Systematic Development and Refinement of a Contextually Relevant Strategy for Undergraduate Medical Ethics Education: a qualitative study

Abstract

Background Delivery of medical ethics education is complex due to various reasons, compounded by the context-dependent nature of the content. The scarcity of relevant resources in the contexts of some developing countries adds a further layer of difficulty to ethics education in these contexts. We used a consultative approach with students, teachers and external experts to develop a practical approach to medical ethics education. This study aimed to develop and refine a contextually relevant approach to ethics education in the region of Saudi Arabia.Methods The study utilised an explorative qualitative methodology to seek views of students and faculty of Rabigh Faculty of Medicine, Saudi Arabia, and international experts in the field of ethics and education to review and enhance a new ethics learning strategy which included a workbook-based tool. Three focus groups with 12 students, in-depth interviews with four faculty members and qualitative feedback from eleven external experts enabled the study participants to objectively critique the WBEL and provide feedback to enhance its quality. Thematic content analysis of the data was done to draw inferences which were used to refine the educational strategy. Results The analysis generated twenty-one sub-themes within four main themes: design features, content, teaching methods and assessment. These findings helped to design the educational strategy to improve its effectiveness in the given context.Conclusion The study drew on the views of students, faculty and external experts to systematically develop a novel approach to ethics education for countries like Saudi Arabia. It also demonstrated the use of the consultative approach for informing a culturally relevant educational strategy in the Middle East context.

Impact of a Novel Approach for Undergraduate Medical Ethics Education in The Middle East and South Asia

“…This study shows that the WBEL strategy is an enabler for the delivery of ethics education, and helps overcome the above resource constraints by creating appropriate content and methods through a robust consultative process [17]. The inclusion of focussed reading material and social interaction with peers and faculty in the WBEL model explicitly compensates for the lack of learning resources relevant to the regions [52,53].…”

“…The re ection and feedback process also supports the students in assessing their learning by articulating how they have approached the given task using their previous knowledge and understanding of the new information [54]. The iterative re nement of this strategy with input from external experts, local faculty, and students (Shamim et al, 2021) is likely to enhance the strategy's effectiveness.…”

“…The ethics course designed using the WBEL strategy and spanning over 30 contact hours [25], structured using the WBEL strategy, was delivered in undergraduate medical programs at the two sites. This strategy used a workbook speci cally designed through a robust consultative process [17] to enhance the delivery of the ethics content. The Workbook was designed as a complete resource to address the constraints introduced above.…”

“…An innovative educational strategy, named workbook-based ethics learning (WBEL), was developed using a robust consultative process undertaken in a prior study [17]. This innovative strategy is grounded in the principles of cognitive load theory and contextually relevant ethics education model (CREEM, Fig.…”

“…The model is considered useful to scaffold the process of ethics education to provide culturally relevant learning experiences, safe and respectful environments for ethical discourse and opportunities for re ection and feedback [18]. The development and re nement of the WBEL through the consultative process [17] ensured that the strategy has the characteristics required for the effective delivery of ethics education. With these characteristics, the WBEL strategy has the potential to 1) be modi ed to suit the contextually relevant needs of the society where it is being implemented, 2) address the resource constraints to medical ethics education by providing contextual reading material and guidance to the teachers on effective delivery of ethics education, and 3) provide engaging exercises for social-learning activities, and structure for re ection and feedback, while ensuring that the cognitive load remains appropriate.…”