Contribution of ethical reasoning learning sessions on medical training

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Published Apr 6, 2024
https://doi.org/10.62438/tunismed.v102i4.4695
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Vol. 102 No. 4 (2024): Tunis Med apr 2024

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Amjed Ben Haouala
Department of Psychiatric, Fattouma Bourguiba’s Hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Badii Amamou
Department of Psychiatric, Fattouma Bourguiba’s Hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Bochra Ben Mohamed
Department of Psychiatric, Fattouma Bourguiba’s Hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Ahmed Mhalla
Department of Psychiatric, Fattouma Bourguiba’s Hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Ferid Zaafrane
Department of Psychiatric, Fattouma Bourguiba’s Hospital, Monastir, Faculty of Medicine of Monastir, Tunisia

Abstract

Introduction: Ethical reasoning is an important skill for all physicians who often face complex ethical dilemmas in their daily practice. Therefore, medical training should include methods for learning ethical theories and concepts, as well as how to apply them in practical situations.


Aim: Assess the contribution of an Ethical Reasoning Learning session to fifth medical students’ training through a comparison of results of the same objective and structured clinical examination (OSCE) in the form of simulated interview before and after sessions.


Methods: Four 45- minutes’ sessions of Ethical Reasoning Learning (ERL) were implemented during a psychiatry internship for four groups of 5th-year students of the faculty of medicine of Monastir (Tunisia). Each session was divided into 7 parts: introduction, reading of a clinical vignette, brainstorming concerning the problems posed by this clinical situation, classification of the problems, identification of the principles of medical ethics, construction of the ethical matrix, and a conclusion.


Results: Fifty-seven students participated in the study divided into 4 groups. We found a significant difference in the means of the OSCE scores before and after the ERL session and a significant difference between the probability of respecting medical secrecy during pre and post-ethical reasoning learning sessions (p <0.001). We have found an effect of ERL sessions on the acquisition of this ethical competence by medical students.


Conclusion: We learned that an ERL session has improved medical training in ethics applied to psychiatry. Other sessions dealing with other ethical skills are necessary to confirm these results.

Keywords:

Learning , Clinical Reasoning, Ethical Issues , Psychiatry , Medical Education

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References

  1. Marcoux H, Patenaude J. L’éthique et la formation médicale Où en sommes-nous? Où allons-nous?. Ped Med. 2000;1(1):23-30.
  2. Askitopoulou H, Vgontzas AN. The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times. Eur Spine J. 2018;27(7):1481‑90. doi:10.1007/s00586-017-5348-4
  3. Llorca G. Ethique et formation médicale Révision des concepts. Ped Med.2002;3(3):169‑79.
  4. Giubilini A, Milnes S, Savulescu J. The Medical Ethics Curriculum in Medical Schools: Present and Future. J Clin Ethics. 2016;27(2):129‑45.
  5. Yazigi A, Madi-Jebara S, Yazbeck P. Les séances d’apprentissage du raisonnement éthiqueappliquées à la formation des résidents en anesthésie-réanimation. Ped Med. 2007;8(3):177‑83
  6. Tsai TC, Harasym PH. A medical ethical reasoning model and its contributions to medical education: Development of a medical ethical reasoning model. Med. Educ. 2010;44(9):864‑73. doi: 10.1111/j.1365-2923.2010.03722.x
  7. Ames A, Smith KL, Sanchez ER, Pyle L, Ball T, Hawk WJ. Impact and persistence of ethical reasoning education on student learning: results from a module-based ethical reasoning educational program. Int. J. Ethics. Educ. 2017; 2:77-96.
  8. Boulianne S, Laurin S, Firket P. Aborder l’éthique en supervision clinique: Une approche en 3 temps. Can Fam Physician. 2013;59(7):795-797.
  9. Mohammed MR, Maizia A, Seddiki MMS, Mokhtari L. Les effets de l’intégration de la simulation sur l’apprentissage des gestes procéduraux de base et de l’examen physique en stage hospitalier dans le cursus pré-gradué des études médicales d’une faculté de médecine en Algérie. Ped Med. 2020;21(2):83‑9.
  10. Kenny B, Lincoln M, Killian F. Ethics Cases: Do they Elicit Different Levels of Ethical Reasoning? J. Acad. Ethics. 2015;13(3):259‑75. doi: 10.1007/s10805-015-9234-6
  11. Simkins DW, Steinkuehler C. Critical Ethical Reasoning and Role-Play. Games Cult. 2008;3(3‑4):333‑55. doi: 10.1177/1555412008317313
  12. Marei HF, Al-Eraky MM, Almasoud NN, Donkers J, Van Merrienboer JJG. The use of virtual patient scenarios as a vehicle for teaching professionalism. Eur J Dent Educ. 2018;22(2):e253‑60. doi: 10.1111/eje.12283
  13. Llorca G. Formation pratique à la décision médicale complexe par la méthode du « microconsensus » : étude préliminaire. Ped Med. 2004;5(4):204‑10.
  14. Patenaude J. Enseignement et évaluation en éthique médicale : pourquoi s’en préoccuper ? Ped Med. 2002;3(3):133‑4.
  15. D’Urzo KA, Flood SM, Baillie C, Skelding S, Dobrowolski S, Houlden RL, et al. Evaluating the implementation and impact of a motivational interviewing workshop on medical student knowledge and social cognitions towards counseling patients on lifestyle behaviors. Teach Learn Med.2020;32(2):218-230. doi: 10.1080/10401334.2019.1681273
  16. Pellerin D. A propos du rapport CORDIER: Ethique et Professions de Santé. Médecine et humanisme. Bull. Acad. Natl. Med. 2004;188(3):539-545. doi:10.1016/S0001-4079(19)33784-7
  17. Barrier JH, Brazeau-Lamontagne L, Pottier P, Boutoille D. Comparaison des compétences médicales éthiques des étudiants de 3e et de 6e année en stage hospitalier en médecine interne. Rev Med Interne. 2005;26(2):128‑36. doi: 10.1016/j.revmed.2004.09.022
  18. Larkin GL. Evaluating Professionalism in Emergency Medicine: Clinical Ethical Competence. J. Acad. Emerg. Med. 1999;6(4):302‑11. doi: 10.1111/j.1553-2712.1999.tb00394.x