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At least 1,279 records · Page 71Linked to original sources
PubMed1989

Medical ethics education: coming of age.

Medical ethics education is instruction that endeavors to teach the examination of the role of values in the doctor's relationship with patients, colleagues, and society. It is one front of a broad curricular effort to develop physicians' values, social perspectives, and interpersonal skills for the practice of medicine. The authors define medical ethics education as more clinically centered than human values education and more inclusive of philosophical, social, and legal issues than is interpersonal skills training. The authors review the history of the emergence of medical ethics education over the last 20 years, examine the areas of consensus that have emerged concerning the general objectives and premises for designing medical ethics programs, and describe teaching objectives and methods, course content, and program evaluation used in such programs on both preclinical and clinical levels. The four interrelated requirements for successful institutionalization of medical ethics education programs are defined and discussed, and the paper ends with an overview of the uncertain future of medical ethics education, an accepted but still not fully mature part of physician training in the United States. An extensive reference list accompanies the article.

Bioethical Issues↗
PubMed1989

The Baylor experience in teaching medical ethics.

This paper describes the activities of the Center for Ethics, Medicine, and Public Issues, a joint project of Baylor College of Medicine, the Institute of Religion of the Texas Medical Center, and Rice University. The center focuses on the clinical teaching of medical ethics, collaborative teaching and research involving ethicists and clinicians, and the training of future practitioners in the field. Problems as well as achievements in each of these areas are discussed.

Bioethical Issues↗
PubMed1989

Development of a teaching program in clinical medical ethics at the University of Chicago.

The University of Chicago Pritzker School of Medicine has developed and evaluated an extensive teaching program in clinical ethics coordinated primarily through the Center for Clinical Medical Ethics. The program provides medical students with a foundation in medical ethics during the four years of medical school and augments the clinical ethics knowledge and teaching skills of the housestaff and clinical faculty at the University of Chicago. Together, medical student teaching and clinical faculty development have made clinical ethics an integral part of medical education at the University of Chicago. Through these efforts, the teaching program aims to incorporate clinical ethics considerations into medical decisions and in this way contribute to improving patient care. (A detailed overview of all clinical ethics instruction at the school is provided.)

Bioethical Issues↗
PubMed1989

Development of the medical humanities program at East Carolina University.

The medical humanities program at East Carolina University School of Medicine has 50 contact hours with medical students in the required curriculum, fourth-year electives that are well-subscribed (47% of the members of the class of 1989 took one or more), and programs for residents, fellows, and faculty. The author discusses several crucial decisions made in the first year of the program (1978-79) that affected the nature and development of the program: first, to begin the medical humanities courses in the preclinical required curriculum and use these courses as a base to build on in the clinical years; second, to develop a program through all years of training while preserving time for faculty research; third, to arrange for program faculty to team-teach with clinical faculty; fourth, to show the importance of the humanities programs and courses by the way in which they were constructed and situated in the curriculum; and fifth, to seek primarily to teach a method of inquiry.

Bioethical Issues↗
PubMed1989

The clinical medical humanities program at Loyola University of Chicago.

The authors emphasize that an effective medical humanities program must be based on clinically oriented training. They then describe in detail such a program at Loyola University of Chicago Medical Center; the program consists of a four-year required curriculum that is clinically reinforced by having the students accompany attending physicians on rounds and is taught by faculty representing a wide range of disciplines in medicine and other fields. The paper offers several guidelines to the person or persons who would organize and direct a clinical medical humanities program, describes obstacles that the Loyola program faced when it was getting started, presents the purpose, focus, and curricular topics of the program, and discusses its future. The authors conclude that the use of the clinically oriented approach will continue to prevail in medical humanities teaching, both at Loyola and in medical humanities programs overall. This approach challenges good teachers to make their best efforts at reconciling their own disciplines with that of medicine; in this process, a new medical humanities discipline emerges that is not so much an application of the humanities to medicine as it is an evocation of humanities themes from the clinical encounter itself.

Chicago↗
PubMed1989

Ethics education at Northwestern University Medical School.

The Northwestern University Medical School's Ethics and Human Values Program spans the medical curriculum from first year to fourth and extends into several residency programs. Taught by scholars in the medical humanities and clinicians from almost every specialty, the courses and seminars draw upon philosophy, literature, and law in addressing both immediately pressing social issues and the enduring "everyday ethics" of the physician-patient relationship.

Chicago↗
PubMed1989

Teaching medical ethics in its contexts: Penn State College of Medicine.

Ethics teaching at The Pennsylvania State University College of Medicine began when the medical school accepted its first students in 1967. The ethics program co-evolved with the school and the Department of Humanities without guidelines or models, since neither medical ethics nor medical humanities had yet been invented as fields of study. The focus of the article is on two key differences between the Penn State ethics program and most other such programs: the teaching of medical ethics within the context of other issues of value and meaning in medicine, and the fact that the humanities faculty is involved in the activities and structures of the medical center of which the medical school is a part. The authors close with a description of successful factors in their program that they maintain could apply to other programs.

