Mun Kit Wong1,2, Daniel Zhi Hao Hong1,2, Jiaxuan Wu1,2, Jacquelin Jia Qi Ting1,2, Jia Ling Goh1,2, Zhi Yang Ong1,2, Rachelle Qi En Toh1,2, Christine Li Ling Chiang1,2, Caleb Wei Hao Ng1,2, Jared Chuan Kai Ng1,2, Clarissa Wei Shuen Cheong1,2, Kuang Teck Tay1,2, Laura Hui Shuen Tan1,2, Yun Ting Ong1,2, Min Chiam3, Annelissa Mien Chew Chin4, Stephen Mason5,6, Lalit Kumar Radha Krishna1,2,3,5,6,7,8,9. 1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 2. Division of Palliative Medicine, National Cancer Centre Singapore, Singapore, Singapore. 3. Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore. 4. Medical Library, National University of Singapore Libraries, Singapore, Singapore. 5. Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, United Kingdom. 6. Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom. 7. Duke-NUS Medical School, Singapore, Singapore. 8. Centre of Biomedical Ethics, National University of Singapore, Singapore, Singapore. 9. PalC, The Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore.
Abstract
INTRODUCTION: Ensuring medical students are equipped with essential knowledge and portable skills to face complex ethical issues underlines the need for ethics education in medical school. Yet such training remains variable amidst evolving contextual, sociocultural, legal and financial considerations that inform training across different healthcare systems. This review aims to map how undergraduate medical schools teach and assess ethics. METHODS: Guided by the Systematic Evidence-Based Approach (SEBA), two concurrent systematic scoping reviews were carried out, one on ethics teaching and another on their assessment. Searches were conducted on PubMed, Embase, PsycINFO and ERIC between 1 January 1990 and 31 December 2020. Data was independently analysed using thematic and content analysis. RESULTS: Upon scrutinising the two sets of full-text articles, we identified 141 articles on ethics teaching and 102 articles on their assessments. 83 overlapped resulting in 160 distinct articles. Similar themes and categories were identified, these include teaching modalities, curriculum content, enablers and barriers to teaching, assessment methods, and their pros and cons. CONCLUSION: This review reveals the importance of adopting an interactive, multimodal and interdisciplinary team-teaching approach to ethics education, involving community resource partners and faculty trained in ethics, law, communication, professionalism, and other intertwining healthcare professions. Conscientious effort should also be put into vertically and horizontally integrating ethics into formal medical curricula to ensure contextualisation and application of ethics knowledge, skills and attitudes, as well as protected time and adequate resources. A stage-based multimodal assessment approach should be used to appropriately evaluate knowledge acquisition, application and reflection across various practice settings. To scaffold personalised development plans and remediation efforts, multisource evaluations may be stored in a centralised portfolio. Whilst standardisation of curricula content ensures cross-speciality ethical proficiency, deliberative curriculum inquiry performed by faculty members using a Delphi approach may help to facilitate the narrowing of relevant topics.
INTRODUCTION: Ensuring medical students are equipped with essential knowledge and portable skills to face complex ethical issues underlines the need for ethics education in medical school. Yet such training remains variable amidst evolving contextual, sociocultural, legal and financial considerations that inform training across different healthcare systems. This review aims to map how undergraduate medical schools teach and assess ethics. METHODS: Guided by the Systematic Evidence-Based Approach (SEBA), two concurrent systematic scoping reviews were carried out, one on ethics teaching and another on their assessment. Searches were conducted on PubMed, Embase, PsycINFO and ERIC between 1 January 1990 and 31 December 2020. Data was independently analysed using thematic and content analysis. RESULTS: Upon scrutinising the two sets of full-text articles, we identified 141 articles on ethics teaching and 102 articles on their assessments. 83 overlapped resulting in 160 distinct articles. Similar themes and categories were identified, these include teaching modalities, curriculum content, enablers and barriers to teaching, assessment methods, and their pros and cons. CONCLUSION: This review reveals the importance of adopting an interactive, multimodal and interdisciplinary team-teaching approach to ethics education, involving community resource partners and faculty trained in ethics, law, communication, professionalism, and other intertwining healthcare professions. Conscientious effort should also be put into vertically and horizontally integrating ethics into formal medical curricula to ensure contextualisation and application of ethics knowledge, skills and attitudes, as well as protected time and adequate resources. A stage-based multimodal assessment approach should be used to appropriately evaluate knowledge acquisition, application and reflection across various practice settings. To scaffold personalised development plans and remediation efforts, multisource evaluations may be stored in a centralised portfolio. Whilst standardisation of curricula content ensures cross-speciality ethical proficiency, deliberative curriculum inquiry performed by faculty members using a Delphi approach may help to facilitate the narrowing of relevant topics.
Entities:
Keywords:
Medical education; assessing ethics; medical ethics; medical school; teaching ethics