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新生儿与围产期医学中的伦理教学:加拿大的情况如何?

Teaching ethics in neonatal and perinatal medicine: What is happening in Canada?

作者信息

Daboval Thierry, Moore Gregory P, Rohde Kristina, Moreau Katherine, Ferretti Emanuela

机构信息

Department of Pediatrics, Division of Neonatology, Children's Hospital of Eastern Ontario; ; Department of Obstetrics and Gynecology, Division of Newborn Care, The Ottawa Hospital - General Campus and University of Ottawa;

Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute;

出版信息

Paediatr Child Health. 2014 Jan;19(1):e6-e10. doi: 10.1093/pch/19.1.e6.

Abstract

Ethically challenging clinical situations are frequently encountered in neonatal and perinatal medicine (NPM), resulting in a complex environment for trainees and a need for ethics training during NPM residency. In the present study, the authors conducted a brief environmental scan to investigate the ethics teaching strategies in Canadian NPM programs. Ten of 13 (77%) accredited Canadian NPM residency programs participated in a survey investigating teaching strategies, content and assessment mechanisms. Although informal ethics teaching was more frequently reported, there was significant variability among programs in terms of content and logistics, with the most common topics being 'The medical decision making process: Ethical considerations' and 'Review of bioethics principles' (88.9% each); lectures by staff or visiting staff was the most commonly reported formal strategy (100%); and evaluation was primarily considered to be part of their overall trainee rotation (89%). This variability indicates the need for agreement and standardization among program directors regarding these aspects, and warrants further investigation.

摘要

在新生儿和围产期医学(NPM)中经常会遇到具有伦理挑战性的临床情况,这给实习生带来了复杂的环境,也使得在NPM住院医师培训期间需要进行伦理培训。在本研究中,作者进行了一次简短的环境审视,以调查加拿大NPM项目中的伦理教学策略。13个经认可的加拿大NPM住院医师培训项目中有10个(77%)参与了一项关于教学策略、内容和评估机制的调查。尽管更多人报告采用了非正式的伦理教学,但各项目在内容和安排方面存在显著差异,最常见的主题是“医疗决策过程:伦理考量”和“生物伦理原则回顾”(各占88.9%);由工作人员或来访人员进行讲座是最常报告的正式策略(100%);评估主要被视为实习生整体轮转的一部分(89%)。这种差异表明项目主任之间需要就这些方面达成共识并实现标准化,值得进一步研究。

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