Topic: Education of Health Care Professionals

MBE Graduate De Jesus Wins National Award for Leadership in Internal Medicine Bioethics

Berman Institute director Jeffrey Kahn, Jeremy Sugarman, Vivian Altiery De Jesus, and Joseph Carrese

Vivian Altiery De Jesus, MD, a graduate of the Berman Institute’s Master of Bioethics Program and a second-year internal medicine resident at Johns Hopkins Bayview Medical Center, has been selected by the JHU Division of General Internal Medicine as the recipient of the 2022 national competition for Housestaff GIM Research Award in bioethics for her abstract “Needs Assessment in Bioethics Education in Internal Medicine, Pediatrics, and Combined Medicine-Pediatric Resident Physicians.” Berman Institute faculty member Joseph Carrese, MD, served as one of DeJesus’s faculty mentors on the project.

The award is named for Berman Institute faculty member Jeremy Sugarman, MD. Six awards are offered, each named for an internationally regarded mentor and researcher at Johns Hopkins with a faculty appointment in the Division of General Internal Medicine.

The awards were established to stimulate interest in academic GIM and recognize outstanding house officers who have the potential to become leaders in GIM-related research. In addition to bioethics, awards are offered in:

  • Medical education
  • Addiction research
  • Clinical care and research in HIV
  • Health services and outcomes research
  • Behavioral medicine and health disparities

Awardees presented their winning abstracts during a special GIM grand rounds on Friday, December 16, 2022.

As part of De Jesus’s Bioethics Practicum written deliverable — a required course where master students are exposed to bioethics field experience — she wrote The Forgotten Text, twelve chapters of narrative medicine about the formation of a physician from 2015 to 2020. The Forgotten Text explores, under an ethical lens, the encounters and challenges that medical students may face during their education.

Dr. Sugarman is the Harvey M. Meyerhoff Professor of Bioethics and Medicine; Professor of Medicine; Professor of Health Policy and Management; and Deputy Director for Medicine of the Berman Institute of Bioethics at the Johns Hopkins University. Dr. Sugarman is Chair of the Ethics Working Group of the HIV Prevention Trials Network, Co-Lead of the Ethics and Regulatory Core of the NIH Health Care Systems Research Collaboratory and Co-Chair of the Johns Hopkins Institutional Stem Cell Research Oversight Committee. Dr. Sugarman conducts both theoretical and empirical research in bioethics. He is renowned for his work on informed consent, research ethics and the ethical issues associated with emerging technologies.

3rd Annual SNFBA Summer Course to focus on Ethics and Research: Lessons from the Pandemic

The Stavros Niarchos Foundation Bioethics Academy (SNFBA) is proud to announce that it will be hosting the 3rd Annual Bioethics Summer Course at the Stavros Niarchos Foundation Cultural Center in Athens, Greece June 19-22, 2022.

The Bioethics Summer Course is an annual training activity of the SNFBA whose goal is to support and enhance knowledge and awareness for bioethics among biomedical researchers, policy professionals, and healthcare administrators in Greece.  The course is co-directed by Prof. Jeffrey Kahn, the Andreas C. Dracopoulos Director of the Johns Hopkins Berman Institute of Bioethics (JHU), and Prof. Effy Vayena, Head of the Health Ethics and Policy Lab at the Swiss Federal Institute of Technology in Zurich (ETH).

The 3rd Annual Bioethics Summer Course  will be a three-day intensive course focusing on Ethics and Research: Lessons from the Pandemic and, as in past years, will include lectures from distinguished bioethics experts from Johns Hopkins and ETH Zurich, and in-depth small group discussion of case studies and lecture topics.

Cost

The SNFBA is free to accepted participants, and fully supported through the generosity of the Stavros Niarchos Foundation (SNF). Airfare and lodging is provided to accepted participants from outside of Greece and lodging (and travel where required) is provided to accepted participants who reside outside of Athens.  The total number of participants is limited to 50 to preserve a high-quality experience.

Eligibility 

Applications are encouraged from professionals working in institutions in Greece and the Balkans, with the following experience and expertise:

  • Professionals working in, or overseeing, Clinical Research
  • Medical Students and Pharmaceutical Students interested in developing capacity in Clinical Research
  • Members of committees performing Biomedical Research Ethics Review
  • Professionals working in health and science policy

Applications:

Applications are now being accepted online until April 11, 2022 but may close earlier if 50-person capacity is reached.

