the time of interview participants would have entered the DR a total of four times (once for the whakawātea, two sessions with prosections and models, then students are introduced to their body donor and interact with them). To acquire a Pasifika perspective, author JM distributed information to Pasifika medical student groups through advertising via the local Pasifika student support center. The Pasifika student cohort for 2023 comprised approximately 30 students; however, not all were eligible to participate due to having had previous engagement with the DR or body donors (e.g., during previous University study). Potential participants were recruited through an email invitation sent to the student cohort, and recruitment posters were placed throughout the medical school. Social media was also used to recruit students for the study, using the student Facebook (Meta Platforms, Inc., Menlo Park, CA) page and class group chat platform. Students who enquired about participation received a participant information sheet, inclusion criteria, and the contact details of the investigators. Potential participants then contacted the investigators and interviews were arranged; signed informed consent was acquired from all participants prior to interview. Ethics approval for this project was provided by the University of Otago Human Ethics Committee (ref. D23/061).</p> <hd id="AN0192092998-7">Data collection and analysis</hd> <p>Face‐to‐face semi‐structured interviews that included the acquisition of basic demographic information were conducted by JM in a private room on the premises of the University of Otago. The research team aimed to sample the cohort and Pasifika students with sufficient information power to address the aims of the study. Information power was underpinned by several factors. The study was designed to be data‐driven rather than led by exploration of a particular theory, however, the high specificity of the participant group (medical students and Pasifika medical students), the narrow aims of the study, the fact the study occurred at a single institution (i.e., single case) with interviews at a specific time point (i.e., immediately after exposure to the body donors within the DR environment) all contribute to the information power of the study.[<reflink idref="bib33" id="ref33">33</reflink>] In addition, high‐quality dialogue was likely due to the interviewer being both Pasifika and a medical student who could create a trustworthy interview environment and relate to the experiences of all participants. This was particularly important in relation to interviewing Pasifika students where aspects of culture were being discussed, as the interviewer could understand issues specifically related to culture and engage authentically with such a topic. In addition, the interviewer being a medical student allowed them to explore nuances within interviews and create a more engaging interview than was likely if a member of academic staff conducted the interviews.</p> <p>All interviews were audio recorded with Otter.ai (Otter.ai Inc., Mountain View, CA) on two separate devices with the interviews being simultaneously transcribed by the software. All transcripts were subsequently checked against audio recordings for accuracy and corrected where necessary by author JM. Open‐ended questions, developed around addressing the aims of the study, centered on participant perspectives on their DR and body donor experience. Questions elicited information about how students thought this was similar or different to other academic experiences within the medical school; what students thought they may acquire from their anatomy experience that they could not acquire elsewhere in their medical education; what they would lose if the DR was no longer used to teach anatomy; what the DR experience may teach them apart from anatomy; and how their culture may have influenced their experience of the DR and body donors. Interviews were concluded when the researchers agreed no novel insights were being gained through interviews. Researchers reflected on the interviews with each other on a daily basis to debrief, ensure perspectives were accurate, and maintain consistency of approach.</p> <p>The interviews were analyzed using thematic analysis. Thematic analysis involves six steps as outlined by Braun and Clarke.[<reflink idref="bib29" id="ref34">29</reflink>] Two investigators (JM and JC) read over transcribed data and familiarized themselves before coding began. This involved repeated rereading of verbatim data to search for meaning and patterns, while researchers made initial notes around ideas that they could refer to during subsequent analysis. Analysis within this stage contributed to a researcher's understanding of the acquired data. The two investigators then independently analyzed each of the interviews and created their own initial codes for the respective interviews. Codes identified features of the data that was of interest to the investigators, with data extracts coded and then collated together. After independent analysis and coding were completed, the two investigators who performed the coding came together to compare codes and search for themes. This involved sharing codes and searching for how the different codes could be combined and collated into themes. The two investigators approached the issue of data connectedness by using mind mapping,[<reflink idref="bib34" id="ref35">34</reflink>] whereby an A0 page of white paper and colored markers to draw, label, and visualize codes and then identify linkages between them in the search for themes of interest. The set of generated themes was brought to members of the team to review, where the focus was discussion around the coding process, illumination of data used to generate codes, and exploration of how and why specific themes were identified. After the research team agreed on the identified themes by consensus, these were further defined and refined by the research team to identify the specific essence captured within each theme. At this point, the names for the individual themes were agreed upon by the research team, while also agreeing on the subthemes contained within each theme. This allowed the development of a report to convey the information acquired within the study. Multiple meetings between researchers around data analysis were undertaken to help consolidate interpretations of the data and reduce researcher positionality.</p> <p>The software package Nvivo 14 (Lumivero, Denver, CO) was used to assist management of interview data. Data was anonymized, with audio recordings and transcriptions of interview data stored on a password‐protected hard drive within the University. Only study investigators had access to study data.</p> <hd id="AN0192092998-8">Team reflexivity</hd> <p>Prior to data collection, the team had regular meetings to discuss the study and reflect on the research questions and proposed methodology.[<reflink idref="bib30" id="ref36">30</reflink>] These meetings illuminated the diverse research experiences of the team and factors that could potentially influence qualitative data interpretation. These factors included a range of experiences with qualitative research (novice to expert) and anatomy education, diverse heritages (Pasifika, New Zealand European), and different professional backgrounds (physiotherapists, medical doctors, medical educators, health professional educators) with two of the four team members being registered health professionals. The team varied in regard to experience with body donors and the DR though all had worked with body donors when they were students, with some working in this capacity recently and others not having engaged with body donors for some time. The meetings highlighted the importance of the Pasifika perspectives of author JM and the Pasifika academic staff member, which served as a lens through which cultural nuances, experiences, and values of Pasifika students would be understood and interpreted. This perspective facilitated reflexivity by allowing the researchers to critically examine their own positionality and cultural assumptions, enriching the study with a nuanced understanding of Pasifika perspectives. The backgrounds and experience of the research team enabled the utilization of different lenses for discussions around the interpretation and analysis of data, generating discussion on the exploration of potential thematics, which was viewed as important for supporting the rigor of the analysis.</p> <hd id="AN0192092998-9">RESULTS</hd> <p></p> <hd id="AN0192092998-10">Participants and interview metadata</hd> <p>In total, 20 interviews were conducted over a period of one week of students' first exposure to the DR and body donors. Participants included eight males and 12 females with a mean age of 22 years (range 18–33 years). Eight participants were of Pasifika heritage (Table 1), with non‐Pasifika students being a mixture of ethnicities primarily comprising New Zealand‐centric ethnicity (European and Māori) students. There were 520 min of audio recordings with a mean interview length of 26 min.</p> <p>1 TABLE Participant demographic data.</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Participants</th></tr><tr><th align="left">Participant number</th><th align="left">Ethnicity</th><th align="left">Age</th><th align="left">Gender</th></tr></thead><tbody valign="top"><tr><td align="left">1</td><td align="left">Pasifika</td><td align="char" char=".">18</td><td align="left">Female</td></tr><tr><td align="left">2</td><td align="char" char=".">18</td><td align="left">Female</td></tr><tr><td align="left">3</td><td align="char" char=".">19</td><td align="left">Male</td></tr><tr><td align="left">4</td><td align="char" char=".">19</td><td align="left">Female</td></tr><tr><td align="left">5</td><td align="char" char=".">19</td><td align="left">Female</td></tr><tr><td align="left">6</td><td align="char" char=".">22</td><td align="left">Male</td></tr><tr><td align="left">7</td><td align="char" char=".">23</td><td align="left">Female</td></tr><tr><td align="left">8</td><td align="char" char=".">32</td><td align="left">Male</td></tr><tr><td align="left">9</td><td align="left">Non‐Pasifika</td><td align="char" char=".">19</td><td align="left">Male</td></tr><tr><td align="left">10</td><td align="char" char=".">19</td><td align="left">Male</td></tr><tr><td align="left">11</td><td align="char" char=".">19</td><td align="left">Female</td></tr><tr><td align="left">12</td><td align="char" char=".">19</td><td align="left">Female</td></tr><tr><td align="left">13</td><td align="char" char=".">19</td><td align="left">Female</td></tr><tr><td align="left">14</td><td align="char" char=".">20</td><td align="left">Female</td></tr><tr><td align="left">15</td><td align="char" char=".">20</td><td align="left">Male</td></tr><tr><td align="left">16</td><td align="char" char=".">20</td><td align="left">Male</td></tr><tr><td align="left">17</td><td align="char" char=".">20</td><td align="left">Female</td></tr><tr><td align="left">18</td><td align="char" char=".">26</td><td align="left">Female</td></tr><tr><td align="left">19</td><td align="char" char=".">30</td><td align="left">Male</td></tr><tr><td align="left">20</td><td align="char" char=".">34</td><td align="left">Female</td></tr></tbody></table> </ephtml> </p> <hd id="AN0192092998-11">Overview</hd> <p>Four main themes were identified: professional identity formation, death and spirituality, educational elements, and cultural perspectives (Table 2). Within the core themes, three subthemes were also identified with these being behaviors, environment, and experiences. This means twelve distinct subthemes exist in total across the four themes (Figure 1). Subthemes related to how students perceived, interacted, and experienced the DR and donor bodies.</p> <p>2 TABLE Data of student perceptions as themes and subthemes with supporting quotes.</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Theme</th><th align="left">Subtheme</th><th>Participant number</th><th align="left">Quote</th></tr></thead><tbody valign="top"><tr><td align="left">Professional identity formation</td><td align="left">Experience</td><td align="char" char=".">17</td><td align="left">I remember our whole group stood far back because we were all anxious and I was standing at the top where they first opened the zip. So, I thought I was going to be the first person to see everything. I was quite nervous and scared about it because I wasn't really prepared, and I didn't have a lot of knowledge about what I was going to see and what I was going to feel</td></tr><tr><td align="char" char=".">6</td><td align="left">...it was quite cool. I enjoyed it. As beforehand, I didn't really know what to expect, but obviously just that we would get introduced to the dissection room... I guess, seeing what the room was like, it was quite interesting thing seeing obviously the bags with the cadavers inside them laying there on the benches</td></tr><tr><td align="left">Behaviors</td><td align="char" char=".">19</td><td align="left">It's stricter but I think it's appropriately strict because people would yarn, and that kind of removes the ignorance and acts as a prevention. So, I think it's a good way to avoid any casual attitudes or slacking off. I also have my own expectations as well and I don't think it's unreasonable to have strict guidelines. I think how we act reflects what the anatomy departments expects of the students</td></tr><tr><td align="char" char=".">9</td><td align="left">I would say I'm well behaved in my lab. But in the dissection lab there was an extra like, awareness. I was a bit more like maybe I should just take the extra step to not mess up. Not say something bad, I shouldn't fail or do something I shouldn't do. It's just that added layer of behaving properly</td></tr><tr><td align="left">Environment</td><td align="char" char=".">20</td><td align="left">I feel like the dissection room is the closest to a professional setting that we're going to get this year and we bring those skills and those ideas and concepts that we've learnt into a practical setting...