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Allana AA, Ali SK, Ghias K. Bioethics curriculum for undergraduate medical students: an evaluation study utilizing mixed methods approach. BMC MEDICAL EDUCATION 2024; 24:385. [PMID: 38589869 PMCID: PMC11003031 DOI: 10.1186/s12909-024-05376-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/31/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The undergraduate bioethics curriculum introduced in a private medical college in Pakistan in 1988 and revised in 2009 has evolved over time to incorporate globally relevant innovations, including integration of bioethics spirally within an existing problem-based learning curricular framework. The present evaluation study shares the results of this integrated bioethics curriculum delivered for 10 years across the five-year undergraduate medical curriculum. The study assessed the effectiveness of the curriculum in terms of student achievement, appropriateness of course contents and efficiency of instructional methods. METHODS The study utilized a mixed method sequential explanatory design. The quantitative method was used in the first phase to gather data by utilizing a structured online questionnaire. This was followed by the second phase of qualitative methods to explain the findings of the first phase and enrich the data gathered. This phase was based on focus group discussions and document review. RESULTS Student and faculty responses showed the curriculum contents to be relevant, informative, and appropriate as per learning objectives and student achievement. Multi-modal instructional methods used were stated to be effective and engaging; small group teaching and shorter sessions suggested to be preferable for fostering discussion and maintaining student engagement and attention. Large class formats were stated to be less effective. Students affirmed the contribution of bioethics education to their personal and professional development and ethical positioning. The majority of students agreed that the curriculum contributed to their knowledge acquisition (60.3-71.2%), skill development (59.41-60.30%) and demonstration of ethical/professional behavior (62.54-67.65%). The ranges indicate agreement with related sets of questions. Participants suggested that the curriculum could be further strengthened by better integration in clinical years, role modelling and providing opportunities for application in clinical health care settings. Moreover, topics like ethical issues related to the use of social media, public health ethics and ethics and law were suggested as additions to the existing curriculum. These findings have regional and global relevance for the development and assessment of effective bioethics curricula. CONCLUSION An effective bioethics curriculum for undergraduate medical education should run longitudinally across the 5 year curriculum and be integrated in the modules and clerkships. Basic acquisition of knowledge and skills takes place in Years 1 & 2 with reinforcement and application in Years 3-5. Learning embedded in an integrated curriculum can help students recognize, critically analyze and address ethical dilemmas. Involvement and commitment of the clinical faculty is essential for reinforcing the ethical principles and concepts learnt in the earlier years.
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Affiliation(s)
- Anita Anis Allana
- Department for Educational Development, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan.
| | - Syeda Kauser Ali
- Institute of Medical Education, Jinnah Sindh Medical University, Rafiqui H. J. Iqbal Shaheed Road, Karachi, 75510, Pakistan
| | - Kulsoom Ghias
- Department of Biological and Biomedical Sciences, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
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AlRukban M, Alajlan F, Alnasser A, Almousa H, Alzomia S, Almushawah A. Teaching medical ethics and medical professionalism in Saudi public and private medical schools. PLoS One 2024; 19:e0298605. [PMID: 38421988 PMCID: PMC10903870 DOI: 10.1371/journal.pone.0298605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
Medical ethics and professionalism are two essential parts of building up the identity of a competent physician. This study was conducted to determine the nature, content, and methods of medical ethics and professionalism education in Saudi public and private medical schools. It also sought to identify the challenges and obstacles in teaching and assessing medical ethics and professionalism and suggest appropriate changes. A cross-sectional study was carried out in Saudi private and public medical schools. To achieve the study's aim, an assessment tool in the form of a novel self-administered questionnaire was developed, piloted, and then used. A representative from each of the 28 Saudi medical schools participated in the study. Twenty-four (82.1%) responding medical schools have no medical ethics department. Most of the medical schools (64.2%) have 25% or less of their faculty staff who teach ethics holding a qualification in medical ethics. Most schools have a specific course for medical ethics and professionalism (85.7% and 57.1%, respectively). Multiple-choice questioning is the most popular assessment method in medical ethics and professionalism courses (89.3% and 60.7%, respectively). The need for more qualified staff and clear guidelines/resources is a significant drawback to the teaching of medical ethics. Therefore, the study recommends developing national guidelines dedicated to the undergraduate teaching curriculum from which courses would be designed to enhance medical ethics and medical professionalism.
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Affiliation(s)
- Mohammed AlRukban
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alajlan
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali Alnasser
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
| | - Hisham Almousa
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
| | - Sulaiman Alzomia
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
| | - Abdullah Almushawah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
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Gemmete JJ. Learning from medical errors. CVIR Endovasc 2024; 7:8. [PMID: 38197983 PMCID: PMC10781906 DOI: 10.1186/s42155-023-00406-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/15/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Joseph J Gemmete
- Department of Radiology, Neurology, Neurosurgery, and Otolaryngology, University of Michigan Hospitals, UH B1D 328, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
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Rahimzadeh V, Kostick-Quenet K, Blumenthal Barby J, McGuire AL. Ethics Education for Healthcare Professionals in the Era of ChatGPT and Other Large Language Models: Do We Still Need It? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023; 23:17-27. [PMID: 37487184 DOI: 10.1080/15265161.2023.2233358] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
In this paper, we contend with whether we still need traditional ethics education as part of healthcare professional training given the abilities of chatGPT (generative pre-trained transformer) and other large language models (LLM). We reflect on common programmatic goals to assess the current strengths and limitations of LLMs in helping to build ethics competencies among future clinicians. Through an actual case analysis, we highlight areas in which chatGPT and other LLMs are conducive to common bioethics education goals. We also comment on where such technologies remain an imperfect substitute for human-led ethics teaching and learning. Finally, we conclude that the relative strengths of chatGPT warrant its consideration as a teaching and learning tool in ethics education in ways that account for current limitations and build in flexibility as the technology evolves.
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Dowie A. Ethical sense, medical ethics education, and maieutics. MEDICAL TEACHER 2023; 45:838-844. [PMID: 36820837 DOI: 10.1080/0142159x.2023.2178885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
CONTEXT The toolbox of instructional methods available to medical ethics educators is richly stocked and well-catalogued. However, the history of ideas relating to its contents is relatively under-researched in the medical education literature. HISTORY This paper proposes an approach to professional medical ethics education that adapts the ancient maieutic, question-asking method associated with Socratic dialogue, and particularly its uptake in educational theory developed by nineteenth and twentieth century American pragmatic philosophers, who in turn were profoundly influenced by the eighteenth century Common Sense school of philosophy from the Scottish Enlightenment. THEORY The 'ethical sense' postulated in this article is a distant echo of moral sense in Scottish Enlightenment thought. However, ethical sense as posited here is not the natural faculty variously theorised by Scottish Enlightenment philosophers such as Francis Hutcheson and Thomas Reid, but derives from the pre-understandings of students with respect to professional medical ethics. CONCLUSIONS The ethics educator can engage the ethical sense of students through maieutic 'teaching and learning by asking' in relation to actual clinical narratives, beginning not with the teacher's questions but importantly with those of the learners based on what they would need to know in order to determine the professional ethical obligations entailed.
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Affiliation(s)
- Al Dowie
- Medical Ethics and Law, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
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Dent JA. The continuing use of the SPICES model in 'SAVOURING' curriculum development. MEDICAL TEACHER 2023; 45:760-765. [PMID: 36630613 DOI: 10.1080/0142159x.2022.2158067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The SPICES model, described by Harden, Sowden, and Dunn in Medical Education 1984, presents a way of re-focussing a traditional curriculum by the addition of various educational strategies or 'SPICES'. These 'SPICES', Student-centred learning, a Problem-based approach, Integrated learning, Community-based education, Elective elements, and a Systematic approach meet perceived deficiencies in a conventional teaching programme and can contribute to the delivery of a reformed curriculum which addresses the educational needs of contemporary healthcare professionals.The evidence: During almost 40 years now the SPICES model has achieved international recognition as a key approach to curriculum development. Its importance in the design, delivery, and audit of a curriculum remains relevant today as is evidenced by:The number of citations in the medical education literature.Its inclusion as a key element of curriculum development in standard texts of medical education.Its prominence as a component of established Certificate, Diploma and Masters courses in medical education.The number of presentations or posters on curriculum development in the annual AMEE conference.The international reports of its use in the design and delivery of a curriculum.The international reports of its use in individual course design.In curriculum design for other healthcare disciplines.In its role in curriculum auditing and reform.The continuing usefulness: This article revises the principles of the SPICES model. It reflects on examples of its continuing international use; its use for curriculum design and development in a variety of healthcare disciplines; and its role in curriculum audit and revision. It also comments on some of the suggested alternatives and modifications described.
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Affiliation(s)
- John A Dent
- AMEE, Centre for Medical Education, Dundee, UK
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Roy S, Shah MH, Ahluwalia A, Harky A. Analyzing the Evolution of Medical Ethics Education: A Bibliometric Analysis of the Top 100 Cited Articles. Cureus 2023; 15:e41411. [PMID: 37416085 PMCID: PMC10321571 DOI: 10.7759/cureus.41411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 07/08/2023] Open
Abstract
Ethics education plays a pivotal role in healthcare by providing professionals and students with the essential competencies to navigate intricate ethical challenges. This study conducts a comprehensive bibliometric analysis of the most-cited articles on ethics education, investigating parameters such as citation count, document types, geographical origin, journal analysis, publication year, author analysis, and keyword usage. The findings reveal a substantial impact characterized by high citation counts and the influence of a prominent publication focusing on the hidden curriculum and structure of medical education. Moreover, the analysis demonstrates a discernible increase in research output since 2000, signaling a growing recognition of the significance of ethics education in the healthcare domain. Notably, specific journals, particularly those dedicated to medical education and ethics, emerge as major contributors in this field, publishing many articles. Renowned authors have made noteworthy contributions, and emerging themes encompass the ethical implications of virtual reality and artificial intelligence in healthcare education. Additionally, undergraduate medical education garners significant attention, emphasizing the importance of establishing ethical values and professionalism early. Overall, this study highlights the imperative of interdisciplinary collaboration and the necessity for effective ethics education programs to equip healthcare professionals with the requisite skills to navigate complex ethical challenges. The findings inform educators, curriculum developers, and policymakers about enhancing ethics education and ensuring the ethical competence of future healthcare practitioners.
