Skip to main content
SpringerLink
Log in

Simulation: an Innovative Approach to Engaging Preclinical Medical Students with Bioethics

  • Short communication
  • Published:
Medical Science Educator Aims and scope Submit manuscript

Abstract

Background

Integrating bioethical concepts into preclinical medical school curriculum and engaging early medical learners in bioethics are a challenge.

Activity

A total of 140 medical students participated in a 2-h simulation activity consisting of a series of standardized patient (SP) encounters.

Results

A total of 41 of 140 students (29%) completed the learner evaluation survey. Ninety-one percent thought that the SP encounter was relevant to their role as a future physician. Ninety-three percent of students rated the exercise as highly effective.

Conclusions

SP encounters enhance preclinical medical students’ engagement with bioethics and provide learners practice applying these concepts to clinically relevant scenarios.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Data Availability

Data collected is non-identifiable and secured with institutional password protection in survey program

References

  1. LCME. Functions and Structure of a Medical School: Standards for accreditation of Medical Education Programs Leading to the MD Degree. http://lcme.org/wp-content/uploads/filebase/standards/2019-20_Functions-and-Structure_2018-09-26.docx.

  2. Lehmann LS, Kasoff WS, Koch P, Federman DD. A survey of medical ethics education at U.S. and Canadian medical schools. Acad Med. 2004;79(7):682–9. https://doi.org/10.1097/00001888-200407000-00015.

    Article  Google Scholar 

  3. Giubilini A, Milnes S, Savulescu J. The medical ethics curriculum in medical schools: present and future. J Clin Ethics. 2016;27(2):129–45.

    Google Scholar 

  4. Carrese JA, Malek J, Watson K, Lehmann LS, Green MJ, McCullough LB, et al. The essential role of medical ethics education in achieving professionalism: the Romanell Report. Acad Med. 2015;90(6):744–52. https://doi.org/10.1097/acm.0000000000000715.

    Article  Google Scholar 

  5. Eckles RE, Meslin EM, Gaffney M, Helft PR. Medical ethics education: where are we? Where should we be going? A review. Acad Med. 2005;80(12):1143–52. https://doi.org/10.1097/00001888-200512000-00020.

    Article  Google Scholar 

  6. Goldie J. Review of ethics curricula in undergraduate medical education. Med Educ. 2000;34(2):108–19. https://doi.org/10.1046/j.1365-2923.2000.00607.x.

    Article  Google Scholar 

  7. Persad GC, Elder L, Sedig L, Flores L, Emanuel EJ. The current state of medical school education in bioethics, health law, and health economics. J Law Med Ethics. 2008;36(1):89–94, 4. https://doi.org/10.1111/j.1748-720X.2008.00240.x.

    Article  Google Scholar 

  8. Lakhan SE, Hamlat E, McNamee T, Laird C. Time for a unified approach to medical ethics. Philos Ethics Humanit Med. 2009;4:13. https://doi.org/10.1186/1747-5341-4-13.

    Article  Google Scholar 

  9. Perkins HS, Geppert CM, Hazuda HP. Challenges in teaching ethics in medical schools. Am J Med Sci. 2000;319(5):273–8. https://doi.org/10.1097/00000441-200005000-00002.

    Article  Google Scholar 

  10. Stites SD, Clapp J, Gallagher S, Fiester A. Moving beyond the theoretical: medical students’ desire for practical, role-specific ethics training. AJOB Empir Bioeth. 2018;9(3):154–63. https://doi.org/10.1080/23294515.2018.1472149.

    Article  Google Scholar 

  11. McDougall R. Combating junior doctors’ “4 am logic”: a challenge for medical ethics education. J Med Ethics. 2009;35(3):203–6. https://doi.org/10.1136/jme.2008.026609.

    Article  Google Scholar 

  12. McGaghie WCIS, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011;86(6):706–11.

    Article  Google Scholar 

  13. Appleton JJCS, Furlong MJ. Student engagement with school: critical conceptual and methodological issues of the construct. Psychol Sch. 2008;45:369–86.

    Article  Google Scholar 

  14. Wang M-T DJ. Staying engaged: knowledge and research needs in student engagement. Child Dev Perspect. 2014;8(3):137–43.

    Article  Google Scholar 

  15. Rosenbaum ME, Kreiter C. Teaching delivery of bad news using experiential sessions with standardized patients. Teach Learn Med. 2002;14(3):144–9. https://doi.org/10.1207/s15328015tlm1403_2.