</td></tr><tr><td align="char" char=".">6</td><td align="left">The big thing is you have the bodies there. So, it probably creates some form of atmosphere around the room. It helps provide more of a practical aspect to what we do. Not saying that, our tutorials don't do that, because they do but they help provide just a different aspect of professionalism and that development. But the DR offers another side of the practicality of medicine</td></tr><tr><td align="char" char=".">10</td><td align="left">If you're in the DR ... it feels wrong to act anything short of reverent in there, I guess is what I would say. It doesn't feel right to not be reverent. Knowing that there are people who have given their bodies</td></tr><tr><td align="left">Death and spirituality</td><td align="left">Experience</td><td align="char" char=".">11</td><td align="left">I think that I was a bit more apprehensive because it was the first dead body that I was seeing. And it's kind of I was thinking that you know what's (it) going to look like, what am I going to feel, what am I gone to experience</td></tr><tr><td align="char" char=".">19</td><td align="left">It was fine when we saw the body and the person on the table, and I felt just the person is lying there. I didn't feel anything, so it was quite weird. Maybe I thought maybe it's because I don't really know the person. It's just a surprise to see that a person was lying there just dead</td></tr><tr><td align="left">Behaviors</td><td align="char" char=".">3</td><td align="left">It's dead material, it's someone's body. You can't just not learn anything from it. You've held it in your hand. It's (a) privilege and you got to learn something, as opposed to just models</td></tr><tr><td align="char" char=".">18</td><td align="left">I think it's about getting use to the idea of death. Which sounds really morbid at first, but this experience is causing you to desensitize to it but still give the awareness that death happens and that's still a person at the end of the day, regardless of what dissection happens</td></tr><tr><td align="char" char=".">13</td><td align="left">When I go to dissect someone because they have donated their body and they have chosen not to have a normal funeral or burial or whatever they would have chosen to do with their body. It's not a normal thing to do and I think some people wouldn't understand that. And from that I feel that I have these expectations to uphold their wishes as a person and I should make the most out of my learning and the experience as a whole</td></tr><tr><td align="left">Environment</td><td align="char" char=".">9</td><td align="left">I think it's coming back to the death thing because in normal labs we are not seeing a dead person and death is obviously something quite taboo. Being (a few) feet away from it. I don't think everyone wants to talk about death every single day. So, when you have that realisation, this is a dead person in front of me. It's a bit different. So, I think to myself I should probably pay attention to this</td></tr><tr><td align="char" char=".">10</td><td align="left">Potentially there's a little bit of maturation that comes with working with material like this. If we didn't have prosections, if we didn't have cadavers and then you are put in and you're looking at a surgery taking place it would be hard if you hadn't seen anything like it</td></tr><tr><td align="left">Educational elements</td><td align="left">Experiences</td><td align="char" char=".">11</td><td align="left">I don't think I was prepared in the way that I knew what it was going to look like and what was going to happen, but I did feel prepared and that I wasn't terrified or that I was gone to run away but I was still nauseous. I felt uncomfortable in the space, but I still didn't really know what was going to happen</td></tr><tr><td align="char" char=".">13</td><td align="left">There's a feeling of that you should be respectful, and you shouldn't really mess around or get silly with things, and I think also, at least for me, I felt like I needed to take full kind of opportunity of the whole room. Otherwise, your kind of not doing that person justice... I felt like I should be doing my best in this kind of learning</td></tr><tr><td align="left">Behaviors</td><td align="char" char=".">19</td><td align="left">I think this is a unique experience in its own, getting to know each individual because we're going to be in there three hours working on each body as a group. And so, it's like it's a unique way to work together to solve to make decisions. And these are sort of things that you will be doing in the in the hospital setting as well</td></tr><tr><td align="char" char=".">12</td><td align="left">There is like an expectation that the people that the people that donated their bodies had, like, yeah, that it's really expected of us to be really upstanding citizens. Kind of like expecting their bodies to be used respectfully for learning. Like back to that professionalism side</td></tr><tr><td align="left">Environment</td><td align="char" char=".">7</td><td align="left">In tutorials I feel totally comfortable, totally safe, compared to in the dissection room, I'm definitely on my toes. Because there's cadavers in the same room and because I'm scared that we're going to be dissecting them. I think it's uncomfortable but it's a new space. Because with anything new including growth, you're never going to be comfortable</td></tr><tr><td align="char" char=".">16</td><td align="left">It's not just a tool. The person died and before that they had a history. They lived their lives, and when you're dissecting the body, you can't really forget about it completely. So, there's the additional parts of the person that even though they are not living. They have a history, so it's more than just flesh and bone. So, if you think of it like that, it kind of makes sense. That it's a teacher</td></tr><tr><td align="char" char=".">11</td><td align="left">If you remove the donors, the DR space is less confronting and easier to deal with</td></tr><tr><td align="left">Cultural perspectives</td><td align="left">Experiences</td><td align="char" char=".">8</td><td align="left">Everyone casually approached that room. There's like a sense of excitement. To see the dead people, which is weird because just the idea of having so many dead people in one space in the first place was confronting but casually walking into the space. It just felt like you wanted to do more to respect the dead but didn't feel that you could</td></tr><tr><td align="char" char=".">12</td><td align="left">I personally, even though I am not a Māori person, I really liked the fact that they incorporated the whakawātea and Māori culture. I don't know a whole lot about it, but it is a Māori ceremony and those elements of it helped me. Even though that's not particularly in my culture, I'm still from New Zealand. So, to me, it really is important, and I really thought it was necessary</td></tr><tr><td align="left">Behaviors</td><td align="char" char=".">8</td><td align="left">If you're in a funeral and to walk like casually, in front of a deceased person. You either have to say 'tulou' which is like what you say when you excuse me or, and, it's also like sort of feels disrespectful to just walk tall, in front of a dead person. So, walking in through that door and just walking casually just may make me feel uncomfortable. It was a different experience. I never think that there would come a day where I would walk in tall in the company of so many dead bodies</td></tr><tr><td align="char" char=".">7</td><td align="left">...seeing the demonstrator open her head and then popping a bone down and then putting it back up and obviously she's very enthusiastic about that ... But for me, culturally, that's disrespectful playing with someone's body. It may not come off as playing with someone's body to them. But that's how it comes off to me. For me I don't appreciate people moving things around. In my beliefs and cultural beliefs, you just let them rest because they're at rest</td></tr><tr><td align="left">Environment</td><td align="char" char=".">4</td><td align="left">I think the atmosphere is definitely different. I think ... that you know that there are bodies and so when you walk in your automatically think oh this is a sacred space, or maybe there's something there like spirits or something that makes you feel different. You feel more like ... you have to be respectful, ... the same feeling when you're going to walk into a marae or a church</td></tr><tr><td align="char" char=".">7</td><td align="left">You just don't donate your body to be dissected because it's something sacred and I think with Polynesian culture, being very religious. And that your body is a gift from God and it's not to be messed with, you take care of it, and everyone else takes care of your body. But you don't allow someone to pull you apart</td></tr></tbody></table> </ephtml> </p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/8Z8K/01feb26/ase2504-fig-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="ase2504-fig-0001.jpg" title="1 Schematic diagram illustrating the relationship of the four themes (horizontal) to the three subthemes (vertical). The three subthemes (behaviors, environment, experiences) are visible within each of the themes, providing distinct and nuanced contributions within each." /> </p> <p></p> <p>The behavior subtheme delves into the specific actions and responses of students around the initial exposure to body donors within the DR. This subtheme captures reflections on the behaviors of participants including motivations or thought processes supporting these actions. It includes how students behaved in the DR, such as engagement during the session where they were exposed to body donors, or how their behavior manifested during this experience. Additionally, this subtheme explores the students' interactions with their peers within the DR, noting instances where behavior was important or underpinned interactions, or communication. The focus on behaviors provides insight into the practical aspects of students' experiences within the DR. The subtheme "experience" centers on the experiential responses of students. It encompasses a range of reported feelings that include initial reactions of curiosity or anxiety to more complex emotions such as respect. Personal reflections and narratives provided by the students offer a unique perspective into their experiences, illuminating how these encounters influenced their initial engagements with body donors, the subject of anatomy, and their future roles as healthcare professionals. The experience subtheme facilitates an understanding of the subjective aspects of the students' immersion in the DR, emphasizing the personal and interpretive nature of their engagement with body donors in this space. The final subtheme, environment, contextualizes data that is focused on the physical DR space. Participants highlighted the distinct characteristics of this environment, noting how it differed from typical classroom settings and how such differences impacted them personally. The distinctive nature of the DR setting contributed significantly to the uniqueness of students' perspectives, shaping their overall engagement.</p> <p>Themes are sequentially presented with information relating to relevant subthemes included in each section. Broadly, the themes and subthemes were consistent across participants regardless of ethnicity, apart from the reporting of cultural perspectives. Within cultural perspectives, the Pasifika perspectives were generally different to those of other participants, with these differences mostly manifesting around religion, filial piety, and how their culture engages with death; these were the only areas where data was not consistent across cultural backgrounds or ethnicities.</p> <hd id="AN0192092998-13">Professional identity formation</hd> <p></p> <hd id="AN0192092998-14">Experiences</hd> <p>Some students reported feeling more "professional" and "more like a doctor" in the DR; however, this was not consistent as some felt "more like a student". Students found that, even though the DR made them anxious or scared, these was viewed as part of their growth—there was a high degree of uncertainty about the environment, but this was part of their "journey". Some reported that it was not always about feeling comfortable and that it was okay to be uncomfortable in this space; the experience was therefore sometimes framed by participants as the beginning of their journey to becoming a doctor, and yet there was a clear distinction between being a doctor and being a student. To some participants, the DR functioned solely as a learning space which reaffirmed their role as a student and not one of a professional—there was no expectation to save lives and the primary focus for the students was learning in a controlled environment.