Objectification,Desensitization,and Personification: Medical Student Strategies for Engaging with Donor Bodies in the Anatomy Lab

Abstract

Background

Human dissection remains a cornerstone of anatomy education, providing students with an early and profound encounter with the dead. Beyond technical skill acquisition, students must navigate the challenge of engaging with donor bodies in ways that are respectful, professional, and emotionally sustainable. Given the formative role of dissection in professional identity formation, this study explored the strategies students adopt in interacting with donor bodies and the motivations guiding these choices.

Methods

All medical students (M1–M4) at a single institution were invited to participate, and recruitment was closed after 44 students volunteered for either an interview or focus group. Of these, 24 joined focus groups and 20 completed individual semi-structured interviews. Sessions were audio-recorded, transcribed verbatim, and thematically analyzed using inductive coding.

Results

Analysis revealed four main strategies employed by students: (1) complete objectification of the donor as a non-living entity; (2) active desensitization to facilitate dissection; (3) overwhelming personification that impeded both learning and technical performance; and (4) middle-ground approaches involving oscillation between desensitization and personification.

Conclusion

These findings highlight the diversity of strategies medical students use to engage with donor bodies in the anatomy lab and underscore the importance of recognizing and supporting this variation to foster ethical, compassionate learning environments and professional identity formation.

Introduction

The anatomy lab often marks students’ first meaningful and authorized engagement with a dead human body—an intimate, hands-on experience that carries emotional weight and professional significance, distinct from prior, more passive encounters with death. This emotionally complex experience frequently prompts reflection on personal, philosophical, and spiritual beliefs about mortality.^1,2-4 Students describe the lab as a site of personal growth, evoking questions about the donor's life, death, and legacy.^5,6 Such encounters can profoundly shape future practice by fostering emotional regulation and prompting identity shifts rooted in personal reflection rather than external expectations or social norms.^7-10 Participation in dissection may also deepen students’ appreciation for humanistic values and reinforce their recognition of patient's personhood, particularly in contrast to peers without dissection experience.^7,8,11 Given these formative impacts, the anatomy lab has become a central focus of research on professional identity formation in medical education.^8,12-15

Despite its formative potential, the anatomy lab is often introduced with minimal guidance on how students might engage meaningfully with the donor body, reflecting a broader lack of education on death and dying in U.S. medical curricula.^16-19 In the absence of structured support, students often default to engagement strategies that prioritize technical mastery over personal or professional growth—such as emotionally distancing themselves from the donor or treating the body as an object of study rather than a once-living person.^1,20 Recent qualitative work has further shown that such approaches are not merely spontaneous reactions, but recognizable strategies that students adopt to manage ethical, emotional, and educational demands in the anatomy lab. ²¹ For instance, Tseng and Lin ²⁰ found that many students avoided “human referents,” deliberately suppressing recognition of the donor's humanity to maintain focus during dissection. These unexamined strategies may limit opportunities for reflective learning and ethical development, and may inadvertently erode empathy or reinforce detachment.^22,23 Yet, the dissection lab also presents a unique opportunity for students to actively construct strategies for grappling with death and uncertainty. When supported by thoughtful instruction and reflection, students may adopt more integrative approaches that cultivate emotional resilience and foster professional identity formation.^7,15,24,25 As they confront mortality in a hands-on, embodied way, students begin experimenting with ways of thinking, feeling, and acting that may shape their future responses to suffering, loss, and ethical complexity in clinical practice.^26,27

To navigate the dissection experience, students employ a variety of engagement strategies—including detachment, objectification, and intellectualization—that allow them to manage the cognitive and ethical demands of working with a human donor.^20,23,24 These strategies reflect forms of cognitive referencing that help students maintain composure and focus under pressure, ²⁸ but may also result in emotional blunting and reduced connection to the donor. ²⁴ Emotional blunting has been reported in over 80% of students in some studies and is associated with decreased empathy, increased burnout, and suboptimal patient care outcomes.^24,29-31 Some students approach dissection with a clinically detached or specimen-focused mindset, interpreting emotional distance as a marker of professionalism.^20,22 Others, particularly those with prior exposure to death, may default to detachment as a familiar coping mechanism. This widespread use of emotionally distancing strategies highlights the need to better understand how students engage with donor bodies—and how these strategies might be supported, challenged, or reoriented through anatomy pedagogy. ²⁴ Conversely, engagement strategies that humanize the donor, such as imagining their life story, ²⁰ or assigning a name to the body, ¹⁸ have been suggested to promote more meaningful learning and support emotional processing. Importantly, students’ emotional processing appears closely tied to their engagement choices. Those who are better supported in acknowledging and navigating their emotions may be more likely to adopt strategies rooted in ethical respect and humanization, highlighting the link between emotional development, reflective capacity, and professional identity formation in medical education. ³²

