Glen A. Medellin, MD, Jean A. Petershack, MD, University of Texas Health Science Center, San Antonio, TX
Background: Multiple barriers deter third year medical students from processing ethically and humanistically challenging issues. Peer discussion groups can help students process conflict and reflection exercises can promote self awareness and empathy. To teach ethics in a busy clerkship requires the flexibility of asynchronous online learning and the engagement provided by live experiences. Design/Methods: Students rotate through the pediatric clerkship for 6-week blocks in groups of 28 in two sites that are separated by more than 300 miles. All large group activities are videoconferenced. We begin with a large group session where general ethical principles are reviewed by an ethicist and controversial pediatric scenarios are presented by clinical faculty. Students then gather into teams of 4-6 and select a challenging case that they themselves have encountered clinically. Over the next week groups role-play the situation online, with students assuming the role of the person with whom they have most difficulty relating. The group then presents a review of the ethical dilemma with an approach to resolving the conflict to the large group. The project culminates in an opportunity to reflect on the entire experience online in private with course directors. Satisfaction data measured by 4 point likert scales and student comments is being collected. Qualitative analysis of depth of reflection and themes is ongoing. Results: After 3 blocks of students, satisfaction revealed that 87% of students were satisfied with the experience. Only 3% did not consider it a useful learning experience. Qualitative comments by the students showed deep levels of reflection. In comments, students repeatedly reflected that they had never considered ethical dilemmas from different viewpoints and the exercise had changed the way that they would approach ethical dilemmas in the future. Conclusions: Blended learning can be used to teach humanism and ethics during a busy clerkship experience. Students appreciate and enjoy the opportunity to analyze a single ethical dilemma in depth. Online journaling and role plays allow students to process difficult situations and provide new insights into problem solving. Qualitative analysis of online activities will inform the medical education community.