The use of autopsy in preclinical medical education: a survey of pathology educators

Abstract

Context: Declining rates and increased competition for student contact hours pose challenges to integrating autopsies into preclinical curricula. Some have stated that the practice is minimally used with few students having the opportunity to observe necropsies.

Objective: To determine the degree to and manner in which autopsies are used in the preclinical medical education.

Design: A survey was distributed to the membership of the Group for Research in Pathology Education, an organization of preclinical pathology educators, assessing the nature of preclinical student exposure to postmortem examinations, how the experience was integrated in curricula, and attitudes toward the practice.

Results: Fifty-one of 131 instructors (38.9%) responded. Most (86.2%) integrated autopsy material into coursework, usually in pathology education (63.1%) with 10.7% using it in discussions on end-of-life issues. The majority (74.5%) furnish students the opportunity to observe autopsies, typically in small groups. Volume was the only variable significantly related to whether the opportunity was provided (P < .001). The experience was required in 56.3% of schools and usually less than 10% of students attended voluntarily. Although most educators felt it was important in general and pathology curricula, responses were mixed regarding autopsy's utility in discussions on death and dying. Common challenges were low autopsy numbers and busy class schedules.

Conclusions: Most surveyed schools formally offer the opportunity to observe autopsies and incorporate autopsy themes in curricula. However, as only 41% of these institutions require the practice and most medical students did not view an autopsy voluntarily, less than half of preclinical students actually observe postmortem examinations.