Required Application Documentation

  • Curriculum Vitae
  • Short Personal Statement no more than 250 words including why the Course is of interest to you, your motivation for applying, and how the Course will be of use in your professional work and professional development

Apply for the 3rd annual SNFBA Bioethics Summer Course now.

For questions please contact Katerina Ligomenides ([email protected])

Berman Institute Creates Course for Medical Students Disrupted by COVID

The education of students at Johns Hopkins School of Medicine was among the countless disruptions caused when the COVID-19 pandemic first struck in March, as new safety measures suddenly prohibited medical students who would normally have been doing clinical rotations from accessing the hospital and patients. Seeing an opportunity to provide a meaningful and timely alternative, the University’s Berman Institute of Bioethics quickly created and offered a new elective, Ethical and Policy Challenges in the Era of Covid-19: Implications for Clinical Practice, Research and Public Health, that immersed students in independent scholarly research projects studying the pandemic’s impact in real time.

“When I was doing background research, ethics felt like a very academic and philosophical subject,” said Laura Pugh, a third-year medical student with an interest in Internal Medicine. “In the course, I really appreciated the application of ethics and the way it was not just used to explore theoretical ideas, but to bring it into practice and make recommendations for ways things could and should be done in a better way.”

During the course, Pugh conducted two projects related to allocation frameworks for rationing life-saving care. One compared systems for allocation, especially for people with disabilities, and one was creating an intellectual history of changes in thinking about allocation frameworks from the early 2000s to the start of the pandemic.

Read Pugh’s paper, “Disability and discrimination in triage frameworks: a commentary on mathematical approaches to reducing discrimination.”

Each student in the course was paired with a Berman Institute faculty member whose research interests aligned with the student’s. Formal courses meetings occurred (via Zoom) once a week for two hours from mid-April until late May. The majority of the course was the students’ independent research work on their projects, guided by weekly meetings with their faculty mentors.

“Bioethics is not just a theoretical field,” said Gail Geller, the Berman Institute’s Director of Educational Programs, who created the course. “These medical students learned that it’s also a place to do serious, rigorous empirical research projects.”

Students Katie Clark and Megan Hunt teamed to conduct an empirical assessment of healthcare workers’ attitudes about self-infection/immunity passports, as well as a state-by-state comparison of plans to end social distancing. Their paper, “SARS-CoV-2 safer infection sites: moral entitlement, pragmatic harm reduction strategy or ethical outrage?” has been published by the Journal of Medical Ethics.

“I became especially concerned about disparities that came up in some of our projects, and how we could create policies that provide everyone equal access to healthcare, and even augment care for those already facing disparities,” said Hunt. “Particularly in the ventilator project, we found it very enlightening to delve into the principles of how people are justifying medical decision making, deciding who is entitled to what, and what risk we’ll accept for ourselves and for other people.”

Also accepted for publication was Jareatha Abdul-Raheem’s paper, “Re-imagining the Role of School-Based Health Centers during the COVID-19 Pandemic,” which will appear in a forthcoming edition of the Journal of School Health.

Other projects included:

  • Qualitative interviews with obstetrical and pediatric providers to assess their views of home vs. hospital births in light of the COVID-19 pandemic;
  • Assessing the impact of infection prevention and control policies, in particular visitor restrictions, in an inpatient labor and delivery setting on exacerbating disparities in obstetric outcomes for black women; and
  • Reimagining the role of SBHCs in increasing access to care during COVID-19 through expansion of telehealth services, enhancing SBHC-parental communication and engagement, and improving continuity of care through SBHC-community provider partnerships.

“As a future physician, a lot of my experience with ethics is cases, the one-on-one patient perspective. I was rarely thinking about public health on a larger scale, but rather dealing with it on a micro level,” said Abdul-Raheem. “What drew me into bioethics was delving deeply into the health implications of the Covid is affecting everything on a macro level.”

The Berman Institute faculty mentors included two physicians, Megan Collins and Marielle Gross, philosopher Anne Barnhill, public health bioethicist Ruth Faden, and general bioethicist Alan Regenberg.

