This article surveys and analyses the reflections on medical ethics teaching by colleagues teaching in United Kingdom (UK) medical schools in the early 2020s. Participants were recruited mainly by using the worldwide web to identify 64 people from 41 UK medical schools who were thought to contribute to teaching medical ethics based on their internet profiles. Twenty-three people responded. The survey data reveals that many staff are happy with the provision of medical ethics teaching, but also that some are concerned (...) about the quality of provision due to concerns with staff expertise and teaching time. In spite of the fact that the General Medical Council (GMC) and other organisations are perceived to have contributed to raising the profile of medical ethics, there is significant concern with how it is embedded within local UK medical curricula. Some participants contributed hardly or not at all to research in medical ethics, where one attributed this decline in research to the pandemic. Future work will need to address what can be done to improve the provision of medical ethics teaching to address some of these findings and to survey and analyse how perceptions might have changed in light of recent challenges and developments. (shrink)

Since the 1980s, there has been an increasing acknowledgement of the importance of recognising the ethical dimension of clinical decision-making. Medical professional regulatory authorities in some countries now include ethical knowledge and practice in their required competencies for undergraduate and post graduate medical training. Educational interventions and clinical ethics support services have been developed to support and improve ethical decision making in clinical practice, but research evaluating the effectiveness of these interventions has been limited. We undertook a systematic review of (...) the published literature on measures or models of evaluation used to assess the impact of interventions to improve ethical decision making in clinical care. We identified a range of measures to evaluate educational interventions, and one tool used to evaluate a clinical ethics support intervention. Most measures did not evaluate the key impact of interest, that is the quality of ethical decision making in real-world clinical practice. We describe the results of our review and reflect on the challenges of assessing ethical decision making in clinical practice that face both developers of educational and support interventions and the regulatory organisations that set and assess competency standards. (shrink)

BackgroundThis study aims to quantitatively and qualitatively evaluate the activities of a Bioethics Unit (BU) 5 years since its implementation (2016–2020). The BU is a research unit providing empirical research on ethical issues related to clinical practice, clinical ethics consultation, and ethical education for health care professionals (HPS).MethodsWe performed an explanatory, sequential, mixed-method, observational study, using the subsequent qualitative data to explain the initial quantitative findings. Quantitative data were collected from an internal database and analyzed by descriptive analysis. Qualitative evaluation (...) was performed by semi-structured interviews with 18 HPs who were differently involved in the BU’s activities and analyzed by framework analysis.ResultsQuantitative results showed an extensive increment of the number of BU research projects over the years and the number of work collaborations with other units and wards. Qualitative findings revealed four main themes, concerning: 1. the reasons for contacting the BU and the type of collaboration; 2. the role of the bioethicist; 3. the impact of BU activities on HPs, in terms of developing deeper and more mature thinking; 4. the need to extend ethics support to other settings. Overall, our results showed that performing both empirical bioethics research and more traditional clinical ethics activities at the same unit would produce an impetus to increase collaboration and spread an 'ethical culture' among local HPs.ConclusionsOur findings contribute to a growing body of literature on the models of clinical ethics support services and the role of empirical research in bioethics internationally. They also prepare the ground for the implementation of a multidisciplinary Clinical Ethics Committee (CEC) that aims to support the BU’s ethics consultation service within the local context. (shrink)

This article discusses the feedback on students’ ethics essays provided by eight markers in the Faculty of Medical Sciences at Newcastle University. It highlights significant shortcomings, including failures to identify instances where students had failed to select and to conclude on ethical issues, logical errors, misunderstandings of ethical arguments made in the literature, instances of simple deference, and a lack of critical engagement with relevant literature. Markers also made a large number of linguistic errors and, on many occasions, failed to (...) explain clearly what they meant. Some indication is given of what the cost of this might be to health care students as well as to those who are affected by the quality of their ethical decisions. The article concludes by providing some guidance on how this cost might be reduced at Newcastle University as well as in many other institutions where similar problems are likely to exist. (shrink)

In Australia, paramedics are obliged to practice ethically. Graduates of baccalaureate degrees in paramedicine should therefore possess a common grounding in ethics to meet the professional capabilities expected of registered paramedics. However, there is a lack of clarity regarding ethics education for paramedicine students, including what is taught, how it is taught, and how it is assessed. This paper explores ethics education for paramedicine students in Australia, how it aligns with current professional expectations, and how it may be enhanced. Point-in-time (...) data regarding ethics education was collected from websites of fifteen Australian universities offering undergraduate baccalaureate degrees in paramedicine. Data collection was supported by consultation with academics from several institutions. Content analysis was utilised to categorise and analyse data to explore similarities and differences in curricula. Similarities included approaches to learning and teaching and the use of case-based learning, with variability found across teaching staff profiles and content areas. Findings suggest it is time for collaboration to develop a model ethics curriculum for paramedicine students in Australia. (shrink)