Beyond silos: An interprofessional, campus-wide ethics education program.

BACKGROUND: Ethics education is essential to the education of all healthcare professionals. The purpose of this study was to evaluate an interprofessional approach to ethics education to all students across an academic health science center. RESEARCH OBJECTIVES: The objectives were to (1) compare student perception of ethics education before and after the implementation of the campus-wide ethics program and (2) determine changes in student ethical decision-making skills following implementation of a campus-wide ethics program. RESEARCH DESIGN: This study was a quasi-experimental design with seniors graduating prior to the intervention serving as the control group. PARTICIPANTS AND RESEARCH CONTEXT: The setting was a comprehensive health science center in the southwestern United States. All students enrolled in the university participated in the intervention; however, 976 graduating students were used for evaluation of the intervention. ETHICAL CONSIDERATIONS: Study materials for each survey were submitted to the university's IRB, and the project was approved as exempt by the Committee for the Protection of Human Subjects. Student participation in the surveys was voluntary. No names or other identifying information were collected, and responses to the survey questions were kept confidential. FINDINGS: Students' perception of the adequacy of time spent on the ethics content in course instruction and practical training decreased from the baseline to the fifth-year survey. Students' overall comfort level with their abilities to deal with ethical issues increased from the baseline to the fifth year. Student ethical decision-making skills were higher at the third-year evaluation for all indicators. For the fifth-year survey, responses were also higher scoring on all four indicators. DISCUSSION: After participation in an interprofessional campus-wide effort on health professions ethics, students demonstrated higher ethical decision-making scores according to the Health Professional Ethics Rubric. However, their scores still did not reach the proficiency level identified in the rubric. CONCLUSION: Examination of the effectiveness of each part of the intervention is needed.

Reflections for Clinical Pastoral Education Students in Psychiatric Settings.

This article focuses on Donald Capps's books on mental illness. In doing so I highlight three key insights from Capps that I have applied in my own ministry with persons with mental illness in various psychiatric hospitals. These insights, together with my own experience as a chaplain, lead to three practical lessons for clinical pastoral education students in psychiatric settings. I provide some context for my interest in mental illness and my friendship with Capps, as well as some background regarding how Capps's writings on mental illness fit with certain broader themes in his own work as a pastoral theologian. This essay is personal throughout.

The Brewsters: A new resource for interprofessional ethics education.

BACKGROUND: One of the barriers to interprofessional ethics education is a lack of resources that actively engage students in reflection on living an ethical professional life. This project implemented and evaluated an innovative resource for interprofessional ethics education. OBJECTIVES: The objective of this project was to create and evaluate an interprofessional learning activity on professionalism, clinical ethics, and research ethics. DESIGN: The Brewsters is a choose-your-own-adventure novel that addresses professionalism, clinical ethics, and research ethics. For the pilot of the book, a pre-test/post-test design was used. Once implemented across campus, a post-test was used to evaluate student learning in addition to a student satisfaction survey. PARTICIPANTS AND RESEARCH CONTEXT: A total of 755 students in six academic schools in a health science center completed the activity as part of orientation or in coursework. ETHICAL CONSIDERATIONS: The project was approved as exempt by the university's Committee for the Protection of Human Subjects. FINDINGS: The pilot study with 112 students demonstrated a significant increase in student knowledge. The 755 students who participated in the project had relatively high knowledge scores on the post-test and evaluated the activity positively. DISCUSSION: Students who read The Brewsters scored well on the post-test and had the highest scores on clinical ethics. Clinical ethics scores may indicate issues encountered in mass media. CONCLUSION: The Brewsters is an innovative resource for teaching interprofessional ethics and professionalism. Further work is needed to determine whether actual and long-term behavior is affected by the activity.

Doctors and Dr. Seuss.

In 2012, Dartmouth College renamed its medical school, founded in 1797, the Audrey and Theodor Geisel School of Medicine. Using the renaming of the medical school of Dartmouth College as a foil, I offer in this article a vision of what it might mean to align Theodor Geisel, better known as Dr. Seuss, with doctors by examining Geisel's You're Only Old Once! A Book for Obsolete Children. In this article, I derive four critiques of modern medicine from the book and offer four strategies as to how these critiques could be explored in medical education. If You're Only Old Once! is read as a pathography, I argue that it can be used as a resource for medical education.

Living in limbo: Ethics and experience in a conversation about persistent oral lesions.

This case report presents a conversation that the authors had with a patient who is suffering from oral lichen planus and oral cancer. The reason that the authors approached the patient for an interview was to find out why he decided to enroll in an experimental study related to his oral cancer. The patient reported that it was "the waiting" that led him to enroll in this study--that is, the pressure of waiting for oral cancer to reemerge was simply unbearable, and enrolling in this experimental study enabled him to take a more proactive approach to his illness. The authors view this "waiting" as a "limbo experience" and reflect on the implications of this limbo experience for dental ethics and research ethics.

The journey beyond silos. Teaching and learning interprofessional ethics at UTHealth.

Interprofessional education and ethics education are two educational programs that blend together well, and, moreover, they are a natural fit for teaching in an academic health science center. The purpose of this paper is to describe our recent journey of developing and implementing an interprofessional ethics curriculum across the six schools of UTHealth. We provide an overview of the goals of the Campus-wide Ethics Program, which is housed in the McGovern Center for Humanities and Ethics, and we highlight certain innovative developments that are the result of the collaborative work of faculty and administrators from all six schools of UTHealth. In addition, a brief synopsis of the specific didactic and clinical courses in which ethics is a significant component is outlined for both the dental and the dental hygiene curricula. Lastly, we describe some of the recent scholarly activities that are a product of this new program. We are excited about our evolving efforts and the potential benefits of weaving interprofessional ethics within our school and across our campus. This article tells the story of our journey beyond "the silos" that are common among academic health science centers.

Living in limbo: ethics and experience in a conversation about persistent oral lesions.

This case report presents a conversation that the authors had with a patient who is suffering from oral lichen planus and oral cancer. The reason that the authors approached the patient for an interview was to find out why he decided to enroll in an experimental study related to his oral cancer. The patient reported that it was "the waiting" that led him to enroll in this study--that is, the pressure of waiting for oral cancer to re-emerge was simply unbearable, and enrolling in this experimental study enabled him to take a more proactive approach to his illness. The authors view this "waiting" as a "limbo experience" and reflect on the implications of this limbo experience for dental ethics and research ethics.

Coming to terms with our regrets.

This article focuses on the personal experience of regret and the importance of coming to terms with our regrets. It begins with a sermon preached by the first author in which the issue of regret is explored by means of a summary of the film The Big Kahuna, continues with a discussion of recent articles (Tomer and Eliason, Existential and spiritual issues in death attitudes, 2008; Mannarino et al., Existential and spiritual issues in death attitudes, 2008) on the concept of regret formulated by Landman (Landman, Regret: A theoretical and conceptual analysis, 1987; Regret: The persistence of the possible, 1993), and on regret therapy, and concludes with a pastoral care case in which a dying woman expresses both future-related and past-related regrets. The case is interpreted in light of regret therapy's emphasis on parabolic experiences and reframing techniques.