The Most Difficult Teachable Moment: Autopsy Consenting

Medical and clinical discoveries through autopsies have informed hundreds of studies elucidating pathophysiological developments of diseases, which are crucial for improving medical treatment. At Johns Hopkins Hospital (JHH), all families of patients who have been inpatients within the past year have the right to an autopsy. This service requires consent of the deceased patient’s next-of-kin. It is important for clinicians to provide empathy while effectively communicating the medical significance and benefits an autopsy can provide for the patients’ families, when asking for consent. However, clinicians frequently find themselves unprepared for this important conversation for two main reasons: 1) lack of training opportunities and 2) lack of educational materials organizing the process of asking for autopsy. To meet the need for educational material and training opportunities, we envisioned a systematic learning experience with three main components: 1) a training module webpage, 2) a quick reference mobile app, and 3) a printed pocket guide. Contents for each component were selected in consultation with a JHH pathologist and clinicians experienced in obtaining autopsy consent. The webpage includes well organized information and interactive simulations to help clinicians learn and retain the material. This knowledge is reinforced by utilizing a mobile app, which enables easy access to necessary information right before or while the clinician is requesting an autopsy consent from the patient’s family. Finally, the hand-held pocket guide provides visual support for not only the clinicians, but also for the families when determining the correct next-of-kin, discussing how the autopsy will affect the funeral, and informing the next steps families should prepare for once their consent is given. Through the novel use of Standardized Patients and interactive-media-building software alongside 2D illustrations, we have developed prototype resources designed for effective information delivery. This opportunity has shed light on the potential use of such hybrid media in creating highly effective medical visualization resources, in this case, to improve the communication in requesting autopsy consent at the Johns Hopkins Hospital