</p> <hd id="AN0192092998-15">Behaviors</hd> <p>The way students behaved and acted was heavily informed by what they felt was expected of them, altering how they acted to fit the requirements of the DR. Students reported the expectations of the Medical School combined with their own personal beliefs culminated in a new set of behaviors within the DR, which caused them to act and behave more professionally. However, some participants reported a lack of understanding surrounding many elements of behavior in the DR and they had to undertake reflection to rationalize a new set of expectations to problem‐solve and develop "new" behaviors or actions. Students knew it was important to be respectful, yet informal situational nuances around "precisely" how to behave, and what you can say, were not clear.</p> <p>For many students, the DR experience was a crucial part of them developing their "professionalism". There are more expectations, and some felt more responsibility, placed upon students. Some students highlighted these expectations came from society's expectation to "do the right thing" with body donors and there was an implicit expectation for students to be professional and make the most of the dissection opportunity. For some participants, this created a sense of doing good and being conscious of what expectations will be placed upon them in their future health professional careers.</p> <hd id="AN0192092998-16">Environment</hd> <p>A dominant finding was that the DR was seen by students as a special environment, and the body donors were the core part of what made the space unique: it was very different from other learning opportunities and spaces they had previously experienced, and for many participants this felt like a first step into the professional world in a "safe" and "comfortable" space where they could put learned skills into practice. Compared to other educational spaces, the DR was perceived by students to have a distinct atmosphere and had its own set of expectations that were separate from those of other parts of the Medical School. The requirements of students were much stricter than any other space they had encountered, which all contributed to the feeling of professionalism, with the DR existing between the world of the layman and the world of the healthcare professional. The uniqueness of the experience had no comparisons students could ground themselves to, and it also created a challenging situation where some students felt directly faced with the reality of their career. For many participants, the DR space commanded a level of respect upon entering, and students had intrinsic expectations that they placed upon themselves, which were shown through actions and behaviors. The respect that students felt during this experience allowed for further introspection and reflection regarding their future profession.</p> <hd id="AN0192092998-17">Death and spirituality</hd> <p></p> <hd id="AN0192092998-18">Experiences</hd> <p>Encountering death was sometimes new and exciting, sometimes confronting, and the way students interacted with the body donors and the DR varied. For many, this was their first encounter with death, which was difficult: just being in the same room as the body donors generated large amounts of anxiety. Participants reported they experienced unease around an unknown expectation of what they should feel or how they should react around the dead, which was new and some students felt that they had nothing to ground themselves to. Students were informed prior to their DR experience that there were no right or wrong feelings when engaging with a body donor for the first time, and that they had the freedom to express what they were feeling; some participants stated this helped them process the experience of being around dead persons. Yet some participants stated that during exposure to a dead person for the first time, they did not feel anything, which for them was strange as they thought that there was an "expected" reaction and when this did not occur, this was confusing and stimulated self‐reflection to explore what it meant. Students recognized no other part of their brief medical journey had allowed for such a close and personal exposure to the dead, and as a result of this experience they made a conscious effort to make the most of working with donors.</p> <hd id="AN0192092998-19">Behaviors</hd> <p>Students exclaimed that they had to act differently because they were dealing with dead persons and there was a requirement to respect and treat them with care and dignity. Their behavior was guided by the realization of the privilege and sacredness of being able to work with the dead, and this set the tone for how they should behave, with participants feeling a deep sense of responsibility around utilizing donors to their maximum potential. For some participants, the best way to overcome the experience of the DR was to desensitize to the emotional and cognitive difficulties of working with the dead, creating a layer of protection that enabled them to operate within the DR and to "make sense of" or process ideas around death and dying. Others found that rather than desensitizing themselves, they experienced a connection to the donor and wanted to reflect that in their behavior.</p> <hd id="AN0192092998-20">Environment</hd> <p>The DR was often viewed by participants as sacred because of the presence of donor's bodies, and death and dying were a central part of many students' immersion in the DR. Even though body donors are dead, the DR environment made students consider death and dying by reflecting on the life the donors had, which made some reflect on their own mortality, views on death, and occasionally on family and loved ones that had passed. The perceived sacredness of the environment set the expectation for what students should get out of the experience, and it was viewed as a privilege to have access to the DR. The DR was seen by students as a place of maturation due to the difficult nature of working with the dead, with desensitization one potential outcome of immersion in the environment as students processed being located in the DR. This experience was deeply confronting yet the ability to engage with the dead in a controlled environment was felt to be vital to students' development. Through this intimate exposure to dead persons within the DR environment, students found it aided in developing their own thoughts and feelings on death and dying.</p> <p>Participants found being exposed to the DR and body donors a deeply confronting experience, and often cited the lack of grounding around how they should feel when exposed to dead persons in the DR space as part of the reason for these feelings; and the large number of unknowns were on occasion anxiety‐provoking as a result. Some students viewed the DR as a purely biomedical space while others saw spirituality as a component of the physical location. Even for those students that viewed the DR as a biomedical space, they felt a strong feeling of sanctity and sacredness when they were located there. Students felt this feeling was comparable to that experienced in other sacred places, with some comparing it as similar to church and the behaviors expected in spiritual locations. This helped make the DR very different from any other educational location they had experienced in the Medical School.</p> <hd id="AN0192092998-21">Educational elements</hd> <p></p> <hd id="AN0192092998-22">Experiences</hd> <p>Preparation including lectures focused on DR preparation was useful for helping alleviate students' worries and anxiety around the DR experience; yet, they still found themselves unsure of what to expect. Even after the preparatory lecture, witnessing the documentary, and having seen body bags containing donors in prior visits to the DR (during the whakawātea), this was seen as no substitute for what students' experienced. For some participants it was an exciting and intriguing new challenge that was focused on the subject of anatomy, and as such it was enjoyable and helped foster their sense of curiosity for learning. A positive outlook with a focus on making the most of the learning opportunity helped some students rationalize what they were seeing, which fostered confidence and decreased feelings of anxiety. The academic staff was seen as a vital support network that guided students through this experience, providing validation for their feelings and bringing a sense of control to what was a surreal moment.</p> <p>The expression of gratefulness and reverence around body donors for the opportunity to learn was present throughout interviews. This interaction between students as learners and body donors as teachers was complex, requiring students to consider it carefully to make sense of it. The interaction with body donors as a formal part of their education was described by participants as very different from engaging with prosections, which could easily be dismissed as "not human", and therefore not require any dissociation that was perhaps necessary when confronted with a "whole" body.</p> <p>Some students suggested that exposure to the DR and body donors was a unique experience that could not be replicated in other areas of their medical education, including aspects of learning anatomy and surgical expertise, and of experiencing the "whole" body and not just prosections or parts—it was important to know about a whole body and how it all works or fits together. Coupled with this was the impression that for those participants who were interested in surgery as a career, this was an important experience. There were other things that were reported, including learning about respect for the dead. This included the experiences and recognition surrounding how different persons and cultures engage with, and behave, around the dead. Students also recognized that they would learn other skills in the DR, such as teamwork, communication skills, and desensitization.</p> <hd id="AN0192092998-23">Behaviors</hd> <p>The DR environment provided a unique learning space, which some participants described as a stepping stone to their clinical years, and they would be able to work together as a team to tackle the challenge of dissecting the donor body. Students found this reflective of what would occur later in their career, and this helped them rationalize what they were doing. The dynamic between the students and the donors was not like a learning resource and a student; some explained it was more intimate, comparing the use of the donors as being like a first patient or even a teacher. This laid the foundation for how students interacted and behaved with the donors.</p> <hd id="AN0192092998-24">Environment</hd> <p>The DR was viewed as transformative, and students had to develop an understanding of how to acquire knowledge around a confronting experience. Most students recognized body donors were important to learning anatomy and held the opinion that you could learn anatomy better from a body donor than a book, model, prosection, or plastination.</p> <hd id="AN0192092998-25">Cultural perspectives</hd> <p></p> <hd id="AN0192092998-26">Experiences</hd> <p>Several Pasifika students identified conflict with their culture and values in the DR due to their spirituality. For these students, the idea of interacting with a dead body felt taboo, which made the DR experience deeply confronting cognitively, emotionally, and culturally. Students explained that burial after death is such an integral part of Pasifika culture that it was incomprehensible you would dissect a person. Some reported the DR was also a confusing experience as some observed behaviors of other students conflicted with the students' own beliefs and they were unsure how to resolve this. However, even though the experience would be forbidden in Pasifika culture, Pasifika students justified the experience of dissection as an academic process that is separate from their culture, thereby allowing resolution of the conflict between adhering to culture or proceeding with "taboo" behavior. Some Pasifika participants noted a collision between these two conflicting perspectives laid the groundwork for a better understanding of the student's own self.</p> <p>Even though there were no specific cultural support strategies for Pasifika students, the incorporation of Māori culture around DR engagement (during introductory sessions, such as the whakawātea) was reported as offering solace to Pasifika students during a confronting experience. Non‐Pasifika students also found that even though they were not of Māori heritage, the incorporation of the Māori culture helped them feel more comfortable during this process. It emphasized the sacredness and privilege of the space, as well as offering cultural and spiritual support for what they were doing.