DFCM Annual Report 2017-2018

EDUCATION: OFFICE OF EDUCATION SCHOLARSHIP
Physicians Services
Incorporated Foundation
Awards Grant to
Researchers for Novel
Ethics Curriculum
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,
GRANT TEAM:
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
Co-PIs: Carrie Bernard and Mahan Kulasegaram
Co-investigators: Risa Freeman, Eva Knifed, Betty Onyura
Collaborators: Nadia Incardona, Connie Williams, Erika Abner, Frank Wagner
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 in
September 2017 and the curriculum will
continue to be rolled out for the next
two years at five different sites.
Department of Family & Community Medicine | Annual Report 2017–2018 31