Recognizing the anatomy lab as a key site of early professional identity formation,^8-10,33 anatomy educators have developed a range of structured, reflective, and humanistic interventions aimed at fostering more intentional and ethically grounded student engagement with donor bodies. Fredrickson's broaden-and-build theory (2001) ³⁴ offers a psychological basis for such interventions, suggesting that positive emotions—such as gratitude, awe, and reverence—can expand students’ cognitive and affective capacities, enhancing openness to meaning-making and engagement. Preparatory strategies like educational videos ³⁵ and interactions with donor families—such as memorial ceremonies or luncheons—have been shown to promote deeper reflection and reduce anxiety, thus encouraging more respectful engagement.^1,36-38 Additional approaches—including artistic expression, ³⁹ reflective writing, ⁴⁰ journaling, and peer dialogue—have been proposed as constructive alternatives to emotionally distancing behaviors like detachment or dark humor. ⁴¹ Reflective journaling, in particular, has been associated with increased self-awareness, ethical sensitivity, and more meaningful engagement with dissection.^2,7,42,43

Building on efforts to foster meaningful engagement in dissection, the gross anatomy lab is increasingly recognized as a critical space for cultivating professionalism, teamwork, and humanistic values in early medical training.^2,9,44 Programs that intentionally embed opportunities for reflective and values-based engagement—such as structured discussions, collaborative dissection tasks, or professionalism workshops—have shown promising outcomes, with many students reporting enhanced awareness of their behaviors, ethical responsibilities, and developing professional identity. ⁴⁵ While prior studies have explored individual emotional coping strategies, often aimed at managing the psychological discomfort of working with human body donors, a comprehensive understanding of how students engage with donor bodies, and why they adopt particular approaches, remains limited. By examining the broad range of student engagement strategies during dissection, this study offers critical insights to inform more compassionate, reflective, and professionally grounded anatomy education.

Methods

Study Setting and Participants

This study was conducted as part of a broader research project exploring medical students’ experiences with anatomy education and professional identity formation. At the time of data collection, approximately 1400 students were enrolled across all four years (M1–M4) at multiple campuses of a single medical school. All students were invited to participate via email and were offered either a free lunch or a $10 Amazon gift card as an incentive. Inclusion criteria were current enrollment as a medical student and prior completion of the required gross anatomy course; no additional exclusion criteria were applied. As this was a qualitative study, no statistical sample size calculation was performed; recruitment was closed after 44 participants enrolled, which was deemed sufficient to support in-depth qualitative analysis. This yielded 20 one-hour individual interviews and four one-hour focus groups, which was deemed sufficient for in-depth qualitative analysis.^46,47

Participants self-selected into either an individual semi-structured interview or a focus group. At the time of recruitment, students were informed that interviews offered flexible scheduling, whereas focus groups were scheduled at fixed times; both formats were approximately one hour in duration. Participation format was determined by student availability and preference. Data collection occurred over a three-month period during a single academic semester.

Gross anatomy was delivered as a one-semester, dissection-based course during the first academic block of medical school. Students engaged in full cadaveric dissection as the primary learning modality, with prosections available as supplemental reference material. Due to the institution's multi-campus structure, students completed the course at different sites and in different academic years, with variability in lab size, instructional teams, class sizes, and learning environments. While senior electives in anatomy involving dissection were available to fourth-year students, none of the participants had taken those electives at the time of the study, and all were asked to reflect specifically on their first-year experiences in the required gross anatomy course. The variation in anatomy course delivery and instructional context across campuses allowed us to capture a broad range of student perspectives, reflecting different stages of training and institutional cultures. This diversity enriched our analysis by highlighting how students engaged with donor bodies within a shared curricular framework. Although students completed the course across different cohorts and instructional contexts, the purpose of this study was not to compare experiences by campus or class year, but to examine shared patterns in how students engaged with donor bodies as part of a common and formative anatomy experience.

