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教育干预在提高外科伦理学知识和信心方面是有效的——一项前瞻性研究。

Educational intervention is effective in improving knowledge and confidence in surgical ethics-a prospective study.

机构信息

Department of Surgery, University of Pittsburgh, PA, USA.

出版信息

Am J Surg. 2010 Nov;200(5):665-9. doi: 10.1016/j.amjsurg.2010.08.002.

Abstract

BACKGROUND

Professionalism and ethics are Accreditation Council for Graduate Medical Education (ACGME) core competencies, but there is little evidence regarding the effectiveness of ethics education.

METHODS

General surgery residents at the University of Pittsburgh completed questionnaires measuring attitudes and knowledge about surgical ethics before and after four 60-minute, faculty-facilitated seminars implementing the American College of Surgeons ethics curriculum.

RESULTS

Most residents experienced ethical challenges at least once every rotation: competition of interests (75%), professional obligations (75%), confidentiality (83%), truth telling (88%), surrogate decision making (91%), and end-of-life issues (100%). The educational intervention increased both knowledge about surgical ethics (P = .013) and confidence in dealing with competition of interests (P = .001), professional obligations (P = .011), truth telling (P = .013), confidentiality (P = .011), end-of-life issues (P = .007), and surrogate decision making (P = .052). Most residents recommended the American College of Surgeons text for future use (84%), considering ethics education a "standard" part of residency training (70%).

CONCLUSIONS

Focused instruction using the American College of Surgeons ethics curriculum can effectively improve both knowledge and confidence about surgical ethics.

摘要

背景

专业精神和道德规范是毕业后医学教育认证委员会(ACGME)的核心能力,但关于道德教育的有效性的证据很少。

方法

匹兹堡大学的普通外科住院医师在参加了四个由教员主持的、时长为 60 分钟的研讨会之后,完成了测量他们对手术伦理的态度和知识的问卷,这些研讨会实施了美国外科医师学院的伦理课程。

结果

大多数住院医师在每一次轮转中至少经历过一次伦理挑战:利益冲突(75%)、职业义务(75%)、保密性(83%)、说实话(88%)、代理决策(91%)和临终问题(100%)。教育干预提高了对手术伦理的知识(P =.013)和处理利益冲突(P =.001)、职业义务(P =.011)、说实话(P =.013)、保密性(P =.011)、临终问题(P =.007)和代理决策(P =.052)的信心。大多数住院医师推荐使用美国外科医师学院的文本进行未来的学习(84%),并认为伦理教育是住院医师培训的“标准”部分(70%)。

结论

使用美国外科医师学院的伦理学课程进行有针对性的教学可以有效地提高对手术伦理的知识和信心。

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