</p> <hd id="AN0192092998-27">Behaviors</hd> <p>Most students reflected their heritage and upbringing influenced how they behaved within the DR. For Pasifika students, deciding how to behave was very difficult with death an extremely sacred part of their culture and the act of dissection a taboo concept, and one Pasifika student described having to "leave (his) culture at the door". Pasifika students felt bound by the behaviors of their non‐Pasifika peers and could not freely express themselves; this created internal conflict where they could not behave in a way that was true to their culture because they did not wish to stand out from their peers.</p> <hd id="AN0192092998-28">Environment</hd> <p>For some Pasifika students, the DR was a space where they felt they could not freely express their own cultural beliefs. This was because the DR and activities contained within were "taboo" and would never occur within their culture; because of this, the DR existed as a cultural purgatory where the usual boundaries of their culture did not apply.</p> <hd id="AN0192092998-29">DISCUSSION</hd> <p>This study offers insights into the experiences of first‐year medical students during their initial experience in the DR with body donors in this first qualitative study focused on this foundational encounter. It corroborates previous findings around the difficulties students experience during their first encounters with the DR and body donors[<reflink idref="bib35" id="ref37">35</reflink>], [<reflink idref="bib36" id="ref38">36</reflink>], [<reflink idref="bib37" id="ref39">37</reflink>], [<reflink idref="bib38" id="ref40">38</reflink>]; however, it also provides important insights and offers new knowledge around how engaging with the DR before undertaking dissection may contribute to PIF. This includes student perspectives on death and spirituality that are intertwined with the DR and body donors, views around PIF and the DR, and perceived educational benefits including those seen as unique to the anatomy environment. Cultural perspectives from Pasifika students, representing a minority group among the cohort, are explored and provide unique insight into cultural elements that may specifically influence PIF within this environment. An educational interpretation of this scenario is provided that identifies this experience as a threshold concept, illuminating the experience as one that demands targeted educational initiatives immediately before and around the initial DR and body donor experiences to both support and benefit students. Though not a specific aim of the study, the data illuminated areas where educational support could be delivered to support students during the difficult first experiences within the DR, and suggestions around support and educational strategies for this transformational event are provided.</p> <hd id="AN0192092998-30">How do medical students perceive their initial experiences of the dissection room and body do...</hd> <p>The first student encounter with the DR and body donors is known to be particularly difficult.[<reflink idref="bib39" id="ref41">39</reflink>], [<reflink idref="bib40" id="ref42">40</reflink>], [<reflink idref="bib41" id="ref43">41</reflink>], [<reflink idref="bib42" id="ref44">42</reflink>], [<reflink idref="bib43" id="ref45">43</reflink>], [<reflink idref="bib44" id="ref46">44</reflink>] However, despite this "common" knowledge, few studies have provided data around student perspectives on this initial experience including some surveys[[<reflink idref="bib14" id="ref47">14</reflink>], [<reflink idref="bib36" id="ref48">36</reflink>], [<reflink idref="bib38" id="ref49">38</reflink>], [<reflink idref="bib45" id="ref50">45</reflink>], [<reflink idref="bib47" id="ref51">47</reflink>]] and limited general qualitative exploration,[[<reflink idref="bib35" id="ref52">35</reflink>], [<reflink idref="bib42" id="ref53">42</reflink>], [<reflink idref="bib44" id="ref54">44</reflink>], [<reflink idref="bib48" id="ref55">48</reflink>]] though none of these specifically focused on students first or "pre‐dissection" engagement with the DR environment. Findings from this study of the initial DR and body donor experience align with prior observations around the initial encounter being difficult for many students; however, they also provide nuanced and novel insight into the first experiences of medical students that highlights the considerable impact the DR environment has on students even before they undertake dissection.</p> <p>The confronting nature of the DR and donor bodies required students to rationalize an incredibly intimate exposure to the dead. In some cases, similar to reports from other studies, it created feelings of excitement[[<reflink idref="bib39" id="ref56">39</reflink>], [<reflink idref="bib50" id="ref57">50</reflink>]] and curiosity,[<reflink idref="bib51" id="ref58">51</reflink>] though for some, the experience did not provoke an emotional reaction[<reflink idref="bib14" id="ref59">14</reflink>]: some participants found it strange, they did not feel an emotional reaction, and wondered why that was. Interestingly, in this study, some students suggested the DR experience provided an opportunity for them to process and develop skills to cope with death, dying, and mortality before they entered the clinical phase of their careers, all of which are contributors to PIF as medical professionals. This means there is an opportunity for students to reflect on aspects around these topics that are relevant to PIF after having minimal exposure to donors and before dissection begins. Already, some behaviors interpreted as "taboo"[[<reflink idref="bib5" id="ref60">5</reflink>], [<reflink idref="bib48" id="ref61">48</reflink>]] were being normalized, with Pasifika students in particular confronted with this challenge because of the clash between their culture and that which was expected of them, and what they observed in the behaviors of others. This illuminates the powerful and immediate influence of the environment on student behavior, reinforcing the necessity to remain vigilant around student behavior and to provide support or interventions from the first exposure to donors, even if this exposure does not involve dissection.</p> <p>The DR required students to be more "professional", and students felt this both from the external pressures of the medical school and their own internal beliefs. Expectations also stood out to students, including those of the institution, societal expectations, and their own personal expectations. These expectations highlighted an obligation to behave in a different, more professional way: students were very aware of the "privilege" of the dissection experience, and that there were higher levels of expectations placed on them. This made some students reflect on their chosen profession and the expectations of themselves and society in this "new" role.[<reflink idref="bib49" id="ref62">49</reflink>] Some expressed a feeling of connection to the donors, describing their relationship to the donor bodies like a patient or teacher,[[<reflink idref="bib52" id="ref63">52</reflink>]] which was a way of rationalizing and coping with the challenges of the DR environment. This is similar to previous studies where students observe donor bodies as something sacred and distinctly human[[<reflink idref="bib35" id="ref64">35</reflink>], [<reflink idref="bib54" id="ref65">54</reflink>]] or form relationships with their donors,[[<reflink idref="bib55" id="ref66">55</reflink>]] and reinforces the point that even exposure to the DR environment will influence student PIF and behavior. This again raises queries around the benefits associated with dissection over and above a simple exposure to the DR and donors.</p> <p>Similar to students who have previously undertaken dissection,[<reflink idref="bib35" id="ref67">35</reflink>] a number of students struggled to ground themselves on "how to be" in this space, raising the issue of uncertainty around behavior and action. Uncertainty in medical training is prevalent, and this finding illuminates a common thread with other experiences students will encounter during their training.[<reflink idref="bib57" id="ref68">57</reflink>] However, an interesting point is they felt that societal expectations were placed upon them before entering the DR and saw this as a necessary step in becoming a doctor due to the sacred and privileged experience that they were undertaking. This means there is an influence on students even before they enter the DR, contributing to behavior change and PIF. Within the DR, some observed "sanctity" in the DR environment and viewed it as a spiritual place where students are required to act and be more professional[<reflink idref="bib20" id="ref69">20</reflink>] or with reverence. This experience demanded rationalization from the students as it was "taboo", and students recognized the necessity to develop skills such as emotional detachment[<reflink idref="bib14" id="ref70">14</reflink>] and desensitization[<reflink idref="bib35" id="ref71">35</reflink>] to cope with the environment and tasks, while others confronted the moral conflict presented by the situation and developed skills to address this. Some students mentioned taking responsibility for working and caring for peers in a difficult time, further highlighting the social and community elements of the experience that was shared with peers and illuminating the impact of the DR space that occurs even without dissection being undertaken by students.</p> <hd id="AN0192092998-31">How do the first experiences of the dissection room and body donors relate to professional id...</hd> <p>Many authors have highlighted the influence of the DR and body donor experience on PIF in medical students,[[<reflink idref="bib3" id="ref72">3</reflink>], [<reflink idref="bib5" id="ref73">5</reflink>], [<reflink idref="bib35" id="ref74">35</reflink>]] with the environment identified as "transformative" at a very early stage in students' medical career.[[<reflink idref="bib55" id="ref75">55</reflink>], [<reflink idref="bib58" id="ref76">58</reflink>]] One aim of this study was to explore whether the first exposure to this environment conveyed any of the same experiences as repeated exposures, with findings indicating many similarities between this "pre‐dissection" student group and other studies, in which students have spent considerably more time in this environment.[[<reflink idref="bib14" id="ref77">14</reflink>], [<reflink idref="bib35" id="ref78">35</reflink>], [<reflink idref="bib48" id="ref79">48</reflink>]] Experiences that may contribute to PIF were replete, where behaviors, experiences, and the environment all demanded from students a change in how they act and engage. This includes exposure to and engagement with death and dying,[[<reflink idref="bib3" id="ref80">3</reflink>], [<reflink idref="bib49" id="ref81">49</reflink>]] examination and reflection on professional attitudes and behaviors.[[<reflink idref="bib4" id="ref82">4</reflink>], [<reflink idref="bib35" id="ref83">35</reflink>], [<reflink idref="bib48" id="ref84">48</reflink>]] The DR also stimulated reflection on professionalism.[[<reflink idref="bib3" id="ref85">3</reflink>], [<reflink idref="bib60" id="ref86">60</reflink>]] Emotional detachment and desensitization were recognized as being important for future clinical work, while exposure to cultural elements and reflection on what these mean will also likely assist PIF.[<reflink idref="bib18" id="ref87">18</reflink>] Students commonly described the space as confronting and challenging and were forced into the reformation of their own personal beliefs, attitude, and behaviors.[<reflink idref="bib61" id="ref88">61</reflink>] The findings from this work, therefore, highlight the important fact that many of the contributions to PIF that have been observed to occur after undertaking dissection also occur without dissection having taken place.</p> <p>How can the initial DR and body donor experience be framed to illuminate the complex processes occurring around PIF? Described as a "moral laboratory",[<reflink idref="bib62" id="ref89">62</reflink>] the DR is often the largest group experience preclinical medical students share together. It has strong elements of conformity and expectation underpinned by ritualized, social interaction in a space that is cognitively, emotionally, and culturally challenging and that demands engagement with moral and ethical questions around death and the dead. This brief and shared exposure of the DR contains experiences that have forced students to "think, act and feel like a physician",[<reflink idref="bib4" id="ref90">4</reflink>] which are crucial in developing authenticity within PIF and are highlighted through multiple references students made around "being" or "acting professional". The social aspect of the DR and dissections helps to formulate behaviors in a way deemed professional,[<reflink idref="bib63" id="ref91">63</reflink>] while critical reflection, socialization, ethical and moral challenges, and the importance of role models are all visible within this initial experience of the DR,[[<reflink idref="bib7" id="ref92">7</reflink>], [<reflink idref="bib63" id="ref93">63</reflink>]] even without dissection being undertaken by students. Jarvis‐Selinger et al.