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Allana AA, Ali SK, Ghias K. Bioethics curriculum for undergraduate medical students: an evaluation study utilizing mixed methods approach. BMC MEDICAL EDUCATION 2024; 24:385. [PMID: 38589869 PMCID: PMC11003031 DOI: 10.1186/s12909-024-05376-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/31/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The undergraduate bioethics curriculum introduced in a private medical college in Pakistan in 1988 and revised in 2009 has evolved over time to incorporate globally relevant innovations, including integration of bioethics spirally within an existing problem-based learning curricular framework. The present evaluation study shares the results of this integrated bioethics curriculum delivered for 10 years across the five-year undergraduate medical curriculum. The study assessed the effectiveness of the curriculum in terms of student achievement, appropriateness of course contents and efficiency of instructional methods. METHODS The study utilized a mixed method sequential explanatory design. The quantitative method was used in the first phase to gather data by utilizing a structured online questionnaire. This was followed by the second phase of qualitative methods to explain the findings of the first phase and enrich the data gathered. This phase was based on focus group discussions and document review. RESULTS Student and faculty responses showed the curriculum contents to be relevant, informative, and appropriate as per learning objectives and student achievement. Multi-modal instructional methods used were stated to be effective and engaging; small group teaching and shorter sessions suggested to be preferable for fostering discussion and maintaining student engagement and attention. Large class formats were stated to be less effective. Students affirmed the contribution of bioethics education to their personal and professional development and ethical positioning. The majority of students agreed that the curriculum contributed to their knowledge acquisition (60.3-71.2%), skill development (59.41-60.30%) and demonstration of ethical/professional behavior (62.54-67.65%). The ranges indicate agreement with related sets of questions. Participants suggested that the curriculum could be further strengthened by better integration in clinical years, role modelling and providing opportunities for application in clinical health care settings. Moreover, topics like ethical issues related to the use of social media, public health ethics and ethics and law were suggested as additions to the existing curriculum. These findings have regional and global relevance for the development and assessment of effective bioethics curricula. CONCLUSION An effective bioethics curriculum for undergraduate medical education should run longitudinally across the 5 year curriculum and be integrated in the modules and clerkships. Basic acquisition of knowledge and skills takes place in Years 1 & 2 with reinforcement and application in Years 3-5. Learning embedded in an integrated curriculum can help students recognize, critically analyze and address ethical dilemmas. Involvement and commitment of the clinical faculty is essential for reinforcing the ethical principles and concepts learnt in the earlier years.
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Affiliation(s)
- Anita Anis Allana
- Department for Educational Development, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan.
| | - Syeda Kauser Ali
- Institute of Medical Education, Jinnah Sindh Medical University, Rafiqui H. J. Iqbal Shaheed Road, Karachi, 75510, Pakistan
| | - Kulsoom Ghias
- Department of Biological and Biomedical Sciences, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
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Shrivastava SR, Shrivastava PS, Pise R, Joshi A. Practice makes perfect: The learner-doctor blueprint for proficient physicians. J Family Med Prim Care 2024; 13:1156-1159. [PMID: 38827667 PMCID: PMC11141965 DOI: 10.4103/jfmpc.jfmpc_1717_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/03/2023] [Accepted: 12/27/2023] [Indexed: 06/04/2024] Open
Abstract
In the process of producing competent and efficient medical graduates, clinical teaching is an integral component of undergraduate training. Even though clinical training has been linked with multiple benefits and plays a defining role in transforming a medical student into a competent doctor, it has some inherent challenges. The learner-doctor method emphasizes learning by doing and has the potential to counter the identified challenges in the traditional mode of clinical training. The learner-doctor method places emphasis on collaborative learning, wherein students learn by experiential learning and active participation in patient care. This method not only fosters the development of clinical skills but also cultivates critical thinking, teamwork, empathy, and effective communication. A number of activities or strategies must be planned and implemented to ensure that the set objectives of the learner-doctor method are accomplished by the medical institutions. In conclusion, as medical education continues to evolve, the learner-doctor method of clinical training is a dynamic approach to bridging the gap between theoretical knowledge and practical skills. As this method enables medical students to actively engage in patient care and improve their critical thinking, it becomes the need of the hour that every medical institution should explore the opportunity to effectively implement the same in their settings.
