Developing and Evaluating an Interprofessional Healthcare Ethics Graduate Course: Lessons Learned

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Developing and Evaluating an Interprofessional Healthcare Ethics Graduate Course: Lessons Learned Collaborating Across Borders Six Banff, Alberta, Canada October 3, 2017 David W. Musick, PhD

David W. Musick, PhD David B. Trinkle, MD Judy Cusumano, PhD Ava Porter, DNP, RN Stephanie DeLuca, PhD Lisa Allison-Jones, PhD, RN Richard Vari, PhD Patty Vari, PhD, RN Authors (with gratitude!)

Disclosures No listed authors have any relevant conflicts of interest to disclose for today s session.

A Brand New Collaboration! 4

Objectives 1. Describe the steps necessary to create an interdisciplinary healthcare ethics course. 2. Explain the strengths and challenges associated with online, on-ground and hybrid models of curriculum delivery. 3. Discuss methods of obtaining meaningful student feedback/course evaluation data that contribute to continuous course adjustments.

Background Multiple challenges exist when planning an IP healthcare ethics course: Student schedules Curricular logistics Topics/content Locations Academic credit hours Faculty workload

Methods Our two institutions (a medical school and an allied health college) have implemented an IP healthcare ethics course for 7 years. We have worked closely across disciplinary and cultural boundaries to achieve success.

Methods Faculty teaching in graduate programs in Medicine, Nursing, Physician Assistant, Occupational Therapy, Health Administration, Bioethics. Enrollment fluctuates, but approximately 130 students from 5 programs are enrolled each year.

2016, 2017 Versions of Course: More revisions Moved back to hybrid format Medical student version of course: shortened to 6 weeks, all in person format

Methods Cases, videos, web materials, powerpoints, assigned readings are all used. Supplemental delivery methods: Chat functions Online posting of materials in Blackboard Face-to-face meetings with student groups Online meetings with student groups (Facetime, Collaborate, Skype, old-fashioned telephone)

Methods Significant number of MHA students (all online) As a team, map out the modes of communication you will use and make sure everyone in the group is comfortable with the technology. All of the resources presented within this module are optional. You are not required to use the technologies listed. (Course syllabus)

Methods (Content Modules) Course Introduction, Ethical Principles and Model of Decision-Making Autonomy, Dignity and Veracity Beneficence and Non-Maleficence Law, Ethics and Practice Distributive Justice Ethics in the Workplace Healthcare Ethics Team Challenge Delivered in different module lengths Jefferson: 10 weeks VTCSOM: 6 weeks

Methods (Content Modules) Model of Ethical Analysis and Decision-Making (Snyder & Gauthier, 2008, Springer) The Patient The Ethical Dilemma The Medicine The Law The Ethics The Formulation Afterthoughts

Methods (Healthcare Ethics Team Challenge) After grouping students into interdisciplinary teams. Students work to analyze a new, clinically complex case using same case guidelines as in the text. Present recommendations to our academic medical center Bioethics Committee. Watch as Committee deliberates on the same case and reaches a conclusion. Modified version of healthcare team challenge (Richardson et al, 2012)

Methods (Healthcare Ethics Team Challenge) Highly interactive format!!

Student Assessment: Methods Participation (team notes, in-person meetings) Weekly or Module-Based Quizzes (3 attempts) Peer evaluations (tried early, subsequently dropped) Ethics Case Study (as a team) Formats: Paper, Powerpoint with extensive documentation, voice-over Powerpoint Student Feedback: End of module surveys End of course surveys

Results/Outcomes Weekly quizzes: students performed well. Various reactions to asynchronous learning. Positive reviews of online course by all except medical students. Definite suggestions for course structure, requirements, faculty interaction. Case studies generally very strong!!

Common themes: Results/Outcomes Wanted adequate opportunity to interact in person with faculty who have bioethics experience. Medical students strongly prefer in-person format involving clinicians or faculty with clinical bioethics experience. Appreciated the interdisciplinary approach, especially regarding assigned readings

Scheduling (students, faculty) Challenges Presenting content in interprofessional manner Choosing faculty across institutions with appropriate backgrounds and workloads Balancing differing needs across institutions and programs Faculty struggling with teamwork issues similar to students Differing teaching philosophies

Conclusions The success of an IP healthcare ethics course will be impacted by course structure and content delivery mechanisms. Faculty must be flexible, and willing to seek creative solutions to short- and long-term challenges posed by this approach. Build into the structure frequent opportunities for student feedback!

Conclusions Faculty must also be well-versed in use of technology, or willing to learn! Regular faculty planning meetings are a must, along with faculty development Support for technology platform(s) used Provide students with detailed feedback BE AVAILABLE!!!

Thank You!!! David W. Musick, PhD dwmusick@carilionclinic.org References: 1. Ives J; Owens J; Cribb A. IEEN Workshop Report: Teaching and Learning in Interdisciplinary and Empirical Ethics. Clinical Ethics 2013; 8 (2/3): 70-74. 2. Lim J. Essentials: Structure and Routine in Online Courses. Available online: http://blog.janinelim.com/?p=5321. Accessed September 18, 2017. 3. Richardson B et al. Health Care Team Challenge: A Versatile Model for Interprofessional Education. Available online: https://www.mededportal.org/publication/9287. Accessed September 18, 2017.