[<reflink idref="bib64" id="ref94">64</reflink>] suggest PIF is developed at both individual and collective levels, and this experience illuminates the potential benefit to PIF of this shared experience to assist socialization into the role of "being" a medical professional with peers. The experience illuminates the role of the hidden curriculum in developing PIF in the DR[<reflink idref="bib16" id="ref95">16</reflink>] where many contributing factors and experiences appear tacit.[<reflink idref="bib4" id="ref96">4</reflink>] What remains unclear is how much development of PIF in this circumstance relies on the experience of dissection, when many of the factors contributing to PIF are observed in students who have not yet undertaken dissection.</p> <p>Challenging experiences provide a foundation for assisting PIF,[[<reflink idref="bib63" id="ref97">63</reflink>], [<reflink idref="bib65" id="ref98">65</reflink>]] and study data show there are many such contributors to PIF without the students having yet started dissection. Previous studies have indicated that the first engagement with the DR is the most stressful,[[<reflink idref="bib44" id="ref99">44</reflink>], [<reflink idref="bib66" id="ref100">66</reflink>]] and it is worth considering the benefits of PIF to limited exposure to the DR as opposed to longer‐term engagement. From the data in this study, it appears logical to question whether there is an educational cost–benefit or temporal relationship that can be identified around PIF—including determining whether dissection is actually required to elicit substantial benefits in PIF. Ethical perspectives have been shown to alter with ongoing DR exposure[<reflink idref="bib68" id="ref101">68</reflink>]; however, it is unclear whether PIF would also follow such a pattern and further work is required to identify how ongoing DR engagement, such as the effects of undertaking dissection, influences such traits. It is also unknown what influence the introductory session students experienced on PIF contributed to their DR experiences, and whether more—or less—preparation around PIF would change how students engage with the DR.</p> <hd id="AN0192092998-32">The initial experience of the dissection room through a Pasifika lens and the impact on profe...</hd> <p>Understanding the cultural dynamics that influence medical student groups is paramount in tailoring effective support to assist PIF. Cultural nuances significantly influence individual perspectives on topics including communication styles, professional relationships, cultural competence, inclusivity, and ethical considerations, all of which contribute to PIF.[[<reflink idref="bib4" id="ref102">4</reflink>], [<reflink idref="bib7" id="ref103">7</reflink>], [<reflink idref="bib69" id="ref104">69</reflink>]] There is also a need to remain culturally aware and safe in education practices,[[<reflink idref="bib70" id="ref105">70</reflink>]] and this includes the teaching of anatomy.[<reflink idref="bib72" id="ref106">72</reflink>] The influence of culture on PIF is reportedly underexplored[[<reflink idref="bib69" id="ref107">69</reflink>], [<reflink idref="bib73" id="ref108">73</reflink>]] and information on how culturally diverse cohorts of students experience the DR is sparse.[[<reflink idref="bib17" id="ref109">17</reflink>]] Findings from this study are a unique description of how different cultures may experience the same educational event, and highlight an important consideration in the development of contemporary education practices around PIF. Pasifika student experiences reported here are similar to those described by Alvord,[<reflink idref="bib17" id="ref110">17</reflink>] who indicated students identifying as Navajo face similar difficulties around engaging with the DR and body donors. These issues are strongly rooted in culture, and will likely impact how PIF occurs in these students.</p> <p>Many Pasifika students did not feel like their culture could exist within the DR, where, for some, the space represented a cultural purgatory. These students felt like they needed to ignore cultural beliefs to "make sense" of the space. As a result, a level of cultural conformity had to occur for these students who felt they could not express themselves in a manner they felt appropriate and that a stigma was associated with their cultural beliefs. This challenge was further magnified through Pasifika student's religious beliefs around what was appropriate in interacting with the dead, which was juxtaposed against what was happening around them. These findings illuminate the necessity to promote specific tools around topics like addressing stigma in practice (e.g., which may occur being a Pasifika doctor in a hospital where most staff are of European ethnicity),[<reflink idref="bib19" id="ref111">19</reflink>] or resolving moral conflict to ensure students develop the skills necessary to address ethical and cultural issues that will also be confronted in practice. Through engaging Pasifika students on this topic, effective communication practices can be modeled that will assist with PIF in undertaking difficult conversations, a skill that will be required when engaging with both colleagues and patients. It also provides the opportunity to discuss the existence of cultural values and priorities for Pasifika students, how these may exist within professional practice, and how these may shape a sense of responsibility and commitment to their role as a professional while allowing them to maintain their cultural identity.[<reflink idref="bib4" id="ref112">4</reflink>]</p> <p>Pasifika culture is strongly rooted in the Christian faith,[<reflink idref="bib74" id="ref113">74</reflink>] and persons are traditionally raised within Christian families where filial piety (deferential respect for elders) is a key element of societal interactions. This meant some students struggled with elements of the DR that seemingly challenged both their faith and respect for elders. The act of dissecting older persons was often referred to as something that was not appropriate because "you don't do this to your elders". The notion of filial piety within the Pasifika student group raises potential issues around engagement within a hierarchy, and with authority figures, within medical practice. Further discussions with Pasifika students around how medical practice operates within a hierarchical framework and how engaging with older authority figures is performed in medical practice will support PIF development and ensure students understand how communication with older, more experienced colleagues can be undertaken in a manner that is respectful and appropriate.</p> <p>Tikanga Māori (indigenous practices) have a prominent presence within the DR with the use of the whakawātea, which has shown to be beneficial in assisting students' learning.[<reflink idref="bib20" id="ref114">20</reflink>] The majority of Pasifika participants reported that the incorporation of tikanga Māori reinforced their feelings of safety and comfort in the DR; however, non‐Māori students also highlighted that Māori practices were valuable for them in breaking down the tapu (sacred) barriers of dissecting a human body and aided them in processing the challenges they faced within this space.[<reflink idref="bib75" id="ref115">75</reflink>] These practices assist students of all cultures in understanding how cultural or religious practices can support the awareness of cultural values, and this shared experience may importantly enhance a feeling of collectivism and identity for this student cohort.[<reflink idref="bib4" id="ref116">4</reflink>] Māori and Pasifika share values and practices, but they are not interchangeable,[[<reflink idref="bib76" id="ref117">76</reflink>]] and though tikanga Māori was beneficial for the majority of students, including both Māori and Pasifika participants, it is possible that support specific to Pasifika students may prove useful in facilitating a sense of community and identity for this minority group.</p> <p>Literature on Pasifika medical students is sparse and reiterates similar points of promoting cultural support and aid for minority students.[<reflink idref="bib31" id="ref118">31</reflink>] Previous studies have explored a variety of ethnic perspectives on the DR and dissection (Abu‐Hijelh et al., 1997)[<reflink idref="bib78" id="ref119">78</reflink>], [<reflink idref="bib79" id="ref120">79</reflink>], [<reflink idref="bib80" id="ref121">80</reflink>], [<reflink idref="bib81" id="ref122">81</reflink>], [<reflink idref="bib82" id="ref123">82</reflink>]; yet, there remains a distinct lack of research into the influence of culture or cultural safety within the DR[[<reflink idref="bib17" id="ref124">17</reflink>]] or PIF. Outside of the DR environment, understanding culture and cultural safety has been brought to the forefront of content debates for determining future medical curricula (Kumar et al., 2022).[[<reflink idref="bib83" id="ref125">83</reflink>]] This highlights a requirement to adopt a culturally aware perspective in and around DR activities so that future healthcare professionals‐in‐training remain supported and aware.[<reflink idref="bib85" id="ref126">85</reflink>], [<reflink idref="bib86" id="ref127">86</reflink>], [<reflink idref="bib87" id="ref128">87</reflink>] Thus, further studies need to explore ways to facilitate support, cultural inclusivity, and engagement for students in the DR who are from cultural minorities: culturally relevant curricula and teaching practices have been shown to assist minority students in their learning outcomes[<reflink idref="bib88" id="ref129">88</reflink>], [<reflink idref="bib89" id="ref130">89</reflink>], [<reflink idref="bib90" id="ref131">90</reflink>] and do need to be considered in this context to support students and facilitate PIF.</p> <hd id="AN0192092998-33">Do students perceive the dissection room and body donor experience provide unique learning op...</hd> <p>The development of alternative forms of teaching anatomy sees the use of dissection and body donors being intermittently revisited.[[<reflink idref="bib24" id="ref132">24</reflink>], [<reflink idref="bib91" id="ref133">91</reflink>]] Evidence of efficacy is required to support the promotion of any mode of teaching, and in the face of alternative—and likely cheaper—models of anatomy delivery, it is useful to explore what students believed were unique about the learning opportunities in the DR. This included questions about learning that they could not acquire from other areas of the curriculum: students were asked what was "unique" about dissection that they could not acquire elsewhere or from other types of resource (e.g., prosections or models). Two major components of the experience that were unique were suggested by students, including those that were not anatomy‐centric, and those that were focused on anatomy content (Table 3).</p> <p>3 TABLE Educational elements reported by students as unique to dissecting room.</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Unique educational elements reported by students</th><th align="left">Description</th></tr></thead><tbody valign="top"><tr><td align="left">Anatomical</td><td align="left">Holistic anatomy</td><td align="left">Donor bodies offer a holistic learning experience for the students. Unlike prosections, there is a feeling of "wholeness" when interacting with the bodies that students find helpful in reinforcing their anatomical knowledge that cannot be gained from prosections or models</td></tr><tr><td align="left">Surgical expertise</td><td align="left">Precision and patience are necessary skills used throughout dissections. Working on a "real" human prepares those students who consider a career in surgery is a possibility</td></tr><tr><td align="left">Nonanatomical</td><td align="left">Respect for the dead</td><td align="left">Immense respect is given to the donors and this is reinforced by the expectations and procedures that accompany dissection. This is reiterated and enforced by tutors and staff members throughout a student's learning</td></tr><tr><td align="left">Cultural engagement around the dead</td><td align="left">Cultural diversity allows for a breadth of students from a variety of heritage to learn from others within the DR. Different cultural backgrounds influence how students behave and react to the donor bodies, as well as how they process this confronting experience. Students learn through observing how other students in the DR act and behave</td></tr></tbody></table> </ephtml> </p> <p>Students reflected on nonanatomical learning, which included learning about how other persons and cultures (in the form of other students) engage and act with the dead. This has not previously been reported, and further illuminates the potential benefits of the DR as a learning space. There were also comments indicating respect for the dead was developed in the DR, which has previously been described.[[<reflink idref="bib14" id="ref134">14</reflink>], [<reflink idref="bib18" id="ref135">18</reflink>]] Common student perspectives on the learning of anatomy were that the practical task of dissection was unique to the DR and body donors, and this was important for students considering a career in surgery. This is interesting because these students had not yet undertaken dissection, indicating a preconceived notion about the skill and its importance. It is also in keeping with previous reports that highlight students believe maintaining dissection opportunities is important to improve anatomical knowledge.