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)

Paramedics encounter ethical dilemmas at work, and while previous research has improved ethics education and practice, more can be learned from the lived experience of paramedics facing ethical challenges. This paper explores the lived experience of two paramedics, one with five years’ experience, the other twenty, presented with comparable cases. The participants, who were interviewed in a broader qualitative study exploring practical wisdom, were asked to select a case involving ethical decision-making from their own practice experience. Semi-structured interviews employed the (...) five-step Critical Decision Method as a framework to explore various aspects of the decision-making process. The two cases were identified as exemplars of prominent themes suitable for discussion. The findings highlighted several factors that influence paramedic ethical decision-making, including practical wisdom, communication and teamwork, clinical support, and education. This case comparison identifies a greater need to focus education on the fostering of practical wisdom, and the development of non-technical skills such as communication and teamwork, supported by interprofessional education endeavours. Furthermore, greater access to support for paramedics must be available to further evolve practical wisdom. The combination of improved education and support will likely cater for the full spectrum of ethical challenges faced by paramedics in their work. (shrink)

Background Although simulation-based learning using simulated patients is a standard part of training in medical school, it is not yet used to the same extent in the teaching of medical ethics. There are good reasons to use simulation-based teaching, especially in clinical ethics, to gain practical experience through the situation-specific combination of knowledge, skills, and attitudes in the learning process. However, there are certain prerequisites regarding the design of simulations with actors in medical ethics education. Topics Using a concrete example, (...) this article aims to provide an overview of the development and conception of simulation and role scripts for simulations with actors to teach clinical ethics, which is an important subfield of medical ethics. The special requirements and specifics of these simulations are addressed. Conclusion Although there are some limitations with regard to integrating simulations into clinical ethics, simulation-based training of knowledge, skills, and attitudes can and should play a role in medical–ethical theory and clinical–ethical practice, not only for medical and nursing students but also in the further training of clinical ethicists. (shrink)

Simulationen mit Simulationspersonen gehören in der medizinischen Lehre zum Ausbildungs-Standard. In der medizinethischen Lehre ist dies bisher nicht in gleichem Umfang der Fall. Für ihren Einsatz, insbesondere in der klinischen Ethik, können gute Gründe angeführt werden, wie beispielsweise die Möglichkeit konkreter Erfahrungen als Lehrelement und die situationsspezifische Verbindung von Wissen, Können und Haltungen in einem Lernprozess. Die Konzeption von Simulationen mit Simulationspersonen in der medizinethischen Lehre ist jedoch voraussetzungsreich. Es müssen die mehrdimensionalen Lernziele und die Anforderungen an die medizinethische Lehre (...) berücksichtigt werden. Der Beitrag möchte anhand eines konkreten Beispiels einen Überblick über die Entwicklung und Konzeption von Drehbüchern bzw. Rollen-Skripten für Simulationen mit Simulationspersonen für die Lehre in der klinischen Ethik als wichtigem Teilbereich der Medizinethik geben. Dabei wird auf die besonderen Voraussetzungen und Spezifika dieser Simulationen eingegangen. Abschließend wird kritisch diskutiert, welchen Stellenwert das Training von kommunikativen Fertigkeiten in der medizinethischen Theorie und klinisch-ethischen Praxis haben kann und soll. Der Beitrag schließt mit der Überlegung, ob nicht auch in der Fortbildung von klinischen Ethiker*innen Simulationspersonen zum Einsatz kommen sollten. (shrink)

Conventional medical training offers little help to students to resolve the ethical dilemmas they face as healthcare professionals. Public awareness of the ethical behavior of medical practitioners has been growing. Aim of this study was to assess knowledge of, practice in and attitudes of healthcare ethics among medical, dental and physiotherapy postgraduate students. A cross-sectional analysis based on a questionnaire was performed at a hospital and dental institution of the medical college. The present study included 60 postgraduate students. The questionnaire (...) on health care ethics is a 44-point self-administered standardized questionnaire that poses ethical dilemmas in 5 vignettes with closed-ended questions to test awareness, attitude and experience in the area of healthcare ethics. In the first half of the questionnaire, knowledge and attitude were assessed using 5 case scenarios representing ethical dilemmas and the participants answered the questions using the 5 point likert scale. The second half assessed the practice of Ethics in research and clinical practice. The expected time to fill each questionnaire was about 10–15 min. 62 questionnaires were distributed. 60 completed questionnaires were returned. The response rate was 96%. The mean age of the postgraduates was 26.23 ± 2.33. Among the participants 28 were male and 32 female. 20 completed questionnaires from each, medical, dental and physiotherapy postgraduate students were collected. The multiple group comparison showed that the difference in the knowledge scores were statistically significant between dental and physiotherapy and between medical and physiotherapy but no significant difference between medical and dental. Study suggests that abstract knowledge cannot be converted into practical knowledge automatically. There is a major lack of knowledge of the ethics of health care among graduate students. The postgraduate curriculum must include a good mix of both theoretical concepts and practical application of multidisciplinary healthcare ethics ethical principles and guidelines. (shrink)

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 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. (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)