Phronesis and the Medical Community: Follow on Impact and Engagement

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Through our 'Phronesis and the Medical Community' (PMC) dissemination activity undertaken to date, we know that currently no consensus exists across UK medical schools about the best way to teach and assess medical ethics. Some principally use lectures, others problem-based learning and interactive resources. In terms of assessment some medical schools use essays, others reflective work, Objective Structured Clinical Examinations (OSCES) and Multiple Choice Questions (MCQs), or a mixture of these methods. Therefore in order to impact on education we need a flexible and adaptable resource. In addition, different medical schools allocate differing amounts of time to the teaching of ethics. Our project, PMC, has shown that ethical principles in terms of a wide variety of practice virtues are expressed by students, trainees and experienced practitioners through their experiential learning within a multi-disciplinary environment and clinical context, along with other clinical skills. These virtues are not applied or fully understood in medical schools or Continuing Professional Development (CPD) education. What we have also found is a significant vertical and horizontal fragmentation in the many medical practice virtues accounted for in the stories from our participants through the different career stage cohorts in the medical community. Our aim is to apply the PMC findings in the form of a flexible, accessible and interactive resource, including teaching material beyond the three partnering University Medical Schools in the original project (Birmingham, Nottingham and Warwick) to other medical schools and CPD medical training providers across the UK. The outcome would be resources and capabilities that would improve ethical decision-making training and education for the wider medical community. The impact would be improved clinical outcomes, patient experience and trust in the medical profession, growing in the community as a whole.We are currently producing a six-episode video serial drama connected to an existing health and social care virtual community called 'Stilwell' (the fictional town in which the community is based), which will enact the combined received wisdom (covering accounts of good and questionable practices) in the research findings from medical school to experienced consultant or GP (using professional actors). Along with this will be tutor notes to guide the use of the resource. Like previous Stilwell applications (for nursing and allied health professionals) it can be used as a safe placement resource by the medical schools and CPD providers we engage with on this project. It will allow medical students to interact with the ethical dilemmas depicted by the consultant and GP characters and have the moral debates about which course of action they think is appropriate for patients and society. It can also be used for CPD applications in the same way. In summary the Stilwell moral debating resource and tutor notes will provide an opportunity to:1. Give clinical context via accessible video and other media resources to the learning of medical ethics.2. Provide a safe controlled placement/ environment with time for reflective learning.3. Enable discussion around what should be taught and assessed in terms of medical ethical and start to generate a consensus as a basis for safe and effective clinical practice.Project DesignWe will engage with medical schools across the UK at three workshops to see how best to adapt the learning resources to fit with their needs. The workshops will co-produce refined versions of the teaching package (video series and tutor notes) with: a) Staff from the medical schools responsible for medical ethics.b) Staff from CPD training providers to cover those from the other medical cohorts at career stages beyond medical school. c) We would also involve medical education policy makers, leading practitioners and medical education leading academics.