[[<reflink idref="bib14" id="ref136">14</reflink>], [<reflink idref="bib18" id="ref137">18</reflink>], [<reflink idref="bib43" id="ref138">43</reflink>], [<reflink idref="bib58" id="ref139">58</reflink>]] The wholeness of a body was viewed as important to learn the "whole" of the anatomy of a person, and make it a holistic anatomy learning experience. This also made the DR more challenging, as interacting with prosections was less difficult because they could be viewed as "not real people", indicating engaging with whole body donors is a very different experience to other modes of learning.</p> <hd id="AN0192092998-34">A new educational perspective on the dissection room: Liminal spaces and threshold concepts</hd> <p>It is useful to consider the DR and body donor experience in relation to contemporary educational theory in order to guide accurate and meaningful educational responses. A challenging and confronting environment such as the DR could be framed as a liminal space: a transformative space that challenges students' own ideas, views, and identity[<reflink idref="bib61" id="ref140">61</reflink>] during an experience that students must "pass through" during their education.[<reflink idref="bib93" id="ref141">93</reflink>] The term "rite of passage" has been used to describe the DR experience,[[<reflink idref="bib20" id="ref142">20</reflink>], [<reflink idref="bib92" id="ref143">92</reflink>], [<reflink idref="bib94" id="ref144">94</reflink>]] despite this phrase carrying unfortunate parallels with "hazing". It is most certainly a form of ritualization, which is similar to events in society like other positive ritualized societal "rites of passage" such as graduation, marriage, or personal ceremony. Indeed, commonly mentioned were references to spirituality with the DR being a "sacred" space "like a church", indicating parallels between the two spaces and experiences. Such experiences lead to change in the individual who is partaking: once they have passed through this liminal phase and undertaken the experience of the DR, they are "changed".[<reflink idref="bib95" id="ref145">95</reflink>] These characteristics can also be used to identify the DR experience as a threshold concept.[[<reflink idref="bib96" id="ref146">96</reflink>]]</p> <p>Threshold concepts are a notion reported infrequently in anatomy education[<reflink idref="bib98" id="ref147">98</reflink>], [<reflink idref="bib99" id="ref148">99</reflink>], [<reflink idref="bib100" id="ref149">100</reflink>] and less in describing the DR experience of students.[<reflink idref="bib93" id="ref150">93</reflink>] They are pivotal and transformative ideas or skills in a discipline[<reflink idref="bib101" id="ref151">101</reflink>] that, once grasped, change the perspective of a learner, or enable deeper understanding.[[<reflink idref="bib99" id="ref152">99</reflink>], [<reflink idref="bib102" id="ref153">102</reflink>]] Characteristics of threshold concepts often include challenging preexisting knowledge, and they mark a crucial point in learning,[<reflink idref="bib61" id="ref154">61</reflink>] which is associated with transition or change.[<reflink idref="bib103" id="ref155">103</reflink>] Common elements include students facing cognitive dissonance against prior knowledge,[<reflink idref="bib104" id="ref156">104</reflink>] requiring a change in thinking,[<reflink idref="bib98" id="ref157">98</reflink>] and being irreversible (unlikely to be forgotten) (Meyer & Land, 2011),[<reflink idref="bib105" id="ref158">105</reflink>] all reported by students in this study. They also include the student struggling for points of reference while immersed in this experience,[<reflink idref="bib97" id="ref159">97</reflink>] which was also frequently reported by students. In this instance, it is posited the threshold concept is an understanding of "how to be" in the DR. Where threshold concepts exist, responses include recognizing students are looking to understand concepts, boundaries, and limitations, and support should be directed at providing points of reference and clarification around expected knowledge or ways of being[<reflink idref="bib97" id="ref160">97</reflink>] and how progress can be made toward a clear goal.[<reflink idref="bib98" id="ref161">98</reflink>]</p> <hd id="AN0192092998-35">Developing support and educational resources for the dissection room experience</hd> <p>The DR has long been identified as an instance where students require additional support in order to adequately prepare them,[<reflink idref="bib106" id="ref162">106</reflink>] and it is suggested an obligation exists to provide such support.[<reflink idref="bib107" id="ref163">107</reflink>] Adverse effects experienced by students do decrease with support[[<reflink idref="bib67" id="ref164">67</reflink>], [<reflink idref="bib108" id="ref165">108</reflink>]] and with further exposure to the environment[[<reflink idref="bib40" id="ref166">40</reflink>], [<reflink idref="bib45" id="ref167">45</reflink>], [<reflink idref="bib50" id="ref168">50</reflink>], [<reflink idref="bib108" id="ref169">108</reflink>]]; however, that does not preclude the necessity to provide adequate support, nor does it mean educational benefits should not be acquired from the experience where it is ethical and appropriate to do so. Perhaps importantly, because the initial exposure to the DR and body donors are the most stressful, educators are obliged to focus support and educational resources around this period. This will ensure students are better prepared[[<reflink idref="bib41" id="ref170">41</reflink>], [<reflink idref="bib109" id="ref171">109</reflink>]] and that an appropriate foundation is provided that sets the tone for their anatomy immersion in regard to expectations, experiences, behaviors, and learning. If the DR and body donor experience is accepted as being a threshold concept, the delivery of these resources needs to focus on supporting students in acquiring points of reference to facilitate understanding and give meaning to the experience,[<reflink idref="bib68" id="ref172">68</reflink>] helping them find coherence and clarity in an unfamiliar space.[<reflink idref="bib97" id="ref173">97</reflink>]</p> <p>Various authors have suggested the integration of different types of support including informing students before they enter the DR environment,[<reflink idref="bib110" id="ref174">110</reflink>] playing music during the DR experience,[<reflink idref="bib112" id="ref175">112</reflink>] showing videos of a dissection prior to the first DR experience,[[<reflink idref="bib45" id="ref176">45</reflink>], [<reflink idref="bib111" id="ref177">111</reflink>]] and visits to an empty DR prior to dissection beginning.[[<reflink idref="bib45" id="ref178">45</reflink>], [<reflink idref="bib110" id="ref179">110</reflink>]] Perhaps the most detailed outline around supporting student immersion in the DR comes from Hildebrandt[<reflink idref="bib113" id="ref180">113</reflink>], who provides an in‐depth program focused on core elements of anatomy education that caters to pre‐, during, and post‐DR periods of engagement with students. Findings from this study suggest additional considerations for pre‐ and during‐DR phases of engagement as mechanisms of supporting students, including discussions around culture and the different cultural responses that may be encountered or observed in the DR, illumination of the spiritual nature of the DR experience that some persons may report, and identification of some people being unsure how to act, behave, or speak when immersed in the DR (Table 4).</p> <p>4 TABLE Study data on student experiences of the dissection room and suggested support opportunities.</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Student experiences</th><th align="left">Support opportunities</th></tr><tr><th align="left">Finding</th><th align="left">Description</th></tr></thead><tbody valign="top"><tr><td align="left">The DR is a spiritual space</td><td align="left">Some students described the DR as a spiritual space with comparisons to a church or sacred space</td><td align="left">Ensuring students are aware of the different ways students experience the DR</td></tr><tr><td align="left">Emotions on entering DR and engaging with donors</td><td align="left">Students experienced a variety of feelings upon exposure to the DR and donors, e.g., anxiety, stress, nothing</td><td align="left">Preparatory and reflective sessions may help students process their feelings around the DR and the donor bodies<xref ref-type="bibr" rid="bibr35">35</xref> and reflect on emotional norms<xref ref-type="bibr" rid="bibr35">35</xref>; peer discussion and support with those who have prior experience with a dead body can assist and support students.<xref ref-type="bibr" rid="bibr39">39</xref> Teaching students explicitly about desensitization and emotional detachment<xref ref-type="bibr" rid="bibr35">35</xref></td></tr><tr><td align="left">Unsure how to act, behave, or speak</td><td align="left">Students reported confusion around ways to behave and act within the DR</td><td align="left">Providing explicit instructions and processes when introduced to the DR, and ensuring students are aware of what will occur<xref ref-type="bibr" rid="bibr110">110</xref> Illuminating this notion and providing examples will assist students, as does validation and strengthening of student's confidence in their abilities<xref ref-type="bibr" rid="bibr43">43</xref></td></tr><tr><td align="left">Physical symptoms</td><td align="left">Some students report experiencing physical symptoms like dizziness or nausea during their first exposure</td><td align="left">Having staff members can help reduce students' negative emotions during this initial exposure through validation of their feelings and explanation of the space (Shugaba et al., 2015)[<xref ref-type="bibr" rid="bibr51">51</xref>, <xref ref-type="bibr" rid="bibr134">134</xref>]</td></tr><tr><td align="left">Cultural perspectives</td><td align="left">Student backgrounds changed and influenced how they perceived the DR space</td><td align="left">Acknowledging and integrating the impact and role of culture in the DR. Prior preparation established feelings of comfort and grounding for students when entering the DR and seeing the donors</td></tr><tr><td align="left">Cultural engagement</td><td align="left">Students found solace in cultural rituals, regardless of their own background or ethnicity</td><td align="left">Use of appropriate cultural acknowledgments and preparation for students before they engage with the DR, such as a ceremony that gives thanks to the donors.<xref ref-type="bibr" rid="bibr20">20</xref> Their use and integration would likely assist students from all backgrounds</td></tr><tr><td align="left">Religious perspectives</td><td align="left">Students were very aware of how the experience related to their religious views</td><td align="left">The provision of a prayer space, or elements that address the spiritual needs of students. Teaching of coping strategies including resolving moral conflict. Appropriate space for prayer, reflection, and spiritual engagement</td></tr><tr><td align="left">Respect for the dead</td><td align="left">Students felt deep levels of respect toward the donor bodies when interacting with them; students referred to "first patient"</td><td align="left">Self‐reflection, ascribing meaning; facilitating explicit conversations around students' thoughts and feelings around interacting with donors and why they have respect for them, discussing parallels with patient interaction</td></tr><tr><td align="left">Death and dying</td><td align="left">Students expressed how DR brought up feelings about death and dying</td><td align="left">Creating guidelines for students on what to expect and providing ways to cope and rationalize this experience</td></tr><tr><td align="left">Becoming a professional</td><td align="left">Some students felt "more like a doctor" in the DR</td><td align="left">Reinforcing students' belief that the experience is seen as preparation for a career and the professional identity that could be acquired. Teaching and reflective sessions aimed at making PIF explicit<xref ref-type="bibr" rid="bibr35">35</xref></td></tr><tr><td align="left">Effective mentoring</td><td align="left">Students report having experienced tutors as supportive</td><td align="left">A diverse, mature staff with perspectives and backgrounds creates more representation so that students feel comfortable and safe within the DR (Time et al., 2023)<xref ref-type="bibr" rid="bibr31">31</xref></td></tr></tbody></table> </ephtml> </p> <p>1 Abbreviations: DR, dissection room; PIF, professional identity formation.</p> <p>Educational initiatives are required to further PIF and to leverage existing teaching within the medical curriculum,[[<reflink idref="bib114" id="ref181">114</reflink>]] ensuring PIF is made explicit[<reflink idref="bib116" id="ref182">116</reflink>] from the outset of engagement with the DR so students can follow their own PIF progress.