“The interdisciplinary nature of the elective’s mentors demonstrates how COVID has blurred boundaries in a beneficial way,” said Geller. “Both within the University and between experts in fields like bioethics, medicine, and public health, we’re all working together in new and effective ways.”

Employing Greek Tragedy to Help Medical Professionals Cope with COVID

Frontline medical workers continue to confront unprecedented professional and personal challenges of the COVID-19 pandemic. From their own inadequate access to personal protective equipment to facing impossible decisions about allocating limited lifesaving resources among their patients, clinicians have experienced feelings of betrayal, anger, and fear.

Now, by combining one of the pandemic’s newest forms of communication – the Zoom webinar – with the ancient art of Greek tragedy, an innovative project is reaching frontline medical workers who may be struggling in isolation, providing them the opportunity to name and communalize their experiences, connect with colleagues, and access available resources.

Theater of War for Frontline Medical Providers – developed by Theater of War Productions, the Johns Hopkins Berman Institute of Bioethics, and the Johns Hopkins Program in Arts, Humanities & Health – presents dramatic readings by acclaimed actors of scenes from ancient Greek plays for audiences of frontline medical providers to open up powerful dialogue about difficult subjects. In a paper published by The Lancet on July 23, the project’s organizers write “we have found that presenting scenes from ancient tragedies about complex ethical situations for frontline medical providers generates an open, non-threatening space in which health personnel can begin to process, interrogate, share, and bear witness to experiences of loss, betrayal, grief, and other forms of moral suffering during the COVID-19 pandemic.”

Theater of War for Frontline Medical Providers events begin with a live reading of scenes carefully curated to address themes and issues that medical providers may be facing during the pandemic, such as personal risk, abandonment, deferred grief, deviation from standards of care, helplessness, and complicity in creating suffering. After the performance, the actors are replaced by four panelists—a diverse group of front-line medical providers—who respond to what they heard in the plays that resonated with their own experiences of caring for patients during the pandemic. After the panelists’ remarks, a skilled facilitator prompts the audience to join the discussion with a series of questions encouraging reflection and dialogue about themes raised by the plays. The discussion provides an opportunity for the medical workers in the audience to take center stage, sharing the impact of COVID-19 on their lives and finding solace in the community of their peers.

The project premiered on May 24, with 417 clinicians from the Baltimore area logging onto Zoom for a performance featuring Frances McDormand, Jesse Eisenberg, David Strathairn, and Frankie Faison. In a post-performance evaluation, 93% of respondents reported that the program offered new insights about their experience during COVID; 92% said the program made it easier to talk about difficult subjects related to COVID. Following that success, the Arts in Health Initiative of the Laurie M Tisch Illumination Fund provided a grant to fund 10 performances of the project in New York City.

The first of these performances, focusing on the EMS/first responder community in NYC will take place Thursday, July 30, at 7 p.m. While focusing on EMS professionals, this first performance will be open to the general public. To register, please visit: www.towems.eventbrite.com. Cast members will include: Anthony Almojera, Vice President of New York City’s Uniformed EMS Officers Union; Amy Ryan, whose credits include “The Office,” “Birdman,” and “Gone Baby Gone;” and Chad Coleman from “The Wire” and “The Walking Dead,” among other credits.

Other actors confirmed to participate in upcoming performances include McDormand, Strathairn, Faison, Eisenberg, and David Zayas. The next two performances will be:

August 19, noon-2 p.m.
Lincoln Medical Center, Bronx
Featuring Frances McDormand, Jesse Eisenberg, David Zayas, Frankie Faison

September 16, noon-2 p.m.
Lenox Hill Hospital
Manhattan Eye, Ear, and Throat
Lenox Health Greenwich Village
Cast TBA

“Ancient tragedies provide a new entry point for clinicians to process moral suffering generated by the pandemic,” wrote Theater of War Artistic Director Bryan Doerries and Berman Institute faculty Cynda Rushton, Jeremy Greene and Gail Geller in The Lancet. “While individual cognitive reframing can be helpful in the treatment of traumatic disorders, there is also a role for collective social interventions in responding to collective trauma. Ancient Greek plays about chronic and terminal illness, moral distress, the challenges of witnessing suffering, and end-of-life care can be used to forge a common vocabulary for openly engaging doctors, nurses, students, and other health-care professionals in creating constructive dialogue, fostering understanding, compassion, and a renewed sense of community.”

