An Interactive Approach to Teaching the Clinical Applications of Autonomy and Justice in the Context of Discharge Decision-Making

Abstract

Introduction: Students are taught the basics of medical ethics during their pre-clinical education, but need additional instruction on how to apply these principles to patient situations they may encounter during their clinical rotations. The ethical principles of autonomy and justice become especially pertinent to patient care in the setting of discharge decision-making. Third-year medical students would therefore benefit from an interactive educational activity that allows them to practice applying these principles within the context of discharge decision-making. Methods: This session was designed for third-year medical students completing their required rotation in neurology. Students participated in a 1-hour, facilitator-led, interactive, small-group, ethics-based activity meant to simulate the typical 4-day post-stroke hospital stay. Learning objectives for the activity were to enhance students' understanding of the principles of autonomy, justice, competence, and capacity. Students were given pretest to gauge prior knowledge of activity learning objectives; their knowledge was again assessed afterwards, and they were surveyed on the usefulness and value of the activity. Results: Twenty-three third-year medical students completed the activity over three sessions. The average improvement between pre-and posttest score was 40%. Lastly, on the qualitative feedback form, a majority of students strongly agreed that the activity was useful and presented new information, with 18 of 23 students giving the activity the highest possible rating of excellent. Discussion: A large majority of the students found the activity to be valuable, and the activity was shown to be effective at improving students' knowledge of a key aspect of successful medical practice.

Clinicians’ perspectives as medical teachers: A qualitative study

“…The limitation of time is one of the barriers to effective clinical education. To handle this barrier, medical teachers tend to act faster and expect students to have prior knowledge [28]. They expect students to be ready for clinical education, otherwise, they think the effectiveness of clinical education would be limited.…”

Autonomia como princípio da bioética: perspectivas de estudantes de medicina

“…O estudo feito por Palanisamy e Xiong (2020) afirma que os estudantes de medicina não recebem informações suficientes, durante o processo de aprendizagem, sobre a bioética, e dessa forma, o conhecimento se torna defasado. Estudo anterior como de Biondo et al (2018), já descreveu que acadêmicos de cursos da saúde têm bom entendimento sobre autonomia como princípio da bioética e o estudo de Fawzi (2011) afirmou que os estudantes observaram grande relevância e benefícios para sua formação prática quando submetidos a cursos de ética médica, principalmente quando expostos a simulações de situações éticas reais (Palanisamy & Xiong, 2020).…”

Ethics of Pediatric and Young Adult Medical Decision-Making: Case-Based Discussions Exploring Consent, Capacity, and Surrogate Decision-Making

“…Current published curricula on the ethics of medical decision-making and capacity center on older adults as opposed to young adults with cognitive impairment. 16 , 17 The same holds true for content focused on performing informed consent, and therefore, the concept of pediatric assent is not addressed. 18 , 19 In addition, several of these published curricula utilize standardized patient encounters, 15 , 18 , 19 which can be too time intensive or costly to integrate into some residency programs.…”