Evaluation of the questionnaire to be completed before watching the autopsy videoDemographic features (Questions 2–5)

From the group invited to the survey (365 students), 169 participants accessed the first questionnaire (before watching the video), of which 127 completed the questionnaire in full (response rate 37,79%). Out of these, 79 participants are women (62.2%) and 47 participants are men (37%). One person did not specify a binary gender identity. The average age was 26.32 years, with 25% younger than or exactly 24 years old and 25% older than or exactly 29 years old at the time of the survey.

Sixty-four participants (50.4%) reported being non-religious, 56 participants (44.1%) were religious, of which 25 participants reported being Catholic, 23 participants were Protestant, and two participants reported being Christian. One person was Muslim and five participants were religious with no indication of their faith. Seven participants abstained when asked about their religious affiliation.

Ninety-two participants (72.4%) had already worked in a non-academic occupation prior to their studies. Out of these, 31 students (33.7%) had worked in rescue services, 28 (30.4%) in nursing, 14 (15.2%) in the technical field, and 19 participants (20.7%) indicated another occupational field. Multiple answers were possible.

Attitudes and expectations (Questions 6–8)

Before watching the autopsy video, 122 people (96.1%) indicated that they would recommend an autopsy to relatives in cases of unusual disease progression.

The question “Do you have any concerns about experiencing the confrontation with dead people as very stressful in your training / your later professional activity?” was rated by the students with an average of 2.07 points out of a maximum of 5 possible points. Here, a score of 1 is considered no concern at all and a score of 5 is considered a very strong concern. There is a statistically significant difference in mean scores for this question related to religiousness. Individuals who reported being religious, with a mean of 2.20, were said to have more concerns about experiencing the confrontation with dead people as stressful than individuals who did not report being religious (mean 1.89). The P value obtained by the Mann-Whitney-U test is 0.049. Thus, the result is below the pre-determined alpha significance level of 5%. Differences are also evident in relation to gender. Females reported a mean value of 2.22, while male participants reported 1.83. The P value is 0.012. Thus, the difference obtained is also statistically significant. Non-academic training before studying medicine also seems to play a modulating role. The arithmetic mean is 2.4 without non-academic training and 1.95 with non-academic training. The P value is 0.018. This difference therefore is statistically significant, too (Fig. 1).

In response to the question “Do you have any concerns about seeing unpleasant images in the video that now follows?”, the mean score is 2.17 out of a maximum of 5 possible points. A score of 1 is considered to mean “no concerns at all” and a score of 5 is considered to mean “very strong concerns”. Similar to the previous question, the answers show a relevant difference with regard to religiosity. For the religious, the mean value is 2.48, and for the non-religious 1.92, with a P value of 0.009. Likewise, there is a difference in the mean values of women and men. For women, the mean value is 2.37, and for men 1.83. With a P-value of 0.012, the difference is statistically significant. The influence of completed non-academic training before studying medicine is reflected as follows: with non-academic training, there is a mean value of 2.13, and without non-academic training 2.26. The P value is 0.822, so the difference is not statistically significant in contrast to the previous question.

Evaluation of the questionnaire to be completed after watching the autopsy video (Questions 10–15)

Out of a total of 89 students accessing the questionnaire after watching the autopsy video, 85 completed the questionnaire in full (response rate 23,29%). Out of these, 81 people (95.3%) watched the autopsy video in its entirety and four people (4.7%) watched only parts of it.

Also, after viewing the autopsy video, students again were asked whether they would recommend an autopsy to relatives in cases of unusual disease progression. Eighty-two people (96.4%) stated to tend to recommend an autopsy to their relatives (score greater than 3). The arithmetic mean is 4.34 on a five-point scale, where 1 means “rather advise against” and 5 means “rather recommend”.

The impression of the autopsy as a medical examination method was as follows: 76 participants (89.4%) perceived the examination method as professional, 66 persons (77.6%) as informative, five persons (5.9%) as irreverent, and one person (1.2%) as antiquated.

We asked the students if their impression of the autopsy was as they had expected it beforehand. This question was answered in the affirmative by 66 students (77.6%). Seven students (8.2%) abstained from answering. Among the twelve students (14.1%) who answered the question in the negative, it is striking that five (5.9%) perceived the autopsy to be rougher or more brutal than they expected.

In response to the question “Do you think a brief introduction about ethical aspects and about the general handling of human corpses is important before an autopsy?” the arithmetic mean on the five-point scale is 4.48, and 74 people (87.1%) think an introduction is important (score greater than 3).

The participants were also asked questions about their emotional experiences watching the autopsy video. For this purpose, the students had to indicate the intensity of the emotions felt (curiosity, anxiety, enjoyment, sadness, disgust, anger, surprise, fear) on a five-point scale. A score of 5 means “very strong sensing”, and 1 means “hardly any sensing of the emotion”. The mean values of this five-point scale can be seen in Fig. 2. The most intense feelings were curiosity and surprise. After all, while watching the video, nine persons felt “disgust” strongly or very strongly, six persons felt “sadness” strongly, four persons felt “anxiety” strongly or very strongly, one person felt “anger” very strongly and one person felt “fear” very strongly.

Fig. 2

Mean values for the emotional experience while watching the autopsy video. The students were asked to indicate the intensity of different emotions when watching the autopsy video on a five-point scale. A score of 5 means “feeling the emotion very strongly”, and a score of 1 means “hardly feeling the emotion”

Participants who expressed that they were more concerned about either seeing unpleasant images in the autopsy video (20%) or having contact with corpses later in their careers (8.2%) now showed higher scores for the emotions “anxiety” (2.17 and 1.71, respectively), “disgust” (3.50 and 3.14, respectively), and “fear” (1.58 and 1.43, respectively). The emotions “curiosity”, with mean scores of 4.00 and 4.29, and “surprise”, with 2.33 and 2.14, respectively, were lower than in the overall group.

Evaluation of the questionnaire to be completed after autopsy participation in our institute (Questions 16–19)

The questionnaire after participation in an on-site autopsy at the Institute of Forensic Medicine was filled out completely by only 28 students. A response rate cannot be given here since autopsy attendance is optional and only those students who actually attended an autopsy were given the questionnaire. Anyway, it was observed that not all participants took time to complete the questionnaire after their autopsy participation. Of those who completed the questionnaire, 25 individuals had viewed the autopsy video in full (23) or in part (2) in advance of their autopsy participation.

Twenty-two participants stated that the autopsy video helped them decide whether to participate in an autopsy at our institute. The three people who answered this question in the negative explained that they had already decided to participate beforehand.

All 25 autopsy participants who had previously viewed the video in whole or in part felt that the video adequately prepared them for the autopsy. In response to the question “How well comparable was the experience of watching a video vs. being present in the dissecting room?” the arithmetic mean on the five-point scale is 3.36, and 13 people (just over half of those who watched the video) think that watching the video was well comparable with the autopsy participation (score greater than 3), as shown in Fig. 3.

Fig. 3

Responses to the question “How comparable was the experience of watching a video vs. being present in the dissecting room?”. Just over half of those who watched the video think that watching the video was well comparable with the autopsy participation (score greater than 3)