Hernández González A, Rodríguez Núñez A, Cambra Lasaosa F J, Quintero Otero S, Ramil Fraga C, García Palacios M V, Hernández Rastrollo R, Ruiz Extremera M A
Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Puerta del Mar, Cádiz, España.
Unidad de Cuidados Intensivos Pediátricos, Hospital Clínico Universitario de Santiago, Santiago de Compostela, España.
An Pediatr (Barc). 2014 Feb;80(2):106-13. doi: 10.1016/j.anpedi.2013.06.002. Epub 2013 Oct 6.
Bioethics has been recently incorporated in to the educational programs of both medical students and medical residents as part of their curriculum. However, its training based on clinical practice is not well structured.
To evaluate the knowledge of bioethics in Spanish paediatric residents, and to analyse how this relates to the medical education during graduate and post-graduate training.
A questionnaire with 20 multiple choice questions was designed to evaluate the knowledge in basic ethics with potential implications in clinical practice. We evaluated the education received during graduate and post-graduate training, and the main ethical conflicts faced.
A total of 210 completed questionnaires were received from medical residents in paediatrics from 20 different Spanish hospitals, of whom 47 of these were first year residents (R1), 49 were second year residents (R2), 57 were third year residents (R3), and the remaining 57 were final year residents (R4). The mean number of correct answers was 16.8 out of 20. No differences were found between residents in different years of training, nor were there any differences between the group that had received specific training in bioethics versus those who had not. Residents were more likely to give wrong answers related with informed consent, the law on the freedom of the patient, principles of quality of life, the case analysis system, and the dimension of distributive justice.
Limitation of therapeutic efforts was identified as the main ethical problem faced in clinical practice by Spanish residents in paediatrics. Most of the knowledge of bioethics is acquired during graduate training, and improved very little throughout the period of medical residence. Our results suggest that efforts are required in organising and structuring the education in bioethics during the training of residents in paediatrics.
生物伦理学最近已被纳入医学生和住院医师的教育计划,作为其课程的一部分。然而,基于临床实践的生物伦理学培训结构并不完善。
评估西班牙儿科住院医师的生物伦理学知识,并分析其与本科及研究生培训期间医学教育的关系。
设计了一份包含20道选择题的问卷,以评估在临床实践中可能产生影响的基础伦理学知识。我们评估了本科及研究生培训期间接受的教育,以及面临的主要伦理冲突。
共收到来自西班牙20家不同医院的儿科住院医师填写的210份问卷,其中47人为一年级住院医师(R1),49人为二年级住院医师(R2),57人为三年级住院医师(R3),其余57人为四年级住院医师(R4)。平均正确答案数为20题中的16.8题。不同培训年份的住院医师之间未发现差异,接受过生物伦理学专门培训的组与未接受过培训的组之间也没有差异。住院医师在知情同意、患者自由法、生活质量原则、案例分析系统和分配正义维度方面更容易给出错误答案。
西班牙儿科住院医师认为临床实践中面临的主要伦理问题是治疗努力的局限性。生物伦理学的大部分知识是在本科培训期间获得的,在整个住院医师培训期间进步甚微。我们的结果表明,在儿科住院医师培训期间,需要努力组织和构建生物伦理学教育。