Incorporating fetal archival tissues into undergraduate medical education

Incorporating fetal archival tissues into undergraduate medical education
Kaylin Jeanne Beiter, Sophie Elise Fourniquet, Jason C Mussell
Federation of American Societies for Experimental Biology, 1 April 2019; 33(1)
[The bolded sections have been added by the editor]
A great deal of time is spent in undergraduate medical education preparing students for death and also the importance of informed consent. Missing from these preparations are the differences students may feel when encountering the death of an elderly individual versus the death of an infant and how the different informed consent processes came to be. Purposeful incorporation of fetal specimens in at various time points throughout the first year may be able to help solve these problems simultaneously.
The Louisiana State University Health Sciences Center at New Orleans (LSUHSC-NO) has in its possession a large repository of fetal specimens, many of which were collected prior to the era of IRB protocols, preventing informed consent from being secured for their use. These fetal specimens are used in anatomy education at LSUHSC-NO annually. We identified appropriate time points throughout the first year of training to insert discussions of informed consent and to examine emotions coincident with dealing with fetal and neonatal death and how they might contrast to student emotions about their cadavers, i.e. adult death, as well as how these feelings evolve over the year. Thematic analyses of self-reflections were used to assess differences in students emotions when confronting death. They will also be used to examine changes in student attitudes regarding death during the entire first year.
Using archival material as the centerpiece for principled discourse challenges students to contextualize the practice of medical ethics socially and historically, heightening awareness of their own cultural and social biases. This experience also provided an outlet for students to share their thoughts on the ethical principles that will guide their future practice and to share their emotional reactions to the fetal specimens. Preliminary results showed themes of anxiety and reverence predominating before students entered the adult cadaver lab while sadness, informed consent, and impropriety predominated student reflections before exposure to fetal specimens.
Providing medical students with an example thought process allows students to begin developing their own methods of incorporating respectful pragmatism into their own careers. Incorporation of fetal collections and discussions of their origins enables undergraduate medical students to think critically and examine their own ethical mores in addition to mastering high volumes of content knowledge.

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