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Teaching Ethics to Pediatric Residents: A Literature Analysis and Synthesis
K Martakis1, K Czabanowska2, P Schröder-Bäck2
1Children's and Adolescents' Hospital, University Hospital of Cologne, Cologne, Germany.
Background:
Ethics education rarely exists in pediatric resident curricula, although ethical conflicts are common in the clinical practice. Ethics education can prepare residents to successfully handle these conflicts.
Aim:
We searched for methods in teaching ethics to clinical and especially pediatric residents, and identified recurring barriers to ethics teaching and solutions to overcome them.
Design:
Literature from 4 electronic databases with peer-reviewed articles was screened in 3 phases and analyzed. The literature included papers referring to applied methods or recommendations to teaching ethics to clinical residents, and on a second level focusing especially on pediatrics. An analysis and critical appraisal was conducted.
Results:
3 231 articles were identified. 96 papers were included. The applied learning theory, the reported teaching approaches, the barriers to teaching ethics and the provided solutions were studied and analyzed.
Conclusions:
We recommend case-based ethics education, including lectures, discussion, individual study; regular teaching sessions in groups, under supervision; affiliation to an ethics department, institutional and departmental support; ethics rounds and consultations not as core teaching activity; recurring problems to teaching ethics, primarily deriving from the complexity of residential duties to be addressed in advance; teaching ethics preferably in the first years of residency. We may be cautious generalizing the implementation of results on populations with different cultural backgrounds.
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