Incorporation of autopsy case-based learning into PhD graduate education: a novel approach to bridging the "bench-to-bedside" gap

Principles of oncology taught in a one-week course

BACKGROUND

Growing challenges in oncology require evolving educational methods and content. International efforts to reform oncology education are underway. Hands-on, interdisciplinary, and compact course formats have shown great effectiveness in the education of medical students. Our aim was to establish a new interdisciplinary one-week course on the principles of oncology using state-of-the-art teaching methods.

METHODS

In an initial survey, medical students of LMU Munich were questioned about their current level of knowledge on the principles of oncology. In a second two-stage survey, the increase in knowledge resulting from our recently established interdisciplinary one-week course was determined.

RESULTS

The medical students' knowledge of clinically important oncological topics, such as the diagnostic workup and interdisciplinary treatment options, showed a need for improvement. Knowledge of the major oncological entities was also in an expandable state. By attending the one-week course on the principles of oncology, students improved their expertise in all areas of the clinical workup in oncology and had the opportunity to close previous knowledge gaps. In addition, students were able to gain more in-depth clinical knowledge on the most common oncological entities.

CONCLUSION

The interdisciplinary one-week course on the principles of oncology proved to be an effective teaching method to expand the knowledge of the future physicians to an appropriate level. With its innovative and interdisciplinary approach, the one-week course could be used as a showcase project for the ongoing development of medical education in Germany.

Autopsies and quality of cause of death diagnoses

Objective:

The consequences of a low autopsy rate are not considered in determining the cause of death.

Method:

We have analyzed the Cause of Death Register of the Swedish National Board of Health and Welfare since it started 1969 to and including 2016 to visualize the decline in the frequency of clinical autopsies over time and evaluated the effect on the quality of the cause of death diagnoses.

Results:

Over the five decades studied, the frequency of clinical autopsies declined from almost 40% to less than 5%. The rate of decline was not even. Political decisions and changes of healthcare organization in Sweden affected the slope of decline of autopsies superimposed on a linear decline over time reflecting changes in clinical routines. A request of clinical autopsies was highly dependent on the level of care at the time of death, with the lowest number of requests for persons who died in nursing homes. The age at the time of death was a major factor affecting the number of autopsies, resulting in an autopsy rate of less than 1% in the ages where most persons die. Although men were autopsied more often than women, a gender-specific difference was not seen after correction for the age of death. We also found a higher rate of unspecific and irrelevant diagnosis in the cases not autopsied and we know from earlier studies by us and other authors that the cause of death diagnoses were missed in between 30% and 50% of the cases not autopsied.

Conclusion:

The decline in the clinical autopsy rate reduced the value of the death certificate register. An increase in the number of autopsies performed will improve the understanding of disease and cause of death, as well as to better inform next of kin.

Autopsy Observation as Experiential Learning for Nurse Practitioner Students in an Online Advanced Pathophysiology Course

BACKGROUND

Many instructional classrooms now exist in the online environment, where it is difficult to integrate experiential teaching strategies. Autopsy-based education has been shown to be a valuable teaching tool for pathophysiology in a medical school curriculum.

PROBLEM

There is a gap in the literature about the use of an autopsy observation in nurse practitioner (NP) education.

APPROACH

The purpose of this project was to develop and evaluate the effectiveness of an autopsy experience for NP students in an online advanced pathophysiology course.

OUTCOMES

Based on a review of course evaluations and reflective essays, the majority of students found this to be a valuable learning experience. The main barrier was locating a facility and scheduling the autopsy observation.

CONCLUSION

The benefits outweigh the barriers to providing experiential learning with an autopsy observation in an online pathophysiology course. As such, it should be considered in similar course offerings.

Comparison of case-based learning and traditional method in teaching postgraduate students of medical oncology

Purpose: Case-based learning (CBL) is now used as a teaching strategy to promote clinical problem-solving ability. The purpose of this study was to determine whether CBL is superior to the traditional teaching method in teaching lung cancer curriculum to oncology students. Methods: This study was a randomized controlled trial, enrolled 80 first-year oncology postgraduates from Bengbu medical college in the past 3 years. They were randomized to divide into 2 groups, had courses with the same lung cancer contents and timing. The experimental group (n = 40) utilized the CBL method while the control group (n = 40) used the traditional lecture-based teaching method. A questionnaire was used to attain the students' learning satisfaction and self-efficacy of the course, and a post-study examination was used to assess end-of-course performance. Results: Complete data were obtained from participating students (n = 40 in CBL; n = 40 in traditional teaching). The CBL group performed significantly better in questionnaire and examination compared to traditional teaching groups. Students showed high levels of satisfaction and problem-solving ability in the CBL group. Conclusion: Compared with the traditional teaching method. The case teaching method is a more effective teaching method to improve the ability of problem-solving for graduate students in medical oncology.