전공의를 대상으로 한 사례중심 의료윤리 (소그룹) 토론교육의 경험

Abstract

Background: Residents struggle with the evaluation and management of inpatient clinical ethical dilemmas. However, few residency programs include medical ethics education as part of their graduate medical training. This study aims to explore the perceived effectiveness, benefits, and learning experiences of residents with small group discussions about ethical dilemmas. Method: We instituted weekly residency ethical conferences to clarify residents’ understanding of medical ethics and to improve their medical ethics competence. Six to nine residents and two or more professors attended the ethical conferences and participated in the discussions. Each participant was given at least five minutes to share their thoughts and reasoning concerning a designated ethical dilemma. In the course of these meetings we also surveyed participants’ self-confidence, level of satisfaction, communication skills, moral motivation, attitudes, reasoning, and moral sensitivity. Result: Teaching residents by means of small group discussions on ethical dilemmas can enhance their ability to address these issues directly and to resolve clinical ethical dilemmas appropriately. Additionally, these group discussions were found to improve participants’ level of satisfaction and ability to communicate. Conclusion: Our experience with small group discussions based on cases involving moral dilemmas shows that discussion can be an effective and practical method of ethics education for residents. The results of this study may have implications for the future improvement of graduate medical education.