Institutions should re-evaluate their orientation practices for ethics committee members that perform ethics consultations, suggests recent research.1 The researchers considered this important question: How are individuals prepared to take on the role of serving on an ethics committee?

“As we examined the literature, it was clear that available data did not answer this important question. So we developed our study,” says Jennifer Cohn Kesselheim, MD, EAC, one of the study’s authors.

The researchers surveyed 116 members and 16 chairs of ethics advisory committees on how members are recruited and what orientation practices are used to educate new members.

“Our aim was to provide data to our own hospitals here at Harvard for purposes of continuous quality improvement,” says Kesselheim, co-chair and the founding director of the Harvard Medical School Master of Medical Sciences in Medical Education program.

The researchers also sought to spark dialogue outside of their institution. “We hope these data motivate ethics committee chairs and hospital ethicists to consider more explicitly how new committee members are oriented and trained,” says Kesselheim.

The researchers hypothesized that responses would be associated with whether participants were familiar with the American Society for Bioethics and Humanities (ASBH) Core Competencies in Healthcare Ethics Consultation. Respondents with greater familiarity with the ASBH competencies did tend to have higher self-reported preparedness. They also experienced more extensive orientation.

“As ASBH continues its important work in setting standards for ethics consultation, we hope our data will be useful,” says Kesselheim. Other key findings include:

• most respondents (62%) found their orientation curricula to be helpful;

• standard educational materials such as readings (50%) and case studies (41%) were offered during orientation;

• videos on ethics consultation were offered 19% of the time;

• a significant number of respondents received no orientation at all (24%) or were unsatisfied with the orientation they did receive (14%).

“We found the data about the rather low prevalence of orientations or other training opportunities noteworthy,” says Kesselheim.

The data spotlight unmet educational needs. “Future research is needed to determine optimal training strategies,” says Kesselheim. Case-based learning, online modules, and simulation are some possible approaches.

Ideally, bioethicists will team with medical educators to devise the best interventions for orientation of ethics consultants, says Kesselheim: “This could be implemented with rigorous outcome measurement to ensure learning objectives are being met.”

REFERENCE

1. Zaidi D, Kesselheim JC. Assessment of orientation practices for ethics consultation at Harvard Medical School-affiliated hospitals. J Med Ethics 2018; 44(2):91-96.

SOURCE

• Jennifer Cohn Kesselheim, MD, Assistant Professor of Pediatrics, Center For Bioethics, Harvard Medical School, Boston. Phone: (617) 355-6363. Email: jennifer_kesselheim@dfci.harvard.edu.