Background Effective management of clinical ethical issues has a significant impact on patients’ experience and outcome. Our anonymous survey found that final year medical students have a confidence of 5.6 (10-point Likert scale) of the management of common clinical medical ethical issues. We have designed high-fidelity simulation teaching to teach about ethical principles and their practical application to patient cases.
Methodology We identified three common clinical ethical issues through focus group work with junior doctors. We designed three high-fidelity simulation scenarios to cover the issues. The scenarios were; (1) maintaining patient confidentiality when talking to relatives, (2) mental capacity assessment in a self-discharge case and (3) acting in a vulnerable patient’s best interests. We delivered the three scenarios with detailed debriefs to five groups of final year medical students.
Results Thirty-three medical students provided feedback (n = 33) through an anonymous paper questionnaire. We collected qualitative and quantitative feedback via fre text boxes and 10-point Likert scales.
Confidentiality: After the confidentiality scenario there was an improved awareness of 1.38/10 (p-value 0.0007) from 8.21 to 9.59. There was an improvement in confidence with management of 2.36/10 (p-value <0.0001) from 5.97 to 8.33.
Capacity: This scenario showed an improved perceived relevance of 1.01/10 (p-value 0.0015) from 8.58 to 9.59. Student’s confidence with management improved by 1.94/10 (p-value < 0.0001) from 6.70 to 8.64.
Best interests: Students reported an improved awareness of 1.03/10 (p-value < 0.0052) from 8.58 to 9.61. The student’s confidence with management improved by 2.30/10 (p-value < 0.0001) from 5.97 to 8.27.
Students commented in the feedback that there was a ‘massive difference to learning in real time than textbook’ and it made the ethics teaching ‘much more fun and more memorable.’
Recommendations We hope to expand this teaching to students within other healthcare professions and postgraduate healthcare professionals.
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