Fanous Amanda, Rappaport Jamie, Young Meredith, Park Yoon Soo, Manoukian John, Nguyen Lily H P
Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Center for Medical Education, McGill University, Montreal, Quebec, Canada.
Laryngoscope. 2017 Nov;127(11):2501-2509. doi: 10.1002/lary.26551. Epub 2017 Aug 29.
To develop, implement, and evaluate a longitudinal, simulation-based ethics and legal curriculum designed specifically for otolaryngology residents.
Otolaryngology residents were recruited to participate in a yearly half-day ethical-legal module, the curriculum of which spanned 4 years. Each module included: three simulated scenarios, small-group multisource feedback, and large-group debriefings. Scenarios involved encounters with standardized patients. Residents' ethical-legal knowledge was assessed pre- and postmodule with multiple-choice questions, and ethical reasoning was assessed by a variety of evaluators during the simulated scenario using a locally developed assessment tool. Participants completed an exit survey at the end of each module.
Eighteen residents completed four modules from the academic years of 2008 to 2009 to 2011 to 2012. The first year was considered a pilot module, and data were collected for the following 3 years. Knowledge of legal issues improved significantly among residents (mean at pre = 3.40 and post = 4.60, P < 0.05). Residents' ethical reasoning skills also improved across years (mean 3.60/5 in 2009-2010, 3.76/5 in 2010-2011, and 4.33 in 2011-2012, P < 0.05). Survey results revealed a statistically significant self-perceived improvement in ethics reasoning skills (mean pre = 3.62, post = 4.86, P < 0.05). Participants reported that the curriculum was relevant to their practice (85%), that the debriefings were of high quality (83%), and that they would recommend this module to others (88%).
To our knowledge, this is the first study exploring a longitudinal simulation-based ethical-legal curriculum tailored to otolaryngology-head and neck surgery residents. This educational program resulted in a both objective and subjective improvement in legal and ethics knowledge and skills.
NA. Laryngoscope, 127:2501-2509, 2017.
开发、实施并评估一项专门为耳鼻咽喉科住院医师设计的基于模拟的纵向伦理与法律课程。
招募耳鼻咽喉科住院医师参加为期半天的年度伦理 - 法律模块课程，该课程为期4年。每个模块包括：三个模拟场景、小组多源反馈以及大组总结汇报。场景涉及与标准化病人的接触。在模块前后通过多项选择题评估住院医师的伦理 - 法律知识，并在模拟场景期间由多名评估人员使用当地开发的评估工具评估伦理推理能力。参与者在每个模块结束时完成一份结业调查问卷。
18名住院医师完成了从2008至2009学年到2011至2012学年的四个模块。第一年被视为试点模块，并在接下来的3年收集数据。住院医师对法律问题的了解有显著提高（课前平均分为3.40，课后平均分为4.60，P < 0.05）。住院医师的伦理推理能力也逐年提高（2009 - 2010年平均为3.60/5，2010 - 2011年平均为3.76/5，2011 - 2012年平均为4.33，P < 0.05）。调查结果显示，在伦理推理能力方面自我感觉有统计学意义的提高（课前平均分为3.62，课后平均分为4.86，P < （此处原文有误，应补充0.05））。参与者报告称该课程与他们的实践相关（85%），总结汇报质量高（83%），并且他们会向其他人推荐这个模块（88%）。
据我们所知，这是第一项探索专门为耳鼻咽喉 - 头颈外科住院医师设计的基于模拟的纵向伦理 - 法律课程的研究。该教育项目在法律和伦理知识与技能方面带来了客观和主观的提升。
无。《喉镜》，2017年，第127卷，第2501 - 2509页
