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让未来的医生参与临床伦理:对医疗机构的影响。

Engaging Tomorrow's Doctors in Clinical Ethics: Implications for Healthcare Organisations.

机构信息

Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.

University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK.

出版信息

Health Care Anal. 2021 Dec;29(4):319-342. doi: 10.1007/s10728-020-00403-z.

Abstract

Clinical ethics can be viewed as a practical discipline that provides a structured approach to assist healthcare practitioners in identifying, analysing and resolving ethical issues that arise in practice. Clinical ethics can therefore promote ethically sound clinical and organisational practices and decision-making, thereby contributing to health organisation and system quality improvement. In order to develop students' decision-making skills, as well as prepare them for practice, we decided to introduce a clinical ethics strand within an undergraduate medical curriculum. We designed a programme of clinical ethics activities for teaching and assessment purposes that involved using ethical frameworks to analyse hypothetical and real-life cases in uni- and inter- professional groups. In this paper, we draw on medical student feedback collected over 6 years to illustrate the appeal to students of learning clinical ethics. We also outline the range of benefits for students, healthcare organisations, and the field of clinical ethics arising from tomorrow's doctors experiencing clinical ethics early in their training. We conclude by briefly reflecting on how including clinical ethics within tomorrow's doctors curricular can secure and continue future engagement in clinical ethics support services in the UK, alongside the dangers of preparing students for organisational cultures that might not (yet) exist. We anticipate the findings presented in the paper will contribute to wider debates examining the impact of ethics teaching, and its ability to inform future doctors' practice.

摘要

临床伦理学可以被视为一门实践学科,它提供了一种结构化的方法,帮助医疗保健从业者识别、分析和解决实践中出现的伦理问题。因此,临床伦理学可以促进合理的临床和组织实践和决策,从而有助于改善卫生组织和系统的质量。为了培养学生的决策能力,并为他们的实践做好准备,我们决定在本科医学课程中引入临床伦理学科。我们设计了一个临床伦理活动方案,用于教学和评估,涉及使用伦理框架来分析单学科和多学科小组中的假设和现实案例。在本文中,我们借鉴了 6 年来收集的医学生反馈,来说明学习临床伦理学对学生的吸引力。我们还概述了学生、医疗保健组织和临床伦理学领域从明天的医生在培训早期就体验临床伦理学中获得的一系列益处。最后,我们简要反思了在明天的医生课程中纳入临床伦理学如何能够确保并继续在英国获得临床伦理支持服务的未来参与,以及为可能尚未(存在)的组织文化培养学生的危险。我们预计本文提出的研究结果将有助于更广泛地讨论伦理教学的影响及其为未来医生实践提供信息的能力。

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