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Affiliation(s)
- Sakshi Roy
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, GBR
| | - Muhammad Hamza Shah
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, GBR
| | - Arjun Ahluwalia
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, GBR
| | - Amer Harky
- Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, GBR
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Hlaing PH, Hasswan A, Salmanpour V, Shorbagi S, AlMahmoud T, Jirjees FJ, Kawas SA, Guraya SY, Sulaiman N. Health professions students' approaches towards practice-driven ethical dilemmas; a case-based qualitative study. BMC MEDICAL EDUCATION 2023; 23:307. [PMID: 37131157 PMCID: PMC10152413 DOI: 10.1186/s12909-023-04089-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/09/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND In healthcare practice, ethical challenges are inevitable and their optimal handling may potentialy improve patient care. Ethical development in medical education is critical for the transition from a medical and health sciences student to an ethical healthcare practitioner. Understanding the health professions students' approaches towards practice-driven ethical dilemmas could harness i the effective ethical development in their medical education. This study attempts to identify the health professions students' approaches towards practice-driven ethical dilemmas. METHODS An inductive qualitative evaluation was conducted on six recorded videos of health professions students' case-based online group discussions, followed by a one-hour online ethics workshop. The online ethics workshop was organized with students from the College of Medicine, College of Dental Medicine and College of Pharmacy at the University of Sharjah, and the College of Medicine at the United Arab Emirates University. . The recorded videos were transcribed verbatim and imported to the qualitative data analysis software of MAXQDA 2022. Data were analyzed applying four stages of review, reflect, reduce and retrieve and two different coders triangulated the findings. RESULTS Six themes emerged from the qualitative analysis of the health professions students' approaches to the practice-based ethical dilemmas; (1) emotions, (2) personal experiences, (3) law and legal system, (4) professional background, (5) knowledge of medical research and (6) inter-professional education. In addition, during the case-based group discussions in the ethics workshop, students efficiently applied the relevant ethical principles of autonomy, beneficence, non-maleficence and justice in their reasoning process to reach an ethical decision. CONCLUSION The findings of this study explained how health professions students resolve ethical dilemmas in their ethical reasoning process. This work sheds light on ethical development in medical education by gaining students' perspectives in dealing with complex clinical scenarios. The findings from this qualitative evaluation will aid academic medical institutions in developing medical and research-based ethics curriculum to transform students to ethical leaders.
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Affiliation(s)
- Phyu Hnin Hlaing
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed Hasswan
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Vida Salmanpour
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sarra Shorbagi
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Tahra AlMahmoud
- College of Medicine and Health Science, United Arab Emirates University, Sharjah, United Arab Emirates
| | | | - Sausan Al Kawas
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Nabil Sulaiman
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
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Ting JJQ, Phua GLG, Hong DZ, Lam BKY, Lim AJS, Chong EJX, Pisupati A, Tan R, Yeo JYH, Koh YZ, Quek CWN, Lim JY, Tay KT, Ong YT, Chiam M, Zhou JX, Mason S, Wijaya L, Krishna LKR. Evidence-guided approach to portfolio-guided teaching and assessing communications, ethics and professionalism for medical students and physicians: a systematic scoping review. BMJ Open 2023; 13:e067048. [PMID: 36977542 PMCID: PMC10069516 DOI: 10.1136/bmjopen-2022-067048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES Guiding the development of longitudinal competencies in communication, ethics and professionalism underlines the role of portfolios to capture and evaluate the multiple multisource appraisals and direct personalised support to clinicians. However, a common approach to these combined portfolios continues to elude medical practice. A systematic scoping review is proposed to map portfolio use in training and assessments of ethics, communication and professionalism competencies particularly in its inculcation of new values, beliefs and principles changes attitudes, thinking and practice while nurturing professional identity formation. It is posited that effective structuring of portfolios can promote self-directed learning, personalised assessment and appropriate support of professional identity formation. DESIGN Krishna's Systematic Evidence-Based Approach (SEBA) is employed to guide this systematic scoping review of portfolio use in communication, ethics and professionalism training and assessment. DATA SOURCES PubMed, Embase, PsycINFO, ERIC, Scopus and Google Scholar databases. ELIGIBILITY CRITERIA Articles published between 1 January 2000 and 31 December 2020 were included. DATA EXTRACTION AND SYNTHESIS The included articles are concurrently content and thematically analysed using the split approach. Overlapping categories and themes identified are combined using the jigsaw perspective. The themes/categories are compared with the summaries of the included articles in the funnelling process to ensure their accuracy. The domains identified form the framework for the discussion. RESULTS 12 300 abstracts were reviewed, 946 full-text articles were evaluated and 82 articles were analysed, and the four domains identified were indications, content, design, and strengths and limitations. CONCLUSIONS This review reveals that when using a consistent framework, accepted endpoints and outcome measures, longitudinal multisource, multimodal assessment data fashions professional and personal development and enhances identity construction. Future studies into effective assessment tools and support mechanisms are required if portfolio use is to be maximised.
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Affiliation(s)
- Jacquelin Jia Qi Ting
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Daniel Zhihao Hong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Bertrand Kai Yang Lam
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Annabelle Jia Sing Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Eleanor Jia Xin Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Rei Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Jocelyn Yi Huang Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Yi Zhe Koh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Chrystie Wan Ning Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Jia Yin Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Kuang Teck Tay
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
| | - Jamie Xuelian Zhou
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, University of Liverpool, Liverpool, UK
| | - Limin Wijaya
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Department of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Palliative Care Institute Liverpool, University of Liverpool, Liverpool, UK
- Duke-NUS Medical School, Singapore
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Olaiya O, Hyatt T, Mathew A, Staudaher S, Bachman Z, Zhao Y. Building connections between biomedical sciences and ethics for medical students. BMC MEDICAL EDUCATION 2022; 22:829. [PMID: 36456922 PMCID: PMC9714188 DOI: 10.1186/s12909-022-03865-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Medical ethics education is crucial for preparing medical students to face ethical situations that can arise in patient care. Instances of ethics being integrated into biomedical science education to build the connection between human science and ethics is limited. The specific aim of this study was to measure student attitudes towards an innovative curriculum design that integrates ethics education directly into a biomedical science course in pre-clinical medical curriculum. METHODS In this cross-sectional study, three ethics learning modules were designed and built in a biomedical science course in the pre-clinical curriculum. All students of Class of 2024 who were enrolled in the course in 2021 were included in the study. Each module integrated ethics with basic science topics and was delivered with different teaching modalities. The first module used a documentary about a well-known patient with severe combined immunodeficiency disease. The second module was delivered through a clinical scenario on HIV infection. The third module used small group discussion and debate on the topic of blood transfusion. For evaluation, students were asked to self-identify the ethical challenges associated with each module and complete reflective writing to assess their knowledge and attitude. Quantitative and qualitative analyses were conducted on student perceptions of each module. RESULTS Likert scale ratings on the usefulness of each module revealed significantly higher ratings for the small group discussion/debate module, seconded by the documentary and lastly the case scenario only modules. Narrative analysis on student feedback revealed three themes: General favorable impression, Perceived learning outcomes, and Critiques and suggestion. Common and unique codes were identified to measure the strengths and weaknesses of each module. Overall, students' perception of the curriculum design was extremely positive. CONCLUSIONS This curriculum design enabled us to highlight foundational biomedical sciences and clinical conditions with ethical dilemmas that physicians are likely to face in practice. Students found value in the modules, with a preference for the most active learning method. This study provides insight on a novel approach for integrating medical ethics into biomedical science courses that can be tailored to any institution. Strategies learned include utilizing active learning modalities and discussion.
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Affiliation(s)
- Oluwaseun Olaiya
- Department of Primary Care and Clinical Medicine, College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Travis Hyatt
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Alwyn Mathew
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Shawn Staudaher
- College of Osteopathic Medicine, Sam Houston State University, Conroe, USA
| | - Zachary Bachman
- Department of Psychology and Philosophy, College of Humanities and Social Sciences, Sam Houston State University, Huntsville, USA
| | - Yuan Zhao
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, USA.
