Results
COPING
Coping is defined as the process of executing a response to a stressful situation . To determine how medical students respond when confronted with stressful events in their lives ( Carver , 1997 ), we used the brief COPE Scale . The brief COPE contains an inventory of 28 items that incorporate 14 discreet scales to measure active coping , planning , positive reframing , acceptance , self-distraction , turning to religion , behavioral disengagement , self-blame , seeking of instrumental support , seeking of emotional support , venting , substance abuse , humor , and denial . Responses to each item of the 28 items are scored on a scale of 1 to 4 , where 1 indicates little or no use of that coping behavior ; and 4 indicates frequent use of the same . The brief COPE has been used extensively in health settings and has been tested for validity and reliability ( Miyazaki , et al ., 2008 ; Yusoff , 2010 ).
CULTURAL ATTACHMENT
Cultural attachment is referred to as a process that allows culture and its components to provide psychological security when facing stressful situations ( Yap et al ., 2019 ). Although culture is a broadly defined term , for the purpose of this study , it is a framework of beliefs and values shared by the group that influences the perception and interpretation of experiences by individuals within that group . To determine how culture impacts the perception and emotional experience of medical students during cadaver dissection , we included questions on cultural identity . The questions focus on how students identify themselves with a set of cultural views and the importance of culture . We also included an item assessing whether their cultural view impacted their perception and experience in the dissection room and their view of human mortality . This variable was ultimately coded as a binary ( high versus low ) at the 50th percentile . The Cronbach ' s alpha ( ‐ ) generated in the analysis for the 4-item cultural attachment scale ranged from 0.613 - 0.713 across the three time points . Cronbach ' s Alpha measures item consistency on a scale ; a sufficiently high Cronbach ' s Alpha suggests that individual items on that scale covary and it provides an estimate of reliability as a precursor to aggregating those items into a single measure .
STATISTICAL ANALYSIS
The data collected from the Qualtrics survey was exported to SPSS ( IBM SPSS Statistics , Version 28.0.0 ) for statistical analysis . The data extracted at the three time points were analyzed using repeated measures ANOVA to test within and between-group differences over time . A Bonferroni adjustment was used for multiple comparisons . The critical score was set a priori at 0.05 .
Results
In the early stage of cadaver dissection , medical students experience a range of emotions . In order to understand the factors involved , our study assessed and compared medical students ’ selfrated perceptions of their emotional experiences and the impact of cultural attachment on emotions during cadaver dissection .
DEMOGRAPHIC PROFILE
All but one student from the entire first-year medical student cohort ( n = 310 ) participated in this study , yielding a final sample size of 309 students . Of these , 154 ( 49.7 %) were male , and 155 ( 50 %) were females . The overwhelming majority of the students 291 ( 93.9 %) had no previous dissection experience . Among the sample , 168 ( 54.2 %) reported their ethnicity as Amhara , 52 ( 16.8 %) as Oromo , 11 ( 3.5 %) as Tigre , 3 ( 1 %) as Gurage , and 78 ( 25.3 %) as “ other ”. In terms of religious affiliation , 97.4 % of students identify with some religion . Among these , 261 ( 84.5 %) were Christian , 33 ( 10.7 %) were Muslim , and 8 ( 2.6 %) selected ‘ other ’. Age ranged from 18 and 22 years with the majority ( 81 %) being < 20 , and 20 ( 14.8 %), > 20 ( 3.6 %). The distribution of respondents according to gender , age , ethnic background , and religious affiliations is summarized in Table 1 .