The cadaver experience: The effects of self-esteem and denial on existential terror in medical students.

Abstract

Eighty-four medical students at the University of Arizona were administered measures of self-esteem, medical attitudes, social desirability, purpose in life, satisfaction with life, state and trait anxiety one week before their first cadaver dissecting experience. On the day of the experience, half of the subjects completed these measures again in addition to a death anxiety scale just prior to their first cadaver exposure. The other half completed these measures immediately after their first cadaver exposure. Results found main effects of self-esteem with high self-esteem subjects endorsing higher purpose in life and medical attitudes and lower state anxiety and death anxiety. Time by condition interactions were found for state anxiety and purpose in life, with both significantly higher in subjects assessed following exposure to the cadaver. Finally, a main effect for condition was also seen with regard to fear of death, with those exposed to the cadaver scoring significantly higher. Implications with regard to terror management theory and medical education were discussed. In particular, the results tend to support the notion of self-esteem as a psychological buffer against the existential anxiety resulting from an awareness of mortality. Further, results also suggest that cadaver dissection is a powerful emotional experience for physicians in training, significantly affecting their attitudes and requiring sensitivity of medical educators to the psychological impact of cadaver dissection.