Teaching clinical medical ethics: a model programme for primary care residency.

Abstract

Few residency training programmes explicitly require substantive exposure to issues in medical ethics and fewer still have a formal curriculum in this area. Traditional undergraduate medical ethics courses teach preclinical students to identify ethical issues and analyse them at a theoretical level. Residency training, however, is the ideal time to establish the critical behavioural link which makes ethics truly useful in clinical medicine. The General Internal Medicine Residency Training Program at Rhode Island Hospital has developed an integrated, three-year curriculum with the goals of helping residents to perceive ethical issues in clinical practice, to utilise basic philosophical principles in resolving ethical dilemmas and to communicate these issues clearly and sensitively to patients. The curriculum has been well received by residents and has had a hospital-wide impact. We believe that training residents in medical ethics and communication skills is an effective approach to developing physicians' humane qualities.

Croatian physicians’ and nurses’ experience with ethical issues in clinical practice

“…Participation in more focused types of training such as medical ethics conferences (17% of physicians, 10% of nurses) or intensive medical ethics courses (4% of physicians, 8% of nurses) are also discouraging. These findings highlight the need for systematic ethics education during residency and for continuing education programs, and are comparable to the findings of DuVal and colleagues on US internists’ experiences with ethical dilemmas,7 especially the need for and usefulness of ethics continuing education while in practice 29 – 31. In addition, lack of time or low motivation may contribute to the low participation in non-obligatory types of ethics education, for both physicians and nurses.…”

Long Hours, Luck, and a Cast of Thousands

“…They got me involved in teaching ethics while I was struggling with what I would do with my life. 7 Their collegiality and enthusiasm was contagious. Indeed, this is my hope for this emerging field.…”

Les séances d’apprentissage du raisonnement éthique appliquées à la formation des résidents en anesthésie-réanimation

“…Plusieurs auteurs ont rapporté la perception et l'impact favorable des méthodes d'apprentissage de l'éthique basée sur l'analyse de cas et sur les discussions avec les pairs. Ces résul-tats ont été retrouvés chez des résidents en médecine 14 , en chirurgie 7 , en obstétrique 6 et en médecine de famille 15 . L'impact positif de ces méthodes d'enseignement sur le raisonnement éthique a aussi été décrit au cours des études prédoctorales 16,17,18 .…”