MRC MPH student

The Doctors’ World.  Getting it Right on the Facts of Death

The final fact of life is that after your death, a doctor is required to complete a death certificate, specifying the cause of death.  Death certificates are therefore important sources of information to use in setting national priorities in health care and in directing future research.  Because mortality statistics are also reliant on the information on death certificates, it is extremely important that all death certificates be completed with accuracy and swiftness.  It is often the primary care physician that is responsible for completing the death certificate and for explaining the cause of death to the family.  Explicit understanding of how to verbalize the cause of death and the use of concise, clear language in completing death certificates is important.  This protocol describes research to determine whether a simple self-study module used by practitioners can make a significant improvement in the quality of death reporting. 

The aim of this study is to develop and evaluate an educational intervention to motivate accurate certification and provide clear guidance on the certification process.  

A randomised controlled trial will be conducted among interns at a local training hospital using both a non-intervened control group, and a before-after intervention study group to measure the effect of the educational intervention.  The control group will receive the intervention after the completion of the trial.

A structured questionnaire to participants who will complete a model death certificate that includes 5 case scenarios (vignettes) with death as final outcome, after which half will be randomly assigned to the self study module intervention. Two weeks later, a 10 item questionnaire and five more cases will be administered to both groups.

The intervention will begin with a brief didactic session outlining the process of death certification, the use of mortality data and the terminology used in writing Cause of Death Certification statements.  Each participant will be given written educational material for self-study addressing the most common errors in death certification.  All participants will be tested two weeks later with a set of death certification exercises which will include case scenarios and identifying the underlying cause of death from death drafts.

Supervisors:  Dr Pam Groenewald MRC Burden of Disease Research Unit and Prof. Jon Rhode (James P Grant School of Public Health, BRAC University in Dakar, Senegal.