Data Generation

Data collection methods consisted of one-on-one interviews and focus groups. Focus groups were conducted to facilitate shared reflection and peer interaction within similar training contexts. In contrast, individual interviews allowed for more personal, in-depth exploration of students’ experiences and perspectives. Participants in the interviews and focus groups were mutually exclusive; no student took part in both formats. This distinction ensured that the two datasets reflected independent participant cohorts, supporting methodological triangulation and contributing to the rigor of our analysis. All sessions employed a semi-structured format, using a common set of guiding questions to promote comparability across participants while allowing flexibility to explore emergent themes.

All data collection sessions were conducted in person on the medical school campus, in the interviewer's office. Sessions were audio-recorded and transcribed verbatim for qualitative analysis, with transcripts generated and verified manually by multiple members of the research team without the use of transcription software or artificial intelligence tools. Transcripts were not returned to participants for comment or correction.

The semi-structured interview guide and focus group guide are provided in Supplementary File 1 and Supplementary File 2, respectively. Supplementary File 1 includes the semi-structured interview guide, and Supplementary File 2 includes the focus group guide used to facilitate data collection. Interview and focus group guides were developed by the first author (HA) and used consistently across sessions; guides were not pilot tested, which is consistent with inductive qualitative approaches. Participants took part in a single interview or focus group, and no repeat interviews were conducted. No participants withdrew or declined participation after voluntarily enrolling in the study. Field notes were not generated during or after data collection.

All interviews and focus groups were conducted by HA. At the time of data collection, the interviewer was a graduate PhD student with training in qualitative research methods and medical education. Although the interviewer had been involved in anatomy teaching as a teaching assistant for first-year medical students, she did not have an evaluative or supervisory role over study participants and was not involved in grading or assessment. No prior research relationship with participants existed beyond the teaching context. Consistent with a constructivist orientation, the research team acknowledged that the interviewer's background in anatomy education and interest in professional identity formation informed the framing of interview questions and the interpretation of participants’ accounts. No non-participants were present during the interviews or focus groups.

One-on-one Interviews

Twenty semi-structured individual interviews were conducted in person (see Supplementary File 1 for interview questions), each lasting approximately one hour. A total of 20 students participated, including eight M1, three M2, five M3, and four M4 medical students.

Focus Groups

Four semi-structured focus groups were conducted in person (see Supplementary File 2 for focus group questions), each lasting approximately one hour. A total of 24 students participated across the four groups, with one group for each class year (M1–M4). The M1 focus group included nine participants, the M2 group included seven, the M3 group included three, and the M4 group included five. Self-reported gender and race/ethnicity information for all study participants is presented in Table 1.

Table 1.

Self-Reported Demographic Data of Study Participants.

Participant	Interview	Focus Group
Gender Men	12	14
Women	8	10
Race/Ethnicity
Caucasian	12	13
White Middle Eastern	0	3
South Asian	2	3
African American	2	2
Multiracial	4	2
Asian		1
Total	20	24

A relatively detailed description of study participants is provided to illustrate the diversity of the sample, address concerns about representation ⁴⁸ and enhance the transferability of findings to similar educational settings. ⁴⁷

Data Analysis

Data analysis proceeded in two phases. The first phase involved a preliminary review of interview transcripts to identify emerging themes, which informed the design of the focus group protocol. The second phase consisted of a comprehensive analysis of both interview and focus group data using an inductive, open coding approach that allowed themes to emerge from the data. Data analysis continued until thematic sufficiency was reached, with no new patterns emerging from subsequent transcript review.

Prior to data analysis, all transcripts were anonymized and assigned unique participant identifiers to ensure confidentiality. Participants were labeled by data collection method—“IN” for interview and “FG” for focus group—and year of study. This system is also used throughout the results section (eg, “IN4, M3” refers to the fourth interview participant, a third-year medical student).

