Integrating Second-Year Medical Students and First-Year Physician Assistant Students Into a 12-Week Ethics Course

Volpe, Rebecca L.; Bruce, Christine; Green, Michael J.

doi:10.1097/jpa.0000000000000175

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Relying on the team's expertise in library sciences, medical humanities education, and health services and educational research, we conducted a scoping review and qualitative metasynthesis. The purpose of a scoping review is to examine the extent, range and nature of research activity; such reviews can be especially helpful in complex areas of inquiry that have not previously been mapped .…”

Section: Methodsmentioning

confidence: 99%

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

et al. 2019

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OBJECTIVE Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.METHODS The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology. For the scoping review, four databases were searched using a combination of keywords to identify empiric studies on PIF in trainees. After a two-step screening process, thematic analysis was used to conduct the metasynthesis on screened articles. RESULTSA total of 7451 titles and abstracts were screened; 92 studies were included in the scoping review. Saturation was reached in the qualitative metasynthesis after reviewing 29 articles.CONCLUSION The metasynthesis revealed three inter-related PIF themes across the helping professions: the importance of clinical experience, the role of trainees' expectations of what a helping professional is or should be, and the impact of broader professional culture and systems on PIF. Upon reflection, most striking was that only 10 of the 92 articles examined trainee's sociocultural data, such as race, ethnicity, gender, sexual orientation, age and socioeconomic status, in a robust way and included them in their analysis and interpretation. This raises the question of whether conceptions of PIF suffer from sociocultural bias, thereby disadvantaging trainees from diverse populations and preserving the status quo of an historically white, male medical culture.Professional identity formation (PIF) in medicine focuses attention on the career-long process of becoming a clinician. 1,2 PIF can be thought of as a double helix: the individual and the profession form parallel strands that become intertwined. Each strand must bend in order to accommodate the other; however, this burden of bending and changing to accommodate seems to fall more acutely on the individual strand, with the profession's strand remaining more fixed. PIF frequently involves experimentation, change and uncertainty, and ideally results in the successful reconciliation of conflicting ideals, values and roles. Although successful formation of a professional identity has been linked to career success 3 and creativity at work, 4 a mismatch between an individual's internal bearings and the roles and expectations of the profession can create anxiety, frustration and feelings of inadequacy, and can result in the individual leaving the profession. 5 The role of culture, race, socioeconomic status and gender might be expected to be critical components of the individual strand, and could prove to be important confounders in the study of this complex process.We set out to gain an understanding of the current state of the PIF literature in medicine by conducting a scoping review and metasynthesis of the literature across three of the helping professions (medicine, nursing and counselling/ p...

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Section: Methodsmentioning

confidence: 99%

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

et al. 2019

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“…Maintaining dedicated time and space for group discussion allows students to self-direct their learning and self-reflect on patient care encounters with an ethical dimension that brings about emotional responses of worry, anxiety, doubt, anger, and uncertainty. With mounting attention highlighting the benefits of interprofessional education (IPE), 19 , 20 our vision is to incorporate nursing, dental, and allied health students in group discussion and reflection, which will positively impact trainees’ opportunities to learn respectful consideration of the perspective from their multidisciplinary peers as well as promote group collaboration and communication. Future areas of research focus for the informal medical ethics training include improved outcome analysis for content acquisition, formal assessment, and positive physician attributes.…”

Section: Future Directionmentioning

confidence: 99%

A Novel Peer-Directed Curriculum to Enhance Medical Ethics Training for Medical Students: A Single-Institution Experience

Sullivan

DeFoor

Hwang

et al. 2020

Journal of Medical Education and Curricular Development

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Background: The best pedagogical approach to teaching medical ethics is unknown and widely variable across medical school curricula in the United States. Active learning, reflective practice, informal discourse, and peer-led teaching methods have been widely supported as recent advances in medical education. Using a bottom-up teaching approach builds on medical trainees’ own moral thinking and emotion to promote awareness and shared decision-making in navigating everyday ethical considerations confronted in the clinical setting. Objective: Our study objective was to outline our methodology of grassroots efforts in developing an innovative, student-derived longitudinal program to enhance teaching in medical ethics for interested medical students. Methods: Through the development of a 4-year interactive medical ethics curriculum, interested medical students were provided the opportunity to enhance their own moral and ethical identities in the clinical setting through a peer-derived longitudinal curriculum including the following components: lunch-and-learn didactic sessions, peer-facilitated ethics presentations, faculty-student mentorship sessions, student ethics committee discussions, hospital ethics committee and pastoral care shadowing, and an ethics capstone scholarly project. The curriculum places emphasis on small group narrative discussion and collaboration with peers and faculty mentors about ethical considerations in everyday clinical decision-making and provides an intellectual space to self-reflect, explore moral and professional values, and mature one’s own professional communication skills. Results: The Leadership through Ethics (LTE) program is now in its fourth year with 14 faculty-clinician ethics facilitators and 65 active student participants on track for a distinction in medical ethics upon graduation. Early student narrative feedback showed recurrent themes on positive curricular components including (1) clinician mentorship is key, (2) peer discussion and reflection relatable to the wards is effective, and (3) hands-on and interactive clinical training adds value. As a result of the peer-driven initiative, the program has been awarded recognition as a graduate-level certification for sustainable expansion of the grassroots curriculum for trainees in the clinical setting. Conclusions: Grassroots medical ethics education emphasizes experiential learning and peer-to-peer informal discourse of everyday ethical considerations in the health care setting. Student engagement in curricular development, reflective practice in clinical settings, and peer-assisted learning are strategies to enhance clinical ethics education. The Leadership through Ethics program augments and has the potential to transform traditional teaching methodology in bioethics education for motivated students by offering protected small group discussion time, a safe environment, and guidance from ethics facilitators to reflect on shared experiences in clinical ethics and to gain more robust, hands-on ethics training in the clinical setting.

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Integrating Second-Year Medical Students and First-Year Physician Assistant Students Into a 12-Week Ethics Course

Cited by 2 publications

References 12 publications

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

A Novel Peer-Directed Curriculum to Enhance Medical Ethics Training for Medical Students: A Single-Institution Experience

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