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Kidszun A, Forth FA, Matheisl D, Busch F, Kaltbeitzel L, Kurz S. Ethics education in pediatrics: Implementation and evaluation of an interactive online course for medical students. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc55. [PMID: 36540566 PMCID: PMC9733484 DOI: 10.3205/zma001576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/04/2022] [Accepted: 09/01/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has catalyzed the development of online learning formats in virtually all areas of medical education. In pediatric ethics, online learning may not only substitute but also offer specific advantages over traditional classroom teaching. Many pediatricians rate their ethics education as poor and medical ethics education lacks evaluation, especially regarding the students' needs. The aim of this project was to implement and evaluate a novel interactive distance learning approach to engage medical students in pediatric ethics education. METHODS An online ethics course was designed and delivered between May and June 2020. Core item of this course was a moderated, written forum discussion spanning several days. Evaluation was mixed methods. We evaluated the effectiveness of the course in terms of quality of the learning environment with a particular focus on relevance to students as well as interactive learning and reflective thinking. The Constructivist On-Line Learning Environment Survey (COLLES) was used to evaluate six different domains of the course. Data are presented as mean (standard deviation [SD]). The respective score range is 1-5, whereby a score of 4 or 5 means that the participants indicated the corresponding item as frequently or almost always present. RESULTS Responses were available from 104 (78.3%) of the 133 participating students. "Relevance" yielded a score of 4.17 (0.83), "reflective thinking" a score of 4.22 (0.83). "Interactivity" was scored 3.76 (0.99) and "tutor support" 4.72 (0.53). "Peer support" and "interpretation" scored 3.87 (0.98) and 4.49 (0.60), respectively. In qualitative analysis, students particularly valued the structure of the course, the relevance for their professional practice, their active participation and the incentive to reflective thinking. Students also indicated that this was an innovative and exciting format, which fills a current educational gap and should hence be continued beyond the pandemic. CONCLUSION In conclusion, students actively engaged in online learning and perceived this ethics course as highly relevant for their professional practice.
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Affiliation(s)
- André Kidszun
- Johannes Gutenberg-University Mainz, University Medical Center, Department of Pediatric and Adolescent Medicine, Division of Neonatology, Germany
- University of Bern, Bern University Hospital, Inselspital, Department of Paediatrics, Division of Neonatology, Bern, Switzerland
| | - Fiona A. Forth
- Johannes Gutenberg-University Mainz, University Medical Center, Institute for the History, Philosophy and Ethics of Medicine, DFG-Research Training Group “Life Sciences – Life Writing”, Mainz, Germany
| | - Daniel Matheisl
- Medical Center-University of Freiburg, Center for Pediatrics, Department of Neonatology and Pediatric Intensive Care, Freiburg im Breisgau, Germany
| | - Franziska Busch
- University of Bern, Bern University Hospital, Inselspital, Department of Paediatrics, Division of Neonatology, Bern, Switzerland
| | - Lara Kaltbeitzel
- Johannes Gutenberg-University Mainz, University Medical Center, Rudolf Frey Lernklinik, Mainz, Germany
| | - Sandra Kurz
- Johannes Gutenberg-University Mainz, University Medical Center, Rudolf Frey Lernklinik, Mainz, Germany
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Deckers J. A survey and critical analysis of the teaching of medical ethics in UK medical schools. INTERNATIONAL JOURNAL OF ETHICS EDUCATION 2022; 8:177-194. [PMCID: PMC9632565 DOI: 10.1007/s40889-022-00158-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 06/13/2024]
Abstract
This article surveys and analyses the reflections on medical ethics teaching by colleagues teaching in United Kingdom (UK) medical schools in the early 2020s. Participants were recruited mainly by using the worldwide web to identify 64 people from 41 UK medical schools who were thought to contribute to teaching medical ethics based on their internet profiles. Twenty-three people responded. The survey data reveals that many staff are happy with the provision of medical ethics teaching, but also that some are concerned about the quality of provision due to concerns with staff expertise and teaching time. In spite of the fact that the General Medical Council (GMC) and other organisations are perceived to have contributed to raising the profile of medical ethics, there is significant concern with how it is embedded within local UK medical curricula. Some participants contributed hardly or not at all to research in medical ethics, where one attributed this decline in research to the pandemic. Future work will need to address what can be done to improve the provision of medical ethics teaching to address some of these findings and to survey and analyse how perceptions might have changed in light of recent challenges and developments.
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Affiliation(s)
- Jan Deckers
- School of Medicine, Newcastle University, NE2 4HH Newcastle, United Kingdom
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O'Brien DC. Medical Ethics as Taught and as Practiced: Principlism, Narrative Ethics, and the Case of Living Donor Liver Transplantation. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2022; 47:95-116. [PMID: 35137171 DOI: 10.1093/jmp/jhab039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The dominant model for bioethical inquiry taught in medical schools is that of principlism. The heritage of this methodology can be traced to the Enlightenment project of generating a universalizable justification for normative morality arising from within the individual, rational agent. This project has been criticized by Alasdair MacIntyre who suggests that its failure has resulted in a fragmented and incoherent contemporary ethical framework characterized by fundamental intractability in moral debate. This incoherence implicates principlist conceptions of bioethics. Medical ethics as practiced, though, is partially in keeping with teleological alternatives to principlism. Nonetheless, the hegemony of principlism threatens to harm the practice of good medicine whenever it is used to provide justification for the sanction or prohibition of practices, despite not being equipped to grant moral authority to such justifications. An example of this failure and its resulting harm is expressed in the growing obsolescence of living donor liver transplantation.
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Affiliation(s)
- Daniel C O'Brien
- University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
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Wong MK, Hong DZH, Wu J, Ting JJQ, Goh JL, Ong ZY, Toh RQE, Chiang CLL, Ng CWH, Ng JCK, Cheong CWS, Tay KT, Tan LHS, Ong YT, Chiam M, Chin AMC, Mason S, Radha Krishna LK. A systematic scoping review of undergraduate medical ethics education programs from 1990 to 2020. MEDICAL TEACHER 2022; 44:167-186. [PMID: 34534043 DOI: 10.1080/0142159x.2021.1970729] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Ensuring medical students are equipped with essential knowledge and portable skills to face complex ethical issues underlines the need for ethics education in medical school. Yet such training remains variable amidst evolving contextual, sociocultural, legal and financial considerations that inform training across different healthcare systems. This review aims to map how undergraduate medical schools teach and assess ethics. METHODS Guided by the Systematic Evidence-Based Approach (SEBA), two concurrent systematic scoping reviews were carried out, one on ethics teaching and another on their assessment. Searches were conducted on PubMed, Embase, PsycINFO and ERIC between 1 January 1990 and 31 December 2020. Data was independently analysed using thematic and content analysis. RESULTS Upon scrutinising the two sets of full-text articles, we identified 141 articles on ethics teaching and 102 articles on their assessments. 83 overlapped resulting in 160 distinct articles. Similar themes and categories were identified, these include teaching modalities, curriculum content, enablers and barriers to teaching, assessment methods, and their pros and cons. CONCLUSION This review reveals the importance of adopting an interactive, multimodal and interdisciplinary team-teaching approach to ethics education, involving community resource partners and faculty trained in ethics, law, communication, professionalism, and other intertwining healthcare professions. Conscientious effort should also be put into vertically and horizontally integrating ethics into formal medical curricula to ensure contextualisation and application of ethics knowledge, skills and attitudes, as well as protected time and adequate resources. A stage-based multimodal assessment approach should be used to appropriately evaluate knowledge acquisition, application and reflection across various practice settings. To scaffold personalised development plans and remediation efforts, multisource evaluations may be stored in a centralised portfolio. Whilst standardisation of curricula content ensures cross-speciality ethical proficiency, deliberative curriculum inquiry performed by faculty members using a Delphi approach may help to facilitate the narrowing of relevant topics.
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Affiliation(s)
- Mun Kit Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Daniel Zhi Hao Hong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jiaxuan Wu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jacquelin Jia Qi Ting
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jia Ling Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Zhi Yang Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Rachelle Qi En Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Christine Li Ling Chiang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Caleb Wei Hao Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Jared Chuan Kai Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Clarissa Wei Shuen Cheong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Laura Hui Shuen Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, United Kingdom
- Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, United Kingdom
- Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom
- Duke-NUS Medical School, Singapore, Singapore
- Centre of Biomedical Ethics, National University of Singapore, Singapore, Singapore
- PalC, The Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore
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Sabeghi H, Yazdani S, Foroutan SA, Hosseini SM, Afshar L. Value-rich exposures in medical education: phenomenology of practice according to the lived experiences of medical students in Iran. J Med Ethics Hist Med 2022; 14:9. [PMID: 35035797 PMCID: PMC8696577 DOI: 10.18502/jmehm.v14i9.6753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
Values predispose people to make the right and especially ethical decisions, and are important for good performance in medical sciences. Students’ lived experiences and the value-rich exposures during their education are some effective means of achieving professional values that help them build their own value frameworks. In this phenomenology of practice study, we aimed to explore and describe the lived experiences of a sample of medical students in Shahid Beheshti University of Medical Sciences regarding their value-rich exposures. In-depth interviews, students’ written stories, recorded video interviews related to past trips and photographs were used to collect data. The data was analyzed based on Van Manen’s thematic analysis method. Five themes emerged from the data: “in the shadow of a supportive mentor”, “a well-orchestrated, value-rich program”, “human interactions in a value system”, “acquiring values in a real-life environment”, “and seeking values in oneself”. Our study identified different dimensions of value-rich exposure based on the lived experiences of medical students and pointed out some issues that medical education planners can consider to improve the quality of value-based education for medical students.
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Affiliation(s)
- Hakimeh Sabeghi
- PhD Candidate in Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Yazdani
- Professor, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Foroutan
- Associate Professor, Permanent Member, Academy of Medical Sciences of Iran, Tehran, Iran
| | - Seyed Masoud Hosseini
- Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Afshar
- Associate Professor, Department of Medical Ethics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Moonaghi H, Abbaspour H, Kareshki H, Esmaeili H. Positive consequences of the hidden curriculum in undergraduate nursing education: An integrative review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:169-180. [PMID: 36237954 PMCID: PMC9552589 DOI: 10.4103/ijnmr.ijnmr_325_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/20/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022]
Abstract
Background: Hidden Curriculum (HC) plays an essential role in nursing education and professionalism. However, its positive consequences have been overlooked. Thus, this study aimed to explore and discuss the positive consequences of HC in nursing undergraduate education. Materials and Methods: A comprehensive literature search was conducted to investigate articles published between January 2010 and December 2020. Furthermore, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to select articles, and Consolidated criteria for Reporting Qualitative research (COREQ) and Strengthening the Reporting of Observational studies in Epidemiology (STROBE) tools were employed to appraise qualitative and quantitative studies, respectively. The applied search strategy resulted in a final list of 16 articles out of a total of 132 articles. Next, the data were integrated and categorized using the Whittemore and Knafl methodology. Results: Three categories were identified: Individual Consequences; involving increased self-confidence, self-esteem, assertiveness, adaptation, autonomy, and lifelong learning. Social Consequences; involving enhanced socialization, cultural consciousness, and social interactions. Professional Consequences; involving professional socialization, professional identity, professional ethics, link theory and practice, and professional dignity. Conclusions: Altogether, we concluded that the emergence of HC and its positive and remarkable consequences in nursing knowledge helps the personal, social, and professional development in nursing.
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Heath J. Ethical Issues in Physician Billing Under Fee-For-Service Plans. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2021; 45:86-104. [PMID: 31922579 DOI: 10.1093/jmp/jhz029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Medical ethics has become an important and recognized component of physician training. There is one area, however, in which medical students receive little guidance. There is practically no discussion of the financial aspects of medical practice. My objective in this paper is to initiate a discussion about the moral dimension of physician billing practices. I argue that physicians should expand their conception of professional responsibility in order to recognize that their moral obligations toward patients include a commitment to honest and forthright billing practices. I argue that physicians should aspire to a standard of clinical accuracy-not legal adequacy-in describing their activities. More generally, physicians should strive to promote an integrity-based professional culture, first and foremost by stigmatizing rather than celebrating creative billing practices, as well as condemning the misguided sense of solidarity that currently makes it taboo for physicians to criticize each other on this score.
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Mobasher M. Painting as a reflective method in teaching medical professional values. J Med Ethics Hist Med 2021; 14:1. [PMID: 34122782 PMCID: PMC8165576 DOI: 10.18502/jmehm.v14i1.5316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/16/2021] [Indexed: 11/24/2022] Open
Abstract
The article's abstract is not available.
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Affiliation(s)
- Mina Mobasher
- Assistant Professor, Department of Medical Ethics and History of Medicine, School of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
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19
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Janairo MP, Cardell AM, Lamberta M, Elahi N, Aghera A. The Power of an Active Shooter Simulation: Changing Ethical Beliefs. West J Emerg Med 2021; 22:510-517. [PMID: 34125020 PMCID: PMC8202989 DOI: 10.5811/westjem.2021.4.51185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/03/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction During a hospital-based active shooter (AS) event, clinicians may be forced to choose between saving themselves or their patients. The Hartford Consensus survey of clinicians and the public demonstrated mixed feelings on the role of doctors and nurses in these situations. Our objective was to evaluate the effect of simulation on ethical dilemmas during a hospital-based AS simulation. The objective was to determine whether a hospital-based AS event simulation and debrief would impact the ethical beliefs of emergency physicians relating to personal duty and risk. Methods Forty-eight emergency physicians and physicians-in-training participated in this cohort study based in an urban academic hospital. Simulation scenarios presented ethical dilemmas for participants (eg, they decided between running a code or hiding from a shooter). Surveys based upon the Hartford Consensus were completed before and after the simulation. Questions focused on preparedness and ethical duties of physicians to their patients during an AS incident. We evaluated differences using a chi-squared test. Results Preparedness for an AS event significantly improved after the simulation (P = 0.0001). Pre-simulation, 56% of participants felt that doctors/nurses have a special duty like police to protect patients who cannot hide/run, and 20% reported that a provider should accept a very high/high level of personal risk to protect patients who cannot hide/run. This was similar to the findings of the Hartford Consensus. Interestingly, post-simulation, percentages decreased to 25% (P = 0.008) and 5% (P = 0.041), respectively. Conclusion Simulation training influenced ethical beliefs relating to the duty of emergency physicians during a hospital-based AS incident. In addition to traditional learning objectives, ethics should be another important design consideration for planning future simulations in this domain.
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Affiliation(s)
- Maria-Pamela Janairo
- State University of New York Downstate Medical Center, Department of Emergency Medicine, Brooklyn, New York.,Kings County Hospital Center, Department of Emergency Medicine, Brooklyn, New York
| | | | - Michael Lamberta
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Nubaha Elahi
- Osceola Regional Medical Center, Department of Emergency Medicine, Kissimmee, Florida
| | - Amish Aghera
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
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Murakami K, Ito M, Tsutsumi M, Nagata C, Tanaka A, Conway J, Stone TE. Students and Faculty Perspectives of a Problem-Based Learning Online Nursing Ethics Seminar in Japan. JOURNAL OF PROBLEM-BASED LEARNING 2021. [DOI: 10.24313/jpbl.2021.00024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Bishop CE, Maradiaga G, Freeman KR, Peters TR, Jackson JM. Simulation: an Innovative Approach to Engaging Preclinical Medical Students with Bioethics. MEDICAL SCIENCE EDUCATOR 2021; 31:325-329. [PMID: 34457887 PMCID: PMC8368169 DOI: 10.1007/s40670-020-01159-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Integrating bioethical concepts into preclinical medical school curriculum and engaging early medical learners in bioethics are a challenge. ACTIVITY A total of 140 medical students participated in a 2-h simulation activity consisting of a series of standardized patient (SP) encounters. RESULTS A total of 41 of 140 students (29%) completed the learner evaluation survey. Ninety-one percent thought that the SP encounter was relevant to their role as a future physician. Ninety-three percent of students rated the exercise as highly effective. CONCLUSIONS SP encounters enhance preclinical medical students' engagement with bioethics and provide learners practice applying these concepts to clinically relevant scenarios.
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Affiliation(s)
- Christine E. Bishop
- Department of Pediatrics, University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA 15224 USA
| | - Gerardo Maradiaga
- Department of Internal Medicine, Medical Center Bioethics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Kendall R. Freeman
- Academic Affairs, Bowman Gray Center for Medical Education, Wake Forest School of Medicine, 475 Vine Street, Winston-Salem, NC 27101 USA
| | - Timothy R. Peters
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Jennifer M. Jackson
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
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22
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Bajpai S, Lindeman B. The Trainee's Role in Patient Safety: Training Residents and Medical Students in Surgical Patient Safety. Surg Clin North Am 2020; 101:149-160. [PMID: 33212075 DOI: 10.1016/j.suc.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
"The focus on patient safety offers a new framework not only for delivering health care but also for training physicians. Medical school and surgical graduate medical education must transition to a more holistic approach by teaching technical and nontechnical skills. Formalized safety curricula can be developed by adopting recommended guidelines and content from national and international organizations, existing validated practices of training programs, frequent simulation exercises, and objective evaluation tools."
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Affiliation(s)
- Swara Bajpai
- Department of Surgery, 1808 7th Avenue South, BDB 202, Birmingham, AL 35294, USA
| | - Brenessa Lindeman
- Endocrine Surgery, General Surgery, Department of Surgical Oncology, BDB 603, Birmingham, AL, USA.
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23
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Hawking M, Kim J, Jih M, Hu C, Yoon JD. "Can virtue be taught?": a content analysis of medical students' opinions of the professional and ethical challenges to their professional identity formation. BMC MEDICAL EDUCATION 2020; 20:380. [PMID: 33092593 PMCID: PMC7584068 DOI: 10.1186/s12909-020-02313-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/16/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND Efforts have begun to characterize the ethical and professional issues encountered by medical students in their clinical years. By applying previously identified taxonomies to a national sample of medical students, this study seeks to develop generalizable insights that can inform professional identity formation across various clerkships and medical institutions. METHODS In a national survey of medical students, participants answered an open-ended survey item that asked them to describe a clinical experience involving an ethical or professional issue. We conducted a content analysis with these responses using the Kaldjian taxonomy of ethical and professionalism themes in medical education through an iterative, consensus-building process. Noting the emerging virtues-based approach to ethics and professionalism, we also reexamined the data using a taxonomy of virtues. RESULTS The response rate to this survey item was 144 out of 499 eligible respondents (28.9%). All 144 responses were successfully coded under one or more themes in the original taxonomy of ethical and professional issues, resulting in a total of 173 coded responses. Professional duties was the most frequently coded theme (29.2%), followed by Communication (26.4%), Quality of care (18.8%), Student-specific issues of moral distress (16.7%), Decisions regarding treatment (16.0%), and Justice (13.2%). In the virtues taxonomy, 180 total responses were coded from the 144 original responses, and the most frequent virtue coded was Wisdom (23.6%), followed by Respectfulness (20.1%) and Compassion or Empathy (13.9%). CONCLUSIONS Originally developed from students' clinical experiences in one institution, the Kaldjian taxonomy appears to serve as a useful analytical framework for categorizing a variety of clinical experiences faced by a national sample of medical students. This study also supports the development of virtue-based programs that focus on cultivating the virtue of wisdom in the practice of medicine.
