Impacts of a gross anatomy laboratory course on medical students’ emotional reactions in Taiwan: the role of high-level emotions

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Background: Gross anatomy laboratory course at medical school is usually an important learning subject for medical students; however, seeing a cadaver often makes them feel uncomfortable. According to the broaden-and-build theory, positive emotions broaden our inventory of thoughts and actions, and build physical, mental, and social resources. Research on positive psychology found that through direct thanks and positive reframing, people who feel gratitude show fewer depressive symptoms. The present study tried to reduce students’ negative emotions towards cadavers by sequential activities, such as family interviews and an initiation ceremony, which induced gratitude and other positive emotions. Methods: The Emotional Reactions Towards Cadavers Scale (ERTCS) was used to evaluate medical students’ emotional reactions after they see a cadaver. Third year medical students (n = 105) at Taipei Medical University in northern Taiwan completed ERTCS on three occasions within a single semester during academic year 2016. Repeated-measures ANOVA and hierarchical regression analyses were then conducted to identify any changes in the emotional reactions of these students. Results: The ERTCS showed satisfactory internal consistency and a three-factor structure, i.e., negative emotions, high-level emotions, and excited emotions. High-level emotions were the highest, and negative emotions were the lowest among the three in our sample. Three-wave data showed that participants’ high-level emotions increased, negative emotions decreased, and the former simultaneously predicted the latter after controlling for the influence of gender, religious beliefs, experience of the death of a family member or friend, and burnout level. Conclusions: While past research usually focused on coping strategies to reduce medical students’ negative emotions, our study supported the broaden-and-build theory, which emphasizes positive emotions, and demonstrated that elevating medical students’ gratitude to ‘silent mentors’ is an effective way. It is suggested that combining dissection courses with medical humanities can help students successfully handle negative emotions during a gross anatomy laboratory course.

Original languageEnglish
Article number489
JournalBMC Medical Education
Issue number1
Publication statusPublished - Dec 2021


  • Ceremony
  • Death anxiety
  • Gross anatomy education
  • High-level emotion
  • Silent mentor
  • Laboratories
  • Humans
  • Students, Medical
  • Emotions
  • Anatomy/education
  • Taiwan
  • Education, Medical, Undergraduate
  • Cadaver

ASJC Scopus subject areas

  • Education


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