Medical student attitudes to the autopsy and its utility in medical education: A brief qualitative study at one UK medical school

Abstract

Attending postmortems enables students to learn anatomy and pathology within a clinical context, provides insights into effects of treatment and introduces the reality that patients die. Rates of clinical autopsies have declined and medical schools have cut obligatory autopsy sessions from their curricula making it difficult to assess medical student perceptions of, and attitudes towards, the educational value of autopsy. Our aim was to investigate these perceptions by designing a brief qualitative study comprising nominal technique and focus group discussions with Cambridge Graduate Course students, all of whom had attended autopsies. Three general themes emerged from the focus group discussions: the value of autopsy as a teaching tool and ways the experience could be improved, the initial impact of the mortuary and the autopsy itself, and the "emerging patient"-an emotional continuum running from cadaver to autopsy subject and living patient. Educational benefits of autopsy-based teaching included greater understanding of anatomy and physiology, greater appreciation of the role of other health care professionals and an enhanced appreciation of psycho-social aspects of medical practice. Students suggested improvements for ameliorating the difficult emotional consequences of attendance. We conclude that autopsy-based teaching represents a low-cost teaching technique which is highly valued by students and has application to many diverse medical specialties and skills. However, careful preparation and organization of sessions is required to maximize potential educational benefits and reduce any negative emotional impact.

Evaluation of a teaching strategy based on integration of clinical subjects, virtual autopsy, pathology museum, and digital microscopy for medical students

“…[318] However, laboratory work is limited by time and personnel restrictions because in this setting, professors and students typically interact on a one-on-one basis. [19] Finally, the use of clinical autopsy as a teaching tool has significantly declined, strongly influenced by worldwide reduction in consented clinical autopsies. [16] Reasons for this decline include negative public attitudes in the wake of organ retention scandals,[1920] medical provider attitudes, biological risks, legal concerns, and family ethical and religious dilemmas.…”

“…[19] Finally, the use of clinical autopsy as a teaching tool has significantly declined, strongly influenced by worldwide reduction in consented clinical autopsies. [16] Reasons for this decline include negative public attitudes in the wake of organ retention scandals,[1920] medical provider attitudes, biological risks, legal concerns, and family ethical and religious dilemmas. [20] Autopsies, as a teaching tool, provide valuable information to preclinical medical students by integrating knowledge with clinical skills, while promoting both deductive reasoning and clinical problem solving.…”

“…[20] Autopsies, as a teaching tool, provide valuable information to preclinical medical students by integrating knowledge with clinical skills, while promoting both deductive reasoning and clinical problem solving. [1619] Some have also suggested that exposure to autopsies during medical school will help future doctors understand the autopsy process and its utility, potentially making students more likely to recommend autopsies to family members of future patients. [1920]…”

“…[1619] Some have also suggested that exposure to autopsies during medical school will help future doctors understand the autopsy process and its utility, potentially making students more likely to recommend autopsies to family members of future patients. [1920]…”

The social life of the dead: The role of post-mortem examinations in medical student socialisation

“…In these circumstances, consent of the relatives is required. In either case, consent for student observers is not currently required (Burton and Underwood, 2007), but permitted at the discretion of the coroner (Bamber et al, 2014) although whether consent should be sought from relatives is a matter growing debate (Burton, 2001;Weiss Roberts et al, 2000). At the time of data collection (2012), consent for medical student observers at PMEs was granted by the coroner but not explicitly sought from relatives, as per Human Tissues Authority (HTA) guidance.…”