Bioethical Issues↗
PubMed1989

The effect of teaching medical ethics on medical students' moral reasoning.

A study assessed the effect of incorporating medical ethics into the medical curriculum and the relative effects of two methods of implementing that curriculum, namely, lecture and case-study discussions. Results indicate a statistically significant increase (p less than or equal to .0001) in the level of moral reasoning of students exposed to the medical ethics course, regardless of format. Moreover, the unadjusted posttest scores indicated that the case-study method was significantly (p less than or equal to .03) more effective than the lecture method in increasing students' level of moral reasoning. When adjustment were made for the pretest scores, however, this difference was not statistically significant (p less than or equal to .18). Regression analysis by linear panel techniques revealed that age, gender, undergraduate grade-point average, and scores on the Medical College Admission Test were not related to the changes in moral-reasoning scores. All of the variance that could be explained was due to the students' being in one of the two experimental groups. In comparison with the control group, the change associated with each experimental format was statistically significant (lecture, p less than or equal to .004; case study, p less than or equal to .0001). Various explanations for these findings and their implications are given.

Control Groups↗
PubMed1993

Studying science in the context of ethics.

The authors describe their experiences in developing and introducing a course on responsible conduct at the Graduate School of Biological Sciences at the University of Texas Health Science Center at Houston. The paper covers issues involved with course faculty, course content and format, and evaluation. At least half of the course time focused on general or case-study discussions of the students and faculty about ethical problems raised in course readings or the students' research experiences. An important issue for institutions trying to encourage students to recognize, reason about, and understand ethical concerns is how the institution itself becomes aware of the ethical implications of its own unconsciously or explicitly stated policies. Such reflection among institutional leaders is critical to fostering the public trust necessary for a profession to sustain its right to self-regulation and its claim of authenticity.

Academic Medical Centers↗
PubMed1993

A new perspective on scientific misconduct.

The level of social concern about any form of deviance reveals much about the society that disapproves of the behavior. In that light, why has scientific misconduct recently received so much public attention and opprobrium? Inquiring into this and related areas raises questions about the changing relationship between science and society. Rising concern about scientific misconduct may indicate that the state and other powerful actors see the value of science clearly, a perception perhaps intensified by a growing reliance upon science, the value of science as a resource for power, and the resulting desire of powerful social groups to control science. An important factor is the increased importance science has acquired within organizations (such as universities and businesses), requiring scientists to engage in more intense interactions with the professionals who work there, including lawyers, accountants, public relations specialists, and administrators. In itself, this tighter coupling of science to other social and organizational purposes would be expected to increase scrutiny and the likelihood of interventions. Also, this more frequent contact makes competition for dominance between professions more likely. Policies might be devised to renegotiate the relationship between science and society in a way that might alleviate the "pathogenic pressures" in the present environment. Specifically, the author suggests eight changes, including reducing and redistributing the financial rewards immediately available to scientists, their companies, and their universities by installing a form of "escrow" account to hold profits for a fixed period of time; decoupling graduate student and postdoctoral support from research grants; and resisting the trend to replace intrinsic rewards and controls with extrinsic ones.

Attitude↗
PubMed1995

Bridging the professions: an integrated and interdisciplinary approach to teaching health care ethics.

In 1993, the authors introduced an interdisciplinary course in health care ethics at the University of British Columbia. They were motivated by two convictions: (1) an interdisciplinary approach to health care decision making is best; and (2) every significant health care decision has an ethical component. They wanted to encourage students from the various health care disciplines to participate in interdisciplinary decision making in their future practices by giving them an opportunity to study health care ethics together during their training. The authors give detailed descriptions of the objectives, format, curriculum, and evaluation of this innovative course in the hope that other educators who may want to develop similar courses can learn from their experience.

British Columbia↗
PubMed1998

Educating residents for managed care: report on a multidisciplinary conference.

A growing number of residency programs are preparing their graduates for the realities of managed care practice. In 1996, The Cleveland Clinic Foundation, a private, nonprofit academic medical center, hosted a two-day conference on managed care education to develop innovative instructional and evaluative approaches that, where appropriate, would build on existing expertise. The conference was attended by invited national experts who had a stake in residents' education: clinical faculty, residents, medical educators, executives of managed care organizations, and representatives of other interested organizations. Participants spent much of their time in four small break out groups, each focusing on one of the following topics that were judged particularly relevant to managed care: preventive and population-based medicine, appropriate utilization of resources, clinician-patient communication, and interdisciplinary team practice. Participants shared existing materials, discussed teaching goals and objectives, and generated ideas for teaching methods, teaching materials, and evaluative methods for their respective topics. The authors summarize the recommendations from the four groups, with an overview of the issues that emerged during the conference concerning curriculum development, integration of managed care topics into existing curricula, staging of the curriculum, experiential teaching methods, negative attitudes and resistance, evaluation of trainees and profiling, program assessment, faculty development, and cooperation between academic medical centers and managed care organizations.

Educational Measurement↗