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Topic: Medical Education
November 11, 2014 | Posted By Jane Jankowski, DPS, LMSW

In Peter D. Kramer’s New York Times piece published in the ‘Couch’ section on October 18, 2014 (Why Doctors Need Stories) he affirms the experience of learners, educators, and researchers in his arguments that a case vignette can provide a kind of instruction that cannot be duplicated by data collection alone. While we do still need evidence based material to assure safety and efficacy of treatments, the case study offers contextual material that makes the evidence come to life.

As a Clinical Ethicist each clinical encounter is rich with substantive information that is part of an individual or family story intersecting with the healthcare setting. When invited to provide input, support, or recommendations in any given case, the most informative elements of any case are the story of the patient. What was before, what is now, and what the future may require is different for each patient, and I am often awed by the ‘before.’ The contextual landscape of each story is often where we come to understand the psychosocial factors that weigh heavily in how a patient, family, or community interacts with the healthcare community. Hard data is not as useful as hearing the story that belongs to the patient.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

October 21, 2014 | Posted By Jane Jankowski, DPS, LMSW

The clerkship years of medical school expose students to a range of specialties medical practitioners may select as an area of advanced study during residency. Pediatrics, surgery, general medicine, radiology, psychiatry, and more are part of the array of educational exposures students gain from during these rotations. As an educator facilitating discussion groups which provide the opportunity for reflection, questioning, and connecting expectations to the actual experiences, I have found that there are gaps in understanding the roles of other personnel that are essential to the physician role, but not always well defined. As we strive to encourage future physicians to do their best to understand that the business of medicine takes a small village of practitioners in order to work best, we do too little to help them learn the perspective of these other providers. Lectures and readings may offer some insight, but the street-level day to day operations may be a bit of a mystery. I propose clerkship years include time spent working alongside professionals beyond physicians such as pharmacists, billing specialists, security guards, social workers, lab technicians, and visiting nurses. While learners may not be able to fully walk in the shoes of other essential staff members, but being alongside another who is willing to teach and share the tasks, the struggles and rewards of their position. Many med students will someday be in position to lead large groups of staff members in clinics, hospitals, and private offices. Recognizing the unique roles, strengths, and limitations of the non-physicians who contribute to the day to day operations of our vast healthcare industry will help build well rounded doctors who are prepared to be effective leaders. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

March 31, 2014 | Posted By Zubin Master, PhD

I have written on this blog about the topic of stem cell tourism and the different strategies that have been proposed to stop the phenomenon. Just to provide a background on the topic from a previous blog: stem cell tourism is used to describe an internet-based direct-to-consumer advertised industry where clinics offer untested and unproven stem cell interventions as bonafide therapies to patients with a range of diseases and injuries including Parkinson’s disease, multiple sclerosis, ALS, blindness, cancer, cerebral palsy, spinal cord injury and many others. Basically there is no scientific evidence of safety of efficacy of these modalities to offer them on a for-profit basis to patients. The term was originally coined as a form of tourism because patients traveled from countries like the U.S., U.K., Canada and Australia to clinics in countries with lax regulations, but this simply is not the case anymore. There are several clinics within highly regulated countries like U.S. that offer stem cell interventions.

Of the several strategies people have discussed, one of the first has been on the topic of providing education to patients and the public. Here, people argue that providing education on the dangers of stem cell tourism might actually sway patients to not undertake unproven stem cell interventions. As some scholars have mentioned, education might not be as effective because it depends on a “rationale actor model” where we assume that patients will behave rationally and make choices based on weighing the harms and benefits of seeking unproven treatments. More so, such an argument does not sufficiently consider the hope patients have to ameliorate their disease, reduce pain or other symptoms, and increase their quality of life. While these counterarguments are certain rational and likely to be true, there is yet no solid evidence showing whether education on stem cell tourism is effective at swaying people from traveling for unproven interventions. But even if before we go into whether education might influence a patient’s decision to travel for unproven stem cell treatments, I think we need to assess the role of patient education in medicine.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

September 19, 2013 | Posted By Wayne Shelton, PhD

When ethics and humanities were first introduced into the first few medical curricula in the early 1970’s, there was considerable optimism about how the exposure to ethics and humanities could “humanize” young physicians and positively affect their practice habits. Learning about the humanistic areas of medicine from trained experts, sometimes referred to as “humanists”, was perhaps naively assumed to be somewhat of an antidote to the effects of the growing medical industrial complex that had become evident to many. Although we take for granted the place of ethics and humanities in most medical school curricula today, those of us who teach in these areas forget that the1970’s were not that long ago and that we are still learning the ropes of how to integrate our efforts into the medical culture. The field has matured as evidenced in the transition from the early naivety regarding the potential impact of knowledge and ideas presented in the abstract versus the realization of how knowledge and ideas are learned, and indeed embodied, in clinical practice; this growing understanding of the factors at work in medical education also parallels the growth and development of educators in ethics and humanities, who by the 1990’s had become entrenched in the mainstream of U.S. medical centers. Many of these same ethics and humanities faculty had made a huge transition from being isolated in an academic area like philosophy to being deeply involved in the hospital clinical setting.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

April 4, 2013 | Posted By John Kaplan, PhD

It is now just about a year since the American Association of Medical Colleges (AAMC) announced major changes to the Medical College Admission Test (MCAT). These changes will go into effect in about two years from now. This is a very big deal. These are the first changes since 1991. During 2011 86,181 people took the MCAT. This event was extremely important to all of these people. These are the people who wish to go to medical school. The results of the MCAT will be an extremely important determinant of who is admitted to medical school. The number of people who took the exam is approximately five times the number of people who will actually be admitted to and enter an American allopathic medical school for studies leading to the coveted Doctor of Medicine (M.D.). Those on this path have been planning and preparing for the MCAT for years. A change in the test will lead to corresponding changes in the path.

According to AAMC President and CEO Darrell G. Kirch, M.D. “We all know America is becoming much more diverse, and we have an aging population unlike anything we’ve seen in this country. These changes to the exam have been done with a very clear eye toward the changes that are occurring in health care and the kinds of physicians we will need.”

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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