Objective-Ethics training has become a core component of medical student and resident education. Curricula have been developed without the benefit of data regarding the views of physicians-intraining on the need for ethics instruction that focuses on practical issues and professional development topics.Methods-A written survey was sent to all medical students and PGY1-3 residents at the University of New Mexico School of Medicine. The survey consisted of eight demographic questions and 124 content questions in 10 domains. Responses to a set of 24 items related to ethically important dilemmas, which may occur in the training period and subsequent professional practice, are reported. Items were each rated on a 9-point scale addressing the level of educational attention needed compared to the amount currently provided.Results-Survey respondents included 200 medical students (65% response) and 136 residents (58% response). Trainees, regardless of level of training or clinical discipline, perceived a need for more academic attention directed at practical ethical and professional dilemmas present during training and the practice of medicine. Women expressed a desire for more education directed at both training-based and practice-based ethical dilemmas when compared to men. A simple progression of interest in ethics topics related to level of medical training was not found. Residents in diverse clinical specialties differed in, perceived ethics educational needs. Psychiatry residents reported a need for enhanced education directed toward training stage ethics problems.Address correspondence to Dr. Roberts, Professor and Chair, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226; RoberteL@mcw.edu (E-mail).. Editor-in-Chief of Academic Psychiatry.Manuscripts authored by an Editor of Academic Psychiatry or a member of its Editorial Board undergo the same editorial review process, including blinded, peer review, applied to all manuscripts. Additionally, the Editor is recused from any editorial decision making.The authors wish to acknowledge the recent passing of Dr. W. Sterling Edwards. Conclusions-This study documents the importance placed on ethics education directed at practical real-world dilemmas and ethically important professional developmental issues by physicians-in-training. Academic medicine may be better able to fulfill its responsibilities in teaching ethics and professionalism and in serving its trainees by paying greater attention to these topics in undergraduate and graduate medical curricula.
NIH Public AccessHow does one become a good doctor? Mastery of knowledge and acquisition of technical skill are the principal emphases of formal medical training, but it is clear that these achievements, while necessary, are not sufficient (1,2). It is the ability to make and enact sound decisions with professionalism that defines the truly good doctor (3,4). Preparing physicians-in-training to become independent decision makers dedicate...
This survey identified areas of strength (positive attitudes about providing genetic services, belief in the heritability of mental illness) and future targets for educational intervention (general genetics, information about testing and counseling resources). The association between recent training and a greater level of clinical genetics experience suggests that educational efforts may be successful in preparing psychiatrists to provide genetic services in the future.
This probability sample of U.S. psychiatrists expressed a strongly positive view of genetic testing in psychiatry, while voicing nearly unanimous support for seven ethical and legal safeguards.
Residents at times postpone or avoid seeking care. Time and scheduling difficulties influence the ability to obtain care. Perceptions of potential academic jeopardy, stigma, and reactions of colleagues may affect residents' attitudes and care-seeking. Further inquiry is essential to understand how extensively these factors may influence the well-being of residents.
Residents' perceived stigma for clinical situations was an influential factor, strongly affecting concern about jeopardizing training status and likelihood of avoiding care at their home institution.
Objective-Physicians-in-training today are learning in an ethical environment that is unprecedented in its complexity. There is a call for new approaches in preparing medical students and residents for the ethical and professional issues they will encounter. The perspectives of physicians-in-training at different levels regarding the level of curricular attention needed for emerging bioethics concepts, practical informed consent considerations, and the care of special populations are unknown.Method-The authors performed a hypothesis-driven, confidential survey study to assess perceived needs and preferences among medical students and residents related to medical ethics education at the University of New Mexico School of Medicine.Results-A total of 336 physicians-in-training volunteered (62% response rate). Overall, strong interest was expressed for increased curricular attention to the domains of bioethics principles, informed consent, and care of special populations. Women students expressed greater interest generally. For certain domains, clinical students expressed relatively less curricular need and psychiatry and primary care residents expressed relatively greater curricular need. Two of the four hypotheses were supported, a third received partial support, and a fourth was not supported by the findings.Discussion-To be valuable and effective, new ethics curricular approaches must be responsive to the current complex ethical environment and attentive to the preferences of medical students and residents of both genders, at different stages of training, with different patient care responsibilities. This hypothesis-driven study provides guidance for the inclusion of novel and important ethics domains in training curricula across medical school and diverse residency programs.There have been significant changes in the health care system since bioethics education first became an essential part of medical school curricula in the 1980s. 1 The extraordinary growth in technology, the dominance of managed care in health delivery systems, the expanding cultural diversity of the American population, and changing commitment to the care of underserved and uninsured groups by academic medical centers have raised novel ethical
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