This study was grounded in a constructivist research paradigm, which emphasizes the co-construction of meaning between researchers and participants and the contextual nature of knowledge. Consistent with this orientation, our analysis followed an inductive, bottom-up approach and was not guided by a pre-existing theoretical framework. Instead, we allowed patterns and themes to emerge directly from students’ narratives, focusing on their subjective experiences and meaning-making. This approach aligns with Braun and Clarke's model of reflexive thematic analysis, ⁴⁹ which highlights the researcher's active role in identifying and interpreting patterns of meaning grounded in lived experience.

To enhance rigor and credibility, thematic analysis was conducted collaboratively by multiple members of the research team (HA, MV, and SH). Initial codes were developed independently through repeated readings of the transcripts. These preliminary codes were then discussed and refined through collaborative consensus-building, with attention to recurring patterns and differences across participants’ experiences. Codes were grouped into broader categories that captured shared features in how students engaged with donor bodies. Through an iterative process, we identified four major themes that reflected the spectrum of engagement strategies described by students. Analyst triangulation was employed to reduce individual bias and increase interpretive reliability. Methodological triangulation was achieved by comparing insights from individual interviews and focus groups to identify areas of convergence and divergence in participant perspectives. Additional strategies included reflexive dialogue among the research team to surface and examine assumptions, and the use of illustrative verbatim quotes to substantiate interpretations with direct evidence from participants’ narratives.

These efforts reflect current qualitative best practices, which emphasize collaborative code development, negotiated consensus, and ongoing reflexivity as key strategies for ensuring analytical depth and interpretive integrity in thematic analysis.^49,50

Statistical Analysis

No statistical analyses were performed, as this study employed a qualitative design focused on thematic and interpretive analysis of interview and focus group data.

Reporting Standards and Ethical Approval

This study is reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for interviews and focus groups (Tong et al, 2007) ⁵¹ [see Supplementary File 3] and was reviewed by the Institutional Review Board at Indiana University, which granted exempt status (protocol #1810969045); all procedures followed the Declaration of Helsinki, participation was voluntary, and the requirement for written informed consent was waived.

Results

We identified four key engagement strategies that students used to relate to and interact with donor bodies in the dissection lab: objectification, desensitization, personification, and middle ground approaches (see Figure 1). Objectification involved a passive attribution of the donor as a clinical object. Desensitization reflected a deliberate detachment from the donor's humanity to enable study. Personification was marked by an overwhelming recognition of the donor as a person, which hindered learning. Middle ground strategies aimed to balance desensitization and personification, with occasional shifts between the two. To preserve the context and meaning of participants’ experiences, selected quotations are presented in extended form rather than as brief excerpts.

Figure 1.

Medical student strategies for engaging with donor bodies in the anatomy lab. The figure depicts four qualitatively distinct engagement strategies identified in the analysis—objectification, desensitization, personification, and middle-ground approaches—which are presented as non-linear patterns rather than stages along a developmental continuum.

Objectification

Some students reported instinctively treating the donor body as a non-human entity, removing all notions of personhood. They primarily viewed the body as a medical object—an object of investigation and learning. This distancing allowed them to engage in dissection with minimal stress or emotional discomfort.

“I was over-stressed about how well we will dissect that body … I do not think I actively tried a strategy, but I think subconsciously I dehumanized the body. I think I even referred to it as “it” at times. I am not sure why. I had not really considered, I guess, I was interested to know what caused him to die and trying to figure out different comorbidities he may have had, but by no means had I ever wanted to know his name, or what his family was like. I was definitely appreciative that he gave up his body - once he no longer needed it - to teach me. But I did not ever feel like I kind of owed him anything. Maybe just because I did not really think of him as a person before I started cutting him.” [IN10, M3]

“I was just so involved in the act of trying to learn the actual anatomy… I was just so fascinated by it … but no, it did not bother me. I never felt like this was a person, no. I did not feel like that at all, I do not know” [IN4, M3]

Objectification functioned as an unreflective mode of engagement in which the donor body was approached primarily as a biological specimen rather than as a once-living person. Unlike desensitization, which involved an active and often conscious effort to manage emotional responses, objectification appeared largely automatic and unexamined. Students employing this strategy did not describe internal negotiation or emotional regulation; instead, the donor's personhood was largely absent from their accounts, allowing dissection to proceed with minimal affective disruption.