    Article  Google Scholar 

  16. Boggs SDT, Ben Fadel N, Moore G, Ferretti E. Neonatal ethics teaching program - scenario-oriented learning in ethics: announcing the diagnosis of trisomy 21. MedEdPORTAL. 2017;13:10575.

    Article  Google Scholar 

  17. Moore GFE, Rohde K, Muirhead P, Daboval T. Neonatal ethics teaching program - scenario-oriented learning in ethics: critically ill newborn in the neonatal intensive care unit. MedEdPORTAL. 2015;11:10083.

    Google Scholar 

  18. Daboval TFE, Rohde K, Muirhead P, Moore G. Neonatal ethics teaching program - scenario-oriented learning in ethics: antenatal consultation at the limit of viability. MedEdPORTAL. 2015;11:10043.

    Article  Google Scholar 

  19. Ferretti EMG, Rohde K, Muirhead P, Daboval T. Neonatal ethics teaching program - scenario-oriented learning in ethics: unexpected birth malformation. MedEdPORTAL. 2015;11:10044.

    Article  Google Scholar 

  20. Lupi CBM, Runyan A, Schreiber N. Conscientious refusal: a workshop to promote reflective and active learning of ethics, communication skills and professionalism. MedEdPORTAL. 2012;8:9077.

    Google Scholar 

  21. Schmitz CCMJ, Woll A, Chipman JG. Implementation manual for the University of Minnesota family conference OSCE: an assessment of physicians’ professionalism and interpersonal and communication skills in discussing “bad news.”. MedEdPORTAL. 2011;7:9015.

    Article  Google Scholar 

  22. Lupi CSN, Runyan A. Objective structured clinical examination: non-directive pregnancy options counseling with communication and ethical challenges. MedEdPORTAL. 2012;8:9075.

    Google Scholar 

  23. Brock KCH, Sourkes B, et al. Teaching pediatric fellows palliative care through simulation and video intervention: a practical guide to implementation. MedEdPORTAL. 2015;11:10284.

    Article  Google Scholar 

  24. Singer PA, Robb A, Cohen R, Norman G, Turnbull J. Performance-based assessment of clinical ethics using an objective structured clinical examination. Acad Med. 1996;71(5):495–8. https://doi.org/10.1097/00001888-199605000-00021.

    Article  Google Scholar 

  25. Gisondi MA, Smith-Coggins R, Harter PM, Soltysik RC, Yarnold PR. Assessment of resident professionalism using high-fidelity simulation of ethical dilemmas. Acad Emerg Med. 2004;11(9):931–7. https://doi.org/10.1197/j.aem.2004.04.005.

    Article  Google Scholar 

  26. Mylopoulos M, Kulasegaram K, Woods NN. Developing the experts we need: fostering adaptive expertise through education. J Eval Clin Pract. 2018;24(3):674–7.

    Article  Google Scholar 

  27. Kulasegaram K, Min C, Howey E, Neville A, Woods N, Dore K, et al. The mediating effect of context variation in mixed practice for transfer of basic science. Adv Health Sci Educ Theory Pract. 2015;20(4):953–68.

    Article  Google Scholar 

  28. Kulasegaram KM, Chaudhary Z, Woods N, Dore K, Neville A, Norman G. Contexts, concepts and cognition: principles for the transfer of basic science knowledge. Med Educ. 2017;51(2):184–95.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA

    Christine E. Bishop

  2. Department of Internal Medicine, Medical Center Bioethics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA

    Gerardo Maradiaga

  3. Academic Affairs, Bowman Gray Center for Medical Education, Wake Forest School of Medicine, 475 Vine Street, Winston-Salem, NC, 27101, USA

    Kendall R. Freeman

  4. Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA

    Timothy R. Peters & Jennifer M. Jackson

Authors
  1. Christine E. Bishop
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gerardo Maradiaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kendall R. Freeman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Timothy R. Peters
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jennifer M. Jackson
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conceptualization and design. Material preparation and data collection were performed by Bishop, Jackson, Maradiaga, and Freeman. Data analysis was performed by Bishop and Jackson. The first draft of the manuscript was written by Bishop and Jackson, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Christine E. Bishop.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Wake Forest School of Medicine Institutional Review Board, IRB00050949) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to Participate

Informed consent given with completion of survey

Consent for Publication

Not applicable

Code Availability

Not applicable

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bishop, C.E., Maradiaga, G., Freeman, K.R. et al. Simulation: an Innovative Approach to Engaging Preclinical Medical Students with Bioethics. Med.Sci.Educ. 31, 325–329 (2021). https://doi.org/10.1007/s40670-020-01159-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40670-020-01159-w

Keywords

Search

Navigation