Prepared for practice? UK Foundation doctors’ confidence in dealing with ethical issues in the workplace

Abstract

This paper investigates the medical law and ethics (MEL) learning needs of Foundation doctors (FYs) by means of a national survey developed in association with key stakeholders including the General Medical Council and Health Education England. Four hundred sevnty-nine doctors completed the survey. The average self-reported level of preparation in MEL was 63%. When asked to rate how confident they felt in approaching three cases of increasing ethical complexity, more FYs were fully confident in the more complex cases than in the more standard case. There was no apparent relationship with confidence and reported teaching at medical school. The less confident doctors were no more likely to ask for further teaching on the topic than the confident doctors. This suggests that FYs can be vulnerable when facing ethical decisions by being underprepared, not recognising their lack of ability to make a reasoned decision or by being overconfident. Educators need to be aware of this and provide practical MEL training based on trainee experiences and real-world ethics and challenge learners’ views. Given the complexities of many ethical decisions, preparedness should not be seen as the ability to make a difficult decision but rather a recognition that such cases are difficult, that doubt is permissible and the solution may well be beyond the relatively inexperienced doctor. Educators and supervisors should therefore be ensuring that this is clear to their trainees. This necessitates an environment in which questions can be asked and uncertainty raised with the expectation of a supportive response.

Medical students and COVID-19: the need for pandemic preparedness

“…In such unprecedented times, it is unreasonable to assume that medical students-with no training or experience-would be equipped to handle such responsibility. 47 Mitigating the effects of such distress is vital for the prevention of adverse mental health outcomes. Therefore, appropriate pandemic preparedness should be structured as such.…”

Exploring UK foundation doctors’ perceptions surrounding raising concerns in the workplace

“…However, simply providing further teaching is insufficient in tackling the challenges identified in our study. On the contrary, we have previously identified that FDs' confidence for dealing with ethical issues in the workplace was unrelated to their ethics teaching received at medical school (Corfield et al 2020). Furthermore, it has been argued that teaching about whistleblowing without providing the supportive work environment for it to occur in can negatively impact FDs by causing moral distress (Martinez et al 2017).…”