Training pediatric house staff in evidence-based ethics: an exploratory controlled trial.
OBJECTIVE
To evaluate an educational intervention in evidence-based ethics (emphasizing clinical knowledge, epidemiologic skills, and recognition of ethical issues) administered to house staff before rotating through our neonatal intensive care unit.


METHODS
A controlled trial of 64 pediatric house staff assigned to alternating control and intervention rotations. Questionnaires were administered at the end of the rotation.


RESULTS
Some benefits of the intervention were observed. However, a large percentage of intervention and control house staff substantially overestimated (>1.25 correct value) predischarge mortality (23% vs. 55% of house staff; p<0.02), mortality or major morbidity (74% vs. 46% of house staff; p=0.04), and cerebral palsy rates (70% vs. 87%; p=0.12). Neither group cited many methodological criteria for evaluating follow-up studies (3.3 vs. 2.4 criteria; p=0.05) or ethical issues considered in treatment recommendations for extremely premature infants (3.1 vs. 2.8 issues; p=0.35).


CONCLUSIONS
Improved house staff training in evidence-based ethics is needed.
Major-Kincade
T L
TL
UT Southwestern Medical Center at Dallas, Department of Pediatrics, Dallas, TX 77030-1503, USA.
Tyson
J E
JE
Kennedy
K A
KA
D004992:Ethics, Medical; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality*; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital; D010372:Pediatrics; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D013781:Texas