Desensitization

The desensitization approach involves actively dissociating the donor body from its human identity to bypass what students described as a paralyzing emotional response. Students reported that this enabled them to engage effectively during dissection, while still acknowledging the donor's humanity when they were not directly handling the body.

“We often called our cadaver our first patient. I get that; we appreciate it, they dedicated their body to us, and everyone deserves respect and dignity… However, rather than seeing it as our first patient, I took it more as a learning experience. So, like, working on the face, it is a sensitive area, and at the end, bisecting the head when it does not really look like human anymore… that was the part for me where I was like, whoa! We just did that?! If I did not desensitize myself, there comes almost a little bit of a paralysis of decision making like, people who are in the surgery often experience that feeling.” [FG1, M4]

“With my donor, I was understanding that this is not an instrument… and not to treat this person as a “thing”. I think there is an interesting transition between a person and a cadaver… So, like, there is a different aspect of meaningfulness in desensitization. I mean, you can’t function, if you completely think about that this is a human that you are working with; and unfortunately, that's I think the kind of compromise that you have to make. To honor your cadaver and not letting her donation be wasted on you, you need to learn what you need to learn, and to be able to help the hundreds or thousands of patients in the future, you have to objectify this one body to a level that enables you to function.” [FG14, M1]

Desensitization differed from objectification in its intentionality. Rather than passively erasing the donor's humanity, students described a deliberate and effortful process of emotional distancing that allowed them to function within the demands of dissection. Importantly, this strategy did not require a complete denial of the donor's personhood; instead, students often described toggling their awareness of the donor's humanity depending on the task at hand. In participants’ accounts, desensitization functioned as a pragmatic way to maintain technical focus while managing emotional overwhelm during dissection.

Personification

At the opposite end of total objectification is the notion of extreme personification. Some students reported feeling overwhelmed by the donor's humanity, forming an emotional connection that hindered their ability to learn from the dissection experience. For some, this level of personification discouraged active participation in the anatomy lab.

“The reason I was so afraid of the anatomy lab is that they [cadavers] actually look like dead people. I did not want to be around that, I was thinking that these people have families, are their families okay with this? I kept thinking that what if it was my sister with all of this happening to her… so what if their families did not want this? And, I do not know, it was just very hard for me to… So, I was just never able to desensitize myself, I know people do that as a strategy to be able to work with cadavers, but I just - thinking of it spiritually - I could not do that.” [IN5, M1]

“Human dissection was just very hard for me. I was like, I don’t want to do it. But it was like, here I go, I am walking through this waterfall, I am crossing this line… but I was fully cognizant that it's not a normal thing that people do… it's kind of sick in a way and it's kind of wrong, and it does feel wrong… so, did I objectify the guy's body? No. I never wanted to treat him like an object. I saw him as a human being, and I always was cognizant of the fact that I was defying this guy's body. I was taking his body apart like a machine, was destroying him. So, I felt bad. I felt like it was a defilement, and it was defilement… I always padded him on the shoulder when we got to work on him, I was like, here we go buddy… and I would call him ‘buddy’.” [IN8, M1]

In contrast to objectification and desensitization, personification was characterized by a sustained and emotionally salient recognition of the donor as a person with a life history, relationships, and moral standing. While grounded in empathy and ethical concern, this mode of engagement often intensified emotional responses to a degree that interfered with students’ ability to participate fully in dissection. Rather than facilitating reflection and meaning-making about the donor and the dissection experience alone, extreme personification sometimes generated moral distress and avoidance, highlighting how humanization, when unmodulated, may impede both learning and emotional sustainability.

Middle Ground Strategies

A cohort of students described engaging in middle ground strategies, aiming to balance personification with desensitization throughout their dissection experience. Rather than adopting one fixed approach, they actively navigated between recognizing the donor's humanity and distancing themselves emotionally to complete their tasks. For many, personification was unavoidable—they felt a deep awareness of the donor as a person—but they also relied on desensitization to maintain focus and continue working. While balance was the goal, some students acknowledged that it was difficult to sustain; at times, they felt emotionally overwhelmed and had to consciously reorient themselves toward detachment in order to proceed with dissection.

