The value of postmortem experience in undergraduate medical education: current perspectives

Abstract

The autopsy has traditionally been used as a tool in undergraduate medical education, but recent decades have seen a sharp decline in their use for teaching. This study reviewed the current status of the autopsy as a teaching tool by means of systematic review of the medical literature, and a questionnaire study involving UK medical schools. Teachers and students are in agreement that autopsy-based teaching has many potential benefits, including a deeper knowledge of basic clinical sciences, medical fallibility, end of life issues, audit and the “hidden curriculum”. The reasons underlying the decline in teaching are complex, but include the decreasing autopsy rate, increasing demands on teachers’ time, and confusion regarding the law in some jurisdictions. Maximal use of autopsies for teaching may be achieved by involvement of anatomical pathology technologists and trainee pathologists in teaching, the development of alternative teaching methods using the principles of the autopsy, and clarification of the law. Students gain most benefit from repeated attendance at autopsies, being taught by enthusiastic teachers, when they have been effectively prepared for the esthetic of dissection and the mortuary environment.

Keywords:

• medical education
• autopsy
• postmortem

Supplementary material

Medical student attendance at post mortem examinations   Medical School:____________________

1. Do your undergraduate medical students attend post mortem examinations?

   • □ Yes – Go to question 2

   • □ No – Go to question 9

2. Is such attendance optional or compulsory?

   • □ Optional – Go to question 3

   • □ Compulsory – Go to question 4

3. Is attendance encouraged at all? If it is, how is this achieved?

4. At what stage does attendance take place?

5. Is attendance integrated into the course?

6. Are attendances structured in any way (eg, structured questions, reflective writings etc)?

7. What format does the session take (eg, observing the whole autopsy, or seeing eviscerated individual organs)?

8. How many post mortem examinations on average would your students attend?

   Please go to question 12

9. Could they attend post mortem examinations if they wished?

   • □ Yes – Go to question 11

   • □ No – Go to question 10

10. Please could you explain briefly why not?

    Please go to question 12

11. Please explain very briefly how they would have to make arrangements to do so.

12. Are the principles of the autopsy used in ways other than direct observation at your institution (eg, virtual autopsies, online modules, case studies etc)?

13. Do you think attending post mortems had educational benefits for medical students? If so, what are they?

14. Please list below any further comments regarding the use of the autopsy for medical education in your institution and in general which you feel may be of interest to the study team.

    Many thanks for taking the time to complete this questionnaire. Should you wish to be apprised of the findings of the study, please write a contact email address below:

Disclosure

The authors have no conflicts of interest to disclose.