Berman Featured at “Hopkins on the Hill”

To underscore the role and subsequent results of federally-funded research, Johns Hopkins hosted a showcase of 21 project teams from all corners of the institution, including three Berman Institute faculty, at a special June 12, event in the House of Representatives, called Hopkins on the Hill.

Berman Institute Associate Director for Global Programs Joe Ali was selected to present the Berman Institute’s training programs for scholars in sub-Saharan Africa.

“Debates about ethical controversies in global health research are often dominated by voices from the global ‘North,’” said Ali. “Federally-funded global bioethics initiatives empower sub-Saharan African researchers and institutions to meaningfully engage in local and international research and deliberations about the ethics of such research.”

Ali was joined by Berman Institute associate faculty member Megan Collins, whose presentation was titled “A Vision for Success: How Providing Glasses is Helping Baltimore’s Youth.”

Also presenting was Carey Business School professor Mario Macis, who recently became an affiliate member of the Berman Institute faculty. Macis presented about “Motivating HIV Testing with Incentives and Behavioral Nudges.”

“We are thrilled to highlight these early career researchers whose scientific investigations and innovations represent a fraction of the remarkable, publicly funded research underway at Johns Hopkins,” says JHU President Ronald J. Daniels. “Their work is not only advancing scientific understanding, but also creating products and therapies that improve the quality of life in America.”

Daniels has long been an advocate for the importance of federal support for research, especially for young researchers. Johns Hopkins has led U.S. universities in research and development spending for 39 consecutive years, putting a record $2.562 billion in FY2017 into projects to cure disease, promote human health, advance technology, and expand knowledge of the universe and ourselves.

“The wide breadth of research at Johns Hopkins, from engineering to the life sciences, from the social sciences to the humanities, continues to be funded at record levels,” says Denis Wirtz, the university’s vice provost for research. “This support allows the institution to uphold its critical mission of fostering independent and original research, and bringing the benefits of discovery to the world.”

Berman Institute Launches SNF Bioethics Academy

The Johns Hopkins Berman Institute of Bioethics (JHU) in conjunction with the Bioethics Chair at the Swiss Federal Institute of Technology (ETH) have launched a new initiative called the Stavros Niarchos Foundation Bioethics Academy (SNFBA). The SNFBA is exclusively supported by the Stavros Niarchos Foundation (SNF) and was created with the intent to support and enhance knowledge and awareness for bioethics in Greece.

Visit the SNF Bioethics Academy for full information.

The three main components of the SNFBA are:

  1. An intensive bioethics summer course offered every June, beginning in 2019, in Athens, Greece;
  2. Annual in-depth workshops alternating between Zurich, Switzerland (hosted at ETH) and Baltimore, USA (hosted by JHU), beginning winter 2021;
  3. An alumni network that provides ongoing connections with other Greek bioethics professionals, resources and information through a dedicated website, and virtual discussions via webinar.

Summer Bioethics Course

June 20-22, 2019
Stavros Niarchos Foundation Cultural Center

The SNFBA is co-directed by Prof. Jeffrey Kahn, the Andreas C. Dracopoulos Director of the Johns Hopkins Berman Institute of Bioethics (JHU), and Prof. Effy Vayena, Head of the Health Ethics and Policy Lab at the Swiss Federal Institute of Technology in Zurich (ETH).

The inaugural Bioethics Summer Course in 2019 is a three-day course including lectures by international faculty followed by small group discussions facilitated by JHU and ETH faculty and Greek bioethics experts.

IN-DEPTH WINTER TWO-DAY WORKSHOPS

These workshops will alternate between Zurich, Switzerland (hosted at ETH) and Baltimore,  U.S.A. (hosted at JHU) and will include faculty from the Summer Course along with additional visiting faculty. Approximately 20 attendees will be invited per workshop, based on their interest in further training and education in bioethics and their aptitude for bioethics.

Workshop content will be topical and developed with input from the selected participants.  The program will include presentations by all participants, intensive case analysis and consultation (with at least some actual cases provided by participants), train-the-trainer exercises so that participants can return to their institutions/workplaces to help educate their peers, and additional specialized content.

ALUMNI NETWORK

The third component of the Stavros Niarchos Foundation Bioethics Academy will be an Alumni Network created for summer course participants, all of whom will automatically be members.

