Student perceptions of medico-legal autopsy demonstrations in a student-centred curriculum

Abstract

OBJECTIVES Teaching autopsies in undergraduate medicine, although traditionally considered valuable by both educators and students, have been marginalised in modern curricula. This study explored medical students' experiences of the medico-legal autopsy demonstrations which formed part of their training in forensic medicine. METHODSIn this phenomenological study, qualitative data obtained by interviewing 10 Year 4 medical students from various sociocultural backgrounds were interpretively examined. One-to-one, semi-structured interviews were tape-recorded and transcribed. The data were thematically organised and then analysed using a theoretical framework of three dimensions of learning, namely, cognitive, emotional and societal.RESULTS Students still perceive autopsies as essential even in the context of self-directed learning. They identified a better understanding of anatomy and traumatology as the main cognitive benefits. At an emotional level students felt they had developed a degree of clinical detachment and would be better equipped to deal with issues surrounding death. Although socialisation influenced students' feelings about the autopsy, it did not detract from their appreciation of the educational value of the experience. CONCLUSIONSThe results support previous findings from both students, prior to curriculum reform, and medical educators who were canvassed for their opinions in relation to a modern curriculum. Besides the obvious cognitive advantages, educators should be mindful of the hidden curriculum that emanates from autopsies because it impacts on the development of professionalism and ethical behaviours of future medical practitioners. student observations

Attitudes of healthcare students on gross anatomy laboratory sessions

“…Our results point to a hidden curriculum in such laboratories, one that transforms attitudes and transmits values to students both by what is (and what is not) taught and how such teaching features in the curriculum (Burton, 2003). In one study about medico-legal autopsy teaching, autopsies were found to carry a considerable hidden curriculum concerning attitudes of respect, empathy, and compassion (McNamee et al, 2009). Laboratories promote reflection (Lachman and Pawlina, 2006) and develop students' humanity.…”

“…A phenomenological study of medical students, in contrast, found that future physicians felt it important for all medical practitioners to attend at least one autopsy in the course of their professional training (McNamee et al, 2009). Physical therapy and medical students may have different opinions on this subject because, compared to medical doctors, physical therapists seldom deal with human death in clinical practice.…”

Teaching post-mortem external examination in undergraduate medical education—The formal and the informal curriculum

“…At the same time, very few studies have addressed the effects of confronting students with dead bodies and most of these studies have focused on autopsies [6][7][8] as well as course content. In addition, these studies did not cover undergraduate but mainly postgraduate education [9][10][11][12][13][14].…”

The forensic autopsy as a teaching tool: Attitudes and perceptions of undergraduate medical students at the University of Pretoria, South Africa

“…A second reason could be that the SWOT analysis might not have been the best tool with which to evaluate the perceptions of students. The study also reiterated the findings of McNamee et al [12] regarding the emotional aspect surrounding the attendance of forensic autopsies, indicating that the autopsy aided in the description of trauma and differentiated between natural and unnatural causes of death.…”

“…In a study by McNamee et al, [12] from the Department of Forensic Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, 10 students took part in semistructured interviews after completion of the forensic medicine practical rotation. All students experienced a degree of discomfort, 70% indicated that they had a better understanding of the mechanism of death and could better differentiate between natural and unnatural causes of death, and 80% indicated that the description of trauma aided a great deal.…”