Ritualized reflection in human dissection: Liminality, ethical negotiation, and professional identity formation among South Korean medical students

Human dissection is a foundational component of medical education, yet it places students in profound ethical tension between scientific objectification and respect for human dignity. While prior studies have documented students' emotional responses, the structural transformation of their moral narratives over time, particularly within non-Western cultural contexts, remains under-theorized. This study examines longitudinal changes in student-written body donor eulogies to explore how ritualized reflection mediates ethical tension and professional identity formation. Using a qualitative-dominant mixed-methods design, 273 reflective eulogies were collected from medical students at two ritualized thresholds before and after human dissection: the pre-dissection memorial service (n = 138) and the post-dissection encoffining ceremony (n = 135). Drawing on Victor Turner's theory of the ritual process, the texts were analyzed using thematic content analysis and quantitative text mining to identify systematic shifts in narrative perspectives. Pre-dissection eulogies were dominated by formal “Heroic Pledges” (86%) characterized by naive idealism. Post-dissection narratives shifted significantly toward “Confessional Apologies” (78%), reflecting guilt, humility, and ethical reintegration (χ² = 132.84, p < 0.001). Quantitative analysis also confirmed a surge in the honorific framing of donors as Seonsaengnim (teacher) (73%, χ² = 108.92, p < 0.001), which served as a cultural mechanism to restore moral hierarchy. Ritualized reflection across dissection serves as a mechanism for navigating ethical challenges in South Korean medical students' identity formation. These findings highlight the pedagogical value of structured reflective practices in fostering compassionate physicians who preserve human dignity while developing technical competence.