Oct 17, 2017

Physicians Services Incorporated Foundation Awards Grant to Researchers for Novel Ethics Curriculum

The Office of Education Scholarship

Drs. Carrie Bernard and Mahan Kulasegaram received $79,500 from the Physicians Services Incorporated (PSI) Foundation for their upcoming project: The development of a novel ethics curriculum pilot at the University of Toronto Department of Family and Community Medicine (DFCM).

“The PSI Foundation typically funds a wide range of projects but to get a grant of this nature is quite rare. It is one of the few grants to be given for research in education,” says Dr. Bernard. “This grant will help us connect practice, research and theory together. We hope to develop an ethics curriculum based on sound scholarship.”

PSI Foundation’s mission is to improve the “health of Ontario” by funding programs that educate practicing physicians and advance health research. The project, titled From Classroom to Clinic: Assessing a Novel Integrated Curriculum to Teach Ethical Decision Making for Future Physicians, is a mixed-methods study which will evaluate the efficacy and utility of a new ethics curriculum for postgraduate family medicine trainees at DFCM.

The new ethics curriculum has several objectives. It will compare the new pilot curriculum with the traditional methods of teaching ethics. Based on the emerging field of learning sciences, it will aim to integrate classroom teaching with clinical experience. This new curriculum will instill knowledge to better prepare doctors to apply ethical principles when seeing patients in clinical settings. To do so, teaching faculty will work closely with the study team, bioethicists as well as master teachers to apply insights from research in psychology and education to the teaching of ethics.

The study will then examine the curriculum’s impact across multiple settings and teaching sites at DFCM. Researchers anticipate that this new approach will highlight the best principles for teaching ethics and the impact of this approach on how residents make decisions.

“Initially, a group of educators and ethicists got together to review how educators across the world were teaching medical learners about ethics,” says Bernard. “We were joined by Dr. Kulasegaram who had a great deal to offer about new ways of teaching ethics.”

The project began many years ago as DFCM, under the former Chair Dr. Lynn Wilson, sought to collaborate with the Central Community Care Access Centre (CCAC), the Joint Centre for Bioethics, and the Local Health Integration Network (LHIN). The discussion was centered squarely on developing a curriculum that would increase the capacity of ethical deliberation in primary care.

“At the heart of our curriculum is the idea that ethics is not about facts and terminology but changing the way you think about decision making,” says Dr. Kulasegaram. “Ethics is often taught in an abstract way, separated from the clinical realities’ trainees face. Our goal was twofold: Teaching basic ethics well and exposing to the trainees how ethical judgement connects to their daily practice in clinical settings”

Both researchers acknowledge that while the curriculum was developed by a team comprised of various DFCM researchers and educators who worked together cohesively, Dr. Risa Freeman, Vice-Chair of Education at DFCM, was largely responsible for giving the curriculum its rigour.

“Dr. Freeman was the one who advised us about finding the right people for the research team. She also provided guidance on how to create a curriculum that was evidence-based. It took three years to get to this point because we adhered to a rigorous scholarly method on which to build our curriculum. Dr. Freeman wanted us to look at best practice and evidence in building the curriculum which would then be piloted and evaluated at DFCM sites. She helped us to see that medical education can and should be evidence-based and evidence-informed.”

To deliver the curriculum, the team has adopted a “train the trainer” model. A cadre of dedicated DFCM teaching faculty have volunteered to teach the material and they are supported by bioethics experts and the research team.

The first session designed to support local faculty teachers was delivered last September 15 and the curriculum will continue to be rolled out for the next two years at five different sites.

Grant Team:
Co-PI's: Carrie Bernard Mahan Kulasegaram
Co-investigators: Risa Freeman, Eva Knifed, Betty Onyura
Collaborators: Nadia Incardona, Connie Williams, Erika Abner, Frank Wagner