[<reflink idref="bib4" id="ref183">4</reflink>] This could include introducing concepts such as virtue ethics in PIF, whereby students reflect on becoming "moral agents" in developing their standards and behaviors.[<reflink idref="bib116" id="ref184">116</reflink>] In addition to illuminating the role of the DR in a medical student's professional journey, this may also include explicitly addressing or assessing NTDIS, highlighting the important roles of communication skills, empathy, teamwork,[<reflink idref="bib117" id="ref185">117</reflink>] and clinical detachment or desensitization as potential coping strategies within the DR.[[<reflink idref="bib35" id="ref186">35</reflink>], [<reflink idref="bib68" id="ref187">68</reflink>]] There is also a necessity to acknowledge the role of the spiral curriculum in medical education[<reflink idref="bib118" id="ref188">118</reflink>] by ensuring that modules that could support the DR experience are delivered concurrently, and undertake these where they can leverage social learning principles[[<reflink idref="bib4" id="ref189">4</reflink>]] that the DR environment provides.</p> <p>The safe space of the DR offers a multitude of possibilities for students to develop clinical, professional, technical skills, and attitudes on top of the existing anatomical curriculum[<reflink idref="bib79" id="ref190">79</reflink>] in a supportive social learning experience, where persons are aware of learning with and from others. As such, it is strongly identifiable with social constructivism and social learning theory,[[<reflink idref="bib4" id="ref191">4</reflink>]] and this should be leveraged in educational opportunities that will benefit students. Examples of these could include small‐group learning opportunities that address death and dying or confronting situations so that medical students can develop appropriate attitudes around sensitive subjects such as death.[<reflink idref="bib119" id="ref192">119</reflink>] Ethics modules are likely of relevance,[<reflink idref="bib120" id="ref193">120</reflink>] such as if body donors are acquired through medical assistance in dying,[<reflink idref="bib121" id="ref194">121</reflink>] as well as modules focusing on the history and ethics surrounding anatomy,[[<reflink idref="bib113" id="ref195">113</reflink>], [<reflink idref="bib122" id="ref196">122</reflink>]] cultural differences and values around death and dying, and the humanistic elements associated with the experience.[[<reflink idref="bib2" id="ref197">2</reflink>], [<reflink idref="bib124" id="ref198">124</reflink>], [<reflink idref="bib126" id="ref199">126</reflink>]] Teaching students concurrently about moral conflict and strategies to address this would also be useful: Pasifika students in this study struggled to reconcile cultural values against educational requirements.</p> <hd id="AN0192092998-36">Supporting sustainable dissection room teaching of anatomy: Looking for answers around learni...</hd> <p>Many medical programs focus on students satisfying learning outcomes to progress, and it is necessary to consider how the DR and body donor experience relate to curricula frameworks that pivot around learning outcomes. Learning about anatomy is "different" without body donors, though programs successfully achieve this,[<reflink idref="bib24" id="ref200">24</reflink>] and learning outcomes focused around using a scalpel or demonstrating surgical skills are likely rare in undergraduate medical programs. Discovering how other cultures engage and act with the dead is perhaps unique to the DR space, but this is not a learning outcome that likely exists. For many students, this was their first experience with the concept of death[[<reflink idref="bib67" id="ref201">67</reflink>], [<reflink idref="bib128" id="ref202">128</reflink>]] causing many to reflect on death, dying, and the loss of loved ones.[[<reflink idref="bib14" id="ref203">14</reflink>], [<reflink idref="bib42" id="ref204">42</reflink>]] However, this also is not a learning outcome in many programs, though some student cohorts may be expected to meet learning outcomes involving death through attending an autopsy or assisting with a death certificate. Findings illuminate the difficulty in matching perceived benefits of the DR experience with learning outcomes in modern curricula.</p> <p>There is no doubt the DR and body donor experience is unique—the literature is replete with references highlighting the "special" nature of the DR[[<reflink idref="bib5" id="ref205">5</reflink>], [<reflink idref="bib35" id="ref206">35</reflink>], [<reflink idref="bib43" id="ref207">43</reflink>], [<reflink idref="bib114" id="ref208">114</reflink>]] and this is supported by the findings of this study. The DR experience can be framed as a professional development opportunity that supports and assists PIF due to a combination of experiences, including this being very much a challenging, moral experience[[<reflink idref="bib35" id="ref209">35</reflink>], [<reflink idref="bib62" id="ref210">62</reflink>]] that is underpinned by significant humanistic elements,[[<reflink idref="bib114" id="ref211">114</reflink>], [<reflink idref="bib124" id="ref212">124</reflink>], [<reflink idref="bib129" id="ref213">129</reflink>]] all of which were observed in this study. However, many of the educational benefits commonly associated with the DR are experiential, and this is potentially problematic. If the unresolved debate around "best" modes for learning anatomy[[<reflink idref="bib24" id="ref214">24</reflink>]] is set aside, this raises the question: why use the DR and body donors if specific and unique learning outcomes cannot be attributed to it? The argument surrounding retention of this experience, therefore, somewhat depends on the value(s) attributed to it. These remain difficult to consolidate, partly because it is problematic to attach specific learning outcomes to many of the humanistic benefits described in literature.[[<reflink idref="bib3" id="ref215">3</reflink>], [<reflink idref="bib5" id="ref216">5</reflink>], [<reflink idref="bib16" id="ref217">16</reflink>], [<reflink idref="bib35" id="ref218">35</reflink>]] This presents a risk to the ongoing use of the DR as an educational resource if learning outcomes are used to justify educational support, curriculum development, and resourcing.</p> <p>This study has shown that many of the elements of PIF historically attached to the DR and dissection are apparent at the first DR experience, without students even having started dissection. For the students in this study, it is argued that DR is the single largest transformational event in their preclinical education. Central to this experience remain the body donors who generate the atmosphere, respect, and expectations that underpin student responses and engagement: "If you remove the donors, the DR space is less confronting and easier to deal with" said one student. Required then is an exploration of how much exposure to the DR environment is necessary to elicit substantial changes in PIF for students, and the nature of this relationship—for instance, how many visits to the DR are required to acquire most of the benefits. To answer this, information must first be acquired that further substantiates "what it is" that students will end up with in the first instance, and it is difficult to argue against a substantial part of any benefit being the contribution to PIF. Without data providing further insight into tangible benefits, or somehow framing these benefits more tangibly, there remain risks to the long‐term sustainability of DR and thus body donor programs. Such risks are further amplified when consistent reductions in anatomy teaching time over recent decades are considered.[[<reflink idref="bib130" id="ref219">130</reflink>]]</p> <hd id="AN0192092998-37">Limitations</hd> <p>There are a small number of limitations associated with this study. Issues with Pasifika student recruitment resulted in fewer than expected numbers of Pasifika students being involved in the study; however, the overall sample size and collated interviews provided information that no longer yielded substantially new insights.[<reflink idref="bib33" id="ref220">33</reflink>] Most students were less than 26 years old though there were three in their thirties; despite this, there appeared no substantial influence of age on response, which is perhaps expected given the focus was on DR experience, which was similar across all participants (Tables 1 and 2). The number of Pasifika students interviewed was fair (eight interviewed); however, when viewed in the context of those eligible (approximately 22–25), this number represents a very good proportion, and data collection for this group was ceased when researchers agreed no novel insights were being gained through interviews. There is also the possibility of alternative framing around data analysis, and we acknowledge the potential for these data to reveal different stories in such cases. The participant sample had different proportions of some ethnicities; however, this can also be interpreted as a strength as many medical student cohorts are likely heterogeneous and the resulting information is therefore of broad interest. Finally, the study focused on a first engagement with body donors that did not include dissection, which has been the focus of many other studies in this area, and it is difficult to directly compare findings between studies. Nevertheless, the finding that reactions and experiences are similar between this study and others focusing on dissection is in itself unique, indicating that there are novel stresses involved in engaging with the DR and body donors and not necessarily with dissection itself.</p> <hd id="AN0192092998-38">CONCLUSIONS</hd> <p>The DR is a pivotal event for medical students and has a key role to play in their development as young health professionals.[<reflink idref="bib132" id="ref221">132</reflink>] This study has focused on the first encounter of students with the DR and body donors prior to dissection occurring, and findings from this study illuminate several novel features of this experience. Outcomes show that many of the factors contributing to PIF in students occur just by being immersed in the DR and interacting with a donor, even before dissection has been initiated. This has both assisted an understanding of what student support and education is required for this event and raised questions about the amount of DR exposure required to acquire substantial benefit in PIF.</p> <p>For the first time, cultural elements relating to the DR experience and their potential influence on PIF have been illuminated in a cohort of Pasifika students. This has highlighted the difficulties ethnic minorities may face when immersed in the DR, where for some students this space exists as a "cultural purgatory" where cultural values must be left at the door. Examining the influence of Pasifika culture within the DR has shown areas where PIF can be assisted and facilitated in direct response to challenges faced in the DR, including specific culturally influenced elements around moral conflict, communication, and reduction of stigma. These observations, and the distinct lack of research in this space, suggest the topic and influence of culture in the DR requires immediate consideration to ensure future healthcare professionals from all backgrounds are appropriately supported in their educational journey.[<reflink idref="bib133" id="ref222">133</reflink>]</p> <p>Data on student perceptions around "unique" learning outcomes showed students generally perceive the DR as providing anatomy‐focused skills of "holistic" anatomy and surgical skills; however, they suggest learning about respect for the dead and how different cultures interact and engage with the dead as important skills that students believe cannot be acquired elsewhere in the curriculum. This is likely a benefit derived in part from having multicultural student cohorts engaging with body donors. The experience has also been framed as an educational threshold concept that has not previously been suggested for the DR, which assists with designing and planning educational initiatives and support for students entering this space, some of which are suggested. Last, further studies are required to further illuminate the influence and impact of nonanatomical skills and PIF in this DR to inform how to implement educational initiatives and draw the "hidden" curriculum into a space where it is less tacit, more explicit, and visible, and more tangible. Empirical evidence of this kind will assist the maintenance and relevance of the DR in a contemporary educational environment.</p> <hd id="AN0192092998-39">INTERVIEW PROTOCOL</hd> <p></p> <hd id="AN0192092998-40">Opening script for interviews</hd> <p>Talofa lava, my name is Jacob, and I will be interviewing you today. I am a 4th‐year medical student currently undertaking a gap year to complete an honors degree. My project is exploring student experiences of their first engagement with body donors (the deceased persons used in the dissection room for the teaching of anatomy) in the dissection room.</p> <p>Today I am going to be asking you some questions about your experience in the dissection room (DR) and your first engagement or interaction with body donors. The interview will last approximately between twenty and thirty minutes.