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Purpose: To obtain data about students' actual individual choices for certain activities in dissection courses and about possible factors that influence those choices., Method: During one winter semester that ended in 2004, the authors asked 371 students from three dissection courses within one medical school in Germany to complete questionnaires on the amount of time spent each course day on certain lab activities (hands-on dissection, prosection, reading, etc.). Additional questions inquired about students' motivation, attitude towards dissection, emotional or ethical concerns, course evaluation, and personality traits., Results: A total of 309 students (83%) responded. On average, students spent about 33% of their course time with active dissection, 27% studying prosected material, and 31% with cadaver-unrelated activities. There were statistically significant differences among all of the three courses. Individual variability in dissection activity was very high: time devoted to active dissection ranged from 0% to 82% of daily course time. In a multiple linear regression model, the personal factors measured (e.g., attitude towards dissection) accounted for 9% of the total variance of time devoted to active dissection., Conclusions: A dissection course is not a uniform learning experience--a fact that should be borne in mind in general discussions about dissection and in the planning of dissection courses. Students within the same course seek divergent learning experiences. More still needs to be learned about the motivation for their individual choices. The data from the present study constitute a baseline for future research into anatomical dissection as a teaching method.

The objective of this study was to identify factors associated with anal sphincter laceration in primiparous women. A subpopulation of 40,923 primiparous women at term with complete data sets was abstracted from a state-wide perinatal database in Germany. Outcome variable was anal sphincter laceration. Independent variables were 17 known obstetrical risk factors/conditions/interventions impacting childbirth recorded on the perinatal data collection sheet. Cross table analysis followed by logistic regression analysis was used for data analysis. Logistic regression showed episiotomy (OR, 3.23; CI, 2.73-3.80) and forceps delivery (OR, 2.68, CI, 2.17-3.33) to be most strongly associated with anal sphincter laceration. Women with a BMI >or= 30 kg/m2, and smokers had a significantly lower risk of anal sphincter laceration. Local, pudendal, and epidural analgesia all reduced the risk of anal sphincter laceration. Iatrogenic factors most strongly associated with anal sphincter laceration in primiparous women include routine episiotomy and forceps delivery.