Bamber Andrew R, Quince Thelma A
UCL Institute of Child Health, London, UK.
Department of Public Health and Primary Care, Primary Care Unit, School of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK.
Adv Med Educ Pract. 2015 Mar 11;6:159-70. doi: 10.2147/AMEP.S46669. eCollection 2015.
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.
传统上,尸检一直被用作本科医学教育的一种工具,但近几十年来,其在教学中的使用急剧下降。本研究通过对医学文献的系统回顾以及一项涉及英国医学院校的问卷调查研究,审视了尸检作为一种教学工具的现状。教师和学生一致认为,基于尸检的教学有许多潜在益处,包括对基础临床科学有更深入的了解、认识到医学的易错性、临终问题、审计以及“隐性课程”。教学使用下降背后的原因很复杂,但包括尸检率的下降、对教师时间的要求增加以及某些司法管辖区法律方面的混乱。通过让解剖病理技术人员和实习病理学家参与教学、利用尸检原理开发替代教学方法以及澄清法律,可实现尸检在教学中的最大程度利用。当学生为解剖的美学和停尸房环境做好有效准备、由热情的教师授课并多次参加尸检时,他们能获得最大益处。