. 2023 Jun 22;15(6):e40775. doi: 10.7759/cureus.40775

Table 4. Study characteristics of the selected articles included in the review.

NA: Not available, VBD: Voluntary body donation, BD: Body donation

Authors

Year

Place of study

Keywords

Students involved (UG/PG/Nursing/Paramedical)

Sample size

Age

Gender distribution

Religion

Type of intervention

Knowledge

Attitude

Practice

Facilitators

Barriers

Solutions/sugesstions

Awareness of procurement

Awareness of the use of cadavers for teaching and research

Source of awareness

Positive

Neutral

Negative

Will they donate?

Will they recommend VBD?

Education

Gratitude to medical sciences

Motivation

Disrespect in cadaver handling/misuse

Damage to the body

Religious beliefs

Discomfort to family

Media

Friends and family

Medical persons

Perry et al. [47]

2009

University College Dublin, Ireland

Anatomical donor program; dissection; death; cadavers; bequeath

First-year graduate

52.6% were between 22 and 25 years, 34.2% were between 26 and 29 years, and 7.9% were under 21

51.4% males, 48.6% females

Data obtained via a survey involving the administration of three structured, standardized, and anonymized multi-item questionnaires with five-level Likert scales containing questions designed to measure student responses and attitudes to the idea of whole-body donation to medical science

43.20%

35.1% were strongly supportive. The support reduced as the time increased in medical school

83% by strangers, 54.1% by a family member

Media will play an important role

Rokade et al. [36]

2012

Maharashtra, India

Gross anatomy education; whole-body donation; anatomical donor program; bequest program; attitude to body donation; anatomy dissection; cadaver; undergraduate medical education; India

Medical students

115

Anonymous, prestructured, pretested questionnaire

Aware of BD: 60 males (91.7%) and 50 females (92%)

28 males (46.7%), 19 females (38%)

90.94% of graduates and postgraduates were willing compared to 8.89% of the lower education group (10th/12th)

44% of medical professionals

32 males (27.82%), 34 females (33.66%)

15 males (13.04%), 9 females (8.91%)

Strongly impacted 25 males (21.73%), 20 females (19.8%) agreed

Mistrust toward hospitals negatively influenced VBD

Saha et al. [38]

2015

Kolkata, India

Awareness, cadaver, medical and non-medical population

100 medical students (male: female=70:30), 100 engineering students (male: female=60:40), and 100 doctors (male:female=50:50)

300

18 to 22

70 males, 30 females

Hindu (100%)

Survey

27% were not aware of the pledge form

32.69% motivated by media

48.38% were motivated by family and 8.95% by self

71.80%

62 (62%)

24 (24%)

14 (14%)

70% approximately

30% approximately

All were Hindus. None opted for VBD as religion is a barrier to their willingness

40%

Mwachaka et al. [39]

2016

University of Nairobi (UoN) in Kenya

150 first-year UG students, 55 surgical residents (PG)

205

Survey

Yes: 10 (13.9%); no: 62 (86.1%)

16 (10.66%)

7 (12.72%)

49 (89.09%)

16 (10.66%)

7 (17.17%)

Asl et al. [48]

2016

Kashan University of Medical Sciences, Iran

Gross anatomy education; undergraduate education; medical education; body donation; bequest program; personal willingness; medical student; cultural acceptability

331

Medical students: 238 (71.9%); non-medico students: 93 (28%)

17 to 30

Male: 126 (38.1%); Female: 205 (61.9%)

Muslim: 329 (99.4%); Christian: 2 (0.6%)

255 (77.03%)

88 (34.5%)

45 (17.7%)

122 (47.8%)

57 (22.4%)

135 (52.9%)

63 (24.7%)

51 (60.7%)

Cultural acceptability through mass media: 30 (25.6%), respect cadavers: 29 (24.8%), modify religious beliefs: 10 (8.5%)

Kar et al. [40]

2017

Tertiary health care centre of North Bengal, India

Attitude, body bequest program, cadaver, co-donation, willingness

First-year MBBS students, junior doctors, senior doctors, nursing staff, and technicians

69 first-year MBBS

Not given separately for students

Not mentioned

Questionnaire

17 (38.63%) were willing to pledge for medical education and organ donation

42 (23.20%) overall. Not mentioned separately for students

34 (18.78%) overall. Not mentioned separately for students

74 (40.88%) overall. Not mentioned separately for students

63.76% of students

10 (21.73%) overall. Not mentioned separately for students

Prameela et al. [41]

2017

GITAM Dental College and Hospital, Andhra Pradesh,

Awareness, organ and whole body donation, the medical fraternity

Medical students (undergraduates: 3rd & 4th year, graduates, postgraduates)

273 undergraduates (56.4%)

Males: 63, Female: 210

Cross-sectional study with multiple questionnaires

25%

Only 6% toward dissection purpose

46%

Self-motivation: 60%

10% to 15%

15%

15% prevented by family members

Mistrust was a main barrier in 60%

Ghosh et al. [49]