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Affiliation(s)
- Saurabh RamBihariLal Shrivastava
- Deputy Director (Research and Development), Off Campus, Datta Meghe Institute of Higher Education and Research, Department of Community Medicine, Datta Meghe Medical College, Off-campus Centre of Datta Meghe Institute of Higher Education and Research, Hingna Road, Wanadongri, Nagpur, Maharashtra, India
| | | | - Rainita Pise
- Department of Community Medicine, Datta Meghe Medical College, Off-campus Centre of Datta Meghe Institute of Higher Education and Research, Hingna Road, Wanadongri, Nagpur, Maharashtra, India
| | - Abhishek Joshi
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
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Althagafi NA, Alahmad G. Ethics education among obstetrics and gynecologists in Saudi Arabia: a cross-sectional study. BMC MEDICAL EDUCATION 2023; 23:872. [PMID: 37974171 PMCID: PMC10655446 DOI: 10.1186/s12909-023-04824-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
There are a lot of efforts to promote ethics education and training at an undergraduate and postgraduate level around the world, including in Saudi Arabia. However, there is still a lack of structured ethics education curricula in obstetrics and gynecology residency programs in Saudi Arabia. In the current scenario, where new ethical dilemmas are emerging, an ethics education that only focuses on teaching the ethical principles does not enhance the competence to deal with the ethical challenges in daily practice. This study evaluates the lack of ethics education and training in obstetrics and gynecology residency programs in Saudi Arabia. A cross-sectional survey of working obstetricians and gynecologists in Saudi Arabia was conducted among all working levels of doctors (the residents, registrars, consultants, and program directors) from various hospitals of Saudi Arabia. 391 practitioners responded to the survey, representing a response rate of 39.1%, including 257 (66.4%) females and 130 (33.6%) males. 74 (23.0%) received formal education (medical school = 35%; residency programs = 11.8%; sub-specialty programs = 4.3%; postgraduate programs = 7.4%), 85 (26.4%) received informal education (online training = 12.8%; conferences = 18.9%; courses and workshops = 13.3%; self-learning = 31.7% and daily practices = 20.7%), and 78 (19.95%) received no ethics education. Almost all the respondents had a positive attitude towards ethical principles, but a least percent were competent to deal with the ethical challenges. The bottom line of this survey is the imperativeness of reinforcement of formal ethics education in obstetrics and gynecology postgraduate programs in Saudi Arabia.
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Affiliation(s)
- Noha Abed Althagafi
- King Fahad National Guard Hospital, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ghiath Alahmad
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
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Wicaksono RB, Ferine M, Lestari DWD, Hidayah AN, Muhaimin A. Experience of Indonesian medical students of ethical issues during their clinical clerkship in a rural setting. J Med Ethics Hist Med 2022; 14:6. [PMID: 35035794 PMCID: PMC8696554 DOI: 10.18502/jmehm.v14i6.6750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 06/01/2021] [Indexed: 11/29/2022] Open
Abstract
Although ethics is an essential part of medical education, little attention has been paid to ethics education during the clerkship phase, where medical students observe how physicians make decisions regarding various ethical problems. Specific nuances and cultural contexts such as working in a rural setting can determine ethical issues raised. This phenomenology study aimed to explore ethical issues experienced by Indonesian students during clinical clerkship in a rural setting. In-depth interviews were used to explore students’ experiences. Participants were ten students, selected on gender and clerkship year variations. Data saturation was reached after eight interviews, followed by two additional interviews. Thematic analysis was used in this study, and trustworthiness was ensured through data and investigator triangulation, member checking, and audit trail. Three main themes found in this study were limited facilities and resources, healthcare financing and consent issues, as well as unprofessional behavior of healthcare providers. Many ethical issues related to substandard care were associated to limited resources and complexities within the healthcare system in the rural setting. Early exposure to recurrent ethical problems in healthcare can help students prepare for their future career as a physician in a rural setting.
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Affiliation(s)
- Raditya Bagas Wicaksono
- Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Miko Ferine
- Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Diyah Woro Dwi Lestari
- Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Arfi Nurul Hidayah
- Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Amalia Muhaimin
- Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia; Researcher, Department of Ethics, Law, and Humanities, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
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Chappell AG, Kane RL, Wood SM, Wescott AB, Chung KC. Representation of Ethics in the Plastic Surgery Literature: A Systematic Review. Plast Reconstr Surg 2021; 148:289e-298e. [PMID: 34228030 DOI: 10.1097/prs.0000000000008232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A 2009 systematic review demonstrated that ethical discourse was underrepresented in the plastic surgery literature; approximately one in 1000 articles contained ethical discussions. In the decade since, advances in plastic surgery and continued social progress have created new ethical dilemmas. However, it is unclear whether these developments have augmented the representation of ethics in the plastic surgery literature. A review of publications over the past decade can assess whether progress has been made and identify where deficits persist. METHODS The authors searched eight bibliographic databases to identify peer-reviewed articles discussing ethical issues in plastic surgery over the past decade. Independent reviewers extracted characteristics and ethical principles from included articles. RESULTS A total of 7097 articles were identified from the initial search and 531 articles were included for analysis. The principle of autonomy, present in 87.9 percent of articles, had the greatest representation, followed by beneficence (74.4 percent), nonmaleficence (72.3 percent), and justice (51.2 percent). Informed consent and face transplantation were the most prevalent topics discussed. Aesthetic surgery was the subdiscipline of plastic surgery with the greatest ethical discourse, representing 29.8 percent of all included articles. CONCLUSIONS In the past decade, there was approximately a five-fold increase in plastic surgery publications that include ethical discourse, indicating a growing awareness of ethical implications by the plastic surgery community. However, representation of ethical principles remained uneven, and specific subdisciplines of plastic surgery were substantially underrepresented. Plastic surgeons should adopt a more comprehensive approach when framing ethical implications in clinical and research settings.
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Affiliation(s)
- Ava G Chappell
- From the Division of Plastic Surgery, Department of Surgery, and Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - Robert L Kane
- From the Division of Plastic Surgery, Department of Surgery, and Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - Shannon M Wood
- From the Division of Plastic Surgery, Department of Surgery, and Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - Annie B Wescott
- From the Division of Plastic Surgery, Department of Surgery, and Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - Kevin C Chung
- From the Division of Plastic Surgery, Department of Surgery, and Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
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Introduction: Special Issue on Undergraduate Medical Education in Ethics and Professionalism. HEC Forum 2020; 32:77-83. [PMID: 32399953 DOI: 10.1007/s10730-020-09407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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