RESUMO
BACKGROUND: Medical ethics is a critical component of the curriculum for clinical trainees. Educational initiatives should adapt content to participants' experience in order to ensure relevance and retain their interest. AIM: To develop and evaluate an experiential educational program for physicians. SETTING: Academic medical center. PARTICIPANTS: Senior internal medicine residents (n = 40). PROGRAM DESCRIPTION: A case-based didactic program was designed in which each resident shared a difficult ethics case from their clinical experience. We created a curriculum around these cases involving formal didactics as well as open-ended discussion and summarized the ethical issues most relevant to the participants. A course survey was administered based upon the validated Students' Evaluation of Educational Quality (SEEQ). PROGRAM EVALUATION: Common issues raised included surrogate decision-making (18 %), refusal of treatment (14 %), capacity/informed consent (10 %), and medical futility (10 %). Mean SEEQ subscale scores for learning value, organization/clarity, group interaction, breadth of coverage, and assignments/readings were 4.5 (maximum possible score 5). Residents unanimously rated the course overall as good/very good, and all agreed or strongly agreed that the course was useful and its structure effective. DISCUSSION: An experiential case-based didactic program in medical ethics engaged adult learners and facilitated a comprehensive and clinically relevant educational initiative.
Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Ética Médica/educação , Internato e Residência/organização & administração , Aprendizagem Baseada em Problemas/organização & administração , Centros Médicos Acadêmicos/organização & administração , Atitude do Pessoal de Saúde , Currículo , Educação de Pós-Graduação em Medicina/métodos , Humanos , Medicina Interna/educação , Prontuários Médicos , New York , Aprendizagem Baseada em Problemas/métodos , Avaliação de Programas e Projetos de SaúdeRESUMO
A patient diagnosed with REM behavior sleep disorder (RBD) has as much as a 65% risk of developing an α-synucleinopathy. Currently, it is not possible to predict whether an individual will develop a disease, or, if so, which disease.The neurologist treating the patient must consider (1) the difference between disclosing a diagnosis and disclosing the risk of a diagnosis; (2) whether to disclose this risk to patients; and (3) if deciding to disclose the risk, the appropriate timing of such a conversation.