2018

ESI- PGIMSR & ESIC Medical College, Kolkata, West Bengal, India

Body donation; ethics; Unclaimed cadavers; anatomy education; medical students

First-year undergraduate medical students

100

Male: 61 (62.2%)l; Female: 37 (37.8%)

Questionnaire

61 (62.2%) did not know the source of cadavers, 85 (86.7%) did not know whom to approach for body donation, 66 (67.5%) did not know about pledging

64 (65.30%)

22 (22.44%)

51 (52%)

9 (9.2%)

38 (38.8%)

Increase awareness, handling bodies with respect

Ciliberti et al. [46]

2018

School of Medical and Pharmaceutical Sciences, University of Genoa, Italy

Postmortem body donation; cadaver; ethics; students’ attitudes; anatomy education; medical education; cadaver lab; unclaimed bodies

Students from all years

1781

19 to 42 years, mean age of 22 years

Male: 208 (44.07%); Female: 264 (55.93%)

Catholic: 266 (56.36%); non-religious: 185 (39.19%); other: 19 (4.03%); Muslim: 1 (0.21%); other: 1 (0.21%)

Both open and close-ended questionnaire

95%

31 (7.09%)

Awareness of the ethical value of body donation

Altruism

Students not holding religious beliefs were 5.9 times more likely to be in favour of donation

Suggested but number not mentioned

Sah et al. [45]

2018

Hind Institute of Medical Sciences, Barabanki and Sitapur, UP, India

Body donation, medical research, willingness, educational qualification

100 medical students (Male: Female=59:41), 100 paramedical students (Male: Female=47:53), 100 nursing students (Male: Female=22:78)

300

243: 17 to 23 years, 45: 24 to 30 years, 7: 31 to 37 years

Males: 128 (42.67%); Females: 172 (57.33%)

Hindus: 278 (92.67%), Muslims: 14 (4.67%), Others: 2%, did not disclose: 2%

Predesigned questionnaire performa

246 (82%) were aware

Internet: 64 (21.33%), newspaper: 50 (16.67%), radio: 35 (11.67%), TV: 42 (14%)

Friends: 200, family members: 77

28 (9.33%)

122 (40.67%) were willing to donate

165 (55%) will recommend donation to family, 199 (66.33%) agreed to convince others to pledge

31 (10.33%)

32 (10.67%)

19 (6.33%)

20 (6.67%)

Biasiutto et al. [50]

2019

Faculty of Medical Sciences, Faculty of Dentistry, National University of Cordoba, Cordoba, Argentina

Anatomy, corpses, cadavers, dissection- room, body donation

First-year students

237

19.27+/-2.25

Males: 84 (35.44%); Females: 150 (63.29%); Did not mention: 3 (1.27%)

127 (55%) Catholic; 88 (38%) no religion; 13 (6%) non-Catholic Christians; 1 Jew

Anonymous surveys with multiple choice and semi-structured answers; 3 surveys: one at the start of the course, one on exposure to cadavers, and the final one just before finishing the course

First survey: 136 (57.38%) positive (60% women); second survey: 114 (49%) positive, 119 (51%) negative; third survey: 119 (52%) positive, 108 (47%) negative

Karmakar et al. [51]

2020

Tripura Medical College and Dr. BRAM Teaching Hospital, Hapania, Tripura, India

Cadaver, death, education, India, mass media

Undergraduate medical students and internees

361

Males: 174 (48.2%); Females: 187 (51.8%)

Hindu: 304 (84.2%); Muslim: 15 (4.2%); Christians: 21 (5.8%); Buddhists: 12 (3.3%), Jain: 1 (0.3%)

Cross-sectional study survey

Yes: 318 (88.1%), No: 43 (11.9%); urban residents, older medicos, and men had better knowledge

50.10%

28.80%

302 (83.7%) younger medicos and men had a positive attitude

36 (10.0%)

23 (6.4%)

27 (7.5%) registered willingness to donate (n= 245 67.86%)

232 (64.3%)

59.60%

People exposed to dissection hall less likely to donate

28.40%

64 (17.7%)

Varalakshmi et al. [44]

2020

Bangalore, India

Body donation, informed consent, autonomy, dignity, confidentiality, post-act benefit

75 medical students (8th and 9th terms), and 75 (final year) engineering students

150

Survey, 5-point Likert scale

57 (76%)

24 (32%)

1 (1.3%)

50 (66.7%)

63 (84%)

7 (9.3%)

5 (6.6%)

37%

Kundu et al. [42]

2021

Chattisgarh, India

Body donation, organ donation, awareness, attitude, medical professionals, donors, tribals

First to final-year undergraduates, n=630 (181 MBBS students and 449 Paramedical staff); MBBS students (each batch 50 students) and all para medical staff and technicians (all graduates) including nursing staff (study sample)

181 MBBS students and 449 paramedical staff

5 (52.49%) MBBS students were male and 86 (47.51%) were female students; 253 (56.35%) male paramedics; 196 (43.65%) female paramedics

Data were obtained by survey, cross-sectional study

165 (91.16%) were aware; the awareness level increased from the first year to the final year of MBBS

44 (24.31%)

17 (9.39%)

109 (60.22%)

165 (91.16%)

84.93%

81.75%

26.52%

Singh et al. [21]

