Teaching clinical ethics as a professional skill: bridging the gap between knowledge about ethics and its use in clinical practice.

Myser, Catherine; Kerridge, Ian; Mitchell, Kenneth R.

doi:10.1136/jme.21.2.97

Cited by 33 publications

(21 citation statements)

References 21 publications

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“…Teaching MEL by facilitating its application in clinical practice is not new and is advocated by educational principles15 and previous work 7 8 16. Currently it is unclear whether all aspects of ethics and law teaching are successful in becoming applied.…”

Section: Discussionmentioning

confidence: 99%

FY1 doctors’ ethicolegal challenges in their first year of clinical practice: an interview study

Vivekananda-Schmidt

Vernon

2013

J Med Ethics

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The data provide a snapshot of the real challenges faced by MEL FY1 doctors in early clinical practice: they may feel ill-prepared and sometimes unsupported by senior members of the team. The key themes suggest areas for development of undergraduate and postgraduate MEL curricula. We will work to develop our own curriculum accordingly. We intend to further investigate the applicability of our findings to UK medical ethics and law curriculum.

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Section: Discussionmentioning

confidence: 99%

FY1 doctors’ ethicolegal challenges in their first year of clinical practice: an interview study

Vivekananda-Schmidt

Vernon

2013

J Med Ethics

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“…Although ethics has been a part of most medical school curricula for some years, it does not always explicitly include these kinds of skills. [27][28][29][30] Conflict prevention and resolution are usually completely absent from both clinical training and medical ethics curricula. Interpersonal skills such as interviewing are taught, but the focus is usually on obtaining and providing information, not negotiation or conflict prevention.…”

Section: Discussionmentioning

confidence: 99%

How physicians face ethical difficulties: a qualitative analysis

Hurst

Hull²,

DuVal³

et al. 2005

J Med Ethics

125

117

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Background: Physicians face ethical difficulties daily, yet they seek ethics consultation infrequently. To date, no systematic data have been collected on the strategies they use to resolve such difficulties when they do so without the help of ethics consultation. Thus, our understanding of ethical decision making in day to day medical practice is poor. We report findings from the qualitative analysis of 310 ethically difficult situations described to us by physicians who encountered them in their practice. When facing such situations, the physicians sought to avoid conflict, obtain assistance, and protect the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These goals could conflict with each other, or with ethical goals, in problematic ways. Being aware of these potentially conflicting goals may help physicians to resolve ethical difficulties more effectively. This awareness should also contribute to informing the practice of ethics consultation. Objective: To identify strategies used by physicians in dealing with ethical difficulties in their practice. Design, setting, and participants: National survey of internists, oncologists, and intensive care specialists by computer assisted telephone interviews (n = 344, response rate = 64%). As part of this survey, we asked physicians to tell us about a recent ethical dilemma they had encountered in their medical practice.Transcripts of their open-ended responses were analysed using coding and analytical elements of the grounded theory approach. Main measurements: Strategies and approaches reported by respondents as part of their account of a recent ethical difficulty they had encountered in their practice. Results: When faced with ethical difficulties, the physicians avoided conflict and looked for assistance, which contributed to protecting, or attempting to protect, the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These efforts sometimes reinforced ethical goals, such as following patients' wishes or their best interests, but they sometimes competed with them. The goals of avoiding conflict, obtaining assistance, and protecting the respondent's integrity and that of the group of decision makers could also compete with each other. Conclusion: In resolving ethical difficulties in medical practice, internists entertained competing goals that they did not always successfully achieve. Additionally, the means employed were not always the most likely to achieve those aims. Understanding these aspects of ethical decision making in medical practice is important both for physicians themselves as they struggle with ethical difficulties and for the ethics consultants who wish to help them in this process.

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“…A crença de que a formação profissional influencia a conduta do médico e a relação que este estabelece com os pacientes justifica uma análise do panorama do ensino da ética médica e da bioética [11][12][13] , que tem sofrido grandes transformações nos últimos 30 anos 14 . Somente a partir da década de 1970 as escolas médicas introduziram o ensino da deontologia e diceologia (ética médica) como disciplina autônoma e obrigatória, ainda que ministrada por filosofia moral ou teologia 7,10,15,16 .…”

Section: Introductionunclassified

Conhecimento e interesse em ética médica e bioética na graduação médica

Almeida

Bitencourt

Neves

et al. 2008

Rev. bras. educ. med.

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-Ensino. (4,7 ± 0,7 vs. 4,5 ± 0,8; p = 0,086), enquanto o autoconhecimento sobre o tema foi maior no primeiro grupo (3,4 ± 0,9 vs. 3,2 ± 0,7; p = 0,017 RESUMO Objetivos: Avaliar o interesse e o conhecimento sobre ética médica e bioética na graduação médica. Méto-dos: Estudo transversal e descritivo. Foram utilizados dois questionários auto-aplicáveis, um para docen ABSTRACT Objectives: To evaluate the interest and knowledge about Medical Ethics and Bioethics in medical graduation. Methods: Transversal and descriptive study. Two different questionnaires were applied with questions about the interest in Medical Ethics and Bioethics and the knowledge about the Brazilian Code of MedicalEthics (CME), one to professors and the other to students. Results: One hundred and one professors and 331 students answered the questionnaires. The Brazilian CME had been read by 86.2% of the teachers and by 100% of the students. The importance given to the discipline Medical Ethics, on a scale from 1 to 5, was similar among teachers and students (4.7 ± 0.7 vs. 4.5 ± 0.8; p = 0.086); however the self-evaluation on knowledge about this subject was higher in the first group (3.4 ± 0.9 vs. 3.2 ± 0.7; p = 0.017). In a block with 9 questions, the right answer was given by 5,0 ± 1.9 of teachers and 5.9 ± 1.5 of students (p < 0,001); the mean of correct answers were related to the reading of the CME. Conclusions: The present study presents unpublished data about the perception of medical teachers and students about medical ethics and bioethics and can be useful for improving the teaching of these disciplines in our medical schools.

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Teaching clinical ethics as a professional skill: bridging the gap between knowledge about ethics and its use in clinical practice.

Abstract: Ethical reasoning and decision-making may be thought of as 'professional skills', and in

Cited by 33 publications

References 21 publications

FY1 doctors’ ethicolegal challenges in their first year of clinical practice: an interview study

FY1 doctors’ ethicolegal challenges in their first year of clinical practice: an interview study

How physicians face ethical difficulties: a qualitative analysis

Conhecimento e interesse em ética médica e bioética na graduação médica

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