Interpreting educational evidence for practice: are autopsies a missed educational opportunity to learn core palliative care principles?
- SpR in Palliative Medicine, West Midlands Deanery and NIHR Clinical Lecturer in Medical Education, Keele University Medical School, Staffs, UK
- Correspondence to Dr Sarah Yardley, SpR in Palliative Medicine, West Midlands Deanery and NIHR Clinical Lecturer in Medical Education, Keele University Medical School, Staffs, ST55BG, UK;
Objectives UK policy requires undergraduate medical curricula to equip students to care for dying patients. The educational potential of autopsy attendance during authentic early experience to learn about the social context of death and dying has not been fully explored. In this paper the author: (1) explores how meaning is created from autopsies in authentic early experience; (2) compares views of students, curriculum designers and pathology supervisors; and (3) identifies actual/potential learning about death and dying.
Methods This paper is based on a qualitative study of authentic early experiences situated in a UK medical school. Semistructured interviews were conducted with students in year two (n=12), workplace supervisors (n=2) and curriculum designers (n=13). Narrative analysis was used to contrast empirical data with socio-cultural perspectives on learning. Language and metaphor were used as tools to interpret knowledge construction and meaning-making in addition to a thematic approach.
Results The autopsy enabled students to learn about death and dying in a social context. Variance between groups in perceptions of autopsy experiences may reduce educational value. Autopsies were considered by students to be opportunities for ‘meeting’ real people, albeit dead ones, and learning from them. Tensions between lay and medical perspectives influenced learning.
Conclusions Increasing communication and collaboration between medical school curriculum designers and disciplines such as Palliative Medicine as well as Pathology could address concerns regarding student/doctor competencies to deal with death and dying. Further research is needed to evaluate changes in curriculum design and to establish if similar concerns are found in other settings.
- Received 16 July 2012.
- Revision received 28 September 2012.
- Accepted 19 November 2012.
- Published Online First 14 December 2012
- Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions