Ethics and the evidence in medical school education: melding outpatient medical ethics with training in evidence-based medicine

Tags: Poster
Domino F, Comes J, Levin L

Background: Traditional medical ethics focus on the events of life and death. Outpatient medical ethics address the issues that occur in the ambulatory setting, and most often involve the concept of informed consent. In an effort to integrate the Evidence Based Medicine (EBM) curriculum at the University of Massachusetts with the outpatient ethics content, a unique intervention was devised and will be presented for discussion.

Objectives: By the end of this session, the learner will:

1. Understand the concepts of outpatient medical ethics

2. Consider a novel instructional method that combines ethics and EBM concepts

3. Observe examples of how students have integrated ethical and EBM concepts in a simple educational intervention.

Methods: Following a three-hour EBM training provided to all students during their Family Medicine Clerkship, all students are sent an email via listserv (group email discussion list) asking them to choose a clinical intervention. Using the EBM resources presented during the training, students are asked to find a systematic review on their chosen topic, and determine the intervention's effectiveness by evaluating the data using methods presented during their EBM training. Students are asked to consider their perception of this intervention before and after their review, and determine if this EBM perspective has changed their understanding. Based upon this information, students are asked if they would still recommend this intervention to patients.

Results: Students rank their EBM training in the Family Medicine clerkship very high. Additionally, their self-rated understanding of ambulatory medical ethics was significantly improved by this listserv intervention. Qualitative evaluation of students' specific comments is currently underway to assess if this intervention has changed their appreciation of the effectiveness of medical treatments.

Conclusions: Medical ethics and EBM can be easily integrated into undergraduate medical education. This process allows learners to demonstrate their new skills of identification and interpretation of the medical evidence, while expanding their appreciation of how ethics plays a role in every medical decision in the ambulatory setting.