Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL; Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL.
Am J Obstet Gynecol. 2015 Mar;212(3):397.e1-8. doi: 10.1016/j.ajog.2014.12.027. Epub 2014 Dec 18.
The objective of the study was to assess the current status of ethics education in obstetrics-gynecology residency programs.
A cross-sectional, web-based survey was designed in conjunction with a professional survey laboratory at the University of Chicago. The survey was piloted with a convenience sample of clinical medical ethics fellows to assess question content and clarity. The survey was deployed by e-mail to all obstetrics-gynecology residency program directors. Descriptive statistics were used to analyze participant responses. The University of Chicago's Institutional Review Board deemed this study exempt from institutional review board formal review.
Of 242 eligible obstetrics-gynecology residency program directors, 118 (49%) completed the survey. Most respondents were from university-based programs (n = 78, 66%) that were not religiously affiliated (n = 98, 83%) and trained 4-6 residents per postgraduate year (n = 64, 70%). Although 50% of program directors (n = 60) reported having ethics as part of their core curriculum, most programs teach ethics in an unstructured manner. Fifty-seven percent of respondents (n = 66) stated their program dedicated 5 or fewer hours per year to ethics. The majority of program directors (n = 80, 73%) responded they would like more to a lot more ethics education and believed that ethics education should be required (n = 93, 85%) for residents to complete their training. Respondents identified that crowding in the curriculum was a significant barrier to increased ethics training (n = 50, 45%) and two-thirds (n = 74, 67%) reported a lack of faculty expertise as a moderate barrier to providing ethics education in the residency curriculum.
This study found that a lack of structured curricula, inadequate faculty expertise, and limited time were important barriers for ethics education in obstetrics-gynecology programs across the nation. Despite these existing challenges, program directors have a strong interest in increasing ethics education in residency training. Therefore, additional resources are needed to assist program directors in enhancing resident ethics education.
本研究旨在评估妇产科住院医师培训计划中伦理教育的现状。
采用横断面、基于网络的调查与芝加哥大学专业调查实验室合作设计。该调查采用临床医学伦理研究员的便利样本进行了试点，以评估问题内容和清晰度。该调查通过电子邮件发送给所有妇产科住院医师培训计划主任。采用描述性统计方法分析参与者的反应。芝加哥大学机构审查委员会认为这项研究无需进行机构审查委员会的正式审查。
在 242 名符合条件的妇产科住院医师培训计划主任中，有 118 名（49%）完成了调查。大多数受访者来自大学附属项目（n = 78，66%），没有宗教附属（n = 98，83%），每年培训 4-6 名住院医师（n = 64，70%）。尽管 50%的项目主任（n = 60）报告将伦理纳入其核心课程，但大多数项目以非结构化的方式教授伦理。57%的受访者（n = 66）表示，他们的项目每年用于伦理的时间为 5 小时或更少。大多数项目主任（n = 80，73%）表示希望增加更多的伦理教育，并认为伦理教育对于居民完成培训是必要的（n = 93，85%）。受访者认为课程拥挤是增加伦理培训的一个重大障碍（n = 50，45%），三分之二（n = 74，67%）的人报告说，缺乏师资专业知识是在住院医师课程中提供伦理教育的一个中等障碍。
本研究发现，缺乏结构化课程、师资专业知识不足以及时间有限是全国妇产科项目伦理教育的重要障碍。尽管存在这些挑战，但项目主任对增加住院医师培训中的伦理教育有浓厚的兴趣。因此，需要额外的资源来帮助项目主任加强居民的伦理教育。
