Teaching Ethics using a Small-Group, PBL Format

Abstract

Ethics is a key component of our first-year Introduction to Clinical Medicine-1 (ICM-1) course. ICM-1 uses a small-group, problem-based learning (PBL) format to involve groups of seven to nine students and two facilitators, one a physician and the other a non-physician, in realistic clinical problems. The course’s six cases emphasize ethics learning issues, but also include human behaviour, basic science, clinical medicine, and prevention issues. The ethics learning issues require students to identify the case’s ethical problems and to explain options to resolve the conflicts. Three ICM-1 cases use written case vignettes, and the other three cases use standardized patients (SPs). Groups meet twice for each case. In the first session, students read a case introduction, obtain data from the written case or SP, formulate learning issues, and assign research responsibilities. Between sessions, the students research the learning issues identified in session one. In the second session students present and discuss their assigned learning issues and address the case’s ethical dilemmas by planning and justifying clinical actions. Following three cases, groups write an essay discussing their learning issues and describing how they would resolve the ethics, human behaviour, clinical medicine, basic science, and prevention issues.