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医学生对尸检的态度及其在医学教育中的作用:英国一所医学院的一项简要定性研究。

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

机构信息

Department of Paediatric Pathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom.

出版信息

Anat Sci Educ. 2014 Mar-Apr;7(2):87-96. doi: 10.1002/ase.1384. Epub 2013 Jul 22.

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.

摘要

参加尸检使学生能够在临床环境中学习解剖学和病理学,深入了解治疗效果,并认识到患者死亡的现实。临床解剖的比例已经下降,医学院校已经从课程中删除了强制性解剖课程,这使得评估医学生对解剖教育价值的看法和态度变得困难。我们的目的是通过设计一项简短的定性研究来调查这些看法,该研究包括对剑桥研究生课程学生的名义技术和焦点小组讨论,所有这些学生都参加过解剖。焦点小组讨论中出现了三个主题:解剖作为教学工具的价值以及如何改进这种体验、太平间和解剖本身的最初影响,以及“新兴患者”——从尸体到解剖对象和活体患者的情感连续体。基于解剖的教学的教育益处包括对解剖学和生理学的更深入理解,对其他医疗保健专业人员的作用的更大赞赏以及对医疗实践的心理社会方面的更深刻理解。学生们提出了改进建议,以减轻参加尸检带来的困难的情绪后果。我们的结论是,基于解剖的教学代表了一种低成本的教学技术,受到学生的高度重视,并且适用于许多不同的医学专业和技能。但是,需要仔细的准备和组织课程,以最大限度地发挥潜在的教育益处并减少任何负面的情绪影响。

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