title: Interpreting educational evidence for practice: are autopsies a missed educational opportunity to learn core palliative care principles?
abstract: OBJECTIVE
  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.
authors.affiliation: SpR in Palliative Medicine, West Midlands Deanery and NIHR Clinical Lecturer in Medical Education, Keele University Medical School, Staffs, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Yardley
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001344:Autopsy / Q000379:methods*; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D010166:Palliative Care / Q000379:methods*; D065126:Palliative Medicine / Q000193:education*; D013337:Students, Medical; D006113:United Kingdom
keywords: Bereavement; Communication; Education and training; Supportive care; Terminal care