“There needs to be a balance between mindfulness and objectivity. Sometimes the balance does not hold up and one side takes over, like you objectify the donor to an extent that you completely forget that this was a person and needs to be treated with due respect. And other times, some students fall completely on the side of personalizing their cadaver that all they see is a person who is a human, is somebody's loved one, has had a life, etc In that situation too, they can’t really function and learn and the entire process kind of goes for nothing… So, you need to remember that it's not a tool to the extent that you just treat it like a toy. So, it can’t be a toy, and it can’t be a person. It needs to be something in the middle of those two poles/extremes for everything to go well.” [FG24, M1]

“It was strange to think of it at times, but when the body is flipped over and you are just working on the back, you kind of forget that it's a human being. But when you see the face, the hands with fingernails like some cadavers have nail polish, or you see hair on some body parts, then it's kind of, at least for me, you know, stop and appreciate them, do not treat your cadaver poorly. Somebody gave their body to do this… and so you know, you completely forget for an hour but then again you remember what it is that you are doing.” [IN6, M3]

Middle-ground strategies reflected students’ attempts to actively balance emotional engagement with functional detachment. Unlike the other strategies, this approach was marked by flexibility and situational responsiveness, with students moving between personification and desensitization as anatomical tasks, emotional capacity, or contextual cues shifted. Rather than representing a stable endpoint, this strategy appeared dynamic and effortful, with students reflecting on how they navigated the balance between respect for the donor, emotional regulation, and their responsibilities within the anatomy lab.

Discussion

Our analysis identified four qualitatively distinct strategies that students used to engage with donor bodies: objectification, desensitization, personification, and middle-ground approaches. Although this study was not designed to longitudinally track changes over time, participants frequently described shifting between these strategies depending on the task, emotional context, or moment in the dissection process. Rather than forming a linear continuum, these strategies represent different modes of engagement shaped by varying levels of emotional awareness, intentionality, and ethical orientation. Objectification tended to be passive and unreflective, treating the donor primarily as a biological tool, whereas desensitization involved an active effort to regulate or suppress emotional responses to remain focused during dissection. Personification emphasized empathetic connection with the donor but could become emotionally overwhelming and interfere with learning, while middle-ground strategies reflected deliberate attempts to balance respect for the donor's humanity with functional emotional regulation. As depicted in Figure 1, these strategies are shown as overlapping, non-hierarchical patterns, underscoring their coherence, fluidity, and situational movement. Together, they highlight that students’ engagement with donor bodies reflects meaningful expressions of professional identity formation rather than simple emotional coping alone.

Students’ engagement strategies can be understood as reflecting personal values, lived experiences, and moral perspectives, though these influences were not always explicitly articulated. This interpretation is grounded in a constructivist paradigm, which attends to how meaning may be embedded in participants’ narratives and experiences even when not overtly stated. While some participants referenced personal histories or beliefs, others did not, and the analysis reflects a synthesis of participants’ accounts and theory-informed interpretation rather than claims of direct causality.

While our findings intersect with prior literature on coping in dissection, we frame the strategies identified here as modes of engagement rather than emotional regulation alone. Rather than focusing solely on how students manage distress, this analysis attends to how students describe relating to the donor body itself—as an object, a person, or somewhere in between. These engagement strategies point to ethical orientations and understandings of respect and care that are implicated in early professional identity formation.

While prior studies have examined how students engage with donor bodies,^22,52 recent work has begun to explicitly characterize these engagement patterns as distinct student strategies, including objectification, desensitization, and personification. ²¹ Building on this foundation, our study advances this work by organizing these engagements into a structured typology: objectification, desensitization, personification, and middle-ground strategies. Rather than framing these solely as coping responses to distress, this typology highlights ethically meaningful ways of relating to the human body. By positioning the donor body as a student's first patient, this framing underscores early encounters in anatomy as formative contexts for developing respect, empathy, and professional identity.