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Affiliation(s)
- Michael Hawking
- Hematology and Oncology, The University of Chicago, Chicago, IL, USA
| | - Jenny Kim
- Department of Biological Sciences, The University of Chicago, Chicago, IL, USA
| | - Melody Jih
- Department of Economics, The University of Chicago, Chicago, IL, USA
| | - Chelsea Hu
- Department of Economics and the Department of Political Science, The University of Chicago, Chicago, IL, USA
| | - John D Yoon
- MacLean Center for Clinical Medical Ethics, Department of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
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Torda A. CLASSIE teaching - using virtual reality to incorporate medical ethics into clinical decision making. BMC MEDICAL EDUCATION 2020; 20:326. [PMID: 32967692 PMCID: PMC7509501 DOI: 10.1186/s12909-020-02217-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 08/31/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Teaching medical ethics (ME) in the clinical environment is often difficult, uncalibrated and medical students get variable exposure to skilled educators. Explicit discussion of ethical dimensions of patient management is often neglected, as clinical teachers may feel inadequately skilled to do this. METHODS We developed a suite of online modules. Each consisted of a clinical scenario filmed using virtual reality (VR) technology, linked to an adaptive, interactive, online tutorial which explicitly discussed the relevant ethical issues and guidelines. These were embedded in clinical placements of students to encourage the transfer of knowledge from these modules to clinical skill competency. We conducted a pilot study to evaluate these modules which examined student engagement, knowledge gains (self-perceived and measured) and user experience. We also reviewed reflections to assess the incorporation of these modules and transfer of knowledge into the clinical learning and skill development of the students. RESULTS Engagement and self-perceived knowledge gains were extremely high. Students found these modules realistic, interesting and helpful. The measured knowledge gains (module exit quiz) were moderate. User experience was positive overall, although students were intolerant of any technical glitches. There was mixed feedback on whether the VR aspect of the clinical scenarios added value. Student reflections showed high level incorporation of these modules into clinical practice of the students and evidence of knowledge transfer (level 3 Kirkpatrick model of evaluation) in over ¾ of students. CONCLUSIONS This study showed that the use VR clinical scenarios combined with interactive online learning modules resulted in demonstrable high-level student engagement and learning gains in medical ethics and transfer of knowledge to clinical application. It standardised and ensured the student experience of high-quality educational deliverables in clinical years of medical education. This use of VR and online technology can be adapted for use in many areas of the medical curricula where we need to ensure the delivery of well calibrated, high quality, educational deliverables at scale for students.
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Affiliation(s)
- Adrienne Torda
- Faculty of Medicine, UNSW Sydney, Kensington, NSW, 2052, Australia.
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Souza AD, Vaswani V. Diversity in approach to teaching and assessing ethics education for medical undergraduates: A scoping review. Ann Med Surg (Lond) 2020; 56:178-185. [PMID: 32642060 PMCID: PMC7334795 DOI: 10.1016/j.amsu.2020.06.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/20/2020] [Accepted: 06/20/2020] [Indexed: 11/28/2022] Open
Abstract
There are diverse methods to teach medical ethics, and there is no single accepted approach towards its learning and assessment. The authors aim to explore the various strategies practised to teach undergraduate medical students the fundamentals of medical ethics and their evaluation. The authors reviewed the articles published from January 2014 to September 2019. The authors searched PubMed for the relevant publications and extracted the information using a data extraction sheet. Twenty-nine articles were included for the review, which fulfilled the inclusion criteria. Case-based discussions were a widely accepted strategy to learn ethics. The studies highlighted a mixed teaching approach using multiple teaching tools. A qualitative approach was preferred for the assessment through reflections, simulated patient interactions, and development of portfolios. However, there are gaps in the existing literature on the assessment strategies for ethics education. Heterogeneity still exists in the planning of the curricula, teaching, and assessment methods. These curricula suit the cultural and religious set up of that particular country. Case-based discussion is a popular teaching strategy, and there exist numerous innovative and cost-effective active teaching strategies. There is a need for studies that are more rigorous to address the evaluation of the ethics curricula. This review would help educators to choose their preferred approach based on their teaching environment. The major learning strategies were ‘Case-based,’ ‘video/movies,’ ‘role modelling,’ ‘lectures,’ and ‘patient interactions. A mixture of learning methods have proven to be beneficial. The assessment of ethics education is still a challenge, and there is a gap in the literature on their strategies. Curricula are evaluated mainly by the student feedback using unstructured, open-ended questionnaires and reflections. There is a need to have studies that are more rigorous to evaluate the long-term impact of the ethics curricula.
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Affiliation(s)
- Anne D Souza
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Vina Vaswani
- Head of Forensic Medicine Department, Centre for Ethics, Yenepoya Medical College, Yenepoya (Deemed to Be University), Deralakatte, Mangaluru, India
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Liu Y, Erath A, Salwi S, Sherry A, Mitchell MB. Alignment of Ethics Curricula in Medical Education: A Student Perspective. TEACHING AND LEARNING IN MEDICINE 2020; 32:345-351. [PMID: 32000533 DOI: 10.1080/10401334.2020.1717959] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Issue: Although there is consensus on the importance of including ethics in the medical school curriculum, there is wide variation in how this topic is taught. Recent literature also questions the effectiveness of current ethical teaching methods in changing student attitudes and future behavior. Furthermore, from the student perspective, there is a marked disconnect between the stated importance of and lack of effort in ethics courses. Evidence: Applying a student perspective of the hidden curriculum, as well as reviewing and applying insight from the available literature, we advocate for alignment of instructional design, content, and assessments. This article provides specific recommendations to increase student engagement in ethics courses and concludes by discussing whether a lack of engagement is attributable to intrinsic qualities of medical students in addition to pedagogical technique and educational setting and culture. Implications: This article has practical suggestions for medical educators to improve their ethics courses, leading to more well-rounded and thoughtful physicians.
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Affiliation(s)
- Yangzi Liu
- VUSM Medical Ethics, Law, & Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Alexandra Erath
- VUSM Medical Ethics, Law, & Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Sanjana Salwi
- VUSM Medical Ethics, Law, & Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Alexander Sherry
- VUSM Medical Ethics, Law, & Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Margaret B Mitchell
- VUSM Medical Ethics, Law, & Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Kavas MV, Ulman YI, Demir F, Artvinli F, Şahiner M, Demirören M, Şenyürek G, Pakiş I, Bakırcı N. The state of ethics education at medical schools in Turkey: taking stock and looking forward. BMC MEDICAL EDUCATION 2020; 20:162. [PMID: 32448274 PMCID: PMC7245803 DOI: 10.1186/s12909-020-02058-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 05/01/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND Ethics teaching is globally considered an essential part of medical education fostering professionalism. It does not only provide knowledge for good clinical conduct, but also trains medical students as virtuous practitioners. Although Turkey has had a considerable experience in ethics education of healthcare professionals, the general state of ethics curricula at medical schools in Turkey is unknown. METHODS The purpose of this study was to collect comprehensive data about the ethics education programs at medical schools in Turkey. To this aim, we designed a cross-sectional descriptive questionnaire survey which focuses on the content, teaching years, teaching, assessment and evaluation methodologies, workforce and infrastructure. We delivered the questionnaire to all medical schools in Turkey. Seventy-nine medical schools participated in this study (response rate: 78%). RESULTS Although most institutions had an undergraduate ethics curriculum (91.1%), the findings suggest deficiency of teaching personnel (34.2% had no instructors). Furthermore, the distribution and composition of the workforce was imbalanced. The content varies largely among institutions. Medical schools with an ethics department were more likely to diversify teaching topics. However, ethics education was largely based on the four-principle approach. The content was usually conveyed to students theoretically. Around 90% of schools had classroom lectures. It is the only method used at one-third of them. Clinical ethics education was mostly lacking. Multiple-choice tests were widely used to assess and evaluate student attainments (86.1%). CONCLUSIONS Staff qualified to teach ethics and ethics education integrated into the six-year medical curriculum given by a multidisciplinary team are urgent necessities. Considering teaching, assessment and evaluation methodologies used, most medical schools seem to fall short of fostering students to develop ethical attitudes. Endeavors aiming for modern topics should be encouraged. As the organization ethics education change continuously, we think that a platform for monitoring ethics education at medical schools in Turkey should be established. Such a body would help ethics instructors to network and find solutions to current problems and build shared wisdom.
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Affiliation(s)
- Mustafa Volkan Kavas
- Department of History of Medicine and Ethics, Ankara University, School of Medicine, Morfoloji Building, 06230, Ankara, Altındağ, Turkey.
| | - Yesim Isil Ulman
- Department of History of Medicine and Ethics, Acibadem University, School of Medicine, Kayışdağı Caddesi No:32, 34752, İstanbul, Ataşehir, Turkey
| | - Figen Demir
- Department of Public Health, Acibadem University, School of Medicine, Kayışdağı Caddesi No:32, 34752, İstanbul, Ataşehir, Turkey
| | - Fatih Artvinli
- Department of History of Medicine and Ethics, Acibadem University, School of Medicine, Kayışdağı Caddesi No:32, 34752, İstanbul, Ataşehir, Turkey
| | - Melike Şahiner
- Department of Medical Education, Acibadem University, School of Medicine, Kayışdağı Caddesi No:32, 34752, İstanbul, Ataşehir, Turkey
| | - Meral Demirören
- Department of Medical Education and Informatics, Hacettepe University, School of Medicine, 06230, Ankara, Altındağ, Turkey
| | - Gamze Şenyürek
- Department of History of Medicine and Ethics, Acibadem University, School of Medicine, Kayışdağı Caddesi No:32, 34752, İstanbul, Ataşehir, Turkey
| | - Işıl Pakiş
- Department of Forensic Medicine, Acibadem University, School of Medicine, Kayışdağı Caddesi No:32, 34752, İstanbul, Ataşehir, Turkey
| | - Nadi Bakırcı
- Department of Public Health, Acibadem University, School of Medicine, Kayışdağı Caddesi No:32, 34752, İstanbul, Ataşehir, Turkey
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DeFoor MT, Chung Y, Zadinsky JK, Dowling J, Sams RW. An interprofessional cohort analysis of student interest in medical ethics education: a survey-based quantitative study. BMC Med Ethics 2020; 21:26. [PMID: 32268890 PMCID: PMC7140336 DOI: 10.1186/s12910-020-00468-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 03/20/2020] [Indexed: 11/25/2022] Open
Abstract
Background There is continued need for enhanced medical ethics education across the United States. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level medical ethics curriculum. Methods In January 2018, following the successful implementation of a peer-led, grassroots medical ethics curriculum, student leaders under faculty guidance conducted a cross-sectional survey with 562 of 1357 responses received (41% overall response rate) among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/(D) MD Professional Scholars programs at The Medical College of Georgia at Augusta University. An in person or web-based questionnaire was designed to measure perceived need for a more in-depth medical ethics curriculum. Results The majority of respondents were female (333, 59.3%), white (326, 58.0%) and mid-20s in age (340, 60.5%). Almost half of respondents (47%) reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more medical ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students (28%) were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods. Conclusions The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Grassroots student-driven curricular development and leadership in medical ethics can positively impact medical education. Subsequent integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos.
