Improving ethics education during residency training

Background: Trainees struggle with the evaluation and management of inpatient clinical ethical dilemmas. Aim: To meet their needs for both conceptual clarification and practical management, we designed a program to teach medical residents a systematic approach to resolving clinical ethical dilemmas. Methods: We instituted monthly resident ethics educational case conferences to clarify residents' understanding of key concepts of medical ethics and to teach an 8-step systematic approach to resolving ethical dilemmas. We surveyed learners on the appropriateness, immediate utility, and potential for future usefulness of the approach. Results: The vast majority of residents found the approach to be applicable and helpful with clinical decisions and interactions with patients and their family members. Conclusions: Teaching residents to use a systematic approach in understanding and resolving ethical dilemmas can facilitate their management of the ethical dilemmas that arise in clinical practice. Providing trainees with a concise structure for the thought process involved gives them confidence in their ability to address the issues directly and to act for reasons that are explicit, transparent, and reflect medical professionalism.

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