2021

Nepalese Army Institute of Health Sciences, Nepal

Body donation; knowledge; medical students; organ donation

Medical students from the College of Medicine, Basic Science and Clinical Faculties, nursing students from the Faculty of Nursing College, and medical officers from a tertiary care hospital were included in the study

115 medical students, 73 nursing students

223 (58%) were between 18 and 25 years

145 males were between 18 and 25 years, 85 were females in the same age group

369 (91.5%) were Hindus, 20 (5%) were Buddhists

A structured questionnaire was used for the study

360 (90%)

374 (93.5%)

43 (23.5%)

33 (18.9%)

36 (20.6%)

Males: 28 (46.7%)

7 (1.8% )were willing to donate for educational purposes only 5.66% were willing to donate for dissection purposes

174 (43.5%) were motivated nearly half

14%, out of which 3% thought the body would be wasted

14%

Lee (&) Lee [53]

2021

Korea

Cadaver anatomy program, cadaver donation, attitude, intention, nursing student

First-year nursing students

Males: 6; Females: 74

Religious: 27 (33.8%), non-religious: 53 (27%); a significant difference according to religion (p<0.001>)

Questionnaire covered general characteristics, attitudes toward cadaver donation, and cadaver donation intention, and the change in the intention for cadaver donation was identified after the end of the four-day practice session

Before exposure: 12.5%; after exposure: 37.5%; total students with a change of attitude: 24 negative than the original i.e., only 9 positive than the original 15

Before exposure: 43 (53.8%)

Before exposure: 27 (33.8%); after exposure: 37 (62.5%); attitude toward cadaver donation had changed more negatively than before

Though they have asked the question they have represented the responses collectively with other responses as positive or negative attitudes toward body donation

Exposure to dissection increases respect to donors; reported as a facilitator but numbers not mentioned

Reported as a factor for change toward a negative attitude

Jenkin et al. [43]

2022

University of Sydney, Australia

Anatomical dissection, attitudes, body donation, cadaver, gross anatomy education, organ donation, postgraduate education, undergraduate education

Undergraduate students. Mathematics (n=133) and Anatomy Experience (n= 172), Health Sciences students (n=279), Medical Sciences students (n=863), Postgraduate Medical and Dentistry students (n=555)

305

Medical science students- 20

Females: 548 (63.5%), Males: 269 (31.2%)

Practice religion 321 (37.6%)

Survey

79%

Willing to donate own body: 243 (28.2%); support family member donation: 599 (69.5%); support donation by a stranger: 717 (83.1%)

Donate own body: 395 (45.8%); support family member donation: 163 (18.9%); support donation by strange: 120 (13.9%)

Donate own body: 225 (26.1%); support family member donation: 100 (11.6%); support donation by a stranger: 26 (3.0%)

Registered donor: 19 (2.2%)

67.3% (overall and not only pertaining to medical sciences students)

17% said religion doesn't allow VBD (overall and not only pertaining to medical sciences students)

30% non-English speaking participants said family will not allow (overall and not only pertaining to medical sciences students)

Guo et al. [28]

2020

Guangzhou, China

Humanistic qualities, medical education, human anatomy, ethics, silent mentor

Third-year medical students

171

20.6 (± 1.0)

72 (42.11%) - males 99 (57.89%) - females

150 atheists, 10 Buddhists 3 Christians, 2 Muslims, and 1 Hindu

Questionnaires

60.82%

Cadaver ceremony to increase respect and awareness

Cahill et al. [52]

2008

University College Dublin, Ireland

Death, anatomical donor program, cadaver dissection, bequeath, anatomy education

First-year medical students

212

18 to 24

Females > Males, numbers NA

Christians

Questionnaires

Stranger: 22.8, 24.5, and 22.5% of respondents to the first, second, and third questionnaires family member: decreased from 31.7% to 14.7% and self from 31.5% to 19.6%

Stranger: neutral; 38.6% of responses to the first questionnaire and 31.4% to the third questionnaire; Family member: 38.9 to 45.4%

Stranger: <1%; family member: increased from 22.9% to 43.1% and self from 23.4% to 40.2%

Anyanwu et al. [37]

2013

University of Nigeria

Organ donation; cadaver dissection; gross anatomy laboratory; psychosocial impacts; anatomy education; altruism; whole body donation

Students and professionals

Students: 780, professionals: 420

Students with dissection experience: 178 (61%) males and 112 (39%) females; students exposed to dissection room without dissection experience: 135 (61%) males and 85 (39%) females; students never exposed to dissection room: 166 (62%) males and 104 (38%) females

Questionnaire

Exposed to dissection: 527 (68%); not exposed to dissection: 277 (44%)

Willingness to donate own body and exposed to dissection: 105 (13%); not exposed to dissection: 70 (17%)

Anxiety related to the mistreatment of cadavers observed in the exposed and dissecting category, religious belief seen in the exposed and non-dissecting category

Strong sanctions should be imposed on the indecent treatment of cadavers by staff and students. The creation of more opportunities in medical school curricula for non-dissecting students who are exposed to the dissection room but do not participate in dissection is advised