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Teaching global health ethics using simulation: interprofessional training
Meeting Abstracts
Teaching global health ethics using simulation: interprofessional training M Shoeb, T Logar, M H Glass, J D Harrison, T P Brock, S James-Ryan, S Barajas, P V Le
Abstract Background Many ethical dilemmas in global health fieldwork stem from cultural differences and limited resources, and trainees frequently report feeling ill-equipped to deal with such issues. A literature review shows a need for predeparture training that would enable participants to develop a strategy for recognising and resolving such problems. Methods After reviewing global health ethics education and predeparture training resources, we organised multidisciplinary focus groups with global-health experts at our institution. These sessions identified key ethical issues that our training should address: scope of practice, informed consent, privacy or confidentiality, professional ethics, harm and benefit, and corruption. We then developed four scenarios focusing on these ethical issues. Each scenario was followed by a debriefing session led by a faculty facilitator. We piloted the simulation training with a multidisciplinary cohort (n=27) of postgraduate trainees. All participants completed prestimulation and postsimulation evaluations that assessed their exposure to the scenarios’ ethical issues and ability to deal with these ethical dilemmas and identify resources for help. Findings The results showed a significant knowledge gain in the above domains. Paired t-tests were used to compare participants’ agreement scores with the statement “I have a strategy to deal with this ethical issue,” which significantly increased (p<0·05) postsimulation for the following ethical issues: scope of practice, privacy, harm, and corruption.
Published Online May 10, 2014 This online publication has been corrected. The corrected version first appeared at thelancet.com on July 30, 2014 University of California, San Francisco, San Francisco, CA, USA (M Shoeb, T Logar, M H Glass, J D Harrison, T P Brock, S James-Ryan, S Barajas, P V Le) Correspondence to: M Shoeb, University of California, San Francisco, 533 Parnassus Avenue, Suite U149, Box 0131, San Francisco, CA 94141, USA [email protected]
Interpretation Our preliminary results show that the simulation sessions accomplish our training’s objectives. Further, our institution’s ethics faculty expressed a keen interest in integrating these exercises into the mainstream ethics curriculum. Funding The Haile T Debas Academy of Medical Educators Innovations Funding Grant. Copyright © Shoeb et al. Open Access article distributed under the terms of CC BY. Contributors All authors have contributed to study design, implementation, and write-up equally. All authors have seen and approved the final version of the Abstract for publication. Declaration of interests We declare that we have no competing interests. Acknowledgments We thank Dr Pierre Minn and Dr Madhavi Dandu for their important contributions to this pilot.
www.thelancet.com/lancetgh
5
Teaching global health ethics using simulation: interprofessional training M Shoeb, T Logar, M H Glass, J D Harrison, T P Brock, S James-Ryan, S Barajas, P V Le
Abstract Background Many ethical dilemmas in global health fieldwork stem from cultural differences and limited resources, and trainees frequently report feeling ill-equipped to deal with such issues. A literature review shows a need for predeparture training that would enable participants to develop a strategy for recognising and resolving such problems. Methods After reviewing global health ethics education and predeparture training resources, we organised multidisciplinary focus groups with global-health experts at our institution. These sessions identified key ethical issues that our training should address: scope of practice, informed consent, privacy or confidentiality, professional ethics, harm and benefit, and corruption. We then developed four scenarios focusing on these ethical issues. Each scenario was followed by a debriefing session led by a faculty facilitator. We piloted the simulation training with a multidisciplinary cohort (n=27) of postgraduate trainees. All participants completed prestimulation and postsimulation evaluations that assessed their exposure to the scenarios’ ethical issues and ability to deal with these ethical dilemmas and identify resources for help. Findings The results showed a significant knowledge gain in the above domains. Paired t-tests were used to compare participants’ agreement scores with the statement “I have a strategy to deal with this ethical issue,” which significantly increased (p<0·05) postsimulation for the following ethical issues: scope of practice, privacy, harm, and corruption.
Published Online May 10, 2014 This online publication has been corrected. The corrected version first appeared at thelancet.com on July 30, 2014 University of California, San Francisco, San Francisco, CA, USA (M Shoeb, T Logar, M H Glass, J D Harrison, T P Brock, S James-Ryan, S Barajas, P V Le) Correspondence to: M Shoeb, University of California, San Francisco, 533 Parnassus Avenue, Suite U149, Box 0131, San Francisco, CA 94141, USA [email protected]
Interpretation Our preliminary results show that the simulation sessions accomplish our training’s objectives. Further, our institution’s ethics faculty expressed a keen interest in integrating these exercises into the mainstream ethics curriculum. Funding The Haile T Debas Academy of Medical Educators Innovations Funding Grant. Copyright © Shoeb et al. Open Access article distributed under the terms of CC BY. Contributors All authors have contributed to study design, implementation, and write-up equally. All authors have seen and approved the final version of the Abstract for publication. Declaration of interests We declare that we have no competing interests. Acknowledgments We thank Dr Pierre Minn and Dr Madhavi Dandu for their important contributions to this pilot.
www.thelancet.com/lancetgh
5