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Affiliation(s)
- Mikalyn T DeFoor
- School of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, 30909, USA.
| | - Yunmi Chung
- Institute of Public and Preventative Health, Augusta University, Augusta, GA, 30909, USA
| | | | - Jeffrey Dowling
- Augusta University Rehabilitation, Augusta, GA, 30909, USA.,Center for Bioethics and Health Policy, Medical College of Georgia at Augusta University, Augusta, GA, 30909, USA
| | - Richard W Sams
- Center for Bioethics and Health Policy, Medical College of Georgia at Augusta University, Augusta, GA, 30909, USA.,Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, GA, 30909, USA
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Gholamzadeh S, Shayestehfard M, Torabizadeh C, Ebadi A. Ethical Sensitivity in Nursing Students: Developing a Context–based Education. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2020. [DOI: 10.29333/ejgm/7812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Gille F, Nardo A. A Case for Transformative Learning in Medical Ethics Education. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520931059. [PMID: 33062894 PMCID: PMC7536470 DOI: 10.1177/2382120520931059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/08/2020] [Indexed: 05/20/2023]
Abstract
In this article, we discuss the current state of medical ethics education. In Higher Education, ethics is taught predominantly through discussion and case study-based teaching formats. At present, however, only little can be said about the adequacy of these teaching methods in attaining complex educational objectives as ethics education poses challenges regarding meaningful student assessment and evaluation of educational methods. Output-oriented evaluation and assessment paradigms that centre quantified student performance fail to meaningfully capture the learning of ethics. Currently, we argue that comparatively small efforts are being devoted to the advancement of innovative and adequate approaches to teaching and assessment in ethics education. In response to these shortcomings, drawing from educational traditions that focus on preparatory activities, we work towards a new approach to evaluate teaching methods and assessing the learning in ethics.
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Affiliation(s)
- Felix Gille
- Health Ethics and Policy Lab, Department of
Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
- Felix Gille, Health Ethics and Policy Lab,
Department of Health Sciences and Technology, ETH Zürich, Hottingerstrasse 10, 8092
Zürich, Switzerland.
| | - Aline Nardo
- Department of Humanities, Social and Political
Sciences, ETH Zürich, Zürich, Switzerland
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Stephens GC, Rees CE, Lazarus MD. How does Donor Dissection Influence Medical Students' Perceptions of Ethics? A Cross-Sectional and Longitudinal Qualitative Study. ANATOMICAL SCIENCES EDUCATION 2019; 12:332-348. [PMID: 30903742 DOI: 10.1002/ase.1877] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/07/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
The contribution of donor dissection to modern anatomy pedagogy remains debated. While short-term anatomy knowledge gains from dissection are questionable, studies suggest that donor dissection may have other impacts on students including influencing medical students' professional development, though evidence for such is limited. To improve the understanding of how anatomy education influences medical student professional development, the cross-sectional and longitudinal impacts of donor dissection on medical students' perceptions of ethics were explored. A cross-sectional and longitudinal qualitative study was undertaken at an Australian university where student responses to online discussion forums and in-person interviews were analyzed. Data were collected across the 1.5 years that undergraduate medical students received anatomy instruction (three semesters during first and second years). A total of 207 students participated in the online discussion forums, yielding 51,024 words; 24 students participated in at least 1 of 11 interviews, yielding over 11 hours of interview data. Framework analysis identified five themes related to ethics in an anatomical education context: (1) Dignity, (2) Beneficence, (3) Consent, (4) Justification for versus the necessity of dissection, and (5) Dichotomy of objectification and personification. The dominant themes of students' ethical perceptions changed with time, with a shift from focusing on donors as people, toward the utility of donors in anatomy education. Additionally, themes varied by student demographics including gender, ancestry, and religiosity. Together this study suggests a strong impact of donor dissection on priming students' focus on medical ethics and provides further advocacy for formal and purposeful integration of medical ethics with anatomy education.
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Affiliation(s)
- Georgina C Stephens
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Muramatsu T, Nakamura M, Okada E, Katayama H, Ojima T. The development and validation of the Ethical Sensitivity Questionnaire for Nursing Students. BMC MEDICAL EDUCATION 2019; 19:215. [PMID: 31208409 PMCID: PMC6580574 DOI: 10.1186/s12909-019-1625-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/22/2019] [Indexed: 06/06/2023]
Abstract
BACKGROUND Recent advances in medicine and an increasingly demanding healthcare environment are causing various complicated ethical problems. Nursing students need to prepare to deal with ethical issues in their future roles. Ethical sensitivity is a key aspect of the ethical decision-making process; however, there is no scale to measure nursing students' ethical sensitivity. Therefore, we developed a scale and verified its reliability and validity. METHODS The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) was developed in three phases. First, questionnaire items were formulated after a literature review and interviews with nursing students. Next, its face and content validity were examined by an expert panel and piloted among nursing university graduates. Then, a final draft questionnaire survey was administered to nursing university students from 10 Japanese universities in 2015 and an exploratory factor analysis was performed. Criteria-related relevance was examined to compare established scales (i.e. the Japanese version of the Moral Sensitivity Test (JMST) and the Japanese version of the revised Moral Sensitivity Questionnaire (JMSQ)) using single regression analysis. A second questionnaire survey was conducted in one of the 10 universities to examine reliability. RESULTS Initially, 48 items including ethical conflict in clinical nursing practice were formulated, and 47 items were approved by the expert panel. Five-hundred and twenty-eight nursing students responded to the final draft questionnaire. Participants' mean age was 20.4 (standard deviation = 3.1) years. The questionnaire was reduced to 13 items and three factor structures were determined by exploratory factor analysis: 'respect for individuals', 'distributive justice', and 'maintaining patients' confidentiality'. The Cronbach's alpha values for items in each domain ranged from 0.77-0.81, and the Cronbach's alpha for the entire ESQ-NS was 0.82. The ESQ-NS was significantly associated with specific domains: ‛Judgment of the care conflict' from the JMST and 'Sense of Moral Burden' from the JMSQ. Pearson's correlation coefficient of the ESQ-NS between the first and second survey was 0.42 (p < .01). CONCLUSIONS The EAQ-NS, which was developed to evaluate the ethical susceptibility of nursing students, showed good validity, internal consistency, and reliability. This questionnaire can be used to evaluate nursing students' ethics education by self-evaluation.
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Affiliation(s)
- Taeko Muramatsu
- Department of Fundamental Nursing, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 4313192 Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 4313192 Japan
| | - Eisaku Okada
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 4313192 Japan
| | - Harumi Katayama
- Department of Fundamental Nursing, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 4313192 Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 4313192 Japan
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Ng SL, Crukley J, Kangasjarvi E, Poost-Foroosh L, Aiken S, Phelan SK. Clinician, student and faculty perspectives on the audiology-industry interface: implications for ethics education. Int J Audiol 2019; 58:576-586. [PMID: 31084367 DOI: 10.1080/14992027.2019.1602737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Supporting audiologists to work ethically with industry requires theory-building research. This study sought to answer: How do audiologists view their relationship with industry in terms of ethical implications? What do audiologists do when faced with ethical tensions? How do social and systemic structures influence these views and actions? Design: A constructivist grounded theory study was conducted using semi-structured interviews of clinicians, students and faculty. Study sample: A purposive sample of 19 Canadian and American audiologists was recruited with representation across clinical, academic, educational and industry work settings. Theoretical sampling of grey literature occurred alongside audiologist sampling. Interpretations were informed by the concepts of ethical tensions as ethical uncertainty, dilemmas and distress. Results: Findings identified the audiology-industry relationship as symbiotic but not wholly positive. A range of responses included denying ethical tensions to avoiding any industry interactions altogether. Several of our participants who had experienced ethical distress quit their jobs to resolve the distress. Systemic influences included the economy, professional autonomy and the hidden curriculum. Conclusions: In direct response to our findings, the authors suggest a move to include virtues-based practice, an explicit curriculum for learning ethical industry relations, theoretically-aligned ethics education approaches and systemic and structural change.
