title: An innovative approach to teaching bioethics in management of healthcare.
abstract: BACKGROUND
  Bioethical courses were introduced in the curricula in medical universities in Bulgaria in 1990s. In the beginning, the courses were mainly theoretical, and systematic case analyses and discussions of movies were introduced later on. The benefits of using films to teach ethics have been previously analyzed in the literature; however, to our knowledge such studies in Bulgaria are yet lacking.
  
  
  OBJECTIVE
  The aim of this study was to survey the opinions of students and analyze the results from the application of movies in bioethics teaching in a medical university in the north of Bulgaria.
  
  
  METHODS
  A survey was carried out among 92 students in the management of healthcare. Two movies were used, and separate protocols for film discussion were developed.
  
  
  METHODS
  The study was conducted anonymously and with students' free informed consent.
  
  
  CONCLUSIONS
  The students distinguished in total 21 different dilemmas and concepts in the first movie. The ethical dilemmas were classified into five groups: general ethical issues, deontological issues, special ethical issues, principles of bioethics, and theories of ethics. The second movie focused students' attention on the issues of death and dying. In total, 18 elements of palliative care were described by the students. The range of different categories was a positive indicator of an increased ethical sensitivity. The students evaluated the movies' discussions as a generally positive educational approach. They perceived the experience as contributing to their better understanding of bioethical issues.
  
  
  CONCLUSIONS
  The innovative approach was well accepted by the students. The introduction of movies in the courses of bioethics had the potential to provide vivid illustrations of bioethical issues and to contribute to the exploration of specific theses and arguments. The presentation and discussion should be preceded by accumulation of theoretical knowledge. The future of effective bioethics education lays in the interactive involvement of students.
authors.affiliation: Medical University of Pleven, Bulgaria silviya_aleksandrova@hotmail.com.
authors.forename: Silviya
authors.initials: S
authors.lastname: Aleksandrova-Yankulovska
mesh_terms: D001291:Attitude of Health Personnel; D001675:Bioethics / Q000193:education*; D002031:Bulgaria; D003479:Curriculum; D004059:Diffusion of Innovation; D004501:Education, Medical / Q000379:methods*; D006801:Humans; D009040:Motion Pictures; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Bioethics; ethical dilemmas; innovative approach; movies’ discussion; teaching bioethics