</p> <p>Can you please read the information sheet, and if you are comfortable proceeding please sign the informed consent form.</p> <p>Before we begin, can I just check once again that you are comfortable with being recorded?</p> <p>If you feel uncomfortable at any time during this interview, or if you find any of the content or discussion distressing, please let me know if you would like to stop the interview. You are welcome to change your mind, stop the interview, and withdraw from the study at any time.</p> <p>We are going to start with some questions about you and your personal background, then move into some more specific questions about your DR and body donor experience.</p> <p></p> <ulist> <item> Start two audio recording devices.</item> </ulist> <p>This interview is now being recorded—interview number XX on (date) at (time).</p> <hd id="AN0192092998-41">INTERVIEW QUESTIONS</hd> <p></p> <hd id="AN0192092998-42">Demographic</hd> <p></p> <ulist> <item> What ethnicity do you identify with?</item> <p></p> <item> What gender do you identify with?</item> <p></p> <item> What is your current age?</item> <p></p> <item> Where were you raised?</item> <p></p> <item> Would you say you strongly identify with a particular culture? If yes, which one(s)?</item> <p></p> <item> Why do you think you identify strongly with that culture?</item> </ulist> <hd id="AN0192092998-43">First body donor experience</hd> <p> <emph>Preparing for engagement with body donors</emph> </p> <p></p> <ulist> <item> How prepared did you feel for your first experience with body donors in the DR?</item> <p></p> <item> What things helped you feel prepared, or not prepared, for experiencing the body donors in the DR?</item> <p></p> <item> What was done to help you prepare?</item> <p></p> <item> What would have made you feel more prepared?</item> </ulist> <p> <emph>Support and assistance</emph> </p> <p></p> <ulist> <item> Was there anything about your first body donor experience that you would say made the experience better or worse for you?</item> <p></p> <item> What sorts of things could have been done to make you more comfortable in your engagement with the body donors?</item> </ulist> <hd id="AN0192092998-44">Culture and cultural safety</hd> <p> <emph>Cultural safety</emph> </p> <p></p> <ulist> <item> What is your understanding of the concept of cultural safety?</item> <p></p> <item> How would you define cultural safety?</item> </ulist> <p> <emph>Exploring impact of culture</emph> </p> <p></p> <ulist> <item> What was your first experience or interactions with body donors like, in relation to your culture?</item> <p></p> <item> Were there any things around your first engagement with body donors that you thought were different from what would be culturally appropriate for you?</item> <p></p> <item> How do you think your culture influenced your experiences or engagement with the body donors?</item> </ulist> <hd id="AN0192092998-45">Professional and education</hd> <p> <emph>Compared to other teaching spaces</emph> </p> <p></p> <ulist> <item> How is the DR and body donor space or experience similar or different to other learning experiences or spaces that you have already encountered in medical school?</item> <p></p> <item> What are the expectations around student behavior like for the DR space compared to other teaching spaces?</item> <p></p> <item> How do you think the DR and body donor environment influences student behavior, as a teaching space?</item> </ulist> <p> <emph>Uniqueness of body donors</emph> </p> <p></p> <ulist> <item> What do you think your DR and body donor experience will give you that other teaching experiences in medical school may not provide you?</item> <p></p> <item> If the DR and use of body donors were not available to teach anatomy, what would the impact be?</item> <p></p> <item> What sorts of things do you think the DR and body donor experience teaches you, apart from anatomy?</item> </ulist> <hd id="AN0192092998-46">Closing script for interviews</hd> <p>Thank you very much for your time, we have reached the end of the interview. Do you have anything further you would like to add about your body donor and DR experience before I stop recording?</p> <p></p> <ulist> <item> Stop two audio recording devices once appropriately prompted by participant.</item> </ulist> <hd id="AN0192092998-47">Post‐interview</hd> <p></p> <ulist> <item> Check participant is OK; refer participant to appropriate person or group if they indicate they require additional support.</item> <p></p> <item> Discuss comments or reflections with participants should they prompt or engage around interview content.</item> <p></p> <item> Provide the participant with contact information about study should they wish to contact research team.</item> <p></p> <item> Remind participants all data are confidential.</item> </ulist> <hd id="AN0192092998-48">Additional notes</hd> <p></p> <ulist> <item> Use probing questions (e.g., 'Can you tell me more about that?') to explore and acquire more in‐depth information as required.</item> <p></p> <item> Ensure supportive environment throughout interview.</item> <p></p> <item> Make sure to be aware of verbal and nonverbal cues.</item> <p></p> <item> Allow breaks if the participant requests them.</item> </ulist> <hd id="AN0192092998-49">AUTHOR CONTRIBUTIONS</hd> <p> <bold>Jacob Madgwick:</bold> Conceptualization (equal); data curation (equal); formal analysis (equal); investigation (equal); methodology (equal); project administration (equal); writing – original draft (equal); writing – review and editing (equal). <bold>Lynley Anderson:</bold> Conceptualization (equal); investigation (equal); methodology (equal); project administration (equal); supervision (equal); writing – original draft (equal); writing – review and editing (equal). <bold>Jon Cornwall:</bold> Conceptualization (equal); data curation (equal); formal analysis (equal); investigation (equal); methodology (equal); project administration (equal); supervision (equal); writing – original draft (equal); writing – review and editing (equal).</p> <hd id="AN0192092998-50">ACKNOWLEDGMENTS</hd> <p>The authors would like to thank Sabine Hildebrandt and Thomas Champney for their suggestions around data interpretation, Iris Wainiqolo for suggestions on the influence of culture within medical education, and Latika Samalia for her thoughts and guidance on the dissection room experience at Otago Medical School. JM would like to thank Otago Medical School, University of Otago, for the Otago Medical School scholarship that has provided support for his studies. This study was presented at the Australian and New Zealand Association of Clinical Anatomy/Asia Pacific International Congress of Anatomists conference in Dunedin, in November 2023, where it won "Best Student Education Presentation". Open access publishing facilitated by University of Otago, as part of the Wiley ‐ University of Otago agreement via the Council of Australian University Librarians.</p> <hd id="AN0192092998-51">CONFLICT OF INTEREST STATEMENT</hd> <p>The authors declare that they have no competing interests.</p> <ref id="AN0192092998-52"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Habicht JL, Kiessling C, Winkelmann A. Bodies for anatomy education in medical schools: an overview of the sources of cadavers worldwide. 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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 convenor 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, Dip. Phty., B.Sc. (Physiol.), D.M.Phty. (Manipulative Phty.), M.Sc. (Anat.), Ph.D. (Anat.), 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. 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Header DbId: eric
DbLabel: ERIC
An: EJ1498740
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Medical Students' Initial Experiences of the Dissection Room and Interaction with Body Donors: A Qualitative Study of Professional Identity Formation, Educational Benefits, and the Experience of Pasifika Students
– 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>. 2026 19(2):280-300.
– 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: 21
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research<br />Tests/Questionnaires
– 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="%22Laboratory+Procedures%22">Laboratory Procedures</searchLink><br /><searchLink fieldCode="DE" term="%22Human+Body%22">Human Body</searchLink><br /><searchLink fieldCode="DE" term="%22Donors%22">Donors</searchLink><br /><searchLink fieldCode="DE" term="%22Professional+Identity%22">Professional Identity</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Experience%22">Student Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Cultural+Influences%22">Cultural Influences</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Death%22">Death</searchLink><br /><searchLink fieldCode="DE" term="%22Religion%22">Religion</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Behavior%22">Student Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Environmental+Influences%22">Environmental Influences</searchLink><br /><searchLink fieldCode="DE" term="%22Pacific+Islanders%22">Pacific Islanders</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22New+Zealand%22">New Zealand</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1002/ase.2504
– 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) likely influences professional identity formation (PIF). Sparse data exist exploring how exposure to the DR and body donors without undertaking dissection influences PIF, or how culture may influence this experience. This qualitative study explored students' first, non-dissection DR experience to determine how this contributes to PIF, including the impact of culture through a Pasifika-student lens. It also explored student perspectives on what learning opportunities are unique to this experience. Medical students with no prior DR experience were recruited and then interviewed after initial engagement with the DR and body donors. Questions included participant experiences, cultural perspectives, and how the DR differed from other teaching experiences. Interviews were recorded, transcribed, and analyzed thematically. Twenty students were interviewed (mean age 22 years, 12 females; 8 Pasifika) resulting in 520 min of audio recording (mean 26 min). Four primary themes were identified: professional identity formation, educational elements, death and spirituality, and cultural perspectives. Three subthemes including student experiences, behaviors, and environment were developed within each theme. Findings indicate development of PIF likely occurs from a single engagement with body donors without undertaking dissection, including recognition of professional role. Culture can play an important role for students, with several Pasifika students viewing the DR as a "cultural purgatory". Unique learning experiences are identified, such as cultural awareness around behaviors with the dead. The experience is an educational "threshold concept" where students likely undergo substantial developments in PIF, and educational initiatives to support students are outlined.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1498740
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1498740
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1002/ase.2504
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 21
        StartPage: 280
    Subjects:
      – SubjectFull: Medical Students
        Type: general
      – SubjectFull: Laboratory Procedures
        Type: general
      – SubjectFull: Human Body
        Type: general
      – SubjectFull: Donors
        Type: general
      – SubjectFull: Professional Identity
        Type: general
      – SubjectFull: Student Experience
        Type: general
      – SubjectFull: Cultural Influences
        Type: general
      – SubjectFull: Student Attitudes
        Type: general
      – SubjectFull: Death
        Type: general
      – SubjectFull: Religion
        Type: general
      – SubjectFull: Student Behavior
        Type: general
      – SubjectFull: Environmental Influences
        Type: general
      – SubjectFull: Pacific Islanders
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: New Zealand
        Type: general
    Titles:
      – TitleFull: Medical Students' Initial Experiences of the Dissection Room and Interaction with Body Donors: A Qualitative Study of Professional Identity Formation, Educational Benefits, and the Experience of Pasifika Students
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Jacob Madgwick
      – PersonEntity:
          Name:
            NameFull: Lynley Anderson
      – PersonEntity:
          Name:
            NameFull: Jon Cornwall
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      – BibEntity:
          Dates:
            – D: 01
              M: 02
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 1935-9772
            – Type: issn-electronic
              Value: 1935-9780
          Numbering:
            – Type: volume
              Value: 19
            – Type: issue
              Value: 2
          Titles:
            – TitleFull: Anatomical Sciences Education
              Type: main
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