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Affiliation(s)
- Stella L Ng
- a Centre for Faculty Development, St. Michael's Hospital, Centre for Ambulatory Care Education, Department of Speech-Language Pathology , University of Toronto , Toronto , Canada
| | - Jeffery Crukley
- b Department of Speech-Language Pathology, University of Toronto, and Department of Psychology , Neuroscience, and Behaviour, McMaster University, Starkey Hearing Technologies , Eden Prairie , Minnesota
| | - Emilia Kangasjarvi
- c Centre for Faculty Development , St. Michael's Hospital , Toronto , Canada
| | | | - Steve Aiken
- e School of Communication Sciences and Disorders, Departments of Surgery, Psychology, and Neuroscience , Dalhousie University , Halifax , Canada
| | - Shanon K Phelan
- f Department of Occupational Therapy, Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Canada
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Aguilera ML, Martínez Siekavizza S, Barchi F. A Practical Approach to Clinical Ethics Education for Undergraduate Medical Students: A Case Study From Guatemala. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519869207. [PMID: 31448334 PMCID: PMC6691661 DOI: 10.1177/2382120519869207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This case study describes a faculty initiative to create a curriculum in applied medical ethics for undergraduate medical students at the Universidad Francisco Marroquin (UFM) in Guatemala City, Guatemala. METHODS The new ethics curriculum (PRACTICE) incorporates ethics short-courses into the university's system of nontraditional, credit-bearing electives offered to students as part of their 6-year undergraduate medical education and complements existing didactic courses in normative ethics. Structured case-based activities allow for flexibility in design and scheduling, do not compete with core requirements of the existing curriculum, and enable students to develop critical reasoning approaches to ethical situations they will encounter in medical practice. Two preliminary workshops provided teaching opportunities for the faculty, stimulated student interest in future ethics courses, and provided an evidence base to guide the development of a formal curriculum. RESULTS The elective currently includes six 2-hour modules, each of which is a stand-alone unit with learning goals and objectives, brief didactic lecture, assigned readings, discussion case, and assessment. To date, more than 110 students have participated in the workshops and courses. Student feedback and evaluations are being used to refine pedagogical approaches and drive future course content. CONCLUSIONS The PRACTICE course format offers a transformative model for ethics education in Guatemala that can be used in medical education throughout the country and region.
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Affiliation(s)
| | | | - Francis Barchi
- Edward J. Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Shaw MK, Rees CE, Andersen NB, Black LF, Monrouxe LV. Professionalism lapses and hierarchies: A qualitative analysis of medical students' narrated acts of resistance. Soc Sci Med 2018; 219:45-53. [DOI: 10.1016/j.socscimed.2018.10.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 10/11/2018] [Accepted: 10/15/2018] [Indexed: 11/26/2022]
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Grace AJ, Kirkpatrick HA. Teaching ethics that honor the patient's and the provider's voice: The role of clinical integrity. Int J Psychiatry Med 2018; 53:445-454. [PMID: 30079812 DOI: 10.1177/0091217418791445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Medical ethics training is as variable as it is widespread. Previous research has indicated that medical learners find systematic approaches to ethical dilemmas to be helpful. This article describes a bioethics educational module. It includes an overview of common bioethical principles and presents a tool for organizing health-care providers' thinking and discussions about challenging ethical dilemmas. We discuss an area of bioethics that is often neglected, clinical integrity, and the role that a health-care provider's clinical integrity plays in ethical decision-making. We provide several hypothetical ethical vignettes for practice and discussion using the clinical integrity tool. The article also describes how this module has been implemented in one medical education setting and provides suggestions for educators.
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Affiliation(s)
- Aaron J Grace
- 1 Waukesha Family Medicine Residency Program, ProHealth Care, Inc, Waukesha, WI, USA
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Dong H, Sherer R, Lio J, Jiang I, Cooper B. Twelve tips for using clinical cases to teach medical ethics. MEDICAL TEACHER 2018; 40:633-638. [PMID: 29058565 DOI: 10.1080/0142159x.2017.1390218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The essential role of clinical case discussions in the teaching of medical ethics is well recognized. Based upon published literature and the authors' curricular development experience, the following 12 tips cover all major aspects of the case method for teaching clinical ethics and offer practical suggestions for designing and conducting case discussions.
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Affiliation(s)
- Hongmei Dong
- a Department of Medicine , University of Chicago , Chicago , IL , USA
| | - Renslow Sherer
- a Department of Medicine , University of Chicago , Chicago , IL , USA
| | - Jon Lio
- a Department of Medicine , University of Chicago , Chicago , IL , USA
| | - Ivy Jiang
- a Department of Medicine , University of Chicago , Chicago , IL , USA
| | - Brian Cooper
- a Department of Medicine , University of Chicago , Chicago , IL , USA
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Okoye O, Nwachukwu D, Maduka-Okafor FC. Must we remain blind to undergraduate medical ethics education in Africa? A cross-sectional study of Nigerian medical students. BMC Med Ethics 2017; 18:73. [PMID: 29221454 PMCID: PMC5723059 DOI: 10.1186/s12910-017-0229-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 11/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As the practice of medicine inevitably raises both ethical and legal issues, it had been recommended since 1999 that medical ethics and human rights be taught at every medical school. Most Nigerian medical schools still lack a formal undergraduate medical ethics curriculum. Medical education remains largely focused on traditional medical science components, leaving the medical students to develop medical ethical decision-making skills and moral attitudes passively within institutions noted for relatively strong paternalistic traditions. In conducting a needs assessment for developing a curriculum germane to the Nigerian society, and by extension most of Sub-Saharan Africa, this study determined the views of Nigerian medical students on medical ethics education, ethical issues related to the doctor-patient relationship and the ethical/professional dilemmas they are confronted with. METHODS Using self-administered 63-item structured questionnaires, a cross-sectional survey of the final year medical students of the University of Nigeria was conducted in July 2015.Using the Statistical Package for the Social Sciences software (SPSS Version 17), frequency counts and percentages were generated. RESULTS The sample included 100 males (71.4%) and 40 females (28.6%), with the respective mean (SD) age being 24.6(5.61) and 21.8 (6.38) years. Only 35.7% were satisfied with their medical ethics knowledge, and 97.9% indicated that medical ethics should be taught formally. Only 8.6% had never witnessed a medical teacher act unethically. The dilemmas of poor communication between physicians and patients, and the provision of sub-standard care were reported highest for being encountered 'often'. A majority (60.7%) indicated that "a doctor should do his best always, irrespective of the patient's wishes". No significant difference in responses across gender was noted. CONCLUSION There is a strong desire by the contemporary Nigerian medical student for medical ethics education. Their lack of exposure in medical ethics in an ethically challenging environment suggest a dire need for the development of an appropriate medical ethics curriculum for them and the provision of an ethically conducive learning environment.
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Affiliation(s)
- Onochie Okoye
- Department of Ophthalmology, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Enugu State, Nigeria.
| | - Daniel Nwachukwu
- Department of Physiology, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Ferdinand C Maduka-Okafor
- Department of Ophthalmology, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Enugu State, Nigeria
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Khan R, Hodges B, Martimianakis MAT, Cole D. Twelve tips for undertaking reflexive global health experiences in medicine. MEDICAL TEACHER 2017; 39:1023-1028. [PMID: 28598707 DOI: 10.1080/0142159x.2017.1333589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND While interest and opportunities for global health experiences (GHE) continue to grow, the preparation of students and health professionals alike to engage in these GHEs remains limited. AIMS This article provides tips for reflexivity prior to undertaking a GHE and suggests ways to debrief the experience in order to ensure that trainees and professionals that engage in GHEs can both help their intended communities and also get the most out of the experience. METHODS The authors conducted a scoping review using Medline, PubMed and Google scholar using searching the terms: global health, global health experience, global health research, and international medical elective. We supplemented this search with our own experiences working with international partners. CONCLUSIONS GHEs should be undertaken with reflexivity prior to, during and subsequent to the experience in order to ensure that all collaborators in the partnership meet their intended goals.
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Affiliation(s)
- Rabia Khan
- a The Wilson Center, Faculty of Medicine, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - Brian Hodges
- a The Wilson Center, Faculty of Medicine, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | | | - Donald Cole
- a The Wilson Center, Faculty of Medicine, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
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Kong WM, Knight S. Bridging the education-action gap: a near-peer case-based undergraduate ethics teaching programme. JOURNAL OF MEDICAL ETHICS 2017; 43:692-696. [PMID: 28143942 DOI: 10.1136/medethics-2016-103762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 12/14/2016] [Accepted: 01/10/2017] [Indexed: 05/17/2023]
Abstract
Undergraduate ethics teaching has made significant progress in the past decade, with evidence showing that students and trainee doctors feel more confident in identifying and analysing ethical issues. There is general consensus that ethics education should enable students and doctors to take ethically appropriate actions, and nurture moral integrity. However, the literature reports that doctors continue to find it difficult to take action when faced with perceived unethical behaviour. This has been evident in recent healthcare scandals, in which care has fallen below acceptable ethical standards, despite the presence of professional ethical guidelines and competencies. The National Foundation Training Programme forms the first 2 years of training for new UK doctors. We designed a Foundation Doctor (FD)-led teaching programme in which medical students were invited to bring cases and experiences from clinical placements for small group discussion facilitated by FDs. The aim was to enable students to act ethically in practice through developing moral sensitivity and moral identity, together with skills in ethical reasoning and tools to address barriers to taking ethical action. FDs were chosen as facilitators, based on the evidence that near-peer is an effective form of teaching in medicine and may provide positive role models for students. This article reviews the background rationale for the programme and its design. Important themes emerging from the case discussions are explored. Student and FD facilitator feedbacks are evaluated, and practical challenges to the implementation of this type of programme are discussed.
