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Practice-based learning and improvement is one of the six core competencies listed by the Accreditation Council for Graduate Medical Education (ACGME) for residency programs (post-graduate medical training). ACGME defines practice-based learning and improvement as “an ability to investigate and evaluate the care of patients, appraise and assimilate scientific evidence, and continuously improve patient care based on constant self-evaluation and life-long learning”.1 Assessing resident (also known as housestaff or a house officer) competency in practice-based learning and improvement is the most challenging of the six competencies as there are very few published tools to assess a resident's performance in this competency. We aim to develop a standardized resource, which could be utilized by residents for learning and self-reflection, and would also provide evaluators with an objective tool for assessing practice-based learning and improvement competency of residents through an approach known as the “Autopsy Learning Module”. Autopsy has long been recognized as an important tool for learning and quality improvement in clinical practice. Physicians often utilize autopsy findings for evaluating the accuracy of their clinical diagnosis, identifying any unsuspected conditions, and establishing a cause of death. To reiterate the importance of autopsy in medical education, we performed a study through a retrospective chart review of 141 autopsies conducted at our institution between January 2011 and May 2015. We measured the level of agreement between the clinical cause of death established by the treating clinician and the cause of death listed by the pathologist after autopsy using Kappa coefficients. We found there was poor agreement between the clinical and autopsy diagnosis, especially among cases of pulmonary embolism and liver cirrhosis, while there was moderate agreement among cases of myocardial infarction. Our findings were consistent with the available literature.2 The rate of disagreement between the clinical diagnosis and autopsy findings highlights an opportunity to use an autopsy in a meaningful way as both a learning experience and as a tool for self-reflection.

Autopsy learning module: a tool for assessing self-reflection and practice improvement competency