title: The status of ethics education in obstetrics and gynecology.
abstract: To establish the present status of ethics education in obstetrics and gynecology, 256 questionnaires were sent to residency (graduate) and student (undergraduate) education programs. One hundred ninety-eight questionnaires were returned. Fifteen programs offered no ethics education; 167 offered resident level courses; 123 offered undergraduate (student) level courses; and 84 offered postgraduate education. The median number of hours offered was 2 undergraduate, 4 graduate, and 2 postgraduate. The courses offered relied primarily on formal lecture presentation, even though this was not considered most effective by the respondents. Most institutions (85%) used more than one format to present ethics material. General ethics principles were covered in 78% of the reporting institutions. Where ethics case histories were used, they were rated higher in efficacy by the respondents. Only 15% of the reporting institutions had any means of measuring outcomes. The issues cited most frequently as critical in a curriculum were abortion, maternal-fetal conflicts, issues surrounding care decisions at the end of life, and informed consent. The few hours dedicated to ethics were small relative to a long list of issues. Obstetric-gynecologic faculty with any training in medical ethics were uncommon (29%). The form of teaching, except in rare circumstances, seemed to lack structure or design and used few of the available reading materials. Recommendations from this survey include the development of a uniform national curriculum for undergraduate and graduate medical ethics, development of evaluation alternatives for ethics education, and encouragement and support for faculty development in medical ethics.
authors.affiliation: University of Washington Medical Center, Seattle.
authors.forename: J M
authors.initials: JM
authors.lastname: Cain
authors.forename: T
authors.initials: T
authors.lastname: Elkins
authors.forename: P F
authors.initials: PF
authors.lastname: Bernard
mesh_terms: D026688:Bioethical Issues; D002170:Canada; D003479:Curriculum; D003625:Data Collection; D004503:Education, Medical, Graduate; D004504:Education, Medical, Undergraduate; D028663:Ethical Theory; D004992:Ethics, Medical / Q000193:education*; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D009774:Obstetrics / Q000193:education*; D011795:Surveys and Questionnaires; D014481:United States