A companion to bioethics , A companion to bioethics , کتابخانه مرکزی دانشگاه علوم پزشکی تهران

A Companion to Bioethics

Medical ethics education, it has been said, has 'come of age' in recent years in terms of its formal inclusion in undergraduate medical curricula. This review article examines the background to its inclusion in undergraduate curricula and goes on to examine the consensus that has arisen on the design of ethics curricula, using Harden's curriculum and S.P.I.C.E.S models as templates. While there is consensus on content for undergraduate medical ethics education, there is still significant debate on learning and teaching methods. Despite the broad agreement on the need to apply adult education principles to ethics teaching, there would appear to be some tension between balancing the need for experiential learning and achieving the 'core curriculum'. There are also as yet unresolved difficulties with regards to resources for delivery, academic expertise, curriculum integration and consolidation of learning. Assessment methods also remain contentious. Although there is consensus that the ultimate goal of medical ethics, and indeed of medical education as a whole, is to create 'good doctors', the influence of the 'hidden curriculum' on students' development is only beginning to be recognized, and strategies to counteract its effects are in their infancy. The need for proper evaluation studies is recognized. It is suggested that the areas of debate appearing in the literature could be used as a starting point for evaluation studies, which would form the empirical basis of future curriculum development.

http://ethicist.kmu.edu.tw/pimages/p-55/j.1365-2923.2000.00607.pdf

Review of ethics curricula in undergraduate medical education.

Introduction Most medical schools in the UK have been engaged in major curriculum reform based on their premises of what might improve undergraduate medical education. In 1994 the course at the medical school of the University of Manchester changed to an integrated course using problem-based learning throughout and with increased emphasis on community-based medical education. This study explores whether the new curriculum has produced any differences in perceptions of how well graduates are prepared for the role of preregistration house officer. Methods A postal questionnaire was used to survey 1998 Manchester graduates (traditional course) and 1999 Manchester graduates (new course), three months into their first pre-registration house officer placement. A similar questionnaire was sent to the educational supervisors who were supervising the graduates. The questionnaire was designed to measure perceptions of levels of preparedness for the role of pre-registration house officer, using a list of broad areas of competence and specific skills listed in the General Medical Council’s ‘The New Doctor’. 1 Results Graduates rated the new course significantly more effective for 12 of the 19 broad competences and eight of the 13 specific skills that were listed. The ‘new’ graduates rated their understanding of disease processes lower than the ‘traditional’ graduates, but there was no difference in the ratings given by the educational supervisors for this. Overall the educational supervisors rated the new course as better preparing graduates in five of the competences. Conclusions Overall, the evaluation shows that a major change in curriculum approach has changed the profile of the perceived preparedness of graduates for entering professional practice.

Perceptions of how well graduates are prepared for the role of pre-registration house officer: a comparison of outcomes from a traditional and an integrated PBL curriculum.

Communication teaching and assessment in medical education: an international consensus statement

PurposeDespite attempts to describe the “ideal” medical ethics curriculum, few data exist describing current practices in medical ethics education to guide curriculum directors. This study aimed to determine the scope and content of required, formal ethics components in the curricula of U.S.

Ethics education in U.S. medical schools: a study of syllabi.

The General Medical Council has stated that medical ethics and law should constitute one of the core components of the medical curriculum.' The practice of good medicine inevitably raises both ethical and legal issues and demands an understanding of both. In this document, teachers of medical ethics and law in medical schools throughout the UK now offer their own consensus statement about the issues, concepts, arguments, skills and attitudes that all medical students should understand and know how to apply in practice by the time they qualify. This consensus proposes a minimal core undergraduate programme ofwork which we believe to be consistent with the stated objective of the General Medical Council that students should acquire a knowledge and understanding of "ethical and legal issues relevant to the practice of medicine" and an "ability to understand and analyse ethical problems so as to enable patients, their families, society and the doctor to have proper regard to such problems in reaching decisions".' Some organisational principles are also summarised which we believe to be crucial for the successful implementation of our proposed undergraduate programme.

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Teaching medical ethics and law within medical education: a model for the UK core curriculum

Teaching medical ethics and law within medical education: a model for the UK core curriculum. Consensus statement by teachers of medical ethics and law in UK medical schools

Detonation development in the presence of hot spots is a challenge for some combustion concepts based on autoignition. When those reactivity gradients are caused by temperature inhomogeneities, the disturbed autoignition process can be affected by fuel blends, which reduce the temperature sensitivity of ignition delay times. In Part I of this study, a fuel blend of dimethyl ether (DME) and dimethoxymethane (DMM) is proposed. The reduction of temperature sensitivities of ignition delay times was experimentally confirmed. In the present Part II of this study, fuel blends of DME and DMM are investigated numerically to classify the effect on the mode of autoignitive wave propagation. Two none-dimensional parameters ξ and ε are usually used to create regime diagrams for autoignitive wave propagation in the presence of hot spots. The parameter ξ is a measure for coupling between pressure wave and reaction wave, whereas ε qualitatively describes the characteristic time scale of heat release. Both parameters are calculated using zero-dimensional simulations. Fuel blending using DME and DMM allows for a reduction of ξ lower than unity over a wide range of temperatures, which is associated with supersonic autoignitive wave propagation. Comparing calculated ξ and ε values to an existing regime diagram from the literature, fuel blending has a significant impact on the position in the regime diagram and thus helps to inhibit detonation formation in the presence of hot spots. 

L Zander

Papers

Teaching medical ethics and law within medical education: a model for the UK core curriculum

Teaching medical ethics and law within medical education: a model for the UK core curriculum. Consensus statement by teachers of medical ethics and law in UK medical schools

Autoignition of DME/DMM Fuel Blends: Part II: Reaction Wave Propagation Modes in the Presence of Temperature Gradients