Problem: A curriculum on bioethics is an accreditation standard of the LCME for all medical schools in the U.S. The majority of the standardized curriculum at our institution occurs in the pre-clinical years before students have experienced ethical dilemmas in clinical practice. The lack of exposure to discussion-based bioethics teaching may limit students’ development of empathy, active listening, and communication strategies.
Intervention: We have implemented two one-hour debate sessions into the Women’s Health Clerkship with the topics of Maternal Fetal Conflict and Periviable Resuscitation. Students watch a video with background information and are pre-assigned a specific viewpoint they will debate in a small group session. Following the debate, the preceptor leads a debrief including communication strategies and ethical guidelines for managing bioethical dilemmas in clinical practice.
Context: The debate sessions were conducted by a faculty preceptor during scheduled didactics on the Women’s Health Clerkship. This context was chosen to maximize the potential for students to debate a bioethical dilemma they would experience during the clerkship.
Outcome: To date, we have successfully completed seven debates. Sessions have varied significantly in arguments and clinical examples presented. Student evaluations of the debates indicate they enjoyed the debate style of learning bioethics, felt the debates fostered an inclusive environment, and appreciated being pre-assigned a viewpoint as this required exploring different viewpoints than those previously held by the student.
Amy Brown, MD