Our findings align with prior research showing that students often adopt strategies such as detachment and intellectualization to manage the demands of dissection.^20,23,24 While these approaches may support technical focus, they have been associated with risks such as emotional blunting and reduced empathy. Prior literature has generally framed personification strategies—such as naming the donor or imagining their life—as facilitating reflection and meaningful engagement.^9,20,43,53 Although prior literature has frequently emphasized the benefits of humanizing approaches, some educational contexts discourage practices such as naming donors or forming strong attachments, citing concerns about emotional burden and professional boundaries, and some students themselves have described cadaver naming as potentially disrespectful.^9,22,53 Extending this work, our study uniquely highlights that personification, when intensified, may also become emotionally overwhelming and interfere with learning. While personification is often framed as an ethically grounded and reflective form of engagement, our findings suggest that it may also be shaped by fear, distress, or prior personal experiences with death. In some cases, this heightened emotional response contributed to difficulty engaging in dissection rather than facilitating reflection alone. Some students described adopting flexible engagement strategies, shifting between desensitization and personification depending on the task or stage of dissection, allowing them to maintain technical focus while acknowledging the donor's humanity. This situational balancing echoes Lief and Fox's (1963) ⁵⁴ concept of “detached concern” and underscores the complexity of integrating emotional engagement with professional distance in anatomy education.

Although our study was inductive and not guided by theory during data collection or analysis, our findings can nonetheless add meaningful depth to existing frameworks such as professional identity formation (PIF) and medical socialization theories. For readers already familiar with these theories, our findings offer additional examples of how early dissection experiences may reflect and reinforce developing professional values. PIF, as described by Cruess et al (2015, 2019),^55,56 is the developmental process by which medical students come to “think, feel, and act” like physicians. It emphasizes how students gradually internalize the ethical values, norms, and responsibilities of the profession—not just through formal instruction, but through experiences, reflection, and role modeling. Similarly, medical socialization theory ⁵⁷ highlights how cultural norms, peer dynamics, and institutional signals shape students’ behaviors and self-concepts over time. These theories also highlight the subtle ways in which the hidden curriculum—through institutional tone, modeling, and peer dynamics—can shape how students come to view and engage with the human body. Viewed through these lenses, the ways students engage with donor bodies—whether through emotional distancing or connection—may reflect early orientations toward the human body and professional care. Unexamined objectification may contribute to emotional distancing in future patient care, while intensified personification may become emotionally overwhelming in clinical contexts. From this perspective, the anatomy lab emerges as a site of early professional moral development, not solely emotional adaptation.

Study Limitations

While offering valuable insights, this study has several contextual limitations. Conducted at a single institution with a semester-long anatomy course embedded in a demanding first-semester curriculum, the findings may not generalize to other educational models. The structure and timing of anatomy instruction, alongside concurrent coursework, likely influenced how students responded both cognitively and emotionally. Potential self-selection bias may have favored participants with stronger reactions to dissection; however, it may also have attracted students with milder emotional responses or particular academic interests (eg, surgery-oriented students), potentially shaping the range of engagement strategies represented. While the sample size enabled rich thematic analysis, a larger or longitudinal design might capture additional nuance. Nonetheless, our findings underscore the importance of recognizing the diversity of engagement strategies and guiding learners toward more reflective, ethical, and professionally grounded approaches within anatomy education.

Implications for Medical Education

Our findings carry important implications for anatomy education and early professional identity formation. Educators should recognize the diverse engagement strategies students bring to the dissection lab, ranging from detachment to personification, and create space for this variation to be acknowledged and supported. Rather than viewing dissection as solely a technical or emotionally taxing experience, it should be framed as an ethically significant and professionally formative one. To foster constructive engagement with donor bodies, anatomy educators and institutions might consider several curricular and structural strategies. These include: (1) integrating early conversations about ethical and emotional engagement with donor bodies; (2) embedding structured reflection and facilitated discussions into the anatomy curriculum; (3) providing faculty development to help instructors recognize and respond to diverse student strategies, and model balanced, humanistic engagement; and (4) creating low-stakes, nonjudgmental spaces for students to reflect on their evolving responses, such as small-group check-ins or opt-in debriefs. Such interventions can help students critically examine their engagement strategies, integrate ethical reflection into their practice, and cultivate habits of respect, empathy, and professionalism.^8,9,45 Ultimately, framing dissection as a space for professional identity formation—not just anatomical training—can help support student learning and well-being while fostering a more compassionate and ethically grounded physician workforce.

