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Learning about ethics

Hospitalist Leadership Connection, November 2, 2010

Attending physicians can take an active role in instilling ethics into the student setting, according to a new study, “Postcards from Our Students—Reflections on Professionalism and Ethics,” published in the October Journal of Hospital Medicine.

During their junior medicine rotation, students at Northwestern University’s Feinberg School of Medicine post vignettes about ethical situations on their online student forum. From those experiences, researchers share these scenarios with the department of medicine conference, as well as the monthly ethics conference. For example, in one post, a student describes a situation in which a patient was administered 25mg of morphine instead of 2.5mg. Because an error in a decimal point, a patient was sedated for a day, but there was no lasting harm. No one told the patient or the family about the mistake. The goal of sharing these experiences is to raise awareness about under-the-radar issues, explore attitudes about professionalism and ethics, and share skills.

From these experiences, article authors extracted the following strategies to help attending physicians foster an ethical climate:

• Create an open climate by breaking down the communication barriers, such as setting aside time for introductions
• Set clear expectations about patient-clinician and family-clinician communications, including difficult conversations, such as bad news or code status
• Have regular check-ins during rounds
• Supervise, plan, and debrief

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