a Division of Infectious Diseases , University of California-San Francisco Medical Center , San Francisco , CA , USA.
b Division of General Pediatrics , University of Pennsylvania , Philadelphia , PA , USA.
Med Teach. 2018 Jan;40(1):53-61. doi: 10.1080/0142159X.2017.1391374. Epub 2017 Nov 2.
This study describes the impact of an open-access, case-based global health ethics workshop and describes the breadth of dilemmas faced by students to inform future interventions.
Eighty-two medical students who undertook electives at 16 international sites between 2012 and 2015 received web-based surveys at three time points, incorporating quantitative and free-text probes of knowledge, skills, and attitudes related to global health clinical ethics dilemmas. Sixty students (73%) completed the pre-workshop survey, 38 (46%) completed the post-workshop survey, and 43 (52%) completed the post-trip survey.
Analysis demonstrated improvement following the workshop in self-rated preparedness to manage ethical dilemmas abroad, identify ways to prepare for dilemmas, engage support persons, and manage related emotions (all comparisons, p < 0.001). Participants described 245 anticipated or actual dilemmas, comprising nine domains. Nearly one-third of the dilemmas that were experienced involved the student as an active participant. Only 21% of respondents experiencing a dilemma discussed the dilemma with a local support person.
This analysis describes an ethics curriculum that prepares students to face ethical dilemmas during international clinical rotations. It broadens the representation of the dilemmas that students face, and highlights areas for curricular focus and optimization of on-site and post-trip student support resources.
本研究描述了一个开放获取、基于案例的全球卫生伦理研讨会的影响，并描述了学生所面临的各种困境，以为未来的干预措施提供信息。
2012 年至 2015 年间，82 名在 16 个国际站点进行选修的医学生在三个时间点接受了基于网络的调查，其中包括与全球卫生临床伦理困境相关的知识、技能和态度的定量和自由文本探测。60 名学生（73%）完成了课前调查，38 名（46%）完成了课后调查，43 名（52%）完成了课后调查。
分析表明，在研讨会后，学生在自我评估准备在国外处理伦理困境、确定为困境做准备的方法、获得支持人员的支持以及管理相关情绪方面的自我评估有了提高（所有比较，p<0.001）。参与者描述了 245 个预期或实际的困境，包括九个领域。近三分之一经历过的困境涉及学生作为积极参与者。只有 21%的遇到困境的受访者与当地的支持人员讨论了这个困境。
本分析描述了一门伦理课程，为学生在国际临床轮转中面临伦理困境做好准备。它拓宽了学生所面临的困境的代表性，并强调了课程重点和优化现场和课后学生支持资源的领域。
