Emotionally challenging learning situations: medical students' experiences of autopsies

Maria Weurlander1, Max Scheja2, Håkan Hult3 and Annika Wernerson3

1Department of Learning, Informatics, Management and Ethics, Centre for Medical Education, Karolinska Institutet, Stockholm, Sweden

2Department of Education, Stockholm University, Stockholm, Sweden

3Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Renal Medicine, Karolinska Institutet, Stockholm, Sweden

Submitted: 26/10/2011; Accepted: 30/03/2012; Published: 31/03/2012

Int J Med Educ. 2012; 3:63-70; doi: 10.5116/ijme.4f75.fb65

© 2012 Maria Weurlander et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0

Objectives: To explore medical students' experiences of an emotionally challenging learning situation: the autopsy.

Methods: Qualitative data were collected by means of written accounts from seventeen students after their first and third autopsies and a group interview with seven students after their first autopsy. Data was interpreted using inductive thematic analysis.

Results: Students experienced the autopsy in three ways: as an unnatural situation, as a practical exercise, and as a way to learn how pathologists work. Most students found the situation unpleasant, but some were overwhelmed. Their experiences were characterised by strong unpleasant emotions and closeness to the situation. The body was perceived as a human being, recently alive. Students who experienced the autopsy as a practical exercise saw it mainly as a part of the course and their goal was to learn anatomy and pathology. They seemed to objectify the body and distanced themselves from the situation. Students who approached the autopsy as a way to learn how pathologists work concentrated on professional aspects of the autopsy. The body was perceived as a patient rather than as a biological specimen.

Conclusions: Autopsies are emotionally challenging learning situations. If students attend autopsies, they need to participate in several autopsies in order to learn about procedures and manifestations of pathological changes. Students need opportunities to discuss their experiences afterwards, and teachers need to be aware of how different students perceive the autopsies, and guide students through the procedure. Our findings emphasize the importance of investigating emotional aspects of medical education.