Future Directions

Future research should explore how curricular structure, timing, instructional influences (such as faculty tone and behavior modeling), and integration of anatomy shape students’ engagement strategies across diverse institutional settings. Incorporating background variables, such as religious, spiritual, and cultural identities, may offer deeper insight into how students’ lived experiences shape their responses to death and dissection. Longitudinal studies are especially needed to examine how early anatomy lab experiences, when supported by structured reflection and ethical guidance, influence long-term outcomes such as empathy, professional identity formation, and risk of burnout in clinical practice. These efforts must also attend to the hidden curriculum, the implicit values conveyed through institutional culture, which can quietly undermine formal instruction in empathy and humanism.^58-61 For example, respectful faculty modeling, intentional language when referring to donor bodies, and structured opportunities for reflection may support alignment with humanistic values. In contrast, dismissive language, normalization of emotional detachment without reflection, or tolerance of disrespectful behaviors may inadvertently reinforce distancing and undermine these goals.. Aligning institutional culture with humanistic values ensures that the hidden curriculum reinforces, rather than contradicts, professionalism in the anatomy lab.

Additionally, future studies should also examine how broader sociocultural factors, such as societal norms, peer expectations, and social identity, shape students’ engagement strategies. While our findings highlight the influence of personal values and lived experiences, we did not systematically explore the role of cultural context or institutional messaging. Investigating these dimensions may offer deeper insight into how students’ ethical development is shaped by both individual and environmental forces.

Conclusions

This study highlights the diverse and deeply personal engagement strategies students use to relate to donor bodies in the dissection lab, ranging from objectification to personification and the nuanced approaches in between. These strategies are not simply ways to manage emotional discomfort; they reflect how students make sense of their relationship to the donor body, and by extension, to the human body in medical practice. In this way, their approaches to dissection offer a window into early ethical development and the shaping of professional identity. Shaped by individual values and experiences, these strategies influence students’ engagement, emotional processing, and emerging professional identity.

Recognizing the anatomy lab as a formative space, educators should acknowledge the emotional labor involved and provide structured support through reflective practices, ethical guidance, and normalization of emotional responses. Such efforts can help students balance clinical detachment with empathy, an essential skill for compassionate care. Supporting ethically grounded engagement, not just emotional coping, can foster habits of respect and reflection that carry forward into patient care. Future research should explore how dissection experiences and student engagement strategies shape professional development across varied educational contexts and examine their long-term impact on students’ growth as compassionate and conscientious physicians.

Supplemental Material

sj-docx-1-mde-10.1177_23821205261438883 - Supplemental material for Objectification, Desensitization, and Personification: Medical Student Strategies for Engaging with Donor Bodies in the Anatomy Lab

Supplemental material, sj-docx-1-mde-10.1177_23821205261438883 for Objectification, Desensitization, and Personification: Medical Student Strategies for Engaging with Donor Bodies in the Anatomy Lab by Homaira M. Azim, Mekha M. Varghese, Skylar J. Henderson, So Hyun Jeon, Christian J. Faller, Alec Y. Luna and Evan W. Fairweather in Journal of Medical Education and Curricular Development

Supplemental Material

sj-docx-2-mde-10.1177_23821205261438883 - Supplemental material for Objectification, Desensitization, and Personification: Medical Student Strategies for Engaging with Donor Bodies in the Anatomy Lab

Supplemental material, sj-docx-2-mde-10.1177_23821205261438883 for Objectification, Desensitization, and Personification: Medical Student Strategies for Engaging with Donor Bodies in the Anatomy Lab by Homaira M. Azim, Mekha M. Varghese, Skylar J. Henderson, So Hyun Jeon, Christian J. Faller, Alec Y. Luna and Evan W. Fairweather in Journal of Medical Education and Curricular Development

Supplemental Material

sj-pdf-3-mde-10.1177_23821205261438883 - Supplemental material for Objectification, Desensitization, and Personification: Medical Student Strategies for Engaging with Donor Bodies in the Anatomy Lab

Supplemental material, sj-pdf-3-mde-10.1177_23821205261438883 for Objectification, Desensitization, and Personification: Medical Student Strategies for Engaging with Donor Bodies in the Anatomy Lab by Homaira M. Azim, Mekha M. Varghese, Skylar J. Henderson, So Hyun Jeon, Christian J. Faller, Alec Y. Luna and Evan W. Fairweather in Journal of Medical Education and Curricular Development