Students' perceptions of medico-legal autopsy demonstrations as a learning experience at a South African medical school.
How do medical students experience autopsy demonstrations that form part of the undergraduate curriculum? This was the primary question guiding this phenomenological study within the interpretive paradigm. Both explicit cognitive outcomes and elements of the “hidden curriculum” associated with autopsies were evaluated. Most previous studies on this topic employed survey questionnaires and were conducted prior to the radical curriculum reformations in medical undergraduate training. Some of these pedagogical changes have threatened the use of autopsies for teaching. More recently some other studies concentrated on aspects that were not directly related to educational outcomes. Burton (2003) conducted a phenomenological study interviewing medical educators about the uses of autopsy in the modern undergraduate curriculum, essentially detailing the “delivered curriculum”. Therefore this study focused on the “received curriculum”. Interviews were conducted with 10 medical students in their 4th year of study, having attended medico-legal autopsy demonstrations forming a central part of a course in Forensic Medicine. The underlying assumption of the study is that ‘student voices’ need to be heard in determining what is taught and how (Brooker & MacDonald, 1999), something typically determined by academic staff. This need is especially highlighted in a climate of “self-directed learning” promoted by modern medical curricula. The data are analysed qualitatively using a theoretical framework of three dimensions of learning (Illeris, 2004): (1) cognitive content dimension, (2) emotional psychodynamic, attitudinal and motivational dimension, (3) social-societal dimension. Findings of the study show that medical students perceive autopsy demonstrations to be of considerable benefit to their learning; both cognitive and affective outcomes are discussed detailing individual contextual factors that influenced the outcomes. Some suggestions regarding curriculum and autopsy-based teaching are made in the light of various factors found to influence students’ attitudes towards autopsies.