INFLUENCE OF SPECIALISTIC TRAINING IN FAMILY MEDICINE ON DETECTION AND MANAGEMENT OF ETHICAL DILEMMAS

Abstract

Background Ethical dilemmas are an important part of daily routine in family practice. One of the options for better quality in family practice is also an effective postgraduate education in the field of bioethics. We wanted to determine the influence of the specialization process on the susceptibility of family physicians to ethical dilemmas and their solving difficulty. We hypothesized that specialists in family medicine would detect the ethical dilemmas more often and that they would report of less problems in their managing. Methods The cross-sectional study included a random sample of 259 Slovenian family medicine physicians (30 % of the whole population of family physicians). Participants were given a self-administered questionnaire on perceived ethical dilemmas in family practice with responses on a 5-point scale and a maximum score of 100. Results In the final analysis 142 Slovenian family medicine physicians (55 % response rate) were included. Specialists in family medicine and residents of family medicine reported ethical dilemmas more often than their colleagues without specialization (37.0 ± 12.6 vs. 30.7 ± 10.8; P = 0.05). Similarly, the residents of family medicine reported ethical dilemmas more often than their colleagues without specialization (39.5 ± 12.5 vs. 30.7 ± 10.8, P = 0.04). Specialists in family medicine and residents of family medicine considered solving ethical dilemmas to be more difficult than their colleagues without specialization (57.3 ± 11.6 vs. 47.1 ± 11.8, P = 0.001). The same differences exist also between the specialists in family medicine and their colleagues without specialization (56.7 ± 11.7 vs. 47.1 ± 11.8, P = 0.003) and between the residents of family medicine and their colleagues without specialization (62.0 ± 10.0 vs. 47.1 ± 11.8, P = 0.001). Conclusions Physicians that are working in family practices need effective postgraduate education in the field of detection and management of ethical dilemmas. The questionnaire for perceived ethical dilemmas proved to be a reliable instrument for evaluation of education’s effectiveness.