Ethical reasoning in clinical years: ethics rounds, Acibadem University experience


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Işil Ülman F. Y. , Topsever F. P. , Vatansever K., Artvinli F.

28th European Conference on Philosophy of Medicine and Health Care, Bioethics and Biopolitics, Debrecen, Macaristan, 27 - 30 August 2014, ss.132-133

  • Basıldığı Şehir: Debrecen
  • Basıldığı Ülke: Macaristan
  • Sayfa Sayısı: ss.132-133

Özet

28th EUROPEAN CONFERENCE ON PHILOSOPHY OF MEDICINE AND HEALTH CARE

“Bioethics and Biopolitics”, 27 – 30 August, 2014, Debrecen (Hungary), Oral Paper Abstract

 

"ETHICAL REASONING IN CLINICAL YEARS:

ETHICS ROUNDS, ACIBADEM UNIVERSITY EXPERIENCE"

 Yesim Isil Ulman*, Pinar Topsever**, Kevser Vatansever*** Fatih Artvinli****

 

 Introduction: at Acibadem University School of Medicine, medical ethics and bioethics are integrated in the curriculum in phase one (year 1-2-3) within the professionalism program entitled "Clinical Medicine and Professional Skills (CMPS)" in form of a "Medical Ethics & Humanities" track and in phase two (years 4-5-6) within the clinical clerkships as "Ethics rounds".

Aim: The ethic rounds aim to develop ethical sensitivity and professional motivation during the clerkship period by fostering professional and ethical values in clinical and ethical decision-making in daily practice; to integrate ethical formation in preclinical years with the practice based clinical experience with actual cases.

Materials and methods: Ethic Rounds are featured within the internal medicine clinical clerkship which takes place four times within the academic year, rotating groups of students. Additionally, Forensic Medicine inserted Ethics Rounds in the Clerkship curriculum in the 5th year. Thus, five ethics rounds are organized.

The ethics rounds are organized in an interdisciplinary manner with clinicians from different branches. Presented cases may feature different themes working together with the department of medical ethics.  The clinicians are asked to choose a case representing an ethical dilemma from their daily clinical practice. They are provided with a guide to prepare this case for discussion with the students during the ethics round. The format of this guide includes a short case description, formulation of the problem and identification of the related ethical values and/or principles. The clinicians are also provided with a short theoretical outline about ethical values and principles.

Results:

The students described the ethics rounds as beneficial, remindful, stimulating, and proposed repeating these exercises in each clinical year. They think this practice has stabilized what they have already learned in ethics lessons at preclinical years. They find it instructive to think over the clinical case in the perspective of ethical issues and legal practice. They liked that the cases were chosen from the real daily clinical practice. They enjoyed to express their ideas and views actively and in an open way with peers and clinicians and instructors. They commented that they glean ideas, take lessons from the clinicians’ experiences for managing difficult patient encounters and breaking bad news.

The clinicians find the ethics rounds beneficial. They think that the systematic real life experience such as ethics rounds at undergraduate level will be quite helpful for students to get ready for coping with the ethical dilemmas and conflicts in professional life.

Conclusion: Ethics Rounds is sustainable and compatible with the vertical integration in medical education in order to enhance professionalism.

 

Sources:

1) M Svantesson, R Löfmark,  H Thornsén, K Kallenberg, G Ahlström,  “Learning a way through ethical problems: Swedish nurses’ and doctors’ experiences from one model of ethics rounds”, J Med Ethics 2008;34:399–406.

2) Fryer-Edwards K, Wilkins D, Baernstein A, Braddock CH. Bringing Ethics Education to the Clinical Years: Ward Ethics Sessions at the University of Washington, Academic Medicine, 2006; 81(7): 626-631.

 



* PhD, Prof of History of Medicine and Ethics, Acibadem Univ. School of Medicine, Istanbul TRyesimul@yahoo.com

** MD, Assoc. Prof. of Family Medicine, Acibadem Univ. School of Medicine, Istanbul TR

*** MD, PhD, Assist. Prof. of Public Health and Medical Education, Ege Univ. School of Medicine, Izmir TR

**** PhD, Assist. Prof. of History of Medicine and Ethics, Acibadem Univ. School of Medicine, Istanbul TR