Teaching Ethics to Pediatric Residents: A Literature Analysis and Synthesis.
BACKGROUND
Ethics education rarely exists in pediatric resident curricula, although ethical conflicts are common in the clinical practice. Ethics education can prepare residents to successfully handle these conflicts.


OBJECTIVE
We searched for methods in teaching ethics to clinical and especially pediatric residents, and identified recurring barriers to ethics teaching and solutions to overcome them.


METHODS
Literature from 4 electronic databases with peer-reviewed articles was screened in 3 phases and analyzed. The literature included papers referring to applied methods or recommendations to teaching ethics to clinical residents, and on a second level focusing especially on pediatrics. An analysis and critical appraisal was conducted.


RESULTS
3 231 articles were identified. 96 papers were included. The applied learning theory, the reported teaching approaches, the barriers to teaching ethics and the provided solutions were studied and analyzed.


CONCLUSIONS
We recommend case-based ethics education, including lectures, discussion, individual study; regular teaching sessions in groups, under supervision; affiliation to an ethics department, institutional and departmental support; ethics rounds and consultations not as core teaching activity; recurring problems to teaching ethics, primarily deriving from the complexity of residential duties to be addressed in advance; teaching ethics preferably in the first years of residency. We may be cautious generalizing the implementation of results on populations with different cultural backgrounds.
Children's and Adolescents' Hospital, University Hospital of Cologne, Cologne, Germany.
K
K
Martakis
Department of International Health, CAPHRI-School of Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
K
K
Czabanowska
Department of International Health, CAPHRI-School of Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
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P
Schröder-Bäck
D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D004992:Ethics, Medical / Q000193:education*; D005858:Germany; D006801:Humans; D007396:Internship and Residency; D010372:Pediatrics / Q000193:education*