In addition to providing news, resources and information via a dedicated SNFBA website, email, and social media channels, the network will be a means for staying in touch with other SNFBA alumni in Greece and bioethics faculty at JHU and ETH. The network will host virtual discussions via webinar and convene in-person reunions and events in conjunction with the timing of the annual summer course and SNF Annual International Conference in Athens.

Cynda Rushton Named to Nurse Researcher Hall of Fame

Berman Institute faculty member Cynda Rushton has been selected for induction into the Sigma Theta Tau International Honor Society of Nursing (Sigma) 2019 International Nurse Researcher Hall of Fame. Professor Rushton was chosen for significant contributions to the nursing profession and her sustained research efforts to improve the care and health of people, specifically in the areas of aging and nursing ethics.

As Anne and George L. Bunting Professor of Clinical Ethics at the Berman Institute and the Johns Hopkins School of Nursing, Rushton, PhD, RN, FAAN, focuses on moral suffering and resilience of clinicians, and designing cultures of ethical practice. In 2014, she co-led the first-ever National Nursing Ethics Summit to prepare a blueprint for nursing ethics in the 21st century, and in 2016, an initiative to help nurses transform morally distressing experiences into moral resiliency.

Her most recent work has been designing, implementing, and evaluating the Mindful Ethical Practice and Resilience Academy (MEPRA) to train nurses challenged with patient suffering, resource allocation, and other ethical situations to respond with integrity. She is author and editor of a new book Moral Resilience: Transforming Moral Suffering in Healthcare (Oxford University Press).

“Ethical practice is the bedrock of nursing, and we are at a pivotal junction in health care that demands that we reorient toward our moral compass,” says Rushton. “My work has been supported by so many peers and mentors along the way, which has helped make this honor a reality. I am humbled and grateful to have been selected as part of this distinguished group of nurses.”

Rushton will be inducted at Sigma’s 30th International Nursing Research Congress in Canada, July 2019.

A version of this article was first published by the JHSON.

Joseph A. Carrese, MD, MPH, FACP

Joseph Carrese, MD, MPH, FACP is Professor of Medicine at the Johns Hopkins University School of Medicine, a member of the Division of General Internal Medicine at the Johns Hopkins Bayview Medical Center, and a core faculty member of the Johns Hopkins Berman Institute of Bioethics.

Dr. Carrese’s scholarship focuses on clinical ethics and professionalism, with a particular interest in medical education, examining ethical issues in the context of cultural diversity and clinical ethics consultation. Dr. Carrese’s peer-reviewed articles have been published in leading medical and bioethics journals, such as JAMA, BMJ, CHEST, Academic Medicine, the Hastings Center Report, the Journal of General Internal Medicine, the Journal of Clinical Ethics, the American Journal of Bioethics and Medical Education. Dr. Carrese has been a visiting professor at several academic medical institutions and he has been invited to speak at many national and international meetings.

Dr. Carrese was on the Board of Directors for the American Society for Bioethics and Humanities from 2012-15. In 2012 Dr. Carrese was a founding Board member and Chair-elect of the Academy for Professionalism in Healthcare (APHC). From 2013-2015 he was Chair of the Board of Directors of APHC and he was the immediate past-Chair 2016-18.

Dr. Carrese received a National Award for Scholarship in Medical Education at the Society of General Internal Medicine annual meeting in April 2008 for his body of work in the area of clinical ethics education. From 2009-2014 Dr. Carrese was a member of the ASBH standing committee on Clinical Ethics Consultation Affairs (CECA) and in October 2011 he received the ASBH Presidential Citation Award for his work on this committee. Dr. Carrese is a Fellow of the Hastings Center.

Dr. Carrese is Chair of the Ethics Committee at the Johns Hopkins Bayview Medical Center, Chair of an Institutional Review Board at the Johns Hopkins School of Medicine, and primary care doctor to a panel of patients seen at the Bayview Medical Offices internal medicine clinic on the Johns Hopkins Bayview Medical Center campus.

Dr. Carrese graduated from Williams College and the University at Buffalo School of Medicine. He completed a fellowship in the Robert Wood Johnson Clinical Scholars Program at the University of Washington in Seattle, where he studied medical ethics and anthropology. Dr. Carrese joined the faculty at Johns Hopkins in 1994.