579 - Ethical Concerns of Pediatric Clerkship Students
Saturday, April 26, 2025
2:30pm – 4:45pm HST
Publication Number: 579.4583
Stavroula Spyropoulos, Joseph M. Sanzari Children's Hospital Hackensack University Medical Center, Hackensack, NJ, United States; Daniel A. Rauch, Hackensack Meridian School of Medicine, Hackensack, NJ, United States; Jasmine Gadhavi, Hackensack Meridian School of Medicine, Hackensack, NJ, United States
Professor of Pediatrics Hackensack Meridian School of Medicine Hackensack, New Jersey, United States
Background: The Liaison Committee on Medical Education requires medical schools to cover bioethics in their curricula. However, how this is done is variable. Clinical situations provide an opportunity for students to be exposed to ethical considerations in real life versus classroom discussion. Pediatrics provides an additional layer of complexity in that patients are minors and mostly not autonomous. Even knowing when a minor is able to make decisions can be confusing. We recently introduced a bioethics session into the pediatric clerkship to allow students a venue to report observed ethical challenges and discuss their thoughts. Objective: We report a descriptive study of the types of ethical cases that were reported. Design/Methods: Ethics cases were submitted anonymously by students during their pediatrics clerkship. Students rotate at 3 different hospitals 7 blocks of data were collected and analyzed. 159 students submitted 117 scenarios. Cases were categorized as one of the four major ethical principles of medicine: autonomy, beneficence, non-maleficence, and justice plus an additional category for cases that did not fit any of the principles. 1 author led the case discussions, another gathered clerkship feedback. Results: The break down of types of cases is shown in the pie chart. Within the principles several themes recurred (Theme table). Sample quotes from the student submissions are provided. Cases that didn't fit an ethical category were questions of legal obligations and risk management. During case discussions, students all reported that ethics was not discussed during the or after the clinical situation.
Conclusion(s): Students during their pediatric clerkship are exposed to and recognize a wide range of ethical considerations. They have enough understanding of ethical principals to identify ethical considerations in clinical encounters. They report the dynamics of children and parental care is an additional challenge. Although students recognize ethical situations they report the lack of discussion of ethical issues. Planned case discussions provide an opportunity to debrief. We will also be engaging with clinical faculty to encourage ethical discourse in the moment.
Ethical Principles Identified by Students Untitled document.pdfEthical Principles Identified by Students
