Clinical Ethics Education

Ethics Education in the Graduate Medical Curriculum

In the graduate medical curriculum, ethics is taught in conjunction with professionalism as part of the “Culture of Medicine” core theme which is co-directed by Dr. Gail Geller. The ethics and professionalism content has four overarching goals:

• research ethics;
• clinical ethics;
• ethics and health policy;
• and professionalism.

Basic and advanced objectives have been developed for each overarching goal and specific learning objectives have been articulated for each course in which ethics is highlighted. Most of the introductory material is taught in “Foundations of Public Health, Epidemiology & Ethics” (FPHE). Following FPHE, ethical issues are addressed in numerous other courses as well as clinical clerkships. Several Berman Institute faculty serve as lecturers, small group facilitators, or panel members in these courses.  Dr. Moon oversees the “Professionalism” and “Medicolegal Aspects of Health Care” units in the Transition to Wards course, with Drs. Carrese, Hughes and Berger playing key teaching roles.

In addition, ethics and professionalism is highlighted in the Scholarly Concentrations (SC) course.  SC is required of all first year students who choose one of five concentrations and complete a scholarly project by the middle of their second year. One of the concentrations, co-directed by Drs. Geller and Carrese, is “Humanism, Ethics, and the Art of Medicine.”

Ethics in Residency Training

Since 2006, Berman Institute faculty have been working to enhance ethics education for trainees in several SOM residency training programs. The broad goals of the ethics education program for residents are to:

• increase residents’ awareness of ethics issues in clinical practice;
• increase residents’ appreciation of the importance of ethics to the competent practice of medicine;
• improve residents’ knowledge attitudes and skills with respect to clinical ethics issues;
• have residents develop a common language and approach to ethics issues by becoming familiar with and using our case method for approaching, analyzing, and resolving ethics problems; and
• help prepare residents for the ethics portion of their respective Board exams.

A group of BI faculty currently maintain ethics educational programs in eight residency programs that together account for approximately 400 residents: Child and Adolescent Psychiatry, Gynecology/Obstetrics, Medicine (JHBMC), Medicine (JHH), Neurology, Ophthalmology, Pediatrics, and Surgery.

Berman Institute faculty have been working with the School of Nursing to integrate ethics content into the curricula in the masters entry into practice, master’s specialty, and doctoral programs to provide nursing students the opportunity to learn ethical frameworks and concepts that will enhance their ability to approach ethics issues in practice, education, policy, and research.

As part of the master’s entry into practice curriculum revision, the School of Nursing adopted a systematic framework for ethical analysis and is expanding opportunities for students to apply this framework to practice, including the use of high fidelity simulation. The School of Nursing also offers a required core course in Philosophical, Theoretical, and Ethical Basis of Advanced Practice Nursing for all Master’s and Doctor of Nursing Practice students.

In addition, the Mindful Ethical Practice and Resilience Academy (MEPRA), an academic/practice partnership, provides frontline nurses with an intensive 24 hour program aimed at fostering mindfulness, ethical competence and moral resilience.

The Berman Institute of Bioethics and the Bloomberg School of Public Health partnered to offer a certificate in Bioethics and Health Policy. The Certificate Program’s educational objectives are to:

• Develop students’ ability to recognize and analyze a moral problem in public health practice, research, and health policy;
• Develop students’ ability to further public policy debate concerning moral problems in public health practice, research, and health policy.

The certificate is open to students enrolled in any graduate degree (Masters or Doctoral) program at JohnsHopkins (all divisions). Since its inception in 2008 ,21 graduates have received certificates.