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Ethics Skills Lab Experience for Surgery Interns Margaret Moon, MD, MPH; Erin L. McDonald, MPP; Mark T. Hughes, MD, MA ; Joseph A. Carrese, MD, MPH Johns Hopkins Berman Institute of Bioethics, Program on Ethics in Clinical Practice ETHICS SKILLS LAB BACKGROUND
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Margaret Moon, MD, MPH; Erin L. McDonald, MPP;
Mark T. Hughes, MD, MA; Joseph A. Carrese, MD, MPH
Johns Hopkins Berman Institute of Bioethics, Program on Ethics in Clinical Practice
ETHICS SKILLS LAB
1. Residents discussed experiences with delivering bad news and obtaining informed consent:
2. Faculty facilitated small group discussion to generate frameworks for appropriate practice:
Delivering Bad News: Interns developed ideas about appropriate and inappropriate interactions when delivering bad news.
Setting appropriate for discussion
Patient’s perceptions clarified
Invitation to discuss news
Strategy / Summary of next steps
Informed Consent: Interns developed consensus framework for meaningful informed consent.
Consensus frameworks developed through group discussion closely approximated the established models for both delivering bad news and obtaining meaningful informed consent.
3. Simulated Patient Experience:
Case involving new diagnosis of breast cancer was developed in consultation with Dept. of Surgery faculty.
Role for simulated patient was developed in consultation with Dept. of Surgery and the Simulation Center.
Checklists of appropriate skills when delivering bad news and obtaining informed consentwere distributed to interns to be used while observing simulated patient interactions. Checklists were compared to the consensus frameworks created by the interns.
Case: 33 year old single mother with family history of lung cancer and a new diagnosis of stage 1 ductal carcinoma of the breast. Initially noted on self breast exam; confirmed by mammography. Biopsy occurred 2 weeks ago. Options for surgery include radical mastectomy or lumpectomy with radiation.
2 simulated patient scenarios: