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Ethical dilemmas in clerkship rotations
1Dr. Myers is professor of clinical psychiatry, immediate past vice chair of education, and program director, Department of Psychiatry, and medical student ombudsman, SUNY Downstate Medical Center College of Medicine, Brooklyn, New York. Ms. Herb is clinical professor, Departments of OB/GYN and Family Practice, SUNY Downstate Medical Center College of Medicine, Brooklyn, New York.
Academic Medicine : Journal of the Association of American Medical Colleges
|September 28, 2013
Summary
Medical schools must address ethical challenges by fostering faculty-student dialogue. Systemic issues and faculty burnout impede ethical training, impacting patient care and increasing medical errors.
Area of Science:
- Medical Education
- Bioethics
- Healthcare Professional Development
Background:
- Clinical education should prepare medical students for ethical challenges.
- Many medical schools face barriers like denial, system overload, and faculty burnout, hindering ethical discussions.
- Burnout in students and faculty can lead to patient dissatisfaction and medical errors.
Purpose of the Study:
- To examine persistent themes in student reflections on ethical dilemmas.
- To highlight the inadequacy of didactic teaching alone for ethical preparedness.
- To advocate for a significant culture change in medical education regarding ethics.
Main Methods:
- Analysis of hundreds of student reflections on ethical dilemmas.
- Identification of recurring themes in student-submitted classroom exercises.
Main Results:
- Classroom and didactic teaching alone are insufficient for equipping students to navigate ethical dilemmas.
- Persistent themes indicate systemic issues and faculty-related problems impede ethical training.
- Faculty burnout is a significant factor contributing to negative outcomes.
Conclusions:
- A major culture shift is required in medical education to effectively address ethical challenges.
- Recommendations include administrative buy-in, appointing an ombudsperson/ethicist, faculty training, and addressing faculty performance.
- Ongoing research and inter-institutional dialogue are crucial for developing novel solutions.
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