Residents' attitudes to training in ethics in Canadian obstetrics and gynecology programs

To determine residents' attitudes toward their current training in ethics, including their preferred learning format, time commitment, and the influences of training and personal background on their views and decision-making process.

All 203 residents from English-speaking Canadian obstetrics and gynecology programs were mailed an 18-question, numerical-response questionnaire in prestamped return envelopes. One hundred thirty-one residents (64.5%) responded (81 to the first mailing and 50 to the second).

The number of hours in the residency program devoted to ethical issues correlated positively with the residents' perception of the residency program in shaping their ethical views (P = .015, r = 0.22). Of the respondents, 44.7% preferred case presentations as their learning format and 30.7% ranked seminars as their first choice. Informal discussions and rounds were less popular, and lectures were considered least appropriate by 69.3%. When asked what most influenced the residents' ethical decision-making process, 34.2% indicated family views, 17.1% undergraduate teaching, 15.4% religious background, 12.8% views of consulting staff, 11.1% residency training, and 9.4% peer attitudes. Sixty-eight percent of residents felt that their training in ethics during their residency program should be increased; this may reflect response bias. A position of conscience conflict during residency training was reported by 28.9% of residents.

Findings from this survey support the benefit of more discussion of ethical issues during residency programs, particularly with the use of case presentations.