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Affiliation(s)
- Wing May Kong
- Imperial College London and Central Middlesex Hospital LNWH NHS Trust, London, UK
| | - Selena Knight
- Department of Primary Care and Public Health Sciences, King's College London and Chelsea and Westminster NHS Foundation Trust, London, UK
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Physicians' Practice of Dispensing Medicines: A Qualitative Study. J Patient Saf 2017; 12:82-8. [PMID: 25136851 DOI: 10.1097/pts.0000000000000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The physical act of giving medication to patients to administer away from a health care setting, dispensing, is normally performed by pharmacists. Dispensing of medication by physicians is a neglected patient safety issue, and having observed considerable variation in practice, the lead author sought to explore this issue further. A literature review yielded zero articles pertaining to this, so an exploratory study was commenced. The qualitative arm, relating to junior physicians' experience of, and training in, dispensing, is reported here. METHODS Focus groups were conducted to explore the beliefs, ideas, and experiences of physicians-in-training pertaining to dispensing of medication. These were recorded and transcribed. The transcriptions were thematically analyzed using the grounded theory. RESULTS The emergency department was the most common site of dispensing. No formal training in dispensing had been received. Informal training was variable in content and utility. The physicians felt that dispensing was part of their role. CONCLUSIONS Despite being expected to dispense, and the patient safety issues involved in giving drugs to patients to use at home, physicians do not feel that they have been trained to undertake this task. These findings from 1 hospital raise questions about the wider quality and safety of this practice.
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D S, Vaz M, Vaz M. "Thinking ethics": a novel, pilot, proof-of-concept program of integrating ethics into the Physiology curriculum in South India. ADVANCES IN PHYSIOLOGY EDUCATION 2017; 41:306-311. [PMID: 28526695 DOI: 10.1152/advan.00183.2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 03/01/2017] [Accepted: 03/23/2017] [Indexed: 06/07/2023]
Abstract
Integrating medical ethics into the physiology teaching-learning program has been largely unexplored in India. The objective of this exercise was to introduce an interactive and integrated ethics program into the Physiology course of first-year medical students and to evaluate their perceptions. Sixty medical students (30 men, 30 women) underwent 11 sessions over a 7-mo period. Two of the Physiology faculty conducted these sessions (20-30 min each) during the routine physiology (theory/practicals) classes that were of shorter duration and could, therefore, accommodate the discussion of related ethical issues. This exercise was in addition to the separate ethics classes conducted by the Medical Ethics department. The sessions were open ended, student centered, and designed to stimulate critical thinking. The students' perceptions were obtained through a semistructured questionnaire and focused group discussions. The students found the program unique, thought provoking, fully integrated, and relevant. It seldom interfered with the physiology teaching. They felt that the program sensitized them about ethical issues and prepared them for their clinical years, to be "ethical doctors." Neutral observers who evaluated each session felt that the integrated program was relevant to the preclinical year and that the program was appropriate in its content, delivery, and student involvement. An ethics course taught in integration with Physiology curriculum was found to be beneficial, feasible, and compatible with Physiology by students as well as neutral observers.
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Affiliation(s)
- Savitha D
- Department of Physiology, St. Johns Medical College, Bangalore, Karnataka, India; and
| | - Manjulika Vaz
- Health & Humanities Division, St. John's Research Institute, Bangalore, Karnataka, India
| | - Mario Vaz
- Department of Physiology, St. Johns Medical College, Bangalore, Karnataka, India; and
- Health & Humanities Division, St. John's Research Institute, Bangalore, Karnataka, India
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Volpe RL, Hopkins M, DuBois JM. Mapping the Terrain of Ethics Education for Physician Assistants: A Delphi Consensus Panel Report. J Physician Assist Educ 2016; 27:196-199. [PMID: 27820790 DOI: 10.1097/jpa.0000000000000092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Rebecca L Volpe
- Rebecca L. Volpe, PhD, is an assistant professor and vice chair for education in the Department of Humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. Margaret Hopkins, MA, MEd, is research manager in the Department of Humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. James M. DuBois, DSc, PhD, is a professor in the Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri
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Abstract
The post-Soviet scene in Lithuania is one of rapid change in medical and nursing ethics. A short introduction to the current background sets the scene for a wider discussion of ethics in health care professionals' education. Lithuania had to adapt rapidly from a politicized nursing and ethics curriculum to European regulations, and from a paternalistic style of care to one of engagement with choices and dilemmas. The relationships between professionals, and between professionals and patients, are affected by this in particular. This short article highlights these issues and how they impact on all involved.
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Abstract
This descriptive study investigated the current status of ethics instruction in Turkish nursing education programs. The sample for this study comprised 39 nursing schools, which represented 51% of all nursing schools in Turkey. Data were collected through a postal questionnaire. The results revealed that 18 of these nursing schools incorporated an ethics course into undergraduate and three into graduate level programs. Most of the educators focused on the basic concepts of ethics, deontological theory, ethical principles, ethical problems in health care, patient rights and codes of ethics for nurses. More than half of the educators believed that students' theoretical knowledge of ethics is applied to their clinical experiences. The teaching methods used included discussion in class, lectures, case studies, small group discussion, dramatization and demonstration. Assessment was carried out by means of written essays and written examinations.
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Ghias K, Khan KS, Ali R, Azfar S, Ahmed R. Stretching the boundaries of medical education A case of medical college embracing humanities and social sciences in medical education. Pak J Med Sci 2016; 32:911-6. [PMID: 27648038 PMCID: PMC5017101 DOI: 10.12669/pjms.324.10237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/21/2016] [Accepted: 06/25/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Aga Khan University, a private medical college, had a vision of producing physicians who are not only scientifically competent, but also socially sensitive, the latter by exposure of medical students to a broad-based curriculum. The objective of this study was to identify the genesis of broad-based education and its integration into the undergraduate medical education program as the Humanities and Social Sciences (HASS) course. METHODS A qualitative methodology was used for this study. Sources of data included document review and in-depth key informant interviews. Nvivo software was utilized to extract themes. RESULTS The study revealed the process of operationalization of the institutional vision to produce competent and culturally sensitive physicians. The delay in the establishment of the Faculty of Arts and Sciences, which was expected to take a lead role in the delivery of a broad-based education, led to the development of an innovative HASS course in the medical curriculum. The study also identified availability of faculty and resistance from students as challenges faced in the implementation and evolution of HASS. CONCLUSIONS The description of the journey and viability of integration of HASS into the medical curriculum offers a model to medical colleges seeking ways to produce socially sensitive physicians.
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Affiliation(s)
- Kulsoom Ghias
- Kulsoom Ghias, PhD. Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Kausar S Khan
- Kausar S Khan, MA. Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Rukhsana Ali
- Rukhsana Ali, MA. Curriculum Office, Aga Khan University, Karachi, Pakistan
| | - Shireen Azfar
- Shireen Azfar, MA. Office of the President, Aga Khan University, Karachi, Pakistan
| | - Rashida Ahmed
- Rashida Ahmed, MBBS, FCPS, MHPE. Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
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Ekberg ME. Exploring the Design, Delivery and Content of a ‘Bioethics for the Biosciences’ Module: An Empirical Study. JOURNAL OF ACADEMIC ETHICS 2016. [DOI: 10.1007/s10805-015-9246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Barnie BA, Forson PK, Opare-Addo MNA, Appiah-Poku J, Rhule GP, Oduro G, Adu-Sarkodie Y, Donkor P. Knowledge and Perceptions of Health Workers' Training on Ethics, Confidentiality and Medico-Legal Issues. JOURNAL OF CLINICAL RESEARCH & BIOETHICS 2016; 6. [PMID: 26998404 PMCID: PMC4795178 DOI: 10.4172/2155-9627.1000205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Introduction Health care delivery in recent times has become more complicated, as patients expect health personnel to not only provide professional services but be accountable as well. It is thus imperative that health personnel are aware of their responsibility to the patient and also sensitive to medico legal issues if quality health care is to be assured. Objective The aim of the study was to assess the knowledge and perception of health care workers on their training in ethics, confidentiality and medico-legal issues. It was expected that the results would inform policy on the training of the health workers. Method A cross-sectional survey was conducted among some categories of health workers (Doctors, Nurses and Health care assistants) at the Accident and Emergency directorate of Komfo Anokye Teaching Hospital, Ghana. A self-administered questionnaire was used to elicit information on ethics, confidentiality and medico- legal issues. Data collected was analyzed using SPSS version 16. Results A total of 103 health care workers were enrolled on the study representing 96% response rate. The study revealed that 74% had knowledge on ethics, confidentiality and medico- legal concepts; and 35.4% of the respondents indicated that health workers attitudes to ethics, confidentiality and medico- legal concepts was inadequate. About 28.3% indicated that their attitudes were good while 26.3% indicated attitudes were adequate with only 2% indicating that attitudes were very good. Nearly, 49% of the respondents also indicated that training on medico-legal issues should be taught during formal training and also on-the-job. Conclusion Knowledge of health workers on ethics confidentiality and medico-legal issues is high and their perceptions are positive. However, regular training to update their knowledge will be necessary in order to ensure continuous improvement of the quality of health care delivery.
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Affiliation(s)
| | | | | | - John Appiah-Poku
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - George Oduro
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yaw Adu-Sarkodie
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Donkor
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Margetts JK. Learning the law: practical proposals for UK medical education. JOURNAL OF MEDICAL ETHICS 2016; 42:138-140. [PMID: 23161613 DOI: 10.1136/medethics-2012-101013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 09/21/2012] [Indexed: 06/01/2023]
Abstract
Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested.
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Affiliation(s)
- J K Margetts
- Centre for Medical Education Research, Durham University, Durham, UK
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Abstract
Although ethics is an essential component of undergraduate medical education, research suggests that current medical ethics curricula face considerable challenges in improving students' ethical reasoning. This article discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised: the Medical Ethics Bowl (MEB). Finally, we suggest the pedagogical advantages of the MEB when compared to other ethics curricula.
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