Learning by doing: effectively incorporating ethics education into residency training.

BACKGROUND

Medical ethics is a critical component of the curriculum for clinical trainees. Educational initiatives should adapt content to participants' experience in order to ensure relevance and retain their interest.

AIM

To develop and evaluate an experiential educational program for physicians.

SETTING

Academic medical center.

PARTICIPANTS

Senior internal medicine residents (n = 40).

PROGRAM DESCRIPTION

A case-based didactic program was designed in which each resident shared a difficult ethics case from their clinical experience. We created a curriculum around these cases involving formal didactics as well as open-ended discussion and summarized the ethical issues most relevant to the participants. A course survey was administered based upon the validated Students' Evaluation of Educational Quality (SEEQ).

PROGRAM EVALUATION

Common issues raised included surrogate decision-making (18 %), refusal of treatment (14 %), capacity/informed consent (10 %), and medical futility (10 %). Mean SEEQ subscale scores for learning value, organization/clarity, group interaction, breadth of coverage, and assignments/readings were 4.5 (maximum possible score 5). Residents unanimously rated the course overall as good/very good, and all agreed or strongly agreed that the course was useful and its structure effective.

DISCUSSION

An experiential case-based didactic program in medical ethics engaged adult learners and facilitated a comprehensive and clinically relevant educational initiative.